You will often hear that the VA is required to offer a C&P Examination to Veterans seeking compensation for a service-connected disability. It is true that, as part of the VA‘s Duty to Assist, it may have to offer an examination to the Veteran seeking compensation or benefits. However, that does not mean that they must offer a VA compensation exam in every single claim or appeal.
When is the VA REQUIRED to Offer a VA Compensation Exam?
The BVA issued a recent decision in which it found that a Veteran was not entitled to a C&P exam for the portion of his claim having to deal with leukemia – because there was no evidence of a diagnosis of leukemia.
The BVA stated the criteria that it believes require the VA to offer a C&P exam:
The BVA said: “In determining whether the duty to assist requires that a VA medical examination be provided or medical opinion obtained with respect to a Veteran’s claim for benefits, there are four factors for consideration. These four factors are:
- whether there is competent evidence of a current disability or persistent or recurrent symptoms of a disability;
- whether there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumption period;
- whether there is an indication that the disability or symptoms may be associated with the Veteran’s service or with another service-connected disability; and,
- whether there is competent medical evidence of record to make a decision on the claim. “
In this recent decision, the BVA focused on the third factor, stating that it is a “low threshold” and “requires only that the evidence indicate that there may be a nexus between a current disability or symptoms and the Veteran’s service”, including…
…equivocal or non-specific medical evidence, credible evidence of continuity of symptomatology, lay statements of pain and other symptoms, etc.
Why Wouldn’t the VA offer a Compensation Exam (C&P Exam)?
If the VA did not offer you a C&P exam, there really are only two reasons:
- the VA messed up and did not offer one when they should have, or
- the Veteran didn’t provide enough information to trigger the Duty to Assist.
If your claim for disability compensation was denied, and you did not receive a C&P examination from the VA, it is more likely than not that the VA made an error.
And then there is always the BIG problem in VA Compensation and Pension Exams….
That problem is that the VA doctors that are assigned to do them RARELY have expertise in the medical condition that they are evaluating.
Many VA Compensation and Pension Exams are – in my opinion and experience – “junk science”.
Or the VA just sends you to someone that shouldn’t be rendering an opinion in the first place – someone like a nurse or a med school intern.
How do you start to find these errors – or more important…..
How does a Veteran Go About FIXING His/Her Own VA Claim?
For years, I have taught veterans the 8 Steps to Improving Your VA Claim. I can’t guarantee you will win your claim if you follow those 8 Steps.
The only way to win a VA claim is to have 5 star evidence establishing each element of a VA claim for service connection, and have the grit and resolve to stick through the appeals process until the VA gives in and decides in your favor.
If you are just looking for more information about getting ready for a VA Compensation Exam then check out my 3-part series with 10 HUGE tips to help you be ready to go for your C&P Exam.
All readers of VLB, I started working my own claims in November 2015. I purchased the “All VLB” package in the spring of 2016 and studied it along with other M21 Adjudication material. With the guidance from VLB Material, rating increased to 50% in May 2016, to 100% in August 2017. Best investment ever.
Congratulations, John!! I remember when you joined, and am glad to see these great results!!
Hi Chris you are spot on. I recently purchased your VA Sleep Apnea Field Manual, read it thoroughly, took notes, and was successful in my sleep apnea claim. Thank you!
Congratulations Joel!! Glad the materials helped!
We sure need to be educated by someone because the VA won’t tell you anything but lies. Thank you
Thanks for the compliment. That is the idea – educate Veterans, because the VA isn’t. Information is power, my friend!
The va did back surgery on me at the end of august i had my c&p exam in feb but it didnt include my back im still waiting for compensation for my surgery i made aclaim for my back in april of 2014.
This is very informative information!
My VSO had put me in for a C&P exam back on October 28, 2013. It is for the disabilities I have a 0% for. Do you think I will get an exam for this and if so when? I have called the appointment line and keep checking my mail box but have not seen or heard anything fom VA. I am going out of town to visit family in NC from Dec 14-Jan 5. I don’t want to miss my appointment if I get one.
Depending on the medical conditions involved, the C&P might be scheduled by the VA Regional Office, or by the nearest VA Medical Center. And, depending on the condition, your C&P Exam may be scheduled with a VA Doctor or a doctor that contracts with the VA. For these reasons, its impossible to tell when you will get an exam scheduled. I have seen them scheduled in 2 weeks, and sometimes it has taken 2 years.
This isn’t legal advice, just something that we do when Vets face similar situations:
1) Keep calling — and MORE IMPORTANTLY — document your phone calls. Write down who you talked to, when you talked to them, and what they said. Be VERY clear that you will be out of town and repeatedly request, in writing, that no C&P Exam be scheduled during your out-of-town dates. Send a fax to the VA Regional Office immediately after each call, and ask that they include each fax in your C-File.
2) Have a friend watch your mail for you while you are out of town. I have seen vets get as little as 2 weeks notice on a C&P Exam, and on occasion, we’ve scheduled them on much shorter timelines. You can call and reschedule when you get the notice (which you should also document in writing to the VA).
3) Consider using a Disability Benefits Questionnaire through your private doctor or VA Doctor – if your condition has one. They can be a good substitute for a C&P Exam. Read about VA Disability benefit Questionnaires (DBQ) here.