Comp & Pen Exams: What You Need to Know

Throughout the course of your initial claim or appeal, the VA may order you to go to a Compensation & Pension (Comp & Pen) exam. The VA orders these exams to obtain an opinion about the cause and severity of your condition. These exams can be conducted either at the VA or by a contract examiner (a private company like LHI, VES, or QTC), and last anywhere between 10 minutes to multiple hours.

Getting a favorable opinion from a Comp & Pen exam is the key to your case! A favorable opinion (often called a positive “nexus”) can provide you with the medical evidence you need to service connect most claims.

Unsurprisingly, the VA usually falls short in providing an adequate exam. A lot of examiners fail to review your file, spend enough time with you to properly evaluate your symptoms, or make unfair assumptions about your medical history.

Here’s some things you need to know to maximize your chances of getting a positive nexus from any examiner:

• The examiner will be observing you very closely, including your body language and tone of voice.
• Do not assume that the examiner has fully reviewed your claims file. It is your job to educate them on the cause and severity of your disabilities.
• Remember that “a closed mouth never gets fed,” or “the squeaky wheel gets the grease.” Be honest and detailed about what happened to you in service as well as your symptoms.

For mental health exams,
• When the examiner asks you “how are you doing,” that is a question about your current mental state! Do not say “fine” or “good” if that’s not the case.
• Be detailed about the in-service stressor that caused your mental health condition. Give dates, locations, people involved (if you remember the names), and the circumstances of the stressor.
• If applicable, be sure to emphasize that you were in good health prior to service, and that you’ve consistently had mental health symptoms since your in-service stressor.

For physical exams,
• Most physical exams involve the measurement of your joints’ range of motion. Make sure:
o You STOP immediately when the movement becomes painful. The point that you begin to feel pain is where the examiner should document the end of your range of motion.
• Be detailed about the specific in-service injury that caused your physical condition, or how your MOS caused your disability over time. Give dates, locations, and the circumstances of the injury.
• If applicable, be sure to emphasize that you were in good health prior to service, and that you’ve consistently had physical symptoms since your in-service injury.

After the exam, the examiner will draft a report that will be uploaded to your claims file. Be sure to get a copy of that report! Call the VA benefits hotline (800-827-1000) to request a mailed copy. Stay tuned for tips on attacking inadequate Comp & Pen exams – coming soon!

P.S. I would like to introduce my audience of Veterans to the author of the above article. Kelsey Craveiro Esq. will be one of our new contributing authors.  Ms. Craveiro is the Managing Veterans Disability Attorney at Rob Levine & Associates in Providence, New Jersey. Welcome aboard, Ms. Craveiro. 

This entry was posted in C&P exams, Duty to Assist, Nexus Information, Tips and Tricks and tagged , , , . Bookmark the permalink.

7 Responses to Comp & Pen Exams: What You Need to Know

  1. Richard Arthur Brothers says:

    Just had a C&P exam yesterday , for an increased rating for a left eye injury. The exam took place at the VA and was conducted by a doctor older than myself ( I am 65). I tried to get the doctor to review the medical records concerning this injury that are from a private doctor, he didn’t wanted to be bothered. saying he read my file He would ask me questions, but when I answered him he told me that doesn’t matter. He kept confusing my left eye injury with treatment to my right cataract removal. He kept insisting that my condition was not caused by what the records showed, he was discrediting 12 years of medical history, which consisted of VA treatment (except the last 6 months.)
    In the end he indicated and showed me that he was checking the box that indicates 7 or more incapacitating episodes in the last 12 months, which should increase my rating to 60%. But later when I tried to find a copy of the DBQ for the eyes, that was created after the latest changes to the ratings, I could only find the older DBQ… anyway… after having had many exams in the past, this is the first time an examiner didn’t want to talk about my condition, it was as if he had already decided what he was going to say before he even called me in for the exam. I left not really knowing what to think. Since the exam was done at the va I will be able to download a copy of the narrative within 3 days of the exam.

  2. Raymond Reid says:

    I have my claim at BVA and it has been there for a little over 2 years. I am treated by VA at no cost for medical problems for exposure to herbicide while in Thailand. I also have civilian doctors who treat me for the same illnesses. The only VA doctor who has seen me is my Primary Care and a foot doctor. My civilian heart doctor treats me for my heart attack, 3 stents, and 2 Aorta aneurysms. My civilian doctor treats me for stage 3 kidney disease. I see a civilian pain specialists for the neuropathy in my feet. VA treats me for diabetes type 2. My heart doctor has completed a DBQ for my Ischemic Heart condition and stated in it that my condition will not allow me to work. I am not on Social Security Disability due to retiring at age 62, before having the heart attack. All of the civilian medical reports have been sent to VA to be included in my files. VA has never sent me for any Comp hearing or test. When asked about it VA told me that if my civilian medical records are from specialists in the related field and indicate the severity of my condition then they will not usually send you for a comp hearing or test but will accept the civilian records as proof of your condition.

  3. Dee says:


    I would just add that one should consider ($10.00 word alert ahead) the ‘ameliorating’ effects of medication: NSAIDS, cortisone injections, epidurals, topical pain relieving rub, TENS units. Any of the aforementioned items can have a big impact on the demonstrated ROM, artificially producing a ‘rose colored lens’ through which the examinee’s movement will be perceived. I would advise (if possible and safe) to suspend usage of any of the above, several days in advance of the C & P. Additionally, if the vet experiences more musculo-skeletal symptomatology during a specific part of the day (morning/late afternoon), the scheduling activity is to take note, and ensure the exam occurs under circumstances that coincide with ‘flare ups’ of the condition. (which is one of the questions asked of the examiner on the DBQ).

  4. john king says:

    I had many C&P exams through the 70’s, 80’s and 90’s. The VA doc would ask me one question right away….”Are you working?” I would say “Yes” because I had to work to live. That was the basic end of the exam. Then once in the late 80’s I actually had an exam doctor that asked me about my moods. I explained my highs and lows etc. I got bumped up to 30% for bipolar 11. Then I learned from some of our good friends about getting IMO’s and IME’s and how to appeal with evidence instead of trusting DAV or VFW to just run with the few facts of a case. DAV and VFW were just useless in helping me develop my claim. did that for me. Through many exams and appeals I got up to 70% for Bipolar11 and then got TDIU P&T. I would basically not trust a VA exam doctor as far as I could throw one of them. I always want my own doctor to make a report to substantiate the level of my disability. I can prove service-connection myself. Now I deal with the Agent Orange stuff and I have a separate 90% disability on those things.
    Alex is right about getting a good exam from a VA doctor for service connection. However, I have appealed every single rating decision I ever got and I have won about 90% of them because of the shoddy work of the VA and their exams. I am not bragging, just saying it can be done if you don’t give up or believe them without verification.

    • Vicki Foley says:

      And I thought I held first prize for being a major pain in the butt to the VA since 1993. We successfully ended my husband’s disagreement with that agency last November. We are having a bit of a challenge adjusting to our new “normal” without having to keep them simmering on the mental back burner.

      We have probably spent enough in imo and DBQ fees paid to Board certified MD treating specialists to buy a good used car. The only time there was no C&P exam scheduled was after two DBQ’s were submitted and the claim was denied with no exam. The DRO upheld that decision. We filed a Board appeal, and the Board granted the claim without an exam.

      The C&P process is one that has made little to no logical sense in our personal experience. It’s lack of procedural consistency and the questionable adequacy of the credentials held by examiners contributes to the frequent waste of time and resources involved. Fortunately, I believe we are now done with it.

  5. I did 2 of them and I can’t think clearly enough to answer properly. The drugs i take for said ailments really screw up my thought process. The Dr. asked me if I could work and I said , I never really thought about when the answer should have been no. I really screwed up with that answer. I take this drug for neuropathy and my thinking is not right. I should have had someone with me @ these exams.

  6. Michael Oliver says:

    Appreciate the education. Awaiting one as we speak now in 2019.

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