A C&P exam examiner job is a clinical role, but it isn't patient care in the usual sense -- you are assessing functional impact for a disability rating, not diagnosing or treating a condition. Nurse practitioners, physician assistants, and physicians who want a break from the exam-room grind, or a flexible part-time role alongside a primary job, regularly move into this work through the VA's contracted examination companies.
Who actually hires C&P examiners
The VA does not employ most C&P examiners directly. Instead, it contracts the exam workload out to a handful of companies that recruit and credential licensed clinicians nationwide. The major contractors are:
- Veterans Evaluation Services (VES) -- handles C&P exams across most U.S. regions.
- Optum Serve (formerly LHI), UnitedHealth's federal health services arm.
- Leidos QTC Health Services, one of the largest disability-exam contractors, handling exams for the VA and other federal agencies.
- Loyal Source Government Services, another contractor active in VA disability exam staffing.
Each contractor recruits its own network of MDs, DOs, NPs, and PAs and assigns exams by region and specialty, rather than veterans applying to work for the VA itself.
What the job actually involves
A typical C&P exam follows a standard structure regardless of which contractor runs it:
- Records review before the appointment, using the veteran's VA claims file.
- A focused history and symptom interview, covering onset, frequency, and functional impact.
- A condition-specific physical or mental health exam, often guided by a VA Disability Benefits Questionnaire (DBQ) template.
- DBQ completion -- structured documentation the VA rater uses to apply the diagnostic code and percentage under 38 CFR Part 4.
Exams run anywhere from 30 minutes for a single straightforward condition to several hours for veterans claiming multiple conditions in one visit.
How it's clinically different from normal patient care
This is the adjustment most new examiners underestimate. A C&P exam is a disability evaluation, not a treatment encounter, and that changes the clinical task itself.
- You aren't treating the veteran. No prescriptions, no treatment plan, no follow-up care -- the exam produces a DBQ, not a care plan.
- You're documenting function, not just diagnosis. The DBQ asks how a condition limits range of motion, work capacity, and daily activities -- specific, measurable findings the rater applies directly to the rating schedule.
- Objectivity is the job. The examiner isn't advocating for the veteran or the VA -- the report has to reflect exactly what was observed and reported, since it becomes part of a federal benefits decision.
- Precision in the DBQ matters more than bedside manner alone. A vague or incomplete DBQ can trigger a request for a new exam and delay a veteran's claim by months.
Licensing and credentialing basics
To work as a C&P examiner, you generally need an active, unrestricted clinical license (MD, DO, NP, or PA) in the state where you'll be examining, plus the contractor's own credentialing process -- background check, malpractice coverage verification, and DBQ-specific training on how the VA's forms are structured and scored. Contractors typically require the examiner to complete their internal orientation on VA exam standards before taking on a caseload, since DBQ documentation quality is audited and inadequate exams get sent back for redo.
Why clinicians take these roles
- Flexible or part-time scheduling that fits around an existing practice.
- No prescribing, billing, or ongoing patient panel management -- the scope of each encounter is contained to a single exam and report.
- 1099 or contract-based pay structures at most contractors, often per-exam or per-block rather than a fixed salary.
- Exposure to a wide range of conditions across musculoskeletal, mental health, and general medical exam types, depending on credentialing.
How to apply
Because examiners work for the contractor, not the VA directly, the application process runs through each company's own careers page and credentialing team -- VES, Optum Serve, Leidos QTC, and Loyal Source all post examiner openings by region and specialty. Confirming state licensure requirements and malpractice coverage before applying speeds up the credentialing timeline considerably.
For the veteran-facing side of this same exam process, see our guides to what to expect at a VES exam and what to expect at an Optum Serve exam.
What a typical exam day looks like
Most examiners work from a rotating regional schedule set by the contractor, seeing several veterans per day at a dedicated exam center or an in-network community clinic. Between exams, the bulk of the administrative work is completing the DBQ accurately and promptly -- contractors track turnaround time, since a slow DBQ delays the veteran's rating decision. Unlike a typical clinic day, there's no chart of chronic patients to manage between visits; each veteran is a self-contained exam and report.
Pay and scheduling expectations
Compensation structures vary by contractor and region, and most C&P examiner roles are contracted (1099) rather than salaried employment, so ask each contractor directly about their current per-exam or per-block rates during the application process rather than relying on secondhand figures. Many clinicians use C&P exam work as a supplemental income stream alongside a primary clinical job, since blocks can often be scheduled around an existing practice rather than replacing it.
Because DBQ quality is audited, contractors generally prioritize accuracy and completeness over raw exam volume when assigning caseload growth to individual examiners -- a new examiner's early DBQs are typically reviewed more closely until a track record is established.
Which specialty background fits best
Contractors credential examiners by exam type, so your prior specialty often determines which caseload you're assigned. Primary care and internal medicine backgrounds tend to cover general medical and musculoskeletal DBQs, while psychiatric and mental health NPs, PAs, and physicians are routed to PTSD, depression, and other mental health DBQs. Audiology and optometry-adjacent training can open hearing loss and vision-related exam assignments at some contractors, though scope varies by state licensure and contractor policy, so confirm with each contractor which DBQ categories your license and background qualify you for before applying.