Secondary conditions

[Raychamp]

On Jan 8, 2016, I had 3 C&P exams completed at the VA Medical Clinic, Orlando FL. that were done by the same doctor.  All 3 medical conditions were secondary conditions to Diabetes Mellitus:  1.  Artery & vein conditions (Vascular diseases including varicose veins). 2  Heart conditions (including ischemic & non-ischemic heart disease arrhythmias, vascular disease and cardiac surgery). 3. Hypertension.  On all 3 DBQ’s the doctors MEDICAL OPINION were the same “IS LESS AS LIKELY AS NOT PROXIMATELY DUE TO OR THE RESULT OF DIABETES MELLITUS.”  My question is, somewhere I read that to be rated separately for secondary conditions or complications the conditions must not have been considered in your initial rating decision.  When they say “INITIAL RATING DECISION” are they referring to the about 3 C&P exams for are they referring to the ‘RATING DECISION” they mail you?  I never received a RATING DECISION for the 3 C&P exams.  I want to file a claim with a DBQ along with a medical opinion on all the secondary conditions they said were likely as not proximately due to or the result of diabetes mellitus.  What do you suggest I do?

 

[JKWilliamsSr]

you can be rated for secondary conditions at any time.   However, in order to have a secondary condition you must first have a primary service connected disability.  I have seen and heard of instances where secondary claims are denied quickly because the primary condition has not been yet adjudicated.  

From the statement you listed the C&P examiner is basically stated the issues you are claiming as secondary were more than likely not due to your diabetes.  Since this was done in 2016 your best bet is to request your claim be reopened since you have new evidence to submit. 

[63Charlie]

As the OP stated, the C&P examiner's opinion stated "IS LESS AS LIKELY AS NOT " which indicates the examiner opinion was UNFAVORABLE toward an approval of your benefit claim.

To be favorable the opinion should state AT LEAST AS LIKELY AS NOT, or MORE LIKELY AS NOT.

Based upon the above, the VA is not following the rules by not adjudicating your claim..

When the VA plays silly games, I find it MUCH more productive to hire a pro.

When the VA plays silly games, the veteran always gets silly prizes.

Edited May 30, 2019 by 63Charlie

[vetquest]

63Charline is right.  When the VA starts to dismiss evidence or not provide a good medical opinions it is best to hire a professional and get IMO's that support your claims.