324 - Compensation & Pension Exams: Workflow, Cases, and Defensible Opinions

Session Description: Veterans are presenting in record numbers for Compensation & Pension (C&P) exams, especially with the expansion of conditions under the PACT Act. Many OEM physicians are asked to perform these evaluations without structured training, leading to variable quality and frequent addenda requests. This session will provide a practical, case-based framework for conducting C&P exams that are both thorough and defensible. Using three real-world case patterns, burn pit/airborne hazards, musculoskeletal injuries, and pulmonary exposure-related conditions, participants will practice focused history-taking, evidence review, and writing concise nexus opinions using VA-preferred language. The session also introduces a 10-point quality checklist and sample templates to reduce errors and remands. Through interactive case discussions and simple polling options, attendees will leave with repeatable methods to improve documentation and opinion quality, while distinguishing C&P evaluations from clinical care and exposure registries. The focus is on delivering exams that support fair adjudication and withstand legal and regulatory scrutiny.

Educational Gaps: Many physicians approach C&P exams as routine clinical visits, leading to incomplete exposure histories, vague nexus opinions, and inconsistent documentation. This session closes the gap by teaching structured workflows, checklists, and case-based skills to deliver high-quality, defensible evaluations that meet VA and adjudication standards.

Is this session being sponsored by an ACOEM Section or Component?: No

Has this session previously been presented?: No

The AOHC 2026 theme is Healthy workers. Healthy world: This session advances the AOHC 2026 theme by highlighting how better disability evaluations directly support worker health and community wellbeing. Veterans represent a distinct worker population whose service-related exposures and injuries often limit employability and long-term function. The Compensation & Pension exam is the key tool for connecting these workers to benefits, care, and rehabilitation. When exams are inconsistent or poorly documented, the result is delays, unnecessary appeals, and lost trust in the system. By training physicians to conduct structured, defensible C&P evaluations, this session equips attendees with practical skills that improve outcomes for both workers and the health system. Stronger documentation and exposure assessment ensure that service-connected conditions are recognized promptly and fairly. This not only validates occupational and environmental exposures but also reinforces the role of occupational medicine in advancing equity. Helping Veterans access what they have earned through their service reflects the larger principle of healthier workers contributing to a healthier world.