By Larry Dandridge
Veterans can find the answers to commonly asked questions about Compensation and Pension (C&P) Exams at https://tinyurl.com/4twt6jx3. This article is the last article in a series of three answering questions on C&P Exams.
16. What happens at a C&P exam?
A claim exam is not like a normal medical exam. The provider will not treat the veteran for any illness or injury, give the veteran referrals to other providers, or prescribe medicine. The only purpose of the exam is to gather information that will help the VA make a decision on the veteran’s claim.
- During the veteran’s exam, the provider may do any or all of these things:
- Perform a basic physical exam. This may include physical contact.
- Ask the veteran questions based on the medical records in their claim file. These may include questions from the Disability Benefits Questionnaire (DBQ) for each condition the veteran is claiming. DBQs help collect necessary medical information to process a veteran’s claim. Veterans can use these forms to submit medical evidence from their healthcare providers. Veterans should have their healthcare provider fill out and submit the appropriate forms for their claimed conditions.
- The VA does not pay any expenses incurred while completing or submitting DBQs. There are more than 70 separate DBQs at the VA’s DBQ webpage, https://tinyurl.com/yzd6b7ac.
- Ask the veteran to get other tests (like X-rays or blood work), at no cost to you.
If a veteran has questions about what’s happening during their C&P exam, they can ask the provider. The Provider cannot answer questions about the claims process, give the exam results, or make decisions about the veteran’s claim.
17. Who will examine the veteran?
Either a VA provider or a VA contract provider will do the exam.
VA contractors follow the same medical training and licensing standards and privacy policies as VA providers.
Veterans can request a male or female provider in these situations:
- If the veteran is having a reproductive health, breast, rectal, or mental health exam, or
- If the veteran’s claim is related to a mental or physical health condition resulting from military sexual trauma.
- Veterans can also have their own provider examine them and fill out a form called a Disability Benefits Questionnaire. Then the veteran’s (civilian) provider can submit the DBQ form to the VA.
Veterans and their private Providers should read and follow the DBQ instructions at https://tinyurl.com/4mc4xvsh.
The VA will NOT pay any costs related to the veteran’s own provider completing a DBQ. The VA encourages veterans to submit their private medical records for consideration during the processing of their benefits claims. The VA values evidence from the veteran’s private treatment providers.
18. Can a veteran bring a family member or caregiver to his or her claim exam?
If the veteran has children, they may want to plan for childcare during their exam. This is because the veteran and the provider may need to discuss sensitive topics related to the claim.
If a veteran would like a caregiver or family member to stay with them during the exam, the veteran can discuss this with the VA or VA contractor provider. The VA provider may ask caregivers and family members to stay outside of the exam room.
For sensitive physical exams, the veteran can ask for a medical assistant who works with the VA provider to stay in the room with the veteran.
19. How long will the claim exam take?
A C&P Exam may take only 15 minutes, or it may last an hour or more. This depends on the conditions the veteran claimed and how much information the VA needs.
The C&P Exam is only one part of the claim review process. The VA provider will also spend time outside the exam carefully reviewing your records.
20. What happens after the veteran’s claim exam?
The VA provider will write up an exam report and send it to the VA.
The VA reviews all the evidence in the veteran’s file, including the exam report from the provider. Then the VA makes a decision on the veteran’s claim and sends the veteran a decision letter.
The processing time for a claim depends on how complex the claim is and how many conditions the veteran claimed. According to the VA’s webpage, https://tinyurl.com/ynh6nfzu, the average number of days it takes the VA to process and complete a claim (as of September 2023) is 103.3 days. Veterans can check online their claim, decision, review, and appeal, status at https://tinyurl.com/yf39aczm.
21. How can a veteran get his or her claim exam results?
The veteran will need to request a copy of the final exam report. The veteran cannot get the results of their exam from the VA provider or VA contract provider.
To request a copy of the exam report, the veteran needs to fill out a Freedom of Information Act Request (VA Form 20-10206). Download a copy of Form 20-10206 at https://tinyurl.com/mr259z6u.
Veterans can submit the form by mail or in person.
By mail. Mail the completed form to this address: Department of Veterans Affairs, Evidence Intake Center, P.O. Box 4444, Janesville, Wis. 53547-4444.
In-person. The veteran can bring the completed form to his or her nearest VA regional office. Veterans can find the nearest VBA Regional Office at https://tinyurl.com/8b3vxrh7.
22. What information will the VA use to make a decision on a veteran’s claim?
The VA will review:
- Medical records the veteran gave the VA.
- Exam report from the provider who did the veteran’s claim exam.
- Results of any medical tests the VA provider or VA contract provider ordered.
- Statements from the veteran and others (Lay Witnesses, Private healthcare providers, etc.) about the veteran’s claim.
- The veteran’s military medical and personnel records.
23. What if the veteran had a bad experience at his or her claim exam?
If a veteran has a bad experience with the provider at their claim exam, the VA encourages the veteran to report their concerns right away. Veterans can report their concerns in any of these ways:
- Give feedback on the contractor’s customer satisfaction survey.
- Write a letter and submit it as part of your claim file.
- Call the contractor who scheduled your exam.
- Call the VA at 800-827-1000 (TTY: 711).
- Or you can contact your local VA regional office.
The bottom line
It should be apparent that should use a VA-accredited advisor to help them file claims for VA benefits and prepare for VA C&P Exams. Learn more at https://tinyurl.com/2hfe28w3.
Larry Dandridge is a Vietnam War wounded warrior, disabled veteran, ex-Enlisted Infantryman, ex-Warrant Officer Pilot, and retired Lt. Colonel. He is a past Veterans Service Officer, a Patient Adviser at the RHJ VA Hospital, the Fisher House Charleston Good Will Ambassador, and the VP for Veteran Affairs for the local Army Association Chapter. Larry is the author of the award-winning book Blades of Thunder and a contributing free-lance writer with the Island News. Contact him at LDandridge@earthlink.net or 843-276-7164.
