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VA Rating Assistant

DC 7833 · 38 CFR 4.118

Malignant Melanoma C&P Exam Prep

To evaluate the current severity of malignant melanoma, document treatment history (including whether treatment rises to the level warranting a 100% evaluation), assess residuals such as scars or disfigurement, and determine functional impairment for rating purposes under DC 7833.

Format:
Interview + Physical
Typical duration:
15-30 minutes
DBQ form:
Skin_Diseases (Skin_Diseases)
Examiner:
Dermatologist or appropriate clinician

What the examiner evaluates

  • Diagnosis confirmation and ICD code for malignant melanoma
  • Whether the melanoma is primary or metastatic/secondary
  • Current active disease status versus remission
  • Type and extent of treatment received (surgery, chemotherapy, radiation, immunotherapy, targeted therapy)
  • Whether treatment is comparable to systemic malignancy treatment (systemic chemotherapy, radiation more extensive than to skin, or surgery more extensive than wide local excision)
  • Date treatment was initiated and anticipated or actual date of treatment completion
  • Presence of local recurrence or metastasis
  • Residual scars from excision - location, type (linear, superficial non-linear, painful/unstable), and dimensions (length x width in centimeters)
  • Disfigurement of the head, face, or neck resulting from the melanoma or its treatment
  • Functional impairment of any body system caused by melanoma or its treatment
  • Impact of the skin condition on occupational and daily functioning
  • Associated conditions requiring separate DBQs (e.g., lymphedema, peripheral neuropathy)

Exam will involve both a structured interview about your medical history and treatment timeline, and a physical inspection of excision sites, scars, and affected skin areas. Bring all relevant oncology and dermatology records. The examiner will document findings on the Skin Diseases DBQ. If photos are taken at the time of examination, they will be submitted with the DBQ for rating consideration.

Measurements and tests

Scar Measurement

What it measures: Dimensions (length and width in centimeters), location (e.g., left upper extremity, head/face/neck), and type (linear, superficial non-linear, painful, or unstable) of excision scars from melanoma surgery

What to expect: The examiner will visually inspect and physically measure any scars using a ruler or measuring tape. They will assess whether the scar is painful to touch or pressure, whether it is unstable (breaks down with minor trauma), and whether it is on an exposed body area.

Critical thresholds

  • Painful or unstable scar of any size Eligible for rating under DC 7804 (painful or unstable scars); even a single painful scar can warrant a compensable rating
  • Superficial non-linear scar greater than 39 sq cm (6 sq in) on exposed surface Eligible for higher rating under DC 7802
  • Scar on head, face, or neck causing disfigurement Rated separately under DC 7800 based on character of disfigurement
  • Multiple scars from wide local excision plus skin grafting May support separate ratings under DC 7801 (deep, non-linear) and DC 7805 (other scars with functional impairment)

Tips

  • Know the precise location of each scar before your exam - bring a written list
  • Tell the examiner if any scar is painful to direct pressure, touch, or during temperature changes
  • Report if any scar has ever broken open, ulcerated, or required treatment after healing
  • If a scar limits movement (e.g., over a joint), specifically state that functional limitation
  • Request that the examiner measure and document every scar, not just the largest one

Pain considerations: Pain from scars is critically important. A scar that causes pain - even intermittently - qualifies as a 'painful scar' under DC 7804. Describe pain on your worst days, not your average days. Include pain with clothing contact, weather changes, and activity.

Body Surface Area Assessment (if applicable)

What it measures: Total body surface area and exposed body surface area affected by active skin disease (relevant if melanoma is associated with active skin involvement or satellite lesions)

What to expect: If there are active skin manifestations beyond resolved excision sites, the examiner should document the percentage of total body surface area and exposed body surface area affected. This is a regulatory requirement per M21-1 for skin conditions rated on area of involvement.

Critical thresholds

  • Active lesions on exposed surfaces Exposed area involvement is weighted more heavily in rating criteria

Tips

  • Point out all active lesions, satellite nodules, or areas of skin involvement to the examiner
  • Do not assume the examiner will find every affected area - assist by directing their attention

Pain considerations: Note any itching, burning, or pain associated with active skin involvement on your worst days.

Treatment Classification Assessment

What it measures: Whether the treatment received or ongoing meets the threshold for a 100% evaluation - specifically: systemic chemotherapy, radiation more extensive than to the skin only, or surgery more extensive than wide local excision (e.g., sentinel lymph node biopsy, lymph node dissection, reconstructive surgery)

What to expect: The examiner will ask detailed questions about your treatment history. They will document the type of surgery performed, whether radiation extended beyond the skin, and whether systemic agents (immunotherapy, targeted therapy, chemotherapy) were or are being used.

Critical thresholds

  • Systemic chemotherapy (e.g., dacarbazine, temozolomide) 100% rating from date of treatment onset
  • Immunotherapy (e.g., pembrolizumab, nivolumab, ipilimumab) - note: VA has extended 100% treatment provisions to immunotherapy comparable to systemic malignancy treatment 100% rating from date of treatment onset - confirm with your VSO whether your specific immunotherapy qualifies
  • Targeted therapy (e.g., BRAF/MEK inhibitors such as vemurafenib, dabrafenib) May qualify as treatment comparable to systemic malignancy - document and confirm with VSO
  • Radiation more extensive than to the skin (e.g., nodal irradiation, adjuvant radiation to regional nodes) 100% rating from date of treatment onset
  • Surgery more extensive than wide local excision (e.g., sentinel lymph node biopsy, complete lymph node dissection, skin grafting, reconstructive flap surgery) 100% rating from date of treatment onset
  • Treatment completed with no recurrence or metastasis 100% continues for mandatory 6-month period post-treatment; then rated on residuals (scars, disfigurement, functional impairment)

Tips

  • Bring a complete list of all treatments with dates: surgery type, radiation dates and fields, chemotherapy/immunotherapy/targeted therapy agents and dates
  • Bring operative reports documenting exact type of surgery performed
  • If you received a sentinel lymph node biopsy, document this - it is surgery beyond wide local excision
  • If treatment is ongoing, the examiner should document the anticipated completion date
  • Ask your oncologist to provide a letter summarizing your treatment in terms that align with the VA criteria

Pain considerations: Document all treatment-related side effects you experience, including fatigue, neuropathy, skin reactions, joint pain, and immune-related adverse events from immunotherapy.

Rating criteria by percentage

100%

Active malignant melanoma requiring treatment comparable to that used for systemic malignancies: systemic chemotherapy, radiation therapy more extensive than to the skin, or surgery more extensive than wide local excision. The 100% evaluation is assigned from the date of onset of such treatment and continues until a mandatory VA examination six months after treatment completion. If no local recurrence or metastasis is found at that examination, the rating is then based on residuals.

Key symptoms

  • Active malignant melanoma diagnosis
  • Receiving or has received systemic chemotherapy
  • Receiving or has received immunotherapy (e.g., checkpoint inhibitors) comparable to systemic malignancy treatment
  • Receiving or has received targeted therapy (e.g., BRAF/MEK inhibitors)
  • Radiation therapy beyond skin-only field (e.g., nodal radiation)
  • Surgery beyond wide local excision (e.g., sentinel node biopsy, lymph node dissection, skin grafting, reconstruction)
  • Documented active disease or treatment side effects
  • Metastatic melanoma to any organ system

From 38 CFR: Per 38 CFR 4.118 DC 7833: 'If a skin malignancy requires therapy that is comparable to that used for systemic malignancies, i.e., systemic chemotherapy, X-ray therapy more extensive than to the skin, or surgery more extensive than wide local excision, a 100-percent evaluation will be assigned from the date of onset of treatment.' The 100% continues through the mandatory exam 6 months post-treatment completion under - 3.105(e) provisions.

0%

Malignant melanoma where treatment has been confined to the skin only (e.g., wide local excision without systemic treatment, sentinel node biopsy not performed, no radiation beyond skin, no systemic agents), or where the veteran is in remission following qualifying systemic treatment and the 6-month mandatory post-treatment examination shows no recurrence or metastasis. In these cases, the rating is based entirely on residuals: scars (DC 7801-7805), disfigurement of the head/face/neck (DC 7800), or functional impairment of affected body systems.

Key symptoms

  • Melanoma in complete remission with no recurrence
  • No metastasis documented
  • Treatment confined to wide local excision only
  • Residual scars from excision (rated separately under scar DCs)
  • No functional impairment beyond resolved excision site

From 38 CFR: Per 38 CFR 4.118 DC 7833: 'If treatment is confined to the skin, the provisions for a 100-percent evaluation do not apply.' And: 'If there has been no local recurrence or metastasis, evaluation will then be made on residuals.' Residuals are rated under DC 7800 (disfigurement, head/face/neck), DC 7801 (deep non-linear scars), DC 7802 (superficial non-linear scars), DC 7803 (linear scars), DC 7804 (painful or unstable scars), or DC 7805 (scars with functional impairment).

Describing your symptoms accurately

Treatment Type and Extent

How to describe it: Be specific and precise about every treatment you received. Do not use vague terms. State the exact name of surgical procedures, the names of chemotherapy or immunotherapy agents, the radiation fields treated, and all dates. Differentiate between wide local excision alone versus any additional procedures such as sentinel lymph node biopsy or lymph node dissection.

Example: I underwent a wide local excision of a 2.5mm Breslow depth melanoma on my left upper back, followed by a sentinel lymph node biopsy that returned positive. I then had a complete axillary lymph node dissection and received adjuvant pembrolizumab immunotherapy infusions every 3 weeks for 12 months, completing treatment on [date]. During treatment I experienced severe fatigue, joint pain, immune-related colitis requiring steroid treatment, and was unable to work for [duration].

Examiner listens for: Specific procedure names, treatment agent names, dates of treatment initiation and completion, whether treatment extended beyond the skin, current disease status (active vs. in remission), and treatment-related functional limitations.

Avoid: Do not say 'they just removed it' or 'I had minor surgery.' A sentinel lymph node biopsy is surgery beyond wide local excision and may trigger the 100% provision. Do not omit immunotherapy or targeted therapy agents - these are critical to the rating determination.

Scar Pain and Instability

How to describe it: Describe pain at scar sites in terms of frequency, severity, and triggers. Note whether pain occurs with clothing contact, pressure, temperature changes, or spontaneously. Report any episodes of the scar breaking down, ulcerating, or requiring treatment after the initial healing period.

Example: On my worst days, the scar on my back from the wide local excision is intensely painful - I cannot wear anything that puts pressure on it, including a shirt collar or backpack. The pain is a 7 out of 10 and prevents me from sleeping on my back. The scar has broken open twice in the past year with minimal friction, requiring wound care.

Examiner listens for: Pain with contact or pressure (qualifying for DC 7804), instability or breakdown of the scar (qualifying for DC 7804), limitation of motion if over a joint (DC 7805), and size of the scar in relation to rating thresholds for DC 7802.

Avoid: Do not say 'the scar is mostly fine' if it causes you pain even occasionally. A scar that is painful even intermittently qualifies as a painful scar under DC 7804. Report your worst-day experience, not your best day.

Functional Impairment from Melanoma or Treatment

How to describe it: Describe how melanoma, surgery, or treatment has impaired your ability to use the affected body part, perform work duties, or complete daily activities. If lymph node dissection caused lymphedema, describe swelling, heaviness, and functional limitations in detail.

Example: After my axillary lymph node dissection, I developed chronic lymphedema in my left arm. On my worst days, my arm is so swollen and heavy that I cannot lift it above shoulder height, cannot type for more than 15 minutes without pain, and cannot carry groceries. The swelling requires daily compression garment use and manual drainage therapy.

Examiner listens for: Residual functional impairment from surgery (e.g., lymphedema, limited range of motion, nerve damage), treatment side effects affecting body systems (e.g., peripheral neuropathy from chemotherapy, immune-related adverse events from immunotherapy), and how these impairments affect work and daily functioning.

Avoid: Do not fail to report lymphedema, neuropathy, joint pain, chronic fatigue, or other systemic effects of treatment. These may support separate ratings under the appropriate body system diagnostic codes or additional SMC considerations.

Disfigurement of Head, Face, or Neck

How to describe it: If your melanoma was located on the head, face, or neck, describe the visual appearance of the residual scar or defect, including color changes, tissue distortion, loss of symmetry, and any psychological or social impact. Be factual and specific.

Example: The excision scar on my left cheek is approximately 4 centimeters long, raised, and hyperpigmented. It causes a visible tissue depression that distorts my facial symmetry. I have avoided social situations because of the appearance, and I experience significant emotional distress when I see my reflection.

Examiner listens for: Location on head, face, or neck; visible characteristics of disfigurement; size and character of the scar; whether the scar is near or involves loss of anatomical structures (nose, ear, lip); and psychosocial impact.

Avoid: Do not minimize disfigurement by saying 'it's not that bad.' The examiner must document objective findings, but your subjective experience of impact is also relevant. DC 7800 has multiple severity levels based on the character of disfigurement.

Disease Recurrence, Metastasis, and Ongoing Surveillance

How to describe it: Describe your ongoing surveillance schedule, any recurrences you have experienced, and any findings on imaging or biopsies. If you are under active monitoring for potential recurrence, that is relevant context.

Example: I completed immunotherapy 8 months ago. I am still undergoing PET scans every 6 months and full-body skin exams every 3 months due to the high-risk stage of my original melanoma. I have significant anxiety related to recurrence that affects my sleep and daily functioning. A recent lymph node on my right groin was identified as suspicious and a biopsy is pending.

Examiner listens for: Active disease versus remission status, surveillance frequency indicating ongoing medical concern, recurrence history, documented metastasis to any organ system, and the psychological burden of ongoing surveillance.

Avoid: Do not present yourself as 'cured' simply because treatment is complete. VA rates melanoma on residuals after treatment completion, but ongoing surveillance, risk of recurrence, and treatment side effects remain relevant. Report all of these accurately.

Common mistakes to avoid

Failing to document that surgery went beyond wide local excision

Why: Many veterans know they had 'skin cancer surgery' but do not realize that a sentinel lymph node biopsy, lymph node dissection, skin graft, or reconstructive flap surgery constitutes surgery 'more extensive than wide local excision' - the legal threshold for the 100% evaluation under DC 7833.

Do this instead: Obtain your operative reports and review them before the exam. Bring copies to the appointment. Specifically tell the examiner: 'My surgery included a sentinel lymph node biopsy and complete axillary lymph node dissection, which I understand is more extensive than wide local excision.' Know the exact name of every procedure you underwent.

Impact: 100%

Not mentioning immunotherapy or targeted therapy by name

Why: Veterans sometimes describe their treatment as 'the cancer pills' or 'the infusions' without specifying the agent. Immunotherapy agents (pembrolizumab, nivolumab, ipilimumab) and BRAF/MEK targeted therapies are systemic agents that may qualify as treatment comparable to systemic malignancy treatment, triggering the 100% provision. If not documented specifically, the examiner may not apply the 100% provision.

Do this instead: Know the names of every medication you received for your melanoma. Bring a complete medication list from your oncologist. Specifically state: 'I received pembrolizumab (Keytruda) immunotherapy infusions every 3 weeks for 12 months, which I understand is systemic treatment comparable to chemotherapy.'

Impact: 100%

Describing scars as healed and non-problematic when they are actually painful

Why: Veterans commonly minimize scar symptoms, particularly if the scar is not visually dramatic. However, any scar that is painful - even intermittently - qualifies as a 'painful scar' under DC 7804, which is separately ratable. Failing to report this leaves a compensable condition undocumented.

Do this instead: Report all scar symptoms accurately, including intermittent pain with clothing contact, pressure, or weather changes. State your worst-day experience. Use specific language: 'This scar is painful when touched, when wearing a seatbelt, and when the temperature drops. On my worst days, the pain is a 6/10.'

Impact: Scar rating under DC 7804

Not reporting treatment-related complications as separate potential disabilities

Why: Melanoma treatment - particularly lymph node dissection and immunotherapy - commonly causes secondary conditions (lymphedema, peripheral neuropathy, immune-related adverse events, chronic fatigue) that may be independently ratable or support higher combined ratings. Veterans who focus only on the melanoma itself may miss these.

Do this instead: Report every persistent symptom related to your melanoma treatment, including lymphedema, neuropathy, fatigue, joint pain, gastrointestinal issues from immunotherapy, and hormonal changes. Ask your VSO whether these should be claimed as secondary conditions at the same time.

Impact: Secondary/associated conditions

Attending the exam without records of treatment dates

Why: The 100% evaluation is assigned from the 'date of onset of treatment.' Without precise treatment dates, the effective date for the 100% rating may be delayed or incorrectly established, potentially costing the veteran months of back pay.

Do this instead: Bring a written timeline of your melanoma treatment: date of diagnosis, date of each surgery, date systemic treatment began, date treatment was completed or anticipated completion. Provide copies to the examiner and retain copies for yourself.

Impact: 100% effective date

Assuming the examiner will find all scars without direction

Why: C&P exams are typically brief. An examiner may examine the primary excision site without checking for additional scars from graft donor sites, lymph node surgery sites, port placement sites, or satellite lesion excisions. Unmeasured scars cannot be rated.

Do this instead: Before the exam, make a written list of every scar location on your body related to melanoma treatment. At the exam, actively direct the examiner: 'I also have a scar at [location] from [procedure]. Can you examine and measure that one as well?'

Impact: Scar ratings under DC 7801-7805

Not requesting the mandatory 6-month post-treatment examination if it was not scheduled

Why: After completing qualifying systemic treatment, VA is required to conduct a mandatory examination approximately 6 months post-treatment to assess the veteran's status. If this exam was not scheduled, the veteran may remain at 100% indefinitely or the rating may be improperly reduced without the required examination.

Do this instead: Track your treatment completion date. If a VA exam was not scheduled within approximately 6-7 months of completing treatment, contact your VSO or VA Regional Office to request the mandatory examination. Your 100% rating cannot be reduced without this examination and proper notice under - 3.105(e).

Impact: 100% continuation and transition to residuals rating

Prep checklist

  • critical

    Gather complete oncology and surgery treatment records

    Obtain operative reports for all surgeries (biopsy, wide local excision, sentinel node biopsy, lymph node dissection, skin graft, reconstruction). These documents specify the exact type of surgery performed, which is critical for establishing whether surgery exceeded wide local excision.

    before exam

  • critical

    Create a written treatment timeline with exact dates

    Document: date of initial melanoma diagnosis; date(s) of all surgical procedures; date systemic treatment (chemotherapy, immunotherapy, targeted therapy) began; name(s) of all systemic agents received; date treatment was completed or anticipated completion date; any recurrences and their dates.

    before exam

  • critical

    Know the names of all systemic treatments received

    Write down the exact names of any immunotherapy agents (e.g., pembrolizumab/Keytruda, nivolumab/Opdivo, ipilimumab/Yervoy), targeted therapy agents (e.g., vemurafenib/Zelboraf, dabrafenib/Tafinlar, trametinib/Mekinist), or chemotherapy agents (e.g., dacarbazine, temozolomide). These are essential for the examiner to classify your treatment correctly.

    before exam

  • critical

    Map all scar locations on your body

    Create a written list of every scar related to your melanoma treatment: primary excision site, graft donor site, lymph node surgery site, port or catheter placement site, any additional biopsy sites. Note the approximate location, size (if known), and whether each is painful, unstable, or functionally limiting.

    before exam

  • recommended

    Obtain a letter from your oncologist summarizing treatment

    Ask your treating oncologist or surgical oncologist to write a brief letter summarizing your melanoma stage (Breslow depth, Clark level, ulceration, mitotic rate), all treatments received and their dates, current disease status (active/remission/NED), and any ongoing surveillance requirements. This letter can support the examiner's findings.

    before exam

  • recommended

    Document all treatment side effects and residual symptoms

    Write a list of every persistent symptom caused by your melanoma treatment, including lymphedema, peripheral neuropathy, chronic fatigue, joint pain, skin changes, immune-related adverse events, hormonal changes, and psychological symptoms. Note frequency, severity, and functional impact.

    before exam

  • recommended

    Consult with a VSO about secondary condition claims

    If you have lymphedema from lymph node dissection, peripheral neuropathy from chemotherapy, immune-related adverse events from immunotherapy, or other treatment-related conditions, ask a Veterans Service Officer whether these should be claimed as secondary service-connected conditions concurrently with this claim.

    before exam

  • optional

    Review applicable scar diagnostic codes

    Familiarize yourself with DC 7800 (disfigurement of head/face/neck), DC 7801 (scars, deep non-linear), DC 7802 (superficial non-linear scars), DC 7803 (linear scars), DC 7804 (painful or unstable scars), and DC 7805 (scars with functional impairment). Understanding these codes helps you ensure the examiner documents all relevant scar characteristics.

    before exam

  • critical

    Wear clothing that allows access to all scar sites

    Wear loose, easily removable clothing so the examiner can inspect and measure every scar. If you have scars on your back, torso, axilla, or groin, ensure these areas are accessible without requiring you to completely undress if possible.

    day of

  • critical

    Bring all medical records and treatment timeline

    Bring physical or digital copies of operative reports, oncology treatment records, pathology reports (including melanoma staging information), radiation treatment records, and your written treatment timeline. Offer copies to the examiner.

    day of

  • critical

    Do not minimize your symptoms on the day of the exam

    Report your condition as it is on your worst days, not your best days. Per M21-1 guidance, veterans should communicate the full spectrum of their symptoms. If you are having a better day than usual, explicitly tell the examiner: 'Today is not a typical worst day for me - my worst days involve [describe worst-day symptoms].'

    day of

  • recommended

    Ask to have your exam recorded if permitted in your state

    Veterans have the right to record their C&P exam in many states. Check the laws in your state beforehand. If permitted, inform the examiner at the start of the appointment that you will be recording for your personal records.

    day of

  • critical

    Direct the examiner to every scar site

    Do not wait for the examiner to find your scars. Actively state: 'I have a scar here from my wide local excision, and I also have scars here from my sentinel lymph node biopsy and here from the complete lymph node dissection. I would like all of these examined and measured.' Request that each scar be measured in centimeters (length and width) and documented as painful or unstable if applicable.

    during exam

  • critical

    Confirm the examiner documents treatment type correctly

    During the interview, confirm that the examiner is documenting the specific type of treatment you received. If they refer to your surgery generically, clarify: 'To be precise, I underwent a sentinel lymph node biopsy and a complete axillary lymph node dissection, which I understand is more extensive than wide local excision.' For systemic treatment: 'I received pembrolizumab immunotherapy, which is a systemic treatment.'

    during exam

  • recommended

    Report functional limitations clearly

    If you have lymphedema, reduced range of motion from surgery, neuropathy, or other functional limitations, describe these specifically: 'Because of lymphedema from my lymph node dissection, I cannot lift my arm above shoulder height, I cannot carry more than [X] pounds, and I require a compression garment daily.'

    during exam

  • recommended

    Report worst-day symptoms for each condition

    For each symptom you describe - scar pain, functional impairment, fatigue, lymphedema - explicitly state what it is like on your worst days. Use the phrase: 'On my worst days...' to ensure the examiner captures the full severity.

    during exam

  • critical

    Request a copy of the completed DBQ

    After the exam, request a copy of the completed Skin Diseases DBQ through your VA MyHealtheVet account, eBenefits, or by submitting a records request. Review it carefully to ensure all scars were measured, treatment type was correctly classified, and current disease status was accurately documented.

    after exam

  • critical

    Review the DBQ for accuracy and report errors to your VSO

    If the DBQ contains factual errors - such as wrong surgery type, missing scars, incorrect treatment dates, or failure to note painful/unstable scars - report these to your VSO immediately. You may be able to submit a written statement to correct the record or request a new examination if the DBQ is materially deficient.

    after exam

  • critical

    Track the mandatory 6-month post-treatment examination requirement

    If you are currently undergoing qualifying treatment (systemic chemotherapy, immunotherapy, radiation beyond skin, surgery beyond wide local excision), note the date treatment is completed. VA is required to schedule a mandatory examination approximately 6 months after completion. If this exam is not scheduled, contact your VSO to ensure compliance with the - 3.105(e) provisions.

    after exam

  • recommended

    File separate claims for secondary conditions if applicable

    If your C&P exam identified or you reported conditions secondary to melanoma treatment (lymphedema, neuropathy, immune-related adverse events), ensure these are formally claimed as secondary service-connected conditions with appropriate nexus documentation from your treating provider.

    after exam

Your rights during a C&P exam

  • You have the right to record your C&P examination in many states - check your state's laws on one-party or two-party consent for audio recording before the exam.
  • You have the right to receive a copy of the completed DBQ through your VA records - request this via MyHealtheVet or a formal records request after the exam.
  • You have the right to submit a written statement correcting factual errors in the DBQ if you believe the examiner inaccurately documented your condition, treatment type, or scar findings.
  • Under 38 CFR - 3.105(e), your 100% rating (if applicable) cannot be reduced without a mandatory examination and proper advance written notice from VA, giving you an opportunity to respond.
  • You have the right to a new or additional C&P examination if the original DBQ is found to be inadequate, incomplete, or based on an inaccurate factual premise - your VSO can help you challenge an insufficient exam.
  • You have the right to bring a VSO, accredited claims agent, or attorney to your C&P exam to observe (though they typically may not actively participate in the medical examination itself).
  • You have the right to submit buddy statements (lay statements from family, friends, or colleagues) corroborating your symptom descriptions, functional limitations, and treatment history.
  • VA's duty to assist requires that the agency help you obtain relevant records (including private medical records with your authorization) - you do not have to obtain all records independently.
  • You have the right to request an Independent Medical Opinion (IMO) from a private physician if you believe the C&P examiner's conclusions are inaccurate or insufficiently supported.
  • Under the PACT Act and related legislation, veterans exposed to toxic substances may have additional presumptive service connection considerations - consult your VSO about whether any environmental exposure during service is relevant to your melanoma claim.
  • If treatment is ongoing, VA should not reduce your 100% rating without conducting the mandatory 6-month post-treatment examination required under - 3.105(e) - any premature reduction is appealable.

Related conditions

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This C&P exam preparation guide is for educational purposes only and does not constitute legal, medical, or claims advice. Always consult with a qualified Veterans Service Organization (VSO) representative or VA-accredited attorney for guidance specific to your claim. Never exaggerate, minimize, or fabricate symptoms during a C&P examination.