Medical record review only c&p

[SPO]

I actually asked this question in another topic but wanted to bring this particular question up independently.  

So I talked to VES today and they said it was a medical record review only C&P. I’m not sure whether that is good or bad. My private doctor mentioned painful movement but he did not do a range of motion test. I really hope they give me at least a minimum on each joint if that that is the case.  Otherwise they are not doing their part to determine severity,  am I correct in that?

[broncovet]

Yes, you can file a nod disputing the C and P exam.  You can dispute the exam in one of 2 ways:

1.  You can challenge the competency of the examiner.  To do that, you would need to find out some background on the doc.  Was he a MD experienced in treating and diagnosiing your claimed disorder?  Did he state he "reviewed your records" in the exam?  

2.  You can "refute" the examiner with another doctor, that is, usually an IMO/IME.  

     However, your disagreement with the doctor is unlikely to produce satisfactory results:  You need MEDICAL evidence to refute medical evidence, not "lay evidence".  (Your testimony is lay evidence, unless you are a qualified medical professional) . 

 

[SPO]

So saying he did not complete all the facets of the c&p exam is not enough.  In this case arthritis is rated an active process, which has its own rating criteria and requires incapacitating episodes. This case is not me.  Stated so in my private doc dbq.  The other rating criteria is residuals.  Such as limited ranges of motion. If he doesn’t cover everything can it be disputed that way?

[broncovet]

You can try amending your records:  

https://www.law.cornell.edu/cfr/text/38/1.579

But, you would basically be asking the doc to "alter" his record, which he may or may not be willing to do.  

However, as I mentioned, you can not refute medical evidence with lay evidence.  It takes medical evidence to refute unfavorable medical evidence.  So, basically, the VA will take the Doctors opinion, over your lay opinion on medical issues each time.  

Not even a BVA judge can substitute his unsubstantied opinion over a competent qualified medical professional on matters of medical facts.  

[SPO]

Maybe I don’t understand but I’m not refuting evidences but the fact that the evidence is incomplete because they didn’t perform a full c&p

Maybe I don’t understand but I’m not refuting evidences but the fact that the evidence is incomplete because they didn’t perform a full c&p

[doc25]

12 hours ago, SPO said:

So I’m guessing in the end of the never seem and don’t get the rating I think I should I can file NOD and say insufficient c&p?

You want to contend that the C&P exam was inadequate in your claim. Is this correct?

 

[Carl the Engineer]

OK, so I am rated for arthritis.  First 10% for arthritis by x-ray and then 20% from range of motion.  All claims and increases the VA C&P examiner used a goniometer.

Now, from what you wrote, you had your civilian doc fill out the DBQ and he/she did not fill it out completely or adequately.  First, congrats on getting a private doc to fill out one, second, they don't have too, or fill out to anyone's standard.  So, there is that.  The VA isn't going to demand your private doctor do another exam on you.  You provided evidence from you private doctor and that is what the incomplete DBQ is.  The VA probably sent your private doctor a request for all your records concerning your claim.

So, I don't think you have a case against the VA for your private doctor not completing the DBQ.  The DBQ is a VA thing.

With that said, I believer the rater is looking at your evidence and had the VA C&P examiner opine on your medical history and records.  You may end up with 10% for arthritis just from your private doctors records.  It's a lowball, but thats how its done.  After that you can file for an increase, which I have done on all my arthritis claims (9 joints to date).  You can also claim adjacent joints that get overworked from the arthritic joint.

Or, they could want you to come in for another C&P exam to measure your range of motion.

I think you will need to wait for a C&P appt letter or the rating letter to see what's up.

But, I don't think you will be successful in filling a NOD because your private doctor did not fill out the DBQ correctly.  You are lucky the private doctor even looked at it, much less tried to fill it out.

I had to have a private doctor fill out my VA claim form for spousal A&A and he only filled in two blocks and both were illegible. He left a lot of it blank.  I was lucky to get that.  Try telling a doctor what to do.  LOL.  Ask, and hope...

Hope you get good news,

Hamslice