Documenting flare-ups

For musculoskeletal and many other conditions, the VA must consider the worst-case picture of your condition, not just how it looks on the day of a C&P exam. Under Mitchell v. Shinseki (2011) and Correia v. McDonald (2016), C&P examiners are required to address flare-ups and to test range of motion under both passive and active motion in weight-bearing and non-weight-bearing positions.

Keep a symptom diary

Six weeks before a scheduled C&P, start a simple daily log of your condition. Include:

• Date
• Severity (1–10)
• What triggered any flare
• What activities were limited
• What you took for it

This becomes objective evidence the examiner cannot dismiss as memory.

Strategy

If your C&P exam happens on a good day, the rating will reflect a good day. If your symptoms vary, bring your symptom diary and explicitly tell the examiner: “Today is a moderate day. Three days ago I could barely walk. Two weeks ago I had to leave work early.” Force them to document flare-ups in the report. If they don’t, the exam may be inadequate — see inadequate exam doctrine.

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