What to Expect at a PTSD C&P Exam: Stressors, DBQ, and Questions

An initial PTSD exam must be conducted by a doctoral-level psychologist or board-certified psychiatrist to confirm an official clinical diagnosis under DSM-5 criteria. A review PTSD exam (for a rating increase) focuses primarily on whether your occupational and social impairment has worsened since your last evaluation, and can be completed by a wider range of licensed mental health clinicians.

For combat veterans who received combat decorations (such as the Combat Action Ribbon, Combat Action Badge, or Purple Heart), lay statements describing the traumatic stressor are accepted without independent corroboration under 38 CFR 3.304(f). For non-combat trauma (including training accidents, natural disasters, or Military Sexual Trauma), the VA requires corroborating evidence, such as unit history logs, buddy statements, or police reports.

The examiner completes the Review PTSD DBQ by checking one of six boxes in Section III that represents your overall level of occupational and social impairment (ranging from 0% no impairment to 100% total impairment). In Section IV, the examiner checks specific symptom boxes (such as panic attacks, suicidal ideation, memory loss, and flat affect). Raters compare these sections to assign your percentage.

The examiner will ask about your childhood history, military service history, traumatic events, current interpersonal relationships, sleep patterns, and employment stability. Be honest about your worst symptoms, including hypervigilance, nightmares, angry outbursts, and isolation. Do not downplay suicidal thoughts, substance use, or relationship failures out of embarrassment.

If the examiner spends less than 15 minutes, refuses to let you describe your symptoms, or expresses skepticism, immediately write a detailed Memorandum for the Record describing the examiner's behavior and appointment duration. Upload this statement through VA.gov as a 21-4138 Statement in Support of Claim and request a new, adequate examination before an initial decision is rendered.