Private surgeon vs C&P NP

[ed33]

Hi everyone,  

I've got a question about when my personal surgeons opinion differs from what the C&P nurse puts in her report. I recently went for a C&P exam and it was clear from the start that she was very unfamiliar with the entire process. I was walking her through the entire DBQ and telling her what to put down as the answers. Let's say she doesn't write up favorable findings, will they take the opinion over my personal doctor who wrote up a very detailed and favorable NEXUS letter?

Also, is she required to write up an opinion about her findings? she never asked me anything about why I thought it should be service connected or about my history. She said all she does is fill out the form and send it in without an opinion on anything. Is it possible the rater already established service connection with my prior evidence, and the exam was to just establish a rating?

Thanks for the input

[vetquest]

Usually when there is positive and negative evidence the decision goes in favor of the veteran.  Especially a doctor's opinion against a nurse's.  If they do not you have a very solid claim at the BVA.

[ed33]

24 minutes ago, vetquest said:

Usually when there is positive and negative evidence the decision goes in favor of the veteran.  Especially a doctor's opinion against a nurse's.  If they do not you have a very solid claim at the BVA.

Good to know. Thanks. I seriously doubt she even looked at his DBQ or nexus letter. It was weird that when I asked her if she submits an opinion about SC she said no. 

[broncovet]

You need to make sure the VA has , in their possession the "favorable evidence".  VA seems to have a knack at losing our favorable evidence.  I suggest you read over your file.  

The Board "can" elect to favor one medical opinion over another, but has to give a reasons and bases as to why they found one medical opinion more probative.  

A key component is did your private doctor supply "all" of the requirements:

1.  Did the doc state he "reviewed your records"?  

2.  Did the doc supply a CV with his opinion?  Was he qualified to make said opinion?  A surgeon may not be qualified to opine on, say, PTSD.  

3.  Did the doc give a medical rationale as to why he made his stated opinion?  

If any of these components are lacking, the VA can reject this opinion.  

[ed33]

1 minute ago, broncovet said:

You need to make sure the VA has , in their possession the "favorable evidence".  VA seems to have a knack at losing our favorable evidence.  I suggest you read over your file.  

The Board "can" elect to favor one medical opinion over another, but has to give a reasons and bases as to why they found one medical opinion more probative.  

A key component is did your private doctor supply "all" of the requirements:

1.  Did the doc state he "reviewed your records"?  

2.  Did the doc supply a CV with his opinion?  Was he qualified to make said opinion?  A surgeon may not be qualified to opine on, say, PTSD.  

3.  Did the doc give a medical rationale as to why he made his stated opinion?  

If any of these components are lacking, the VA can reject this opinion.  

Definite yes to all three requirements. And he worked 5 years at Walter reed. 

[Berta]

Make sure the VA has his DBQ and nexus statement- 

What you are describing is a contracted NP from VES, who might  not have a clue.

If they deny without consideration of the surgeon's opinion, that would be a CUE and I can write the CUE for you- based on whether you can scan and attach the denial here, and what it says.

It is possible they wont deny, if the IMO/IME was medically favorable.

 "It was weird that when I asked her if she submits an opinion about SC she said no. "

That is concerning but then again is your Nexus strong?

 

 

( Cover C file #, name, address prior to scanning it, if they deny.)

 

[ed33]

2 hours ago, Berta said:

Make sure the VA has his DBQ and nexus statement- 

What you are describing is a contracted NP from VES, who might  not have a clue.

If they deny without consideration of the surgeon's opinion, that would be a CUE and I can write the CUE for you- based on whether you can scan and attach the denial here, and what it says.

It is possible they wont deny, if the IMO/IME was medically favorable.

 "It was weird that when I asked her if she submits an opinion about SC she said no. "

That is concerning but then again is your Nexus strong?

 

 

( Cover C file #, name, address prior to scanning it, if they deny.)

 

Ive got a copy of my nexus letter if you wouldn't mind giving it a quick read. I feel like it's pretty strong. How do I upload documents here?

Edited March 3, 2019 by ed33