Hi, my name is Zack Evans. I'm a Veterans Disability Benefits
Hi, my name is Zack Evans. I'm a Veterans Disability Benefits

attorney with Woods and Woods Attorneys in Evansville,
attorney with Woods and Woods Attorneys in Evansville,

Indiana and today, we're going to be talking about C&P
Indiana and today, we're going to be talking about C&P

examinations. I'm going to talk a little bit about what a
examinations. I'm going to talk a little bit about what a

compensation and pension examination is, what to expect,
compensation and pension examination is, what to expect,

how to prepare for it, and just generally how they're laid out.
how to prepare for it, and just generally how they're laid out.

So, first of all, a C&P examination. It's a
So, first of all, a C&P examination. It's a

compensation and pension examination is set up by the VA
compensation and pension examination is set up by the VA

Regional Office by the Veterans Benefits Administration. It's to
Regional Office by the Veterans Benefits Administration. It's to

assess your level of disability or it is to assess whether a
assess your level of disability or it is to assess whether a

disability that you suffer from is related to your time in
disability that you suffer from is related to your time in

service.
service.

So a C&P examination will typically be performed by a
So a C&P examination will typically be performed by a

medical professional. It's not always a doctor but a lot of
medical professional. It's not always a doctor but a lot of

times they are performed by doctors. We also see
times they are performed by doctors. We also see

psychiatric nurses, clinical psychologists, nursing
psychiatric nurses, clinical psychologists, nursing

practitioners, people with credentials to administer some
practitioners, people with credentials to administer some

sort of medical examination or make an analysis. So the
sort of medical examination or make an analysis. So the

difference between a C&P examiner and a private doctor
difference between a C&P examiner and a private doctor

sometimes is nothing. Sometimes we'll have private doctors that
sometimes is nothing. Sometimes we'll have private doctors that

will contract with the VA in order to do some compensation
will contract with the VA in order to do some compensation

and pension exams because as you can imagine there's a huge
and pension exams because as you can imagine there's a huge

backlog of claims. There's a huge backlog of of exams that
backlog of claims. There's a huge backlog of of exams that

need to be completed. So sometimes you'll go to a VA
need to be completed. So sometimes you'll go to a VA

medical center and you'll receive a compensation and
medical center and you'll receive a compensation and

pension exam from a VA doctor in a VA facility. Sometimes
pension exam from a VA doctor in a VA facility. Sometimes

your C&P exam will be performed by someone who is affiliated
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
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
necessarily work for the VA directly and the goal is to try

to get this huge volume of exploratory examinations and
to get this huge volume of exploratory examinations and

and assessments completed so that the regional office can
and assessments completed so that the regional office can

issue you a decision on either service connection or about the
issue you a decision on either service connection or about the

severity of your disability.
severity of your disability.

Typically at a C&P exam, you'll show up to the location of the
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
exam and you'll have a battery of questions that an examiner

will ask you about your condition. If it's a
will ask you about your condition. If it's a

psychiatric examination, they'll ask you a little bit
psychiatric examination, they'll ask you a little bit

about your personal history. They'll ask you about your
about your personal history. They'll ask you about your

current symptoms. They'll ask you about some of the
current symptoms. They'll ask you about some of the

challenges you face in your daily life, how either your
challenges you face in your daily life, how either your

PTSD, your major depressive disorder, your anxiety
PTSD, your major depressive disorder, your anxiety

disorder, how those things impact you on a daily basis and
disorder, how those things impact you on a daily basis and

some of these exams are more thorough than others but
some of these exams are more thorough than others but

typically, what I see in my practice is the issues that
typically, what I see in my practice is the issues that

arise with the thoroughness of exams tend to come up more
arise with the thoroughness of exams tend to come up more

often in mental health exams because it's really tough to
often in mental health exams because it's really tough to

cover the full breadth of someone's mental health disability
cover the full breadth of someone's mental health disability

in the course of a relatively short examination period.
in the course of a relatively short examination period.

This depends on what you're going in to have assessed. What's
This depends on what you're going in to have assessed. What's

being evaluated. So obviously if it's a psychological
being evaluated. So obviously if it's a psychological

assessment that's not likely to happen unless maybe you have
assessment that's not likely to happen unless maybe you have

other examinations pending that day because you might go see an
other examinations pending that day because you might go see an

orthopedist in the morning and then a couple of hours later
orthopedist in the morning and then a couple of hours later

you might talk to a clinical psychologist and some of those
you might talk to a clinical psychologist and some of those

assessments can dovetail together really nicely. So,
assessments can dovetail together really nicely. So,

let's say you have a back condition that you sustained in
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
service as a result of a lumbar spine injury and that is really

impacting your activities daily living, really impacting your
impacting your activities daily living, really impacting your

your mood and your state of mind. Some of those things will
your mood and your state of mind. Some of those things will

overlap. For the orthopedic conditions themselves, there's
overlap. For the orthopedic conditions themselves, there's

absolutely a physical component. One of the things
absolutely a physical component. One of the things

that needs to be tested on orthopedic examinations is your
that needs to be tested on orthopedic examinations is your

range of motion and your range of motion is going to be
range of motion and your range of motion is going to be

impacted by things like flare ups, what your current level of
impacted by things like flare ups, what your current level of

baseline severity is, what happens to you during a
baseline severity is, what happens to you during a

flare-up event, what happens to you during periods of prolonged
flare-up event, what happens to you during periods of prolonged

usage such as during a typical work day especially if you work
usage such as during a typical work day especially if you work

on your feet. So some of these examinations will have a
on your feet. So some of these examinations will have a

physical component where they're testing a certain body
physical component where they're testing a certain body

part and how it moves whether it moves freely whether you get
part and how it moves whether it moves freely whether you get

some locking or some crepitus in the knee something like that.
some locking or some crepitus in the knee something like that.

Because of these varying types of C&P examinations, the length
Because of these varying types of C&P examinations, the length

and the breadth of what's discussed can vary pretty
and the breadth of what's discussed can vary pretty

significantly. Some of these examinations unfortunately
significantly. Some of these examinations unfortunately

we've heard only last 5-10 minutes and the evidence has
we've heard only last 5-10 minutes and the evidence has

unfortunately born that out when we review the file. We'll
unfortunately born that out when we review the file. We'll

get a questionnaire typically in a standard form called a a
get a questionnaire typically in a standard form called a a

DBQ or disability benefits questionnaire where a psychologist will
DBQ or disability benefits questionnaire where a psychologist will

run through pretty quickly some boxes that ask a certain number
run through pretty quickly some boxes that ask a certain number

of questions and they'll you know, like I covered earlier,
of questions and they'll you know, like I covered earlier,

they'll ask you about your employment history, they'll ask
they'll ask you about your employment history, they'll ask

you about your diagnosis and then they'll ask you about the
you about your diagnosis and then they'll ask you about the

current challenges that you face with that condition. In my
current challenges that you face with that condition. In my

opinion, the mental health examinations should be longer.
opinion, the mental health examinations should be longer.

There should be much more time dedicated to farding out
There should be much more time dedicated to farding out

what has occurred to a veteran, how some of these behaviors or
what has occurred to a veteran, how some of these behaviors or

coping skills, coping mechanisms took root in service
coping skills, coping mechanisms took root in service

and then progressed throughout a person's life.
and then progressed throughout a person's life.

What you really need to be doing to prepare for your C&P
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
exam is getting yourself in an open mental space to be able to

talk about these things that you're dealing with especially
talk about these things that you're dealing with especially

for mental health exams. It is very easy for survivors of
for mental health exams. It is very easy for survivors of

military trauma to want to shut down in the middle of a psych
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
exam, to not want to discuss the full range of things that

they've been dealing with. It's understandable. Sometimes
they've been dealing with. It's understandable. Sometimes

that's a coping mechanism that is wrapped up in someone's
that's a coping mechanism that is wrapped up in someone's

diagnosis. You need to be thinking about exactly how your
diagnosis. You need to be thinking about exactly how your

condition impacts you and the things that you want to get out
condition impacts you and the things that you want to get out

there. One of the things that I see pretty commonly in veterans
there. One of the things that I see pretty commonly in veterans

psych files is a diminished or impaired ability to interact
psych files is a diminished or impaired ability to interact

with loved ones, even people that they trust, like their
with loved ones, even people that they trust, like their

family, and that is not something that you want to
family, and that is not something that you want to

leave out of a C&P exam discussion because if
leave out of a C&P exam discussion because if

it's not discussed, if it's not brought up, if you are not
it's not discussed, if it's not brought up, if you are not

being heard in this examination, then, by omission,
being heard in this examination, then, by omission,

the VA will assume that you're functioning at a normal level
the VA will assume that you're functioning at a normal level

in terms of your social and familial interactions, and often
in terms of your social and familial interactions, and often

times, that simply isn't the case. Some of those things are difficult
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
to recall. They're difficult to bring up in the moment just

relying on your memory. Sometimes, there's a lot of
relying on your memory. Sometimes, there's a lot of

ground to cover in these examinations. Sometimes, there are
ground to cover in these examinations. Sometimes, there are

quite a few different areas of impairment related to a mental
quite a few different areas of impairment related to a mental

health condition or related to a back injury, and in order to
health condition or related to a back injury, and in order to

make sure that you're covering all the bases and you're
make sure that you're covering all the bases and you're

getting everything on the record that you can in that
getting everything on the record that you can in that

exam, having good notes, and trying to think clearly before
exam, having good notes, and trying to think clearly before

you go in about exactly what you need to get out there can
you go in about exactly what you need to get out there can

be really helpful. I really recommend that veterans keep journals of
be really helpful. I really recommend that veterans keep journals of

their conditions. I really think that if you journal in
their conditions. I really think that if you journal in

the morning and in the evening, it doesn't have to be very
the morning and in the evening, it doesn't have to be very

long. Just something that recounts during the day, some
long. Just something that recounts during the day, some

challenges that you faced as a result of your service
challenges that you faced as a result of your service

connected knee pain as a result of your PTSD but a journal does
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
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
impacts you day to day and that's the piece that's

typically missing from C&P exams. In the couple of weeks
typically missing from C&P exams. In the couple of weeks

leading up to a scheduled compensation and pension exam
leading up to a scheduled compensation and pension exam

if you can sort of do a daily rundown of what your day looks
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
like, challenges that you're facing as a result of your

service-connected conditions. You are, without them being
service-connected conditions. You are, without them being

there, you're essentially trying to walk the examiner
there, you're essentially trying to walk the examiner

through how this impacts you on a daily basis. So obviously
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
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
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
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
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
locked up. And I noticed that my service-connected ankle was

extremely swollen. I had fluid on my knee. Something
extremely swollen. I had fluid on my knee. Something

like that. And then I went outside to get the mail and I
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
got a few steps and my sciatica started acting up from my old

back injury that I received whenever I was in the
back injury that I received whenever I was in the

Marines. So these are all little pieces that can help
Marines. So these are all little pieces that can help

paint a really good picture of how these conditions are
paint a really good picture of how these conditions are

impacting you. The goal is to make it real for the person
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
reading it. Because it is easy for an examiner to just see you

as a number or as an appointment. And to check down
as a number or as an appointment. And to check down

a few discussion drivers or items of conversation. They'll
a few discussion drivers or items of conversation. They'll

check some boxes on what your functionality is and then
check some boxes on what your functionality is and then

that's it. They're on to the next examination. The plain
that's it. They're on to the next examination. The plain

language that you use, a lay person's language that you use
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
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,
outs of clinical psychology. You don't have to know exactly,

you know, the mechanics of orthopedic injuries. No one's
you know, the mechanics of orthopedic injuries. No one's

expecting you to understand or be fluent in those
expecting you to understand or be fluent in those

things. Certainly, some of you probably are because you've
things. Certainly, some of you probably are because you've

been dealing with these things for so long. You've been in and
been dealing with these things for so long. You've been in and

out of doctor's offices. You've had multiple surgeries. Um
out of doctor's offices. You've had multiple surgeries. Um

you've probably seen multiple mental health providers that
you've probably seen multiple mental health providers that

have provided you some insight using these special words,
have provided you some insight using these special words,

these medical terms and if you're comfortable using those
these medical terms and if you're comfortable using those

words, certainly. But don't let that deter you from just saying
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
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,
dealing with because this is your chance to get all of this,

like I said, on the record, this is your chance to tell
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
your story and if you feel like an examiner is rushing you, do

everything you can to respectfully slow them down ask
everything you can to respectfully slow them down ask

them for an opportunity to be heard make sure that they know
them for an opportunity to be heard make sure that they know

that you feel the examination is not complete that the
that you feel the examination is not complete that the

discussion is not over that you have more that you want to talk
discussion is not over that you have more that you want to talk

about. Remember, this examination while it's being administered
about. Remember, this examination while it's being administered

by a medical professional is your examination. If you feel
by a medical professional is your examination. If you feel

like something isn't being explored enough 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
like you're being glossed over in the examination, you need to

say something. You need to redirect the conversation. You
say something. You need to redirect the conversation. You

need to say, you know, excuse me, sir or ma'am but I feel
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
like there are a few other things that I would like to

discuss here that are important that relate to how this
discuss here that are important that relate to how this

condition impacts my life. Take notes when you leave your exam
condition impacts my life. Take notes when you leave your exam

about your feelings, things that were discussed, things
about your feelings, things that were discussed, things

that were not discussed, and keep that. If someone provides
that were not discussed, and keep that. If someone provides

me notes that they felt like an examiner was rushing over bits
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
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
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
would like to jump on that. So, you want to make sure you're

keeping good notes on exactly what was discussed, what was
keeping good notes on exactly what was discussed, what was

not discussed, how many times you were rushed or hurried through
not discussed, how many times you were rushed or hurried through

conversations that's all useful because if they are ignoring
conversations that's all useful because if they are ignoring

your discussion items, if they're ignoring recent operations
your discussion items, if they're ignoring recent operations

that you've had, if they're ignoring some of the directives of your
that you've had, if they're ignoring some of the directives of your

mental health treatment provider and they're not
mental health treatment provider and they're not

encompassing that within the scope of this C&P examination,
encompassing that within the scope of this C&P examination,

there's an argument to be made that we have an inadequate exam
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
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
as valid. Do something fun when you're done. So, schedule some

time with your family, schedule some time with your friends,
time with your family, schedule some time with your friends,

whether it's fishing with a buddy or taking
whether it's fishing with a buddy or taking

your grandson to a racetrack or you know, if it's running racks
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
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
time to do something that's enjoyable and can get your mind

out of this cyclical type of thinking that can result from
out of this cyclical type of thinking that can result from

digging up these old bones so to speak because what we
digging up these old bones so to speak because what we

want to make sure is that the C&P examination is as accurate
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
and as thorough as possible, but we don't want you to be

impacted long term. These examinations are difficult
impacted long term. These examinations are difficult

enough. We want to make sure that you're trying to make
enough. We want to make sure that you're trying to make

plans to do something that can sort of relieve the stress and
plans to do something that can sort of relieve the stress and

allow you to get back to as much functionality as you can
allow you to get back to as much functionality as you can

because life is about enjoying.
because life is about enjoying.

Go online or give us a call. Again, my name is Zack Evans, a
Go online or give us a call. Again, my name is Zack Evans, a

VA Disability Benefits Attorney with Woods and Woods in
VA Disability Benefits Attorney with Woods and Woods in

Evansville, Indiana and we look forward to hearing from you.
Evansville, Indiana and we look forward to hearing from you.