Free Case Review

How to Prepare, Spot Bad Exams, and Challenge Them

When you file a VA disability claim, your Compensation & Pension (C&P) exam—also called a VA claim exam—is often the single most important piece of medical evidence in your file. VA’s own VA claim exam page explains that the exam helps decide if your condition is service-connected and how severe it is, which directly affects your disability rating and monthly
compensation.

The problem? Many exams today are done by contractors like VES, QTC, or OptumServe/LHI under tight timelines and mixed quality control. If you don’t know how to prepare for your C&P exam—or how to challenge a bad one—your rating and back pay are at risk.

At Pacific Valor Law, we’re an accredited VA disability firm based in Okinawa and focused on veterans across Japan and the Pacific. Our mission is simple: give you clear, honest guidance on your VA claim, walk you through C&P exams step-by-step, and fight back when an exam is rushed, unfair, or flat-out wrong.

Get a Free C&P Exam Review
Upload your decision letter or exam report and tell us what happened.
We’ll review it and outline your best next steps.

About Us

What Is a VA C&P Exam (VA Claim Exam) ?

A VA C&P exam (or VA claim exam) is a medical evaluation ordered by VA to help decide your disability claim. It is not regular treatment. The examiner’s job is to answer specific questions for VA, such as:
  • Is your condition related to your military service?
  • How severe is the condition today?
  • How does it affect your ability to work and function day-to-day?

VA’s disability ratings guide confirms that
they base your rating on:

  • The medical and lay evidence you submit
  • The results of your VA claim exam (C&P exam), if they schedule one
  • Other information VA obtains from other sources

In other words, your exam isn’t the only evidence that matters—but it often carries a lot of weight in
the rater’s decision.

At Pacific Valor Law, we treat your C&P exam as core evidence—something to plan for, not just react to.
For many clients, we review their file, walk them through what the examiner is looking for, and help them
understand how their story fits VA’s rating criteria before they ever step into the exam room.

If you’d like an attorney to walk through
your upcoming exam with you, you can request a free C&P prep review

request a free C&P prep review

Who Actually Does VA C&P Exams Now?

Years ago, many C&P exams were done by VA clinicians inside VA medical centers. Today, a large
share are handled by contract exam companies that VA hires under nationwide contracts, including:

  • Veterans Evaluation Services (VES)
  • QTC Medical Services
  • OptumServe / LHI (Logistics Health)

That means your C&P exam notice might come from a company name you don’t recognize—not from “VA
hospital.” The exam may be scheduled at a third-party clinic, not your usual VA facility.
This setup isn’t automatically bad. But contractors are paid to move quickly and meet timelines, which
can lead to rushed or incomplete exams if no one is paying attention to quality.

Because Pacific Valor Law routinely helps veterans in Japan who deal with these contractors, we’re
familiar with the way they schedule exams, what their DBQs look like, and the most common problems in
their reports. You don’t have to guess whether what happened to you was “normal” or not—we can tell you

About Us

Why Your VA C&P Exam Matters So Much

Your VA disability rating is supposed to reflect the average impact your service-connected disabilities have on your ability to work and function. VA’s rating rules and guidance make clear that C&P exam findings are a key part of this decision.
  • Put simply:
  • If the exam understates your symptoms or functional limits, your rating will likely be too low
  • If the exam misses a key diagnosis or linkage to service, you may be denied altogether.

The good news is that both VA regulations—like 38 C.F.R. § 3.159(c)(4) (duty to assist with exams) and 38 C.F.R. § 4.2 (interpretation of examination
reports)—and case law say exams must be adequate. If they’re not, you can challenge them.

At Pacific Valor Law, one of the first things we do in a case is read the exam and rating decision
together. If your exam doesn’t match your history or symptoms—or doesn’t meet VA’s own standards—that becomes a central argument in your appeal.

If you already have an exam and decision, we can review both and tell you whether the exam itself is hurting your rating.
Start with a free C&P exam review

Benefits

Legal Standards For
Adequate Exams

VA’s Duty to Assist: When VA Must Provide an Exam

Under 38 C.F.R. § 3.159(c)(4), VA’s “duty to assist” includes providing a medical exam or opinion when it’s needed to decide your claim. Once VA decides to give you an exam, the courts have held that the exam must be adequate for rating purposes—not rushed, incomplete, or based on the wrong facts.

38 C.F.R. § 4.2: VA Must Return Inadequate Exams

38 C.F.R. § 4.2 says exam reports must contain enough detail for rating purposes. If an exam is missing key information or doesn’t describe your disability accurately, the rater must return the report as inadequate instead of guessing. This regulation is one of your strongest tools when challenging a bad C&P exam.

What the Courts Have Said About Bad VA Exams

Veterans’ cases in federal court have driven home three important points:

  • If VA chooses to give you an exam, it has to be adequate, or VA must fix it.
  • An exam must have a clear explanation (“rationale”), not just a bare conclusion.
  • A well-reasoned private medical opinion can be more persuasive than a weak VA exam.

At Pacific Valor Law, we use these rules every day in written arguments, Higher-Level Reviews, and Board
appeals. You don’t have to know the case names—that’s our job—but you should know you’re allowed to call
out a bad exam when you see it.

Why Choose Us?

Common Problems We See in VA C&P Exams

Red flags:
“I cannot say without resorting to mere speculation” with no explanation – Cut-and-paste language that could apply to any veteran – Ignoring strong medical or lay evidence that supports your claim

A good opinion doesn’t just give a yes/no answer—it explains why.

Problems:

  • Examiner clearly hasn’t reviewed your private records or key VA notes
  • Lay statements and buddy
    letters are never mentioned
  • Prior favorable medical opinions are ignored

An exam based on half the story is not a reliable basis for your rating.

Examples:
  • A general doctor giving a detailed opinion on complex mental health or neurology
  • No physical exam for a clearly physical condition
  • No real discussion of how your condition impacts work or daily function
When the exam is outside the examiner’s expertise – or doesn’t cover what VA asked for – you can challenge its weight.

Warning signs:

  • Exam lasts only a few minutes for a complex condition
  • Most of the DBQ is checkboxes with little
    narrative
  • Examiner barely looks at you or your records

There’s no official minimum exam time, but if the process clearly wasn’t thorough, that’s evidence the
exam may be inadequate.

We see these patterns again and again in C&P exams for veterans in Okinawa, mainland Japan, and across the Pacific. Part of our role at Pacific Valor Law is to spot these defects early, explain them in plain English, and then translate them into the legal language VA and the Board understand.

How to Prepare for
Your VA C&P Exam

The mechanics of filing a VA disability claim from Japan are the same as anywhere else—but the way you prepare and the strategy behind your claim matters more when you’re overseas. Here’s a step-by-step roadmap built for veterans in Japan.

Before the C&P Exam

  • 1. Know your story. Write a short summary of when your condition started, how it has progressed, and how it affects your work, sleep, relationships, and daily activities.
  • 2. Track your symptoms. Keep a simple log: how often symptoms occur, how severe they are, how long they last (for example, migraine days per month, panic attacks per week, how far you can walk or stand).
  • 3. List your meds and providers. Bring a list of your medications (names and dosages) and all treating providers (VA and private).
  • 4. Bring key records. Especially recent private records or specialist reports that might not be in your VA file yet.
  • 5. Consider a support person. If allowed, bring a spouse, family member, or friend to observe and help you remember what happened.
At Pacific Valor Law, if you’re unsure how much detail to share, what to emphasize, or how to talk about bad days without sounding like you’re exaggerating, we can do a pre-exam strategy call and help you organize your thoughts.

During the C&P Exam

  • Be honest—but don’t minimize. Don’t say “I’m fine” if you’re not. Describe your worst days, not just your good days.
  • Focus on function, not just pain. Explain what you can’t do (or can only do with difficulty): lifting, standing, sitting, concentrating, interacting with others. VA must consider you from the perspective of a person working or seeking work.
  • Answer the question, then stop. Be clear and specific, but don’t guess or speculate if you don’t know.
  • Observe the process. Quietly note start and end time, whether a physical exam was done, what body parts were examined, and whether the examiner looked at records in front of you.
The goal is not to game the system—it’s to tell the truth without minimizing what you’re going through. Having a plan going in makes that much easier.

After the C&P Exam (Critical Step)

Within 24–48 hours:
  • 1. Write everything down. - Date, time, and approximate length of the exam - Examiner’s name (or best you can get) and facility - What questions were asked - What tests were done—or not done - Any concerning statements
  • 2. Request a copy of the exam report. You can usually get it through your VA medical records (online or in person) or via the records tools on VA.gov
  • 3. Compare your notes to the report. Look for: - Missing symptoms or limitations - Misstatements about what you said or what tests were done - Claims that certain records were reviewed when they weren’t
If what’s written in the report doesn’t match what happened in the room, you have a solid basis to challenge the exam.

Want help reading your exam report? Once you’ve requested your report and compared it with your
notes, we can walk through it line-by-line with you, highlight what VA will focus on, and point out where
the exam might be vulnerable to challenge.

Start with a free C&P exam review

How to Challenge an Inadequate VA C&P Exam

Step 1

Document Exactly What Went Wrong

Use a Statement in Support of Claim (VA Form 21-4138 or its online equivalent) to:

  • Identify the exam (date, facility, examiner name if known)
  • Explain, in bullet points, what was wrong, such as: - “Exam lasted approximately 7 minutes; no physical exam of my knee was performed.”
  • Examiner did not ask about migraine frequency or missed work.
  • Examiner stated she didn’t review my private neurology records
  • Attach your post-exam notes as an exhibit.

This creates a clear record that you are challenging the adequacy of the exam.

At Pacific Valor Law, we often draft these statements for our clients or edit the drafts they’ve started,
so the issues are crystal clear to whoever picks up the file next at VA.

Step 2

Ask VA to Return the Exam or Order a New One

In your statement (or with your representative’s help), ask VA to:
  • Return the exam as “inadequate for evaluation purposes” under 38 C.F.R. § 4.2
  • Order a new exam with a different examiner

Point out specific issues:

  • Lack of rationale
  • No real physical examination
  • No review of key records
  • Wrong specialty for the condition
When we write to VA, we don’t just say “this exam is bad.” We tie specific problems to specific rules—like § 4.2 and VA’s own guidance on insufficient examinations—so the reviewer has a legal reason to send the exam back or order a new one.

Step 3

Submit Your Own Medical and Lay Evidence

You don’t have to rely only on the VA C&P exam. You can also submit:
  • DBQs completed by your own doctor or specialist
  • Nexus letters explaining how your condition is linked to service or to another service-connected disability
  • Specialist opinions for complex conditions
  • Lay statements from you, your spouse, coworkers, or supervisors describing how your condition affects work and daily life

A well-reasoned private opinion can often outweigh a weak VA exam—especially when it is detailed, cites
your records, and explains why your condition is linked to service.

For many veterans, we help coordinate independent medical opinions or DBQs from specialists who
understand both the medicine and what VA needs to see.

Step 4

Use Higher-Level Review, Supplemental Claims, or Board Appeals

If VA has already issued a decision based on a bad exam, you can still fight back by choosing the right review lane under the Appeals Modernization Act (AMA):
  • Higher-Level Review (HLR): - Ask a more senior VA adjudicator to review your case. - Argue that the prior decision relied on an inadequate exam that should have been returned under § 4.2 and the duty to assist
  • Supplemental Claim: - Submit new and relevant evidence, such as private DBQs or nexus letters, to counter the bad exam
  • Board Appeal: - Ask a Veterans Law Judge to review your case. - Present detailed legal arguments about exam adequacy, medical rationale, and conflicting opinions.
For more complex challenges, many veterans choose to work with an experienced VSO or an accredited VA disability attorney.
Talk to Us About Fixing a Bad C&P Exam
Tell us what happened at your exam and what VA decided. We’ll tell you how we’d challenge it—and you can decide whether to move forward with us.

How Pacific Valor Law Helps With VA C&P Exams

At Pacific Valor Law, we treat C&P exams as core evidence, not an afterthought. Because we operate out of Okinawa and focus on veterans across Japan and the Pacific, we understand the extra challenges of exams scheduled overseas and through contractors.
  • We can:
  • Review your C&P exam reports line by line
  • Compare what’s written to your actual records and what really happened in the room
  • Identify where the exam fails VA’s own standards or leaves out critical details
  • Draft targeted requests for clarification or new exams, citing 38 C.F.R. § 3.159(c)(4), 38 C.F.R. § 4.2 and VA’s own guidance on insufficient examinations
  • Coordinate strong private medical opinions and DBQs when needed
  • Build appeals that explain why a bad exam should carry little or no weight
Most importantly, we explain your options in plain English, so you’re never guessing what VA is doing or why.
Get a Free C&P Exam Review
Share what happened at your exam, upload your decision letter or report, and tell us what you’re trying to achieve. We’ll review everything and give you a clear plan—no pressure, no scare tactics, and no surprise fees.

VA C&P Exam
Frequently Asked Questions

Can I have someone accompany me to the C&P exam?
Yes, you can typically have a family member, friend, or representative accompany you to observe the exam and provide support.
Bring a list of your current symptoms, medications, treating physicians, and any recent medical records not already in your VA file. Also bring a notebook to document the exam process.
Yes, veterans have the right to request and receive copies of their C&P exam reports through their VA records FOIA request. This often can takes six months. An accredited VA attorney or VSO can pull your exam within VMBS saving the veteran months of time.
The examiner’s opinion is just one piece of evidence. If you disagree, you can submit additional medical evidence, request a new exam, or work with a VSO or attorney to challenge the opinion during the appeals process.
View All FAQS

VA Disability for Veterans in Japan

For veterans stationed in Okinawa, mainland Japan, or living in Japan after separation.

Va disability japan

Testimonials

We are very happy for our
client’s feedback

“I spent 14 years at 50% after retirement. James Smith identified issues in my claim and got to work. I had a step-by-step strategy, organized the evidence, coordinated supporting statements, and prepared me for the VA exams. My claim was fully developed and approved at 100% P&T—the process was efficient and transparent. Truly grateful!”

Jim Friedhoff

Okinawa, Japan

“As a surviving spouse living overseas, I found the DIC process daunting. James Smith conducted a review, established a precise checklist, assembled a complete, fully developed claim, and submitted it. Approval arrived within a week. I had complete confidence in Pacific Valor Law’s counsel throughout.”

Jim Wentling

virginia

I would like to thank the whole team that was responsible for completing a successful claim on my behalf. My family and I are forever grateful for your service on my claim. I pray that other veterans who need wise counsel and advocacy will contact you. May God bless each and everyone of you.

Thomas Sedgwick

Okinawa, Japan

Ready to Get Started?

Find out where you stand. We'll review your situation, explain your options, and tell you whether we can help—no cost, no pressure.

Get Your Free Case Review

Pacific Valor Law

Based in Okinawa, Japan — Serving U.S. veterans and military families worldwide

VA-accredited attorney | Licensed in New Jersey

Attorney Advertising. Prior results do not guarantee a similar outcome. This website is for informational purposes only and does not constitute legal advice.

Support
Facebook
Linked in
Pages

Get A Free Case Evaluation

Okinawa-based. VA-accredited. Straight answers. No obligation.