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VA Rating Assistant

DC 7520 · 38 CFR 4.115b

Penis, Removal of Glans C&P Exam Prep

To document the anatomical extent of penile tissue loss, confirm the nature and cause of the removal or loss, assess any residual functional impairments including urinary and sexual dysfunction, and establish the appropriate disability rating under 38 CFR 4.115b diagnostic codes 7520 or 7521.

Format:
Interview + Physical
Typical duration:
20-30 minutes
DBQ form:
Male_Reproductive_Organ (Male_Reproductive_Organ)
Examiner:
Urologist or Physician

What the examiner evaluates

  • Extent of penile tissue removed or lost (glans only vs. half or more of the entire penis)
  • Whether loss was due to trauma, disease (e.g., penile cancer, Fournier's gangrene), or surgical procedure
  • Presence and severity of urinary voiding dysfunction, including stream abnormalities, hesitancy, frequency, and retention
  • Presence of erectile dysfunction with or without penile deformity (DC 7522)
  • Any urethral stricture disease or need for periodic catheterization
  • Post-void residual urine volume
  • Incontinence severity and use of absorbent materials
  • Presence of any neoplasm (benign or malignant) related to the condition
  • Current treatment status including surgery dates, radiation, chemotherapy, or hormonal therapy
  • Functional impact on work, daily activities, and quality of life
  • Eligibility for Special Monthly Compensation (SMC-K) based on anatomical loss of a creative organ

This exam involves an in-person physical examination of the genitourinary system. You have the right to request a same-sex examiner. In most states, you have the right to record the examination. Bring a support person if needed, but note the examiner may ask them to wait outside during the physical examination portion. The exam will include review of service treatment records, VA medical records, and any private medical records submitted.

Measurements and tests

Physical Measurement of Penile Tissue Loss

What it measures: The anatomical extent of penile tissue removed or absent, specifically whether loss encompasses the glans only (DC 7521, 20%) or half or more of the entire penile shaft (DC 7520, 30%)

What to expect: The examiner will visually inspect and potentially measure the remaining penile tissue. They will document whether the glans (head of the penis) is absent and the extent of any additional shaft tissue loss. Photographs may be taken for the record.

Critical thresholds

  • Loss or removal of the glans only 20% rating under DC 7521 - confirm the glans is completely absent, not merely scarred or deformed
  • Loss or removal of half or more of the penile shaft (including glans) 30% rating under DC 7520 - the higher rating requires documented loss of at least half of the total penile length
  • Loss of less than half of the penile shaft Rated under DC 7521 or DC 7522 depending on functional residuals; ensure any deformity with erectile dysfunction is captured under DC 7522 (0% but SMC-K eligible)

Tips

  • Ensure the examiner documents the complete absence of the glans, not merely partial damage
  • If penile shaft tissue beyond the glans was removed, explicitly state the approximate length or proportion of the shaft that is absent
  • Bring operative reports, pathology reports, or discharge summaries that describe the extent of surgical resection
  • If the loss occurred due to trauma rather than surgery, bring any service records, injury reports, or post-injury medical documentation

Pain considerations: Report any phantom sensation, stump pain, scarring pain, or hypersensitivity at the surgical site or remaining tissue, as these may support additional ratings or functional impairment documentation.

Uroflowmetry / Voiding Function Assessment

What it measures: Urinary stream strength and flow rate, particularly peak flow rate, to detect obstructive voiding dysfunction that may result from urethral changes following penile surgery

What to expect: You may be asked to urinate into a specialized device that measures urine flow rate. A peak flow rate of less than 10 cc/sec is a specific threshold noted in the DBQ. Post-void residual (PVR) may also be measured via ultrasound to determine how much urine remains in the bladder after voiding.

Critical thresholds

  • Peak flow rate less than 10 cc/sec Supports obstructive voiding dysfunction ratings; may support higher combined ratings when evaluated alongside the penile loss rating
  • Post-void residual greater than 150 cc Indicates significant urinary retention; may support additional rating under voiding dysfunction criteria
  • Urinary retention requiring intermittent catheterization Elevates the severity of voiding dysfunction documentation and may support a higher combined genitourinary rating

Tips

  • Arrive with a comfortably full bladder if uroflowmetry is likely to be performed
  • Report your typical voiding interval accurately - how often you urinate during the day and how many times you wake at night
  • Note whether you experience hesitancy, slow or weak stream, dribbling, or a sensation of incomplete emptying
  • If you use a urinary appliance or catheter, bring it to the exam and describe how frequently you use it

Pain considerations: Report any pain or burning with urination, urethral discomfort, or difficulty directing the urine stream due to absence of the glans, which normally assists with stream direction.

Assessment of Erectile Dysfunction

What it measures: Presence and severity of erectile dysfunction (ED) with or without penile deformity following penile surgery or trauma, evaluated under DC 7522

What to expect: The examiner will ask about your ability to achieve and maintain erections, whether ED was present before or developed after the penile loss, and whether you use any assistive devices or medications. This is typically an interview-based assessment rather than a physical measurement.

Critical thresholds

  • Complete loss of erectile function (loss of use of a creative organ) Rated 0% under DC 7522 but qualifies for Special Monthly Compensation (SMC-K) under 38 U.S.C. 1114(k) and 38 CFR 3.350(a) - this is a significant benefit separate from the percentage rating
  • Penile deformity interfering with sexual function Also rated under DC 7522; document any scarring, angulation, or structural changes to remaining tissue

Tips

  • Be explicit that your ED is directly related to the penile tissue loss or surgical procedure
  • Mention if ED developed immediately after surgery or trauma versus pre-existing
  • Ask your examiner to document SMC-K eligibility if you have complete loss of use of the creative organ
  • Describe any psychological impact of the condition on intimacy and relationships to support the functional impact section of the DBQ

Pain considerations: Report any pain associated with attempted sexual activity, residual stump sensitivity, or psychological distress (anxiety, depression) related to the sexual dysfunction, which may support claims for related mental health conditions.

Rating criteria by percentage

30%

Removal of half or more of the penis, including the glans and a significant portion of the penile shaft. This is the maximum schedular rating under DC 7520 and reflects the most extensive anatomical loss.

Key symptoms

  • Complete absence of the glans and at least half of the total penile shaft length
  • Altered or impaired urinary stream direction and control due to absence of the natural urethral meatus positioning
  • Erectile dysfunction secondary to tissue loss (rated separately under DC 7522 with SMC-K potential)
  • Scarring, contracture, or deformity of the remaining penile stump
  • Psychological and functional impact on sexual and reproductive capability
  • Possible need for urinary appliance or assistive device for voiding

From 38 CFR: 38 CFR 4.115b, DC 7520: 'Penis, removal of half or more' - rated at 30%. Note 1 indicates this condition may entitle the veteran to Special Monthly Compensation under 38 CFR 3.350(a) for anatomical loss of a creative organ.

20%

Removal or loss of the glans penis only, without removal of half or more of the penile shaft. This applies when the glans (head) is absent but a substantial portion of the shaft remains intact.

Key symptoms

  • Complete absence of the glans penis confirmed on physical examination
  • Remaining penile shaft is more than half of the original length
  • Altered urinary stream due to absent natural meatus structure
  • Erectile dysfunction may be present and rated separately under DC 7522
  • Scarring or deformity at the site of glans removal
  • Possible urethral stricture or meatal stenosis as a residual of surgery

From 38 CFR: 38 CFR 4.115b, DC 7521: 'Penis, removal of glans' - rated at 20%. Note 1 similarly applies for SMC-K eligibility if there is loss of use of a creative organ.

0%

Erectile dysfunction with or without penile deformity rated separately under DC 7522. While the schedular rating is 0%, this is critically important because it qualifies the veteran for Special Monthly Compensation (SMC-K), which provides additional monthly compensation above the combined rating.

Key symptoms

  • Inability to achieve or maintain an erection sufficient for sexual intercourse
  • Loss of use of a creative organ due to penile tissue loss or surgical/traumatic damage
  • Penile deformity (scarring, angulation, contracture) interfering with sexual function
  • Psychological sequelae including depression and anxiety secondary to sexual dysfunction

From 38 CFR: 38 CFR 4.115b, DC 7522: 'Erectile dysfunction, with or without penile deformity' - rated at 0%. Note: a disease or traumatic injury of the penis resulting in scarring or deformity shall be rated under DC 7522. SMC-K entitlement under 38 U.S.C. 1114(k) and 38 CFR 3.350(a) applies when there is anatomical loss or loss of use of a creative organ.

Describing your symptoms accurately

Anatomical Extent of Penile Loss

How to describe it: Clearly and factually describe what tissue was removed, when, and why. State whether the glans is completely absent. If more tissue was removed, describe the approximate proportion of the shaft that is gone. Reference your operative reports or medical records to anchor your description in documented facts.

Example: On my worst days, the physical absence of the glans and portion of my penis causes significant difficulty with urinary stream control, requiring me to sit to urinate to prevent splashing. I experience discomfort at the surgical site, and the visible disfigurement causes me significant psychological distress, including avoidance of intimate situations.

Examiner listens for: Clear confirmation that the glans is absent and the extent of any additional shaft tissue loss. The examiner needs precise anatomical information to select between DC 7520 (half or more removed) and DC 7521 (glans only). They also listen for any spontaneous description of functional limitations.

Avoid: Do not say 'it was just a partial surgery' or minimize the extent of tissue removed. Do not assume the examiner has reviewed your surgical records. State explicitly: 'The glans was completely removed' or 'approximately [X]% of the penile shaft was removed along with the glans.'

Urinary Voiding Dysfunction

How to describe it: Describe your urinary habits in specific, quantifiable terms. Report daytime voiding frequency (hours between urinations), nighttime awakenings to void, stream strength, hesitancy, dribbling, incomplete emptying, and any episodes of retention. Reference your worst typical day, not your best day.

Example: On my worst days, I urinate every hour during the day and wake up three to four times at night to void. My stream is slow and weak, and I have difficulty directing the stream without the glans. I often experience dribbling after voiding and a persistent feeling that my bladder is not fully empty. I have had episodes where I could not urinate at all and required catheterization.

Examiner listens for: Specific voiding intervals, nighttime awakening frequency, stream characteristics (weak, slow, hesitant), and any history of urinary retention or catheter use. These directly map to checkboxes on the DBQ that correspond to different rating levels.

Avoid: Do not say 'I use the bathroom a normal amount' if you are compensating with behavioral adjustments like limiting fluid intake. Report your symptoms as they occur when you have not intentionally restricted fluids or activity. Do not omit nighttime voiding symptoms - nocturia is heavily weighted in genitourinary ratings.

Erectile Dysfunction and Sexual Function

How to describe it: Be direct and clinically factual. State whether you can achieve an erection, whether it is sufficient for sexual intercourse, and whether the dysfunction began after your penile surgery or trauma. Describe any penile deformity of the remaining shaft tissue, including scarring or abnormal angulation.

Example: Since the surgery, I have been completely unable to achieve an erection. This represents a total loss of sexual function that I did not experience before my service-connected condition. The scarring on the remaining penile shaft creates a deformity that would prevent normal sexual function even if partial erectile function were present. This has caused significant depression and has severely impacted my relationship with my spouse.

Examiner listens for: Clear establishment that erectile dysfunction is present and that it is related to the penile tissue loss. The examiner also listens for any penile deformity on the remaining shaft, use of erectile aids (vacuum devices, medications, penile implants), and the psychological impact. This supports both DC 7522 and SMC-K eligibility.

Avoid: Do not omit erectile dysfunction because it is rated at 0% - the SMC-K benefit it triggers can be worth hundreds of dollars per month in additional compensation. Do not fail to mention the emotional and relational impact. Do not assume the examiner will independently assess SMC-K eligibility without your prompting the documentation of loss of use of a creative organ.

Pain, Scarring, and Residual Physical Symptoms

How to describe it: Describe any ongoing pain at the surgical site or stump, hypersensitivity, phantom sensations, scar tissue discomfort, or difficulty with clothing contact on the remaining tissue. Use a consistent pain scale (0-10) and describe frequency, duration, and triggers.

Example: On my worst days, the scar tissue at the surgical site is hypersensitive and causes a burning, aching pain rated 7 out of 10 that lasts for hours. Contact with clothing aggravates the pain. I experience phantom sensations in the absent glans several times per week. The scarring has contracted and causes visible deformity of the remaining shaft.

Examiner listens for: Any ongoing pain, sensitivity, or physical discomfort associated with the tissue loss. The examiner documents this in the functional impact and remarks sections of the DBQ, which supports the overall picture of disability severity and may support related claims for penile deformity under DC 7522.

Avoid: Do not minimize pain by saying 'it's manageable' without describing its frequency and impact. Do not omit phantom sensations - these are medically recognized sequelae of tissue amputation. Report your actual pain levels, not what you think is acceptable to mention.

Psychological and Functional Impact

How to describe it: Describe how the condition affects your work, relationships, daily activities, and mental health. Be specific about activities you can no longer perform or must modify. Include the impact on employment if relevant (e.g., difficulty with urination in workplace settings, need for frequent bathroom breaks, avoidance of physical activity due to discomfort).

Example: The disfigurement and functional loss from this condition has caused me to withdraw from social situations and intimate relationships. I experience depression and anxiety that I attribute directly to this condition. At work, I must take additional bathroom breaks and use the accessible stall to sit and urinate. I avoid physical activity that causes friction or discomfort at the surgical site. I have been in mental health treatment since the injury.

Examiner listens for: Concrete examples of how the condition limits daily function, employment, and quality of life. The DBQ has a dedicated functional impact field that the examiner must complete, and specific examples you provide will be recorded verbatim or summarized. This information also supports secondary mental health condition claims.

Avoid: Do not say 'I get by fine' when describing your daily function if you have substantially altered your lifestyle to accommodate this condition. Adjustments and workarounds are evidence of disability, not evidence of normalcy. Describe what you cannot do naturally, not just what you have adapted to do differently.

Common mistakes to avoid

Failing to distinguish between removal of the glans only (DC 7521, 20%) versus removal of half or more of the total penis (DC 7520, 30%)

Why: The distinction between these two diagnostic codes is worth a 10-percentage-point difference in the rating (20% vs. 30%). Veterans sometimes broadly describe their surgery without specifying the anatomical extent, leaving the examiner without sufficient information to apply the higher-rated DC 7520.

Do this instead: Bring your operative report to the exam and explicitly state: 'The surgery removed [the glans and approximately X cm/proportion of the penile shaft].' Ask the examiner to document whether the loss constitutes removal of half or more of the penis, which should trigger DC 7520 at 30%.

Impact: 30% (DC 7520) vs. 20% (DC 7521)

Not claiming erectile dysfunction separately under DC 7522 and missing SMC-K eligibility

Why: Veterans with penile tissue removal frequently have co-existing erectile dysfunction, which is rated under a separate diagnostic code (DC 7522) at 0%. While the rating appears to add nothing financially, it triggers eligibility for Special Monthly Compensation under SMC-K, which provides significant additional monthly compensation beyond the combined disability rating.

Do this instead: Explicitly report erectile dysfunction to the examiner and ensure it is documented as a separate diagnosis on the DBQ. Ask the examiner to note loss of use of a creative organ and SMC-K eligibility. File a separate claim for erectile dysfunction if it has not been service-connected.

Impact: SMC-K eligibility (significant additional monthly benefit beyond schedular rating)

Describing symptoms only on average days rather than worst typical days

Why: M21-1 guidance directs that ratings should reflect the predominant symptom picture, including the frequency and severity of the worst manifestations. VA adjudicators are trained to consider 'worst day' reporting, and underreporting leads to ratings that do not reflect the full disability.

Do this instead: Prepare specific examples of your worst typical days before the exam. Use concrete language: 'On my worst days, which occur [X times per week/month], I experience [specific symptoms].- Frame your condition at its worst without fabricating or exaggerating.

Impact: All rating levels - affects both primary rating and functional impact documentation

Neglecting to document urinary dysfunction symptoms that may exist as a residual of penile surgery

Why: Penile surgery, particularly total or partial penectomy, can result in urethral changes, meatal stenosis, or altered voiding mechanics. These voiding symptoms are separately evaluated on the DBQ and can support additional genitourinary ratings when combined with the penile loss rating.

Do this instead: Track your voiding patterns for at least one to two weeks before the exam. Note your daytime voiding interval, nighttime awakenings, stream characteristics, and any episodes of urinary retention. Report these accurately to the examiner even if you have not previously discussed them with a provider.

Impact: Voiding dysfunction ratings that combine with penile loss rating in the overall genitourinary evaluation

Failing to bring documentation of the surgical procedure, diagnosis, and treatment history

Why: The DBQ requires specific dates of surgery, diagnosis, and treatment completion. An examiner who cannot access these records may document incomplete information, which can delay processing or result in a lower rating due to insufficient evidence of the extent of the condition.

Do this instead: Bring copies of all surgical reports, pathology reports, operative notes, treatment records, and follow-up care documentation. Organize these chronologically and flag the key documents (date of surgery, description of tissue removed, treating physician's notes on functional outcomes).

Impact: All rating levels - affects completeness of the DBQ and nexus documentation

Not mentioning psychological sequelae (depression, anxiety, PTSD-like symptoms) related to the penile loss

Why: Mental health conditions secondary to physical disability are ratable and compensable as secondary service-connected conditions. Veterans often omit psychological symptoms during genitourinary exams, missing an opportunity to initiate or support secondary mental health claims.

Do this instead: Briefly but clearly mention any depression, anxiety, relationship difficulties, or psychological distress related to your penile loss or erectile dysfunction. The examiner can document this in the functional impact section, and you can file a separate secondary claim for a mental health condition if not already service-connected.

Impact: Secondary mental health condition claims - separate from the genitourinary rating

Prep checklist

  • critical

    Gather all surgical and medical records related to the penile loss

    Collect operative reports, pathology reports, discharge summaries, post-operative follow-up notes, and any records from treating urologists or oncologists. These documents provide the anatomical detail (extent of tissue removed, date of surgery) that distinguishes DC 7520 from DC 7521 and establishes the service nexus.

    before exam

  • critical

    Research and understand the DC 7520 vs. DC 7521 distinction

    DC 7520 (removal of half or more, 30%) and DC 7521 (removal of glans, 20%) are separated by a 10-point difference. Review your surgical records to determine which applies. If you lost the glans plus a significant portion of the shaft, ensure you can clearly articulate this to the examiner.

    before exam

  • critical

    Track voiding patterns for one to two weeks before the exam

    Keep a voiding diary documenting: daytime frequency (hours between voids), nighttime awakenings to urinate, stream quality (weak, slow, hesitant, dribbling), episodes of incomplete emptying, and any use of catheterization or urinary appliances. Bring this diary to the exam.

    before exam

  • critical

    Prepare a written symptom summary in your own words

    Write a one to two page summary describing: (1) the date, cause, and extent of penile loss; (2) your current urinary symptoms on worst and average days; (3) your erectile function status; (4) any physical symptoms (pain, scarring, hypersensitivity); and (5) functional impact on work, relationships, and daily activities. Bring this to read from or reference during the exam.

    before exam

  • critical

    File or confirm a separate claim for erectile dysfunction (DC 7522) if not already service-connected

    If you have not separately claimed erectile dysfunction, consider doing so before or simultaneously with this exam. A DC 7522 rating at 0% is needed to trigger SMC-K eligibility. Consult a Veterans Service Organization (VSO) or accredited claims agent if needed.

    before exam

  • recommended

    Verify your right to record the exam and prepare your recording device

    Most states permit recording of C&P examinations. Notify the exam facility in advance that you intend to record. Bring a smartphone or voice recorder, ensure it is charged, and have your recording application ready before you enter the exam room.

    before exam

  • recommended

    Contact a VSO or accredited claims agent to review your claim file before the exam

    A VSO can review your claims file (C-file) to confirm what evidence the examiner will have access to and identify any gaps in documentation. They can also advise on whether to request a records subpoena for service treatment records or private medical records not yet in the file.

    before exam

  • optional

    Consider requesting a same-sex examiner if preferred

    VA policy permits veterans to request a same-sex examiner for sensitive examinations. Submit this request to the exam scheduling office in advance of your appointment. This is a personal comfort decision and will not negatively affect your claim.

    before exam

  • critical

    Arrive early with all documents organized

    Arrive 15 minutes early. Bring your voiding diary, symptom summary, surgical records, and any current medications list. Organize documents in chronological order with key pages flagged. Bring a copy of your rating decision if previously rated for related conditions.

    day of

  • recommended

    Do not restrict fluids in anticipation of the exam if uroflowmetry is possible

    If uroflowmetry is to be performed, you need a comfortably full bladder. Unless directed otherwise by the facility, maintain your normal hydration. Restricting fluids to avoid urinary symptoms will artificially improve your uroflowmetry results and may result in an underestimate of your disability.

    day of

  • recommended

    Announce your intent to record the examination before it begins

    Inform the examiner at the start of the appointment that you intend to record the exam. Place your recording device visibly on the exam table or counter. If the examiner objects, note this objection for your records and contact VA or your VSO to address it.

    day of

  • critical

    Report symptoms at their worst, not their best

    When the examiner asks about your symptoms, describe your worst typical days. Use phrases such as 'on my worst days' or 'at its most severe' to frame your descriptions. Do not minimize symptoms out of stoicism or embarrassment - the examiner is there to document your condition as it truly is.

    day of

  • critical

    Explicitly confirm the anatomical extent of your penile loss

    Do not wait for the examiner to make this determination solely from physical inspection. Verbally state: 'The glans was completely removed in the surgery on [date]' or 'The surgery removed the glans and approximately [proportion] of the penile shaft.' Reference your operative report if you have it.

    during exam

  • critical

    Report erectile dysfunction and request documentation of SMC-K eligibility

    Explicitly state: 'I have complete erectile dysfunction as a result of this condition, which represents loss of use of a creative organ.' Ask the examiner directly: 'Will you be documenting loss of use of a creative organ for Special Monthly Compensation purposes?' Ensure this is addressed.

    during exam

  • critical

    Provide specific examples of functional limitations

    When asked about functional impact, give concrete examples: 'I must sit to urinate due to inability to direct the stream'; 'I cannot engage in sexual intercourse'; 'I take 3-4 bathroom breaks during an 8-hour workday'; 'I wake up 3 times per night to urinate.' Specific examples are more compelling and documentable than general statements.

    during exam

  • recommended

    Mention all related symptoms including pain, scarring, and psychological impact

    Do not wait to be asked about every symptom. Proactively mention: site pain or hypersensitivity, phantom sensations, scar tissue changes, depression or anxiety, and relationship impact. If you are in mental health treatment related to this condition, state this clearly.

    during exam

  • critical

    Write notes immediately after the exam

    Within one hour of the exam, write down everything you remember: what the examiner said, what was documented, what questions were asked, any findings mentioned, and anything you forgot to say. If you recorded the exam, review the recording as soon as possible.

    after exam

  • recommended

    Request a copy of the completed DBQ

    You are entitled to a copy of the completed C&P examination report. Submit a written request to the VA Regional Office or contact your VSO to request the DBQ be added to your claims file. Review it for accuracy and completeness before the rating decision is issued.

    after exam

  • recommended

    File a Notice of Disagreement if the exam is inadequate

    If the examiner's report is cursory, fails to address the extent of tissue loss, omits erectile dysfunction, or does not document SMC-K eligibility, you have the right to challenge the adequacy of the examination during the appeals process. Contact your VSO or accredited attorney promptly.

    after exam

  • critical

    Follow up on SMC-K benefit entitlement

    If your rating decision grants DC 7520 or DC 7521 but does not explicitly award SMC-K for loss of use of a creative organ, contact your VSO immediately. SMC-K is a significant additional benefit and must be explicitly awarded. It is not automatically included in the combined rating percentage.

    after exam

Your rights during a C&P exam

  • You have the right to request a same-sex examiner for this sensitive examination. Submit the request to the scheduling office before your appointment.
  • In most states, you have the right to record your C&P examination. Notify the examiner before the exam begins and place your recording device visibly in the room.
  • You have the right to have a support person present during the interview portion of the examination, though the examiner may ask them to step out during the physical examination.
  • You have the right to review your complete claims file (C-file) before your examination. Contact your VSO or the VA Regional Office to request access.
  • You have the right to submit additional evidence (buddy statements, private medical opinions, treatment records) before the rating decision is finalized.
  • You have the right to request an independent medical examination (IME) from a private physician if you believe the VA examination is inadequate or inaccurate.
  • You have the right to challenge a rating decision that does not reflect the full extent of your documented disability through the Supplemental Claim, Higher-Level Review, or Board of Veterans' Appeals process.
  • You have the right to have a Veterans Service Organization representative, accredited claims agent, or accredited attorney represent you at no charge or for regulated fees throughout the claims process.
  • You have the right to be informed of Special Monthly Compensation (SMC-K) eligibility when loss of use of a creative organ is documented. This benefit is separate from and in addition to your schedular combined rating and must be explicitly claimed and awarded.
  • You have the right to a fully reasoned rating decision that explains how your evidence was weighed. If the decision does not clearly address the DC 7520 vs. DC 7521 distinction or SMC-K eligibility, you have the right to request a Higher-Level Review.
  • Under the Benefit of the Doubt standard (38 CFR 3.102), when there is an approximate balance of positive and negative evidence, VA must resolve the question in your favor. Ensure the examiner documents all your symptoms even if their severity is uncertain.

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.