Aggressive - Honest - Experienced - Military Veteran Attorneys
Aggressive - Honest - Experienced - Military Veteran Attorneys
Please contact us at admin@southwestlawfirm.com if you cannot find an answer to your question. **However, please understand if you are not a legal client, we cannot advise you on what to do. Please note, the below answers are not to be used as legal advice or guidance. Every case is unique, and you should discuss your case with a free VSO, Agent or Attorney before making any decision on how to proceed forward. The answers below do not constitute an attorney-client relationship. An attorney-client relationship can only be established when both parties sign a contingency agreement for representation. The information provided is a combination of public information provided by the VA and reputable sources.
Welcome to our comprehensive guide on Veteran Disability Benefits Questionnaire (DBQs) and Compensation and Pension (C&P) Exams. Whether you are a Veteran seeking VA benefits or a healthcare provider involved in the evaluation process, this page aims to provide you with a clear understanding of the difference between DBQs and C&P exams, and their significance in the VA Disability Claims, Rating Appeals and Benefits processes.
A DBQ, or Disability Benefits Questionnaire, is a form developed by the Department of Veterans Affairs (VA). It is used to gather medical information and provide a standardized evaluation of Veteran's disabilities to assess the current severity of a Veteran’s disability and can be used in appeals, to attain or increase service-connected claims. If a correlation can be drawn between a current injury or medical condition and their time served in active-duty military service, the disabled veteran may be able to file for a VA Disability Rating Increase and receive disability compensation that takes into account their spouse and dependents as well. For instance, those servicemen and women who have come into contact with toxic substances like Agent Orange or jet fuel, might need continuing medical care and are eligible to be considered for a VA Disability rating. There are companies who aim to simplify the complex process of applying for a disability rating increase from the VA by connecting Veterans with qualified medical professionals in their area who are well-versed in VA claim documents. Ensuring that the doctor, physician or psychologist administering the DBQ Accurate documentation allows Veterans to submit comprehensive, detailed evidence with their disability claims.
DBQs serve as a tool for healthcare providers to document and report the severity and impact of a veteran's disability. They provide a structured format to gather information on symptoms, diagnoses, medical history, and functional limitations. They can be used to report multiple disabilities. DBQs are often utilized to support claims for disability benefits and to establish the nexus between a veteran's condition and their military service.
DBQs are completed by licensed healthcare professionals, including physicians, psychologists, and other practitioners with expertise in the specific condition being evaluated. It is crucial to select a provider who is knowledgeable about the disability in question to ensure accurate and comprehensive documentation.
A physician uses a DBQ form to record your disability during an examination. You then use the form to support your disability claim to the VA. They also can use it to document changes in your disability if the VA requires follow-up examinations. The VA then uses the form as it determines the outcome of your claim, which may include your VA disability rating and your VA compensation amount.
The DBQ typically includes sections for the physician to discuss:
A physician can complete one of about 70 specific DBQ forms, depending on your symptoms and diagnosis. You want the exam to be as accurate and thorough as possible, representing the full extent of your disabilities to be considered.
Compensation and Pension (C&P) Exams are medical evaluations conducted by the VA to assess the current severity of a veteran's service-connected disability or to determine the presence of a new condition. The completed form and exam results will inform the VA Disability Claim process and affect your VA Disability Benefits.
C&P exams provide the VA with objective medical evidence to evaluate the degree of disability, determine eligibility for benefits, and establish appropriate VA disability ratings and benefit compensation levels for veterans. These exams play a vital role in the claims process and aid in making fair and informed decisions.
During a C&P exam, the health care providers will review the veteran's medical history, inquire about current symptoms and their impact on daily life, and may perform a physical or psychological examination if necessary. If the status of physical or mental health conditions are severe, you may be eligible for additional testing. It is essential to be honest when filing your C&P Exam form as it is protected by federal law. Be thorough in your account and provide any supporting documentation to ensure an accurate assessment.
DBQs and C&P exams provide crucial medical evidence to support VA claims. The exam's subsequent documentation by a third party medical professional helps establishes a nexus between a veteran's condition and their military service, enabling the VA to make fair determinations regarding benefits and compensation.
DBQs and C&P exams aim to ensure accuracy and consistency in evaluating disabilities. Standardized forms and protocols help healthcare providers consistently assess and report on the severity of conditions, reducing subjectivity and promoting fair evaluations. They get you in touch with third party physicians near you who specialize in helping military veterans such as yourself attain the necessary medical records through either a disability benefits questionnaire and C&P Exam to begin or appeal the claims process.
By providing complete and detailed information in DBQs and actively participating in C&P exams, veterans can maximize their chances of a successful claim. Note that clear and comprehensive documentation helps the VA understand the impact of disabilities, leading to fair and appropriate decisions.
DBQs and C&P exams are essential components of the disability claim and appeal process for veterans. These evaluations provide valuable medical evidence, test results, diagnoses, and review increasingly worse symptoms that play a crucial role in determining eligibility for benefits. By understanding the purpose and significance of DBQs and actively participating in C&P exams, veterans can enhance their chances of receiving the support they deserve. If you have questions or need assistance, it is advisable to pick up the phone and call a company like REE Medical who can help you get started.
Purpose:
Completion:
Documentation:
Role in the Claims Process:
In summary, DBQs are structured questionnaires completed by healthcare providers to document specific medical details about a veteran's disability, while C&P Exams are comprehensive medical evaluations conducted by the VA to assess the severity and impact of service-connected disabilities. Both DBQs and C&P Exams contribute to the VA's decision-making process in determining eligibility and compensation for veterans.
#1 Q: Should I file an Intent to File form when filing claims for increase/new claims?
Absolutely! Filing a 21-0966 - Intent to File (ITF) - The date VA receives your intent to file will be protected as your effective date. This process allows you more time to collect information to support your claim. It also protects the earliest possible effective date for any benefits resulting from your claim. However, the correct application form must be submitted within one year. *This means you have one year to submit your formal claim using a 20-0995, 20-0996 or 10182 form. You can only file one ITF at a time. You can file an ITF by calling the VA at 1-800-827-1000, faxing to 1-800-531-7818 or mailing your ITF form directly to DEPARTMENT OF VETERANS AFFAIRS CLAIMS INTAKE CENTER, P.O. BOX 4444, JANESVILLE, WI 53547-4444Click here for a copy: 21-0966 (va.gov)
#2 Q: What is a VA claim exam, also known as a Compensation and Pension (C&P) exam?
If you’ve filed a claim with the U.S. Department of Veterans Affairs (VA) for disability compensation or pension benefits, VA may ask you to go to an examination as part of the claim process. For disability compensation, this exam helps VA determine if your disability is service connected, and the severity of your condition if you are already service connected. In the case of pension claims, the exam documents the level of your disability. A VA claim exam is different from a regular medical appointment because the examiner won’t prescribe any medicine or treat you – for instance, you won’t receive a referral to a specialist. The examiner will only address the claimed disabilities that VA determined warrant an examination. Following your exam, your exam results will be uploaded to your VA claims file. These results will be used along with the evidence of record to make a decision on your claim.
#3 Q: Is everyone scheduled for a VA claim exam?
No, not everyone is required to attend a VA exam. After you apply for disability compensation and/or pension, you may receive a phone call or a letter from VA or a VA contract examiner to schedule you for your C&P exam. If you claimed benefits for several disabilities, you may be asked to report for one or more exams, so each disability can be assessed by an appropriate examiner. The C&P exams may be completed at a VA facility or with a VA contract examiner. Not every claim will require an exam; it depends on what medical evidence was included with the application.
#4 Q: How is the VA claim exam or C&P exam scheduled?
VA or a VA contract examiner will either mail you a letter or call you with your appointment date and time. If you are receiving treatment at a VA medical center, make sure the facility has your current address, phone number and email information. The wrong information could cause your appointment letter to be delayed and not reach you in time. You can request the specific sex of your medical provider for gynecological, breast, anal/rectal and mental health examinations during the scheduling process. Also, if your claim is related to a mental or physical health condition resulting from Military Sexual Trauma (MST), the law permits that you may choose the sex of your examiner. Please notify your scheduler if you have a preference for the sex of your examiner. Prior to your exam, contact the VA or VA contract examiner to confirm your exam date, time and location. If you don’t show up to your exam, it may delay your claim. Additionally, your claim may be decided based on the evidence of record.
#5 Q: The date and/or time of my C&P exam doesn’t work for me. Can I reschedule my exam?
If your scheduled exam date or time does not work due to some other life event, immediately call the number provided and try to reschedule. Unless it is an emergency situation, requests to reschedule should be completed at least 48 hours prior to the scheduled appointment. Not responding to a phone or letter request for scheduling an exam or missing the exam could cause VA to delay its decision on your claim.
#6 Q: How early should I arrive for my VA claim exam?
It is recommended you arrive at least 15 minutes prior to your scheduled exam time. Please note, many examiners will not perform your exam if you are late, due to scheduling restrictions.
#7 Q: What can I expect during my VA claim exam?
Unlike a typical medical exam, the VA claim exam will not give you any treatment or prescribe any medicine. The examiner may ask you questions, observe you, and/or perform a limited physical exam. The purpose of the exam is to have an examiner evaluate your condition and review claim-related medical records and your claim file (c-file/e-file). The c-file typically includes medical records from Department of Defense (DoD), DoD personnel records, treatment records from your health care providers and any other documents submitted.
#8 Q: How long will my VA claim exam take?
The length of your VA claim exam depends how much information the examiner needs to review, and the type of examination being completed. You can expect to spend anywhere from 15 minutes to over an hour. Following your exam, the examiner completes a report that includes any test results and opinions that were requested. You have the right to request and receive copies of your exam results by contacting your VA regional office.
#9 Q: Where does the VA claim exam fit within the claim process?
After you submit your claim, VA reviews it and begins to gather information pertinent to your claim. If an examination is needed, one will be requested. After your exam, results are uploaded to your c-file/e-file. Once all development for pertinent records is completed, VA then performs a final review of your claim package and makes a decision on your claim.
#10 Q: Can the VA examiner or VA contract examiner tell me the status of my claim?
No, the examiner only performs the exam and provides the results to VA; they are not part of the decision-making process and they do not make the decisions. The examiner will never know the outcome of your pending claim. Only a VA regional representative can answer questions regarding your application or claim status. To get a claim status update, contact VA at 1-800-827-1000; a representative will answer your questions. To ensure that claimants have access to responsible and qualified representation on their VA benefits claims, VA’s Office of General Counsel accredits attorneys, agents and Veterans Service Organization (VSO) representatives. For more information about VA-accredited representatives, go to Accredited Representatives Home (va.gov); to conduct a state-by-state search for an accredited representative, go to OGC - Accreditation Search (va.gov).
#11 Q: Can I bring new medical records that I did not submit with my claim to my VA claim exam?
If you have new non-VA medical records, please submit them to VA before your appointment. The examiner is not able to submit these records to VA for you. The examiner may review the records you bring, but they will not be part of your claim file if you do not submit them to VA. All new information should be uploaded online, submitted to your accredited VSO representative or mailed to VA using the appropriate address found at How to File A VA Disability Claim | Veterans Affairs or Mailing Address for Disability Compensation Claims - Compensation (va.gov).
#12 Q: Can I bring my spouse or family member to my VA claim exam?
Based on the approval of the examiner, a caregiver may be allowed to join you during the examination but may not participate in the examination process. Service animals are also permitted.
#13 Q: I missed my scheduled claim exam, what should I do?
Veterans may request that their appointment be rescheduled directly with the contract vendor identified in their appointment letter (not directly with the doctor, nor the medical facility). If you have any questions concerning your claim exam or need to cancel or reschedule your appointment(s), please contact the contract vendor that scheduled your appointment(s) directly or call the VA Hotline at 1-800-827-1000 for assistance.
#14 Q: My claim exam is scheduled far away from where I live. Does VA cover travel costs?
Veterans traveling to a claim exam in the United States are eligible for travel reimbursement to and from the examination. Veterans scheduled for a claim exam or C&P exam with a contract vendor will receive mileage reimbursement from the contract vendor. You should expect to receive reimbursement within 14 days of the completed appointment. The current mileage reimbursement rate is 41.5 cents per mile. Note: Active-duty Service members are not eligible for mileage reimbursement.
#15 Q: The examiner didn’t touch me during my VA claim exam. Is this normal?
The purpose of the VA claim exam is not to provide treatment, but to evaluate your condition. Based on the information in your claim file, such as medical documents from current providers, and completed Disability Benefit Questionnaires (DBQs), the examiner will determine what additional questions and information are needed to evaluate your condition and complete the exam. In some instances, your file may be so complete that only a few additional questions are needed. Your claim will be carefully reviewed, and VA’s decision will not depend on the length of your exam visit. The in-person part of your claim exam is only one part of what examiners do as part of their evaluation. They also spend time reviewing your claim file to ensure they are providing the most complete and accurate information possible. All of the documents you provide to support your claim play an important part in the examiner’s report. If you have a question about what is happening during your claim exam, ask the examiner about what he or she is doing. Remember, VA examiners and VA contract examiners are not involved in deciding your claim. They are not always familiar with the full claim process and cannot tell you when a decision will be made. All claims-related questions should be directed to the VA regional office nearest you.
#16 Q: I am unhappy with the treatment I received from the person doing my VA claim exam. What should I do?
If you attend your VA claim exam and have a negative experience with a VA examiner or VA contract examiner, VA encourages you to share feedback immediately. You may contact the C&P exam supervisor or VA patient advocate at the VA medical center. You may also contact the supervisor at the VA contract facility or call the number on your original appointment letter. It is helpful to write out a statement of concern that can be submitted as part of your claim file. Share concerns immediately. Do not wait until your claim decision has been made. This will help ensure any issues are handled as quickly as possible.
#17 Q: My claim was denied without a VA claim exam or C&P exam. Is this normal?
VA grants service connection when the claim file shows three things: 1. Current diagnosis of a disability 2. Record of an event that happened during military service that could have resulted in the disability 3. An opinion that the current disability is related to military service, also called a “nexus opinion.” If there is no evidence of a current diagnosis and no evidence showing an event in service, an examination may not be warranted. If there is evidence of a diagnosis and evidence of an event in service, an examination is usually requested so an examiner can provide an opinion regarding the probability that the condition is related to active-duty service. For this reason, it is important you submit all relevant military and treatment records when you initially file your claim.
#18 Q: Why is a contractor conducting my VA claim exam and not a VA examiner?
VA may use contractors to expedite the claim process. VA contractors are medical experts with experience working with Veterans. Depending on scheduling, your local VA medical center may not have timely availability to complete your VA claim exam. For this reason, VA contracts with private providers, allowing claimants to have their VA claim exams completed sooner, rather than waiting for availability at a VA medical center. VA contract examiners follow the same HIPAA policies as VA, so you are guaranteed that your privacy is protected.
#19 Q: Are there free organizations that can help me with my claim?
VA recommends you work with an accredited representative, such as a Veterans Service Officer (VSO), to help guide you through the entire claims process. VSOs do not charge for services and can help you gather evidence in support of your claim, help file your claim and address issues as you move through the claim process.
#20 Q: Do I have to attend a C&P exam if I have a DBQ?
It depends. If you are trying to secure service connection on initial claims and/or if the VA has proposed a rating reduction, you must attend any VA scheduled C&P exams. If you are requesting an increase to an existing service connection due to worsening conditions and you have current, relevant, thorough and competent medical evidence (DBQ's, IMO's, IME's) in the record, a C&P is not required, and the VA should be able to make a decision based on the evidence of record. However, there are exceptions in which trigger the VA to schedule an exam such as conflicting records, suspected fraud, incomplete records, missing information, etc. You should consult with a free VSO, Agent or Attorney if you are unsure what to do.
#21 Q: Who are VES, QTC and LHI?
All three companies are VA examiner contractors.
#22 Q: I decided not to attend a C&P exam and submitted my DBQ's, but VA contractors keep calling me for a C&P exam. Why?
The VA contractor has one mission. That is to provide an exam for Veterans at the request of the VA. These contractor companies obviously are paid per exam, so there is an incentive to get every request through the door. Once the VA provides the request, the contractor does not necessarily communicate with the VA. Each contractor has their own protocol. They should not intimidate you or use scare tactics. Let the VA know if they do.
#23 Q: Will I get denied if I do not attend a C&P exam for an increase request?
Possibly. The VA's reasons for requesting an exam may be due to many factors such as conflicting records, suspected fraud, incomplete records, missing information, etc. In some cases, the VA reviewer may schedule an exam so there is not a duty to assist error. The VA should not deny your request for increase simply because you did not attend a C&P exam. Instead, the VA should make a decision based on the evidence of record.
#24 Q: If I get denied, can you represent me?
It depends. We can certainly review your case and speak with you. However, due to our workload we cannot take every case we review.
#25 Q What does it mean to have a Permanent and Total (P&T) rating?
Permanent and Total (P&T) is simply a term that means your service-connected conditions will not improve. Having a P&T rating can also protect you from having your file randomly review and thus limit a rating reduction proposal.
#26 Q How do I secure a Permanent and Total (P&T) rating?
A Permanent and Total (P&T) classification is usually granted when a doctor provides an opinion that your service-connected conditions will not improve. This is usually done by using medical opinions by doctors.
#27 Q Is there an income limit for Permanent and Total (P&T) rating?
Unlike Total Disability Individual Unemployability (TDIU), A Permanent and Total (P&T) rating does not have an income limit.
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