1. Compensation and Pension (C&P) Exams: Background
- What is a C&P exam?
- When does VA typically order a medical exam?
- What if you’re denied and VA didn’t order a C&P exam?
- Do you have to go to a C&P exam for every condition you claim?
2. What is a DBQ? Are there any tips for making DBQs more effective?
3. What are Independent Medical Opinions (IMOs)?
DO’S AND DON’TS OF C&P EXAMS
4. Tips for before the exam
- What to do if you have to miss a VA exam
- What you should know before you go
- Getting transportation to a C&P exam
- Viewer Question: What if my doctor won’t fill out the DBQ?
5. Tips for during the exam
- How should veterans communicate with the examiner?
- What it means and how to respond if an examiner says you are malingering
Viewer Question: How does VA notify you of a C&P exam?
Viewer Question: Should I bring buddy statements to a C&P exams
7. Tips for after the exam
- How to request a copy of your exam
8. How to fight an unfavorable VA exam
- Can you get a VA examiner’s credentials?
- Does the examiner have to explain how and why they came to their conclusion?
9. Getting a second opinion
More Viewer Questions
Jonathan: Welcome. My name is Jonathan Green. I’m with the law firm of Chisholm Chisholm & Kilpatrick. With me today is Christian McTarnaghan and Courtney Ross. We’re going to be talking about C&P exams. So Courtney, what is a C&P exam? What does the C and what does the P stand for?
Courtney: So, C&P exam it stands for Compensation and Pension examination. It’s a medical exam that’s completed for the disabilities that you have pending or that you claim. So, typically when you file a claim for service connection or an increased rating for certain disability as part of, VA’s duty to assist the order and examination to assess the severity or etiology of the disability that you’re claiming.
Jonathan: And who is typically conducting the exam?
Courtney: Usually it’s a VA medical professional or a third party medical professional that VA has contracted. So, it’s not always a doctor, it can be a nurse practitioner or a physician’s assistant as well.
Jonathan: Okay. So, Christian, Courtney mentioned the duty to assist. When does VA typically order a medical exam?
Christian: Well, they’ll order a medical examination if someone has applied for service connection and they don’t have all of the necessary elements to meet what you need to show for the claim. Courtney mentioned etiology, that means what caused your disability. So, if there’s a question as to what caused your disability after you file the claim, VA will get a medical professional’s opinion on whether it was caused by your in-service accident, your in-service trauma, or something to that affect. Also, when you have claimed that your disability has worsened. So, those types of examinations aren’t concerned about what caused your disability, they’re concerned about how severe it is at that point in time.
Jonathan: And what if your file and you’re denied and VA didn’t order a C&P exam? Is that legal?
Christian: It depends. So, in my practice, I practice at the court level and what that means is I’m appealing final board decisions to the Court of Appeals for Veterans Claims. So, typically if we have a case where there’s no medical evidence in the file and they’ve completely denied it, the board tries to do the best that they can but there’s usually some sort of legal error in there. VA really should be most of the time, in my opinion probably all of the time, getting an opinion to find out what caused your disability.
Jonathan: In compliance with what we —
Christian: In compliance with the duty to assist. They have to help you. Their duty is to assist the veteran, to help the veteran, get everything they need in order to substantiate or prove their claim.
Jonathan: And so veterans oftentimes will have– you can see this in the decision that they filed for several different types of disabilities or several different increased ratings. Does that mean that you have to go to a C&P, a Compensation and Pension exam for every single claim?
Courtney: Yes, typically you’ll have to have a different examination for each different condition that you have pending. So, you might have a service connection for an orthopedic condition, let’s say a back condition and then a separate increased rating claim pending for PTSD which you might already have service-connected for. You’d have to go to at least two different examinations, one for your back and one for your PTSD.
Jonathan: Okay. So, we’re talking about the type of C&P exam where the claim is filed, they order a C&P exam and the veteran goes and attends an examination and somebody’s looking at them. Let’s talk about some other types of VA examinations. So, we’ve heard and you can see it in the file the acronym DBQ. Christian, what does DBQ stand for?
Christian: It’s a Disability Benefits Questionnaire. So, a C&P examination is a type of examination but a lot of times it’s a medical health professional filling out a DBQ. A DBQ is a series of questions that are prompting the medical professional to answer in a lot of different checkboxes. “Can the veteran move their knee to 130 degrees, 120 degrees? How severe is the veteran’s disability? Mild, moderate, severe”, things like that. That’s what a Disability Benefits Questionnaire looks like.
Jonathan: And there are somewhat controversial because it is a little bit check off off the box, attempt to answer certain questions of what is oftentimes a very complicated, substantive medical issue. So, are there any tips for making them more effective?
Courtney: Making the DBQs more effective?
Courtney: I mean, as the veteran if you go to a VA examination and examiner just completes the DBQ without providing any additional analysis, you yourself can argue that that exam is inadequate due to the lack of analysis that’s provided in there and the examiner is just essentially checking off the boxes that are completed in the form. You could also, as an alternative, the DBQ forms for each condition are actually available on VA’s website, so if your doctor, your personal training doctor is willing to fill one out that’s going to be supportive for the conditions you have pending, you can use it to your advantage in that way and have your treating doctor fill out the form and submit it to VA.
Christian: And also, there are a lot of checkboxes but there is also supposed to be a narrative portion of these exams. And what I mean by that is they’re supposed to basically dictate what you’re telling them. So, “I can’t walk up the stairs. I have a lot of trouble sitting or standing. I have a difficulty working because of my knee condition”, things to that effect. That might not be easily reflected in the boxes that the examiner can choose from, but they’re supposed to type that out and have it as the precursor to the examination which is largely checkbox. So with you, I think we’re going to talk about this a little bit more in depth later, but that’s something that you can do as a veteran in an examination to try to get as much medical information about your symptoms and severity in front of the board or the regional office.
Jonathan: Okay, and this is a good time to pause and remind everyone that this is a Facebook live with Chisholm Chisholm & Kilpatrick. We’re talking about compensation and pension examinations and please visit our website at cck-law.com. You can find all sorts of good stuff there including material on what we’re discussing today. Let’s talk about IMOs. You hear about Independent Medical Opinions, when are those ordered?
Courtney: Yes. So, in certain cases your appeal might get all the way up to the board of appeal, a board of–
Jonathan: The Board of Veteran Appeals?
Courtney: The board of veteran appeals, yes. Excuse me, sorry.
Christian: We just call it the board.
Courtney: Yeah, the board. So, the board’s going to be reviewing your file in its entirety and they might decide that even previous VA exams that you’ve had are inadequate or don’t answer all of their questions, or based on what’s in the file it leaves them with additional medical questions. So, the board can request what is known as an IMO or an Independent Medical Opinion from a doctor of the specialty that’s relevant to the pending appeals. When they’re requested, it’s not usually an exam the veterans will have to attend. It’s typically going to be a record review based on what’s in the record and the examiner will ask or answer questions that’s been proposed by the board. Usually, once the IMO is completed, the veteran and/or the representative should be notified, and you’ll have 60 days to respond to that IMO.
Jonathan: Okay. So that’s an important time period to keep in mind, this 60-day period to respond with your own evidence or argument either explaining why the IMO is insufficient or explaining why it actually does support your claim. So, we’re going to talk about a few do’s and don’ts, some tips when an exam is requested by VA. So, let’s go to before the exam. What are some important tips, do’s and don’ts, before an exam?
Christian: Yeah sure. So, I think before the exam, I think it’s a good idea for veterans to sort of take stock of what and how, what types, how their disability affects them in everyday life, how it affects their work. Because that’s sort of what the examiners are going to be focusing on. They’re going to be focusing on your physical limitations if it says an orthopedic disability and how those may affect your ability to do occupational tasks. And if it’s a psychological examination, they’ll be asking a very similar question. How did this affect your everyday life? How does this affect your ability to be productive in the workplace? So, take stock of how you actually feel and try to do your best to explain to the examiner how this disability is affecting you day to day and your ability to do certain things.
Courtney: And I think too, I’ll just add. I think, having an understanding of the type of exam you’re going to. So, if the exam is for a condition where you have an increased rating claim pending on appeal, the examiners are really going to be focused on the severity of that specific condition. If it’s an exam for a condition where a service connection is pending, they’re getting focused on the severity but also more focused on the etiology, your service history, the event that you’re claiming is the cause of the condition pending. So, understanding what the exam is for too I think will help you be better prepared.
Christian: That’s a really good point. So, once service connection has been established, the examiner is not going to be really interested in what happened to you in service. It’s not that they don’t believe you or that they don’t think that that’s important or anything like that, it’s just because it’s a different type of examination. So, don’t be put off if the examiner seems to be disinterested by what happened to you in service, it doesn’t undermine that it did or how severe that was, but it’s just really not the focus of what they’re trying to show about your disability.
Jonathan: And I think that we see that as advocates in hearings where the hearing will be about getting the veteran entitled to an increased rating and the client does want to talk about what happened to them in service. And as Christian said it’s not that that’s not important but it just isn’t relevant to the issue of the severity of the condition to determine the appropriate rating. And on the other side, if it’s about establishing service connection, it is important, the impact and severity of the condition but first, we need to establish what caused the condition and if it is somehow related to service to establish that link. So, make sure that you do know what the exam is for. We have a question from the audience from JJ, asking, “What if the doctor won’t fill out a DBQ?”. You have any thoughts or tips on what to do in that situation?
Christian: So, I’m assuming this is their treating physician in some way. See what they would be willing to provide. An opinion or some sort of explanation of exactly those elements that we’re talking about. How severe your disability is, how it affects your everyday life, how it potentially affects your occupational functioning. Those are really the broad-strokes answers that’s not articulately put, but that’s what the DBQs are trying to get at, right? So, maybe your treating physician doesn’t feel comfortable filling out the actual form, providing some information that will help the board and the VA and the rating officers officials understand how severe the disability is. I think that would be a good way to maybe change tact, to try to get some helpful information from your provider.
Jonathan: And just in case the question was by a medical professional contracted by the VA or a VA employee who’s not filling out the DBQ, that’s not our concern. That’s not the concern of the client because that is actually ordered by VA. So, if that’s the case, deal with the evidence as it comes, you’re probably better off frankly, but if it is as Christian said, if it’s us trying to obtain DBQ information from private treating physician then there are ways to go around it and to see what they will provide in order to get at the substance of what the DBQ is trying to say.
Courtney: And in those cases you might actually be better served if a doctor is willing and they don’t want to fill a form but maybe they want to provide or can provide a letter outlining the relevant information, you’re likely to get more thorough analysis in that kind of format than just the checkboxes of the DBQ form.
Christian: And if you go to an ordered examination, the doctor really should be conducting the examination. So, maybe that would be like the last possible way to interpret it, that’s something you need to contact VA about immediately. If the examiner that you’ve been told to go to is refusing to conduct the exam a letter, a phone call, some way to let VA know about that.
Jonathan: Okay. We talked about before the examination and just the importance of knowing the purpose of the examination. Let’s talk about during the exam. So, VA has ordered the examination, the day of the exam, what’s the most important thing to do?
Courtney: Show up to your VA examination is the first and most important thing. VA places a lot of weight on the VA examinations when the adjudicators are making their decision to grant or deny you an increased rating or service connection. They’re going to be looking to these VA examinations, and if you miss the VA exam and don’t provide or reschedule it, you’re going to get a denial from VA.
Jonathan: What if you have a valid reason for not being able to make it to the examination?
Christian: That would be different but you really need to tell VA about it preferably before you don’t show up, but if for some reason you can’t make it there you just need to let VA now because as Courtney said, if it’s an initial examination and you don’t show cause that would be the good reason why you couldn’t make it, it will be an explicit denial. If it’s an increased rating, then you really lose the benefit of the fact that you’ve told VA that your condition is worsening and they’ll just rely on the medical evidence as is. Some of that evidence might not be up-to-date to rate your condition but that’s the way that the law has come down and that’s the way that the law is applied, so it will just be based on how maybe it was severe even six or seven years ago, if you don’t go to that increased evaluation examination.
Jonathan: Let’s talk about, so let’s assume that the veteran has made it to the exam, what are some tips about how they should be communicating their symptoms or their condition or what happened to them in service?
Courtney: Yeah, so I think one of the most important things is to be consistent and don’t downplay the severity of your symptoms. So, if it’s a service connection claim, again you’re at the exam for a condition where service connection is pending, you want to keep in mind that in theory the VA examiner should have reviewed your entire file or will be reviewing your entire file. So, try to be as consistent as possible with what you’ve recorded in the past in terms of what happened to you in service and how it led to your current condition because the examiner will compare what you’ve said previously to what you say during the exam. And also, don’t downplay the severity of your symptoms. It’s really important that you are being as honest as possible about how the symptoms impact you on a daily basis because the examiner is really making note of everything from the second that you walk in the door to the exam. So, if you have really bad days where you have flare-ups of your symptoms, be honest about that, be honest about how common you have bad days, give some context to the examiner of what a bad day means for you because they’re recording everything.
Christian: Yeah, it’s not for treatment. So, your relationship with your treating provider is going to be very different than how the examination is conducted. And an example that I like to use in all seriousness if you walk into a psychological Compensation and Pension examination and the examiner says, “How are you doing?”, if you’re not doing well you say, “I’m not doing well.” To say, “Oh, I’m doing good”, that seems you’re just being polite. The first thing in the narrative section that I was talking about before of the examination is going to say, “Veteran is doing well. Veteran is doing good”, and that might not be the case. If it is, that’s great, be honest like Courtney was saying, but if it isn’t, just be careful with how you’re talking to the examiners because they’re going to be noting everything.
Courtney: Yeah, and you can consider making a list of your symptoms before you think you’re going to have a difficult time remembering them in the exam. Bring them with you. If you have a spouse or a friend that you’re close to and knows the severity of your symptoms, you can consider bringing them with you to the exam. They may be able to help you fill in some gaps if you forget some of your symptoms.
Jonathan: Yeah. So, honesty, making sure that people are not downplaying their symptoms. I think a lot of the of our disabled veteran population does try to be stoic and strong and doesn’t feel as comfortable expressing the impact that their condition has on their day to day activities. But let’s talk about something called malingering. What is malingering and what does it mean? What’s our advice to clients regarding malingering?
Courtney: So, malingering means it’s an exaggeration of your symptoms. So, sometimes the examiners will note in their opinion after the exam if they believe the veteran has malingering or has been exaggerating their symptoms. If that’s noted on your exam, some things that you can consider are submitting a statement from you or affidavits from people close to you who are very familiar with your symptoms in support of the level of severity that you reported during the examination to show you are not exaggerating your symptoms and that what you reported was an accurate depiction of your condition. You could also consider again having your doctor provide a letter or some kind of statement in support of the severity of your condition as well.
Jonathan: So, be honest, don’t exaggerate but also don’t downplay. Let’s take a pause for a second and take a question from the audience. We have a question from Dick, “How does VA notify you of a C&P exam?”.
Courtney: Yes. So, you should receive a letter from your regional office notifying you that they’ve scheduled you for the exam, where it’ll take place and the time and date of it.
Jonathan: So, you have to be provided with written notification and what if you are unable to make it to the exam by your own method of transportation?
Courtney: So, you can reach out to your regional office and let them know that you’re unable to make it to the exam. If it’s possible that you can reschedule it, you can ask them to reschedule it to a different time when you might be able to make it there. If there’s financial concern with being able to make it there, there’s ways that you can apply to get reimbursement for the cost of getting to the exam.
Christian: And if for some reason VA doesn’t have your correct address and you’ve moved and you notified VA of that and they send the notification to the wrong address and you don’t show, that relates back to showing good cause as to why you didn’t go to the examination.
Jonathan: So again, I’m Jonathan Green with Christian McTarnaghan and Courtney Ross, we’re all attorneys with the law firm Chisholm Chisholm & Kilpatrick. Please check out our website www.cck-law.com to read about C&P exams that we’re discussing today and a lot of other good materials. So, we do have another question from JJ, “Should I bring buddy statements to a C&P exam?”. Anyone want to take that?
Christian: I don’t see why not. I think it would probably also be a good idea. It’s always a good idea to submit that to VA separate from your examination just to make sure that they have it. I’m trying to remember but I think in some instances maybe in the narrative portion of the exam, I have seen examiner’s say, “The veteran brought a statement from so-and-so, saying this”, and hopefully you also submit it because that way when the rater is looking at they’ll say, “Oh, a statement from Mr. Smith”. They’ll actually, maybe the examiner will explain some of what the statement says, but then they’ll have the whole statement also in a separate part of the record that they can review in its entirety as well.
Jonathan: So, it’s a good question and it also brings up another point I wanted to make about – remember that you might be observed outside of the actual examination room. We’ve all probably seen files where the C&P exam has something written like, “Observed the veteran getting out of their car without assistive devices and then walked up the ramp”. Things like that are tough and it’s difficult to give advice on that but it goes back to being honest with your symptoms, makes sure that if you regularly use an assistive device, for example, that you bring it to the exam and that you use it to the exam. Again, there’s no reason for you to be toughing it out just so you can reach the waiting-room area and things like that. Make sure that you’re actually accurately demonstrating the severity of your symptoms. So, let’s talk about after the examination. So, you’ve attended, successfully attended, the exam was conducted, now what happens?
Courtney: So, what you want to do after you complete the exam is request a copy of the exam. As I said before VA places a lot of weight on these VA examinations when they’re just making a decision to deny or grant your claim. So, you want to request a copy from VA and you can just send a letter to your regional office requesting a copy and they should send you one. And then review the exam to make sure that you think that it adequately represents what you reported to the examiner, and if you don’t think it does, assess how you want to respond to it or if you have a representative how they can respond to it. And there’s a number of ways that you can do that depending on the inadequacy you see with the examination.
Jonathan: For advocates out there with access to the Veteran’s Benefits Management System, VBMS, it’s always a good idea to give yourself a reminder a couple weeks after the exam was conducted, to check VBMS and see if you can pull a copy of that C&P exam. It saves everyone a lot of time. So, what if the exam is unfavorable?
Christian: I think it sort of goes right from what Courtney was saying, explain why. Maybe there were inconsistencies or things wrong with the examination. I remember a case where my client essentially wrote my brief for me because she had the examination, she made, and of course, you don’t have to do this but this is just like an example of how you could do it perfectly. In one column she had the statement in the examination, and another column she cited to all the evidence and an explanation as to why that was inaccurate, and that’s what I wrote about. So, just try to flag the issues with the examination. And I think immediacy isn’t really– I think it’s held in higher regard when you do it quickly and it’s something that references the examination and explains why it’s wrong, not just, “My symptoms are more severe than that”. You can, of course, if that’s how you feel and that’s all you want to write, that’s, by all means, appropriate especially and when it’s true. But some sort of explanation as far as much as you possibly can, why you don’t agree with the conclusions or some of the things that were said, are very helpful for raters and for advocates if an advocate is involved, and just for your claim in general.
Courtney: And I think some common inadequacies that we see is obviously a lack of rationale supporting the conclusion. In some cases the VA examiner hasn’t actually reviewed the file in its entirety, in other cases, they’ve ignored favorable medical evidence that is appropriate and close in time to the examination. So, those are all things that you can look for when you’re reviewing the exam or also if you just think that the examiner isn’t representing the symptoms that you reported to them during the time. As an advocate, if you are representing a client and you get an unfavorable VA exam, you can consider getting your own private medical opinion done with the veteran to counter that VA exam and have that private expert specifically address the VA exam as well.
Jonathan: So, you mentioned getting your own exam to kind of counter, tip the scales in your favor. Another thing that advocates can do is sort of attack, it’s a little bit of an aggressive term but attack the credentials of the examiner. So, the veterans oftentimes are examined by people, it’s not like they’re provided with a resume from the examiner. Usually, the examiner probably is just introducing themselves by name, they don’t know if they’re a doctor, they don’t know if they’re a nurse practitioner or what their qualifications are. Are there rules about requesting a copy of their credentials?
Christian: Well, what I do and an easy way to do it is on a basic level, you can look it up online. I’ve never been particularly expressly involved in a case where we’ve requested it, so maybe Courtney can speak better to that as she practices the agency level.
Courtney: Yeah, so I think ways we’ve requested it in the past is under FOIA, which is the Freedom of Information Act, requesting the experts CV and any other documents that would outline the qualifications that they have in their background and education and knowledge and expertise to be able to opine on those specific issues. And you can also consider, so there’s a presumption that the VA examiner who’s completing the exam has the background knowledge and expertise to opine on that issue, but in some cases you’ll see that you can make an argument just based on the fact that they’re orthopedic doctor opining on a psychiatric issue. Sometimes there’s such a clear inconsistency with the condition that’s being examined and the type of doctor who’s doing the exam that you can make an argument based on that, even if you don’t have their CV or other qualifications.
Christian: I actually had a case where the examiner was like, “I don’t understand why I am doing this. I am a foot doctor, this is an exposure case”, but they did it anyway because they were asked to and that’s their job.
Jonathan: It’s good that they wrote that because that helps out the advocate.
Christian: Absolutely. That examination was inadequate and they had to get a new one, but I thought that was interesting.
Courtney: So, just one more point too, because there is a presumption that the examiner is competent to be of pining on the issue. As the veteran or the advocate, if you don’t think that that expert had the expertise, you want to make sure you raise that because VA is not otherwise going to address that issue or make that decision on their own.
Christian: And you can be stuck if your case ever gets to court because there’s some case law that says, “If you have that problem with a competency you really should be raising it below”, in fact, the Supreme Court has said that.
Jonathan: And if they are the wrong type of specialist you had mentioned get an exam preferably from somebody with that specialty to write an opinion. Another avenue is we can submit interrogatories and asking the medical expert to provide information about their expertise and then also about maybe the content of that exam specifically.
Christian: Yeah, absolutely.
Jonathan: So, we had talked about DBQs and Christian mentioned that they do have to provide some sort of narrative. Does the examiner have to explain how and why they came to their conclusion?
Christian: They do and that’s something that they frequently don’t do. I think you had noted or alluded to that before that, that’s one of the things that you can advocate for yourself and say, “There’s no explanation and this is why, if there had been an explanation, the negative examination would have come out differently”.
Courtney: So, in the same vain, if you go out and get your own medical opinion from your treating doctor or if you have a representative who gets an outside private medical opinion, you want to make sure that the opinion you are getting includes a thorough analysis and explains the how and the why and the connection that they’re making.
Christian: Absolutely. I’ve seen countless number of board decisions that have said, “Okay, there’s this treatment doctor who’s provided an opinion that says it did a current service, and has been a problem since service”, but they don’t explain why and they afford it no probative value, which basically means it doesn’t matter.
Jonathan: So, if you’re getting your own opinion make sure that it’s supported by adequate rationale for how they reach that, that it doesn’t just jump from facts to conclusion.
Christian: Yep, absolutely.
Jonathan: So, we’re talking about getting a second opinion. Who should be providing that or who are some people you can go to get that second opinion?
Courtney: So, your treating doctor obviously is a good first place to start if they’re willing to provide positive opinions. If not, like I said there you can consider getting an outside private medical opinion from someone who doesn’t treat you but is willing to review your file and its entirety and talk to you about your condition, so that they have a foundation of their knowledge to provide the positive opinion.
Jonathan: And something that we often do and that Courtney has been involved in specifically is going outside and getting private medical or vocational expert opinions to opine on the different issues at stake. So, if we don’t have any further questions that’s– Oh, I just heard that we do have a question from the audience. We’ll take a second just to remind everyone that this is Chisholm Chisholm & Kilpatrick with Christian McTarnaghan, Courtney Ross and myself Jonathan Green. We’re all attorneys with the firm and we’re talking about Compensation and Pension examinations. So, we do have a question from Kevin. Kevin says, “My C&P examiner stated my condition was hereditary, but I have no family history and symptoms didn’t start until years into service. How can I respond?”
Courtney: So, I would say you one, can consider submitting an affidavit stating that you have no family history of the condition that the examiner has said is hereditary. You can also, depending on what rationale the examiner provided in support of that or how they would know that the condition is hereditary or your family history if they didn’t get into any of that, you can attack for lack of a better word the exam based on that and that examiner’s conclusion.
Christian: Yeah. I would start by saying that. Exactly what you just said and then preferably have some information as to why medically it might not be hereditary in your case. There are some examples of cases that I’ve had where although this isn’t going to be completely, the board or the raters aren’t going to rely on this completely, but there are some articles online that people submit, and the board or the rater is supposed to consider everything in your file. So, if this article or this medical opinion that you submit undermines the VA examiner’s conclusion, the board will have to look to that and if they don’t do so sufficiently or the rater doesn’t do so sufficiently that’s the basis to get the case back to the RO, back to the board because that’s an error.
Jonathan: And you just said something Christian, that’s important to going back to that question I believe from JJ about bringing buddy statements. If that isn’t in the file and you feel it’s important, go ahead – whether it’s buddy statements or something else, bring it to the examination and hand it to the examiner because they should be considering it. It’s also good to not just leave those copies there and then that be the end of it because chances are it’s not going to actually make it into your claims file. Submit those separately to the VA regional office. But it is still it’s not a bad idea if it’s that important, it’s not already in the file to bring it, to hand it over to the examiner. So, we do have another question from our audience from Janet, “Do I need to be in the VA Medical system or is the C&P exam simply triggered by a compensation claim?”.
Christian: That’s our heating system if anyone’s hearing that noise.
Courtney: It’s an old building.
Christian: We so apologize for that.
Courtney: No, you do not need to be in the VA Medical system if you file a claim for a compensation that should trigger the VA’s duty to assist to order the C&P examination.
Jonathan: So if you treat exclusively with private medical providers and you file a claim for disability, you can still have a C&P exam. In fact, they should order a C&P examination that will typically be conducted by a VA medical professional. And I believe that we have another question from our audience. It’s great to get so many questions. Obviously, people deal with this and it does provide some confusion. And I can imagine that because of the importance that VA puts on these examinations, it can be very stressful. So, Antonio asks, “What if I have gone to an outside VA doctor to do my service connection disabilities and did not use the choice program? Will they still look into my exams from these conditions and do I bring all documents to the exam?”. So that’s a little bit involved there, you guys want to give him some advice.
Courtney: Yeah, if the examinations that you have done were for service-connected disabilities, if I’m following the question correctly, or for conditions that you have pending on appeal, you should be able to submit it to VA in support of your current appeals that you have pending if it’s for the conditions that are relevant.
Jonathan: And again, if I’m following the question, it kind of goes back, if something isn’t in the file and you feel it’s important for the medical professional that’s doing the C&P exam to see it, absolutely bring it with you. If that’s all the questions we have, I think we can close up. Again, this is Jonathan Green with Christian McTarnaghan and Courtney Ross. We’re all attorneys with the law firm Chisholm Chisholm & Kilpatrick. Check us out at www.cck-law.com and thanks for tuning in.