A Compensation and Pension (C&P) exam is a medical examination ordered by the Department of Veterans Affairs (VA) after a veteran files a claim for disability benefits or a pension. The purpose of this appointment is to gather medical evidence for the VA claims processor to use in making a decision. Unlike a standard medical appointment, the provider does not offer treatment, prescriptions, or referrals. The C&P exam strictly evaluates the claimed condition’s existence and severity to determine eligibility and the appropriate level of benefits.
Defining the Role of the C&P Exam in VA Claims
The C&P exam helps the VA fulfill its duty to assist the veteran by obtaining necessary medical information for the claim. The primary objectives of the exam are to assess two things: whether the claimed disability is connected to military service and the current severity of the condition. Without sufficient medical evidence on these points, the VA is often unable to grant a claim.
Service connection hinges on the medical opinion provided by the examiner following the C&P appointment. The examiner reviews the veteran’s entire claim file and then provides an opinion on the likelihood of a link between the condition and military service. This medical opinion must be stated using specific terminology, such as “at least as likely as not,” which indicates a 50% or greater probability of service connection.
Beyond establishing service connection, the C&P exam data is used to determine the disability rating, which directly affects the amount of monthly compensation. The examiner documents the current symptoms and functional limitations of the veteran’s condition, often by completing a standardized Disability Benefits Questionnaire (DBQ). This documented information then helps the VA claims processor, known as a rater, apply the criteria from the VA Schedule for Rating Disabilities (VASRD) to assign a percentage rating.
VA claims processors initiate the C&P exam when the evidence submitted by the veteran is insufficient to make a decision, or if the medical information is outdated or incomplete. While the examiner’s findings are heavily weighted, they do not make the final decision on benefits; that remains the role of the VA rater. The rater reviews the C&P report alongside all other evidence in the veteran’s file, such as lay statements and medical records, before issuing a final determination.
What to Expect During the Examination Appointment
C&P examinations may be conducted by healthcare providers employed by a VA medical center or by contracted, non-VA providers working for third-party companies. The scheduling entity typically notifies the veteran by mail with the date, time, and location, sometimes following up with a phone call or email. Veterans must ensure their contact information is current with the VA, as failing to attend a required exam can lead to a claim denial.
The examination procedure often involves a combination of a records review, a detailed interview, and a physical assessment. Some claims, particularly those with extensive existing medical documentation, may be handled entirely through an Acceptable Clinical Evidence (ACE) review, where the provider reviews records without the veteran present. For in-person or telehealth appointments, the provider will review the claim file beforehand and then ask questions specific to the claimed condition to complete the DBQ.
During the appointment, the examiner’s focus is on gathering facts about the onset, progression, and current impact of the disability. For a physical condition, the examiner may measure the veteran’s range of motion or assess pain and instability. For mental health claims, the evaluation centers on the veteran’s mood, behavior, memory, and how the condition affects social and occupational functioning.
Appointment duration can vary significantly, depending on whether the issue is straightforward or involves complex conditions or mental health evaluations. The examiner’s role is to act as a neutral fact-finder, not to discuss the claims process or predict the outcome. After the exam, the provider summarizes their findings in a report and submits it directly to the VA claims processor.
Strategies for Effective Exam Preparation
Before the scheduled appointment, veterans should thoroughly review their claim file, including their medical and personnel records. Understanding the evidence already submitted helps the veteran anticipate the examiner’s line of questioning and ensures all necessary details are covered.
One of the most valuable preparation steps is keeping a detailed symptom journal in the weeks leading up to the exam. The journal should document the frequency, severity, and duration of symptoms, noting how the condition affects daily activities and work. Veterans should condense this information into a clear list to reference during the appointment, helping to prevent forgetting details.
Veterans must be honest and specific when describing symptoms, avoiding the tendency to minimize pain or limitations. They should explain how their condition affects their ability to function on a typical bad day, rather than focusing on a day when symptoms are less noticeable. Providing specific, real-world examples of functional limitations helps the examiner accurately document the disability’s impact on the DBQ.
Practical preparation involves planning logistics, such as confirming the date and location and arranging reliable transportation. Arriving at least 15 minutes early is recommended to ensure the appointment proceeds smoothly. Veterans should bring a government-issued identification and any necessary paperwork they may have been sent.