A Compensation and Pension (C&P) exam is a routine part of your application for VA disability benefits. However, C&P exams for mental health conditions have changed a little bit since the Covid-19 pandemic. Mental health conditions that often require a C&P exam include anxiety, depression, and posttraumatic stress disorder (PTSD).
The VA conducts C&P exams to confirm your diagnosis and assign your disability rating. Your disability rating then determines how much the VA pays you per month for disability compensation. The VA might also use C&P exams for other reasons – for instance, to review a veteran’s assigned rating, as discussed in a later section.
In this article, we explain the details of the C&P exam process and address common questions about the exam that are unique to mental health disorders.
In this article about C&P exams for PTSD and other mental health conditions:
- Overview of C&P Exams
- Are C&P Exams Required for All VA Disability Benefit Applications?
- The Timeline for C&P Exams
- VA Disability Ratings for Mental Health Disorders
- The C&P Exam Process for PTSD, Anxiety, and Other Mental Disorders
- C&P Exams to Increase Your Mental Health Disability Rating
- Extra Help Preparing for Your C&P Exam
Overview of C&P Exams
The scope of a C&P exam is limited to the medical condition listed on your application. However, if your application has multiple service-connected medical conditions, then the VA might conduct a C&P exam for each condition. For example, an application for anxiety and arthritis might require two separate C&P exams – one from a mental health specialist and another from a musculoskeletal specialist.
To perform the C&P exam, the VA will assign either one of its examiners or a third-party examiner, which the VA contracts. The length and nature of your exam will depend on the medical condition the VA is evaluating. You will not have to pay a co-pay or any fee for your C&P exam.
Most C&P exams involve the examiner:
- Reviewing your medical and service history based on the contents of your file
- Performing tests to diagnose your condition and determine its severity
- Gathering any other information relevant to the evaluation of your medical condition
Unlike other VA medical exams, your C&P examiner will not provide any treatments or prescribe medication. In addition, the examiner will not look at any new or unrelated medical conditions.
Are C&P Exams Required for All VA Disability Benefit Applications?
Not all medical conditions that qualify for VA disability benefits will require a C&P exam. The VA decides if a C&P exam is necessary on a case-by-case basis. Typically, C&P exams are needed in cases that lack the medical evidence required to diagnose your medical condition.
C&P exams are also common if the disability can’t be evaluated using objective testing methods. Objective testing methods include MRIs, CT scans, blood samples, and other measurables. Disabilities like mental health disorders, therefore, rely more on subjective testing (i.e., a description of feelings and symptoms by the veteran).
The Timeline for C&P Exams
If your case requires a C&P exam, the VA will notify you through a letter containing the date and time of your exam. The local VA office or examiner contracted to perform the exam might also call you to schedule your appointment. Also, note that scheduling your C&P exam could take anywhere from 3 to 4 separate phone calls.
Since the lockdown of the Covid-19 pandemic, the VA has ramped up their telehealth services. If you have your C&P exam via telehealth, the VA will work with you to make sure the technology works for you and not against you. You’ll have a phone call to take down general medical information, and then another call to confirm the appointment time. You may have an additional video call to make sure your cell phone and internet connection can handle the call. Be patient through this process. Only after all of that will you get in touch with an examiner to conduct your exam.
That said, if your address or phone number changes, be sure to notify your local VA office immediately to avoid delaying or missing your appointment.
C&P exams occur about halfway through the application process, during the information gathering stage. After your exam, the VA will review the exam findings and notify you of the results at a later date.
Here are some tips on your C&P exam from one of our VA disability lawyers.
VA Disability Ratings for Mental Health Disorders
The VA rates mental health disorders like PTSD, anxiety, and depression under the ratings schedule in Section 4.130 of Title 38 of the Code of Federal Regulations. Your assigned percentage could range from 0 to 100 percent based on your symptom frequency and the presence of more serious symptoms of PTSD (e.g., suicidal ideation or hallucinations). The more severe your condition, the greater your rating and monthly compensations.
|VA Rating||Severity of Conditions|
|0% VA Rating||The VA gives this rating if your diagnosis does not require constant medication or interfere with your work and other social activities.|
|10% VA Rating||This rating may apply if your mental disorder only decreases your work or social function during times of high stress. A 10 percent rating also applies if your mental disorder requires constant medication.|
|30% VA Rating||The VA awards a rating of 30 percent if the veteran experiences recurring periods of decreased work productivity and social activity because of depression, panic attacks, anxiety, disrupted sleep, and memory loss.|
|50% VA Rating||The VA assigns this rating if weekly panic attacks, impaired cognitive abilities, and other shifts in mood reduce the veteran’s ability to work and perform social tasks.|
|70% VA Rating||For this, the effect of the veteran’s mental disorder will be more widespread and apparent in most aspects of their life, including work, school, family, and other relationships. Typical symptoms for a 70 percent rating include suicidal ideation and obsessive compulsions that interrupt the veteran’s daily living. A veteran may qualify for this rating if they experience episodes of unexpected irritability and violence, along with a general inability to adapt to stressful situations. An inability to maintain their hygiene is also common.|
|100% VA Rating||A veteran will receive a total disability rating if their thought process and ability to communicate are significantly impaired. Qualifying symptoms include hallucinations and frequent instances of inappropriate behavior (e.g., violence). Memory loss and cognitive impairment will likely result in disorientation and difficulty remembering basic facts about themselves or others.|
For an estimate of your VA disability benefits for your mental health condition, use our VA disability calculator. Simply insert the rating percentage for each of your disabilities along with other required information, such as your marital status and the number of dependents you have. Our calculator does the VA math for you.
The C&P Exam Process for PTSD, Anxiety, and Other Mental Disorders
As mentioned above, your VA disability benefits application will likely involve a C&P exam if you are seeking benefits for service-connected mental health issues.
Who Conducts the C&P Exam for Mental Disorders?
The VA assigns a mental health specialist to perform the exam. These could be:
- A board-certified psychiatrist
- A licensed doctorate-level psychologist
- Another mental health specialist who is under the supervision of a psychiatrist or a psychologist, such as a doctorate-level mental health provider, licensed clinical social worker, nurse practitioner, or physician assistant.
Moreover, the type of medical professional assigned to perform your C&P exam will likely depend on your location and the availability of mental health examiners when you schedule your appointment.
In this video, one of our VA disability lawyers talks about the VA Rating Formula for Mental Disorders and Disabilities like PTSD.
What Happens During Mental Health C&P Exams?
A C&P exam for a mental health condition can take a couple of hours. These are usually longer than C&P exams for other conditions.
Currently, the VA conducts C&P exams both in-person and remotely, through virtual communication methods. The format of your C&P exam will likely depend on your location and the mental health examiner coordinating your exam. You may also be able to choose the format of your C&P exam when you schedule your appointment.
For an accurate evaluation, mental health C&P examiners ask a lot of personal questions. Relevant parts of these exams include the following:
Questions about Important Medical Information
Mental health disorders are often associated with other medical conditions, and their symptoms can overlap with those of other conditions. Your C&P examiner will probably ask about other medical conditions you have and any medications you take.
Other relevant medical information you will need to provide includes the frequency and severity of your psychological symptoms. The frequency of panic attacks, memory loss, mood shifts, hallucinations, and other physiological permutations of your mental disorder are all relevant and worth mentioning to your C&P examiner.
Incapacitating Episodes Have a Direct Effect on Your VA Rating
Many VA disability ratings are based on how many times a year you are rendered helpless.
A Status Update of Your Social Functions
Your C&P examiner will also be interested in any changes to your social behavior and how your symptoms affect your ability to function in social settings. The examiner will ask about your work history and whether your condition has led to an inability to work. This includes an inability to keep or find employment. If you are in school, then the examiner may be interested in any relevant changes regarding attendance or academic performance.
You may also have to answer questions about your family and other relationships. Questions about how your relationships are with your spouse, children, friends, and other relatives are common. The examiner may also want to know about your performance in family roles. This is a good opportunity to ask your family if they will write a lay statement. You can also ask them to call us for help writing a lay statement.
The C&P examiner will also wonder about your self-care (e.g., your exercise, diet, and hygiene). The examiner may have an interest in your participation in any hobbies and other activities outside of work or school.
Other Relevant Histories
The C&P examiner may ask about your legal history, including arrests and other interactions you have had with the law.
Any history of violence or suicide attempts could also be a topic of discussion. The examiner will likely inquire about your use of substances (i.e., drugs and alcohol) as well. Be honest with the examiner. Drug abuse will not disqualify you from receiving VA disability.
A Mental Examination
Your examiner will also study your mental status. During the VA C&P exam, how you talk, your thought process, appearance, and other relevant behaviors will be examined and documented.
You may not realize this mental assessment is happening as the examiner will make observations based on how you respond to their questions. Note that all interactions with your examiner could become a part of the C&P exam report.
The examiner could ask about your habits, compulsive behaviors (if any), sleep patterns, and any other information indicative of mental disorders. If you completed a disability benefits questionnaire (DBQ) before the exam, the examiner could review it with you to expand on the information you provided.
Be Prepared to Discuss Difficult Subjects
As mentioned earlier, C&P exams for mental health conditions can be more difficult than C&P exams for other conditions. This is because they require discussing personal information and reliving traumatic experiences.
For most veterans, their PTSD and anxiety are a result of difficult traumatic events from their service. The VA will usually allow you to bring a family member, caretaker, or another individual to the exam for support. Service animals can also accompany you to the exam. Simply inform the office coordinating your C&P exam if you plan to bring someone or a support animal.
C&P Exams to Increase Your Mental Health Disability Rating
The VA may require a C&P exam if you want to increase the rating previously assigned to your mental health disorder. The VA will increase your disability rating when your condition has worsened.
A C&P exam to increase your rating differs from a C&P exam that initially established your disability rating. Instead of looking for symptoms related to your mental health disorder, the examiner and VA office will look for evidence that your disability has worsened since your initial application for benefits.
For example, the VA would likely not increase the rating of your PTSD from 50 to 70 percent without proof of a worsened condition. This might include the presence of new symptoms, such as unprovoked irritability, violence, or compulsive rituals.
If you can’t work because of your PTSD but you don’t have a high enough rating, give us a call. Most veterans don’t just have one disability, but it does happen. We can look over your medical records and see if you might be eligible for TDIU.
The VA doesn’t usually give 100% TDIU for just a single disability. They typically add up disabilities and veterans meet the criteria like this:
Extra Help Preparing for Your C&P Exam
A C&P exam can be a stressful event for veterans, especially those dealing with difficult mental health conditions like anxiety, PTSD, and depression. The C&P examiner may ask questions that can be confusing and make you nervous about saying the wrong thing.
The important thing to remember is that the goal of the C&P exam is to make an appropriate diagnosis so the VA can assign a disability rating to your condition. The best approach for the exam is to be prepared to discuss personal details of your life and be genuine about your health and symptoms.
At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid pandemic to serve disabled veterans better in difficult times.
Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.
Talk to Us About Your Claim: (866) 232-5777
Yes. Unlike an amputation or other condition that can be clearly seen on a medical exam, the VA always requires C&P exams for mental health issues. The good news is that you’ll likely only have one and that it will probably be via a phone or video call.
There are two main areas of questions, your past and your present. The examiner will want to know what happened to you and what experiences you had in the service. The more detail you have and witness accounts you have for this the better. You’ll also have to talk about how your present life is affected by your condition. How often do you have to stay home, experience highs and lows, etc. We’ve helped thousands of veterans with this, so feel free to call us first to talk about your claim.