The Compensation and Pension (C&P) exam is a medical evaluation ordered by the Department of Veterans Affairs (VA) to assess a veteran’s claimed disability. For hypertension, this examination determines two things: whether your high blood pressure is connected to military service and the current severity of the condition. The C&P exam is a structured process where a healthcare provider collects medical evidence to complete a specific questionnaire for the VA.
Preparing for the C&P Exam
Preparation for the C&P exam involves organizing a comprehensive medical history. Gather all relevant private and VA medical records pertaining to your hypertension diagnosis and treatment. This documentation helps establish the “nexus,” or the link between your service and the onset or aggravation of the condition.
Compile a complete list of all current medications, including dosage and frequency. The examiner needs this information to understand your current treatment regimen and its effectiveness. Tracking blood pressure readings taken outside of the VA system, such as those from a home monitor, is helpful. These outside readings provide a more accurate picture than a single reading taken during the potentially stressful examination setting.
The Examination Day Protocol
Upon arrival, you will check in before being called back for the examination. The process begins with an initial interview, where the healthcare provider reviews your file and confirms your medical history. This discussion focuses on the onset and duration of your hypertension symptoms, and how the condition impacts your daily life and ability to function.
The examiner then proceeds to physical measurements, which are central to the C&P exam. A standard protocol for taking blood pressure readings is followed, often involving multiple measurements for accuracy. You are expected to be physically rested for the readings to be considered valid, as the VA recognizes anxiety or exertion can temporarily elevate blood pressure. The examiner gathers factual data and clinical observations to complete a specialized Disability Benefits Questionnaire (DBQ), a standardized form used to record findings and provide a structured medical opinion on severity.
How Hypertension Severity is Assessed
The VA rates hypertension based on Diagnostic Code 7101, found in the Schedule for Rating Disabilities. This code uses specific, sustained systolic and diastolic blood pressure measurements to assign a rating percentage. The highest rating of 60% is given when the diastolic pressure is predominantly 130 mmHg or higher.
A 40% rating is assigned if the diastolic pressure is predominantly 120 mmHg or more. A 20% rating applies if the diastolic pressure is predominantly 110 mmHg or more, or if the systolic pressure is predominantly 200 mmHg or higher. The minimum compensable rating of 10% is warranted if the diastolic pressure is predominantly 100 mmHg or more, or the systolic pressure is predominantly 160 mmHg or higher. This 10% rating is also the minimum evaluation for an individual who requires continuous medication to control their blood pressure, provided they have a history of a diastolic pressure predominantly 100 mmHg or more.
The rating can also be influenced by damage to other organ systems caused by the hypertension. High blood pressure can lead to secondary conditions such as ischemic heart disease, chronic kidney disease, or vision problems. If medical evidence shows that your service-connected hypertension has caused or aggravated these secondary conditions, those complications may result in a higher overall combined disability rating, even if the blood pressure numbers alone do not meet the highest thresholds. The examination is designed to document this potential organ damage and its functional impact.