Hi, my name is Zack Evans. I'm a Veterans Disability Benefits
attorney with Woods and Woods Attorneys in Evansville,
Indiana and today, we're going to be talking about C&P
examinations. I'm going to talk a little bit about what a
compensation and pension examination is, what to expect,
how to prepare for it, and just generally how they're laid out.
So, first of all, a C&P examination. It's a
compensation and pension examination is set up by the VA
Regional Office by the Veterans Benefits Administration. It's to
assess your level of disability or it is to assess whether a
disability that you suffer from is related to your time in
service.
So a C&P examination will typically be performed by a
medical professional. It's not always a doctor but a lot of
times they are performed by doctors. We also see
psychiatric nurses, clinical psychologists, nursing
practitioners, people with credentials to administer some
sort of medical examination or make an analysis. So the
difference between a C&P examiner and a private doctor
sometimes is nothing. Sometimes we'll have private doctors that
will contract with the VA in order to do some compensation
and pension exams because as you can imagine there's a huge
backlog of claims. There's a huge backlog of of exams that
need to be completed. So sometimes you'll go to a VA
medical center and you'll receive a compensation and
pension exam from a VA doctor in a VA facility. Sometimes
your C&P exam will be performed by someone who is affiliated
with the VA or has an agreement with the VA, but doesn't
necessarily work for the VA directly and the goal is to try
to get this huge volume of exploratory examinations and
and assessments completed so that the regional office can
issue you a decision on either service connection or about the
severity of your disability.
Typically at a C&P exam, you'll show up to the location of the
exam and you'll have a battery of questions that an examiner
will ask you about your condition. If it's a
psychiatric examination, they'll ask you a little bit
about your personal history. They'll ask you about your
current symptoms. They'll ask you about some of the
challenges you face in your daily life, how either your
PTSD, your major depressive disorder, your anxiety
disorder, how those things impact you on a daily basis and
some of these exams are more thorough than others but
typically, what I see in my practice is the issues that
arise with the thoroughness of exams tend to come up more
often in mental health exams because it's really tough to
cover the full breadth of someone's mental health disability
in the course of a relatively short examination period.
This depends on what you're going in to have assessed. What's
being evaluated. So obviously if it's a psychological
assessment that's not likely to happen unless maybe you have
other examinations pending that day because you might go see an
orthopedist in the morning and then a couple of hours later
you might talk to a clinical psychologist and some of those
assessments can dovetail together really nicely. So,
let's say you have a back condition that you sustained in
service as a result of a lumbar spine injury and that is really
impacting your activities daily living, really impacting your
your mood and your state of mind. Some of those things will
overlap. For the orthopedic conditions themselves, there's
absolutely a physical component. One of the things
that needs to be tested on orthopedic examinations is your
range of motion and your range of motion is going to be
impacted by things like flare ups, what your current level of
baseline severity is, what happens to you during a
flare-up event, what happens to you during periods of prolonged
usage such as during a typical work day especially if you work
on your feet. So some of these examinations will have a
physical component where they're testing a certain body
part and how it moves whether it moves freely whether you get
some locking or some crepitus in the knee something like that.
Because of these varying types of C&P examinations, the length
and the breadth of what's discussed can vary pretty
significantly. Some of these examinations unfortunately
we've heard only last 5-10 minutes and the evidence has
unfortunately born that out when we review the file. We'll
get a questionnaire typically in a standard form called a a
DBQ or disability benefits questionnaire where a psychologist will
run through pretty quickly some boxes that ask a certain number
of questions and they'll you know, like I covered earlier,
they'll ask you about your employment history, they'll ask
you about your diagnosis and then they'll ask you about the
current challenges that you face with that condition. In my
opinion, the mental health examinations should be longer.
There should be much more time dedicated to farding out
what has occurred to a veteran, how some of these behaviors or
coping skills, coping mechanisms took root in service
and then progressed throughout a person's life.
What you really need to be doing to prepare for your C&P
exam is getting yourself in an open mental space to be able to
talk about these things that you're dealing with especially
for mental health exams. It is very easy for survivors of
military trauma to want to shut down in the middle of a psych
exam, to not want to discuss the full range of things that
they've been dealing with. It's understandable. Sometimes
that's a coping mechanism that is wrapped up in someone's
diagnosis. You need to be thinking about exactly how your
condition impacts you and the things that you want to get out
there. One of the things that I see pretty commonly in veterans
psych files is a diminished or impaired ability to interact
with loved ones, even people that they trust, like their
family, and that is not something that you want to
leave out of a C&P exam discussion because if
it's not discussed, if it's not brought up, if you are not
being heard in this examination, then, by omission,
the VA will assume that you're functioning at a normal level
in terms of your social and familial interactions, and often
times, that simply isn't the case. Some of those things are difficult
to recall. They're difficult to bring up in the moment just
relying on your memory. Sometimes, there's a lot of
ground to cover in these examinations. Sometimes, there are
quite a few different areas of impairment related to a mental
health condition or related to a back injury, and in order to
make sure that you're covering all the bases and you're
getting everything on the record that you can in that
exam, having good notes, and trying to think clearly before
you go in about exactly what you need to get out there can
be really helpful. I really recommend that veterans keep journals of
their conditions. I really think that if you journal in
the morning and in the evening, it doesn't have to be very
long. Just something that recounts during the day, some
challenges that you faced as a result of your service
connected knee pain as a result of your PTSD but a journal does
a good job of keeping a record for you of exactly how this
impacts you day to day and that's the piece that's
typically missing from C&P exams. In the couple of weeks
leading up to a scheduled compensation and pension exam
if you can sort of do a daily rundown of what your day looks
like, challenges that you're facing as a result of your
service-connected conditions. You are, without them being
there, you're essentially trying to walk the examiner
through how this impacts you on a daily basis. So obviously
a C&P exam can't take two weeks or almost no one would get an
exam done. But if you take a good written record in of you
know, I woke up in the morning and as soon as I tried to get
out of you know as soon as I tried to get out of bed my knee
locked up. And I noticed that my service-connected ankle was
extremely swollen. I had fluid on my knee. Something
like that. And then I went outside to get the mail and I
got a few steps and my sciatica started acting up from my old
back injury that I received whenever I was in the
Marines. So these are all little pieces that can help
paint a really good picture of how these conditions are
impacting you. The goal is to make it real for the person
reading it. Because it is easy for an examiner to just see you
as a number or as an appointment. And to check down
a few discussion drivers or items of conversation. They'll
check some boxes on what your functionality is and then
that's it. They're on to the next examination. The plain
language that you use, a lay person's language that you use
with an examiner is ok. You don't have to know the ins and
outs of clinical psychology. You don't have to know exactly,
you know, the mechanics of orthopedic injuries. No one's
expecting you to understand or be fluent in those
things. Certainly, some of you probably are because you've
been dealing with these things for so long. You've been in and
out of doctor's offices. You've had multiple surgeries. Um
you've probably seen multiple mental health providers that
have provided you some insight using these special words,
these medical terms and if you're comfortable using those
words, certainly. But don't let that deter you from just saying
what's on your mind and what's on your heart and what you're
dealing with because this is your chance to get all of this,
like I said, on the record, this is your chance to tell
your story and if you feel like an examiner is rushing you, do
everything you can to respectfully slow them down ask
them for an opportunity to be heard make sure that they know
that you feel the examination is not complete that the
discussion is not over that you have more that you want to talk
about. Remember, this examination while it's being administered
by a medical professional is your examination. If you feel
like something isn't being explored enough if you feel
like you're being glossed over in the examination, you need to
say something. You need to redirect the conversation. You
need to say, you know, excuse me, sir or ma'am but I feel
like there are a few other things that I would like to
discuss here that are important that relate to how this
condition impacts my life. Take notes when you leave your exam
about your feelings, things that were discussed, things
that were not discussed, and keep that. If someone provides
me notes that they felt like an examiner was rushing over bits
of evidence. Let's say it's for a knee and they didn't even
discuss the knee surgery that occurred just 10 months ago, I
would like to jump on that. So, you want to make sure you're
keeping good notes on exactly what was discussed, what was
not discussed, how many times you were rushed or hurried through
conversations that's all useful because if they are ignoring
your discussion items, if they're ignoring recent operations
that you've had, if they're ignoring some of the directives of your
mental health treatment provider and they're not
encompassing that within the scope of this C&P examination,
there's an argument to be made that we have an inadequate exam
that cannot form the basis for a VA decision that can stand as
as valid. Do something fun when you're done. So, schedule some
time with your family, schedule some time with your friends,
whether it's fishing with a buddy or taking
your grandson to a racetrack or you know, if it's running racks
of eight ball at the VFW with your friends, do that. Take the
time to do something that's enjoyable and can get your mind
out of this cyclical type of thinking that can result from
digging up these old bones so to speak because what we
want to make sure is that the C&P examination is as accurate
and as thorough as possible, but we don't want you to be
impacted long term. These examinations are difficult
enough. We want to make sure that you're trying to make
plans to do something that can sort of relieve the stress and
allow you to get back to as much functionality as you can
because life is about enjoying.
Go online or give us a call. Again, my name is Zack Evans, a
VA Disability Benefits Attorney with Woods and Woods in
Evansville, Indiana and we look forward to hearing from you.