C&P Exam Prep Guide

A Compensation and Pension (C&P) exam is a medical examination the VA may request after you file a disability claim. Its purpose is to help the VA gather evidence about your condition — it is not a treatment appointment. You will not receive medication, referrals, or treatment from the examiner.

The examiner’s job is to document findings and submit them to the VA. The examiner does not decide your rating. A Rating Veterans Service Representative (RVSR) reviews all evidence in your file — medical records, exam results, personal statements, buddy statements, and service records — to make the final determination.

Not all claims require a C&P exam. If the VA already has enough medical evidence in your file, they may use the Acceptable Clinical Evidence (ACE) process and complete a records review without scheduling an in-person exam.

Your exam may be conducted at a VA medical facility by a VHA provider, or at a private location by one of the VA’s contract examination companies. You cannot choose which contractor is assigned — it depends on your location and availability.

If you receive a call and are unsure whether it is legitimate, call the VA directly at 1-800-827-1000.

• You will receive a letter, call, or email with your exam date and location
• Confirm your appointment by calling the number on the letter
• Exams are typically scheduled within 50 miles of your home (100 miles for specialty exams like dental, eye, hearing, or mental health)
• You may request a male or female examiner for reproductive health, breast, rectal, mental health, or Military Sexual Trauma (MST) exams
• To reschedule, provide at least 48 hours notice. With contractors, you can only reschedule once, and the new date must be within 5 days of the original

Exams range from 15 minutes to over an hour depending on the number and complexity of conditions being evaluated. The examiner uses a standardized form called a Disability Benefits Questionnaire (DBQ) specific to each condition.

Preparing for a C&P exam means being organized and informed so you can communicate your condition completely and accurately. It does not mean rehearsing answers or planning how to present symptoms.

• Review your own medical records to refresh your memory on diagnoses, treatments, and timelines
• Look up the DBQ for your condition on the VA website so you understand what the examiner will be evaluating
• Write down your symptoms — including frequency, severity, and how they affect your daily life — so you don’t forget anything under stress
• Bring a list of all medications with dosages and side effects
• Bring any assistive devices you regularly use (braces, cane, CPAP documentation, etc.) — do not bring devices you do not normally use
• Bring copies of relevant medical records organized in a folder
• Consider bringing a support person (spouse, family member, caregiver) who can speak to how your condition affects your daily life, if the examiner allows
• Arrive 15 minutes early and bring your appointment letter and ID

The following observations come from veteran communities and veteran advocacy organizations. They reflect commonly reported experiences — not instructions on what to say or how to act. Every veteran’s situation is different.

Lay evidence — written statements from you and people who know about your condition — is part of your claim file and must be considered by the VA. These are submitted with your claim, not given to the C&P examiner during the exam.

The VA is legally required to consider lay evidence under the Veterans Claims Assistance Act of 2000.

Missing a C&P exam without good cause has serious consequences under 38 CFR 3.655:

• Original claim: Rated on existing evidence only (may result in denial due to insufficient evidence)
• Claim for increase or supplemental claim: Claim is denied
• Existing benefits (reexamination): VA must issue a notice before reducing or discontinuing payment, with a 60-day window to respond

Good cause includes hospitalization, death in the family, serious illness, or homelessness.

If you miss your exam, contact the VA at 1-800-827-1000 immediately to explain and request rescheduling.

An exam may be considered inadequate if the examiner did not review your records, did not address all claimed conditions, did not complete the DBQ fully, or provided an opinion without adequate rationale.

Steps you can take:

1. Write down everything you remember about the exam as soon as possible (date, duration, what was asked, examiner behavior)
2. Request a copy of the exam report using VA Form 20-10206 (FOIA/Privacy Act request)
3. Review the report for inaccuracies, missing information, or boilerplate language that doesn’t reflect your case
4. Report concerns by calling 1-800-827-1000 or filing a complaint with the contractor
5. File a Supplemental Claim with new evidence (such as a private medical opinion) addressing the deficiency
6. Request a Higher-Level Review — a senior reviewer can identify duty-to-assist failures and order a new exam
7. File a Board Appeal — the Board of Veterans’ Appeals can remand your case for a new examination

You do not have to accept a result you believe was based on an inadequate exam. The system has built-in mechanisms for challenging examinations that were incomplete, inaccurate, or improperly conducted.

You can have your own private healthcare provider examine you and complete a DBQ for publicly available conditions. The VA must consider this evidence but does not reimburse the cost. All clinician information sections must be completed with signatures and dates.

Some conditions have restricted DBQs (TBI, hearing loss, cold injury, former POW) that require specialized training and are not publicly available.

A nexus letter from a treating physician can help establish the connection between your condition and your service. If your claim is denied or underrated, an independent medical opinion (IMO) from a qualified expert can provide counter-evidence. Your treating doctor may be willing to write a nexus letter — try that before paying for an independent opinion.

The PACT Act of 2022 expanded VA benefits for veterans exposed to burn pits and other toxic substances, adding more than 20 presumptive conditions. For presumptive conditions, you do not need to prove that service caused the condition — you only need to meet the service requirements for the presumption.

A C&P exam may still be required to confirm the diagnosis and assess severity, but the nexus (connection to service) is presumed. This significantly simplifies the process for qualifying conditions.

More than 40 unaccredited companies market themselves as “claims consultants” or “coaches,” sometimes charging thousands of dollars for claims assistance. Some have been investigated for coaching veterans to misrepresent symptoms — putting veterans at legal risk.

• You do not need to pay anyone to file a VA claim. You can file yourself through VA.gov.
• Be skeptical of anyone who promises a specific rating or uses language like “maximize,” “dominate,” or “guaranteed.”
• VA-accredited representatives (including VSOs and attorneys) are subject to oversight and ethical standards. Unaccredited companies are not.
• You are legally responsible for the accuracy of your claim, even if someone else files on your behalf.

To report a predatory claims company: VSAFE.gov or call 1-833-38V-SAFE.

• You may bring a family member or caregiver to the exam (discuss with the examiner at the start)
• You may request a medical chaperone for sensitive physical exams
• Recording is at the examiner’s discretion — you have no legal right to record, but it is not prohibited. If asked to stop, you must comply or the exam may be terminated.
• You can request a copy of your exam report using VA Form 20-10206
• You can report concerns about the exam to the VA (1-800-827-1000) or the contractor
• The VA reimburses travel to VA medical center exams through the Beneficiary Travel program