Evidence

[cooter]

Say a Vet already has a claim in process and an IME Dr finds, during his exam of him, another injury that is secondary to the injury that's in the claim being processed. If the IME Dr writes that in his report, and is turned in as evidence, will VA make the Vet subject to another C&P exam before making their decision?

Coot

[jvretiredvet]

will VA make the Vet subject to another C&P exam before making their decision? Mebbe, mebbe not. Whether another C&PE is needed depends upon whether there is sufficient evidence to appropriately rate the secondary condition. 38 CFR 3.326(a) http://www.benefits....ART3/S3_326.DOC appears to be the guideline.

For example, say the originating condition was a right knee condition and your IME critter stated that a left knee condition developed because of an altered gait. However, the IME critter did not provide any Left knee ROMs, stability checks, etc. Unless there is other information about the left knee (prolly somewhat unlikely), another C&PE targeted to the left knee would be appropriate.

Presuming the IME was strong enough, I could see condition A being granted and rated, and condition B deferred for exam.

If there is insufficient evidence to evaluate, another option (that certainly tends to piss vets off) would be to grant service connection for the secondary condition but at a 0%. While the primary hurdle of service connection would be met, it would create an appeal.

Of course, this example presumes that the right knee would be service connected.

Say a Vet already has a claim in process and an IME Dr finds, during his exam of him, another injury that is secondary to the injury that's in the claim being processed. If the IME Dr writes that in his report, and is turned in as evidence, will VA make the Vet subject to another C&P exam before making their decision?

Coot

[john999]

The VA also just likes to send vets for C&P exams. You may have a ton of evidence and the VA will still send you for an exam so their doctor can try and talk it down. I have gotten most of my significant ratings not on c&p exams but on IMO's and appeals. I think the VA likes to use C&P's as training vehicles for new quacks and NP's.

[Teac]

It depends on the nature of the opinion... if the opinion is all inclusive than it is possible the va would not require another c/p exam. The only time a c/p exam is required is when the rater feels there is not enough evidence to make a valid decision. I have had PCP doctors write opinions for example.. my need for aid and attendance and while it was granted to me on de novo appeal, I never went to a c/p exam.

Contray to popular opinion .. it is so much eaiser for the va to grant a claim than to deny a claim...... and c/p exams are not always required.

[cooter]

Great info guy's!..Between the 3 of you, that perty much wraps up what I needed to know. Yea, my claim being adjudicated is for my SC knee, for TDIU. The IMO Dr found Arthrofibrosis in the capsule of the knee making it very stiff. My C&P exam on the ROM shows that. He also found CRPS as well. That's the reason for my question. Wasn't sure if they would subject me to another exam or not. I again appreciate the comeback guys!

Do you guys think the newly found disabilities should not be mentioned at this time, due to this may be a good importunity to use this in case I'll need "new evidence" down the road?

Coot

[Teac]

Great info guy's!..Between the 3 of you, that perty much wraps up what I needed to know. Yea, my claim being adjudicated is for my SC knee, for TDIU. The IMO Dr found Arthrofibrosis in the capsule of the knee making it very stiff. My C&P exam on the ROM shows that. He also found CRPS as well. That's the reason for my question. Wasn't sure if they would subject me to another exam or not. I again appreciate the comeback guys!

Do you guys think the newly found disabilities should not be mentioned at this time, due to this may be a good importunity to use this in case I'll need "new evidence" down the road?

Coot

In my opinion,... it won't matter since most knee ratings are based on range of motion....

[john999]

What kills me about joint ratings is that ROM is the main factor, but in my case, for instance, ROM was not what was killing me but pain. I had Full ROM of my shoulder but the pain would start up and drive me crazy. If I had had only 50% ROM I could have worked that job, but with constant ever increasing pain I could not stand it.