C&P Exam Guide: What to Expect and How to Prepare

What Is a C&P Exam?

The Compensation and Pension (C&P) exam is a medical evaluation ordered by the VA to assess your claimed conditions. It is not a treatment appointment—it is an evidence-gathering exam that helps the VA decide your claim.

The examiner's job is to:

Confirm whether you have the condition you claimed
Provide a medical opinion on whether the condition is related to your military service
Assess the current severity of the condition

The examiner's report and opinion carry significant weight in the VA's decision. This exam is often the most important part of your claim.

How Exams Are Scheduled

After you file a claim, the VA will schedule your C&P exam. Here is how it works:

You will receive a notice: The VA or a contractor (like QTC, VES, or LHI) will contact you to schedule the appointment
Location varies: Exams may be at a VA medical center, a contractor's office, or sometimes via telehealth
Multiple exams possible: If you claimed several conditions, you may have separate exams with different examiners
Do not miss it: Missing your exam without rescheduling can result in a denial based on the evidence available

If the scheduled time does not work, call to reschedule as soon as possible. The VA is generally flexible about rescheduling, but repeatedly missing exams hurts your claim.

What to Expect

The exam format depends on the condition being evaluated. Most exams last 15 minutes to an hour, though complex cases or mental health exams may take longer.

During the exam, the examiner will typically:

Review your medical history and claims file
Ask about your military service and the in-service event or onset
Ask about your current symptoms and their frequency
Ask how the condition affects your work and daily life
Perform a physical examination (for physical conditions)
Conduct a psychological evaluation (for mental health conditions)
Possibly order additional tests if needed

Be prepared to describe your worst days, not just how you feel at the moment of the exam. The examiner needs to understand the full picture.

Getting Diagnosed at the Exam

Here is something many veterans do not realize: you do not need a diagnosis before your C&P exam for most conditions. The C&P examiner is a qualified medical professional who can diagnose you during the evaluation.

Key Point

Many veterans receive their first formal diagnosis at the C&P exam. If you have symptoms but have never been officially diagnosed, the examiner can provide that diagnosis based on their examination.

Conditions commonly diagnosed at the C&P exam include:

Mental health conditions: PTSD, anxiety, depression, adjustment disorder
Musculoskeletal conditions: Back problems, knee conditions, shoulder injuries, arthritis
Tinnitus: Ringing in the ears (often based on your reported symptoms and noise exposure history)
Headaches and migraines: Based on your description of frequency and severity
Skin conditions: Eczema, psoriasis, scars
Respiratory conditions: Asthma, chronic bronchitis
Gastrointestinal conditions: GERD, IBS

This means you can file a claim based on symptoms, even without a prior diagnosis. The C&P exam is designed to evaluate and diagnose.

Conditions That Need Prior Testing

While most conditions can be diagnosed at the exam, some require specific diagnostic testing that the C&P examiner cannot perform on the spot.

Sleep Apnea

Sleep apnea cannot be diagnosed at a C&P exam. It requires a sleep study (polysomnography) that shows you stop breathing during sleep. If you suspect you have sleep apnea, get a sleep study done before or shortly after filing. Without sleep study results, the examiner cannot confirm a diagnosis.

Other conditions that may require prior testing:

Heart conditions: May need an EKG, echocardiogram, stress test, or cardiac catheterization
Hearing loss: Requires an audiogram (the VA will usually order this as part of the C&P process)
Pulmonary conditions: May need pulmonary function tests (PFTs)
Certain neurological conditions: May need MRI, nerve conduction studies, or other imaging
Diabetes: Requires blood tests showing elevated blood sugar levels

For these conditions, try to get the necessary testing done before your C&P exam so the examiner has results to work with. If you have already had this testing through the VA or a private doctor, bring copies of the results.

Mental Health Exams

Mental health C&P exams are conducted by psychologists or psychiatrists. These exams typically last 30 minutes to two hours and involve a detailed interview rather than a physical examination.

The examiner will ask about:

Your military service and any traumatic or stressful events
When your symptoms started and how they have progressed
Current symptoms (nightmares, anxiety, depression, hypervigilance)
How symptoms affect your work, relationships, and daily activities
Treatment history and medications
Substance use
Suicidal ideation (this is a standard question—be honest)

Tips for Mental Health Exams

Describe your worst days: Do not minimize or downplay your symptoms. Explain how bad it gets.
Be specific: Instead of "I have trouble sleeping," say "I wake up 3-4 times a night with nightmares about twice a week"
Cover all symptoms: Mention sleep issues, irritability, anger, avoidance, hypervigilance, concentration problems, memory issues
Explain functional impact: How has this affected your job, marriage, friendships, ability to be in public?

Physical/Musculoskeletal Exams

For physical conditions like back, knee, shoulder, or other joint problems, the examiner will conduct a physical examination including:

Range of motion testing (how far can you move the joint?)
Pain assessment (where does it hurt, when, how much?)
Strength testing
Observation of gait, posture, and movement
Functional testing (can you squat, bend, reach?)

Tips for Physical Exams

Do not push through pain: When it hurts, say so and stop. The examiner needs to see your actual limitations.
Mention flare-ups: If you have good days and bad days, explain what happens during flare-ups
Describe daily impact: Difficulty sitting, standing, walking, sleeping, working
Bring assistive devices: If you use a brace, cane, or other device, bring it and explain when you use it

How to Prepare

Preparation can significantly affect your exam outcome. Here is what to do:

Before the Exam

Review your claim: Know what conditions you claimed and what evidence you submitted
Write down key points: Dates, incidents, symptoms, and how they affect your life
Gather documentation: Bring copies of medical records, buddy statements, and any other evidence
Know your medications: Names, dosages, and what they are for
Prepare a symptom log: Recent examples of symptoms and their severity

Day of the Exam

Arrive early: Give yourself time to check in and settle
Bring your notes: It is okay to reference your notes during the exam
Bring someone with you: A spouse or buddy can wait in the lobby and help you remember what was discussed afterward
Be honest: Do not exaggerate, but do not minimize either. Describe your condition accurately.

Common Mistakes

These are the mistakes that hurt veterans' claims:

Minimizing symptoms: Saying "it is not that bad" or "I deal with it" when you are actually struggling
Putting on a brave face: You are not there to impress the examiner—you are there to be evaluated
Describing your best day: If the examiner asks how you are, they mean in general, not just today
Pushing through pain during testing: If range of motion hurts, stop and say so
Forgetting to mention symptoms: Write them down beforehand so you do not forget
Not explaining functional impact: Symptoms alone are not enough—explain how they affect your life
Being combative or defensive: The examiner is doing their job. Be cooperative and straightforward.

Remember

The C&P exam is your opportunity to show the VA how your condition affects you. Be honest, be thorough, and do not downplay your struggles. You earned these benefits through your service.

After the Exam

After the exam, the examiner will complete a Disability Benefits Questionnaire (DBQ) with their findings and medical opinion. This report is sent to the VA for review.

What happens next:

Processing time: It typically takes several weeks to months for a decision after your exam
You can request your DBQ: After the decision, you can obtain a copy of the examiner's report
Additional exams: The VA may request follow-up exams if more information is needed
Track your claim: Use VA.gov or eBenefits to monitor your claim status

How Valor Rating Can Help

Being prepared for your C&P exam can make a significant difference. Valor Rating helps you get ready:

Claim organization: Keep all your conditions, evidence, and documentation in one place
Personal statements: Prepare detailed statements about your conditions that you can reference during the exam
Buddy statements: Collect supporting statements from people who have witnessed your condition
Evidence tracking: Know exactly what evidence you have submitted and what gaps remain

The C&P exam is not something to fear—it is an opportunity. With the right preparation, you can ensure the examiner has the information needed to fairly evaluate your claim.