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.
How to Become a C&P Examiner, Step by Step
You become a VA Compensation and Pension (C&P) examiner by getting hired by VA or one of its exam contractors, then passing VA's required C&P training. These steps are for licensed clinicians who will perform exams. If you are a veteran with an upcoming exam, see VA's claim exam page.
- Confirm your license. VA C&P postings in 2026 ask for one full, current, unrestricted license from any U.S. state, territory or the District of Columbia. Your license type also limits which exams you can do: initial post-traumatic stress disorder (PTSD) exams need a psychiatrist or doctorate-level psychologist, and hearing exams need a state-licensed audiologist. The C&P examiner requirements by license page covers every exam type.
- Choose a route. For a VA staff job, search USAJOBS for "Compensation & Pension" or "C&P", which returns titles such as "Physician (Compensation & Pension)". Contract work goes through the four contractors VA lists on its claim exam page, and the Government Accountability Office (GAO) found they completed 93% of VA disability exams in fiscal year 2024. The C&P examiner salary page compares pay by route.
- Apply and get credentialed. VA staff roles are Title 38 excepted service positions posted on USAJOBS. On the contract side, Veterans Evaluation Services (VES) describes an online application, credential verification and a background check, and says most clinicians finish onboarding in 10 to 45 days. GAO reports that you may work for more than one contractor.
- Finish VA's C&P certification training. VA requires its C&P certification courses before your first exam, and contract examiners take more than 11 hours of them. The C&P examiner training and certification page lists the courses.
- Start with the exam types you are certified for. VA lets an examiner perform only the exam types they are certified for. To take other exam types, finish the matching specialty course first.
- Check portability for out-of-state contract work. A federal law lets physicians, physician assistants, nurse practitioners, audiologists and psychologists with a current unrestricted license examine in any state under a Veterans Benefits Administration (VBA) contract. Physicians' portability is permanent, while the other four professions are covered through January 5, 2027. Before you take out-of-state cases, check the note to 38 United States Code (U.S.C.) 5101 to see whether Congress has extended that date.
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.
Working for the VA Directly vs. a Contractor
Choose the VA if you want a Title 38 federal job at a VA medical center. Choose a contractor if you want per-exam work with QTC, VES, OptumServe or Loyal Source, or a salaried W-2 examiner job, which Loyal Source and OptumServe post.
| Factor | VA staff examiner | Contract examiner |
|---|---|---|
| Who employs you | A VA medical center, as a Title 38 federal employee | QTC, VES, OptumServe or Loyal Source |
| How you apply | USAJOBS, using search terms like "Compensation & Pension" or "C&P" | Each contractor's own application and credentialing, such as credential verification and a background check at VES |
| How you're paid | VA pay schedule | Salary (W-2), or per exam and per DBQ as an independent contractor |
| License rule | One full, current, unrestricted license from any U.S. state, territory or D.C. | A federal portability law for VBA contract exams, plus each contractor's own rules by role |
| Training platform | VA's Talent Management System (TMS) | VHA TRAIN, with more than 11 hours of training before conducting exams |
| Recertification | Not required by the VHA directive for staff examiners | Every 5 years, or after 12 months without conducting an exam |
VA physician C&P postings list ACE (Acceptable Clinical Evidence) exams among the duties. In an ACE exam, you complete the DBQ from existing records, sometimes with a telephone interview, and you do not examine the veteran in person. Ask the hiring medical center or contractor which exam types you would do through ACE or telehealth before you accept an offer.
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). For VA staff jobs, that license can come from any state, and contract work outside your license state depends on the portability law in step 6. You also need VA or contractor credentialing: 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
On the contractor route, 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 many contractor roles are paid per exam (1099). Ask each contractor directly about its 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.