A VA compensation and pension (C&P) exam is an integral part of the process for seeking veterans disability benefits from the U.S. Department of Veterans Affairs (VA). A VA provider or a contracted non-VA provider will conduct the exam by posing a series of questions to gauge your level of injury or illness and how the prevailing condition impacts your life.
What happens after a VA C&P exam depends on the results. First, the examiner will submit their findings to VA along with the rest of your application for your disability rating. Then, VA will use the exam results and other documents to rate your condition and determine how much compensation to award you. This final review phase can take several months, depending on the claim’s complexity. If your claim results in a denial after this phase, a veterans disability attorney can explain your next steps.
When does the Review Process Commence?
Once you finish the C&P exam, the panel will embark on the review process, which entails inspecting all the evidence in your C-File. This job is done by a claims processor who develops and deliberates over each claim to determine if they are legitimate or potentially fraudulent. The eventual outcome is assigning a disability rating for your illness within a reasonable timeframe.
After the C&P exam, the doctor will draft a report outlining your medical history, prevailing symptoms, and the seriousness of your condition. They will also give their professional opinion regarding whether your disability is connected to your military service. This report goes to the VA Regional Office for processing, where the Ratings Veterans Services Representative (RVSR) will qualify or deny your claim.
When the C&P Exam Goes Well
The RSVR will base their decision on the evidence presented in the C&P exam and other documents in your file. You could get a favorable decision under these conditions:
- The C&P exam went well, meaning you completed all questions, and the exam report was declared veteran-friendly.
- The attending physician reviewed all medical records and stated as such in their exam report.
- The doctor wrote a nexus letter proving that your condition is related to military service.
- The doctor is experienced and has the necessary certifications to conduct this process.
If the exam goes well and the rest of your claim checks out, VA will assign a disability rating between 10% and 100%. The rating you receive will determine the amount of monthly benefits available to you.
When You Receive a Claim Denial
Despite all your efforts, it is not uncommon for claims to fall apart. In such a situation, you may proceed as follows:
- Get expert medical help by seeking an independent medical examination (IME)
- Seek legal counsel by hiring an accredited VA disability lawyer to guide you through the intricacies of the decision review process
For a free legal consultation, call 1-888-373-4722
Claim Backlog at VA
According to VAntage Point, the VA has been processing record numbers of claims in 2022. While the COVID-19 pandemic sparked delays, creating a significant backlog through most of 2021, recent VA reports indicate that this backlog has leveled out.
The department has made great strides to improve service delivery by hiring additional claims processors and getting funds from the American Rescue Plan to pay for overtime. As of early March 2022, 251,964 claims remain in VA’s backlog.
How to Prepare for a VA C&P Exam
You must prepare well for this exam, as this meeting has significant weight on your claim for VA benefits. Here are a few tips for handling the exam:
- Update your contact information: VA will contact you about your appointment and schedule it based on your location.
- Make sure to attend: This may go without saying, but missing a C&P exam can significantly delay your claim and prolong your time without benefits.
- Reschedule if needed: Give at least 48 hours’ notice if the exam date you receive doesn’t work for you, though VA recommends you reach out as early as possible.
- Submit all of your documents before the exam: This will ensure your paperwork is fully prepared for the appointment.
- Be as truthful as possible: The examiner will ask a series of questions about your condition and the documents in your case file. Any exaggeration regarding your condition could jeopardize your claim.
VA provides additional tips to help you prepare for your C&P exam. Note that you may even require more than one exam if you are seeking benefits for more than one condition. Alternatively, some claimants don’t require a C&P exam at all.
Contact a Qualified VA Lawyer for Legal Counsel
If what happened after your VA C&P exam was not what you expected (i.e., VA denied your claim or gave a disability rating you don’t agree with), a VA disability attorney can help. Your lawyer will explain the decision review process and help prepare your claim for it. Call us for a free consultation.