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saxman

Dr. Noted a secondary condition in C&P Exam

Question

Hi Everybody,  I hope everyone is having a blessed holiday.

I had a C&P exam 6 weeks ago and the QTC office just sent it to the VA.  The doctor told me in the exam that my back condition is related to my service.  He went on to do another exam and found out that I have pain running down my legs from my lower back condition.  My question is if he noted on the exam he sends to the VA as secondary to my lower back condition do I have to do a separate claim for that condition?

 

Thanks for any replies!

 

 

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Why take the chance, file the Secondary FDC, YESTERDAY. Don't rely on the VA Rater to catch it.

Anytime you get a New DX of anything that could be an SC, File the FDC.

Semper Fi

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Gastone,

What would Saxman use for his evidence, the examiner's notes, for that FDC for the pain down the legs as secondary? Or would he need to take that info and secure an IMO/IME?

I have a few IMO/IME appointments in the next few weeks and possibly face a very similar situation as Saxman.

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If I were Sax, I'd copy the Clinician Notes where the New DX Is discussed, scan that as a Pdf and attach it along with a Scanned copy of a 21-4138 (Stmt in Support of Clm) discussing the New DX Condition, to the E-Ben FDC.

Lets say he can't get a copy of the Clinician Notes from the QTC C & P, I'd still file the E-Ben FDC with the Very Through 21-4138, discussing in great detail exactly what the C & P Examining DR had to say.

Just reference that the Supporting Medical Evidence for the Secondary claim from the recent QTC C & P exam has been forwarded to the RO Rating Dept and is now Evidence of Record.

His New Secondary Claim will probably be incorporated into his existing claim, that required the C & P Exam. Just give the Rating Dept a Push with the New FDC.

Semper Fi

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You 3 Gentlemen are my admired Seniors, but from my perspective so far:

1. A rater can do what they want, so wait for that first if in question would be the safest strategy in efficiency. However, you are looking for agreement between the C&P examiner (M.D.) and the Rater (a Fed Professional.) I have not read any threads as to the probabilities of agreement in this case at Hadit yet. It seems like it would depend on how logical your Nexus is and it's historical trends are and how much is otherwise in agreement from all evidence obtained. And there is a rule I have read (?) that says all claims given must be procedurally sought after in the claims process (maybe to eliminate this efficiency in the Vet's favor.)

2. A C&P examiner makes their own decisions, but all M.D. references help. The only thing my last one was interested in from my personal claims package I produced the night before was my personal dbq worksheet which she said she had more :-)

3. Nexus w/IMO's/IME's are the only mechanical force-fit solution, but they take time and money.

The risk of the mentioned claim not being addressed is greater than having all the i's dotted and t's crossed, but a huge expense in time, money, and stress. Stress is the main reason I would not jump at everything a C&P Doctor says. You already have it as evidence "if" they documented the observation. Either way, you need to wait, unless  you have unlimited resources of time, money, and stress. ymmv. It depends on how much the additional claim is and how hard it is to medically document it. But if you are going to Oklahoma, pile it on top (but I don't think it would transform real-time in your claims, but who knows?)

DO IT!

Edited by armorer

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Gastone,

Sure hope that Saxman see the pathway you laid out and start off down that road.  Especially since anything can happen, and as we all know establishing the EED is very important too.

I think I need to go back over my exam notes again.  I think I may have something like Saxman's situation, but don't remember anymore.

armorer,

I don't believe any of us here ever got any SCD primary or secondary based on additional DXs made during a C&P exam.

I finally have found myself in the perfect spot with upcoming appointments for IMOs for my neck and ENT specialist for chronic sinus issues.

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