C&P Exams — What to Expect, How to Prepare and How to Get Your Report
A compensation and pension (C&P) exam, which VA.gov now calls a VA claim exam, is a medical exam VA asks for when it needs more medical information to decide a disability claim. It is not a treatment visit. The provider writes a report, and a VA rater decides the claim from that report and the rest of your file.
The rules below come from 38 CFR 3.326, 3.327 and 3.655 and Part 4 of the rating schedule as published on eCFR (current through October 26, 2026), and from VA's claim exam page and its public DBQ page, all read on October 28, 2026.
When VA asks for an exam
Section 3.326(a) says that when the medical evidence that comes with a claim "is not adequate for rating purposes, a Department of Veterans Affairs examination will be authorized." The same paragraph applies to original claims, supplemental claims and claims for an increase, and it says that people scheduled for an exam "are required to report for the examination."
Not every claim needs one. VA.gov says it asks for an exam "only if we need more information to decide your claim." For the legal test VA applies when you claim service connection, see when VA must give you an exam.
ACE: when VA decides from your records
If your file already holds enough medical evidence, VA.gov says it will "follow the Acceptable Clinical Evidence (ACE) process." VA reviews your medical records and asks you to submit more evidence if needed, instead of scheduling an exam.
The regulation allows this. Under 3.326(b) and (c), a hospital or examination report from any government or private institution, or a statement from a private physician, may be accepted for rating without a further exam if it is "otherwise adequate for rating purposes."
An ACE review is only as good as the records behind it. For a joint, 38 CFR 4.59 says the joints involved "should be tested for pain on both active and passive motion, in weight-bearing and nonweight-bearing," and treatment notes may not record that. If records miss something the criteria need, say so in writing and send what is missing.
How the exam is scheduled
According to VA.gov, your local VA medical center or a VA contractor mails you a letter with the date and time, and you may also get a call or an email. You cannot start scheduling yourself, so keep your address, phone number and email current with VA. Confirm the appointment using the number on the letter. When you confirm, you can ask for help with transportation or other accommodations. You can also ask for a male or female provider for a reproductive health, breast, rectal or mental health exam, or if your claim involves a condition from military sexual trauma (MST).
Some exams are telehealth exams by phone or video. For in-person exams, contractors try to schedule within 50 miles of your home, or 100 miles for a specialist; dental, eye, hearing and mental health exams need specialist providers.
The provider is either a VA provider or a VA contract provider. VA.gov names four contractors: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services and Veterans Evaluation Services. If you need to move the appointment, VA.gov asks for at least 48 hours' notice. A contractor exam can be rescheduled only once, to a date within 5 days of the original. For what happens if you do not attend, see missed C&P exams.
What happens at the exam
According to VA.gov, the provider will not treat you, refer you or prescribe anything. They may do a basic physical exam, ask questions drawn from the Disability Benefits Questionnaire (DBQ) for each condition, and order tests such as X-rays or blood work at no cost to you. They cannot tell you the results or make decisions on your claim. An exam can take as little as 15 minutes, or an hour or more.
VA.gov says you do not need to bring anything. Send new non-VA medical records to VA before the appointment, because the provider may look at records you bring but cannot submit them for you. Arrive 15 minutes early; if you are late, the exam may be canceled.
The rating schedule tells the examiner what to record. Section 4.1 says "accurate and fully descriptive medical examinations are required, with emphasis upon the limitation of activity imposed by the disabling condition." Section 4.10 asks the examiner for a "full description of the effects of disability upon the person's ordinary activity." So describe how the condition limits work and daily life, how often symptoms flare and what a bad day looks like. Be accurate, neither playing symptoms down nor adding to them. A written list of symptoms, medicines and examples helps on the day.
How exams differ by condition
Each exam follows what the rating criteria for that condition need. The schedule itself sets some of the requirements.
| Condition type | What the schedule asks for |
|---|---|
| Joints and spine | Range of motion, plus pain on active and passive motion and in weight-bearing and nonweight-bearing, compared with the opposite joint where possible (4.59). Functional loss from pain, weakness, fatigability and incoordination (4.40, 4.45) |
| Hearing | A state-licensed audiologist, a Maryland CNC speech discrimination test and puretone audiometry, done without hearing aids (4.85(a)) |
| Mental health | A diagnosis that conforms to DSM-5 and is supported by the findings (4.125(a)) |
| Other body systems | The findings the condition's criteria name, such as test results the provider orders |
If you claim several conditions, you may have several exams. VA.gov says it tries to schedule them on the same day. Make sure every claimed condition is actually examined. For how pain and flare-ups count in joint ratings, see the DeLuca factors.
Mental health exams
A mental health exam is done by a specialist provider. VA's public DBQ list includes the Mental Disorders and PTSD Review questionnaires, and it lists the Initial PTSD questionnaire among those not released for public use.
The examiner records your symptoms and how they affect work and relationships. The percentage comes from the General Rating Formula for Mental Disorders in 38 CFR 4.130, which has levels of 0, 10, 30, 50, 70 and 100 percent. The rater assigns it, not the examiner. Section 4.126(a) tells the rater to assign the evaluation "based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination." Treatment records and statements from people who see you every day therefore count alongside the exam.
Topics worth describing, if they apply: sleep and nightmares, avoiding people or places, problems at work, strain in relationships, irritability, memory and concentration, and any thoughts of self-harm. Answer that last one honestly, since it is part of the rating criteria. If you are in crisis, call the Veterans Crisis Line: dial 988, then press 1. For the formula itself, see the mental health rating formula.
Exams for an increase, and review exams
When you claim an increase, the exam is about current severity rather than service connection, and 3.326(a) applies to it in the same way. Section 4.1 says each disability must "be viewed in relation to its history." Section 4.2 makes the rater responsible for reading each report "in the light of the whole recorded history." Before the exam, send VA any recent treatment records that show the change. At the exam, give specific examples, such as how long you can sit or stand, or what you have had to stop doing.
Missing this exam has a set result. Under 3.655(b), a claim for increase is denied if you fail to report without good cause.
VA can also schedule a review exam on its own. Section 3.327(a) says reexaminations will be requested when VA needs to verify "either the continued existence or the current severity of a disability." See reexamination schedules for when they are and are not scheduled.
After the exam
The provider writes a report and sends it to VA. VA reviews all the evidence and sends you a decision letter. VA.gov says you cannot get the results at the exam or from the provider. To get a copy of the report, file VA Form 20-10206, the Freedom of Information Act or Privacy Act request, online, by mail or at a regional office.
If the report itself is wrong or incomplete, see how to check and challenge a C&P exam. For the forms examiners fill out, and for using your own doctor, see DBQs and outside medical opinions.
Note: This article references sections of the VA's M21-1 Adjudication Procedures Manual. The VA periodically reorganizes the M21-1 and section numbers may have changed since this article was written. For the most current section references, visit the VA's public M21-1 Web Automated Reference Material System (WARMS).
Frequently Asked Questions
Does everyone who files a claim need a C&P exam?
No. VA.gov says it asks for an exam only if it needs more information to decide your claim. If your file already holds enough medical evidence, VA uses the Acceptable Clinical Evidence (ACE) process and reviews your records instead (38 CFR 3.326(b) and (c) allow reports that are otherwise adequate for rating).
Does the examiner decide my rating?
No. The examiner writes a report. A VA rater assigns the rating after reading that report in light of your whole recorded history (38 CFR 4.2). For mental disorders, 38 CFR 4.126(a) says the rating rests on all the evidence, not solely on the examiner's assessment at the moment of the exam.
How do I get a copy of my C&P exam report?
VA.gov says you cannot get it at the exam or from the provider. Request it with VA Form 20-10206, the Freedom of Information Act or Privacy Act request, online, by mail to the Evidence Intake Center, or in person at a VA regional office.
Can I reschedule a C&P exam?
Yes. VA.gov asks for at least 48 hours' notice to the VA medical center or contractor, and warns that rescheduling may delay your claim. A contractor exam can be rescheduled once, to a date within 5 days of the original.
Can someone come with me?
VA.gov says you can discuss having a caregiver or family member with you, but the provider may ask them to wait outside. For sensitive physical exams you can ask for a chaperone to stay in the room.
Will VA pay for my travel to the exam?
VA.gov says yes. VA pays travel to an exam at a VA medical center, and a contractor pays travel to its own exams. Active-duty service members and people living outside the U.S. and its territories are not eligible for this travel reimbursement.