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1 1 (October 30, 2024)

handle is hein.crs/goverdl0001 and id is 1 raw text is: Congressional Research Servic~ Informing the legislitive debate since 1914 0 October 30, 2024 Veteran Disability Compensation and Pension Exams The Veterans Benefits Administration (VBA) within the Department of Veterans Affairs (VA) provides a wide range of benefits and programs for veterans and their families. VBA administers monetary benefits for disabled veterans: disability compensation for veterans who have service-connected disabilities and the needs-based pension benefit program for wartime veterans. In September 2024, it took VA an average of nearly 145 days to complete a disability-related claim. The time for the VA to review a claim depends on the type of claim, the number and complexity of the injuries or disabilities claimed by the veteran, and how long it takes to collect the evidence. A Compensation and Pension (C&P) exam to examine the illness or injury claimed by the veteran may be part of the disability claim process. This In Focus discusses C&P exams in the VBA disability claims process, a topic of frequent constituent inquiries and oversight questions. V A Disability Claims Process Fil a Claim Veterans may submit their claims to VA online, by mail, in person, by fax, or with the help of a VA-accredited representative or veterans service organization. VA requires separation documents, service treatment records, and any medical evidence related to the veteran's illness or injury. Lay evidence, such as a witness statement (sometimes called a buddy statement), may also be provided. While VA encourages veterans to submit their supporting documents with their claims, they have up to a year from the date VA receives their claim to provide evidence. Initial Claim Development When a claim enters the adjudication process, VA has a statutory duty to assist the veteran through the claims process. A veteran service representative (VSR) is the primary contact with the veteran, and upon receiving the claim, the VSR is to help the veteran gather needed evidence from federal agencies and private entities. If additional medical evidence is needed, the VSR is to help with scheduling a C&P exam. Compensation and Pension (C&P) Exam The purpose of a C&P exam is for a physician to examine the veteran's disability, illness, or condition. The exam may be performed by a Veterans Health Administration (VHA) provider or a contract examiner. The physician may perform a basic physical, ask questions based on medical records in the claim file, or ask the veteran to get other tests. A C&P exam is not always necessary, and it is not a ruling on whether the veteran's condition is service-connected and eligible for VA benefits, nor is it a determination ofa veteran's level of disability or disability rating. Only VA, based on all evidence in the claim file, makes the disability rating. Figure I. Overview of VBA's Disability Claims Process and Contractor Process for Completing Exams initial development Supplemental development F:s -e e j ene - Rating R1:! F Authorzation 2pro en r i Wmr r xar ru -11 tic, V , Aud, F wds1. 11J I exa ipm CAA Source: Government Accountability Office, VA Disability Exams: Improvements Needed to Strengthen Oversight of Contractors' Corrective Actions, GAO-24- 107730, September 18, 2024, https://www.gao.gov/assets/gao-24-107730.pdf. Notes: The figure represents the general process but does not include every step. See source report for limitations. * Award P ropose

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