C&P Exam: What is your pain rating?

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Veterans Affairs C&P exam: Pain​

Below is a chart that aids in the conversion from the verbiage you may be feeling to a pain scale of 0 to 10. You may also measure this by the expression that you could imagine is on your face that you would envision in your head. However, the best approach is to align the pain descriptor to a numeric value on the pain scale.

Using words to express your feeling of pain opens it up for someone else's interpretation of pain while examining you or your record. It's best to always rate it numerically aligned with the Descriptor as shown.

At a compensation and pension exam (C&P for short), an examiner may ask you how you feel. You could simply answer with, "I'm feeling mild pain." It's now up to the examiner to look at you and interpret your presence, which could look to them as a 1 when you are feeling a 4. Instead, state that you are a 4 on the pain scale and express to them that it's a distraction, what it distracts you from, and provide a quick list of activities that you can and can't do.

Veterans Affairs Pain Scale​

FeelingScaleExpressionPain Descriptor
No pain
0​
🙂
No pain
Mild
1​
😐
Hardly notice pain
2​
😐
Notice pain, does not interfere with activities
3​
🙁
Sometimes distracts me
4​
🙁
Distracts me, can do usual activities
Moderate
5​
☹️
Interrupts some activities
6​
☹️
Hard to ignore, avoid usual activities
7​
😦
Focus of attention, prevents doing daily activities
Severe
8​
😦
Awful, hard to do anything
9​
😖
Can't bear the pain, unable to do anything
10​
😖
As bad as it could be, nothing else matters

If you're experiencing pain or chronic pain​

Be prepared by studying this chart and taking notes of it and how it applies to your life. If this isn't brought up by the examiner, be prepared to bring it up with the notes that you have taken down. This will ensure that the examiner has all the information gathered from you that is necessary for the rater to make a proper determination on your case the first—and hopefully, only—time.

Supplemental questions​

An examiner may bring up these four questions, perhaps even verbatim. Be prepared to honestly answer them after you have covered your current state of pain with the chart above. These questions are made to get a better look at how you are managing your pain on a daily basis and how it truly impacts your life.

The answer you should provide the examiner to these questions will range from 0 of "doesn't impact" to 10 of "fully impact".

Again, be prepared. Print this out; fill it in or copy it to your own notes; and bring it up for discussion if it wasn't covered in your C&P exam when it seems like it's over or the examiner asks you if you have anything to add.

1. Circle the one number that describes how, during the past 24 hours, pain has interfered with your usual ACTIVITY:​

0​
1​
2​
3​
4​
5​
6​
7​
8​
9​
10​

2. Circle the one number that describes how, during the past 24 hours, pain has interfered with your SLEEP:​

0​
1​
2​
3​
4​
5​
6​
7​
8​
9​
10​

3. Circle the one number that describes how, during the past 24 hours, pain has affected your MOOD:​

0​
1​
2​
3​
4​
5​
6​
7​
8​
9​
10​

4. Circle the one number that describes how, during the past 24 hours, pain has contributed to your STRESS:​

0​
1​
2​
3​
4​
5​
6​
7​
8​
9​
10​

Answer for the moment, the past 24 hours, and the average feeling​

  • Be sure that your examiner knows how you feel at the moment and why. Say, you might be a 3 on the pain scale, but, it's still early in the day which you haven't exacerbated yourself enough to the average of 6, and, you might be on a prescription medication that is doing its job in the moment.
  • Cover how you've felt during the past 24 hours such as with the questions and answers in the guide above. Stress each question and explain exactly how its impacted your activities, which ones; your sleep and how; and your mood and stress as these could be secondary to your mental state with an additional rating for mental health.
  • Keep a log of your pain; annotate what caused it and what it prevented you from doing. This log will help you answer the questions about your present pain state and help add to give the examiner a picture of your average day or week.

Prepare for your C&P!​

This cannot be stressed enough: Your C&P is your time, don't feel rushed. Answer everything asked by the examiner as thoroughly as possible. Also, persist to add what you feel can contribute to your claim being approved with a favorable decision.

Feel free to even print out this page or the attached image. It would behoove you to fill in this sheet as well as take notes on it where things apply to your case (or in the margins). That way, you can check them off one by one as your examiner covers them or you bring them up for discussion yourself at the end of the exam.

Don't forget your notes for the C&P! All of this will be helpful for your claim when it comes to pain.

Important note​

Pain in itself is not a rateable ailment. It does, however, closely coincide with others and should be discussed though.

Pain scale image​

va-pain-scale.jpg
 

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Staff member

Veterans suffering from chronic pain​

Some veterans suffer from chronic pain. Whether this is a stabbing, aching, or throbbing pain isolated to one area, it's something that is being constantly dealt with.

I've met a lot of Veterans that downplay their pain. This is because, if you take a look at the severe level in the above chart, it ranges from awful and hard to do anything to as bad as it can be with nothing else mattering. Veterans typically don't put their egos aside when rating their pain; they could imagine the absolute worst for a 10 such as lying on a death bed in the last hours of life. This would make them feel as if a 10 is too high and that they are at a 3 or 4, but that is only pain that distracts you from activities and doesn't necessarily make you work around them.

Veterans need to be able to define their everything in order to gauge their pain correctly when speaking with an examiner. While one may be an 8 with difficulty doing anything, they may still be able to do routine housework such as laundry, the dishes, and making the bed. However, the pain could be so severe that they can't clean out the shower or bathtub, which many others can do and is seen as minimalistic work. Thus, they downplay to a 4 or 5 because it's only distracting from certain activities that they may see their significant other being able to do.

Be ready to explain how pain affects you, understand your pain levels, and don't downplay your pain at a C&P. If you do so, this could prevent you from getting the rating that you feel you deserve.

Again, don't downplay your pain!
 
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