What should I do if my C&P examiner didn't discuss my existing diagnosis during the exam?

A Compensation & Pension exam is meant to give the rating board a medical opinion, not to recreate your entire treatment history in conversation. Examiners are required to review the claims file (including private treatment records, nexus letters, and personal statements) before or as part of the exam, and their written report is supposed to reflect that review even if every diagnosis wasn't verbally discussed. It's fairly common for an exam to focus on current symptoms and functional impact rather than restating a diagnosis that's already well documented elsewhere in the file.

That said, if you're worried the examiner didn't actually review your records, you have a few legitimate options. First, you generally cannot contact the examiner directly to add information — QTC and other contracted examiners work through VA, and ex parte contact isn't the normal channel. Second, you can submit a VA Form 21-4138 (Statement in Support of Claim) to your claims file noting your concern and reiterating the existing diagnosis, nexus letter, and treatment records, so the rating specialist sees it clearly restated alongside the exam report. Third, once you receive the actual rating decision, read the C&P exam summary in your file (you can request a copy) to see whether the diagnosis and records were in fact acknowledged — often they are, even if not verbally covered in the room.

What would this rating pay you? (2026 rates)

Official 2026 VA monthly compensation, including the 2.8% COLA increase.

per month ·  per year, tax-free

Dependent add-ons start at a 30% rating. Child-only and dependent-parent rates: see the full 2026 pay chart.

2026 base rates, all ratings (veteran alone)
RatingMonthly (2026, incl. 2.8% COLA)
10%$180.42
20%$356.66
30%$552.47
40%$795.84
50%$1,132.90
60%$1,435.02
70%$1,808.45
80%$2,102.15
90%$2,362.30
100%$3,938.58
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If the decision comes back denied or under-rated and you believe the exam was inadequate (for example, it shows no evidence the examiner reviewed the file, or omits a diagnosis clearly supported by evidence), you can challenge that specifically through a Supplemental Claim (VA Form 20-0995) with new/relevant evidence, a Higher-Level Review (VA Form 20-0996) arguing duty-to-assist or exam inadequacy error, or a Notice of Disagreement (VA Form 10182) to the Board. Note that among appealed PTSD decisions in VetAid's library, over half were vacated or remanded rather than outright affirmed or reversed, though appealed cases aren't representative of all claims and this isn't a predictor for any individual case.

The concrete next step: don't contact the examiner directly — instead, submit a brief written statement (Form 21-4138) to your claims file now, restating the existing diagnosis and referencing your nexus letter and treatment records, so it's unmistakably part of the record regardless of what the exam report says.

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Disclaimer: VetAid is not a law firm, medical practice, or Veterans Service Organization. This information is for educational purposes only and does not constitute legal, medical, or professional advice. Consult with a qualified VA-accredited attorney or your VSO representative. Veterans Crisis Line: 988 (press 1).