Preparing for a C&P Exam: Things Veterans Should Know

Preparation Help is Available at No Cost to Warriors

The compensation and pension (C&P) exam is often a major factor in deciding whether a veteran qualifies for disability benefits from the Department of Veteran Affairs (VA).  

If a veteran or service member is scheduled for a C&P exam, knowing what to expect and how to best prepare beforehand is important.

Wounded Warrior Project^® (WWP) can help warriors prepare for their C&P exams at no cost. WWP benefits services officers can answer warriors’ questions and concerns, and as VA-accredited national service officers, they can monitor the progress of warriors’ claims, and advocate on their behalf.  

“The C&P exam can basically be the deciding factor,” said Michael Snook, WWP regional benefits director. “There are nuances, and every claim is different, but it can make or break a case. It can be the difference between approval or denial. It’s really the most important part of the process for a lot of warriors to substantiate what is wrong and how bad it is.”  

C&P exams help establish if a veteran’s injury or illness is linked to active-duty military service, a requirement for VA disability compensation. Establishing that link is crucial, and C&P exams are one of the most common and recognized ways VA confirms this connection. C&P exams also determine whether a veteran’s disability rating needs to change due to worsening symptoms or additional illnesses or injuries from military service. 

Obstacles and Advice

WWP Benefits Training Specialist Timothy Velasquez, who spent nine years with the Veterans Benefits Administration (VBA), details some obstacles and advice veterans should consider when it comes to C&P exams. 

• Contract providers: Often, physicians conducting the exam(s) are not connected to VA.  Although certified by VA to conduct C&P exams for the purposes of establishing service connection or an increase in benefits, some physicians might be unfamiliar with veterans issues. Be upfront and direct about your condition and how it is affecting you. If you feel you aren’t being heard or treated fairly by the contract provider, contact VA.

• Distance to exam site: The goal is to have veterans travel no more than 50 miles to an exam, but veterans could opt to travel further if they can get an exam sooner. However, some veterans have had to travel much longer distances to attend an exam because they have few options closer to home. If this is your situation, contact the VA at 800.827.1000 and ask to schedule your examination closer to your home. 

• Scheduling conflicts: It’s important for veterans to know if they need to reschedule, they can call the VA’s main hotline. They can also contact their veterans experience officer at their local VA medical center or VA community-based outpatient clinic for assistance. In some instances, veterans may be unaware that their examinations have been scheduled. That’s why it’s important to read any correspondence from VA or its affiliates during the claims process. Exams with a contract provider can only be rescheduled once per exam, and the new appointment must be within five days of the original appointment.

• Exam preparation: This is not the time to downplay your pain or injuries. VA needs detailed information about your symptoms and how those impact your daily life. WWP helps warriors prepare by explaining what to expect and best practices to avoid unforeseen circumstances. “Our team spends time with warriors individually to ensure they're prepared and know what to expect,” Velasquez said. “We can help prepare them for a positive exam experience.”

C&P Exam: Questions and Answers

Does everyone who files a claim need to take a C&P exam?

Not always. If you have enough medical evidence and documentation that ties your injury or illness to your service, then it may not be necessary to take an exam. The VA’s Acceptable Clinical Evidence (ACE) process allows VA to review medical records and determine if the records are substantial enough to support a claim and make a disability ratings decision, foregoing the need for an exam.

Do I need to have more than one exam?

Possibly. If you claim more than one condition, you may require more exams. You may also need additional exams if your condition has changed or worsened since your original exam. You can also dispute or ask for a review of a claims decision, which may prompt a request for another exam.

What if I miss my exam?

It’s important to attend your scheduled exam if possible. If you’re filing a VA claim, check your mail, email, and voicemails for any correspondence from VA or Veterans Evaluations Services (VES). If the scheduled exam time is inconvenient, call to reschedule right away. Missing the exam could result in a denial of your claim. If you miss the exam, call VA at 800.827.1000 or the number on your appointment letter as soon as possible. If VA determines there was a “good reason” to miss the exam, it will reschedule.

How long does the exam take?

It depends. If you have a single, relatively straightforward condition, the exam could take less than half an hour. It could take longer for more complex medical conditions or multiple conditions.

What happens after my exam?

VA will receive a report from the provider who conducted the exam and will review it along with any other medical evidence. VA will then decide whether to approve the claim, and if approved, VA will assign a disability rating (between 0-100%). You should receive a letter notifying you of VA’s decision, and it should also be available on your VA.gov account.

Can I get a copy of my exam results?

Yes. C&P exam results aren’t automatically available, so you must request a copy, which can be done online, by mail, or in person at a regional VA office. You must also complete a Freedom of Information Act (FOIA) or Privacy Act Request.

Get more information and answers from VA about C&P exams.

C&P Exams and the PACT Act

The SFC Heath Robinson Honoring Our PACT Act guarantees that veterans who suffer ill effects due to exposure to burn pits and other toxic substances while in service receive the care and benefits they deserve.

Among the major achievements of the PACT Act was the creation of new presumptive conditions tied to toxic exposure. Although the diagnosis of one of the presumptive conditions may alleviate some of the obstacles to establishing a service connection, a C&P exam is still likely to be required.

“Though presumptive service connection can be conceded, veterans generally must attend a C&P exam for VA to assign a rating,” Velasquez said.

More Helpful Tips

• Upload medical records through the VA’s claims status tool on the VA website or submit them to an accredited VA representative ahead of the scheduled appointment.
• Confirm your appointment by calling the number on the exam notification letter or on the phone if called. You can also ask for transportation assistance to the exam. 
• If you miss your exam, call VA at 800.827.1000 or upload a letter through the claims status tool to explain the reasons. Some of the valid reasons the VA may reschedule a missed exam include death in the family, homelessness, hospitalization, and terminal illness.
• Don’t expect prescriptions or referrals. The C&P exam is to collect information related to a disability claim.
• C&P exam providers cannot answer questions about your claims process, tell you the results of your exam, or make decisions about your claim.
• VA will make a claims decision based on the review of your C&P exam, as well as other medical records and reports. The timeline for a decision varies by claim. Veterans can check the status of their claims online, request an update from their accredited representative, or wait for their decision letter to arrive in the mail.

Get Help Through the C&P Exam Process

As a veteran, you don’t have to go through the C&P process alone. The WWP Benefits Services program can help guide you through the disability process from start to finish at no cost.

The WWP Benefits Services team can also help post-9/11 veterans file an initial disability claim, appeal a previous claim, and even apply for VA health care benefits.

“When in doubt, talk to a veterans service organization (VSO),” Snook said. “If you’re concerned about your benefits or about being set up for success with your examinations, there are VSOs out there that can help you. We want our warriors to know they can come to us to help them obtain the benefits they’ve earned in a manner that honors their service.” 

Find out more about how WWP can help warriors and their families.

Contact: — Paris Moulden, Public Relations, pmoulden@woundedwarriorproject.org, 904.570.7910

About Wounded Warrior Project 

Since 2003, Wounded Warrior Project^® (WWP) has been meeting the growing needs of warriors, their families, and caregivers — helping them achieve their highest ambition. Learn more about Wounded Warrior Project.