what means when lawyer sends you to doctor for c and p exam

by Prof. Gabriel Schaden 7 min read

Compensation and Pension (C&P) Examinations are medical exams ordered by the Department of Veterans Affairs
Department of Veterans Affairs
A Compensation and Pension (C&P) exam, is a medical examination of a veteran's disability, performed by a VA healthcare provider, or a VA contracted provider. VA uses C&P exams to gather more evidence on a veteran's claimed condition before issuing a decision and assigning a rating.
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(VA) to evaluate the conditions a veteran is claiming for disability compensation.
Nov 4, 2018

How should I phrase my answers to a C&P exam?

If you are attending a C&P exam for a psychological condition, similarly phrase your answers to show the impact it has on your daily life and ability to be productive at work. Be aware of the type of exam that you are attending.

Do the C&P exam physicians have all the information they need?

Even though it shouldn’t be, make it your job to ensure that the C&P Exam physicians (1) have all the information they need and (2) perform the proper tests at the exam. For example, supraventricular arrhythmia (a heart condition) is rated on how many episodes of arrhythmia are recorded every year.

When will I receive a call for a C&P exam?

After you’ve applied for disability and the VA is working to process your claim, it’s almost guaranteed that you’ll receive a call or letter asking you to report for a C&P exam.

What happens if I don't show up for my C&P exam?

After you apply for benefits, make sure the VA Medical Center where you go for treatment has your current address and phone number. Otherwise, you may not get notice of your C&P exam, and if you don't show up, you may not be able to get it rescheduled.

What is a C&P medical exam?

C&P Exam (short for “Compensation and Pension”) is an exam performed by a VA salaried or contracted physician to document the current severity of a condition that is being considered for VA Disability and DoD Disability.

What happens after favorable C&P exam?

Because VA Raters rely (almost) solely on the results of your C&P exam when determining key issues such as medical etiology, service connection, and severity of symptoms. A good C&P exam with a favorable medical opinion (“at least as likely as not”) will result in a VA claim approval.

How long after C and P do you get a decision?

about 3 to 4 monthsWe'll review all the evidence in your file, assign your disability rating, and send you a decision notice (a letter letting you know your disability rating). Each claim is different, but it usually takes us about 3 to 4 months to process a claim from start to finish.

What should you not say at C&P exam?

Don't Lie or Stretch the Truth. This is a big one. Don't ever lie or stretch the truth when it comes to your VA disability claim. At your C&P exam, you should think, look, act, and speak as you would on a normal day.

How can I tell if my C&P exam went well?

The best, and often only, way to tell if a C&P exam went well for the veteran is to read the exam report. However, VA does not issue the veteran a copy of the report unless they specifically request it. To do this, veterans can send a letter requesting a copy of their exam report to their Regional Office.

How long after C&P exam will I get a decision 2022?

4 to 6 weeksWhat is the Timeline From C&P Exam to Decision 2022? In 2022, you can expect to receive a VA rating decision within 4 to 6 weeks after your last C&P exam. If it's been longer than 6 weeks, pick up the phone, call the VA hotline, and ask to speak to a VA representative at 1-800-827-1000.

How do you pass the C&P exam?

How to pass your C&P ExamBeing honest about your disability symptoms. Remember what you're there for! ... Do not exaggerate your symptoms. We've seen several C&P exams where the examiner accuses the veteran of “malingering,” or exaggerating his or her symptoms. ... Bring someone to your C&P Exam.

How important is C&P exam?

A favorable C&P exam is a vital element of any successful disability benefits application because the veteran's disability rating outcome directly depends on the physician's findings.

Does preparation for notification mean denied?

Yes, Preparation for Decision is a good sign! This means your VA claim is progressing and nearing the final stages of a VA rating decision: approval, denial, or deferral. Generally, you can expect to receive a VA rating decision within 30 business days of the Preparation for Decision phase.

Can you fail a C&P exam?

One of the most important things to remember about a C&P Exams is that they're mandatory. If you fail to attend a C&P Exams, the VA will likely deny your claim. However, if you can't make it to an exam and let the VA know in advance, they can often reschedule you for a better time.

How do I get my C&P exam results?

How Do I Request QTC Exam Results?If your regional office is open, you can simply go to the office and ask for a printed copy. ... You can file a claim through the Freedom of Information Act. ... You can contact your agent at the Department of Veterans Affairs, or your claims agent, and ask for a copy of your results.More items...•

How do I pass the VA C&P exam for PTSD?

How to Pass C&P Exam for PTSD BenefitsCriteria A: Stressor (At least 1 required)Criteria B: Intrusion Symptoms (At least 1 required)Criteria C: Avoidance.Criteria D: Negative Changes to Mood and Thoughts (At least 2 required)Criteria E: Differences in Arousal and Reactivity.More items...•

What Happens at A Compensation and Pension Exam?

A Compensation and Pension (C&P) exam is a doctor’s appointment where your disabilities get evaluated. Usually this exam is conducted at a VA hospi...

Who Schedules The C&P Exam

The VA Medical Center is responsible for sending a C&P exam notice to you with the date and time of appointment. After you apply for benefits, make...

How to Answer Questions at The Exam

Don’t exaggerate your symptoms, but don’t diminish them either. When the doctor asks you questions, be truthful. Explain to the doctor exactly how...

Doctor's Review of Your Records

The VA is supposed to send a copy of your claims file to the doctor in advance of the exam. This is because for a C&P exam to be considered adequat...

The Compensation and Pension Report

The doctor will write a report after the exam. This report will usually include information about your medical history and evaluate how severe you...

What is a C&P exam?

VA claim exam (C&P exam) After you file your disability benefits claim, we may ask you to have a claim exam (also known as a compensation and pension, or C&P, exam). Get answers to commonly asked questions about the VA claim exam below.

Why is a VA claim exam not a medical exam?

That’s because the purpose of the exam is to gather information that will help us make a decision on your claim.

What is the VA exam called?

After you file your disability benefits claim, we may ask you to have a claim exam (also known as a compensation and pension, or C&P, exam). Get answers to commonly asked questions about the VA claim exam below.

What is VA disability exam?

This exam will help us rate your disability. Your rating will be based on how severe your disability is—and will affect how much disability compensation you’ll receive. Compensation may include things like monthly payments and enrollment in the VA health care program.

How long does a mental health exam take?

But the questions for a more complex illness or injury could take much longer. A mental health evaluation usually lasts 2 to 4 hours. It’s important to remember that your in-person visit is only one part of the claim review process. The doctor will also spend time outside the exam carefully reviewing your records.

What is a medical report?

The report from the doctor who handled your claim exam, and the results of any ordered medical tests

How long does a psych exam last?

Your exam may be very short, or it may last an hour or more. It all depends on the conditions you’ve claimed and whether we need more information to make a decision.

What Happens After a C&P Exam?

After you’ve had your C&P exam, the doctor will prepare a report that may include information on your medical history, your current symptoms, and the severity of your symptoms, along with a professional opinion about whether your disability is service related .

What is a C&P exam?

A C&P exam is used by the VA to rate disabilities, diagnose conditions, and determine if you have a service-connected disability. After you’ve applied for disability and the VA is working to process your claim, it’s almost guaranteed that you’ll receive a call or letter asking you to report for a C&P exam. Usually this exam will take place ...

What does a doctor ask for in a psychological exam?

If you are suffering from a psychological condition or disorder that creates stress and negatively impacts multiple areas of your life, the doctor will ask you questions and give you an opportunity to describe the symptoms you’ve experienced and how the stress has affected you. The doctor may also ask you to complete some standard psychological tests—for example, a memory test to see how many words you can remember a few minutes after you read them from a list. This part of the exam is minor and routine.

How to contact Cuddigan Law?

Download our free book, The Essential Guide to VA Disability Claims, or call us today at 402-933-5405 to ask us a question about your disability case.

How to refute a medical report?

Get expert medical help. If you want to refute the report, have an independent medical examination (IME) or get an independent medical opinion (IMO). An IMO may or may not require your physical presence; rather, the doctor forms his opinion after reviewing all of your records.

What does a doctor do when you have a physical condition?

A Physical Condition. If you are suffering from a physical illness, injury, or condition, the doctor will examine you to evaluate your situation. He may ask you questions, order lab work, and conduct medical tests standard for your condition.

What are the outcomes of C&P exam?

Your C&P exam will typically result in one of two outcomes: Favorable or Unfavorable. Here is a brief overview of both result types:

What happens at a C&P exam?

What happens at a C&P exam is different than a typical visit to the doctor. Yes, you’ll meet with a doctor and go over whatever symptoms you want to discuss, but the goal isn’t to give you treatment. Don’t expect any advice on how to make anything better or be prescribed anything for your symptoms. This visit is designed to document what condition you think you might have.

When is a C&P exam done?

Unlike a normal doctor’s visit, a C&P exam isn’t done until you have said the laundry list of every ailment or injury you have that could be service-connected to your active duty. Don’t rely on your memory. For the weeks (or months) before your exam, write down any complaints or symptoms you have.

What is a good C&P exam?

For the sake of your fellow veterans and your family, you can’t tough this out and hold in any pain. A good C&P exam completely documents all your symptoms and shows how they are service-connected. You want a doctor that is familiar with the effects of Agent Orange, Burn Pits, PTSD, depression, and other common veterans disability claims.

What is the keyword for a C&P appointment?

If the keyword for a normal doctor’s appointment is healing, the keyword for a C&P exam is documentation. You want to have every one of your service-connected symptoms thoroughly documented. If you already have all your disability claims documented by a doctor that is familiar with VA law and veterans’ disability, you may not be asked to have a C&P exam.

What is the most important appointment for VA?

The C&P Exam Could be the Most Important Appointment of Your Application Process. Since so much of the VA application process is done electronically, you don’t have to show up to many appointments or hearings as you apply or appeal your claim. But the C&P Exam needs to be done in person, like a normal doctor’s visit.

What happens if you miss an appointment?

If you refuse to go or miss your appointment, they can deny your claim altogether. If you need to reschedule, call them ahead of time and don’t reschedule it more than once. The level of importance can make it nerve-racking to go, but don’t give up. Make a day of it.

Is a VA attorney certified?

All of our attorneys are VA-certified. Call us and join the thousands of veterans we have helped to receive the VA disability benefits they deserve.

What is a C&P exam?

Compensation and Pension (C&P) Examinations are medical exams ordered by the Department of Veterans Affairs (VA) to evaluate the conditions a veteran is claiming for disability compensation.

How to request a copy of C&P exam?

DO request a copy of your exam. To request a copy of your C&P examination, you can send a letter requesting it to your Regional Office. Once you obtain this information, you should review the exam to ensure that it adequately represents what you reported to the examiner.

What is VA compensation exam?

updated medical evidence), VA will order a compensation and pension examination. These exams are meant to assess the etiology and/or severity of a veteran’s condition and are a part ...

How to be honest with a C&P examiner?

Your C&P examiner will have already—or will soon read through your file and compare your statements on the day of the exam to the statements you’ve previously provided. Consistency is a key factor here and you do not want to discredit yourself.

What happens if you miss the C&P exam?

If you do not attend or reschedule your initial C&P exam, it will most often result in a claim denial. Be sure to inform VA of your inability to attend this exam as soon as possible and reschedule it. If you are seeking an increased rating, missing your C&P exam could mean depriving your claim of up-to-date medical evidence as adjudicators may have to rely on the potentially outdated evidence of record.

What is an independent medical opinion?

It is in this situation that the Board may request an independent medical opinion (IMO) from a doctor of a specialty that is relevant to the pending appeal. These medical opinions are not exams that a veteran must attend, but rather a review of the evidence currently of record.

What happens if you don't attend the C&P exam?

If you do not attend or reschedule your initial C&P exam, it will most often result in a claim denial.

What is a C&P Exam?

A C&P Exam is a medical exam performed by an approved VA physician to evaluate conditions for disability compensation.

Who performs C&P exams?

Most C&P Exams are performed by general physicians, which is all that is needed for the majority of conditions. Some conditions will require examination by specialists, however, because some conditions need certain tests performed to rate them that only a specialist can perform, etc. If you have a condition that needs a specialist exam, ...

How long will the exam take?

Exams can last 30 minutes to a couple of hours, depending on the number and complexity of your conditions.

How should I prepare for my exam?

It's vital that you bring copies of all your medical records of your conditions so the physician has a complete medical history. Also make sure you know what information is needed to rate your conditions so you can ensure the physician records the correct information and performs the necessary tests.

What if the physician doesn't properly record my conditions?

This is tricky. Without proof of misconduct, it'll be difficult to have the VA approve a new exam. If there isn't enough information recorded to rate the condition, the VA will send the claim back to gather the additional information needed. If the information recorded is enough to rate it, but is just incorrect, then that could negatively affect your ratings. The key to combat this is to submit ample outside evidence that has enough of the correct information about your condition that it negates the incorrect information on the single C&P Exam. With enough outside correct evidence, the VA could overlook the C&P Exam and still rate your condition correctly.

What is the purpose of C&P exam?

Since the purpose of C&P Exams is to help the VA rate conditions for disability, then only the information needed to service-connect and rate each condition needs to be recorded. This includes a full medical history of the condition and any current tests, measurements, etc. needed to rate the condition.

Do VA physicians have DBQs?

All VA Physicians have access to Disability Benefits Questionnaires ( DBQs) that guide them through the exams to ensure that they record the correct information, but while we’d like to think the system works perfectly, there is far too much proof that it doesn’t.

What is an independent medical opinion?

An independent medical opinion (IMO) is more than it sounds. While it’s not proof that you’re condition is related to your time in service, a good IMO will be written exactly to what the VA requires in the 38CFR. Think of an IMO as more of a supporting document than an exam or a medical evaluation.

What exam does the VA use to determine a veteran's disability?

The VA relies on a Compensation and Pension exam to determine a Veteran’s level of disability.

Is the C&P exam thorough?

However, many Veterans feel that the C&P exam process is not thorough enough to support their claim. If you feel your C&P exam was not adequate, you have options to stay on top of your claim and get the best rating you deserve. When Your C&P Exam Doesn’t Go Well….

Does the VA use non-VA medical providers?

The VA has been using non-VA medical providers to conduct C&P exams since 1996. The Medical Disability Examination (MDE) program oversees all private contractors for C&P Exams. All VA Regional Offices (VARO) have access to contracted providers.

Do you have to report a C&P appointment to the VA?

If your C&P appointment is with one of these contracted companies, you will have to report to them as if you are responding to the VA.

Can the VA deny a claim?

Think of it this way: Even if a specialized physician writes about how severe your condition is and they have test results that prove it to your time in service, the VA can still deny your claim. The reason the VA will do this is because your medical evidence has to be written according to the way the VA wants it.

Can VA outsource pension exam?

But they were so backlogged trying to meet the demand that legislation changed the system in 2014. Now, the VA can outsource these Compensation and Pension Exams to qualified medical examiners who meet VA guidelines.

When the VA sends a nurse to your compensation and pension exam, will it send you to a nurse practitioner?

At some point in the VA Claims Process, VA will likely send your claim out for a Compensation and Pension Exam (C&P Exam). And a good number of times, they are going to send you to a nurse practitioner or a physician’s assistant and NOT a medical doctor.

What is the Purpose of the VA Compensation and Pension Exam?

The purpose of the Compensation and Pension Exam – in theory – is to determine whether your particular medical condition is related to your military service or the degree to which it causes a functional impairment of your earning capacity.

What happens if a veteran does not object to the qualifications of the author of the opinion?

If the veteran – whether pro se or represented by a VSO – does not object to the qualifications of the author of the opinion, then the presumption of regularity attaches and the author is presumed competent.

Can a nurse practitioner give medical opinions in VA?

What I am saying in this post is this: in the VA Benefits system, nurse practitioners and physicians assistants should NOT be presumed competent to render medical opinions in a Compensation and Pension Exam.

Does the VA send you to a doctor?

For those of us who have been at this for a while, we know that VA doesn’t always send you to a medical expert with experience in your specific disease or the body system affected by the disease. Sometimes, they send you to a doctor, sometimes to a licensed social worker, sometimes even to residents (doctors who have only recently graduated med school).

Does the VA have to prove medical examiner credentials?

Curiously – particularly for a system meant to be non-adversarial – the Veteran always has to prove the credentials of a medical examiner, but VA does not. In fact, under the “presumption of regularity”, VA is presumed to have chosen the best medical practitioner for the job. This is one of the not-so-subtle ways that “junk science” has crept ...

What should a C&P conclusion include?

A C&P conclusion should describe the details of your condition, address your concerns and statements about your injuries, and state why the evidence used in the conclusion is relevant or not.

What is an example of a doctor overlooking evidence?

For example, if you suffer from a breathing problem that the doctor attributes to your former smoking habit, but neglects to acknowledge known burn pit or chemical exposure during service, you could argue that the doctor overlooked evidence. Drew an inadequate conclusion.

What happens if VA medical examiner overlooks evidence?

If she overlooked evidence that could make a difference in your claim, you can challenge the conclusion and ask for a new exam.

Can a medical professional use the facts of another case?

Each veteran’s disability is different, and even if there are similar injuries, a medical professional cannot use the facts of another case to bear on yours.

Can you disagree with a VA doctor's opinion?

Even if you disagree with a VA doctor’s conclusions in your C&P exam, you must be able to successfully prove that the doctor’s opinion is not accurate. In some cases, veterans may be able to prove that the C&P exam doesn’t provide a thorough picture of the disability because the doctor: Overlooked evidence.