What are the abc's of DBQ's

[Carl the Engineer]

Hey, 

We are all from different parts of the world and experience different VA's etc.  I have been reading a lot on this site doing research on my next set of claims.  In my vast, but naive, experience, I fill(ed) a claim or claims with the VA and submitted my med records with my letter of explanation of what I am claiming and why.  Then, in a month or so, I would get a C&P exam.  And then a rating and or a denial.

Then, starting a couple years ago, I was reading a lot of mention of DBQ's on here.  I had no idea what you guys/gals were talking about.  Then after some more claims, it became apparent to me that the C&P examiners were filling out the so called DBQ's while they examined me.  Then, not sure but probably Berta, mentioned where one (me) could find the DBQ's and see what the examiners were checking off, and then when eBenifits came around, I could read the C&P's and see what was checked and why.  And also the "rationale" from the examiner.

So, far, everything was coming together.

But, now, while researching my next move, I see where some IME/IMO doctors will fill out a DBQ for you, ( I thought they just wrote a letter for you).  Did not know that was done.  The VA sure don't let you know that up front.

My question, I guess, is, have any of you submitted a "private doctor" DBQ with an original claim, or increase claim (not a appeal) and did you or not get a C&P with another DBQ?  And how did that play out.

That's my question for now, more on my plan at a later date,

As always,

Hamslice

 

Edited March 13, 2020 by Hamslice
cause I can

[Guest]

Hamslice,  IMHO, I think a veteran should never submit or file a claim without a current diagnosis and nexus.  The in-service incident, injury and or event should already be in the veteran's file.  Believe it or not, these are very easy to come by and won't cost you a dime.  There are some veterans that go out and pay for IMOs/IMEs and if you can afford it do it.  I couldn't/can't afford it.  The easiest and cheapest way to do this is to have the VAMC treat your symptoms.  By having VA treat your symptoms it starts a paper trail and document your condition(s). You can do this with a private doctor but I think VA doctors would be best.  The doctors don't need to write a letter just filling out your progress reports would be enough evidence.  Not too many C & P examiners will go against a VA treating doctor.  Some doctors for hire will fill out your DBQs for a price and some treating private doctors will fill out your DBQs under your insurance.  It would be your call but the bottom line is to submit this evidence prior to your C & P exam.  Never go to a C & P exam naked (without a current diagnosis and nexus). Veterans think all they have to do is file a claim and VA will take care of them. As we all know the  BVA and CAVC appeals are getting more and more claims that should be granted but the veteran has to fight in order to win.

[El Train]

Ahh yes. The first C&P with the VA was a real eye opener.  I learned so much from it.  I should write that Dr. a thank you letter.  Maybe I will when I win my NOD against him.  After that embarrassment, I had IME/DBQ for all other claims prior to submission.  I utilized outside Dr's who know the in's and out's of VA lingo.  Found them through various websites and facebook groups.  What a difference.  Luckily I had the means to pay for and travel to get them.  Winning was my end goal.  And I didn't want to play their games.  I hammered them, they hammered back, and now I'm 100% P&T.  I abide by their laws and regulations and used it to my advantage.

Winning wars is what we were taught.  I approached this with the same mentality.  After all this, my VSO was asking me for advice.

[Carl the Engineer]

Thanks guys for your comments,

I guess I have been lucky so far as claims go.  I have had a few denied, but I agreed with them, so there is that.  I did have one re-open that I won.  And I am sure I have been low-balled on some, but not sure.

My issue now is that I am at that 90% rating (actual 91 raw score) and have a new condition that will be secondary to a service connected disability and a probable increase to claim.  I would need 40% more to make it to 100% scheduler.  TDIU is not in the cards right now, but I suppose could be later.  My highest single award is only 30%.

Both with the new condition and the increase, the VA has been the sole treatment and diagnostic resources as I only go there for help for the last year since retiring.  No private doctor.

My two options are, 

1., submit the claim(s) like I have in the past and hope for the best, or,

2., travel and get a IME/IMO.  The only reason this appeals to me is that, from what I have read on Dr. Ellis's (as an example) application process, he looks at my complete record and sees what else I may have missed, etc., etc.,  I would pay to have him look at my past claims to make sure I got what I can get.

3., LOL, there is a three, do 1, then if unsatisfactory, do 2.

When you get into the 90's, things get pretty tough to get a higher rating because of VA math.

Bilateral 20, 20, 10, 10, 10, 10

Regular 30, 30, 20, 20, 10, 10,

I'm the nickel and dime guy,

Hamslice

Looking for someone to push me off the fence...

 

Edited March 13, 2020 by Hamslice

[Guest]

Have you considered asking your VA doctor's opinion on if these conditions are secondary to your already service connected condition? No letter just a statement in your progress note that it is as least likely caused by or as a result of your service connected disability and give a medical rationale.

I was a combined 90% and the 40% for fibromyalgia pushed me to 95% and VA then rounded up to 100% scheduler.

[GBArmy]

Hamslice to me, it is straight forward. The difference between a combined rating of 90% and 100% is like $1200 a month. You're a smart guy and this isn't your first rodeo, so you now have the knowledge to determine whether or not you have the 3 elements for a successful claim. You also know that there are dbq (s) involved, and if you are totally objective, you can eval your current symptoms to determine if those symptoms will get you that additional 40% and therefore, 100% scheduler. If you meet those, the only thing stopping you is getting a IMO/IME from Dr. Ellis or whoever. I don't know what it would cost, but I don't expect he does this for free. Say it costs you $6K; is that a reasonable investment to get to 100%? I would think so; even if you had to borrow it, you'd be paid off in 6 months. There are no guarantees, but these experts have a  reputation to keep. They aren't likely to give you a package that doesn't have a fair shot at winning. One other thing: he can look at your current disabilities and maybe you will tell him you have something wrong that you never even thought to consider as a secondary. Some of these experts are really good at this diagnosis stuff. And/or he will eval your current disabilities and suggest you now meet a higher rating for an existing disability. Have the consult with him and make your decision. It is very hard as you know to get t0 100 all by yourself. You know it's like pulling teeth to get that last 10% from the VA. They fight like hell to deny. Wish you luck.

[Carl the Engineer]

Well, I think I will talk if over with the Boss.  She lets me do anything I want, but she will have input.

I am thinking I will follow the application process and send my packet away for an IME/IMO and go to the physical and see what he/she says regards my issues.

The bottom line is I am a little tired, and would not mind a little help.  And the ride (nearest IME doc is 18 hours away) and the money would not be that big of a thing right now. 

My new contention/claim would be nice to get secondary service connected because it may become worse or deadly in the future and a connection would be beneficial for DIC, etc.  I'm service connected for acne, and told my wife if a pimple kills me, tell the VA.. LOL.

And, I agree, since I have done everything myself (I have VFW as my VSO that I have never spoke to or met) to date, it would be nice to have an expert look at my medical record and give it a proper going over.  I have all the required med records except a couple that I will get in the meanwhile.

Anyway,

Thanks,

Hamslice

Has anyone gotten actual film from x-rays the VA has taken?  That would be nice to know.  I got the reports from the radiologists, but the actual films..