Benefits Administration (VBA) is providing information about utilizing
alternatives to in-person Compensation and Pension (C&P) examinations
during the COVID-19 pandemic to support social distancing and the safety
and health of Veterans and clinicians. VBA will continue to complete as many
examinations as possible using virtual means that do not involve a
face-to-face examination. This message is intended to advise you about the
change and provide guidance and resources.
What are C&P Examinations?
- C&P examinations are
forensic examinations used to gather evidence used by VBA claims
processors in making decisions on Veterans’ claims for disability
compensation and pension benefits. C&P exams are scheduled when
the evidence already in the Veteran’s record does not contain all the
information needed to make a decision on the claim.
- Disability Benefits
Questionnaires, or DBQs, are standardized forms used by clinicians
when performing C&P exams. The purpose of a DBQ is to ensure the
clinician performing the exam captures and records all the information
needed by VBA claims processors to make a decision.
- For many years, both
Veterans Health Administration (VHA) clinicians and VBA contract
vendors have conducted C&P examinations using DBQs. In FY19, VBA
completed about 65 percent of the more than 1.6 million examination
requests generated by regional office claims processors.
What are options for conducting C&P Examinations?
- The C&P exam process
most familiar to most people is the in-person appointment where the
Veteran physically reports to the medical provider’s office. For some
disabilities, in-person examinations are required and cannot be
completed through an alternate method.
- C&P examinations can
also be completed using a process called Acceptable Clinical Evidence
(ACE) examinations. ACE examinations can occur after a medical
provider reviews the evidence of record and determines that the
evidence is sufficient to complete a DBQ without an in-person
examination. Sometimes, the examiner may need to call the Veteran and
ask for clarification or ask the Veteran to answer some questions.
Frequently, the ACE examination can be completed without telephone
interaction with the Veteran.
- A third way of completing
C&P examinations is through video or tele-C&P examinations.
Tele-C&P examinations are suitable for the completion of some DBQ
types, most commonly for mental health conditions. Tele-C&P
examinations enable the Veteran to remain in his or her home and
teleconference with the medical provider so the provider can see and
speak to the Veteran.
Why has VA decided to suspend the in-person examination
COVID-19 pandemic, VA recognizes the value of social distancing and the
need to reduce the amount of face-to-face contact. On April 2, 2020, the
VHA temporarily discontinued performing C&P exams in order to
prioritize resources for essential and critically needed health care
services in this emergency. This directive also eliminate in-person
examinations except in urgent care situations and reduces the number of
people entering VHA facilities in order to protect employees and patients.
VHA will conduct some C&P examinations through tele-exams and ACE where
possible. Out of an abundance of caution for Veterans and medical
providers, VBA is similarly suspending in-person C&P examinations until
further notice and will continue to conduct C&P exams through ACE and
Tele-C&P, when possible.
What can I do to assist with my claim?
Make sure your
current private medical records are part of your VA claims file. The
Department of Veterans Affairs encourages all Veterans to submit their
private medical records for consideration during the processing of their
benefits claim. VA values evidence from your private treatment providers
because they are familiar with your medical history, often over a long
period of time. VA appreciates the trusted and special relationship between
private treatment providers and their Veteran/patients.
methods that private medical records can be submitted are as follows:
- Veteran/Private treatment
provider can send medical records directly to the Department of
Veterans Affairs, Claims Intake Center, P.O. Box 4444, Janesville,
WI., 53547-4444 or submit to VA
- VA will request your
private medical records for you if you submit signed a VA Form
21-4142 and VA Form 21-4142a. You must complete and submit
both of these documents.
- Private treatment records
can be uploaded as part of an on-line submission of a claim at https://www.va.gov/disability/how-to-file-claim/.
- We encourage all Veterans
to work with an accredited representative for assistance in completing
claims for VA benefits. The accredited representative can help guide
the Veteran in submitting applicable medical records for consideration
on his or her claim.
- A list of accredited
organizations can be found on the Office of General Counsel site at
this link: Search
the VA Office of the General Counsel’s list.
Questions on Claims?
You can start
and continue to file claims with no delay.
start or continue a claim
individuals who need more assistance, VBA offers robust resources through
the National Call Center (NCC) at 1-800-827-1000.
to file a claim
- Faxing or mailing a
completed VA Form
- Calling the NCC at
1-800-827-1000 or Veterans Service Center,
- Starting a claim
- Asking a Veterans Service
Organization (VSO) to complete one on a claimant’s behalf.
to file a claim will preserve a potential effective date and allow the
Veteran up to one year to submit a completed claim form. Veterans can also
work with a local VSO to submit claims electronically or by mail.
nation thanks you for your service.
-Veterans Benefits Administration