Personal Finance

VA Claim Exam Explained: What it is and What Veterans Should Expect?

The VA claim exam helps decide if a veteran’s condition is service-connected and how severe it is. The exam gathers missing details so the VA can make a fair disability rating decision.

VA Claim Exam: When veterans apply for VA disability benefits, the VA might tell them to go to a special checkup called a VA claim exam, or a C&P exam. This exam is not a normal doctor visit. It follows a fixed plan because the VA uses it to learn two main things. One is if the veteran’s health problem came from their military service. The other is how serious the problem is.

The VA explains the rule very clearly and says, “we’ll ask you to have a claim exam only if we need more information to decide your claim.” This means not every veteran needs an exam. If a veteran already gave the VA enough medical papers, like test results, hospital records, or doctor notes, the VA might decide the case without doing an exam. But if the claim has many issues or if the VA still needs more proof, then the VA will set up one exam or even a few exams. The VA may also ask for a review exam later to see if the condition has changed over time.

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After the VA decides that an exam is needed, they start the scheduling process. Someone from the VA or from a partner company will contact the veteran. They might call on the phone, send an email, or mail a letter to tell the veteran when and where the exam will happen.

What the Exam is Like?

On the exam day, veterans do ot have to bring most things with them. The VA says clearly, “You don’t need to bring anything to your exam.” If a veteran has new medical files from outside the VA, they must give them to the VA before the exam. The exam provider cannot look at new records during the appointment.

It helps to wear simple, loose clothes because the examiner may check how well the veteran moves. Getting there early is a good idea, and being at the exam at least fifteen minutes before the appointment helps avoid problems.

During the exam, the examiner may do a basic physical check or ask many questions based on past medical history. They might also use a Disability Benefits Questionnaire, also called a DBQ, for the conditions the veteran listed in the claim. Even though this feels like a doctor visit, the examiner cannot give medical help. The VA explains this clearly by saying, “the provider won’t treat you for any illness or injury … or prescribe medicine.”

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After the exam ends, the examiner writes a report. They send the report to the VA, and then the VA reviews it along with the veteran’s medical records, test results, and statements. All of this information helps the VA make a final ruling on the disability claim. If the veteran wants the report later, they can ask for it by filing VA Form 20-10206 as a FOIA or Privacy Act request.

What Veterans Should Know

  • Rescheduling: If you need to change your exam date, you should give at least 48 hours’ advance notice. Rescheduling may delay your claim.
  • Travel costs: The VA reimburses travel expenses for in-person exams at its medical centres. If you’re being seen by a contractor, that contractor should cover your travel costs.
  • Missed appointments: If you miss the exam, VA may delay its decision, or worse, make a determination based only on the evidence already in your file. But if you have a “good cause,” for example being hospitalized, VA may rebook you.
  • Privacy & support: You can request a male or female examiner in certain sensitive situations (e.g., mental health or military sexual trauma). You can also bring a family member or caregiver, though they may be asked to wait outside in some cases.
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