Medical Opinion Required ...

[RBrogen]

Scenario:  C&P exam for bilateral knee issues.  The C&P examiner wrote the attached "yellow highlight" in my exam.  The rater denied my claim for service connection stating what is in "blue background attachment".  If the rater knew the examiner didn't mention etiology, is it not a requirement for them to ask the examiner for an addendum and an opinion?  I can't find an actual opinion DBQ in my C-File for this exam ... only the C&P exam.   Note it is from 1999.

Thanks in advance for any insight.

[broncovet]

Not that Im aware of.  C and P examiners, hired by the VA, often do not give an etiology.  Why?  Well because they are paid for by VA, and VA has a "self interest" in denying the Vet.  

Often a Veteran must pay for an IMO to get a nexus.  

However, before hiring an IMO, Check to make sure you have "the other 2" Caluza elements:  Current diagnosis and In service event DOCUMENTED.  

Its pointless to hire an IMO if there is no documented in service event or aggravation.  Exception:  If you apply within a year of exit from service, there is a presumption that "you got it" from service.  

[RBrogen]

9 hours ago, broncovet said:

Not that Im aware of.  C and P examiners, hired by the VA, often do not give an etiology.  Why?  Well because they are paid for by VA, and VA has a "self interest" in denying the Vet.  

Often a Veteran must pay for an IMO to get a nexus.  

However, before hiring an IMO, Check to make sure you have "the other 2" Caluza elements:  Current diagnosis and In service event DOCUMENTED.  

Its pointless to hire an IMO if there is no documented in service event or aggravation.  Exception:  If you apply within a year of exit from service, there is a presumption that "you got it" from service.  

Thanks BroncoVet ... Doesn't that fly in the face of 38 CFR 4.2 and 4.6 about collecting and evaluating all evidence properly.  Perfect example my shin splints, they were pointed out in one of my C&Ps, I then filed a claim for them, and during one of my most recent C&Ps they did medical eval and now I just got a call to specifically go in for shin splint C&P even though all of the DBQs have been completed for them (with the exception of the medical opinion question).  Is it not strange to bring me in to do the medical opinion if they have all of the evidence?.... if it is clear the road is made of yellow brick, and you're traveling with a tin man, scarecrow and lion ... one could surmise your destination is Oz?  lol but not in VA land.

[broncovet]

Well, there IS a Santa Clause in VA's 4.6, but you dont get Santa's services for free.  Va will hire you a doc for a c and p  exam, but this does not guarantee you the doctor will write an etiology (aka nexus) statement.  

The nexus statement is an "opinion" by the doctor, and, like any opinion, you are not required to share your opinion with everyone.  It goes like this: (VA management speaking to doctor)

Quote

Ok, doc, we are pleased you have an opinon on this Veterans etiology of his condition.  Now, keep that opinion to your self  in the future if you like your job here, ok? We are okay if you offer a negative opinion, but we are watching you, and if you offer too many Vets too many favorable nexus opinions, then you obviously need a career outside the VA.  Importantly, we did not have this conversation, is that clear??  Ok, nice talking with you, now feel free to get back to seeing other patients(Vets) and get back to work!! 

You see, the VA interprets its own regulations, and enforces (or chooses not to enforce) them also.  So, the VA picks and chooses which regulations to force on their employees, and you can guess which ones they choose to enforce:  Those that benefit VA at the expense of Veterans.  

[RBrogen]

22 minutes ago, broncovet said:

Well, there IS a Santa Clause in VA's 4.6, but you dont get Santa's services for free.  Va will hire you a doc for a c and p  exam, but this does not guarantee you the doctor will write an etiology (aka nexus) statement.  

The nexus statement is an "opinion" by the doctor, and, like any opinion, you are not required to share your opinion with everyone.  It goes like this: (VA management speaking to doctor)

You see, the VA interprets its own regulations, and enforces (or chooses not to enforce) them also.  So, the VA picks and chooses which regulations to force on their employees, and you can guess which ones they choose to enforce:  Those that benefit VA at the expense of Veterans.  

Yeah I hear ya .... that's why we are forced to dance the VA dance.