Compensation & Pension (C&P) Examinations Guide

For most disability claims, the VA schedules a Compensation & Pension (C&P) exam somewhere in the process. It's one of the most consequential steps in your claim, and one of the most misunderstood.

What a C&P exam actually is

A C&P exam is a medical evaluation ordered by the VA, conducted by a VA physician, nurse practitioner, or a contracted examiner (often through a company like LHI or QTC). The examiner is not your treating doctor, and they won't tell you the result of the exam or make any decision about your claim themselves. Their job is narrower: evaluate your condition and complete a Disability Benefits Questionnaire (DBQ), a standardized form that becomes key evidence in your file.

The exam serves two purposes: helping establish (or confirm) that your condition is connected to your service, and documenting how severe it currently is, which drives the rating percentage a VA rater later assigns.

What happens during the exam

The examiner reviews your service and medical records beforehand, then examines you and asks about your symptoms. For physical conditions, expect range-of-motion measurements, strength testing, and functional assessment. For mental health conditions, expect a structured interview about your symptoms and how they affect daily functioning. Exams typically run 30 to 90 minutes depending on the condition.

How to prepare

• Review the relevant DBQ ahead of time if you can, so you know exactly what the examiner is measuring or asking about (a knee DBQ measures specific range-of-motion figures; a PTSD DBQ asks about specific symptom frequency and severity).
• Describe your worst days, not your average days, and definitely not your best days. The rating system is supposed to reflect how bad your condition gets, not how you happen to feel in that one appointment. If you're having an unusually good day, say so explicitly: "today's better than usual, my typical week involves..."
• Bring a written summary of your symptoms, organized by condition, so you don't forget anything under the stress of the appointment.
• Submit any new private medical records beforehand, not during the exam itself; the examiner may look at documents you bring but generally can't add them to your file for you.
• Arrange childcare if needed. Some exams cover sensitive topics, and the VA recommends not bringing children.

What makes an exam "inadequate"

An exam can be challenged as inadequate if the examiner failed to address all of your claimed conditions, didn't review your service or medical records, didn't use proper testing (for example, no goniometer for range-of-motion measurements), or reached a conclusion that contradicts your documented history without explaining why. If you believe your exam was inadequate, you can request a new exam or raise it as part of an appeal.

After the exam

The examiner submits the completed DBQ, usually within a few days, though the overall claim decision can still take considerably longer while the VA processes everything together. You're entitled to request a copy of your completed DBQ once it's done, which is worth reviewing closely, especially if you're considering next steps.

If you disagree with the outcome

You have appeal options: a Supplemental Claim (with new evidence, such as an independent medical opinion or a buddy statement), a Higher-Level Review, or an appeal to the Board of Veterans' Appeals. A private nexus letter or independent evaluation can carry real weight here, particularly if you believe the VA's own examiner got something wrong.