21-2507 - Decision Makers Request For Examination

[carlie]

I have a 21-2507 Form - Request for Examination.

The person that signed this request has specifically instructed the C&P examiner,

to opine as to if the veterans condition of XXX is

" MORE likely than not"

related to ....

The C&P examiner followed this specific instruction and opined,

"The veterans condition of XXX is "NOT MORE likely than not"

related to ....

We know that the C&P examiners are to state,

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

How do I form the rebuttal against this specific instruction to the

C&P examiner.

Do I simply state,this was prejudicial to the veterans claim,

as this (the specific instruction), limited the C&P examiner to

opineing on MORE likely than not versus, it is at least as likely as not ?

Thanks in advance.

carlie

[Berta]

I think this should be rebutted with medical evidence to directly rebutt the C & P examiner's medical; rationale.

You could say that the wording of the instructions were prejudical but still- prejudicial or not- it is the medical rationale that the examiner used that must be rebutted with medical evidence.

What was the specific medical rationale the VA examiner used for the "not more likely" opinion?

[carlie]

I think this should be rebutted with medical evidence to directly rebutt the C & P examiner's medical; rationale.

You could say that the wording of the instructions were prejudical but still- prejudicial or not- it is the medical rationale that the examiner used that must be rebutted with medical evidence.

What was the specific medical rationale the VA examiner used for the "not more likely" opinion?

Berta,

Thanks for responding.

The medical rationale the C&P examiner used to support his statement of

"NOT MORE likely" was "there is no medical literature to support".

The C&P examiner refused to assept the medical literature from the claimant.

The decision maker made no mention of the medical literature that the supporting IMO doctor provided.

carlie

[Wings]

I have a 21-2507 Form - Request for Examination.

The person that signed this request has specifically instructed the C&P examiner,

to opine as to if the veterans condition of XXX is

" MORE likely than not"

related to ....

The C&P examiner followed this specific instruction and opined,

"The veterans condition of XXX is "NOT MORE likely than not"

related to ....

We know that the C&P examiners are to state,

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

How do I form the rebuttal against this specific instruction to the

C&P examiner.

Do I simply state,this was prejudicial to the veterans claim,

as this (the specific instruction), limited the C&P examiner to

opineing on MORE likely than not versus, it is at least as likely as not ?

Thanks in advance.

carlie

x

x

x

Carlie, This is the second time this week --that a veteran has reported the VARO directing or ordering the C&P Examiner to bias his opinion against the veteran and his or her claim!

IMO, even if the VA Examiner had previously stated "more likely, less likely, as likely as not (etc, etc), I would think the Examiner would have an ethical or professional duty to review the medical file de-novo, or at least re-analyze his opinion and act to clarify his position.

On it's face, I think the Directive to opine one way or another appears prejudicial.

I would want to find --and use in my argument, a VBA Directives, for C&P Examiners. ~Wings

*VSRs at VAROs determine the type of C&P exam(s) a veteran needs based on the available medical records and use the Compensation and Pension Record Interchange (CAPRI) system to order C&P exams from the VA HCF of jurisdiction.

[Wings]

x

x

x

Section A. Examination Requests

http://www.warms.vba.va.gov/admin21/m21_1/...3/ch03_seca.doc.

e. Instructions for Providing Medical Opinions – General Claims When requesting a medical opinion, ask the provider to

identify the specific evidence reviewed and considered in forming the opinion

provide a rationale (explanation/basis) for the opinion presented, and

state his/her conclusion using one of the following legally recognized phrases:

[_____] is caused by or a result of [______]

[_____] is most likely caused by or a result of [______]

[_____] is as least as likely as not (50/50 probability) caused by or a result of [______]

[_____] is less likely as not (less than 50/50 probability) caused by or a result of [______]

[_____] is not caused by or a result of [______], or

[_____] I cannot resolve this issue without resort to mere speculation.

Note: The phrase “caused by or a result of” must be modified for opinion requests based on aggravation. For more information on what to include in this type of request, see M21-1MR, Part IV, Subpart ii, 2.B.6.c.

[gp747]

I have a 21-2507 Form - Request for Examination.

The person that signed this request has specifically instructed the C&P examiner,

to opine as to if the veterans condition of XXX is

" MORE likely than not"

related to ....

The C&P examiner followed this specific instruction and opined,

"The veterans condition of XXX is "NOT MORE likely than not"

related to ....

We know that the C&P examiners are to state,

Is due to- 100%

More likely than not- Greater than 50%

At least as likely as not- 50% (Benefit of doubt goes to Vet)

Not at least as likely as not- Less than 50%

Is not due to- 0%

How do I form the rebuttal against this specific instruction to the

C&P examiner.

Do I simply state,this was prejudicial to the veterans claim,

as this (the specific instruction), limited the C&P examiner to

opineing on MORE likely than not versus, it is at least as likely as not ?

Thanks in advance.

carlie

I had a c&p examiner state that it does not appear to be service connected and the bva chastized the examiner . They said in an attempt to rationalize or whatever their wording was i forgot.

Any way they remanded my case because the examiner did not state it like it was supposed to .

[Vync]

Carlie,

I had 5 C&P exams in the last two weeks. I looked at each of the examination request paper copies, because they were on the desk during each examination. They were all exactly like what Wings posted a moment ago.

My C&P appointment letter said for me to bring any additional medical evidence. I did. The examining doctor accepted my evidence and made copies of it while I was changing into a flimsy examination sheet/gown. She came back in and the copies were date stamped. She gave me back my originals.

My opinion is the examining doc in your case was a real moron.

At the end of each examination, I asked each of my C&P docs what they thought. None of them could tell me specifically the way they would opine, but said they had to review the contents of my thick c-file. They said the results would be posted to my records within 1-2 weeks.