Jump to content


  • veteranscrisisline-badge-chat-1.gif

  • Donation Box

    Please donate to support the community.
    We appreciate all donations!
  • Advertisemnt

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0

Higher Level Review


Question

Hi,

I pray that someone can give me some answers because I feel distraught.  I filed for a higher level review.  The decision came back saying, it was returned for correction of a duty to assist error in the prior decision.  The Va Medical opinion was not sufficient for rating purposes.  What happens now?  Do I have to go for another exam?  I called and was told that no exam was scheduled for me.

Link to post
Share on other sites
  • Answers 7
  • Created
  • Last Reply

Top Posters For This Question

Popular Days

Top Posters For This Question

Popular Posts

If they say you are not required to go to another exam they have most likely contacted the doctor for clarification.  If this is the case there is nothing for you to do right now.  Good Luck.

@msvj3 The VA regional office has a set of minimum requirements for what is considered an adequate exam. Sometimes the doc may fail to provide sufficient information or additional clarification is req

IMHO, this is more of a good thing than a bad thing.  The good thing is instead of denying your claim, VA is taking more time to do a better rating decision.  The bad thing is you may still be denied.

Recommended Posts

  • 0

If they say you are not required to go to another exam they have most likely contacted the doctor for clarification.  If this is the case there is nothing for you to do right now.  Good Luck.

  • Like 2
Link to post
Share on other sites

  • 0
  • HadIt.com Elder

@msvj3 The VA regional office has a set of minimum requirements for what is considered an adequate exam. Sometimes the doc may fail to provide sufficient information or additional clarification is required. 

At this point, there are no plans to bring you back in. Once they get the information they need, they may either proceed and make a decision or bring you back in. Currently, there's no way to tell which way they will go. 

I have been brought back in for a follow up C&P exam once, but it was 20+ years ago. The documentation from the first exam was misplaced, so I had to come back. Ironically, I found the misplaced documentation in my claims folder some years later.

  • Like 2
Link to post
Share on other sites
  • 0
  • Moderator

I agree wit hthe above members  but this don't sound to good

''The Va Medical opinion was not sufficient for rating purposes.  What happens now?  Do I have to go for another exam?  I called and was told that no exam was scheduled for me.''

Link to post
Share on other sites
  • 0
  • HadIt.com Elder

This should be very helpful. Please note that there is much more to this article. Click the link to view the complete article.

M21-1, Part III, Subpart iv, Chapter 3, Section D - Examination Reports

3. Handling Examinations Reports That Are Insufficient for Rating Purposes

Quote
A VA examination report submitted to the rating activity must be as complete as possible.
 
Any missing, required information on the report makes the examination report insufficient for rating purposes.The following are examples of deficiencies that would render an examination report insufficient:
  • The examination report is unsigned.
  • The examination report does not address all disabilities for which an examination was requested.
  • The required question(s) on the DBQ is/are unanswered.
  • The required review of the claims folder was not accomplished.
  • The report is missing information pertinent to the specific disability under review, such as the impact of musculoskeletal pain on the functional loss of an affected joint.
  • A medical opinion is not properly supported by a valid rationale and/or by the evidence of record.
  • A requested medical opinion was not furnished.
Note If the rating activity determines that a necessary examination was canceled without a valid reason, it must submit a new examination request to the examining facility and specify why the previous cancellation was inappropriate.
  
Example:  An examination requested in connection with a claim for a knee condition was not completed because “the claimed condition was not documented and diagnosed in the service treatment records on examiner review.”  If the rating activity determines that such examination is needed, the existing report or cancellation notice should be returned to the examining facility as insufficient for rating purposes.
  
Important:  There are instances where missing information in an examination report does not make the examination itself insufficient.  However, claims processors must seek and obtain the missing information via communication with and clarification by the examiner, as discussed in M21-1, Part III, Subpart iv, 3.D.3.c, before issuing a final decision on the underlying claim.
  
References:  For more information on

 

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

  • Ads

  • Ads

  • Ads

  • Our picks

    • Post in New BVA Grants
      While the BVA has some discretion here, often they "chop up claims".  For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.  

      I hate that its that way.  The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.  
    • Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!

      My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.

      Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
        • Like
      • 13 replies
    • I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even  reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and  nothing about stressor,
    • This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.

      VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
        • Thanks
        • Like
      • 12 replies
    • I don’t say thank you enough to all of you...
      You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.

      Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.

      You all made that possible. Thank you.
        • Like
      • 8 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines