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Errors with C&P exams

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Navy4life

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Hi everyone;

I have several threads going but i want to get these C&P exams out there in the open.  Please look at both C&P exams (Foot Conditions) (Ankle Conditions).  Look at the errors done by ONE doctor.  

The first C&P exam I attached is for Foot Misc.  The very first error by the C&P examiner is the fact that he states under #1 Diagnoses Avulsion Fracture 5th Metatarsal - date of diagnoses 6/23/2013.  That is WRONG!  If you look at the other C&P Exam for Ankles, under #1 Diagnoses he states right 5th metatarsal fracture - date of diagnoses 1993!  YES that is right!  See where I am going with this????

Let's continue on....

C&P exam for Foot Misc - #2 Medical History - he specifically states Toe condition left toe.  The date of the symptoms 1991.

#3 Morton's Neuroma - YES left. 

#15 Functional Impact - YES

#16 Remarks - For the claimant's claimed of RIGHT FOOT CONDITION, there is no diagnoses because the claimant does not claim the condition.  For the claimant condition LEFT FOOT CONDITION, the diagnosis is already noted in the diagnosis section.  For the claimants condition of TOE CONDITION ON LEFT FOOT, the diagnosis is already noted in the diagnosis section.

He is obviously mistaken on my right foot condition because it was in my original claim May 2013 but let's continue....

C&P exam for Ankles - #1 Diagnosis - He notes ankle sprain 1993 and he notes right 5th metatarsal fracture 1993 BUT he puts it as LEFT foot!  WTF?????  Do you see this??? First he has the right fracture on my foot C&P exam with the wrong date, then on this one he has the right fracture but noted on the left foot!

#2 Medical History: States my history 

#17 Functional Impact - YES

#18 Remarks - The claimant now has or has had ankle condition.  For the claimants claimed condition of RIGHT ANKLE CONDITION, the diagnosis is already noted in the diagnosis section.  For the claimant's condition LEFT ANKLE CONDITION, the diagnosis is already noted in the diagnosis section.

this doctor has F'd both C&P's up!!!

To add to this I get some medical opinion in November 2014 from some doctor who apparently reviewed these C&P exams, my DBQ's submitted on my behalf by my Podiatrist at the time.

This is so ridiculous!

On top of this, the DRO takes my Nexus letters supposedly into consideration but no rationale?  See attached the Nexus LetterNexus letter-redacted .pdf

 

C&P Exam Feet 7-2013_Redacted.pdf

C&P Exam Ankles 7-2013_Redacted.pdf

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This may not be what you WANT to hear, but a VSO or others can tell you anything you want to hear.  Your options, in my opinion, are as follows:

1.  File for an amendment of records to "fix" errors on C and P exam.  Should this be successful, then submit corrected exams as evidence under 38 CFR 3.156, and, if possible, in your I9 appeal to the BVA.  You can appeal the VA's written refusal to correct your medical records.  

2.  If the amendment of records is unsuccessful, that is, if the VA refuses to correct the errors in your records, you will need additional favorable medical evidence for your claim to succeed.  (IME/IMO or another favorable VA doc opinon).  

3.  If you can not get the records fixed, and you can not or will not get an IME/IMO,(or another favorable medical opinion)  then your claim is unlikely to suceed.  Quite simply put, the VA will take the word of the doctor over your opinion on medical matters, even if the doctor is wrong.    The doctor is given a "presumptive" that he knows what he is doing, and did a good job, absent a rebuttal FROM ANOTHER DOCTOR.  Your lay evidence wont rebut medical evidence.  

 

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Okay I get medical evidence needs to be refuted by medical evidence but the C&P exams are clearly a CUE.  The dates are transposed, the fracture is on the wrong foot on one C&P exam and he is stating that I didn't claim my right foot condition so I need a medical doctor to refute this?  

Shouldn't I file the Form 9 and point this out?

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This is a little long to read  but it helps understand the appeals process

Once an SOC is issued, the DRO process is complete.  If the appeal continues, it is now under the Traditional appeals process.  DRO authority does not extend beyond the issuance of the SOC.

In order for a Veteran to continue the appeal, the VA must receive a Substantive (Formal) appeal, which is a VA Form 9, Appeal to Board of Veterans’ Appeals, or an equivalent statement of intent to continue the appeal.  There is no legal requirement that a specific VA Form must be received in order to continue an appeal, but VA must receive some form of communication in writing from the Veteran or his Representative indicating an intent to continue the appeal.

A Veteran has EITHER the remainder of one year from the initial decision notification letter, OR 60 days from the date the SOC was mailed, to file his Substantive appeal.  Otherwise, his appeal rights for those issues expire, and the NOD is closed.

If the Veteran has filed a timely Substantive appeal, the next step in the appeals process is to certify the appeal to the Board of Veterans’ Appeals (BVA), which is to transfer jurisdiction of the appeal to BVA.

However, the Regional Office cannot physically send the claims file to BVA until all pending NODs and all pending claims have been decided.  There can be no appeal issues pending before the Regional Office at the time the claims file is sent to BVA; otherwise, BVA will issue a Remand instructing the Regional Office to issue an SOC on any pending appeals.

Additionally, if the veteran has requested a BVA travel board hearing or BVA Video conference hearing, the claims file remains physically at the Regional Office until the BVA hearing can be scheduled.

In the past, if any additional evidence was submitted which related to the issues under appeal, then the Regional Office had to review the additional evidence, and if the appeal continued, it had to issue a Supplemental Statement of the Case (SSOC) explaining why the additional evidence did not change the prior decision and give the Veteran 30 days to reply.  If yet more evidence was received, another SSOC was issued with another 30 day reply period.  There was no limit to the number of SSOCs which could be issued.  The appeal could not be certified to BVA until all of evidence in the claims file had been considered at the Regional Office level.

If an appeal was certified to BVA and additional evidence was subsequently received, the Regional Office had to either obtain a waiver of jurisdiction from the Veteran or his Representative, or the appeal had to be removed from certified status and another SSOC issued.  Following the 30 day reply period, if no additional evidence was added to the claims file, the appeal could be re-certified to BVA.

This is the stage where many delays occurred because many Veterans have multiple appeals pending in various stages of the appeals process.  Additionally, they will also have new claims pending in various stages of initial development.  Therefore, every time additional evidence was added to the claims file, the Regional Office Appeals Team had to review all of the appeals to determine if an SSOC was necessary.  If so, then any appeals already certified to BVA had to be removed from certified status, and the process continued to repeat itself until such time that all evidence in the claims file had been considered in a decision at the Regional Office level.  It was only then that we could physically transfer the file to BVA jurisdiction.

Effective February 2, 2013, Section 501 (Automatic waiver of agency of original jurisdiction review of new evidence) of Public Law 112-154 took effect.  This change in law established an automatic waiver of Regional Office (agency of original jurisdiction) review of evidence received after receipt of the substantive appeal.  The evidence is subject to initial review by BVA unless the appellant specifically requests, in writing, initial review by the Regional Office.

However, to date, we have received no guidance from Compensation Service and Pension and Fiduciary Service on how to implement this provision.

Therefore, at least at the Milwaukee Regional Office, we are still issuing SSOCs until we receive guidance to do otherwise.  I would also note that I personally have seen two separate BVA Remands dated from April 2013, which is after the change in law, in which a BVA judge noted there was evidence in the claims file received after the substantive appeal which the Regional Office had not considered.  Both Remands ordered the Regional Office to consider this evidence as part of the reasons for the Remand.

Hopefully, however, Section 501 of Public Law 112-154 will help us certify and transfer appeals to BVA in a much more timely manner.  It will also, hopefully, reduce the number of Remands caused by the submission of additional evidence without a waiver of review by the agency of original jurisdiction.

As you can see, the appeal process is complex and concerns remain.

As there is no requirement to use a standardized form to file an NOD or a Substantive appeal, it is easy to miss an appeal as it may be hidden on page 22 of a veteran’s handwritten statement.

Furthermore, it is not always clear if the Veteran is actually filing an appeal or not.  For example, use of the word “reconsider” may or may not mean disagreement.  We try to clarify intent with the Veteran or Representative, but even then, the Regional Office may consider the veteran’s statement to be a new claim and issue another Rating Decision, but then BVA considers the same statement to be a missed NOD and Remands the issue for the Regional Office to send an SOC.

VA’s primary focus over the past several years has, understandably, been to find ways to break the backlog of claims.

This has resulted in Journeyman RVSRs feeling constantly pressured to produce more and more decisions at a faster and faster rate, while, at the same time, having their jobs threatened if their accuracy drops in the process.  There are, unfortunately, experienced Journeyman RVSRs who have either quit or retired because they could not tolerate the pressure any longer.

This has resulted in trainee RVSRs (Rating Specialists) being released to single-signature rating before they are truly competent or comfortable in their duties.

The focus on breaking the backlog of claims resulted in the hiring of numerous RVSR trainees over the past several years.  These individuals needed mentoring as well as someone to review the accuracy of their work until management felt they were sufficiently competent to rate single-signature.  In my office, the majority of new hires and internally promoted employees needed second signature review of their work for at least one year before they reached an accuracy level sufficient for single signature.  With the large number of trainees in our office, we did not have a sufficient number of Journeyman RVSRs to complete the reviews.  Additionally, the RVSRs were being mandated to rate claims above all else.  Therefore, the DROs were assigned co-signing and mentoring duties, which took up significant amounts of our time, which were then not spent working appeals.

RVSRs are being trained to use “tools” to help them generate their decisions, so there is nation wide consistency in decision making.  However, unfortunately, it appears the RVSRs are not being fully trained on how to actually analyze all of the evidence in a claims file, so they are not always entering the most accurate and reflective evidence of a Veteran’s disability picture.  Many RVSRs are now simply entering the data found in a VA DBQ Examination report into a tool, rather than looking at and weighing all of the evidence in the claims file.  As a result, we are getting appeals from Veterans and their Representatives noting the other evidence of record which did not appear to be considered.

Likewise, current rating procedures only require an RVSR to provide the reasons for the decision.  There is little to no discussion in the Rating Decision of how evidence was weighed and evaluated.  As a result, we are getting appeals from Veterans and their Representatives because they simply do not understand how we arrived at our decision.

Understandably, DROs are some of the most experienced and knowledgeable employees concerning the claims process at most Regional Offices.  However, as a result, we are regularly pulled from our appeal work duties and assigned other projects.  During the recent Nehmer review, I was one of three DROs in our office who worked Nehmer claims exclusively for almost six months.  We did not work any appeals during the Nehmer review.  I personally spoke to DROs from other offices who also reported they were not working any appeals during the review.

Most recently, the Milwaukee appeals team was informed our office would be brokering-in over 5,000 claims in various stages of development, all of which are over one year old.  The appeals team was informed we would be rating claims full-time through the end of the fiscal year, and other than priority cases, we would not be working any appeals during this time frame.

It is fully understandable that management needs the assistance of DROs to accomplish their goals; however, it is at the expense of the appeal workload, and as a result, appeals keep getting older.

In many Regional Offices, RVSRs work the Traditional appeals, and the DROs work the DRO elections.  Working traditional appeals is actually part of the job standard for RVSRs.  However, with the concern for the backlog of claims, the responsibility for working Traditional appeals is falling mainly on the DROs.  RVSRs are focusing on rating claims, not Traditional appeals.  There are far fewer DROs than there are RVSRs.  DROs simply cannot handle the volume of pending appeals on their own.  If we are going to make a dent in the appeal backlog, then we are going to need the assistance of the RVSRs.

Finally, VBMS is a concern for appeals.  First, while it has been rolled out nation wide, it is not fully functional and has more “work arounds” than can be described here.  The program regularly crashes for at least some portion of the day, so you cannot even use it.  Decision makers regularly lose work they have been working on for hours.  Either the program times them out and they lose their work, or they get an error message and everything just disappears.  The entire program seems designed for initial claims processing, which does not require a detailed explanation of the reasons for the decision.  However, for appeals, we still have to explain everything.  The program has no glossary or autotext, which makes typing a decision even longer.  It has no spell check, so the quality of our writing is poor in many cases.  It does not allow you to copy and paste from another document, which just requires more time to type out the decision, thus getting less work accomplished during the day.  Without any doubt, it has consistently taken me far longer to process an appeal using VBMS and VBMS-R than it ever took with a paper file and RBA 2000.

Finally, there really has been no guidance, to date, on how appeals will be worked into VBMS.  Currently, appeals are controlled through VACOLS without end products.  Therefore, any NODs which are received must be sent to the appeals team so a VACOLS record can be established.  Unfortunately, some NODs are being scanned into an electronic VBMS file without ever being sent to the appeals team.  Therefore, the appeals team does not even know an NOD was received unless someone has a reason to review the VBMS file for a different claim, or a Representative contacts us asking about the status of the Veteran’s appeal.  Right now, under current procedures, it is very easy to lose control of an appeal in VBMS.

Unfortunately, in the entire claims process, appeals seem to be forgotten.  When changes are made to the claims process and/or the programs used to process claims, very rarely is there direction or discussion on how the changes will affect appeals.

While reducing the length of time a Veteran must wait to receive a decision on a claim is very important, it cannot be at the expense of those veterans who are waiting for a decision on an appeal.  As an Agency, we must also be focused on breaking the backlog of appeals.  Why should a Veteran get a decision on his initial claim in 125 days (VA’s goal), but then have to wait 2 to 3 years, if not longer, for a decision on his appeal?


 

UPCOMING HEARINGS

"Possible motions to subpoena information from the U.S. Department of Veterans Affairs”

Wed, 09/07/2016 - 10:15am

334 Cannon House Office Building, Washington, DC 20515

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Wed, 09/07/2016 - 10:30am

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Apparently, Department of Veterans Affairs officials haven’t learned much from the wait-time scandal that shook VA to its foundations and forced the resignation of former Secretary Eric Shinseki.

Miller Statement on President Obama’s Speech to DAV

Aug 1, 2016 Press Release

 

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1 minute ago, broncovet said:

Your options, in my opinion, are as follows:

1.  File for an amendment of records to "fix" errors on C and P exam.  Should this be successful, then submit corrected exams as evidence under 38 CFR 3.156, and, if possible, in your I9 appeal to the BVA.  You can appeal the VA's written refusal to correct your medical records.  So if the C&P Exams were performed in Virginia I still go to my local records office here where I live now?

2.  If the amendment of records is unsuccessful, that is, if the VA refuses to correct the errors in your records, you will need additional favorable medical evidence for your claim to succeed.  (IME/IMO or another favorable VA doc opinon).

The Nexus letter I provided should have refuted the prior doctor's opinions so I am not sure here???

3.  If you can not get the records fixed, and you can not or will not get an IME/IMO,(or another favorable medical opinion)  then your claim is unlikely to suceed.  Quite simply put, the VA will take the word of the doctor over your opinion on medical matters, even if the doctor is wrong.    The doctor is given a "presumptive" that he knows what he is doing, and did a good job, absent a rebuttal FROM ANOTHER DOCTOR.  Your lay evidence wont rebut medical evidence.  How can they ignore all the CUE errors in the C&P exam?  At a minimum I should be remanded to a new C&P exam

 

 

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1.  Yes.  Go where your records are held now, unless you can contact the doctor who made the errors and will correct them.  Your "release of information" manages your medical records.  

2.  If you have another doctors favorable opinion, refuting the C and P exam, then, yes, this should suffice to put your claim "in equipose".  This happens when 2 docs differ on an opinion. (It happens all the time.)  You may not need a third medical exam.  The BVA can choose one doctors opinion over another and base their decision on this, but must give a "reasons and bases" as to why one doc's opinion was considered more probabtive.  Some reasons that work is that Doc A's read your medical history, Doc B did not.  Or, Dr. A was board certified in the applicable speciality so his opinion was more credible.  Or, Doctor A was your regular doc who knew you for 10 years, while Dr. B did a 20 minute exam so Dr. A's opinion was deemed more probative.  

3.  CUE errors have to be "undebatable".  If Dr. A says "yes", and you say "no", then its debatable, and a judgement call isnt CUE.  All CUE claims must meet this criteria.  Cue isnt any kind of error, it must be all these things:

a.  Undebatable.

b.  Based on the evidence and regulations available at the time.  The VA decision maker basing his decision on medical evidence, even if that evidence is incorrect, is not CUE, because the medical evidence is given a presumptive that it is correct, absent a rebuttal.  

c.  It must be outcome determinative.  In other words, if the doc forgot to dot an i, that wont change the outcome.  The burden is on you to prove this is outcome determinitave to show that, except for this error, you would get a higher benefit amount.   

d.  A judgement call, such as a disability percentage, is almost never CUE.  I think its 50%, you think it should be closer to 70%..this is a judgement call by decision maker.  

e.  Violations of duty to assist are considered "harmless error" and not CUE.  If VA failed to get your medical records, it wont be CUE, because you have an obligation to also help get your records.  

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Challenging a C and P exam has specific rules.  Attorney Chris Attig says bad C and P exams can be challenged 6 ways:

Bon Jovi, Bad Medicine, and 6 Ways to Challenge VA C&P Exam Results.

 Chris Attig  2015-09-25  0

va c p exam results

If the BVA had its way, a urologist (the doc that specializes in conditions of the urinary tract) would be competent to offer a medical opinion on the cause of a liver condition.

Fortunately, the BVA did not get its way.  In Maughan v. Shinseki, CAVC Cause No 12-2832 (February 10, 2014), the Court vacated and remanded the BVA decision.

Now, Maughan is a “single-judge” decision, meaning that there is no legal precedent to follow as a “Rule of Law”.

Even Non-Precedential Decisions of the Veterans Court have a LOT of Power.

This week, we are looking at some Veterans Court’s case law that gives us so much more than an opinion and/or an expression of a Rule of Law.

The Veterans Court rulings TEACH us how to improve our own claim.

How do they do that?  Its rare to see a Court give an outline of steps for litigants to follow.  You’ll never see a court issue a ruling that lists the 8 Steps to Improve Your VA Claim.

Here’s how:

Words mean things.

A Judge’s words mean a LOT of things, and one can deduce a LOT from what a Judge does – or does not – write. But when you string a lot of opinions from a particular court together, you start to see some real interesting patterns begin to emerge.

For example, in 2012, some court observers began to notice what they perceive as the Court’s shift towards reliance on lay evidence – I’m not sure I agree that is what the whole “shift” was about, but I’m not debating that article here.

The point is this: courts that act in an appellate capacity don’t just “Bang the Gavel” and make rulings.

The Veterans Court’s opinions comprise a body of work, and that body of work has the power to shift the direction of the court – and an entire practice of law – in one direction or the other.

From the Maughan case, a non-precedential single judge opinion, we can learn 6 concrete ways to challenge the adequacy of a C&P exam opinion.

The (Relevant) Facts of the Maughan Case.

The Veteran claimed he served in Bahrain in support of Desert Storm.  For reasons that are unclear, the VA claimed that there was no evidence that the Veteran served in Bahrain.

I don’t get this. There are ALWAYS orders, somewhere.  I had written orders cut when I was sent, TDY, from Camp Tongducheon to Seoul to participate in computer simulations – “wargames” – testing strategies for a war on the Korean peninsula.  Think those orders aren’t “out there” somewhere?  I’ll bet you a homemade Chicken Fried Steak that if you give me a year, I can find them.  

The Attig Law Firm has found military service records in storage in helicopter hangars used by Customs and Border Protection.  We’ve found military service records stored by the Fish & Wildlife Service and the United States Postal Service.  

We know how to follow government paper trails. The trick is 5 steps: 1) find where the trail starts, 2) pull the string, 3) keep pulling,  4) be patient, its going to take time, and 5) don’t accept the VA’s position that it has been unable to find the records.

Regardless, while serving in Bahrain, the Veteran claimed exposure to a chemical compound known as hydrazine, and in 2007, claimed service connection for the resulting liver conditions that had been diagnosed, post-service, from 1999-2007.

Liver conditions can be very hard to live with: read what Hepatitis C and cirrhosis did to one Veteran.

The VA denied the claim in January 2008, and 3 years later in March 2011, the BVA remanded the case for additional development.   In remanding, the BVA instructed the VARO to get a medical opinion from a “hepatologist” or “gastroenterologist”.

The BVA said to get an opinion from these docs “if at all possible”.  This proved to be key language in the case.  Why?  The VA ended up sending the Veteran to a urologist for his opinion.

The BVA, in endorsing the VA’s failure to follow its order, said this:

“A specialist, albeit not the specific specialist the Board had in mind, performed the exam.”

  The Court’s response was priceless in its directness:

“Applying the Board’s present logic, an opinion from a podiatrist, or an opthalmologist, or a dermatologist would have been acceptable because those examiners are specialists in something, even though their knowledge of liver disease might be restricted to what they learned years ago in their general medical school.”

Importantly, the Court relied on Stegall v West – one of the 10 Court  Cases that I think every Veteran should know. The core concept behindStegall is that the Veteran is entitled to have the VA, and the BVA, fully follow Remand Orders .

But the Court did more. By pulling apart the Maughan case, we can learn the following:

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 examinerand, 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  “SpeculationConclusion”, 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.”

2) For rare, or complex, medical conditions, the examiner fails to fully describe your medical condition, possible etiologies.

The BVA is going to weigh FACTS.

If you have a complex medical condition, and the Board does not have an adequate factual understanding of the condition, then how can it weigh those facts?

Now, the Examiner and the BVA will probably get away with opinions that don’t have a lot of etiological description, or explanation ofsymptomatology for more common conditions.

More complex and rare conditions are going to need a lot more factual development so that the BVA and the Veterans Court can understand the intricacies of the Veteran’s unique medical situation.

3) The examiner is outside his/her area of expertise or specialty.

In the Maughan case, one is left to wonder how a Urologist – Urology is the area of medicine that studies the urinary tract – has sufficient expertise to opine on the etiology and causation of a condition of the liver.

I think that the only thing that liver and urine have in common is that many people think that liver tastes like …. well, you get the idea.

My apologies to the “Liver Lobby” – I actually LOVE liver and onions.  Mmmm, good.

In all seriousness, folks, this is an important point: I see a LOT of C&P opinions where the examiner is a specialist commenting on a general condition, or a generalist opining on a specialized condition.

My favorite is the anesthesiologist that offered an opinion on a rare nerve disorder.

The VA is – if you believe their commercials – the world’s largest health care provider.

Insist on a qualified expert in your VA exam.  The only types of docs I have not yet seen employed by the VA are  maternity care, pediatricians, and forensic pathologists.

4) The examiner does not cite to medical materials used in his/her research.

In the Maughan case, the Court appeared frustrated that the examiner included a printout from a web address as part of his “research”, but did not indicate whether he actually reviewed the information printed out from that web site.

If you use the internet, show where you got it from.

From the Veteran’s side, be sure to include a sworn declaration showing – at least – the date you last visited the site, that it is a true and accurate printout of what you read there, and provide the correct URL to the BVA or the Court.

From the VA’s cite, if the examiner says he did a bunch of research, but its not listed on the exam, or as material relied upon in the VA Ratings Decision, your exam might be inadequate.

5) The examiner cites to outdated materials used in his/her research.

1987 was a LONG time ago.  Bon Jovi was popular in 1987.  They still are popular 25 years later.

Medical research can be a lot like Bon Jovi – it just keeps going, and going, and going.  Most of it, like Bon Jovi (arguably), gets better with age.   And if it doesn’t continue, and doesn’t expand our understanding of medicine, then the credibility of that research is in question.

In the Maughan case, the examiner cited to a 25 year old report published on a website, and stopped his research at that point.

The Veterans Court  said this:

“It is beyond belief that research on this topic, which had been extensive, suddenly ceased in 1987, and that the examiner’s thorough research turned up nothing of note written since that time”.

6) The examiner ignores favorable medical information.

In this case, the examiner relied on a printout from a website that appeared to actually state that the at least one or more of the conditions the Veteran suffered from were caused by the chemical exposure he complained of.

The Court appeared concerned that the Examiner did not comment on this research in any amount of detail in his opinion:

“Whether this material is the actual material reviewed by the examiner is unclear but irrelevant. It plainly demonstrates why the examiner’s conclusion is deficient.”

How do you GET Information to Challenge VA C P Exam Results?

One way is to use Gambill v. Shinseki, 576 F.3d 1306 (Fed. Cir. 2009) – the case from the Federal Circuit that tells Veterans that they can request information about their Examiner’s background, experience, CV, etc.

Another way is to be SURE to include this language in your Notice of Disagreement and VA Form 9…give an attorney a fighting chance to fix this area of law at the Court of Appeals for Veterans Claims.

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