C&P Opine Options

[green]

I was told that there are 5 options for raters to assign or opine on a C&P exam.  Just curious if anyone has ever seen anything other than "at least as likely as not" or "not at least as likely as not"?  My experience is that the Dr or PA choose one of these two.

 

5 Options:

"is due to” (100% sure)

“more likely than not” (> 50%)

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

“not at least as likely as not” (< 50%)

“is not due to” (0%)

[flores97]

Green, on one of my psych c&p exams back in 2013, the psychiatrist stated"It is more likely than not the veterans Major Depressive Disorder is attributable to her service connected lupus". I thought that was odd at the time, considering I hadn't actually been connected for the lupus yet, but she told me "you will receive a rating for this when you are rated for the lupus". She was absolutely right, I did.

[Buck52]

I would think that its on all the C&P Exams  that's how they service connect it...unless you have records to prove it happen in the military.

then they go by evidence found on record

str's =service treatment records

[SemperFiGeek]

Pretty sure these are the five options you are referring to that a VSR is able to request from examiner:

1.  Medical opinion for direct service connection

Choose the statement that most closely approximates the etiology of the claimed condition.

 

a. The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness.  Provide rationale in section c.

 

b. The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness.  Provide rationale in section c.

c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

2. Medical opinion for secondary service connection

 

a. The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran’s service connected condition.  Provide rationale in section c.

 

b. The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service connected condition.  Provide rationale in section c.

c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

3. Medical opinion for aggravation of a condition that existed prior to service

 

a. The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by an in-service injury, event, or illness.  Provide rationale in section c.

 

b. The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness.  Provide rationale in section c.

 

c. Rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

4. Medical opinion for aggravation of a non-service connected condition by a service connected condition

 

a. Can you determine a baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition)?

Yes  No

If “Yes” to question 6a, answer the following:

      i.        Describe the baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition): __________________________________________________________________________________________________________________________________________________________

 

     ii.        Provide the date and nature of the medical evidence used to provide the baseline: ____________________________________________________________________________

 

    iii.        Is the current severity of the (claimed condition/diagnosis) greater than the baseline?

                     Yes  No

If yes, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)?

                     Yes (provide rationale in section b.)

                     No (provide rationale in section b.)                                                                              

 

If “No” to question 6a, answer the following:

i.       Provide rationale as to why a baseline cannot be established (e.g. medical evidence is not sufficient to support a determination of a baseline level of severity): ______________________________________________

ii.       Regardless of an established baseline, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)?

                     Yes (provide rationale in section b.)

                     No (provide rationale in section b.)

 

b. Provide rationale: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

5. Opinion regarding conflicting medical evidence

I have reviewed the conflicting medical evidence and am providing the following opinion:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________