CP Exam "speculation" result

[purexattrition]

If a CP examiner in a mental health claim reports that they'd have to resort to speculation, does that basically set up the claim for denial? I guess I'll find out soon enough, but just thought I'd ask if anyone else has had this happen and their result. Thanks.

[Tbird]

Read Chris Attig's article Bon Jovi, Bad Medicine, and 6 Ways to Challenge VA C&P Exam Results.

Here's an excerpt

Quote

From Chris Attig's The Veterans Law Blog

6 Ways to Spot a Valid Challenge to  VA C P Exam Results.

I’ve said it before, if you don’t think that your C&P Examiner was competent to opine on your case, you HAVE to challenge the examiner and, in the first place, lodge your objection to the medical expert that the VA chose.

1) The examiner, without explanation, uses the words “without resort to mere speculation”.

These words are used in at least 50% of the VA C&P Exams that I review.  And – not once – have I seen an opinion that properly uses them.

If the BVA is going to be able to rely on the examiner’s  “Speculation Conclusion”, the examiner’s opinion and review of the evidence must demonstrate that “no medical expert can assess” the nature of the claimed disorder of that ‘the valid application of current medical knowledge could yield multiple possible etiologies with none more likely than not the cause of  Veteran’s disability.”  Jones v. Shinseki, 23 Vet. App 382, 390 (2010).

In other words, the BVA can only accept “can’t resort to mere speculation” opinions that demonstrate the actual speculation that would need to occur.

The doc can’t just use the phrase as a way to shrug his/her shoulders and say “I dunno.”

This may help Link to BVA cases from 2015 - 2016 containing the phrase "resort to speculation"

Also I believe this case is relevant 

Jones v. Shinseki, 23 Vet. App. 382, 390 (2010) (noting that a speculative medical opinion is not per se inadequate, but the examiner must provide a basis for that determination, or that the reasons for the speculative opinion must be "otherwise apparent in the Board's review of the evidence")

[purexattrition]

Thanks TBird. I've seen that link about grounds for challenging it. I was just curious if anyone has actually gone through this before and what the outcome was, i.e. if their claim was denied based on this (no nexus, I guess), or if they just had another CP exam scheduled with another doctor, or what, before it comes to the point of having to challenge anything.

[broncovet]

Excellent answer, Tbird.  I would add:

1.  Get a copy of your cfile, and, especially C and P exam, to see if the doc actually documented the same. 

2.  I agree that this is probably a great excuse for VA to deny, just to test you to see if you are savvy enough to take Chris Attig's advice.  So, plan for the worst but hope for the best.  

    Here is how you plan for the worst. 

Find out just how "competent" your C and P examiner really is.  Is your C and P examiner experienced in treating mental health disorders or experienced only in C and P exams?  Are they a doctor, nurse, or did they stop by to fix the VA's stopped up toilet and some one handed them a white jacket and told them to do a c and p exam while the real doc was playing golf.  If the C and P examiner does not have medical training and experience in the applicable field, then his opinion can be thrown out as not competent.  In other words my old friend who got a phd in basketweaving is probably not competent to opine the military service did not cause your illness without resort to speculation.    However, he could collect about $300 per hour from VA or qtc, to cut and paste this statement onto Veterans Cand P exams.  VA certainly wont fire them, and he can probably hide from the occassional extremely angry Veteran who goes nuts when he reads the statement.  

[purexattrition]

Thank you broncovet. She seemed well qualified and competent, and was polite enough to deserve not having me attack her character just for being honest that she can't give an opinion without speculating. At this point I'm basically just wondering if they'll have me do another exam or not. I'll just wait and see. If they just deny my claim without giving me a chance to be evaluated one way or the other I suppose I will contest the result.

[Navy4life]

I just had my C&P exam for my left ankle increase and although I was not increased (stayed at 10%) I was awarded the 100% temporary rating I was looking to get.  My C&P exam http://community.hadit.com/topic/65737-cp-exam-for-left-ankle-please-provide-feedback/states those words for my right foot/ankle.  I was in a boot at the time and NWB status.  Read this and you will see that language!

Here is the C&P exam too! C&P left ankle increase (2).pdf

If you post your C&P exam (redacting personal info) we can certainly give our opinions to you :)

 

Edited April 13, 2016 by Navy4life

[purexattrition]

Thanks Navy4Life. That's nice to hear that they don't automatically deny the claim based on that language, though I suppose in your case it was pretty obvious that you rated.