Cp exam weight

[Phild523]

I was just wondering how much weight a rater gives to the results of a c&p exam. I have heard people say that if an examiner gives you at least as likely as not that you are service connected for that issue under the cfr. Others have said that the rater does not have to go by that and only uses the exam as a piece of evidence.  In my situation I have been sent to two initial tbi c&p exams each time with the examiner saying at least as likely as not. I also went to a C&p for PTSD which I received due to or resulting from. Then the cp examiner for ptsd was asked for a medical opinion in which she said at least as likely as not. 

Anyone have any thoughts? Thanks for your input. 

[vetquest]

Have you been denied in such a case?  If so I would file an HLR appeal.  If this does not get results you would have to go to the BVA. 

That is where buck52 says the problems with the VA and denials come from.  A rater denies your claim and then the Higher Level rater denies you and you get stuck waiting for the BVA to adjudicate your case.  This is a sad but true situation.  I had to wait ten years before I was granted TDIU on what should have been an easy case.

If you have been denied please post your denial and let us take a look at it.

[Phild523]

I have not been denied. I think I am getting to myself. I suffer terribly from anxiety and depression like most of us on here do. I put the claim in September of 18. I had my cp exam for PTSD in December. Examiner wrote wrong on dbq caused by or resulting from. It was sent back so that she had to change language to at least likely as not due to military service and stressors. My first Cp exam for tbi initial and migranes examiner wrote at least likely as not with the rationale that I had no head injuries prior to service. That was in February. I redid exam in early June with the same outcome and rationale. Claim went to prep for decision then back to gathering of evidence.  I called Dav and they said they need to differentiate symptoms between social and occupational impairment between tbi and PTSD. 

[Buck52]

Just my 2 cents I believe they can't make a decision on your MH Claim because of the TBI involved, they seem to be having a hard time differentiating the symptoms between the two  PTSD & the TBI,

We usually can't have 2  MH conditions rated at the same time but its possible now days from what I just learn  from another veteran who was rated for both PTSD & TBI  here on hadit.

What you need is them to decide on is  either both conditions  or if this rating only requires one of the two  the TBI would be the one they need to rate because  it carry's more symptom's and conditions  that may arise later in your life time and or other secondary conditions based off the TBI.

As for as being rating for both of these conditions at the same time is new to me so I am not that much help   especially on the TBI.

so now that you have had all your C&P's  all you can do now is sit and wait for a decision unless they need to send you to another C&P (DO NOT MISS IT)  and after you get your decisions , if you don't agree with the decision then you can Appeal.  most of us have been where your at..lets hope you get a fair decision.

I realize waiting is stressful to say the least  but we have to put up with the VA ,  just try not to let all this get to you...keep yourself busy doing a hobby that you love...get your mind away from your claim now that your playing the VA waiting game.

[Berta]

A TBI is a physical injury, PTSD is a MH issue.

Much has happened since the TBI scandal some years ago. Only certain VA professionals can determine TBI and the extent of it, for a proper rating.

This BVA case shows what I mean:

https://www.va.gov/vetapp19/files4/19130605.txt

Buck said:

"As for as being rating for both of these conditions at the same time is new to me so I am not that much help   especially on the TBI."

It has been going on for years- PTSD is a MH issue, TBI is a Physical brain trauma issue.

The VA can separate brain trauma from PTSD. They have done that in many cases.

Often a vet will have PTSD from a different situation and stressor but most of the time the TBI IS the stressor.

Also Stroke is Brain trauma. It is, like TBI, a physical disability.

The VA PTSD doctor ( after a battle with this VAMC) gave my husband a series of 6 tests over a two day period.

The results were 100% P & T  PTSD( awarded posthumously due primarily to these tests) and also 100% P & T (awarded posthumously) for the 1151 stroke.

He also had two separate SSA awards ,both solely for each disability, but I already explained how that was done...SSA made an error in their initial award solely for stroke.But my husband listed PTSD as his main issue. 

He thought he could recover from the stroke. SSA awarded for the stroke. I filed a Reconsideration due to a SSA regulation I found at their office, and they made a new award, SSDI solely for PTSD. 

It is the same thing- brain trauma is a physical disability (that can cause psychiatric symptoms) but the VA has to consider PTSD on it's own, as a mental disorder that fits into the PTSD criteria.

The IG has looking into the TBI issue many times.

The BVA has had 4,698 appeals on this issue since 2015 and my recent search might help many here clarify what the VA is supposed to do regarding claims of PTSD (MH issue) and claims of TBI (physical brain damage)

https://www.index.va.gov/search/va/bva_search.jsp?QT=TBI++PTSD&EW=&AT=&ET=&RPP=10&DB=2019&DB=2018&DB=2017&DB=2016&DB=2015&DB=2014&DB=2013&DB=2012&DB=2011&DB=2010&DB=2009&DB=2008&DB=2007&DB=2006&DB=2005&DB=2004&DB=2003&DB=2002&DB=2001&DB=2000&DB=1999&DB=1998&DB=1997&DB=1996&DB=1995&DB=1994&DB=1993&DB=1992

 

 

 

[Berta]

Here is another BVA decision:

"ORDER

Prior to February 20, 2016, a separate 50 percent rating for headaches as residuals of traumatic brain injury (TBI) is granted.

Prior to August 13, 2014, a separate 10 percent rating (but no higher) for memory loss associated with TBI is granted.

Prior to September 2, 2014, a 70 percent rating (but no higher) for posttraumatic stress disorder (PTSD) with TBI is granted.

From September 2, 2014, to February 19, 2016, a 100 percent rating for TBI with PTSD is granted.

From February 20, 2016, a 70 percent rating (but no higher) for PTSD with TBI is granted.

A total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is granted."

There are other issues in this case on remand:

https://www.va.gov/vetapp19/files4/19128576.txt

We have TBI /PTSD vets here as well.

[Phild523]

Thank you very much guys. You are absolutely right. I will appeal if necessary. Just hoping for a fair decision.