hypothetical increase question

[usmc2511]

probably a very stupid question but here it goes...........So just out of curiosity has anyone ever heard of a service connected condition, that has been rated for 7 years, when filing for an increase a VSR or RVSR questioning the rationale of a C&P doctor from the original grant of a claim. Ive got a buddy who was rated based on rationale and statement that said veteran should be awarded benefit of the doubt in this case and opined service connection should be granted(as least as likely as not). If the VSR or RVSR did ever question the rationale of a SC condition that was 7+ years old what steps, if any could they take. I know this wouldn't be a CUE because original rater went off C&P doc rationale, just wondering if they would ever try and sever service connection based on a difference of opinion years down the road. Or what are the main reasons to sever service connection years later?

[jfrei]

7 minutes ago, usmc2511 said:

probably a very stupid question but here it goes...........So just out of curiosity has anyone ever heard of a service connected condition, that has been rated for 7 years, when filing for an increase a VSR or RVSR questioning the rationale of a C&P doctor from the original grant of a claim. Ive got a buddy who was rated based on rationale and statement that said veteran should be awarded benefit of the doubt in this case and opined service connection should be granted(as least as likely as not). If the VSR or RVSR did ever question the rationale of a SC condition that was 7+ years old what steps, if any could they take. I know this wouldn't be a CUE because original rater went off C&P doc rationale, just wondering if they would ever try and sever service connection based on a difference of opinion years down the road. Or what are the main reasons to sever service connection years later?

Fraud is one way but I'm not as familiar of this happening or having happened I was just reading the law about 5 year rules I think broncovet posted search 5 year ratings protection see if it comes up sorry couldn't be more help.

Edited June 8, 2017 by jfrei

[usmc2511]

thanks for the response, I figured fraud would be the only way. I just wouldn't think difference of opinion that far down the road from a rater would hold any weight due to it not being the original claim for service connection. 

[jfrei]

Agreed not that experienced with this issue did you read the regulations Brocovet posted. What evidence was cited by the doctor in this new opinion... anyone can hire an IMO and dispute this if he didn't have any evidence

[brokensoldier244th]

If the doctor is drawing a pretty obvious rationale that is sketchy then, yes. I have a lower spinal disc condition that directly contributes to ED due to its location. Its not too common, many disc injuries are higher up and dont' affect those nerves. I had a rater question the rationale and send me in to a second doctor. I ended up appealing that one and seeing a third that confirmed the first doctors notes. It took awhile and it was a pain, but I also provided the info I had from the private doctor when I went in the 2nd time and ultimately I prevailed. I would want the raters to question obviously sketchy doctor rationals. They are not doctors, but they see so many claims that after years you would be able to see a blatantly skewed C and P or a questionable rationale. That rater ultimately got to see that some lower discal conditions directly contribute to ED, so bonus for them, they learned something. They are doing their job, and while it may seem adversarial to you, I want to know that they are actually reading the notes. Turns out on the one that I had to appeal the reexamining doctor also noted that I had been prescribed a medication for years that was too high, and not right for the condition. So, its not an automatic red flag if the rater questions something and sends you in for a 2nd C and P.  

Edited June 8, 2017 by brokensoldier244th

[usmc2511]

Nothing like this has happened yet, I guess it is just the thought of filing for an increase and the anxiety that comes with it knowing that the file will be reviewed. This claim was already rated 7+ years ago so its not like they are going to all of a sudden order a new C&P for a review. I think it is more the review that comes when filing for an increase, which when filing for an increase how you got service connected in the first place may have zero importance on the increase and the focus is on the condition of the disability now. 

[brokensoldier244th]

Im with you on the anxiety. Nothing like having your conditions questioned by someone else and having to hash out the whole sordid tale to someone new. I always think Ill forget something important. Journal and notes. I typed up an condensed version of the 'high' points of my notes from over the years to give new doctors. They seem to appreciate it.