Common Questions

A Compensation & Pension exam is a medical or psychological evaluation requested by the VA to help determine whether a condition is related to your military service and how severely it affects your daily functioning. It is not a treatment appointment — the examiner is not your doctor, and the purpose is evaluation, not care.

For mental health claims like PTSD, depression, or anxiety, the examiner will review your records, ask about your symptoms, and assess how your condition affects your work and social functioning. Be honest and thorough: describe your worst days, not just your average ones.

A nexus letter is a written medical opinion that establishes a connection between your current diagnosis and your military service. The VA requires the opinion to be stated to the standard of "at least as likely as not" and supported by a clear rationale.

Not every claim requires one, but many veterans benefit from a nexus letter when their claim was denied for lack of service connection, when the C&P examiner gave a negative opinion, when the condition emerged years after service, or when claiming a secondary condition.

You generally need three things: a current diagnosis recognized in the DSM-5 (such as PTSD, major depression, or anxiety); an in-service event, injury, or stressor; and a medical nexus connecting the two.

Direct service connection means the condition was caused by something during service. Secondary service connection means it was caused or worsened by an already service-connected disability — for example, depression developing because of chronic service-connected pain.

C&P exams are often brief. An examiner may see a veteran on a relatively stable day and miss the full picture of their functioning. Veterans who are articulate or present well can appear less impaired than they actually are.

An independent psychological evaluation provides a more thorough, documented picture of how PTSD is truly affecting your work, relationships, and daily life — which is the basis on which the VA assigns ratings.

Yes. Because Military Sexual Trauma is frequently not reported when it occurs, the VA applies a relaxed evidentiary standard for MST-related claims and does not require official documentation of the incident.

Other forms of evidence can support your claim, including statements from fellow service members, personal journals, behavioral changes noted in service records, or a change in duty station. You are also eligible for free VA mental health treatment for MST-related conditions regardless of claim status.

TBI is a physical brain injury caused by force — blast exposure, vehicle accidents, falls. PTSD is a psychological response to a traumatic event. They share many symptoms (sleep problems, irritability, memory issues), which is why they're often confused or one is missed when both are present.

The VA generally won't rate duplicate symptoms twice, but veterans may still receive separate ratings for distinct TBI residuals — like headaches, vestibular problems, or cognitive deficits — that go beyond what the PTSD rating addresses.