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bbknor

Why No C&p Exam

Question

Applied for Gulf War Illness ad recieved no C&P exam. Can anyone make sence of this? I was told by the phone people that I didn't need one and that the raters have all the information from my records that they need and that they can make a decision from that alone. Is this a common practice or what?

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In the past VA has rated veterans claims without C & P exams. You may still get a C & P exam, some claims get all the way to rating and then the rater request an exam. You never really know with VA.

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"Applied for Gulf War Illness ad received no C&P exam."

If you feel the eventual decision and rating percentage is fair and appropriate, good.

On the other hand, if they deny, lack of a C & P exam would likely result in a remand, assuming you appeal. It might even create a possible "CUE".

It's quite possible to have sufficient evidence supporting your claim in the "C" file, making a C&P un-needed.

RO's favor C&Ps because they can take part of the responsibility/justification for a rating off the RO's back.

In theory, a C&P should examine all a veteran's conditions that have the possibility of being service connectable.

In practice, a C&P examiner will usually say that they are limited to the conditions referenced by the RO in requesting the exam.

The reasoning is obvious. But, sometimes this can also work to a veterans benefit, if the examiner "feels like it", by covering/listing conditions unmentioned

by the RO as "secondary" to the listed conditions.

An example might be hypertension. It is associated with both diabetes and IHD. A veteran may have had a C&P scheduled as a result of a denial appeal.

The examiner can easily associate hypertension with either or both conditions.

Further, an opportunity exists to present the examiner with on file medical evidence that simplifies the examiners job. When this happens, the examiner my cite such.

Usually, a VA examiner is not a board certified specialist in the area to be covered by the exam, and may be a NP or PA. They know very well that evidence and opinions

by/of a doctor that is a true specialist will normally override the examiners opinion in/on an appeal, making the examiner look a bit dumb.

In a C&P exam I had, about a year ago, the examiner tried to say that in my case, hypertension was "Essential". The medical evidence and specialists opinions, actually connected it to IHD/DMII,

and the Nehmer review process disregarded the examiners "essential" opinion. The examiner did not bother to read my medical records. The review board did. (sort of).

In the past this didn't make much difference. Today's VA seems to be watching such things a little more closely.

Edited by Chuck75

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Applied for Gulf War Illness ad recieved no C&P exam. Can anyone make sence of this? I was told by the phone people that I didn't need one and that the raters have all the information from my records that they need and that they can make a decision from that alone. Is this a common practice or what?

My claim went from development to rating in sept.2010 had c&p exam 3-3-2011 made it by to the raters 4-15-2011.still waiting.

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No C&P is usually not a good thing for a Veteran but there are a few exceptions. Opting into one of their special programs is one but I would be nervous.

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Went from 70% PSTD to 100% TDIU P & T without C & P in 2002. Got 100% Prostate Cancer (Agent Orange) without C & P 2004. So it's not always a bad thing not to have C & P.

Good Luck,

Don

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