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SPO

Medical opinion

Question

Just looking for some opinions and input on how my claim sounds like its going to anyone else.  I filed my claim for arthritis with a dbq.  Shortly after that it was sent out for a medical opinion, which was completed by a contract doc within days.  It then sat for 2 months while they worked out some "i.t." issue.  It has gone back to the same doc for clarification, however, I don't know what particularly for.  I still haven't been requested to go to an in person exam, and the va says they don't see any requests for new exams.  In the meantime my estimated completion date went from April 17th to March 29th then to July 1st (I know va.gov or ebenefits is worth much).  Wondering if anyone wants to speculate whether things seem to be looking good for me, or starting to turn down hill.  Also, does anybody know if the completion date is computer generated or manually?

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8 hours ago, SPO said:

Just looking for some opinions and input on how my claim sounds like its going to anyone else.  I filed my claim for arthritis with a dbq.  Shortly after that it was sent out for a medical opinion, which was completed by a contract doc within days.  It then sat for 2 months while they worked out some "i.t." issue.  It has gone back to the same doc for clarification, however, I don't know what particularly for.  I still haven't been requested to go to an in person exam, and the va says they don't see any requests for new exams.  In the meantime my estimated completion date went from April 17th to March 29th then to July 1st (I know va.gov or ebenefits is worth much).  Wondering if anyone wants to speculate whether things seem to be looking good for me, or starting to turn down hill.  Also, does anybody know if the completion date is computer generated or manually?

If your DBQ was sent for a medical opinion, that means that the DBQ was done sufficient for the purpose of the VA ie it was correctly filled out, the examiner cited that they reviewed your C File, and no in person exam will more than likely be needed unless it is later determined that the DBQ submitted was insufficient  

Yes, there are IT issues with a certain vendor (not saying names) and it sometimes can take four days to get a clarification request back or sometimes a month. IT issues obviously extend that issue. 

When somerhing is done with your claim, suspense dates are placed on them, usually 15 or 30 days for most things. Your claim pops back up in somebody’s work que after that suspense date comes around. They will then determine if the appropriate action has taken place ie the vendor examiner has finished the clarification request. If so, they will send it on to a rater if nothing else needs to be completed. If the clarification is not completed, they will follow up with the vendor and put a new suspense date on it. My advice is not to fixate in the arbitrary date in ebenefits. Do everything for your claim and submit it.Dont keep adding to it.  If we need something, we will ask. Adding stuff usually just keeps delaying it even further. Once submitted, forget about it until you hear from us or a vendor. 

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You are in a better position to speculate than we are.  We cant read your medical records, and dont know if you have all 3 caluza elements or not.  You can read your records, looking for the caluza elements and make a guess yourself.  

If you are seeking an increase, then go to the critieria, and see if your "documented" symptoms match up with a higher precent...we dont know what your symptoms are either.  Oh, and yes, you will need a copy of your cfile to know what is documented.  Its not enough that you have "symptom x" or Caluza element 2, you have to make sure both of those are documented in your records.  

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Thanks for the input.  I was mostly curious to know if the VA will go straight to medical opinion if they feel an in person c&p wont be needed.  Why spend time on that when they could send me to an exam and get it all knocked out at once, at least thats my thought.   My doc did not review my c-file, but he has been treating the condition for at least a couple years now.  I thought maybe the medical opinion was for someone to review the c-file and add to what the dbq was missing.  Thoughts?

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Another follow up.  Someone finally gave me the answer that it was not an I.T. issue with the contractor.  It had to do with the exam request software giving them an error, and it has yet to be fixed for about 3 months now.  The thing no one can tell me for sure is whether they were trying to schedule more exams or move forward with the exam they already have.  Frustrating.

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