C&P Examiner Insight
Overview
Understanding how Compensation & Pension examiners approach their work helps veterans prepare more effectively. This article offers perspective on what examiners do before, during, and after your examination.
Chief's Take: Understanding what the examiner is looking for helps you communicate effectively. They're checking boxes on a DBQ and writing an opinion. Your job is to make sure they have the information they need to check the right boxes.
The Examiner's Preparation
What Gets Sent to Examiners
Each examination request includes: - The specific conditions requiring evaluation - Which Disability Benefits Questionnaires (DBQs) to complete - Your complete claims file—which might contain anywhere from a few dozen pages to tens of thousands of documents
Challenges in Records Review
Examiners face real obstacles when reviewing your file: - System search functions don't always work well - Older records may be scanned poorly or contain illegible handwriting - VA-applied bookmarks might miss relevant evidence - Duplicate records require time to sort through
Bottom line: Examiners must examine every document to avoid overlooking critical evidence, which takes significant time.
What Happens During Your Exam
The Examination's Purpose
C&P exams exist to: - Address gaps in existing medical documentation - Measure how severe a condition is today - Provide expert medical opinions on service connection
Scope Limitations
Examiners evaluate only what the VA specifically requested. Raising additional conditions during the exam won't result in their evaluation—those require separate claims.
Why Credibility Matters
Examiners pay attention to consistency. Red flags include: - Statements that conflict with what they observe - History that doesn't align with medical records - Obvious contradictions in your account
Real example: A veteran claiming never to have smoked, while clearly smelling of cigarettes, undermines credibility across the entire evaluation—even for conditions where smoking history doesn't matter.
After the Examination
How Opinions Get Written
Medical opinions must rest on: - Established medical research and literature - The specific evidence contained in your record - Your individual medical history
Examiners cannot simply assert conclusions—every opinion requires documented rationale with supporting evidence.
Elements of a Well-Supported Opinion
Strong examiner opinions include: - Transparent reasoning process - References to specific medical evidence - Citations to relevant medical literature - Logical connections between facts and conclusions
When Examiners Get Called Back
The VA may request clarification when: - Evidence in the file appears to have been missed - Information within DBQs seems inconsistent - Progression statements are missing from rating increase exams
Signs of an Insufficient Examination
Quality concerns arise when: - Requested DBQs remain incomplete - Required questions go unanswered - Medical opinions lack evidentiary support - DBQs aren't properly signed
Veteran Preparation Guide
Before Your Appointment
- Know your records - Review what's documented in your file
- Prepare symptom details - Dates of onset, how often symptoms occur, intensity levels
- Don't bring new records to the exam - Opinions must rely on evidence already submitted
During the Examination
- Listen first - Answer exactly what's asked
- Be honest - Fabrications destroy overall credibility
- Stay focused - Rambling can inadvertently hurt your claim
- Describe worst days - Don't downplay how bad things get
After You Leave
- Document problems immediately - Note any issues with examiner conduct or incomplete testing
- Complete surveys - This is how good examiners get recognized and bad ones reported
- Request your exam report - Check it for accuracy
How to Help the Process
Avoid submitting duplicates - Sending the same records multiple times forces examiners to review each copy to ensure nothing differs. This consumes time that could go toward actual evaluation.
Showing Appreciation
- Survey responses are the primary feedback mechanism
- Examiners are prohibited from accepting gifts
- Positive survey feedback helps good examiners professionally
Understanding the Rating Schedule
- Review criteria before requesting increases - Know what higher ratings require
- Maximum ratings exist - Some conditions cap at certain percentages regardless of severity
- Don't file for maxed conditions - It wastes everyone's time and resources
Related Articles
- C&P Examination Preparation
- Dealing with a Bad Examiner
- VBA Insider Insights
Reference
M21-1, Part IV, Subpart i, Chapter 3, Section C - Insufficient Examinations