The Compensation and Pension (C&P) examination for a Posttraumatic Stress Disorder (PTSD) claim is a formal, administrative process conducted by the Department of Veterans Affairs (VA). This evaluation gathers medical evidence the VA uses to decide if the condition is service-connected and to determine its severity. This appointment is not a session for treatment, but a structured interview designed to assess the current impact of your symptoms on your daily life and functioning. Recognizing the distinction between this examination and therapy can help a veteran manage the stress and anxiety often associated with the process.
Pre-Exam Preparation and Documentation
A productive C&P examination begins with thorough preparation and documentation. Veterans should gather all available supporting evidence, including private medical records and statements from family, friends, or former service members. These lay and buddy statements provide third-party confirmation of the symptoms and functional changes experienced since service.
Prepare a detailed, organized timeline that articulates the stressor event and the subsequent development of PTSD symptoms. This timeline should clearly link the in-service trauma to the current mental health condition, establishing the necessary connection for the VA. Writing down a list of current symptoms, including their frequency, severity, and duration, ensures that no detail is overlooked during the examination.
Understanding the Exam Structure and Interview Focus
The C&P examination is typically conducted by a mental health professional, such as a psychologist, psychiatrist, or, in some cases, a licensed clinical social worker for review examinations. While the duration can vary, most structured interviews last between 10 minutes and an hour, maintaining a professional rather than therapeutic atmosphere. The examiner’s task is to complete the Disability Benefits Questionnaire (DBQ) for PTSD.
The interview focuses on two primary areas: establishing the stressor and assessing symptoms. The first goal is to confirm the “nexus,” which is the link between a specific traumatic event experienced during military service and the current diagnosis. The second goal is to determine the presence and severity of symptoms based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The examiner will inquire specifically about the four clusters of PTSD symptoms:
- Intrusion
- Avoidance
- Negative alterations in cognition and mood
- Alterations in arousal and reactivity
The veteran must clearly articulate how the military service event caused or aggravated the condition and provide concrete examples of current symptoms. Being open and honest about the complete range of emotional and behavioral difficulties is important, as the examiner is tasked with documenting the extent of the disability to inform the eventual rating decision.
The Role of Functional Impairment in Rating
The VA rates PTSD not solely on the diagnosis, but on the degree to which the condition causes functional impairment in a veteran’s life. Functional impairment refers to the reduction in a person’s ability to work, maintain social relationships, and manage the demands of daily living. The general rating formula for mental disorders uses the severity of this impairment to assign a percentage rating from 0% to 100%.
The examiner’s DBQ report focuses on occupational and social functioning markers. The veteran should focus on describing how specific symptoms, such as chronic sleep impairment, panic attacks, or difficulty concentrating, directly limit their life activities.
Rating Thresholds
A 10% rating reflects symptoms that are mild or transient, causing work inefficiency only during periods of high stress.
A 50% rating reflects occupational and social impairment characterized by reduced reliability and productivity.
A 70% rating indicates impairment with deficiencies in most areas, such as work, school, family relations, and judgment.
A 100% rating is reserved for total occupational and social impairment. This is often due to symptoms like persistent hallucinations, gross impairment in thought processes, or a consistent inability to perform activities of daily living. Articulating the limitations imposed by the symptoms is crucial, as the final rating is based on the evidence of record that bears on the extent of occupational and social impairment.
Post-Exam Steps and Next Actions
Once the C&P examination concludes, the examiner forwards the completed DBQ and their findings to the VA rating team. The administrative review process then begins, often representing the longest waiting period for the veteran. A decision regarding the claim typically takes between 30 and 90 calendar days following the final examination, though complex claims or high VA workloads can extend this timeline.
During this waiting period, the VA may contact the veteran or the examiner for clarification or request additional information, which can temporarily delay the decision. Veterans have the right to request a copy of the C&P examination report, including the DBQ, once it is submitted to the VA. Reviewing this report is a valuable step, as it provides insight into the medical evidence the VA will use to make its final determination.