VA Examination for Medical Opinion

[simdog77]

Good morning! 

I can’t seem to find to much information on this issue. I had a claim for spine issues that was denied because of a mistake on the original claim that said I made a lay statement about an injury’s cause which was in the wrong box on the form. They did say I have a recognized disability but did not service connect it. Claim was filed by my VSO. 

After getting service connected for hearing, left knee, and tinnitus, a new VSO had me file a supplemental on the spine issues correcting the lay statement and insuring that my service medical records showing back injuries plus proof of vibration as a cause in my MOS. VA website shows “we don’t know the status of your claim” now for several weeks. Called the VA on another issue and found out that an examination had been ordered for the supplemental. Then I got a letter a couple days later from a VA contractor saying they are doing an exam based on what was submitted (medical records, etc.) for a “medical opinion”. I was expecting a physical C&P exam.

Is this unusual? I couldn’t find much info on it. I did have two C&P exams for my knee issue with the second seeking a “medical opinion” from the examiner.

Thanks in advance for any insights on this.

 

December 4 Update

Now I understand that the “examination” was for a DBQ by the LHI contractor. Today, VA.gov went from “we don’t know the status of your claim” (were it was for almost two months) to CLOSED. No other info, no “we sent you a letter”. Nothing on e-benefits either so I am assuming it got denied. I emailed my VSO but no response as of yet.

I’m traveling for work but plan to follow up when I get back. My thoughts are to get my C File then file for a “higher level review” as they did not order a C&P.

Any other suggestions would be appreciated! I have no intention of giving up this fight.

 

 

Edited December 5, 2019 by simdog77
Update

[ShrekTheTank]

Make sure you keep fighting! You got this and you now have people who can help you!  I started out here a like 30% and now I am headed for my first CAVC appeal!  I am hoping on Friday to have good news that Mr Attig will be taking my case!  

The fight is worth it!  You are worth it!

[ShrekTheTank]

So no this is not unusual.  The contractors can make a determination based on your medical records for Service connection!  They do not need you there for this.  Now if it were for an increase as to how bad the condition has gotten then this would be strange, but not unheard of.  Say you had a yearly follow up and they talked about you back during this time.  They could use this and just say it has or has not.  I would appeal this as they should see you in my opinion.

[paulstrgn]

Shrek is correct, depending on the decision you should appeal it since they did not do a C&P. I understand the medical file review but they need to also do a C&P. They need to determine how bad your disability is which you cannot do with SMR.

[simdog77]

Thanks folks! When they denied it they did acknowledge that I had a disability just not the service connection. Part of my problem has been service medical records. I have some of them but believe there are some missing pieces. I have been trying to get new copies for over a year. DoD sent a letter saying they had been transferred to the VA. VA says they don’t have them. I filed a FOIA claim and they sent me copies of the records I sent them but that’s another story.

If they deny this one I will certainly appeal as I had to have major surgery on the spine a little over a year after I got out. Medical records that I do have state back injuries times 5 while in they just don’t state details of the injuries. I don’t think the saw or read the service files as they seemed to be stuck on the incorrect lay statement.