C&P Examiner Insight
Overview
This article provides an insider's perspective on the work of VA Compensation & Pension (C&P) examiners. Understanding the examiner's process helps veterans prepare for more successful examinations.
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.
Before the Exam: Records Review
What Examiners Receive
Examiners receive requests detailing: - Specific issues to evaluate - Required Disability Benefits Questionnaires (DBQs) - Complete claim file (can range from 25 to over 40,000 pages)
Challenges Examiners Face
- Imperfect search functions within the system
- Illegible microfiche records or poor handwriting
- Missing or irrelevant VA bookmarks
- Duplicate documents requiring review to ensure nothing is missed
Key Point: Examiners must review everything in the file to ensure no relevant evidence is overlooked.
Day of the Exam
Purpose of C&P Exams
Examinations serve to: - Fill gaps in medical records - Assess a condition's current severity - Provide medical opinions on service connection
What Examiners Evaluate
The examiner will only evaluate conditions the VA specifically requested. They cannot assess additional conditions the veteran raises during the exam.
Credibility Matters
Examiners note credibility issues when: - Veteran's account contradicts observable evidence - Claims don't match medical records - Obvious inconsistencies exist
Example: Claiming never to have smoked while appearing to smell of smoke damages overall credibility, even for presumptive conditions.
After the Exam
Forming Medical Opinions
Examiners must base opinions on: - Legitimate medical research and evidence - The specific medical evidence of record - The veteran's particular medical history
Important: Examiners cannot "concoct a tale" to fit personal beliefs—opinions require solid medical rationale supported by documentation.
What Makes a Strong Opinion
- Clear explanation of reasoning
- Citation of relevant medical evidence
- Reference to medical literature when appropriate
- Logical connection between evidence and conclusion
Requests for Clarification
The VA may request clarification when: - Examiners overlooked documented evidence - Information contradicts itself within DBQs - Progression statements missing from increase examinations
Insufficient Examination
Quality issues arise when: - Not all requested DBQs are completed - Required questions remain unanswered - Medical opinions lack proper evidence support - DBQs lack signatures
Tips for Veterans
Before the Exam
- Review your medical records - Know what's documented
- Prepare your symptom history - Dates, frequency, severity
- Don't submit new records on exam day - Opinions must rely on evidence already in VA file
During the Exam
- Listen carefully - Answer only what's asked
- Be truthful - Obvious lies damage credibility
- Don't volunteer excessive information - Can inadvertently undermine claims
- Describe your worst days - Don't minimize symptoms
After the Exam
- Document any issues immediately - Examiner behavior, incomplete evaluation
- Complete satisfaction surveys - Only way to thank or report examiners
- Request exam report - Review for accuracy
How Veterans Help Examiners
Reduce duplicate evidence - Don't submit the same documents multiple times. Examiners must review everything to ensure nothing is missed, so duplicates waste valuable time.
Thanking Examiners
- Complete the satisfaction survey provided by mail
- Examiners cannot accept gifts
- Positive feedback helps good examiners
What to Know About Ratings
- Check the rating schedule before filing increases
- Maximum ratings prevent improvement regardless of exam findings
- Filing for already-maxed conditions wastes resources
Related Topics
- 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