Varo Exceptable Doctor Lingo

[luvHIM]

Wings posted on another thread the following:

VA law requires "as likely as not." Doctors are used to stating opinions to a medical certainty. That is a much higher burden of proof. Show your doctor the following chart. It may help.

continunum of causation-- burdens of proof

standard ---------- how much --------- context

as likely as not ---------at least 50% ------- verteran claims

more likely as not---------- more than 50%-----civil trials

clear and convincing------ about 75% ----civil juvenile court

to a medical certainty===about 80%------ court doctor opinion

beyond a reasonable doubt----- about 90%----criminal trials

beyond a shadow of a doubt-----100%------ignorant doctors

How do I give an opinion for nexus (relationship to a military incident?

When asked to give an opinion as to whether a condition is related to a specific incident during military service, the opinion should be expressed as follows:

1. “is due to” (100% sure)

2. “more likely than not” (greater than 50%)

3. “at least as likely as not” (equal to or greater than 50%)

4. “not at least as likely as not” (less than 50%)

5. “is not due to” (0%)"

So, my question is: Are there other ways of saying the same thing or is the above the only exceptable lingo that the VARO rating specialists will consider?

For example, I have lingo in my C&P exams and throughout VAMR that say

1) "most likely" began..."

2) "Undoubtedly" had its onset..."

3) "...long standing arthritis at these sites indicates onset was in service..."

4) "Current medical condition is service connected."

5) "Based on C-File and SMR's, veteran's condition has been chronic pain condition since 1978."

I'm just wondering because my claim is already in post-determination and I only had one C&P exam. I listed many conditions as either direct and or secondary based on SMR's and current diagnoses. But if the aforementioned from what Wings' posted is a requirement by most rating specialists I will be preparing a NOD.

Any responses would be appreciated. I could just be getting a bit anxious; afterall, its been said, "You think too long...you think wrong." But I don't think the person who said it was a veteran dealing with the VA.

Edited November 14, 2007 by luvHIM

[william n]

Wings posted on another thread the following:

VA law requires "as likely as not." Doctors are used to stating opinions to a medical certainty. That is a much higher burden of proof. Show your doctor the following chart. It may help.

continunum of causation-- burdens of proof

standard ---------- how much --------- context

as likely as not ---------at least 50% ------- verteran claims

more likely as not---------- more than 50%-----civil trials

clear and convincing------ about 75% ----civil juvenile court

to a medical certainty===about 80%------ court doctor opinion

beyond a reasonable doubt----- about 90%----criminal trials

beyond a shadow of a doubt-----100%------ignorant doctors

How do I give an opinion for nexus (relationship to a military incident?

When asked to give an opinion as to whether a condition is related to a specific incident during military service, the opinion should be expressed as follows:

1. "is due to" (100% sure)

2. "more likely than not" (greater than 50%)

3. "at least as likely as not" (equal to or greater than 50%)

4. "not at least as likely as not" (less than 50%)

5. "is not due to" (0%)"

So, my question is: Are there other ways of saying the same thing or is the above the only exceptable lingo that the VARO rating specialists will consider?

For example, I have lingo in my C&P exams and throughout VAMR that say

1) "most likely" began..."

2) "Undoubtedly" had its onset..."

3) "...long standing arthritis at these sites indicates onset was in service..."

4) "Current medical condition is service connected."

5) "Based on C-File and SMR's, veteran's condition has been chronic pain condition since 1978."

I'm just wondering because my claim is already in post-determination and I only had one C&P exam. I listed many conditions as either direct and or secondary based on SMR's and current diagnoses. But if the aforementioned from what Wings' posted is a requirement by most rating specialists I will be preparing a NOD.

Any responses would be appreciated. I could just be getting a bit anxious; afterall, its been said, "You think too long...you think wrong." But I don't think the person who said it was a veteran dealing with the VA.

the best too you..i think you'll be fine..peace, williamn

[john999]

I think other lingo is acceptable as long as it is stated as " It is my opinion that the veterans condition is directly related to his service" or some such statement. The doctor just has to state an opinion that there is no doubt that the current disability is service connected. Most civilian doctors will state it like that if they know what you want from them. Things like "it is my impression" or "it may possibly be related" are not acceptable. Only the VA talks in terms of "as likely as not".

[allan]

Hello Williamn,

keep in mind that a "nexus" is not just the wording a doctor uses, such as "on a more probable than not bases".

The Dr must support his statement using medical science and medical records showing how your currant condition is connected to your in-service injury or illness.

This is one place I see the VA Dr's and VA contracted Dr's providing IMO's repeated fail. They either come up with a favorable or not favorable opinion that is supported by thin air.

Mostly because they primarily use General Practitioners and Internal Medicine MD's who site what the RO dictates. They use phrases like the records are absent for, the records do not support the Veteran and so on.

They will ignor lab results, xrays, MRI's muscle function tests and statements any dr made before them.

VAMC C&P examiners and the private C&P contractors like QTC will focus "only" on what the VARO, BVA etc ordered. They will not look through all your records trying to find something to give you a service connection for. It does matter what you bring them, if it wasn't sent in a sealed packet from the VARO.

The "ONLY" way to have a therough evaluation of your overall records(inservice, since service and current), is if you can afford to pay for someone to spend a couple weeks disecting it.

[Pete53]

Funny I wish that my first C&P was given by a Doc who had a clue what was being looked for by VARO.

[Ricky]

Pete - surely you are not accusing a VA DOCTOR of being an IDIOT are you?

[Josephine]

Pete - surely you are not accusing a VA DOCTOR of being an IDIOT are you?

Ricky,

The two Psychiatrist that I came in contact with or no more than " Stupid Idiots". When they can get by with the word " Appears", this shows ignorance on the part of the R.O and the two doctors.

Always,

Josephine

Josephine