Understanding the VA Claim Exam Process
Author: SLO Veterans Services Office
7/18/2018 12:01:00 AM
After you submit your claim, an important part of the claim decision process may include a VA claim exam, also known as a compensation and pension (C&P) exam.
Understanding the VA Claim Exam Process
Once you have filed a claim with U.S. department of Veterans Affairs (VA) for compensation or pension benefits, you may be asked to attend an examination as part of the claim process. The claim exam, also known as a compensation & pension (C&P) exam, helps VA determine the level of your disability, if your disability is service connected, or if your condition should receive an increased rating due to it worsening. The exam is not a regular medical appointment because you will not be treated for your disability nor will you be prescribed any medications.
Step 1: File a claim with VA
- Submit a claim for compensation or pension benefits
- Submit supporting documents, including completed Disability Benefit Questionnaires (DBQs)
- Ensure VA has your current contact information (address, phone number & email)
Step 2: VA schedules a claim exam
Step 3:Confirm your exam
- Confirm the date, time, and location of your appointment(s) with the number provided
- Reschedule the exam(s) as soon as possible if you have an extreme scheduling conflict
Step 4: Attend exam(s)
- Exams may last up to an hour or more or be very short
- The length of your exam does not affect your claim decision
Step 5: Exam report is added to your electronic claim file
- Upon completion of your exam, the examiner reviews your medical records and makes an exam report
- The report is submitted to a VA claims processor to be added to your electronic claim file
Step 6: VA makes a decision on your claim
- VA reviews your claim application, supporting documents, and claim exam report
to make a decision on your claim
5 Tips About Your VA Claim Exam
Attend your VA claim exam or immediately reschedule if you have a scheduling conflict. Missing your exam could cause VA to delay its decision on your claim or rate your claim "as-is" (i.e. only using the information that is in your file), which could impact your benefits.
- Submit all of your medical evidence with your claim application or before your claim exam. This will help the examiner have the most complete picture of your health status. If, however, you have any medical records that you have not submitted to VA, you may bring them with you. The examiner can review them, but (s)he cannot submit any information on your behalf. All new information can be uploaded through eBenefits.va.gov, submitted to your accredited VSO representative, or mailed to VA using the appropriate address found here https://www.benefits.va.gov/compensation/mailingaddresses.asp.
- Keep in mind, the examiner may:
- ask you questions
- observe your behavior
- perform a limited physical exam
- simply review your file with you
- Make sure that both the VA regional office and the VA medical center nearest to you have your current address, phone, and email information. This will help VA more quickly communicate with you about any need for a claim exam appointment.
- REMEMBER: The examiner is only involved in performing the claim exam. They do not make the rating decision, and they do not have access to the status of your claim. Only a VA regional office can answer questions regarding your claim.
Frequently Asked Questions
When can I expect a rating decision?
Every case has different circumstances. Some applicants may file for many conditions, while others file for one. The complexity of the individual claim also affects the processing time. To find out VA's most recent average processing time, visit www.vets.gov/disability-benefits/apply-for-benefits.
Can I reschedule my VA claim exam?
Yes. Contact VA immediately at the phone number provided in your notification letter or phone call. Unless it is an emergency situation, try not to reschedule the exam the day before or on the day of the exam. Not responding to a phone or letter request for scheduling an exam or missing the exam could cause VA to delay its decision on your claim. Not showing up to your exam takes up an appointment time another Veteran could have used, and also could cause your claim to be rated "as-is" based only on the information in your application. Most facilities try to meet your requests (if possible) if you have a good reason for rescheduling your time and you give enough notice.
I missed my scheduled claim exam. What should I do?
You will need to request a new exam appointment by calling 1-800-827-1000. If you were unable to attend your exam and did not contact VA in advance, your appointment will be considered a "no-show." Your claim may be delayed or rated, "as-is." To ensure you receive notifications about any scheduled exams, please verify that your contact information is current with VA regional office and the VA medical center nearest to you.
The examiner didn't even touch me. Is that normal?
Depending on the information in your claim file, such as medical documents from current providers, and completed Disability Benefit Questionnaires (DBQs), the examiner will determine what additional questions and information are needed to confirm your health status and complete the exam. In some instances, your file may be so complete that only a few follow up questions may be needed. Know that your case is being carefully reviewed and VA’s decision will not depend on the length of your exam visit.
For Department of Veterans Affairs fact sheets about VA claim exams, click here.