What is a Compensation and Pension Exam and why would a veteran be scheduled for one?
Nathan Guin: A Compensation and Pension Exam is an examination that’s set up by the Department of Veterans Affairs in connection with a claim for disability benefits that’s been put in by a veteran. In order to make an initial decision, initial rating decision, a lot times what the VA will need or be lacking is a medical opinion as to whether the veteran’s claimed disability or condition is related to an event or injury that occurred at service.
The Compensation and Pension Exams help the VA get a determination medically from a medical professional regarding whatever ever issue or issues may be claimed by the veteran to help them better make a decision, whether they can grant benefits to a veteran after they put in a claim.
Cindy Speaker: Okay, and should I go to these, is it important for the veteran to attend the Compensation and Pension Exam or is that optional?
Nathan Guin: It’s very important to attend the Compensation and Pension Exams. Generally speaking if you don’t attend, whether it be for a family emergency or you try to reschedule and something falls through the cracks and there’s a clerical error that doesn’t catch the rescheduling, or you just don’t want to go, more often than not what we’ll see in the rating decision is a denial that says, “Well, we scheduled the veteran for a Compensation and Pension Exam, and they didn’t show up for the Compensation and Pension Exam. Therefore we can’t render a medical opinion, therefore we have to deny the claim.” It’s almost as if the veteran can’t make it to the C&P Exam, C&P is short for Compensation and Pension Exam, because Compensation and Pension Exam’s a mouthful.
Cindy Speaker: It is.
Nathan Guin: If they don’t show up a lot of times they’ll say, “Well, if it’s not important enough for them to show up for, then it’s not important enough or severe enough for us to grant the benefits. Now we don’t even have a medical opinion to grant the benefits with, so we have to deny it.”
Cindy Speaker: Okay. Where are the compensate, where are these exams held? Are they in, at a VA facility or are they at a private doctor’s office? Where are they held?
Nathan Guin: They can be at either. A lot of times they’ll be at VA facilities. We’re finding now, at least more recently, there’s a lot more that are scheduled at outside physicians office, private physicians who are contracted through the VA to render medical opinions through the Compensation and Pension, the exam.
A lot of times they won’t have enough doctors or enough time slots and appointment times at VA facilities, and so they’ll farm them out so to speak, or contract out with other doctors to render opinion. If you get a notice of the Compensation and Pension Exam if you’re a veteran and it’s not at VA facility, there’s no need to worry or think that anything is kind of irregular. That’s something that is becoming more and more regular, as we’ve been seeing this a lot more often.
Cindy Speaker: Okay. Okay. Nathan, what if anything should the veteran bring to the appointment?
Nathan Guin: What a veteran want to bring to an appointment a lot of times it’s bring a friend, bring a family member, someone who’s familiar with whatever condition you’re being examined for, or any of your conditions. Sometimes if you have multiple conditions claimed, you’re not a 100% sure what they’re examining you for until you get there, so anyone who’s got any knowledge of any of the conditions or illnesses or injuries that your claiming, bring them along. Sometimes the doctors will let them back, sometimes they won’t, but we find that it’s important to have an extra set of ears.
A lot of times the appointments don’t take that long, there’s a lot of information, so an extra set of ears that can catch something that the veteran might miss, it’s certainly important, and also just from an accountability standpoint it’s always nice to have somebody else in the room. Additionally if you have, if you see private doctors for the conditions claimed, and you haven’t submitted his medical records to the VA, and they’re not associated with your claims file, with the VA, the doctor won’t have access to that at the time of the exam. It’s important if you haven’t submitted those records to bring them with you and they can look at them at their discretion, or as time permits, either during the exam or after. At least they’ll have them, and not have a full picture of kind of the disability or the condition that they’re evaluating.
Cindy Speaker: Right, right. What does the veteran need to do after they’ve attended this exam, what happens next?
Nathan Guin: What’ll happen next is the C&P Examiner will render an opinion. What a veteran will need to do if they are unrepresented, if they’re not represented by an attorney, is go to a records office, request their medical records from that particular appointment, because the initial rating decision that will come after the fact that they used the Compensation and Pension Exam opinion for will cite the Compensation and Pension Exam and the reasoning given by the examiner. It’ll be important for the appeals process, for the veteran, if they’re representing themselves to know what the opinion of the examiner was, what their reasoning was, and have that information in order to respond.
If you are represented by an attorney, we like to get our clients to call us 24 to 48 hours after they’ve gone to a Compensation and Pension Exam, just to let us know so we can order the records from the VA facility. Also within 24 to 48 hours after going to a Compensation and Pension Exam, if you have any concerns as a veteran who’s attended one, if the doctor was rude, if you feel like you weren’t being listened to, if there’s any concern, question, issues that you have in any respect, document those, write them down, submit them to your attorney or to the VA directly if you’re unrepresented so that the judge or the decision maker can have that to review in conjunction with the actual exam and the opinion of the examiner itself.