What is a VES C&P Exam?
CCK Law: Our Vital Role in Veterans Law
After filing a claim for VA disability benefits, many veterans will be requested to attend a Compensation & Pensions, or C&P exam. These exams can be a cause of stress and confusion for many veterans. Additional stress can be caused when veterans find out that their exam may be performed by VES. To learn more about what VES is and how exams are conducted, keep reading.
What is a C&P Exam?
A Compensation and Pension, or C&P, exam is a medical exam ordered by VA to evaluate the condition(s) a veteran is claiming for disability compensation.
C&P exams are generally performed for two purposes:
- Confirm or deny service connection, and/or
- Establish the severity of a veteran’s disability.
Importantly, C&P exams are a major part of the VA disability process. In most cases, VA will require a veteran to undergo a C&P exam.
Since medical evidence is crucial to a veteran’s disability case, C&P exams are provided by VA at no cost to the veteran as part of VA’s duty to assist.
In the past, C&P exams were conducted by VA examiners. However, since 2014, this policy has been shifting and VA now outsources more than 80 percent of all C&P exams. This shift is partly a response to the backlog of C&P exams at VA, which has been worsened by the pandemic.
What is VES?
As mentioned above, most C&P exams are now conducted by VA-contracted examiners. VES, or Veterans Evaluation Services, is one of the major contractors hired by VA to perform exams for compensation and pension purposes.
Essentially, VES performs a portion of the C&P exams that VA calls for. VES is not the only contractor that does this, as VA has several contractors to help perform C&P exams.
How is VES Different From VA?
VES is an entirely separate entity from VA, meaning that it is not part of VA. VES is only contracted by VA to perform C&P exams. VES asserts that their physicians all “must pass rigorous credentialing” and “are trained on the VA Claims Process and Veteran sensitivity before being released to perform Compensation and Pension examinations.”
However, in some cases, these contracted examiners, such as VES, are not as well-versed in diagnosing or treating issues specific to veterans, such as Gulf War Illness or PTSD. Additionally, these examiners are not trained in the same manner as VA examiners, leading to issues and inconsistencies.
How are VES Exams Different from Exams Performed By VA?
VES exams hold the same weight as those performed directly by VA physicians. This means that, for the VA claims and appeals process, VA recognizes the opinion of a VES examiner as having the same validity as a VA examiner would.
This can create some issues, such as when an examiner is not qualified to evaluate their condition, the veteran may end up with an unfavorable exam that could lead to a low rating or outright denial of benefits.
What is the VES C&P Exam Process?
The VES C&P exam process is typically the same as any other C&P exam process. The exam will usually follow this process:
- The Exam is Scheduled – The first step to any C&P exam is to get it scheduled. VA will usually request this exam and contact you via telephone or mail to schedule the exam. They may inform you that the exam is going to be performed by a VA contractor, such as VES. The examiner will also review the veteran’s c-file prior to the exam occurring. This is so that the examiner is familiar with the veteran’s medical and service history prior to the exam.
- Verbal Examination – Once the exam begins, the VES examiner may ask the veteran a series of questions regarding their medical condition or disability. They might ask about the veteran’s military service, and the connection between the claimed condition and military service as well. For example, if the veteran is seeking benefits for PTSD relating to a specific incident they witnessed during their military service, the examiner may ask questions about the incident they witnessed. During the exam, the examiner cannot review new information, meaning that any evidence such as treatment notes from the veteran’s physician must be submitted to VA prior to the exam if the veteran wants the VES examiner to have access to that information.
- Disability Benefits Questionnaire (DBQ) – VA Disability Benefits Questionnaires are forms that either a veteran may have a treating doctor fill out or an examiner may use to help evaluate a veteran’s condition during an exam. This means that the VES examiner may ask the veteran specific questions from the DBQ for their claimed condition. Each DBQ is drafted to correspond to a specific condition and formatted so that the VES examiner will “check a box” next to descriptions that most accurately depict the claimed condition.
- Physical Examination – The exam may also have a physical component. For example, if the veteran is seeking benefits for a knee condition, the VES examiner may need to measure the degree of flexion of the knee, which would require a physical examination. Importantly, the VES examiner will not treat you for any condition or prescribe any form of medication.
- Examiner’s Report – Once the exam is complete, the VES examiner will write up a report, which will include a review of the exam’s findings and any relevant medical literature they may have reviewed to make these findings. If the examiner is trying to determine whether service connection is established, they will write up a medical opinion that states one of two things: (1) it is “at least as likely as not” that the disability was incurred in or aggravated by service, or (2) it is “less likely than not” that the disability was incurred in or aggravated by service.
How Do I Contact C&P Exam Contractors?
If you require customer service support regarding contracted Compensation and Pension (C&P) exams, we encourage you to reach out directly to the designated contractor customer service numbers. C&P contractors and their information are as follows:
- Loyal Source Government Services can be contacted at 833-832-7077.
- For OptumServe Health Services, please dial 866-933-8387; for TTY users, the number is 711.
- For Leidos QTC Health Services, call 800-682-9701.
- And for services related to Veterans Evaluation Services, you may call 877-637-8387 if calling domestically or +1-713-255-5656 for international calls.
How to Receive a Copy of Your VES C&P Exam Report
The VES examiner will not give you a copy of your results at the conclusion of the C&P exam. Instead, they will give the exam results to VA adjudicators who will then decide your claim based on these results and any other pertinent records as mentioned above. However, you are entitled to request a copy of your C&P exam and it is highly encouraged that you do so.
To get a copy of the final report from your exam, you can:
- Contact your local VA regional office;
- Call VA at 800-827-1000 and request an appointment to view your file; or
- Have your representative request a copy on your behalf.
What to Do if You Receive a Negative VES C&P Exam?
Sometimes, an examiner will issue a negative opinion in their exam report. This can be frustrating for veterans, as a negative opinion can severely impact their claim.
There are several ways to challenge an examiner’s negative report. A veteran may submit private treatment notes or private medical opinions.
If you need help refuting a negative exam, an accredited representative may be able to assist you. The veterans’ advocates at Chisholm Chisholm & Kilpatrick have helped veterans facing an unfavorable exam in the past and may be able to help. Call our office today for a free case evaluation.
