Weighing Of Medical Evidence

[Ricky]

I asked this question on another site and when I headed off all of the standard pro VA zombies and demanded straight forward answers I got beat up for being anti-VA it kinda just went to the wayside so I will try it here for I know I will get some well rounded responses:

In weighing medical evidence what gives a VA non-medically trained rater, in other words a LAY PERSON, the right to take a one time 15 min C&P exam for an in-depth medical issue, lets say a neurological condition, and use it to over ride the treatment records and opinions of a neurologist who has treated a veteran for 3 years and deny a claim?

I know, I know the damn regulations do, but, but, but......... Should we not be able to get this changed? By doing so the regulations promote a double standard. By this I mean a non-medically trained veteran is a LAY PERSON and his opinions concerning a diagnosis of his/her disability is worthless, but the same regulation allows a non-medically trained rater, a LAY PERSON, to look at evidence and make a determination about a diagnosis.

On the other site I was beat to death due to the fact that the C&P examiner had made the determination. As I said his determination, a non-speciality trained doctor, was made during a 15 min reviwew and exam of the veteran. When looked at by the rater he decided to use that determination alone to out weight the treatment records and opinions of a medical specialist who had examined the veteran multiple times and provided dedicated treatment for the condition for over 3 years. Therefore, the rater in fact did make a diagnosis and sided with the C&P doctor.

I understand if the medical evidence provided was consistent with a medical opinion received by doctor shopping - for the right amount of money you can find any doctor in these new walk in any time clinics popping up in the community on a daily basis that will say and write anything. However, if the medical evidence is from a dedicated treating specialist there is no way this would hold up in court.

Well it would not hold up in a REAL COURT. In our kangroo court established for us the only thing they can do is issue an opinion which is only binding on the VA if the sec of VA says it is or remand a case back to the board and tell them what to fix in order to make their decision pass muster in the kangaroo va legal system.

This is our problem - we need to work on getting the kangaroo court out of the way so we can go directly to a real court. Even if we can hire attorneys they will be bound and hog-tied by the bogus VA legal system and we MUST remember it is not really a true legal system - the sec of VA can decide what he/she wants to adhere to.

[Vike17]

Ricky,

You didn't get beat up for being "anti VA" or were you "headed of by VA zombies!" Cruiser expalined it pretty well, he even explained he wasn't 'beating you up" so to speak with the quotations. You need to read the post again. Pop (the Admin) even stated you asked a great question!

Here's the other side of the story;

http://p203.ezboard.com/fvetbenefitsfrm73....picID=492.topic

One thing I would add to the discussion of that post is there's probably the factor of what I think is called "secondary gain" also mixed in with such a senario.

Vike 17

[Hoppy]

Ricky,

Without reading both reports and the decision I would not venture the assumption that it is necessarily and issue of "giving weight" to one report over the other. There could be some technicalities in the way the treating physician collected evidence that disallowed the rater from giving any weight to treating physician.

Without any technicalities that would prevent the rater from using the treating physicians report then I agree with you that in a real court treating physicians are given weight over examining physicians.

The RO raters mess up the "weight Issue" and all you can do is either appeal or submit new evidence. The appeal process is much slower than a civil system whereby everybody gets their lawyers and evidence and they battle it out in a couple days. It took the VA 7.5 years to do in my case what would have been worked out in 2 years in an industrial injury system in this state.

Your comparison of raters to veterans won't go far. Raters do have significant training in evaluating the accuracy and strength of logic doctors use to support their opinions. My last SO was a VA rating specialist for 20 years before jumping sides and becoming an SO. He knew exactally what the medical reports that were given weight had to say. He turned my claim into a winner after two other SO's gave up.

[Ricky]

"Here's the other side of the story;

http://p203.ezboard.com/fvetbenefitsfrm73....picID=492.topic

VIKE before you jump the gun and try to discredit me I suggest that you know what you are talking about. First my post here was not in reference to my post on VBN. I have asked this question on many sites and believe it or not there are some sites that are more pro-Va than VBN. If I had wanted people to know which site I was speaking of I would have provided it. I do not jump around on the net and try to discredit other sites by name because even though I have my own opinion of the various site I believe that all of the veteran sites have some benefit to all veterans.

So to other readers of this post please visit my post on VBN. It was a great post and it did result in some good discussion. Although I do not always agree with crusier he is very knowledgeable of the VA system as he was a senior rater for the VA. Visit and read it. HOWEVER, THIS WAS NOT THE POST I SPOKE OF!~!!!!!!! ALTHOUGH IT DID KINDA FOLLOW MY COMMENTS IN THIS POST IT IS NOWHERE NEAR THE SITE I SPOKE OF. IF I HAVE A BAD OPINION OF A VETERAN SITE I WILL NOT NAME IT FOR I DO NOT WANT TO DISCOURAGE ANY VETERAN FROM VISITING AND USING THAT SITE. IT IS NOT FAIR TO THE SITE NOR THE VETERAN.

VIKE - I VALUE YOU OPINIONS, EXPERTISE AND KNOWLEDGE OF THE VA SYSTEM AND I FOLLOW AND USE YOUR ADVISE ALOT IN MY PERSONAL CLAIMS AND WHEN I VOLUNTEER TO ASSIST OTHER VETERANS, HOWEVER, FEEL THAT YOU ARE OUT OF LINE THIS TIME. HOPE YOU DO NOT TAKE THIS THE WRONG WAY AND STOP POSTING REPLYS TO MY POSTS AS I DO NOT MEAN TO DRIVE ANY WEDGES BETWEEN US.

[Ricky]

Hoppy - thanks and I understand your points. This was a general question and I have seen it on several occassions.

However, what techicalities do you speak of? If a medical specialist conducts standard (medical community approved) tests to acheive a diagnosis, then treats the disease or injury, I do not see any technicalities. Now if you went to a foot doctor who was treating you for a foot issue and issued a statement about a neurological issue then I could see your point. But if you have a neurologist who is treating you for a neurological issue and issues a statement then it is an issue of giving weight to a report. This is what raters do. They weigh the evidence against each other in every claim.

Yes my rater vs veteran will not hold much weight under the current system. Although I understand your point - there are many, many new raters who do not have the experience you spoke of however, they have the same power as the old 20 year guy two desks down.

Maybe my post is a bad one because it is preceived as one that requires many assumptions - but to me it does not require any assumptions for you see it happening post after post on veteran sites. Veterans are speechless whey they read their denials especially when they have provided their treatment records with a statement by their treating doc and the bases for the denial was the results of a short C&P exam. Now if the VA doc waited and issued his opinion after conducting the required test then you would have a justified difference of opinon between two doctors in which the benefit of the doubt rule should kick in. However, a simple check of the reflexes and 15 min review and question concerning you medical history is not a justified reason to use the opinion of the VA doc to deny a claim.

Any way as I said maybe this is a bad post or maybe I am simply not able to articulate my question. And maybe it is an area where I am simply being hard headed - you know I can be that way sometimes hahahahaha. [b]Therefore, I ask Pete or one of the other mods to close and remove this post. This will allow me to ponder the issue in my head for a while and if it is a worth while cause I will post it later.

[Vike17]

Ricky,

If that wasn't the post/board you were referring to, then I do apologize. However, based on the answer(s) provided in that post to your question, it would seem that your question has been indeed answered, so why would you bring another post on yet another board into question? It would seem a moot point?

Could you PM me the post/board where you were reffering to? It would be interesting to read some of the responses you received to your question. If you so desire, I will not post the link or any of the discussions of that post. O.k.!

I don't think there is a need to close this thread, it actually helps explain why and how evidence are weighed and so forth, which may help veterans and their claims. This isn't a bad post!

Vike 17

[theotherguy]

I think Hoppy brings up some good points regarding your options at this point. These things are probably a biproduct of them rating claims as quickly as possible to reduce their claims inventory to get all the politicians off of their back or it may be as simple as the rater only looking at your exam. Who really knows, looking at the link provided by Vike it would seem that the rater over on VBN was suggesting that you should appeal the decision. Perhaps he has seen cases similar to yours that could have been handled better. As to whether or not the people are pro-VA, I guess I don't see why that is such a big deal as long as you are able to get your questions answered. Those guys were both vets too and they seem to try and help people every day over there. I think their friends are more worried about them being chased off so I can see why they would be thought of as pro-VA though. Just my 2 cents worth, but everything certainly indicates that you should appealing their decision.