 Hey, so this is Matt Sansing from DAV and I'm here with VA's Executive Director of Medical Disability Exams Program Office, the Veterans Benefits Administration, David McClendon. And we're going to talk about C&P exams and what the VA is doing with allowing these exams recently. But first, David, if you can kind of explain what your office does and how it's important to veterans. Sure. So the Medical Disability Examination Program Office supports basically the Compensation and Pension Benefit Programs. Both of them require us to make a determination about disability. Compensations are our biggest program and pension is different. It's for wartime veterans, but still there's a disability component to it. VA has a duty to assist claimants in developing their claims. One of the most important components of that is providing a medical disability evaluation if it's required in a claim. And it is required in most claims. So if you look at the number of claims that we decide every year, which for many years has been well over a million in compensation and pension claims, generally speaking, there's an exam that's required in every one of those. And in some cases, it's multiple exams. So it's a very important part of our business of providing veterans their benefits and determining what level of valuation, for example, their compensation claim might require. So if veterans that have a VA disability rating went to exams, they went to one of these exams. And if a veteran out there, a CMP exam, if one of these veterans was looking for maybe an increase or looking for to have another lingering ailment checked, the VA would schedule a similar exam, such as this. Is that correct? Yes. So the way it works is our claim processes are just take a look at the claim and decide whether an exam is required or not. They also decide what type of exam. So as you may know, many claims involve multiple conditions. So what we will do is we will schedule exams and it may be a package of exams, dealing with each of the different disability components. So it may be sent to three different individuals who do a particular type of exam that will provide that. It's packaged back up and then sent back to claims processors in the claimant's e-fold in VVMS where we process claims. So that's in general at a very high level how it works is we determine what exam is needed. And there's some nuances that we might want to discuss such as it doesn't always mean that you have to appear in person and this is particularly important during this national emergency that we're in right now because we do many exams without the claimant actually having to show up in person. Interesting. So as everyone's aware, we're in the middle of this ongoing pandemic and I don't think there's any organization under the sun that has not been affected in some way either health wise or economically and the VA is no exception to that and recently VA has announced that they're resuming CMP exams in certain areas. So I'd like to ask where are these locations and what can veterans expect if they have an exam scheduled? Right great question. So let me start at the beginning back in about early April we suspended all in-person exams due to the pandemic. Understandable we have to protect claimants but as well as the providers that are doing doing the exams. So we suspended them. We also took another other steps to ensure that suspending those exams would not have an adverse impact on claimants. So a veteran had a claim pending and there was an exam scheduled the fact that they did not show up for an exam would not be held against them and we would hold that exam till later if asked to be an in-person exam but we would hold it till later and when we can do it we will take care of that exam. We also suspended the rules that apply to responding to VA correspondence, submitting evidence all those types of things were suspended during the pandemic as well. So if somebody failed to respond to our request for some type of evidence or other information that we needed for the claim it's not going to be held against them and of course we pay benefits retroactive to the data claim so in the end no veteran is going to lose out on on any benefits. But what we've done is we decided that we would link our resumption of in-person exams and I will say that most exams need to be an in-person exam although many you know scores of them have been completed through the ACE program acceptable clinical evidence and that's where a examiner reviews a medical record and all the records in the veterans claim that pertain to the disability and see if they can provide the examination result without actually meeting in person. And then secondly we've been doing a lot of what we're calling tele-CNP exam so that's a hookup like we have here where the examiner talks to the the claimant and completes examination in that way. Not all exams can be done that way there's a large set of them that are pending an in-person. So we suspended those in-person exams in early April on May 28th we we issued a news release saying that we were resuming in-person exams in certain areas and what we did is we relied on the risk assessment that's being done by VA medical centers across the country. So I think as you know VA medical centers have in-person primary care appointments where a veteran will go into the facility and meet with their physician in an outpatient clinic setting. What we did is we concluded well and VHA has determined based on the the administration's gating criteria for reopening the country that it's appropriate to do those in-person contacts in a clinical environment in a VA medical center or other outpatient facility that we would do the same for in-person exams so this is kind of our link to we need a risk assessment because we don't want to put any any veterans in harm's way as far as exposing them to the virus but we also don't want to risk providers or having to see multiple people during a during the day. So that's what we did and we we started with 20 areas of the country that VHA identified as their initial sites where they were going to start some of these appointments. The good news is since those 20 sites we've been adding almost on a daily basis we've been adding other areas of the country as VHA open other areas for those primary care outpatient appointments we've been doing the same with exams. When we first started those 20 initial 20 areas it was about 13% of our pending exam inventory that was was pending that was covered by it so a very small portion but what that means is our contract exam vendors we do these exams through contracts that we have with providers. About 13% of our workload could be done for those initial 20 sites we're currently at a point where we can cover 70% of our inventory and we've so that's been since May 28th so basically over the last month we've expanded to about 70% of all the exams that are pending we our contract vendors can work them so a lot of work's been done over that period of time to get them up and going even with that though it's still not an overnight process veterans have to be given at least five days notice when their their exams scheduled in many cases our contract vendors had to bring the local physicians and examiners that they use across the country back in the service so there was no about a week or two delay after we give them the go ahead in a particular area to get started but in general we've made a lot of progress on getting those exams up and going that's basically where we're at now and how does a veteran find out if they're in the area that has these exams they're restarting having these exams right so good question what we've done is we've created an interactive map it's available on the VA's COVID FAQ site so it's really easy to find if you go to that FAQ site where frequently asked questions site where basically VA has centralized all the questions that might come up about how we're handling our work in the you know the COVID-19 environment if you go to that website and there's a link to exams it'll take you to a interactive map and the map will show you all the areas of the country where we've authorized our vendors to start in-person exams you can even type in your zip code type in the zip codes it'll tell you whether it's within or without or outside of that those areas where we started again we you know covered wide swaths of the country nonetheless there are still some some high population areas in certain areas of the country where we're not there yet but that's an easy way to check and see if it's an area where we will be holding exams and these these different regions that are starting to restart you know I think you said calculations are being done on a daily basis and I think as we're seeing the ebb and the flow of of the virus increasing in some areas and decreasing in others the VA is taking a look at that and it's kind of taking that into account and adjusting accordingly and the army would say adjust for fire but probably wouldn't use that language but you're correct I mean this is a concern you know everybody that's watching the news he says you'll see that there are you know there's spikes in and in virus infections around the country more than 20 states now I believe so that's that's a concern and something we have to watch and and we will handle that in the same way that we handled the the startup which is if vha's risk assessment in an area is that they will no longer or will suspend again in-person primary care outpatient appointments then and we will do the same for in-person cmp exams okay I'm hopeful that that we it won't get to that point but we always have to balance that risk against the need to do exams um you know the drawback to all this of course is that we need veterans to get their benefits in their pocket and start that that money flowing but we can't do it without an exam in most cases and so that's the drawback is although everybody's going to be made whole when we eventually complete the claim we really need these exams to to get the decisions flowing on on their claims and especially a lot of a lot of people in the country and veterans are not immune feeling the economic impacts of economies shutting down losing hours losing being furloughed losing jobs if they own a business having orders canceled all these things play into it and so if they're relying on VA compensation or future VA disability getting that exam is really the first part of this of their journey um what can veterans do before their exam to prepare themselves so when they're ready to go the day of the exam sure so uh it's always the case that you know prepare for your exam make sure that VA has all the evidence that's required in in your case make sure that we've received all the medical records that you have and of course veteran doesn't have to actually provide us everything if if we learn of where we might be able to get some some evidence for the claim and the veteran doesn't have it we have an obligation to go out and get it so when I say provide everything you have the quickest way to get the claim going is give us everything you've got to include information that you've gathered on your own but in addition to that identify where we need to go and ask for evidence also so it may be that you receive treatment at a non-VA facility somewhere you don't have the records but you know that you had treatment there that would be something you need to tell us about the idea is you want us to have all the evidence before the exam is done once the exam is done of course the the the examiner will use all of that information that's available to him but we want the claim to flow smoothly from the examination to the decision so you know that's the key thing is is make sure that we have everything we need to decide the claim because we want to we want to decide it quickly a couple other things to keep in mind these days regarding exams the the exams are scheduled by our contract vendors so we you don't need to call VA to schedule an exam we know all of the exams that are pending and the vendors will be reaching out to the oldest first unless it's one of our priority cases like a terminal illness or other hardship priorities that we have they'll be reaching out to the veteran scheduling the exam in that priority order they also have to make sure that the veteran is willing to come in at this time for an in-person exam it is not mandatory during the national emergency if the veteran still has concerns about appearing for an exam that's not a problem we'll just hold that exam in advance and we will reschedule it when the time is right which is probably when the national emergency is over so still no harm to any veteran for not showing up but we'll reach out we'll schedule it be prepared because these days when you show up for an in-person exam you'll have to wear protective equipment such as right you don't have that equipment the the examiner will provide it to you so these days just need to be aware that it's a little bit different than in the past exams can only be done with protective equipment on at this time and we are only doing exams right now that can be done with that equipment in place so if it's a exam where where it has to be done without protective equipment that's a second order of priority because again we are concerned about spreading the virus so just these days a little bit different make sure we have everything but also be aware of what's going to happen and the schedulers will advise veterans of that as they're scheduling the exams and it's great that you mentioned wearing a face covering or bringing their own mask and if they can't do that then VA will provide one but also I would recommend veterans should definitely give ample time for screening and process before entering because there may be a long line and you know some people may be feeling under the weather so they need to do their job so giving a good buffer of time will help move the process along smoothly yeah and just to address concerns I mean the requirements that we gave to our contract vendors for these exams are very thorough and they're based on CDC requirements so as far as protective equipment, sanitation, screening, social distancing all those things have to be in place and addressed before a provider can actually do the examination so to some extent if any veteran has concerns just be aware that that makes the process less efficient but it's for the purpose of everybody's safety. Now we've talked a lot about seeing exams and how they're reopening and but that again we've also talked about how that's kind of the very beginning of the road to getting disability compensation or getting compensation from the VA for service-connected injuries and ailments. What else can veterans do to help move along their claim after the exam you know is there should like require if they come across new evidence or anything like that? Yes so before the pandemic you know we were doing decisions pretty rapidly actually you know we were turning them around in roughly 90 to 100 days which is really quite quite quick compared to you know several years ago in the past where we had a claims backlog so we've gotten very efficient at doing them so the time lag between the exam and actually getting the decision on the claim is not all that long but certainly if at any time a veteran has additional evidence then it should always be submitted to the VA and whether it's establishing a increased disability on a condition that's already service-connected or it's in support of a claim that's pending that should always be done but as far as moving it along more quickly as long as we have everything we're turning the decisions around quickly part of the problem though with having this this inventory of excess exams that we have to get done is what that's going to do is it's going to hurt our timeliness on on processing claims right because if you have a bunch of exams that you need before you can complete a claim and then once we start receiving more new claims behind those we've really got to get through those exams get them get them finished and get the claims process moving back to where it was so it's unfortunate but that's the situation we're dealing with right now. Yeah that makes sense even if it is an unfortunate reality and one thing I should definitely add before I go to my last question here David and thanks again you've been very generous with your time this afternoon. For veterans out there who are who want to know how to start the journey and process of a VA claim you know I work for DAV so I'd definitely say don't go it alone contact the DAV service officer you can go to benefitsquestions.org you can find a local national service officer in your area they can get this ball started for you or at least answer your question so please don't feel like you have to do it all and thanks again David where can veterans go for more information about CMP exams or or anything that has to do with their claim. So VA.gov has has all the information that you could possibly want about how to file a claim you can do it electronically or submit it otherwise I want to echo your recommendation I've worked with DAV for for many years on many different things and it's a great organization so I would echo that work with DAV or you know I think that's you're going to hear that advice from pretty much everybody if you're a claimant there's no need to go it alone you don't have to pay for representation from a veteran service organization so so why not use an organization that's professional like DAV so I would echo that but there's a there's a lot of information on VA.gov the website's been redesigned so it's easy to find everything you go to the website and there's you can see right off off the top that there's links for getting information about claims and how to file them and what's the status and all that information is much more readily available now easily findable on the internet and of course there's also in addition to using your veteran service organization representative you can always call your local VA office as well get information that way awesome well David I really appreciate all the information you were able to shed a lot of light on a topic I think that's that can be confusing and maybe a little intimidating for some people out there so really appreciate it again um I've go to dav.org slash COVID we have updated information for the ongoing pandemic that has to do with not just VA exams but other resources as well and again David we really appreciate it thanks a lot welcome