Vet Dog and wife

Asknod, Berta, Buck Tbird, and many other Hadit members have truly helped us with our VA issues. we could not have done it without your self-sacrificing help. 
we thank you all 

As a veteran who fought for SC for almost 30 years, and now accredited, I would ask you to review any and all DBQs and show me where there is a box that says "Is the condition at least as likely as not SC?" This option is available on the ones used by VES/QTC/LHI occasionally. However, regardless of what the VBA says, the general rule is as it states in your attachment ( VHA Directive 1134) above:
1. Service connection and disability ratings for VA benefits are purely legal determinations belonging exclusively to the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. Additionally, the issues of service connection and disability ratings are governed by statutory and regulatory provisions beyond the scope of VHA examination and/or primary care. Consequently, they are often not well suited to assess causality of a current condition in a manner helpful to inform the VBA adjudication process. VHA providers who wish to provide medical opinions that state causality must include clear and specific rationale citing evidence to support the conclusion reached, and should employ standard language appropriate for medical opinions (such as “at least as likely as not”, etc.)
As for the second document (VHA Directive 2000-029), it is obsolete. It was issued prior to 2010. I don't wish to argue with you. I'm sure you feel I'm wrong. I litigate each and every day for Vets. I live and breathe VA law and study new techniques. I pay $3,000 a year to maintain that accreditation by taking the required CLEs. If I don't know the answer, I use Westlaw to confirm it. Westlaw costs $59  a minute to access. If I thought using VA doctors was a viable option, you would have heard about it years ago, sir. The CAVC and the Fed. Circuit would have tons of cites saying a VA doctor's word is gold.
Now, if you are familiar with VA case law and precedence, you will know that a medical opinion is based on knowledge (the claims file and private medical records-or VA medical records). VHA doctors can fill out generic DBQs  listed at the link above. If they do opine, it rarely has any bearing on a win. If they have not researched your case via the claims file, it isn't a probative nexus, sir. Try talking your VA doctor into reading a 2,000-page c-file and providing a IMO with supportive, peer-reviewed studies. I see hundreds of "nexus letters" by doctors. VA ignores them if they do not specifically note they have reviewed the claims file. You are welcome to believe what you will but speaking from experience, depending entirely on a VA doctor for a nexus is not advised. Here's a few from my file I find very much on point taken from Fed. Circuit and CAVC decisions: 
>The credibility and weight to be attached to medical opinions is within the providence of the Board as adjudicators.  Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993).  Greater weight may be placed on one physician's opinion over another depending on factors such as reasoning employed by the physicians and the extent to which they reviewed prior clinical records and other evidence.  Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994).
>However, Dr. Bash did not address contemporaneous evidence, including VA and private treatment records from throughout the period under consideration, that note the Veteran was, in fact, ambulatory, albeit at times with the assistance of a walker or cane.  His opinions are conclusory, inconsistent with contemporaneous clinically recorded data (which he does not acknowledge), and cannot be afforded any substantial probative value.
>See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (stating that a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (stating that a medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions).
To begin, a VA medical examination report is entitled to no weight if it contains only data and conclusions. Nieves-Rodriguez v. Peake, 22 Vet. App. 304 (2008)
Remember, we are here to help Veterans win. Each must tailor his defense to win using proven techniques. As an example, if you try to submit a psychiatric evaluation from a private doctor at the beginning of your claim, it will be rejected even if it's probative. VA's shrink must always opine first. It's the law. VA c&p doctors/nurses offer their assessment of a disease or injury for the VBA adjudicators to study. It is not binding on VA. I've had hundreds who said "Yep. It's due to AO. A month later I get the denial saying it isn't. 
I take no pleasure in arguing with any of you here. My desire is to teach you what you need to succeed. As they say, you can lead a horse to water but you cannot make him drink. You are free to ignore my advice and it will not hurt my feelings. I've helped thousands over several decades attain SC-usually IU or 100% +. It's a recipe-just like baking cookies. If you choose to substitute baking soda instead of the baking powder called for, you don't get what you desire. Many tell me I'm wrong here at Hadit. Considering I have never lost a claim or appeal yet (knock on wood), I take it with a grain of salt. I wish the best for all of you. VA screwed me in '89 & '94. Every win is a b*tchslap for that treatment I received. They should never have said I was not in Vietnam. 

So sorry to hear that. Hang in there and hope you feel better soon

I personally believe that a letter from your spouse or significant other is one of the most important pieces of evidence you can have inside your claim.  I believe that many examiners and raters do not consider them important and tend to dismiss them and give them no credibility.   However, on appeal it is something that seems to be a deciding factor in overturning  a poor rating decisions by the BVA. 
There are two important pieces to this letter that I believe is critical.
1.  Your spouse should only list symptoms they see.  They should never state in the letter a diagnosis.  If your letter has a diagnosis in it and your spouse is not qualified to render a diagnosis the rater will immediately ignore it.
2.  Your spouse should state how your disabilities impact your day to day living.  What things you could do in the past but cannot do now because of your disabilities.  No one is more qualified to stated how your daily life is impacted than your spouse.
I think anything else in the letter would be overkill but that is just one man's opinion. 

Excellent points broncovet & JKWilliamsSr. 
I've studied mental health C&P exam issues intensively for 8 years, and I continue to learn important details by reading this forum. Y'all are awesome. 👍

This isn't a crucial point as I'm sure Dr. Valette is up to date on VBA regulations and policies. But just as an FYI for everyone, see this part of the M21-1:
M21-1 Adjudicative Procedures Manual, III.iv.3.D.2.c. Telehealth and Telemental Health Examinations 
...
A mental health DBQ submitted by a private provider and based on a telephone interview with a Veteran is not acceptable or actionable for rating purposes under any circumstances. VHA has determined that, in order to assess a Veteran’s mental health via telemental protocol, examiners must be able to see clearly, and fully appreciate all non-verbal cues, mannerisms, and manifestations displayed by the Veteran in a manner on par with an in-person examination.

As a C&P examiner, I took letters from spouses seriously. And, if a vet was accompanied by his or her spouse and asked me to speak with him or her, I would always do so as it often helped me to better understand the frequency, intensity, and duration of mental disorder symptoms and associated functional impairment. 
Unfortunately, VA does not require examiners to interview family members, and there are not any specific requirements for examiners about how to regard letters from family members. 
Nonetheless, letters from "lay witnesses" could help, even help a lot, and they're unlikely to hurt a veteran's claim.
Veterans law attorney Chris Attig recommends submitting lay witness statements as a "Declaration", which he explains in a blog post. Note that Mr. Attig calls it a "sworn declaration" whereas other legal websites, and the relevant U.S. Code, call it either an "unsworn declaration" or simply a "declaration". In my experience reading Mr. Attig's blog over the years, he offers well-written, important, accurate information for veterans and their representatives. I don't know Chris Attig personally, but I respect him and value his opinion.
Although they don't mention using a Declaration, the law firm Chisholm, Chisholm, & Kilpatrick has a good article, accompanied by a question & answer video titled, How to Use Lay Evidence for VA Disability Claims.
There's an easy-to-understand, informative article on the Martindale (legal publisher) website that discusses Declarations in general,  i.e, the article is not specific to veterans law: When to Swear and When to Declare: Affidavit or Declaration? by Matthew J. Bakota (21 May 2012).
Finally, here is the statute itself: 28 U.S. Code § 1746 - Unsworn declarations under penalty of per­jury. I'm not an attorney, but it looks pretty straightforward. If it were me I would write exactly what the law specifies at the bottom of a family member's letter, and ask them to date and sign it:
Note this part: "... under penalty of perjury ...." Chris Attig offers important advice in the blog post I mentioned above:
I hope all your exams go well SwiftSig!
~ Mark

In addition to the excellent advice you've received from your fellow vets, I'll briefly share from an examiner's perspective.
I learned from my friends who are veterans and from the many veterans I evaluated over the years that the "rules of the game" change dramatically when services members leave the military and enter the world of being a veteran.
In the military, seeing the doc for anything that's serious or chronic will likely hurt your career and you'll go from "Awesome member of the team" to "Potential liability". 
Then, when you enter the world of being a veteran all of a sudden everyone is exclaims, "What?! You haven't sought treatment? You gotta do that man."  I don't mean in any way to discount the advice you've received here--I totally agree with it. I'm simply highlighting the stark contrast between life in the military vs. life as a veteran. 
My main point is that decent C&P examiners know that there are many possible reasons why a veteran hasn't sought treatment before. 
When and if it seems appropriate (trust your gut) tell your examiners in a brief, matter-of-fact way (like you did here) why you put off treatment for so long. Don't belabor the point. 
Finally, as others have said, when you go for treatment appointments, try to put your disability claim out of your head. Ask yourself, "If I didn't have a pending claim, what would I say? How would I act?"
I've had severe allergies since I was a teenager and they're awful. People who don't have them really don't understand (unless they're medical folks.) But over the years my doctors have found treatments that work for me and now the allergies are a nuisance, but tolerable. Allergies are just one of the ailments you're dealing with, but my point is that treatment is often quite helpful.
All the best,
Mark

Mark D Worthen PsyD is also top notch and has helped my husband and me. very nice guy with extensive VA knowledge
https://www.drworthen.net/

We like Dr. Bash and he has a great reputation. he helped my husband a few months ago and we will be using him for my husband's claims in the next few months, but have to save some money first.

Hi all,
My Husband is the disabled veteran with TBI, PTSD and other problems. He doesn't read or understand a lot of this. we have been married for about three years and I am trying to help him. My native language is not English and I have some friends help me with editing what I write before I post them. I was a social worker in Europe for several years, but this VA stuff is over my head. My husband told me that Berta, Dr Bash, and others on hadit had helped his wife before and she was in the process of getting his PTSD and TBI separated, Getting his migraines service connected and CUEs but she died of cancer before she could finish. we wanted to have Dr. Bash do an IMO, but my husband's fiduciary would not pay for it. we are living out of the country now waiting for my son and I to acquire our US visas. I have gotten a lot of help here from all of you and really truly appreciate it, but I am completely lost without the help you have given me. My husband always gets stressed when I have to post his personal information on the site, but he tries to stay calm. I am going to post his old C&P exam and other VA claim info over the next few days.
Thank you for helping my disabled veteran husband "all hadit members"   

Christopher Lopez, veterans services officer and his staff are for real
 
http://slocountybusinessmatters.com/2018/07/county-creates-mobile-office-to-aid-veterans/

Thanks for helping so many people, Hadit.

We also have CUE winners here and everything  anyone needs to know about CUE is in our CUE forum.
Until we can read the 1998 decision, however, we don't really have a clue on whether there was an actual CUE.
We would need to see the 1998 rating sheet as well because that is where (in my opinion) the legal error occurred...and as I mentioned before there could well be more than one CUE in it.
No deadlines on filing CUE claims.
And Myler V Derwinski above is one of my FAVORITES !!!!! a Beauty but then again many here, as well as me, have had those beautys too.
I learned a little about CUE from NVLSP (VBM) but the most I learned was from the BVA....their denials of CUE as well as their awards.