Understanding what to expect during a C&P exam for skin cancer can alleviate some of the anxiety associated with the process. Leah Bucholz from Prestige Veteran Medical Consulting, a US Army veteran, physician assistant, and former C&P examiner, shares her insights on what happens during these exams. This article will provide a detailed overview, from the basics of skin cancer to the specifics of the C&P exam process.
Understanding Skin Cancer
Before diving into the specifics of the C&P exam, it’s essential to have a basic understanding of skin cancer. The Mayo Clinic defines skin cancer as the abnormal growth of skin cells, often developing on skin exposed to the sun. However, it can also occur in areas not typically exposed to sunlight. There are three major types of skin cancer:
- Melanoma: A serious form of skin cancer that develops in the cells (melanocytes) that produce melanin, the pigment that gives your skin its color.
- Basal Cell Carcinoma: A type of skin cancer that begins in the basal cells— a type of cell within the skin that produces new skin cells as old ones die off.
- Squamous Cell Carcinoma: A common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin.
Early detection is crucial as it offers the best chance for successful treatment. Veterans are particularly at risk due to increased exposure to ultraviolet (UV) radiation during their service. Recent legislative changes also recognize the connection between Gulf War exposures and skin cancer, especially melanoma.
Preparing for Your C&P Exam
Receiving Your Examination Packet
Before the exam, you will receive a packet detailing where and when your examination will be, who will conduct it, and their professional background. This could be a nurse practitioner, a physician assistant (PA), or a physician. Knowing these details can help you feel more prepared and less anxious.
Understanding the Disability Benefit Questionnaire (DBQ)
The C&P examiner will use a tool called the Disability Benefit Questionnaire (DBQ) during your exam. This form helps the VA determine the extent of your condition and its impact on your life. You can access the DBQs on the VA website (va.gov), which is a fantastic resource for veterans. Reviewing the skin disease DBQ before your exam can give you an idea of what to expect.
The C&P Examination Process
Initial Administrative Information
The DBQ starts with basic administrative information, including your name, social security number, and the specifics of who requested the DBQ. It also asks if the examiner is a VA healthcare provider and if they regularly see you in their clinic.
Medical History and Diagnosis
The examiner will document your medical history, focusing on the onset and progression of your skin condition. You’ll discuss when you first noticed the issue, when you were diagnosed, and any previous skin conditions that have since resolved. This section includes details on the type of skin cancer you have (melanoma, basal cell carcinoma, or squamous cell carcinoma), the ICD code (a diagnosis code used by medical professionals), and the date of diagnosis.
Treatment History
Next, the examiner will review your treatment history over the past 12 months. This includes any medications you’ve been taking, such as steroids or antihistamines, and any treatments like phototherapy, chemotherapy, or surgery. They will note the duration of these treatments, whether they were less than six weeks, six weeks or more but not constant, or near constant.
Physical Examination
During the physical examination, the examiner will check for visible lesions and determine the extent of the affected areas. They will document the percentage of your body affected by the condition, including specific regions like the face, neck, and hands. This section is crucial for understanding the severity of your condition.
Detailed Examination of Cancerous Conditions
For skin cancer specifically, the examiner will determine if you have a benign or malignant neoplasm. They will note whether the neoplasm is active or if you are in remission. If you had surgery, chemotherapy, radiation, or other treatments, the examiner will document these details. They will also consider any residual conditions or complications resulting from your cancer or its treatment.
Scarring and Functional Impact
Scarring is a common concern for skin cancer patients. If your condition has caused scarring, the examiner will fill out a separate DBQ for scars. They will also assess how your condition affects your ability to work. For example, if a melanoma on your finger impairs your ability to type, or if a melanoma on your eye affects your vision, these factors will be documented.
Additional Findings and Functional Impact
The examiner will also record any other physical findings or symptoms not previously mentioned. They will evaluate the overall functional impact of your condition on your daily life and work. This comprehensive assessment helps the VA determine the appropriate rating for your disability.
After the Examination
Examiner’s Certification and Signature
At the end of the DBQ, the examiner will certify and sign the document, including their area of practice and license number. This certification ensures that the examination was conducted thoroughly and professionally.
Utilizing VA Resources
Leah Bucholz emphasizes the value of the VA’s resources. The VA website offers extensive information on various conditions, including skin cancer, PTSD, and more. It also provides tools to find accredited legal professionals, claims agents, and VSOs if you need assistance with your claim.
Conclusion
A C&P exam for skin cancer involves a detailed review of your medical history, current condition, and the impact on your life. Understanding the process and knowing what to expect can help reduce anxiety. By familiarizing yourself with the DBQ and utilizing the resources available on va.gov, you can approach your examination with confidence and ensure that your condition is accurately assessed and documented.
Also read: Knee Pain Secondary to Ankle Pain in Veterans Disability
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
