When must the VA do a C and P exam?

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VA can deny you WITHOUT an exam, but other times they are required.  

Unfortunately, it does not appear the CAVC has addressed this issue, apart from frequent remands for a C and P exam.  However, Chris Attig points out this Board decision indicates its a part of the "duty to assist"

It is true that, as part of the VA‘s Duty to Assist, it may have to offer an examination to the Veteran seeking compensation or benefits.

When is the VA REQUIRED to Offer a VA Compensation Exam?

The BVA issued a recent decision in which it found that a Veteran was not entitled to a C&P exam for the portion of his claim having to deal with leukemia – because there was no evidence of a diagnosis of leukemia.

The BVA stated the criteria that it believes require the VA to offer a C&Pexam:

The BVA said: “In determining whether the duty to assist requires that aVA medical examination be provided or medical opinion obtained with respect to a Veteran’s claim for benefits, there are four factors for consideration. These four factors are:

• whether there is competent evidence of a current disability or persistent or recurrent symptoms of a disability;
• whether there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumption period;
• whether there is an indication that the disability or symptoms may be associated with the Veteran’s service or with another service-connected disability; and,
• whether there is competent medical evidence of record to make a decision on the claim. “