VA Plans to Outsources C&P Exams, How Will That Impact You

Several months ago, the Veterans Administration (VA) announced that it is planning to outsource all of its compensation and pension exams, commonly referred to as C&P exams. As you know, these exams are used to determine whether a veteran is eligible to receive VA benefits. Read on for more information about the decision and what this means for you.

Why Is the VA Outsourcing C&P Exams?

Outsourcing C&P exams to civilian health care providers isn’t exactly a new development. In recent years, as the VA has attempted to get through the backlog of veterans needing services from the agency, more and more of the responsibility for performing these exams was shifted to the civilian healthcare sector. As of 2016, civilian health care providers performed about 60 percent of these exams, at a price tag of $6.8 billion in exam contracts. Before the 2020 pandemic shut down in-person exams for a time, the VA was only conducting about 25 percent of the exams onsite, while outsourcing the remaining three-quarters of these exams. By November 2020, with a backlog of about 350,000 exams when the administration announced its plan to completely outsource this vital veterans’ service, the amount of C&P exams that the VA was conducting on its own was about 15 percent.

While the VA initially announced that it would eventually be outsourcing all of these exams, federal lawmakers who expressed concern about the announced plan encouraged the administration to continue offering the exams in-house for certain groups of veterans already in the VA’s care, including those suffering from Gulf War Illness, military sexual trauma, and traumatic brain injuries, as those issues are unique to veterans and often require specialists to treat.

FIVE TIPS FOR PREPARING FOR YOUR VA C&P EXAM

The Benefits of Outsourcing C&P Exams

As noted in the announcement, the decision to increase the amount of C&P exams that are outsourced to private providers was the result of a growing backlog in exam appointments that skyrocketed due to shutdowns related to the pandemic. Some of the benefits that veterans were already receiving through outsourced C&P exams before the shutdowns, and even more so now include:

• The ability to be seen in a more timely manner due to increased capacity for these exams provided by additional facilities and physicians being authorized to perform them.
• The flexibility of private contractors to be able to work directly with the veteran to schedule a time for the appointment that works better for their schedule. The decision also helps veterans who live in rural areas far from the nearest VA Medical Center to more easily obtain a C&P exam.
• A reduction in the caseload for VA specialists who provide many other services for veterans besides the C&P exams.

Common PTSD C&P Exam Questions?

• Frequency and Intensity of Symptoms: How often do you experience anxiety, flashbacks, or intrusive thoughts related to your PTSD? How severe are these symptoms?
• Impact on Daily Life: How do your PTSD symptoms affect your daily activities, work performance, and social interactions?
• Treatment History: What treatments or therapies have you undergone for PTSD? Have you been on medication, and if so, how effective has it been?
• Functional Limitations: How has PTSD impaired your ability to perform daily tasks or maintain relationships?
• Trauma History: Can you describe the traumatic events that led to your PTSD and how they continue to affect you?
• Coping Mechanisms: What coping strategies or support systems have you used to manage your PTSD symptoms?

The Potential Drawbacks of the Decision

In spite of being touted as a way to examine veterans and determine their eligibility for medical benefits in a more timely manner, lawmakers immediately expressed concern with the VA’s plan to completely outsource this service. Some of the concerns include:

• The ability of the VA to ensure the quality of the services provided by these private C&P contractors to veterans who are relying on accurate results of the exam to assist in the determination of benefits. A number of the contractors who have been providing these services in recent years have been the subject of complaints and investigations into allegations that they were making veterans wait an abnormally long amount of time for an appointment for their C&P exam and were making significant errors on the exam reports.
• The cost to the administration of contracting these services while continuing to keep physicians on staff who are also capable of delivering this service.
• Benefits decisions that are based on the observations of private contractors who are not specifically trained to recognize or treat the unique issues facing veterans. It is believed that these inexperienced decisions will lead to a larger number of veterans appealing their benefit decisions.
• Privacy concerns with the medical records of veterans being handled by the private sector, who has experienced a number of cyber attacks that compromised the personal information of patients.

Let Us Help You Understand Your Options

It remains to be seen if the decision to outsource C&P exams will prove to be financially beneficial for the VA while providing ease to the process for veterans. What you can be sure of is that, if you need legal help with the process of obtaining VA medical and disability benefits, we can help. As the process of obtaining benefits from the VA has become increasingly more complex in recent years, we provide an understanding of the process and of the issues that face veterans when trying to receive assistance.

Contact us today for a free case review.