I encouraged you to keep the exam in perspective. What is that Perspective?
Honestly, it comes down to recognizing that the purpose of the C&P Exam is NOT to convince the doctor that your injury is service connected, but to let him or her conduct their exam and draw their conclusion. In the end, your current disability either is or is not related to military service. Regardless what the doctor says, what the VA Rater says, the limitations or symptoms either are, or are not, related to your time in service.
A doctor’s opinion can’t change what is or is not. It’s just another piece in the puzzle of proof. And the C&P Exam is just another piece in that puzzle. It is not the only piece – but if we view it as such, we often make our claims harder than they have to be. And we certainly make them more stressful.
#1 Every C&P Exam has 2 Goals.
The first goal is to have the doctor confirm that your injury, disability, or limitations are related to your military service – to prove the Nexus Pillar – and/or to establish the degree you are disabled – the Impairment Pillar. The second goal is to draw out the “evidentiary gap” in your claim through a C&P exam. The evidentiary gap is the difference between what is IN the record, and how the VA SEES what is in the record. If you are denied service connection, it is almost always because of an evidentiary gap – and rather than throwing a haystack at the RO and then yelling at the VA for not finding the needle – let the Examiner tell you what is missing by reading his/her opinion.
They tell you what is missing by what they focus hardest on. The key is NOT to provide excessive amounts of information in your C&P exam – keep your answers short, and “make” the doctor get into your file to review the evidence. It is THEIR report which shows the evidentiary gap – not your statements in the C&P. Which brings us to the next tip….
#2: Answer only the questions the doctor asks.
If the doc asks “How are you doing”, and you throw the entire history of your claim at her over the next 15 minutes, what happens? She zones out. She doesn’t hear what you are saying, and may find it hard to care about what you are saying. I get emails every day – some are 8-9 pages of micro-detailed histories of a VA Claim. It’s hard to read them. It’s hard to understand them. It’s hard to pick up the phone and call that person because I know I’m going to get more facts that I don’t need. Listen, I’m really good at doing this work, and while there are some real shit-bird doctors out there, there are some really good ones. They know how to call out the information they need, to get the facts to understand the situation. So just answer the question you are asked – not the question that you want to answer. But when you do answer the question, follow Tip #3
#3: Keep it Simple and Basic.
Limit what you say to symptoms and limitations or nexus to brief statement. If you can’t answer the question “Why is your injury related to military service” in under 20 seconds, you are talking too much. Here’s a great example of how you might respond to a VA C&P Examiner’s question about nexus: “You should defer to my Claims File as that has my complete position on why my injury is related to my service….but, very generally….. Because of the in service injury to my right knee, I began to overcompensate and now my left knee needs replacement.” or “I was raped in basic training, and during the rape, my attacker broke my jaw. I now cannot eat or swallow properly.” or “I was diagnosed with prostate cancer while in service.” The more you talk, the more ways an examiner has to deny your claim without ever looking at the file. The less you talk – the more direct and to the point you are – the more they have to read the file.
#4: Be Polite and Courteous – and Know What the Examiner has to Deal With.
I’ve said it before – there are some real shit-bird docs in the VA system. Even if you are a VA C&P Examiner reading this, I think you would agree with me that you can think of a colleagues that is not doing what he or she is required to do. There’s the examiner that comes into the room – grumbly and angry – and tells you that you have five minutes to tell your story. There’s the examiner that will hear something different than what you said – and twist your words to fit his/her medical theory. And there are the examiners that just plain don’t get it – they may not have the medical training needed to draw the conclusion that they are being asked to draw.
All of these examiners have something in common – they are working in an overburdened system that overloads them with information and gives them a minute amount of time to sort through that information. Your C&P Examiner has a short time to talk to you. He or she will have 15-20 (or more) exams to do in a day. Each of those exams will be for a Veteran with at least 750+ pages of records to comb through. Sometimes they will have to draw conclusions about complex conditions that they are not trained to handle. And a good bit of the time, they will make mistakes. They will get it wrong.
It’s not the end of the world if they do. But what is important – in the grand scheme of fixing this system – is that we treat every C&P Examiner with a modicum of courtesy and respect. Say hello. Smile. Be pleasant and courteous. Know that even if this doctor concludes that there is no nexus between your military service and your condition, it will not be the end of the world. There are ways to “correct” a bad C&P Exam. And there are other types of opinions that you can use – like the Disability Benefits Questionnaire (DBQ).
Get their name, and talk to them about their background – and after the exam, write down thorough notes about what happened – good and bad – in the exam. What did they test? What did they measure? What body parts did the doctor look at – and not look at.
If you are going to legally attack a bad C&P Exam, you will need this information to challenge the methodology, measurements, and conclusions.
And you won’t be able to do this if you start the exam on a bad note.
So – above all – be courteous, civil and concise.