C&P Exams by Condition Type: What to Expect for Your Specific Claim

Not all C&P exams work the same way. A mental health evaluation for PTSD looks nothing like an orthopedic exam for a bad knee, which is completely different from an audiogram for hearing loss. Each condition type has its own examination protocol, its own set of questions, and its own criteria the examiner uses to document severity.

Knowing what to expect for your specific conditions helps you prepare the right documentation, anticipate the examiner's questions, and recognize when an exam seems inadequate. This guide breaks down C&P exams for the most commonly claimed condition types.

Mental Health Exams: PTSD, Depression, and Anxiety

Mental health evaluations are among the longest C&P exams, typically lasting 60 to 90 minutes. They are conducted by psychologists or psychiatrists and rely almost entirely on your verbal account and the examiner's clinical observations.

What the Examiner Covers

Trauma history (15-25 minutes): For PTSD claims, the examiner asks for a detailed description of the traumatic event. They need to know when and where it happened, what you witnessed or experienced, and your immediate reactions. You do not need to provide graphic detail, but be factual and specific.

Current symptoms (15-20 minutes): The examiner assesses each symptom category systematically. For PTSD, that means intrusive symptoms (flashbacks, nightmares), avoidance behaviors, negative mood changes (feeling detached, loss of interest), and arousal symptoms (hypervigilance, irritability, sleep disturbance). For depression and anxiety, the focus shifts to mood, energy, concentration, appetite, sleep, and worry patterns.

Functional impact (10-15 minutes): How do your symptoms affect work, relationships, social activities, and daily self-care? This is where specifics matter most. Do not just say "it affects my relationships." Explain that your spouse sleeps in a separate room because of your nightmares, or that you have been fired from three jobs because you cannot focus.

Mental status examination (10-15 minutes): The examiner observes your appearance, speech, mood, thought process, memory, and judgment throughout the appointment. This is happening the entire time, not just during a formal test section.

How to Prepare for Mental Health Exams

• Write a factual summary of the traumatic event beforehand so you do not struggle to recall details under pressure
• Document the frequency and severity of each symptom (how many nightmares per week, how many hours of sleep, how many panic attacks per month)
• Prepare specific examples of functional impact in each life area
• Bring treatment records showing ongoing symptoms despite therapy and medication
• Plan self-care activities for after the exam, as it can be emotionally taxing

Orthopedic and Musculoskeletal Exams

Physical exams for joint injuries, back conditions, and musculoskeletal problems focus heavily on objective measurements like range of motion. These exams typically last 15 to 45 minutes depending on how many body parts are being evaluated.

Joint Exams (Knees, Shoulders, Ankles, Hips)

The examiner will ask about the injury history, current symptoms, and functional limitations. Then they move to physical assessment:

• Visual inspection: Looking for scars, swelling, deformity, and muscle atrophy
• Palpation: Feeling for tenderness, warmth, and joint stability
• Range of motion: You move the joint yourself (active ROM), then the examiner moves it (passive ROM). Measurements are repeated to assess pain-limited motion with repetition. This is the most critical part for rating purposes
• Strength testing: Resistance testing compared to your opposite side
• Special tests: Knee stability tests, shoulder impingement tests, or ankle stability tests depending on the joint
• Gait assessment: The examiner watches you walk

Spine Exams (Neck and Lower Back)

Spine evaluations add neurological components:

• Range of motion testing for flexion, extension, lateral bending, and rotation
• Reflex testing in your arms and legs
• Sensation testing (light touch and pinprick) for nerve damage
• Straight leg raise test for radiculopathy
• Assessment of incapacitating episodes requiring bed rest

How to Prepare for Orthopedic Exams

• Wear loose, accessible clothing (shorts for lower body exams)
• Bring recent X-rays, MRIs, or other imaging reports
• Document your pain levels during specific activities
• Bring any braces, canes, or assistive devices you use regularly
• Know the difference between your baseline pain and flare-up pain

Hearing Loss and Tinnitus Exams

Auditory exams are conducted by licensed audiologists and combine your personal history with objective testing. They typically last 20 to 45 minutes.

What Happens

Hearing history (5-10 minutes): The examiner asks about noise exposure during service (weapons, engines, explosions, flight lines), when you first noticed hearing loss, and how it affects communication and daily life.

Audiogram testing (15-30 minutes): Conducted in a soundproof booth, this includes pure tone testing at various frequencies and a speech discrimination test called the Maryland CNC test. These objective results are what determine your hearing loss rating.

Tinnitus assessment (3-5 minutes): The examiner asks about ringing, buzzing, or other sounds you hear, whether they are constant or intermittent, and which ears are affected. Tinnitus is rated at either 0% or 10%, based simply on whether it is present and recurrent.

How to Prepare

• Avoid loud noise exposure for 24 hours before the exam
• Get adequate sleep the night before, as fatigue can affect test performance
• Bring documentation of noise exposure during your military occupational specialty
• Prepare specific examples of how hearing loss affects your daily interactions

Traumatic Brain Injury (TBI) Exams

TBI evaluations are comprehensive and lengthy, typically lasting 60 to 120 minutes. They include both physical neurological testing and cognitive assessments.

What the Exam Covers

• Injury history: Description of the head injury, loss of consciousness, post-traumatic amnesia, and initial treatment
• Current symptoms: Cognitive issues (memory, concentration, processing speed), physical symptoms (headaches, dizziness, balance), sensory problems (light and sound sensitivity), and emotional changes (irritability, mood swings)
• Cognitive testing (30-45 minutes): Standardized memory tests, attention tasks, executive function assessments, and processing speed evaluations
• Neurological physical exam: Cranial nerve testing, motor coordination, sensory examination, reflex testing, and balance assessment
• Functional impact: Ability to work, manage finances, maintain relationships, and handle daily responsibilities safely

How to Prepare

• Bring documentation of the initial head injury and any imaging (CT scans, MRIs)
• Document specific cognitive difficulties with real examples (forgetting appointments, getting lost on familiar routes, inability to follow conversations)
• Have family members provide statements about behavioral or personality changes they have observed
• Note safety concerns (difficulty driving, leaving the stove on, getting confused in stores)

Migraine and Headache Exams

Migraine evaluations are shorter (15-30 minutes) but rely heavily on your description of symptom patterns since there is no objective test for pain.

The key rating factor is the frequency of prostrating headaches, meaning headaches severe enough to force you to stop all activity and lie down. Document:

• How many prostrating headaches you get per month
• How long each one lasts
• What triggers them
• What medications you take and whether they help
• How many work days or activities you miss because of headaches

Sleep Apnea Exams

Sleep apnea C&P exams are relatively brief (15-30 minutes) because the key evidence is your sleep study results, which are obtained separately.

The examiner reviews your sleep study, asks about CPAP compliance and effectiveness, assesses daytime symptoms like fatigue and concentration problems, and evaluates functional impact. The critical rating factor is whether you require a breathing assistance device (CPAP or BiPAP). If you do, the condition is rated at 50%.

Respiratory Exams (Asthma, COPD)

Respiratory exams (25-40 minutes) include a symptom history discussion, physical lung examination, and often a pulmonary function test (spirometry). Ratings are based on FEV1 and FVC measurements from the spirometry, so this objective test is the most important component.

Cardiovascular Exams

Heart condition evaluations (20-40 minutes) include cardiac history, physical examination, possibly an ECG/EKG, and review of existing test results like stress tests and echocardiograms. Ratings often depend on exercise tolerance measured in Metabolic Equivalents (METs).

General Preparation Tips Across All Condition Types

Regardless of what conditions you are claiming, these principles apply to every C&P exam:

• Keep detailed symptom diaries documenting frequency and severity over time
• Prepare specific examples of how each condition limits your daily function
• Bring treatment records showing ongoing symptoms despite treatment
• Describe your worst days clearly, not just your typical baseline
• Do not minimize anything, even if you are having a relatively good day at the exam