By Larry Dandridge
Editor’s note: This is the first in a series of three related articles.
Veterans who file a claim for military service-connected disability compensation should expect to have to take a VA C&P Exam for each service-connected disability condition they file a claim for. Veterans can find out how to file a claim for military service-connected disability at https://bit.ly/3wYGMRJ and by asking a Veterans Service Officer (VSO) for help. Learn more about Fully Developed Claims and Standard Claims at https://bit.ly/3CTtFV0 and https://bit.ly/3Z7UGNg.
According to the VA web page titled VA Claim Exam, found at https://bit.ly/3IEQ8He, “After a veteran files their disability benefits claim, the Veterans Benefits Administration (VBA) may ask you to have a claim exam (also known as a compensation and pension, or C&P, exam).” Veterans can find the answers to commonly asked questions about C&P Exams at the above web page.
Although the VBA directs veterans to have C&P Exams, the exams are done either by the Veterans Health Administration (VHA) or one of the VA’s contracted medical services. Therefore, veterans may have to go to a VA Medical Center or one of its Community-Based Outpatient Clinics (CBOCs) or to a contracted doctor for a C&P exam.
This article and the next two weeks’ articles on veterans benefits will answer 24 frequently asked questions about VA C&P Exams.
1. Why might a veteran need a VA claim exam?
The C&P exam will help the VA to determine if the veteran has a service-connected disability. It will also help the VA to rate the veteran’s disability if the veteran has one.
The VA bases a veteran’s disability rating on how severe their disability is – and the veteran’s rating will affect how much disability compensation money the veteran receives. Compensation may include things like monthly payments and enrollment in the VA health care program. Veterans can find out if they are eligible for VA Healthcare at https://bit.ly/3cuf4Vm. Veterans can find out how to enroll in VA Healthcare at https://bit.ly/3B7x5Dz.
2. Does everyone who files a claim need to have a VA claim exam?
No, but veterans should expect that they may be required to take a C&P Exam. The VA should ask you to have a claim exam only if the VA needs more information to decide the veteran’s claim.
If a veteran has enough medical evidence in their file to support their claim, the VA follows the Acceptable Clinical Evidence (ACE) process. This means the VA reviews the veteran’s medical records and asks the veteran to submit more evidence if needed, instead of asking the veteran to have an exam. Medical evidence may include doctor and hospital reports, test results, and other documents. Read about what evidence a veteran will need to support a claim for service-connected disability at https://bit.ly/3w6YGAN.
3. Will a veteran need more than one VA claim exam?
A veteran may need more than one exam in these situations:
- If the veteran submits a claim for more than one condition, the veteran may need more than one exam. The VA will try to schedule all of the veteran’s exams on the same day.
- For some conditions, a veteran may need follow-up exams (called “review exams”). In a review exam, the VA medical provider will determine whether the severity of the veteran’s condition has changed since their last exam.
- If a veteran requests a decision review of their claim decision, the VA may ask the veteran to have another exam.
4. How does the VA schedule a veteran’s VA C&P exam?
The staff at the veteran’s local VA medical center or a VA contractor will mail the veteran a letter with the date and time of his or her exam. The veteran may also get a phone call or email from the VA or from the VA’s contractor.
Veterans should make sure the VA has their up-to-date address, phone number, and email address. Veterans can update their contact information online at https://bit.ly/3QWx50x. Veterans can also change their address by contacting the appropriate VA department directly by using the phone numbers, mailing addresses, and contact information at https://bit.ly/40JEVhh. Veterans cannot start the scheduling process for claim exams themselves. The VA will start the scheduling process by contacting the veteran.
5. How will the VA contact the veteran to schedule their claim exam?
The staff at the veteran’s local VA medical center or a VA contractor will mail the veteran a letter with the date and time of his or her exam. The veteran may also get a phone call or email from the VA or from the contractor. Veterans should make sure the VA has your up-to-date address, phone number, and email address.
6. What should the veteran do when they get their claim exam letter or phone call?
The veteran will need to confirm their appointment. The veteran must call the phone number on the exam letter to confirm the place and time. If the veteran gets a phone call, the veteran can confirm the place and time on the call.
When the veteran confirms their appointment, he or she can request help with transportation or other accommodations they may need need.
The veteran can also 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 (MST).
Find out more about Military Sexual Trauma and MST claims at https://bit.ly/3V0zcAJ and https://bit.ly/3QUimDc.
7. What if a veteran needs to change the day or time of his or her scheduled claim exam?
If a veteran needs to reschedule their exam, they need to tell the VA medical center or contractor at least 48 hours in advance. Rescheduling your exam may delay your claim. I say again, rescheduling your exam may delay your claim.
8. To reschedule, what number should the veteran call?
The veteran should call the number on their appointment letter:
- For Loyal Source Government Services (LSGS), call 833-832-7077 (TTY 711).
- For OptumServe Health Services, call 866-933-8387.
- For QTC Management, call 800-682-9701.
- For Veterans Evaluation Services, call 877-637-8387. If the veteran is outside the continental U.S., call +1-713-255-5656.
- Or call the VA at 800-827-1000. The VA is there Monday through Friday, 8 a.m. to 9 p.m. Eastern Time.
Continued in the Military section of next week’s edition of The Island News.
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.
