How to Prepare for a C&P Exam for PTSD
PTSD is one of the most common service-related disabilities experienced by Veterans from each branch of the military. Before you receive any compensation for PTSD, or are even rated for it, you’ll likely need to undergo a PTSD Compensation & Pension (C&P) Exam. This exam will determine whether you suffer from PTSD, and if so, the severity of it.
Your PTSD C&P exam is one of the most important parts of the claims process—in fact, if you don’t show up for it, your claim could be outright denied. In this article, we’ll cover everything you should know in order to effectively prepare for your C&P exam, including the following:
Contents
What to Bring to Your PTSD C&P Exam
Before your PTSD C&P exam, you’ll want to gather some materials that will be beneficial to your claim.
1. Evidence From Private Physicians
First, if you’ve been seeing a private physician, psychiatrist, or mental health professional about your symptoms, don’t hesitate to bring any documentation or diagnoses they can provide you with. While the VA will come to their own conclusions, they are required to acknowledge medical records that demonstrate PTSD.
2. A Witness Who Can Verify the Quality of the Examination
It can be helpful to have a witness with you in the event you’re unhappy with your exam. A witness may notice things you missed, or be able to take notes on whether the examiner allowed you to fully explain yourself, or if they cut you off. The VA allows you to bring a spouse or family member with you to your C&P exam, but your examiner may not allow them in the exam room.
However, this doesn’t mean the people closest to you can’t provide useful testimony on the ways you’ve changed since your stressor. Although the VA doesn’t allow them to participate in the exam, you could strengthen your claim with their written testimony in the form of a buddy letter or lay statement.
Related read: What to Include in a VA Buddy Letter (With an Example for PTSD claims)
3. Notes About How Your Symptoms Impact Your Life
As we mentioned earlier, it’s not always easy to describe each symptom. There are symptoms that can slip your mind until they suddenly pull you back into memories of your stressor. In the time leading up to your C&P Exam, write down any symptoms you experience, as this can help you paint a picture of what you’re truly experiencing and how it’s impacting your life.
What Is the VA’s PTSD Evaluation Like?
The VA’s psychologists diagnose PTSD, as well as any other psychiatric conditions, using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The DSM-V, published by the American Psychiatric Association, is the same reference that psychiatrists across America use to evaluate their patients and make accurate diagnoses.
After traumatizing events, it’s normal for people to become withdrawn, lose their appetite, or struggle to sleep. However, when these symptoms are unshakeable and persist for months, it might be a sign of PTSD.
To meet the VA evaluation criteria for PTSD, you’ll need to have experienced the following symptoms:
1. A Stressor That Caused Your PTSD
This is what caused your PTSD symptoms. To be diagnosed with PTSD by the VA, you must have been exposed to:
Actual or threatened death
Actual or threatened injury
Actual or threatened sexual violence
This means the stressor could have been something you experienced directly, something you witnessed, like violence, or something you learned details about or were involved with in its aftermath.
2. Persistent Memories of the Stressor
When you suffer from PTSD, intrusion symptoms are one of the most uncomfortable parts of your life. This means that you frequently are sucked into the traumatic memory, have nightmares, or have physical or emotional reactions to things that remind you of the stressor.
3. Avoidance of Triggering Activities or Experiences
Veterans with PTSD commonly withdraw themselves from daily activities to avoid experiences that can trigger traumatic memories.
4. Negative Changes to Mood and Thoughts
After experiencing a traumatic event, if negative thoughts and feelings are more common, it may be a sign of PTSD. To be diagnosed with PTSD by the VA, you’ll need to experience at least two such symptoms. Some of these symptoms include:
A lack of interest in daily activities
Feelings of shame
Difficulty or inability to feel positivity
Difficulty remembering elements of the stressor
5. Changes in Arousal and Reactivity
PTSD often causes Veterans to act differently than they used to. For example, some Veterans are more irritable than they used to be, or may struggle to sleep well. To receive a PTSD diagnosis, you’ll need to experience two of the following symptoms:
You often find yourself more irritable or aggressive than you were before your stressor
You behave in ways that are more risky or destructive than you would have prior to your stressor
You feel the need to be constantly vigilant
You’re easily startled
You struggle to concentrate
You struggle to sleep
6. The Duration of Your Symptoms
As we mentioned earlier, the symptoms of PTSD last longer than a month.
7. Functional Significance
Because PTSD can make it difficult to be interested in anything, personal relationships often suffer, and Veterans may find it difficult to be engaged at work. To receive a PTSD diagnosis, your symptoms need to be causing your ongoing distress, or impairment to your social life or to your work on some level.
8. Exclusion
Finally, a PTSD diagnosis is dependent on these symptoms being caused by your PTSD—not something such as substance abuse or a pre-existing psychiatric condition.
What to Do at Your C&P Exam for PTSD
Speak Plainly and Conversationally
VA psychologists will be paying careful attention to what you say during your C&P exam. In addition to trying to determine whether you have PTSD, they’ll be trying to determine whether you’re lying or being deceptive.
There are lots of resources online telling you exactly what you should say at your C&P exam to get a rating for PTSD, but be careful with this. One thing in particular that the VA will pay attention to is the language you use to describe your symptoms. If you use a lot of buzzwords or language that’s close to how PTSD is defined and diagnosed in the DSM-V, the VA may suspect that you’re ‘malingering.’ This essentially means that you’re exaggerating your symptoms or lying in order to receive a favorable diagnosis and disability rating.
To avoid damaging your claim, speak plainly. Try to avoid using technical terms—simply tell the psychologist about your experience as though you were explaining it to a close friend or relative.
Don’t Assume Your Examiner Has Seen Your Info
VA psychologists examine Veterans for PTSD, traumatic brain injuries (TBI), depression, anxiety, and other psychological disorders every day. While they’re expected to be informed about your case and your file, the reality is that they might not have the time to review your files ahead of your C&P exam.
To ensure the psychologist has a full picture of your experience, take the time to describe your symptoms in detail. If the examiner asks you a question which could be answered by reviewing your files, don’t tell them to review your file; just give them the answer, as they might not get it any other way.
Be Clear, Consistent, and Correct Your Examiner If Needed
In an effort to weed out malingering, VA psychologists may try to trick you into having inconsistent answers. They may ask you similar questions in various different ways to draw inconsistent answers from you.
For example, say a VA psychiatrist might ask you how frequently you have difficulty sleeping due to nightmares about the stressor, and you tell them it happens three or four times a week. Then, five minutes later, they might ask you, ‘besides losing sleep three or four times a month, have you experienced any other symptoms?’
Pay careful attention to what your examiner says, and correct them if they have it wrong.
Tell The Truth, Even When It’s Uncomfortable
First, be careful with casual niceties. Understand that essentially everything you say during your PTSD C&P exam could be used to award your benefits or deny your claim. Therefore, avoid saying things like, ‘I’m doing alright.’ While this is a natural part of small talk, don’t give the VA the change to misinterpret what you mean.
Your PTSD C&P exam is a time for radical honesty. You need to be ready to talk about how your life has been impacted by your PTSD, no matter how it’s been impacted. That’s not always easy. For example, PTSD can have a significant impact on your sexual health, or lead to thoughts of suicide. While these profoundly sensitive topics are the last thing you want to talk about with someone you’ve just met, they’re vital for getting you the compensation you deserve.
How Do I Know If My C&P Exam for PTSD Went Well?
Immediately after your PTSD C&P exam, there’s no accurate way to know if it went well or not. Some Veterans leave feeling confident that they’ll receive a favorable rating, only to have their claim denied; alternatively, some Veterans feel their C&P Exam went poorly, but end up receiving a favorable rating.
After your C&P exam is done, you’ll just have to wait. However, it’s beneficial to take notes about what happened during your C&P exam as quickly as possible afterward. Things you should pay careful attention to include:
How short or long the exam was
If the examiner was engaged with you, or seemed preoccupied
If your supporting witness was given the opportunity to speak
Taking notes on your C&P exam for PTSD is vital because in the event your claim is denied, your appeal may be more successful if you can demonstrate that your initial C&P Exam wasn’t administered properly.
For example, if your C&P examiner didn’t allow you to fully explain the way your symptoms impact your life, it could have had an impact on your claim’s decision. This is another reason why it’s so beneficial to bring a witness with you, as it can be difficult to pay close attention to these things in the moment.
What Should I Do If My Claim for PTSD Is Denied After My C&P Exam?
Having your claim for PTSD denied after your C&P exam can be heartbreaking. A lot of time and energy goes into filing your claim and preparing for your C&P exam, and when it’s denied after all that, it can feel like a betrayal. However, understand that you still have options if your claim is denied, and it’s always worth it to keep fighting for the compensation you deserve.
If your claim is denied, one of your options is appealing that claim. The VA appeals process is no less complex, but with the help of a lawyer who has practiced VA benefits appeals for many years, you can navigate the process with ease.
If your claim was denied, get in touch with the Law Office of Michael D.J. Eisenberg to discuss starting the appeals process. With over 16 years of experience handling Veterans’ benefits matters, Mr. Eisenberg has the knowledge to help you craft a compelling appeal.
Related read: The VA Appeals Process Timeline and What to Expect
Note: Consultations for Veterans’ Benefits Appeals Matters are free; however, consultations for Military Records Issues and Medical/Physical Evaluation Boards are paid.
Disclaimer: The information contained in this article is for general information only, and should not be construed as legal advice, nor does this article establish a client-attorney relationship.