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What to Expect at Your C&P Exam for Sleep Apnea

Pursuing veterans disability benefits can be daunting, from knowing what type of documentation to provide to stressing over hearings and evaluations. Knowing what to expect can eliminate a lot of the uncertainty and anxiety many veterans face, particularly when scheduled for hearings or examinations.

Working with an experienced veterans disability benefits advocate from the beginning can be the best way to avoid unnecessary stress and complications and keep your application moving forward as smoothly as possible. The information below will give you a general understanding of what lies ahead, and your advocate will explain how these issues may impact your claim and what to expect in your specific case.

If you are filing for VA disability benefits for sleep apnea, you may be scheduled for a Compensation & Pension exam (C&P exam). Here’s what you need to know.

What is Sleep Apnea? 

Sleep apnea is a medical condition in which a person’s breathing stops and starts repeatedly during sleep. This can result in low oxygen levels in the blood, which may contribute to a wide variety of other medical conditions. Sleep apnea also has a negative impact on sleep quality. 

There are three types of sleep apnea, all of which are recognized by the VA as potential service-connected disabilities. Last year, more than half a million veterans received VA disability benefits for sleep apnea. The three types are obstructive sleep apnea, central sleep apnea, and mixed sleep apnea (also known as complex sleep apnea). There is a significant overlap in symptoms. 

Signs that you may be suffering from sleep apnea include frequent loud snoring, gasping for breath in your sleep, waking frequently during the night, gasping for breath in your sleep, feeling tired for unexplained reasons during the day, and headaches. 

What is a C&P Exam? 

The Compensation & Pension (C&P) exam, also known as the veterans claim exam, is an examination to help the VA determine whether you have a qualifying disability and determine your disability rating. The exam is only for those purposes, and the examiner is not your doctor and will not provide any treatment or medical instructions. Exactly what happens at the exam will depend on a variety of factors, including: 

• Your condition–and, if you are claiming more than one disability, you may be required to participate in more than one C&P exam, and
• The extent of medical records and diagnostic test results available to the VA for assessing your condition

The examiner will likely ask you questions about your sleep apnea and may use a Disability Benefits Questionnaire (DBQ) as a guide for that discussion. You may find it beneficial to review the sleep apnea DBQ in advance to make sure you are prepared to answer questions thoroughly.  You can also ask your own physician to fill out and submit a DBQ. The type and extent of the physical exam will depend on the specific information the VA is looking for in your case. 

The VA also provides a series of videos offering further information about C&P exams. 

Preparing for Your C&P Exam

You won’t need to bring anything to your exam with you, but you will have the opportunity to submit additional medical records in advance of the examination. You can upload these records using the VA’s online tool or take them to a regional office. If you don’t have anything new to add, don’t worry–this is just your chance to provide any new test results or other medical documentation that may help the VA assess your claim.

You may want to plan to bring a family member or caregiver with you to the hearing. Depending on the examiner and the type of exam being conducted, your companion may be asked to wait outside. However, another person who is familiar with your symptoms and day-to-day life can provide important support and confirmation when you’re answering questions. And, a spouse or partner may be better able to describe the signs and symptoms that occur while you’re sleeping than you can yourself. 

If you are scheduled for a C&P examination, you must attend. If you miss your scheduled exam, you may be able to reschedule. You will have to explain why you missed the appointment, and the VA will determine whether you have shown “good cause.” If you have, they will reschedule your exam. Otherwise, they may make a determination without the exam, which could result in denial or a lower disability rating than you should have received. 

At the C&P Exam

The VA asks that you wear comfortable clothes that will allow you to move freely and that you arrive at least 15 minutes early for your exam. If you arrive late, your exam may be canceled. You may also be asked to wear a mask during the examination. 

In addition to the questions and examination described above, the provider may ask you to undergo additional testing. When you’re applying for veterans benefits for sleep apnea, a sleep study is required. So, if you have been diagnosed with sleep apnea through another process and do not have a sleep study documenting your condition, you will be required to undergo a sleep study. If the VA asks for additional testing to support your claim, you will not have to pay for the tests. 

It’s very important to be honest with the provider and to provide as complete information as possible. Remember that both the provider and the VA will have access to a wide range of other information about your medical condition and your history of symptoms and treatment. 

After the C&P Exam

While the C&P exam is very important, the provider is not the decision-maker. After the exam, the provider will submit a report. Then, the VA will review your claim, including evidence from your service record, medical records you have submitted or the VA has gathered on your behalf, the provider’s report, your nexus letter, the results of any tests requested at the C&P, and other relevant information and send you a decision. As of mid-2023, the average wait for a determination was about 106 days.

Re-examinations for Veterans with Sleep Apnea

After you receive your disability rating for sleep apnea, the VA may reassess your condition. In that case, you will likely be required to attend another C&P examination. Whether or not you are reevaluated will depend on variables such as your age and the stability of your condition.

The C&P Exam is Just One Piece of the Puzzle

The strongest application for VA disability benefits is one that thoroughly considers and prepares for every stage of the process, from completing the application to submitting documentation to preparing for the C&P exam. Most veterans don’t have in-depth knowledge of the veterans benefits application and appeals process, but our advocates do. 

To learn more about how Veterans Help Group can help you, call 855-855-8992 right now, or contact us here.