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Unrebutted Medical Opinion?


hurryupnwait

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Hi All

The Amc sent my favorable C&P exam back to a different doctor for a clarification and it came back very negative.

Would Mariano vs. Principi court case fit this situation?

Happy Trails

Paul

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  • HadIt.com Elder

I would say so, and also get an independent medical opinion (or two) by a Dr. that is qualified in the specialty that deals with the medical problem(s) you are seeking compensation for.

My personal opinion is that both C&Ps should be in your records. And the fact that one is favorable and one not can be dealt with. Since they negate each other, a very favorable IMO should stand on it's own, and tend to validate the favorable C&P.

On the other hand, do not be too surprised if the favorable C&P somehow disappears from your records.

There is always the question to make the VA answer- Why did they order a second C&P if the first was favorable? If done properly, it's possible to nullify the unfavorable results.

Also, if the unfavorable C&P results in improper medical treatment by the VA, an opening may exist for malpractice.

Hi All

The Amc sent my favorable C&P exam back to a different doctor for a clarification and it came back very negative.

Would Mariano vs. Principi court case fit this situation?

Happy Trails

Paul

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  • HadIt.com Elder

Paul,

Do you have a Pastor that knows the you before and after service?

Josephine

(Betty)

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I would say so, and also get an independent medical opinion (or two) by a Dr. that is qualified in the specialty that deals with the medical problem(s) you are seeking compensation for.

My personal opinion is that both C&Ps should be in your records. And the fact that one is favorable and one not can be dealt with. Since they negate each other, a very favorable IMO should stand on it's own, and tend to validate the favorable C&P.

On the other hand, do not be too surprised if the favorable C&P somehow disappears from your records.

There is always the question to make the VA answer- Why did they order a second C&P if the first was favorable? If done properly, it's possible to nullify the unfavorable results. They did not order a second C&P exam, they sent the claims file back to the C&P Exam Supervisor, not back to oiginal writer of the C&P exam, to get a clarification. This doctor put an very negative addendum in the C&P exam concerning a medical opinion the AMC sought. I do not have a copy of the addendum. I had it sent to my SO and now he does not want to send it to me, because of privacy act issues.

Also, if the unfavorable C&P results in improper medical treatment by the VA, an opening may exist for malpractice.

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No, I don't

Paul

Family members and friends, My sister wrote a letter concerning before and after service condition of my back.

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  • HadIt.com Elder

Paul,

If at all possible, I would go see Dr. Bash. I don't know too much of the particulars of your case, for I do not understand the terminology of your illness.

Can or have you faxed Dr. Bash your examination and your SMR'S? Perhaps he can take a look at them and write you up an IMO without the examination, as he has others.

Always,

Betty

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what chuck said about the va exams cancelling each other out and leaving an opening for an independent medical opinion is certainly possible. but there may be a little more to the story.

was the favorable va medical opinion supported by a specific rationale, or did the doctor just make a statement without discussing why he made such an opinion? seems to me if the favorable opinion was sufficient, bva would have used it, and not remanded for another opinion.

what is the quality of the unfavorable opinion? generally, when a claim is remanded for a medical opinion, the bva will be excruciatingly specific about what questions they want answered by the examiner, and the amc will ensure that the remand is complied with or they will send it back to the doctor for compliance. so it is possible that the unfavorable opinion will carry greater weight than the favorable one, instead of the two just cancelling each other out.

if you get an independent medical opinion to rebut the unfavorable opinion, your private doctor will have to address the concerns bva had in its remand.

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  • HadIt.com Elder

"privacy act issues"? Who is he kidding?

If you submit the correct forms, including the FOIA form or letter, and the VA does not provide the requested information, or leaves out part of your records, you can start a complaint process that Berta can tell you about.

Remember it's all a paper war.

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  • HadIt.com Elder

This in itself is interesting, because the second Dr. did not participate in the C&P or examine you. So what we seem to have is two Dr's seeing the same C&P test results differently. You can argue that the second Dr never examined you, and the first did.

A good IMO can also look at the C&P results, and if necessary and possible, refute the unfavorable statements. Opinions are not physical fact, they are opinions from "qualified" medical personnel. The VA's idea of "qualified personnel" is sometimes wanting.

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Hi All

The plan is for me to fly to Washington DC for an exam by Dr. Bash. We are discussing going to the AMC together to view my claims file

I called AMC today, spoke to Mrs. Dunlap, to find what needs to be done to accomplish this. She did not know, she plans to talk to talk to a FOIA supervisor and asked me to call her back tomorrow. I hope they allow Dr. Bash to go with me into AMC and view my c file.

I just printed out Mariano case, I plan to read it tomorrow.

Happy Trails

Paul

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what chuck said about the va exams cancelling each other out and leaving an opening for an independent medical opinion is certainly possible. but there may be a little more to the story.

was the favorable va medical opinion supported by a specific rationale, or did the doctor just make a statement without discussing why he made such an opinion? seems to me if the favorable opinion was sufficient, bva would have used it, and not remanded for another opinion. I have the outline of of what is suppose to be in a C&P exam and it appears that everything was in there. The exam was 4 hrs long and I know the examiner read the file because it asked detailed questions. I m not sure if it was supported by specific medical rational. I m going to read it again. The BVA remanded this case to AMC in June 2005 and they asked that the C&P exam be clarified by the Supervisor of the doctor who did the exam. They made no attempt to send it back to the original doctor who did the exam, which many people at VA told me was the normal practice.

what is the quality of the unfavorable opinion? generally, when a claim is remanded for a medical opinion, the bva will be excruciatingly specific about what questions they want answered by the examiner, and the amc will ensure that the remand is complied with or they will send it back to the doctor for compliance. so it is possible that the unfavorable opinion will carry greater weight than the favorable one, instead of the two just cancelling each other out.

if you get an independent medical opinion to rebut the unfavorable opinion, your private doctor will have to address the concerns bva had in its remand.

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  • HadIt.com Elder

The plan is for me to fly to Washington DC for an exam by Dr. Bash. We are discussing going to the AMC together to view my claims file

I called AMC today, spoke to Mrs. Dunlap, to find what needs to be done to accomplish this. She did not know, she plans to talk to talk to a FOIA supervisor and asked me to call her back tomorrow. I hope they allow Dr. Bash to go with me into AMC and view my c file. 


I just printed out Mariano case, I plan to read it tomorrow.

Paul,

I have noticed lately that the AMC is beginning to treat me like an equal.

I can say that in 18 months, Ms. Dunlap actually returned my phone call.

I think that she will do as she said.

Call her today and I bet that things can be worked out for you.

I believe that it is called, " New Lawyers coming into Play".

Always,

Josephine

(Betty)

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