Which Has More Weight A Strong Dr.s Letter Or Dbq

[Greg88]

Hi everyone,

I have my Proposal to Reduce hearing in 3 weeks, I have a strong Dr.s and letter and a new DBQ which I feel is even stronger because it list's all my actual disabilities. I had my C&P last year and thought I covered all my bases, but the VA still said they want to reduce after 16 years at 100%. Since I have not seen or read much about a hearing, what do they say carry's the most weight, the letter or DBQ.

[jcolwell]

I hope all goes well. I would share that I met with a DRO for my appeal a few months ago, and he commented " oh good you have the DBQ for your Diabetes done ". I think it makes their jobs easier and an outside physician does carry weight with these folks. Good luck JC

[Greg88]

It's strange I brought a DBQ that the C&P examiner basically copied, but I did not put the ICD codes for all my problems, the funny thing is the DBQ for diabetes does not cover some complications of Diabetes. It covers Erectile dysfunction, the problem is ED is under the Diabetic Autonomic Neuropathy (DAN) umbrella, if you have Type 1 or 2 diabetes for a long period of time you more than likely have symptoms of DAN, but I see nothing covering it anywhere. I contacted my DAV office, but no one has called back as of yet, I hope I'm not walking into this hearing by myself with no support (even moral support would be better than none).

[carlie]

It's strange I brought a DBQ that the C&P examiner basically copied, but I did not put the ICD codes for all my problems, the funny thing is the DBQ for diabetes does not cover some complications of Diabetes. It covers Erectile dysfunction, the problem is ED is under the Diabetic Autonomic Neuropathy (DAN) umbrella, if you have Type 1 or 2 diabetes for a long period of time you more than likely have symptoms of DAN, but I see nothing covering it anywhere. I contacted my DAV office, but no one has called back as of yet, I hope I'm not walking into this hearing by myself with no support (even moral support would be better than none).

Don't worry with or about ICD codes when it comes to VBA.

Can you or have you posted the meat and potato's of the proposal to reduce ?

What evidence do they have that supports a reduction ?

What evidence do you have that supports a continuance of your current evaluation/s, benefits ?

The VA actually asks veterans to take the blank DBQ's to their doctor's to fill out and submit.

[harleyman]

Hi everyone,

I have my Proposal to Reduce hearing in 3 weeks, I have a strong Dr.s and letter and a new DBQ which I feel is even stronger because it list's all my actual disabilities. I had my C&P last year and thought I covered all my bases, but the VA still said they want to reduce after 16 years at 100%. Since I have not seen or read much about a hearing, what do they say carry's the most weight, the letter or DBQ.

Greg88, you are getting close to the hearing at the VA RO. I think you ar well prepared, but we have discussed this previously. However, I do think your question bears some comment.

what do they say carry's the most weight, the letter or DBQ.

The DBQ is documentation of an actual examination of the patient/Veteran by the doctor or examiner. The letter or report is an opinion based usually on the records of the patient/Veteran, not necessasarily on examination findings. Someone posted that they had an examination performed by Dr. Bash at the airport. Examination findings will always trump opinion letters at the RO level of claims processing. However, if there is an examination, included with the opinion letter then the person with the best medical credentials would prevail. I believe Dr. Bash was "pulling out the guns" on that Veterans case. He did BOTH, exam and opinion.

VA RO RVSRs use DBQs. If a private doctor who is a board certified specialist submits a DBQ and opinion, 95% of the time the private doc will prevail because the VA doctors they use for examiners, do not have the credentials to overide the private doc. Now keepinng that in mind, VA does have some very good treating physicians in their hospitals, and once in a while they may be asked to provide an expert opinion, but NOT very often. The VA tends to stick with those doctors they have hired to do nothing but exams.

RVSRs follow the general course and they will usually go with the DBQ. A DRO may overide that when they do their DRO review, as they have more experience than an RVSR with the legalities of evidence and the weight of specific evidence.

At the VBA level, the Judges are used to looking at legal documents and medical IMEs, IMOs, AMEs, etc. At the VBA level a qualified doctor's opinion, and or a treating doctor will ususally carry more weight than an examination doctor, who has never treated you and has only spent 15 minutes with you. Judges know by looking at credentials who is the more qualified to give an opinion, and howmuch weight thier medical examinatin and or report carries legally.

- IMO I hope this helps.- Harleyman

Edited September 14, 2013 by harleyman

[Greg88]

Harley, at this point I'd like to know a little about the hearing, what I'll be facing and who I'll be dealing with. The evidence and obvious mistakes in the proposal, the lack of due diligence by the VA in not looking at all records like is required by the CFR, but then again the proposal says they see some improvement, my Dr. has noted that my condition has not improved, it has been in a steady state of decline since 1997. The problem at this point is I have 2 or 3 valid points that should stop the reduction, I have to decide which to start and end with. My Dr. brought up an interesting point, all my lab tests show readings that correlate to a Type 2 (A1Cs all under 6.5), I keep my blood sugar extremely tight, does the computer also pick up on that ?

[harleyman]

Harley, at this point I'd like to know a little about the hearing, what I'll be facing and who I'll be dealing with. The evidence and obvious mistakes in the proposal, the lack of due diligence by the VA in not looking at all records like is required by the CFR, but then again the proposal says they see some improvement, my Dr. has noted that my condition has not improved, it has been in a steady state of decline since 1997. The problem at this point is I have 2 or 3 valid points that should stop the reduction, I have to decide which to start and end with. My Dr. brought up an interesting point, all my lab tests show readings that correlate to a Type 2 (A1Cs all under 6.5), I keep my blood sugar extremely tight, does the computer also pick up on that ?

Your hearing at the Regional Office should consist of yourself and your spouse and anyone you bring with you such as a witness, a VSO representative if you have one. The Regional Office will have the rater that sent you the proposal, or possibly a new rater who will be following up on the proposal to reduce, and possibly a DRO but uually not unless it's a newer RVSR. The hearings are conducted in small hearing rooms. At our RO the rooms can hold about 6 people comfortably. The RO's generally over schedule hearings, as often times the Veteran's do not show up for thier scheduled hearing. You may have an hour or so wait, unless you are scheduled first. These are not like a formal BVA Appeal hearings, generally these hearings are very informal and I think you will find the RVSR friendly enough.

Also in a prior post you mentioned autonomic neuropathy due to your DM I. There is no DBQ exam for this condition. The VA will examine you based on the bodily system affected. If it is causing blader leakage then they would examine you for bladder condition as secondary to your DMII, same holds true for hypoglycemia, heart, PN, DM retinopathy, kidneys, and any other body systems the DM I has affected. That is why is is still very important you file for ALL the conditions that your many years of DM I have caused you to have, as secondary to your DM. Unless you fully meet the criteria for the 100% rating for Diabetes in the 38 CFRs, the RO will reduce you, and break out the secondary conditions separately from the diabetes and evaluate those conditions independently. Good luck.- Harleyman

Edited September 15, 2013 by harleyman