VA Disability: How Much Weight Does a C&P Exam Have?

If you’ve recently filed for VA disability benefits, you’ll probably have to undergo a compensation and pension exam (C&P exam).

It’s normal to feel a lot of anxiety about this. The purpose of the C&P exam, after all, is to help the VA determine if you truly have a service-connected disability, as well as your VA rating. The exam is typically conducted directly by a VA physician or other appropriate healthcare provider at a VA medical center, although in some cases it may be performed by a medical professional contracted by the VA.

It may go without saying that the results of your C&P exam are given a lot of weight by the VA when evaluating your overall VA disability claim. However, it’s important to understand that a C&P exam isn’t the only factor that the VA considers, and that you do have options if you disagree with the examiner’s report.

What Is a C&P Exam?

In short, a C&P exam is a specialized medical examination conducted by a physician that the VA chooses, rather than your regular doctor. Most (although not all) VA claims will require a C&P exam before being approved. Some may require multiple exams if you need to see multiple specialists.

The main goal is for the examiner to confirm that your symptoms are consistent with the disability claim that you made in your initial application and confirm that there is a legitimate connection to your time in the military.

During the appointment, you may be asked to perform a variety of physical or psychological tests, get blood work done, or perform other activities appropriate for your condition. You’ll also be asked a number of questions about your condition, symptoms, and medical history, and may be required to complete a disability benefits questionnaire (DBQ). The examiner will also look at your medical and service records, and other relevant information that you provide.

Once all the evidence has been considered, the examiner will submit the findings of the report to the VA. Their report will become part of your official VA claim file. If things go well, they will agree that your claim is valid and provide a medical nexus letter linking your disability to your military service.

However, the unfortunate reality is that C&P examiners are not perfect, and their medical opinions may not be the same as your own doctors’.

How Much Weight Does a C&P Exam Really Have?

The short answer is “a lot.”

The C&P exam report is one of the most important steps in the VA disability claims process. In terms of the initial application, it’s one of the key pieces of evidence that the VA will use to decide whether to approve, modify, or deny your claim.

But it’s not the full story.

Remember, the C&P exam is not itself an approval or denial of your VA claim; it is simply one piece of evidence that the VA will look at. The examiner does not make the final decision and the exam is not a “rubber stamp.” In fact, it’s possible to get a favorable C&P exam and still get your claim denied.

It is true that an unfavorable C&P exam will usually (although not always) result in your initial claim being denied or reduced. However, this does not mean you are out of options for your VA benefits claim. Depending on the circumstances, you may be able to dispute the results of your exam or seek alternate methods to obtain the benefits you deserve.

How to Prepare for a C&P Exam

Because C&P exams are typically one of the most important components of a favorable disability rating (or an unfavorable one), it’s wise to be as prepared as possible for your appointment. While it may be impossible to overcome an unfavorable C&P exam result, you still want to give yourself the best possible chance of a favorable one.

Here are some tips that can help.

• Thoroughly document your disability. Write down as many details as you can remember about your symptoms (when they started, how severe they are, how frequent they are, whether they’re getting worse, etc.), as well as specific ways that they have impacted your life. Focus on ways they’ve kept you from working and highlight ways that your overall quality of life has suffered. If possible, ask a loved one to help you remember and write everything down. Bring these notes with you to the appointment. These details help paint an accurate and complete picture of your disability, and you don’t want to forget anything or inadvertently downplay the true severity of your condition.
• Be ready to describe your worst day. For a lot of disabilities, symptoms aren’t necessarily the same every day. You might have good days and bad days. If your C&P exam happens to be scheduled on a “good day” for you, it may appear to your examiner that your condition isn’t as severe as it really is. Be upfront with your examiner and talk about what typical and bad days are like, not just your best days.
• Be familiar with what’s in your medical records. This includes things like dates, names and the specialties of doctors you’ve seen, medications you’ve taken, treatment protocols you’re following, etc. You may be asked about them.
• Be polite and on time. We understand—it’s not always easy to be on your best behavior when you’re in pain, you’re frustrated, and you’re nervous about an appointment that could determine whether or not your disability benefits will be approved. And in a perfect world, your attitude shouldn’t have any effect on the examiner’s findings—only the facts. But this isn’t a perfect world, and treating your examiner with respect can only benefit your case.
• Be honest. Never, ever lie or “stretch the truth” with an examiner. They have access to all your medical documents and service records. If you lie, chances are you will be caught, the examiner will note it in the report, and your credibility will be severely damaged. (It’s also illegal, and unethical, to lie to an examiner.)
• Stick to the facts. Only answer the question that you’ve been asked, and try to keep your answers short and to the point. You only have a limited amount of time with the examiner. They are looking for the important facts. Lengthy explanations and small talk can get in the way of effectively communicating the most critical details. Furthermore, resist the temptation to “argue” why your case should be approved or discuss the VA claims process in general. The C&P exam is only a fact-finding appointment—the final decision is not made here.
• Consider bringing a trusted family member or friend. During a C&P exam, you’ll need to be open, honest, and even vulnerable about your symptoms. For many veterans, that’s uncomfortable. A lot of people have a natural tendency to downplay symptoms and not admit that they need help. It may be in your best interest to bring along a spouse, child, caregiver, or other trusted person who can speak honestly and accurately about your situation. It should be someone who you feel comfortable sharing sensitive information with.

Get a Copy of Your C&P Report

After your exam is finished, you will want to request a copy of your exam results as soon as they become available. You have the legal right to see and review your results (along with anything else in your claims file). However, the VA won’t give the report to you automatically—you have to request it. We highly encourage you to do so, since you’ll want to confirm that the exam was thorough, accurate, and fair.

There are a few ways to do this, but the most reliable way is typically to download and complete a Freedom of Information Act (FOIA) request (VA Form 20-10206) and mail it or bring it in person to your nearest VA regional office.

I Disagree With My C&P Exam Results and My Claim Was Denied. What Can I Do?

If your VA disability claim has been denied, one of the first things you should do is request a copy of your C&P exam results (if you haven’t already done so). After reading that report (or, even better, handing it over to an experienced VA disability lawyer for review), you have a few options.

Object to the C&P Exam

If you disagree with examiner’s report, you have the right to challenge it. To do so, you typically need to prove at least one of the following:

• The doctor overlooked critical evidence. A C&P examiner is required to review all of the medical evidence (and other relevant facts) in your file. However, you might discover when reading the full report that the doctor didn’t acknowledge relevant information. For example, they might have attributed your back pain to age or post-military employment, without considering your military service as a potential contributing factor.
• The doctor’s conclusions were not supported by the evidence. The report should provide a clear explanation of the doctor’s medical opinion. It should directly address the details of your condition (symptoms) as well as your specific concerns, then cite specific test results or medical evidence that support or refute the claim. If the doctor doesn’t thoroughly explain their decision, or you can show that their explanation is based on outdated or discredited science, you can challenge it on those grounds.
• The doctor made biased assumptions. Chances are, your examiner has performed countless C&P exams for hundreds of veterans, many of whom might have similar backgrounds and disabilities. Technically, they are not supposed to make assumptions based on past cases. However, in practice, it’s very difficult for examiners to be completely unbiased and impartial each time. Each case is unique, and you should not be discriminated against just because veterans with similar experiences weren’t really disabled or had their claims denied.
• The doctor wasn’t qualified. Veterans have a legal right to request information about their examiner’s credentials, including their educational and professional training and experience. Your exam should have been assigned to a doctor, physician assistant, or other medical professional with the experience and credentials necessary to evaluate your specific condition. For example, an orthopedist wouldn’t be an appropriate expert to evaluate a problem with your vision or hearing.

If it’s determined that your C&P exam was incomplete, biased, or otherwise faulty, you can request a new exam.

Supplement Your VA Disability Claim With Additional Evidence

Even if you can’t necessarily overturn an unfavorable C&P exam or get a new one, remember that it doesn’t necessarily mean you have no chance at a successful appeal.

However, the VA disability appeals process can be complicated and confusing. We highly encourage you to work with an experienced VA disability lawyer to determine your next steps. A good attorney will understand all the options available to you and help you determine which avenue will give you the best chance at obtaining the VA benefits you deserve.

One important step in most cases is getting at least one second opinion from a private doctor. While the government gives a lot of weight to the opinion of the C&P examiner, the reality is that the examiner is limited to reviewing your case files and spending at most a couple of hours (and sometimes as little as 15 minutes) with you. In addition to the advice of your own medical team, you may wish to schedule an independent medical examination with a non-VA doctor you haven’t previously worked with.

You can also supplement your claim file with letters from doctors, friends, family members, and others who know you well and can write about how your disability has impacted your daily life and your ability to maintain substantial gainful employment.

Depending on your circumstances, you may have additional options. For example, in many cases veterans who are clearly disabled nonetheless fail to meet the incredibly specific (and often unfair) disability rating criteria for their condition. You may still be able to increase your disability rating, however, by combining it with other service-connected disabilities, or by filing for total disability based on individual unemployability (TDUI). Again, your attorney can help you evaluate all your options and make the best possible decision about how to handle your claim.

Karl Truman: Count on the Colonel to Fight For Your VA Benefits

Karl Truman has been helping veterans fight the VA and win for more than 30 years.

Karl served his country in the U.S. Army Reserve for 28 years, while also pursuing a career in law. As a veteran himself, he understands the incredible sacrifices that veterans make for their country and their families. And he knows firsthand how frustrating it can be for disabled veterans to overcome a system that is stacked against them and get the VA benefits they deserve.

If you’re considering a VA claim, or even if you just received your denial letter and aren’t sure what to do next, talk to Karl. You can request a free consultation with our team by calling (502) 427-6424 today.

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.