free_spirit_etc

Jesse, I am getting that more than an increased SC rating - you would really like to have your husband back. So I would encourage you to really encourage some intensive testing to find out what the problem is. Or more likely - they can find out some things the problem is NOT. But I have worked in the field of aging for years - and if a young person has the same problem they try to FIND OUT what is causing it. But for an older person - they often just pass it off as Alzheimer's or Alzheimer's Related Dementia, or "aging" - without really knowing. Amazing also is the doctor's just pass out those diagnosis after talking to an older person for a few minutes. There can be SO many things that cause those symptoms - but if you are older - they just slap an easy lable on it - and no one bothers to question it. SO - question, question, question, until you find what the answers really are. Free

RWAY - I guess my advice is two-fold. As for the hope issue. Your husband's attitude for beating the cancer is one of the strongest medicines he can have right now. My husband had that kind of attitude. My husband died this Febraury, so he didn't "beat it" overall. But he beat it a long time; much longer than anyone thought he would. They only expected him to live a few weeks to a few months in June 2004. He pulled back and lived - not just stayed alive - but really lived - for several years. And he was only really "sick" for a short time before he died. My husband was one of those stubborn ones too. He stayed "full code" until the last day of his life. But then HE decided to stop fighting. He told me he still had the will to live - but didn't have the strength anymore - and asked if it was okay for him to go. So I am not sure if it is denial - or just a focused will to survive. Yes, they don't like to talk about the "waht if's" much. It is almost like they think that if they even consider those things - they will bring them upon themselves. And yes, it is hard for those of us who will be left behind if the "what ifs" happen to not be able to talk about them - or feel like we are not being "supportive" if we do. I do know my husband thought about those things much more than he let on. And we talked about them some. He had started making plans, and gave me the song "If tomorrow never comes will she know how much I love her" several months before he died. Here is a good link for an organization whose sole purpose is to help people with cancer survive. http://www.blochcancer.org/ One of the things they talk about is getting a multi-discliplinary "second opinion." They have resources where you can arrange to meet with a whole panel of experts to discuss the best options for your cancer treatment. They all belong to one medical center - but all work from a different approach - so you get the broad spectrum of ALL the things that can be tried - not just a focused approach from ONE direction. On a practical note - as far as the VA is concerned - I would encourage you to have your husband file an Informal Claim. Get a letter to the VA and tell them you want to file a claim for his cancer - and protect the filing date. That way, if he gets approved for Service Connection - they can pay back to the date of the claim. If you wait until you have ALL the evidence - you can lose several months from the claim date. Also - though I would usually say to wait until you get it all pretty well together to send in the evidence - because the VA is not good at putting together bits and pieces, I would suggest that if you get any strong evidence (Doctor statements, evidence of asbestos exposure, etc.) to go ahead and send it in - and pull it all together later. That is my suggestion to protect accrued benefits, if they ar granted. If your husband would die while they are processing his claim. They close his claim. You can reopen it - and file for DIC (survivor) benefits - and also for accrued benefits (benefits that were due to him at the time of his death). The reason I would suggest sending in any strong evidence as you recive it is that they decide the claim for accured benefits based on what was IN the file at the time the veteran died. If it wasn't IN the file - you can still send it for DIC claim - but it won't be considered in the accrued benefit claim. We had quite a bit of evidence about asbestos exposure for my husband's claim. I had it pretty much pulled together - but wanted to wait until I got it ALL pulled together before I sent it in. I planned to do that during the break from school. Unfortunately, my husband got sick - and caring for him and fighting for his life took precendence at that time. So we had quite a bit of evidence that was not sent in before his death. As a practical matter - I know he would have wanted me to take 10 minutes - stuck it in an envelope - and shipped it to the VA - to get it in the file. But I didn't take the time.I can still submit it - but it might affect the accrued benefits portion of the claim. And if SC gets granted - I really want it to be granted to HIM, even if it didn't pay more. It's one of those widow things. He deserved it. I want HIM to get it, even if he is not here anymore. Free

Rway, It sounds like you might have some backing from the VA doc on a cancer claim. If the doctor can give you a statement that the type of cancer your husband has is a type that can result from asbestos exposure - and that IF your husband WAS exposed to asbestos for 3 years on the ship - that is is more likely than not that the asbestos exposure played some role (or cannot be disassociated from) the eventual development of cancer - then you will need to be able to show that it is more likely than not that your husband was exposed to asbestos while in the service. The claim won't be as easy as claims that are more direct - but can be well worth it - as cancer is rated 100% - I'm not sure of all the Navy PIES that Berta has a list of - but it will strenghten the claim if your husband had a job classification in the Navy that would be assumed to have exposed him to asbestos. Also - it will also help your claim that - for all intents and pusrposes -your husband was a nonsmoker - as they won't be able to blame the cancer on that. What would work against his claim would be if your husband had a job AFTER service that exposed him to asbesots. My thoughts and prayers are with you and your husband and the battle against his cancer. I'm rooting for you 100% Free

You have actually done a pretty amazing job of tracking down all the evidence despite their efforts to destroy and hide it. Amazing that they have people who are being discharged with pyschiatric problems sign papers agreeing to anything to "secure their discharge." Yep. That "informed consent" at it's finest. We will traumatize you - and if you become damaged beyond repair from the trauma - we will make you sign papers agreeing to let us destroy all the records of such trauma if you want to escape. Of course, when you can get SC for the anxiety - you will get secondary connection for ALL the secondary conditions it has created. Free

I remember reading once where if a veteran made a statement that was detrimental to the claim - that such a statement could not be used in adjudicating the claim - that the claim had to be adjudicated as if the veteran had not made the statement. In essence, that would mean that a veteran could not "testify" against themselves. It should also mean the RO / BVA can't use any of the veteran's statements "against" them in denying a claim. I would also think this would apply to contradictory statements - that they couldn't use the rationale I have seen them use where they say the vet reported one thing at one time, and then stated something that contradicts that. If the contradictory statement is a detriment to the the vets claim - the claim should be adjudicated AS IF that statement had NOT been made. Does anyone know the law or policy I am referring to? I know I read it somewhere - quite a while back - and thought it was an interesting concept - and should be kept as a resource for those times the VA uses the old "You said blah blah blah.." to deny a claim. Free

Wishing you the most of luck! I really think the grusesome twosome VA psychiatrists let them down on this one. They wrote up your report stating there was no evidence of anxiety problems in service. Dr. C's letter showed this was not true. The reverand's letters also showed significant problems - pinpointing the change to whatever had occured in the service. And even if Dr. K said there was no problem with nerves in Service - Dr. C's statement showed there was. So Dr. K's notes showed ongoing treatment shortly after the service - AFTER treatment had begun IN Service. So with the VA psychiatrists refusing to RECONCILE their report to EXPLAIN why they stated you had no problems in service with anxiety - DESPITE the fact a doctor who treated you in service wrote that the records show that you did, indeed , recieve treatment for such a condition in service - I don't think the VA could give thier report much weight. 1. It was a NEW diagnosis that doesn't match the diagnosis of any OTHER doctor who has treated you. 2. It was a very GENERAL dianosis (not otherwise specified means they couldn't even fit you into the framework of ANY of the stated personality disorder). 3. They ALSO diagnosed you with Anxiety. 4. They did not RECONCILE their opinion with the FACTS that were presented after their diagnosis. (i.e. Their diagnosis might have looked good when the facts were not known - but once other facts came to light - they needed to reconsile their opinion with THOSE facts - and they did not do so.) Did you ever find out about Doris? As to whether she actually drowned? I was thinking about that. If they can't find a record that someone actually did drown in your training - they COULD try to use that against you - but I think that could easily be argued. 1. It is pretty common knowledge that the military did the "sink or swim" game to "teach" people to swim. 2. It is pretty common knowledge that for those who were terrified of swimming - the experience could be pretty traumatic. 3. As you were personally be traumatized during the event - it would be expected that you would be taking in the events in a terrified state. 4. You did see the people trying to resuscitate Doris. 5. You did NOT see that she was resuscitated. 6. You did NOT see her again after that. 7. In your own trauma you came to the conclusion that she had drowned based on the facts you DID see...and the fact that you did not recieve any facts AFTER that - that would have led you to believe different. 8. A normal person would assume that they would not have to ask - that if Doris was okay - that SOMEONE surely would have informed everyone that she was okay. The fact that no one informed you of anything different would lead a normal person to believe that she did, indeed, drown. So whether or not she actually did drown - you ceratinly have a strong basis for believing she did drown at that time and for all these years. Especially when it was coupled with your own trauma. They won't be able to prove Doris did not drown. They may only be able to show that they didn't fina any evidence that Doris drowned. So the fact that you thought she did drown should be enough. Free

Or is there a possibility he had been exposed to asbstos during his time in the Navy? And that he has a type of cancer that would be related to asbestos expsoure? Also - would there be any benefits available through the department of defense? Free Free

Finally, submitted was a statement from a pastor, Reverend B.O.B. who reported having counseled the veteran during the period from 1965 to 1978, at which time she relayed some of the events in service on which she bases the development of her psychiatric illness, specifically the "near drowning" incidents, and "abuse" directed at her by physicians. Obtaining a copy of these counseling records would be beneficial in adjudicating the veteran's claim. This is good. To me it says they are looking at his statements in a positive way for being able to establish in service incurrance. It would be helpful if Dr. P. would provide the basis for his opinion linking the onset of the veteran's psychiatric disability to service, and whether he has any specialized training or expertise in the field of psychiatric illness. This is good. Again, it is like they are saying -there is some evidence here - it would help if it was stronger. 7. After the above development has been completed, the veteran's claims file should returned to the board of VA psychiatrists who participated in the April 2005 examination for clarification of the provided opinion. They should be requested to review the record and reconcile their opinion as to etiology in light of the evidence added since their examination of the veteran, including the May 2005 statement of Dr. Brian C. Campion and the January 2006 statement of Dr. Michael Payne. Key word here is RECONCILE - they were asked to look at the new evidence (especially the evidence that a doctor IN SERVICE admitted to treating you for anxiety - and the statement where YOUR doctor said that they based their opinion on the fact that your SMRs stated that you were treated for anxiety and depression by Dr. C in the service - that shortly after that you were seen by two psychitrists and got an early discharge - that you have been on medicince from 1967 for anxiety - treated by THEM since 1979 - and that they have maintained all your military and post service medical records. So it looks like these two statements are being considered toward SC. So they asked the gruesome twosome to LOOK at those and RECONSILE their opinions IN LIGHT of those statements. (Reconcile -- to settle - to account for - to resolve the differences) So they were supposed to resolve those differences with their opinion. If their opinion said you had no problems in service - and that you were just unsuitable - then how do they settle - or resolve - that Dr. C treated you for anxiety - and trusted you with his children? And as Pete said - even if you DID have a personality disorder - you can STILL have anxiety as a separate diagnosis. Even THEY gave you a diagnosis of anxiety. But if you had to be treated for anxiety IN SERVICE - and discharged shortly thereafter - then how do they RECONCILE - or account for - saying ALL your problems are caused by this magically appearing personality disoder - and NOT the anxiety that may have been so bad that you had to be discharged early. So they asked YOUR doctor and reverand for records or statements which would be HELPFUL. They asked the C&P DOCs to reconcile their opinion now that more evidence is known. I think Dr. P did a good job with saying that he / she maintianed your other medical records too. If it is already of record (in your other records) most doctors aren't going to keep writing it down. You had been on anti-anxiety medicine since 1964 - 1967. This doctor started treating you in 1979 - They were treating you for something that you had already been treated for a long time. They were NOT building evidence for a VA claim. They were treating you as a patient. There wouldn't really be a NEED for them to document about your service experiences - or that it started in the service during all those years of treatment. What was important to them when they started treating you was that you DID have chronic anxiety and had it for a long time already. So the lack of documentation about in service "stressors" is not unusual. It was not a big concern to your doctor in the scope of your treatment. They had no reason to document it. But as your doctor pointed out - --Now that you ask - yes. I think it did start in the service. I reached that opinion because she has been treated for anxiety for a long time - it has been ongoing and chronic - and her records indicate the earliest treatment for anxiety was in the service by doctor C. No. I am not a psychiatrist - but I am an internist that is medically qualified to prescribe medicine for anxiety. And it is my opinion that as she DOES have chronic anxiety - and the first treatment for that was in the service - and then she needed an early discharge - it is reasonable to say that is where this whole problem started. That isn't exactly the words doctor P used - but that it what I took it to mean. Also on Dr. P not having documented in the records - Dr. P states they maintain your records -- i.e. they HAVE other records on you that they did not write. if it is in THOSE records - Dr. P most likely wouldn't have given them to the VA anyway. Actually - Dr's are not SUPPOSED to re-release records. I have seen the military doctors do so - but NOT civilian doctors. They will send THEIR records - but NOT records that were sent to them from someone else. I imagine it is a HIPPA thing. Records are authorized to be released for a specific purpose. Records released TO them from somewhere ELSE are authorized to be released to them for TREATMENT purposes. They are NOT authorized to RE-release those records to someone else. So if you sign a release for them to release THEIR records - they can release ONLY the ones THEY made on you - NOT ones that had been released to them from someone else. On the other doctor noting in the record about not having problems with nerves in the service. It dosn't surprise me one bit. My husband had cancer in his left lower lobe. People stuck it everywhere in their medical notes - right upper lobe, right lower lobe. I was totally amazed at ALL the inaccuracies in my husband's medical records. Geez! When he first got his cancer surgery - they told him it was SMALL cell cancer - a rapid growing type. it is in ALL his medical records at the AF Base. Then - the doctor (a year later) read the pathology report and docemented that he had been misinformed - it was NOT small cell - it was NONsmall cell. That was when he talked to my husband and told him that his cancer had been in existance a long time because of how slow it grows. My husband pointed that out in his FIRST letter to the VA. (I didn't file sooner because they told me my cancer was fast growing small cell - but now they inform me it was actually adenocarcinoma - and told me it probably started during the middle of my 28 year military career) He sent in the paper the doctor wrote out - the doctor notes that SAY "pt was misinfomred. NOT small cell. Adenocarcinoma. Important differences explained to pt." But they VA has not even addressed his claim that it STARTED in service. They just focused in on the asbestos part. But still - a few years later - some of the med records are still calling it small cell lung cancer. It ticks me off that people can be so careless - and report whatever - and then that info is chiseled in stone - as if it is a fact. Free

Free or anyone, You said that you had read the complete remand. I know that I must be the most dumb person around, but to me this makes no sense. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2004 rating decision by the RO of the Department of Veterans Affairs (VA), which denied reopening the veteran's service connection claim for chronic anxiety with depression. In an October 2004 statement of the case the RO reopened the claim based upon the receipt of new service medical records and denied entitlement to service connection upon reconsideration. See 38 C.F.OR. § 3.156© (2005). If the DRO did not open the claim for Anxiety with Depression, Why do I have a Statement of the Case with a Denial to which I filled out the Form - 9. I turned that thing in November 24, 2004. I never turned in a Form _ 9 for a Chronic acquired Psychiatric Disorder. I didn't get any reconsideration either. My claim stayed with the DRO for 14 months after I turned in the form - 9. I turned it in before I received either of the two C&P's. I think what it is saying is that they denied your request to reopen the claim in Febraury. When they recieved the SMR's - they basically HAD to reopen the claim. But they reopened it in October and denied it - it looks like partially in October - to which you submited the appeal. But if they did the C&Ps AFTER that - the C&Ps must have been ordered by the DRO. The DRO does have the right to seek additional evidence while reviewing the claim, if any is needed. (Oddly enough they don't seem to seek it if the they need more evidence to grant the claim.) They should have sent you a SUpplmental statement of case AFTER that. You had remarked how they said they put more weight on the psychiatrist report. That would have had to been AFTER the C&P. So did you get a supplemantal statement of case then? I turned in the New and Material Evidence into Appeals June 1, 2004 and the DRO had this information long before he sent out this Statement of the Case. October 7, 2004 STATEMENT OF THE CASE WE have enclosed a Statement of the Case, a summary of the law and evidence concerning your claim. This summary will help you to make the best argument to the BVA on why you think that our decision should be changed. WHAT YOU NEED TO DO: To complete your appeal, you must file a formal appeal. We have enclosed a VA From 9, Appeal to the Board of Veterans Appeals, which you may use to complete your appeal. We will gladly explain the form if you have questions. The benefit you want The facts in the statement of the Case with which you disagree, and The errors that you believe we made in applying the law The Division Review Officer ) DRO) has completed a preliminary review of your file and has determined that, based on the evidence currently of record your claim cannot be granted. THIS IS NOT THE DRO'S FINAL DECISION. We are sending you this Statement of the Case so that you can better understand your appeal. An examination is being scheduled at the VA Medical Center. The Va Medical Center will notify you about the date and time to report for the examination. DECISION: Service connection for chronic anxiety with depression is denied REASONS AND BASES The additional service medical records submitted from The National Personnel Records Center and the report form Dr. P dated April 2004, are considered to be both new and material and your claim for service connection for an acquired psychiatric disorder is reopened. Why didn't the DRO use those records before he denied me for anxiety with depression? Can you make any sense of this? You were seen for a psychiatric consultation in March 1964. You complained about being unhappy with the Navy since boot camp. Assessment was emotional immaturity, dependency, and instability which precluded futher military service. Your post treatment records show that you were diagnosed with anxiety in 1979 ( WHAT A JOKE, THEY WERE SITTING THERE WITH MY MEDICAL RECORDS FROM 1965 TO DATE) Dr. P reported that he reviewed your March 1964 psychiatric consultations and expressed an opinion that your current anxiety and depression began in service. This shall be my last question. I shall let it rest. Again. This one says it is not final. So I am thinking they are saying. We have new evidence to reopen the claim. - but your claim is still denied. But this is not a final decision. We are sending you for a C&P. Then we will make the final decision. ??? Not sure --but that is the best way it makes sense to me. Thanks, Josephine

Josephine -- gonna try it again.. I looked up the complete BVA remand. It is hard to tell which way it was leaning. It certainly wasn't against you (it wasn't one of those Remand you read that you can see the BVA is ready to deny the claim - but they want to make sure they have all the evidence and the vet was afforded due process before the deny it). It seemed like the genuinely thought you had a case. One of the strong points about that was that they thought your Reverand's counseling notes would be important in adjudicating the claim. Though he isn't a psychologist - most people know dang good and well that minsters DO have some training - and do indeed counsel people. He won't be able to "diagnose" you - but his testimony can be very credible in that he saw a big change -- (i.e. does NOT look like a personality disorder) and gave a good before and after picture to put it in place (even as a LAY person) A reverand who counsels people is a VERY qualified LAY person to testify. No - he can't take on the gruesome twosome's diagnosis -- but he can make their diagnosis look VERY NOT credible - because he DID see a BIG change in you at that time - and you discussed the situation with him. He places it in TIME. And the BVA could see that But they probably aslo know dang good and well that ministers counsel people - but would rarely keep RECORDS of the sessions. They should KNOW that. But even if the AMC denies and picks his testimony apart because he isn't a psychologist -- or didn't keep records... He is a STRONG piece of evidence - and the BVA saw that. A minister would not HAVE to be trained to diagnose or record your visits to be able to remember how you were before the service and how you were after. I posted a court case about LAY testimony on another link. They have to consider it on it's MERITS. Is what he said believable? Yes. I am concerned that the barely MENTIONED the VA psychologist report at all. I wonder why. But I don't think they put a LOT of weight on the gruesome twosome's report either. They just mentioned it more. On your own medical evidence - it seems the biggest thing against you was Dr K -- who had treated you - but not connected the anxiety to the service and had said in her notes that your nerves were fine in the service. And Dr. P gave you a statement to connect to the service - but had never indicated that in the doctor notes. Don't you love how doctors write 2 or 3 lines in your notes and then 15 years later people act like if the doctor didn't write it down - it didn't happen. Anyway -- that is one place the Reverand's testimny becomes important. The more you had to back up what you said - the more credible you beome to them on things that have no backing. Like you had said you filed a claim in 1978. They questioned that. Did they find that you had? If so - that boosts your credibility. Did they find out anything about the drowning incident you reported? If so - that boosts your credibility. It certaily booosted your credibility that yo did get a statement from a doctor that verified he had treated you for your nerves in the service. I am concerned that they put quotation marks around the "near drowning" "abuse" etc. --that kind of takes away from what you reported. But it is kind of like saying "alleged" I think it is in your favor that the gruesome twosome did NOT follow up with another report. To merely say - That doesn't change our opinion certainly does NOT rise to the level of giving reasons and medical rationale. The BVA gave them a chance to SEE that you DO have evidence that you were treated for your nerves in the service - and what the reverand said - etc. AND refine their opinion to explain all that away. They did not do so. So the fact that they didn't helps your case - because they didn't strengthen theirs. ANyway -- those are just some thoughts on some impressions I got. Free

http://www.fedcir.gov/opinions/05-7174.pdf United States Court of Appeals for the Federal Circuit 05-7174 DONALD BUCHANAN, Claimant-Appellant, v. R. JAMES NICHOLSON, Secretary of Veterans Affairs, Respondent-Appellee. Michael J. Mooney, of Cincinnati, Ohio, argued for claimant-appellant. Michael S. Dufault, Trial Attorney, Commercial Litigation Branch, Civil Division, United States Department of Justice, of Washington, DC, argued for respondent-appellee. With him on the brief were Peter D. Keisler, Assistant Attorney General, David M. Cohen, Director, and Kathryn A. Bleecker, Assistant Director. Of counsel on the brief were David J. Barrans, Deputy Assistant General Counsel, and Martin J. Sendek, Attorney, United States Department of Veterans Affairs, of Washington, DC. Appealed from: United States Court of Appeals for Veterans Claims Retired Chief Judge Donald L. Ivers United States Court of Appeals for the Federal Circuit 05-7174 DONALD BUCHANAN, Claimant-Appellant, v. R. JAMES NICHOLSON, Secretary of Veterans Affairs, Respondent-Appellee. __________________________ DECIDED: June 14, 2006 __________________________ Before SCHALL, Circuit Judge, CLEVENGER, Senior Circuit Judge, and PROST, Circuit Judge. PROST, Circuit Judge. Donald Buchanan appeals from the decision of the Court of Appeals for Veterans Claims (the “Veterans Court”) affirming a decision of the Board of Veterans’ Appeals (the “Board”) which denied Mr. Buchanan’s claim for service connection for a psychiatric disorder. Buchanan v. Nicholson, No. 02-1524 (Vet. App. Feb. 16, 2005). Because the Veterans Court accepted the Board’s legally erroneous interpretation of the statutory and regulatory provisions pertaining to a veteran’s ability to prove service connection through competent lay evidence, we vacate the Veterans Court decision and remand for reconsideration of all of the evidence of record, including the lay evidence, under the correct statutory and regulatory construction. I. BACKGROUND Mr. Buchanan served on active duty in the United States Army from January 1973 to December 1975 and also from May 1980 to June 1982. He was honorably discharged following his first period of service, but received an other than honorable discharge after his second. In 1986, he filed a claim for service connection for a psychiatric disorder. The Board denied his claim in 1987, finding that his service medical records were negative for any manifestations of psychiatric problems and that a psychiatric disability was not demonstrated until 1978, nearly three years after his first period of service had ended. Again, in June 1992, a Department of Veterans Affairs (“DVA”) regional office (“RO”) denied service connection for a nervous condition. Since that time, Mr. Buchanan’s attempts to establish service connection have resulted in his claim being sent back and forth between the RO and the Board. Essentially, each remand or reopening of his claim by the Board was accompanied by a DVA medical examination. Thus, by the time the Board rendered its September 5, 2002 decision, which is the subject of this appeal, Mr. Buchanan had undergone three DVA medical examinations over a period of five years. The first of such examinations occurred in July 1997 and resulted in a diagnosis of “chizophrenia, chronic paranoid type, severe.” (R. at 225.) The opinion of the examiner was that “t appears that this disorder first began while he was in the service, although there is no record in his C-file which would substantiate his claim of receiving counsel to seek psychiatric treatment while in the service.” (Id.) The second DVA examination occurred in November 1999 and also reflects a diagnosis of “chizophrenia, paranoid type, chronic, severe.” (Appellant App. 57). The examiner summarized his findings and concluded by stating: “While it is at least as likely as not that the veteran’s symptoms predate his first documented treatment in 1978 05-7174 2 for psychosis, it is not possible without prior records to determine when these symptoms first occurred.” (Appellant App. 57-58). The third DVA examination in March 2002 resulted in a similar diagnosis, “chizophrenia, paranoid type, chronic.” (Appellant App. 51.) This examiner likewise summarized her findings, in pertinent part, as follows: Review of the Veteran’s C-file revealed numerous layperson affidavits attesting to a change in the veteran’s interpersonal style and presentation while the veteran was in the military between 1973 and 1975, and after his discharge from the military. However, there is no medical documentation within the veteran’s C-file to substantiate the presence of any psychotic symptoms or treatment for psychiatric conditions while the veteran was on active duty . . . . Thus, given the absence of any medical documentation from the veteran’s period of active duty service from January 1973 to December 1975, and given the absence of any medical documentation of psychiatric symptoms or treatment within the one-year presumptive period, it is this clinician’s clinical opinion that the veteran’s onset of symptoms of schizophrenia did not occur during his first period of active service or during the one year presumptive period. (Appellant App. 52.) In support of his claim, Mr. Buchanan submitted several affidavits from lay witnesses, including his relatives, acquaintances, and a sergeant who led the unit to which Mr. Buchanan was assigned in 1973, describing their perceptions of the onset of his symptoms while in service or soon thereafter. Additionally, he submitted an August 2001 medical opinion from Dr. Kenneth Manges, who opined that Mr. Buchanan’s signs and symptoms of paranoid schizophrenia first appeared in service and that his paranoid schizophrenia manifested itself to a compensable degree during the first year after his discharge from his first period of service. (R. at 448-63.) In considering whether Mr. Buchanan established service connection, the Board focused on whether the evidence linked the veteran’s psychiatric disability to a disease 05-7174 3 or injury that was incurred in, or was aggravated by, service from January 1973 to December 1975 or whether the evidence demonstrated the presence of that disability to a degree of ten percent within the first post-service year such that service connection would be presumed pursuant to 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137. The Board recognized that Mr. Buchanan’s statements and testimony along with the lay statements indicate that his psychiatric disability began during his first period of service because that is when his behavior changed. The Board also noted that what it called the “objective medical evidence” did not corroborate the presence of psychiatric problems in service or within the first year after service except by medical history reported by Mr. Buchanan. The Board then stated: “Recollections of medical problems some 20 years after the veteran’s separation from service have slight probative value and lack credibility absent confirmatory clinical records to substantiate such recollections.” (Appellant App. 21.) After discussing the four medical opinions, three from the DVA examiners and one from Dr. Manges, the Board found the opinion of the examiner who conducted the third DVA examination to be the most persuasive “because it relie[d] on the objective medical documents in the record rather that [sic] the slight probative recollections of the veteran, his relatives, acquaintances, and a service comrade.” (Appellant App. 22.) The Board indicated that it did not find Dr. Manges’s opinion persuasive because it relied on the recollections expressed in the lay statements, and that the other two DVA examiner opinions did not “unequivocally state that the veteran’s psychiatric disability began in service or within one year of his separation from service in December 1975.” 05-7174 4 (Id.) Thus, the Board found that the preponderance of the evidence was against Mr. Buchanan’s claim for service connection for a psychiatric disability and denied his claim. On appeal, the Veterans Court found that the Board’s decision was not clearly erroneous and that it was supported by an adequate statement of reasons or bases. Specifically, the court noted that the Board considered the lay and medical evidence of record and concluded that service connection was not warranted because the credible evidence of record did not show the presence of a psychiatric disorder during service or that such disability had manifested to a compensable degree during the applicable presumptive period. The court noted that it was not error for the Board to favor the opinion of one competent medical expert over another when the Board provides an adequate statement of its reasons and bases. Further, the court did not find error in the Board’s determination that the lay evidence lacked credibility. Finally, the court rejected Mr. Buchanan’s request for another medical examination because it found that the third DVA examiner’s opinion was sufficiently detailed and that it thoroughly reviewed the available medical records. Thus, the court affirmed the decision of the Board denying Mr. Buchanan’s claim for service connection. Mr. Buchanan timely appealed to this court. We have jurisdiction pursuant to 38 U.S.C. § 7292. II. DISCUSSION A. Standard of Review Pursuant to 38 U.S.C. § 7292(a), any party to the case may obtain review of a Veterans Court’s decision upon a rule of law or the validity or interpretation of any statute or regulation relied upon by the Veterans Court in making its decision. Under 38 05-7174 5 U.S.C. § 7292©, this court has exclusive jurisdiction to “review and decide any challenge to the validity of any statute or regulation or any interpretation thereof brought under this section, and to interpret constitutional and statutory provisions, to the extent presented and necessary to a decision.” This court reviews decisions by the Veterans Court deferentially. Under 38 U.S.C. § 7292(d)(1), we must affirm a Veterans Court decision unless it is “(A) arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law; ( contrary to constitutional right, power, privilege, or immunity; © in excess of statutory jurisdiction, authority, or limitations, or in violation of a statutory right; or (D) without observance of procedure required by law.” 38 U.S.C. § 7292(d)(1) (2000). Except for constitutional issues, we may not review any “challenge to a factual determination” or any “challenge to a law or regulation as applied to the facts of a particular case.” 38 U.S.C. § 7292(d)(2) (2000). This court reviews legal determinations of the Veterans Court under a de novo standard. Prenzler v. Derwinski, 928 F.2d 392, 393 (Fed. Cir. 1991). In doing so, this court may “affirm or, if the decision of the Court of Appeals for Veterans Claims is not in accordance with law, . . . modify or reverse the decision of the Court of Appeals for Veterans Claims or . . . remand the matter, as appropriate.” 38 U.S.C. § 7292(e)(1) (2000). B. Analysis On appeal, Mr. Buchanan asserts that the Veterans Court committed legal error by improperly interpreting 38 U.S.C. §§ 1154(a), 5107(B), 38 C.F.R. §§ 3.303(a), (B), and 3.307(B) to require that lay evidence of medical symptoms be accompanied by 05-7174 6 contemporaneous medical records in order to support an award of service-connected benefits. Specifically, he argues that the Veterans Court erred because it accepted certain statements by the Board that applied the legally erroneous interpretation requiring contemporaneous medical records. The Secretary of Veterans Affairs (the “Secretary”) essentially asserts two arguments in response. First, the Secretary argues that we lack jurisdiction to review a finding by the Veterans Court that the evidence Mr. Buchanan submitted was not sufficient to support his claim for service connection and that the determination of the Board denying his claim was not clearly erroneous. Second, the Secretary asserts that the Veterans Court’s decision cannot be faulted because the court recognized that the Board analyzed the lay and medical evidence and determined that credible evidence did not support Mr. Buchanan’s claim for service connection. In this context, the Secretary argues that the Board did not hold as a matter of law that lay statements are inadequate in the absence of corroborating clinical records, and thus that the Veterans Court decision did not implicitly endorse the allegedly erroneous interpretation argued by Mr. Buchanan. In this case, Mr. Buchanan challenges the Veterans Court’s endorsement of the Board’s legal interpretation of the relevant statutory and regulatory provisions pertaining to the types of evidence which may support a claim for benefits. Contrary to the Secretary’s assertion, Mr. Buchanan is not challenging the application of law to the particular facts of his case, nor asking us to re-weigh the relevant facts. Thus, we have jurisdiction under 38 U.S.C. § 7292© to review the Veterans Court’s interpretation of those provisions. 05-7174 7 Pursuant to 38 U.S.C. § 1154(a), the Secretary was required to include, in regulations pertaining to service connection, “additional provisions in effect requiring that in each case where a veteran is seeking service-connection for any disability due consideration shall be given to . . . all pertinent medical and lay evidence . . . .” (emphasis added). In addition, 38 U.S.C. § 5107(B) provides that [t]he Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. (Emphases added.) In accordance with 38 C.F.R. § 3.307(B), “[t]he factual basis [for establishing a chronic disease] may be established by medical evidence, competent lay evidence or both. . . . Lay evidence should describe the material and relevant facts as to the veteran’s disability observed within such period, not merely conclusions based upon opinion.” (Emphasis added.) Finally, 38 C.F.R. § 3.303(a) provides that each disabling condition for which a veteran seeks service connection, “must be considered on the basis of . . . all pertinent medical and lay evidence.” (Emphasis added.) As these provisions make clear, lay evidence is one type of evidence that must be considered, if submitted, when a veteran’s claim seeks disability benefits. In fact, 38 C.F.R. § 3.307(B) clearly states that the factual basis for proving the existence of a chronic disease may be established by “medical evidence, competent lay evidence or both.” Thus, nothing in the regulatory or statutory provisions described above require both medical and competent lay evidence; rather, they make clear that competent lay evidence can be sufficient in and of itself. 05-7174 8 The Veterans Court here stated that the Board found no “competent” evidence of record to substantiate Mr. Buchanan’s claim that his psychiatric condition began during his first period of service or within the first year after service and thus, the Board’s decision was not clearly erroneous. The Board’s decision, however, does not reflect a determination on the competency of the lay statements. Rather, it reveals that the Board improperly determined that the lay statements lacked credibility merely because they were not corroborated by contemporaneous medical records. The Board stated that “[r]ecollections of medical problems some 20 years after the veteran’s separation from service have slight probative value and lack credibility absent confirmatory clinical records to substantiate such recollections.” (Appellant App. 21.) This statement reflects the Board’s view that it considered the lay statements to be of slight probative value because of the significant time delay between the affiants’ observations of Mr. Buchanan’s behavior and the date on which the statements were written. That determination by the Board is completely within the Board’s discretion to weigh the evidence submitted by the veteran in support of a claim for benefits and it does not appear to be the subject of Mr. Buchanan’s challenge here. The second portion of the Board’s statement, that the lay statements lack credibility absent confirmatory clinical records to substantiate such recollections, however, is another matter. The second portion of the Board’s statement reflects a legally untenable interpretation of the above enumerated statutory and regulatory provisions: that absent confirmatory medical evidence, lay evidence lacks credibility. While the lack of contemporaneous medical records may be a fact that the Board can consider and weigh against a veteran’s lay evidence, the lack of such records does not, in and of itself, 05-7174 9 render lay evidence not credible. Such an interpretation is unreasonable because it would render portions of the statutes and regulations meaningless as it would read out the option of establishing service connection based on competent lay evidence. We also note that the Board found the opinion of the 2002 DVA examiner to be “the most persuasive evidence of record because it relies on the objective medical documents in the record rather that [sic] the slight probative recollections of the veteran, his relatives, acquaintances, and a service comrade.” (Appellant App. 22.) The examiner, however, ultimately relies not on the objective medical evidence, but rather the absence of such in reaching her opinion that the onset of Mr. Buchanan’s psychiatric symptoms did not occur during his first period of service or within one year following that service.1 As the opinion summary states: “Thus, given the absence of any medical documentation from the veteran’s [first] period of active duty service . . . and given the absence of any medical documentation of psychiatric symptoms or treatment within the one-year presumptive period, . . . the veteran’s onset of symptoms of schizophrenia did not occur during his first period of active service or during the one year presumptive period.” (Appellant App. 52.) This is not to say that the Board may not discount lay evidence when such discounting is appropriate. Rather, the Board, as fact finder, is obligated to, and fully justified in, determining whether lay evidence is credible in and of itself, i.e., because of possible bias, conflicting statements, etc. Nor do we hold that the Board cannot weigh 1 Indeed, the examiner’s opinion appears to have failed to consider whether the lay statements presented sufficient evidence of the etiology of Mr. Buchanan’s disability such that his claim of service connection could be proven without contemporaneous medical evidence. 05-7174 10 the absence of contemporaneous medical evidence against the lay evidence of record. Under the correct interpretation of the relevant statutory and regulatory provisions, however, the Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence. If the Board concludes that the lay evidence presented by a veteran is credible and ultimately competent, the lack of contemporaneous medical evidence should not be an absolute bar to the veteran’s ability to prove his claim of entitlement to disability benefits based on that competent lay evidence. III. CONCLUSION The Veterans Court erred by affirming the Board’s erroneous statutory and regulatory interpretation that lay evidence cannot be credible absent confirmatory clinical records to substantiate the facts described in that lay evidence. Accordingly, we vacate the Veterans Court decision and remand the case for proceedings consistent with this opinion. COSTS Each party shall bear its own costs. VACATED and REMANDED 05-7174 11

Spike, I sure know what it is like to lose a soulmate. But my loss was very different than yours. I think one thing my husband really helped me understand is how HORRID it is to a man to feel helpless. They can tolerate pain. They can tolerate suffering. They can tolerate almost anything EXCEPT for feeling helpless. That feeling that something is very broken and they don't know what to do to fix it. I do believe that though you feel helpless right now - that you will begin to find that you aren't near as helpless as you feel. You are smart. You are strong. You will find out ways to start fixing what need fixed. It's just hard right now because everything is all out of balance. Break it down to small chunks if you can. You can't fix it all overnight no matter how bad you want to. Retreat to the point you have influence. What is something you CAN fix right now. Start with fixing whatever you CAN fix. My thoughts are with you, Free

Well dang it - I thought I posted a long reply

It seemed like it was all together in chronological order. So if you send in a packet today - that will be placed in the file how you sent it -- and a letter they send to you next week will be next in the file. At least that is the way it looked like it was organized. I didn't look through much of the file as I was digging through SMR's and they were TOTALLY unorganized (upside down, right side up, not in any chronological order.) My husband bound the last packet he sent - and that was all together still bound. The veteran benefit manual suggests that you do bind your material like THEY do --but I can't remember what that is. I think they holes in the top - with the little slide clip - so they can easily put it in the file they same way the papers they generate are attached. And they recommend a cover sheet for your packet - which briefly lists the evidence you are sending - and the order. Free

Thanks Berta. Thank for your response on my Social Security question also. On the asbestos portion of the cancer claim, they already have the pseudo C&P report that states my husband's cancer couldn't be caused by asbestos because there is no evidence he was exposed to asbestos. But on the whether the cancer started in the service claim - the Va did not pursue that - nor did they obtain a medical opinion as to that issue. So if I submit an IMO on the issue of as to when the cancer started - do they have to approve the claim or obtain a medical opinion that refutes it? We already have documentation from his treating doctor that shows the doubling times and growth rates of cancer - and how long it should take to reach the size it was when diagnosed. And we have a brief statement from the oncologist stating the standard doubling time of that type of cancer is 180 days. And medical journal / treatesies evidence which shows that the information the doctors provided (though the didn't provide their medical rationale) is supported by sound medical principles. This is a case that the argument is pretty much FULLY supported by medical principles. It is standard medical practice that it takes a tumor about 35 doublings to reach 3cm. (This is for ALL kinds of cancer). It is standard medical practice that the typical growth rate for pulmonary adenocarcinoma is approximately 180 days (6 months). This is not just a case where you can find this growth rate in a couple of articles. This is the typical growth rate reported by the National Cancer Institute, SEERS training program, taught in medical schools (it is the ACCEPTED growth rate of this type of cancer). Based on not only sound medical principles - but ESTABLISHED medical principles - 35 doublings x 180 days = 17.2 years. Though growth rates CAN vary - it is MORE LIKELY THAN NOT that my husband's cancer did NOT reach the same size in 2 years (retirement to diagnosis) that the typical cancer of that type would take 17 years to reach. It is all there - between the doctors notes and our submission of medical articles to support the doctors notes. I don't think I have to have any medical expertise to be able to say "See where the doctor says 35 doublings = 3 cm> Here is an excerpt from the National Cancer Institute, Mayo Clinic, and the American Cancer Society that show his opinion is based on sound medical reasoning. See the place in the doctors notes that says Doubling times = 180 days, which is supported by the letter by the oncologist stating the same thing? Here is an articles from the National Cancer Institute, and from Case Western Reserve School of Medicine, etc. that show this is the medically established standard... However, you know how the VA is. So if all the info in the file supports the other info in the file - and I get an IMO that pulls it all together - does the VA pretty much have to grant the claim unless they seek a medical opinion that refutes the opinion and all the evidence in the file? Free

Josephine, What did the remand say? When they BVA remands a claim - they usually say specifically what they want the Ro or AMC to do to further develop the claim. So what did the BVA ask the AMC to do? That is the key to what the BVA needs to know before they could decide your claim. Free

Welllllllllllll. That depends. What type of restrictive lung defect do you have? COPD is usually more of an obstructive lung disease. What are your PFT's. Does the doctor think your lung problems are connected to your heart condition or your blood pressure? Did you have any in service problems with your lungs? Were you exposed to things in service that create lung problems. How long have you been out of the service? And -- on the density in your lung -- you will know better when you find out what it is. Free

Do you know how the VA determines if a child was dependent on the veteran for 1/2 of their support at the time of their death? The DOD counts 1/2 support if the veteran and the spouse combined were providing over 1/2 support. Social Security either uses the pooled fund method (that takes the total household income combined - and allocates support provided by each parent according to their income.) Or if the couple didn't pool their income - they look at what each person provided seperately. They do not count support provided by the spouse as support provided by the person. I was wondering how the VA does it. Basically, my son recieved SSI, but my husband provided over 1/2 his support from the time we were married (totalled over the whole time period). However, as he only lived 5 days in February - and was pretty ill for that time - he didn't buy things for my son, purchase food, etc. So I paid more of these expenses out of MY funds. So because he was ill and died he most likely did not technically provided 1/2 of his support AT THE TIME OF HIS DEATH. And though his funds were availble for supporting my son in February, his bank accout legally became mine on the day of his death (as I was the joint account holder) so even funds spent from THAT money (to pay housing costs etc.) could technically be considered support provided by ME because the money was legally mine by the time those expenses were paid. So do you know if the VA counts support provided by the couple as support provided by the vet? And what do they consider dependent at the TIME OF DEATH? Can they count it against my son that my husband was sick before he died, and didn't pay as much - or that he died before the mortgage was due and therefore hadn't paid it yet for the month? Can they give me one of those "child recieved $____ SSI on the first of the month that was available for his support. Veteran paid ___ during the five days he was ALIVE during the month - therefore had not provided over 1/2 of the child support at the time of his death" kind of decisions? Free

I know that if the VA seeks an IMO in regard to a claim, they have to send you a copy of the IMO and give you an opportunity to respond PRIOR to issuing a ruling on the claim. Does anyone know if this is also true for the RO? i.e.If the RO decides to seek a medical opinion in regard to my husband's cancer claim - do they have to send me a copy of that opinion and give me the opportunity to respond (and have a doctor respond) to that opinion before they decided the claim? Or can they just get the opinion, decide the claim, and then I only have the opportunity to address the opinion through the appeal process? Thanks, Free

And if you miss the jugular - go for the carotid artery. Actually, though, there was just a discussion in here recently about the psychologist vs. psychiatrist debate. And basically, it SEEMS for some reason that a psychiatrist is MORE qualified than a psychologist to issue an opinion because for some reason we see them higher up the pecking order. But if you look it up - the standards of medical practice dictate that it is actually the psychologist who is MOST qualified to do psychological evaluations and psychological testing. And some sources even go so far to say that it is UNETHICAL for a psychiatrist to adminster most psychological tests (as they do not have the training to be QUALIFIED to adminster them or interpret them). I would also think it would be unethical for a psychiatrist to diagnosis you without doing the testing (which they aren't qualified to do or interpret)that are standards of practice. Especially if they are giving a NEW diagnosis. In Josephine's case I would have the tendency to want to be sarcastic in my appeal. Something like "The Statement of Case indicates that more weight was given to the psychiatrist as they were a psychiatrist. However, I consider the exam to be inadequate as no psychological testing was done to confirm the NEW and unspecific diagnosis the psychiatrist gave me. I understand that as under the standards of medical practice that a psychiatrist is not trained or qualified to administer such tests or interpret them, that the psychiatrist couldn't actually adminster the tests, as it would have been unethical for her to do so. However, I question that I could be given a NEW diagnosis by someone, without testing to confirm the diagnosis, merely because that person was not qualified to administer or interpret such tests. I further question why the VA would place more weight on the opinion of the psychiatrist, who is not trained or qualified to do psychological evaluations, than the VA psychologist, who IS trained and qualified to do them. In fact, I fail to understand why the VA would even send me for a second C&P with a person who is NOT trained or qualified to do psychological evaluations, when they already had an opinion from from a trained and qualified VA psychologist." But I think this can also be important in other cases. If they place the weight of probative evidence on a psychiatrist's word OVER a psychologist's - that can be appealed - as a psychologist is MORE trained and qualified to do psychological testing and evaluations and interpret the results. The psychiatrist opinion should rule with regard to medical issues and medicine prescribed. The psychologist should rule in regard to psychological and personality testing and evaluations. They are two distinct branches in the psychological field. Each one has their own area of expertise. When they step out of their area of expertise - their opinion should certainly not be given more weight just because they are more qualified in a DIFFERENT area. That would be like saying we took the opinion of the surgeon over the opinion of the radiologist on the x-ray results, because surgeons have more training than radiologists. Training in WHAT? is the question. Free

So much for caring for him who shall have borne the battle and for his widow, and his orphan. Speaking of widows and orphans maybe you should ask the patient advocate what types of documents the VA can provide you with concerning your VA care at this time to make sure your wife will get the benefits to which she will be entitled to after the VA kills you. Just keep asking - can I have a copy of that for my wife's claim against the VA. I just want to make sure she is taken care of after you have killed me. That is totally ridiculous that they aren't giving you the guards anymore. And evidence that their actions are retaliatory and petty - rather than "in your best interest." They might be able to justify the pain med thing. Not that they are in the right - but they can write it up in a way that makes it APPEAR to be justified. But I can't see how they can write up the refusal to provide you with guards as a justifiable action. Free

Actually, I didn't know that either. But I know they usually refer to it as psychOLOGICAL testing and psychOLOGICAL evaluations. And I remembered when my son was under the care of a psychiatrist - he had discussed his SUSPECTED diagnosis with me - but said he would not CONFIRM them UNTIL he sent my son to a PSYCHOLOGIST for the testing. So I looked up some info to check it out. So I think that will be an important part of your argument in an appeal if you need to do one. They sent you to a psychologist, who is qualified to do psychological evaluations. The psychologist confirmed your diagnosis you already had of anxiety - and was favorable to your claim. Then they sent you to a PSYCHIATRIST for an evaluation. The psychiatrist actually confirmed your diagnosis of Anxiety on Axis I, but also gave you and NEW diagnosis of Personality Disorder on Axis II, and opinioned that your problems stemmed from the Personality Disorder. There are a lot of weak areas in that. The VA SENT you to someone who it is not standard medical practice for them to even DO psychological testing. The psychiatrist gave you a NEW diagnois WITHOUT even doing any psychological testing. The NEW diagnosis wasn't even specific. They tagged you with a Not Otherwise Specified DIAGNOSIS (as there was not evidence that you met the criteria for any of the specific disorders) and then assigned traits from several of the disorders. The VA gave more weight to the psychiatrist just because they were a psychiatrist even though standard medical practice does not involve psychiatrists doing PSYCHOLOGICAL evaluations - and that they did no testing to confirm the NEW diagnosis they gave you. They probably gave more weight to the psychiatrist because 30 years of total disability is expensive and they could pay several people's bonuses out of those funds. Free

Has anyone file a congressional inquiry with Social Security? Do they feel semi-compelled to get their act together upon such an inquiry - or do they just try to justify your poor treatment? I was thinking of filing one. Well - actually, I have my latest appeal for my son about ready to go - and I was going to follow that up immediately with a discrimination complaint - and CC an attorney and Congressman to put them on notice that someone might be watching - so don't use this as an opportunity to mess with me more. Free Free

Social Security also has the "representative payee" program. But I don't think they actually rule you incompetent. But if they think you are not managing your finances - they can appoint someone to be your representative payee. Actually when my son turned 18 - they asked if I still wanted to be his payee. I said No. I would let him get his checks. If we had a problem - we would deal with it. So the checks come in HIS name - though I help him manage his money. They seem to have trouble understanding that. Hey. Give my son his money - and I will help him manage it. But now - though he has signed papers over and over again appointing me as his REPRESENTATIVE with Social Security - I am told over and over again that they can't give me information unless I am his representative PAYEE. Some people will honor that my son has chosen me to represent him in his dealings with Social Security - but still wants to have the checks issued in HIS name. But most of them think that since I am not his PAYEE, I have no right to represent him. Free

Interesting.. Very interesting... In my experience - though my son was under the care of a PSYCHIATRIST (who could prescribe medicine) - he would not render an official diagnosis until he sent my son to PSYCHOLOGISTS for psychological testing. He based the diagnosis on their testing and reports. Notice the word is called PSYCHOLOGICAL testing - NOT psychIARTIC testing. http://www.guidetopsychology.com/testing.htm Psychological tests are usually administered and interpreted by a psychologist because studies in psychopathology, along with academic courses and supervision in psychological testing, are an integral part of the doctoral degree in clinical psychology. A counselor who has had the appropriate academic courses and supervision may administer occupational tests or achievement and aptitude tests, but most counselors have not received the training to administer personality tests. Academic courses and supervision in psychological testing are usually not a part of a psychiatrist’s medical training, so most psychiatrists can ethically administer only some specific clinical tests that are straight-forward check-lists of symptoms. So the VA placed their weight with the opinion of someone who is not the most qualified to administer or interpret psychological tests. Was the first C&P done by a Psycholgist? By the way - did they actually GIVE you any psychological tests? Or was the psychiatrist so brilliant that he could determine that all your problems stemmed from your 'personality disorder not otherwise specified'(i.e "we don't know WHAT kind it is because it doesn FIT any of them") (with traits of three kinds) and NOT from your diagnosed and treated anxiety without having to do any testing (which they aren't qualified to do anyway)? Free