Examiner asked to change medical opinion!?

[HeatherW 1]

I had 3 C&P exams in February

1.  Anxiety and Depression – I was medically discharged for this and my service record flat out said service connected and permanent so I feel like they won’t deny rating me on this.  The Dr said they did me a huge favor writing that in my service record and she would report the same finding.

2. PTSD – MST – I had all the markers and was severely retaliated against afterwards this is shown in my service record with lowered evals, requested transfer, etc.  The assault was also reported so there was a record of that as well and the person was dishonorably discharged.  I feel like they won’t deny rating me on this.  The Dr said the military really did me wrong for how they treated me after that.  It was basically a career ender.

3. Back pain and hallux rigidus – I didn’t seek treatment while in service for this because after the retaliation I stopped seeking help.  The examiner was dismissive, had me out of there in 5 minutes and I’m certain she gave me nothing.

 

Fast forward to today.  The VA rater asked all the examiners for clarification.  First the anxiety examiner to ask if my digestive disorder was secondary to anxiety and/or PTSD. Second for the PTSD examiner to ask if the PTSD was service connected and if the digestive disorder was secondary to anxiety and/or PTSD.  BUT the interesting one is that the VA rater asked the back pain/foot examiner to ADJUST HER MEDICAL OPINION BASED ON WHAT THE PTSD DR SAID.  What in the heck?  Does that sound good or bad?  If it works in my favor then I won’t fight it, but if the rater is asking the examiner in an effort to reduce me, then isn’t it wrong for a rater to ask the dr to change their medical opinion?  Since when is a rater a dr.

Thoughts?

[broncovet 4,245]

Welcome to hadit.  Based on what you posted, I would wait until you get the C and P exams and the written decision, before you take any action.  

You posted:

Quote

BUT the interesting one is that the VA rater asked the back pain/foot examiner to ADJUST HER MEDICAL OPINION BASED ON WHAT THE PTSD DR SAID. 

I might ask as to where you got this information?  If this was in writing, by all means keep a copy.  It may be useful later, if denied.  

You are correct that Raters can not act as MD's.  I recall a CAVC decision which stated, to the effect, that a BVA judge can not substitute his unsubstantiated medical opinion for that of a competent medical professional.  The rating specialists are required to use the medical evidence, not their own feelings on medical issues.  

Dont be suprised if you have to appeal this, about 80 percent of first time claimants have to appeal.  You dont want to know how many times I had to appeal to get my benefits, but it took 18 years for me to win them all including the effective date.  

[HeatherW 1]

I called QTC to ask if they had responded to the VA yet and the girl was reading aloud from the notes on my screen.  I asked her to repeat it more than once so I'm positive of what she said.

What actually makes me somewhat hopeful is that in my gut the back dr was going to say not SC and give me nothing.  Then the only adjustment to the medical opinion would be in an upward direction?

Basically, because of the retaliation and bullying after the MST, which the PTSD and anxiety Drs could see evidence of in my records, there wouldn't be much in the way of in-service diagnoses for my physical issues because I stopped trying to get any help.  They both noted that.

Is it possible the rater is trying to actually help me?  Right the wrongs?

[broncovet 4,245]

Of course its possible the rater is trying to help you.  

Make no mistake, tho.  They will be documenting your Caluza elements for each issue of your claim.  You are going to need a: 1) current diagnosis, 2)an inservice event, and 3) a doctors opinion that your current diagnosis is related to your in service event for SC on each issue.  

I humbly suggest you work on documentation of the these 3 Caluza elements to ensure your claim will ultimately be successful.  "What the rater said in the notes" probably is not that relevant.  But you do need a copy of your c and p exam(s) and see if the doctor opined that your "diagnosis (such as PTSD) is "at least as likely as not" due to some event in service. 

Getting the copy of the c and p exam will serve several useful functions:

1.  You can check to see if the nexus is favorable.  If its favorable, you can have confidence in knowing you will likely eventaully be awarded benefits.  

2.  If the nexus is UNfavorable, the sooner you find that out, the sooner you can fix it and get your benefits.  

If you do not have this nexus opinion OR if the nexus is negative or flawed, then you are highly unlikely to be SC UNTIL OR UNLESS you get another doctor's more favorable opinion (nexus).  

Edited March 31, 2020 by broncovet

[HeatherW 1]

I’m so discouraged.... I was hoping it might be a good thing....I don’t even really care about the physical stuff, it’s the mental torment I have been trying to cope with that hurts the most.  

Edited March 31, 2020 by HeatherW
Added sentence

[broncovet 4,245]

If you have c and p exams, its a very good thing.  It means you have passed some big hurdles.  For example, you have a stressor (documented) for PTSD, and an in service event for other conditions as well.  You see, they dont order a c and p exam if there is no stressor (in service event) because a c and p exam wont fix that..no matter the outcome.  So, you need a diagnosis and a nexus.  I assume you have a diagnosis, and, even if you dont have a nexus now, you can probably obtain one with an IMO.  But you may already have one.  

You have to hang in there just like the rest of us.  We all have had issues.  

As for me, I have won everything I had hoped for..100 percent plus SMC..with backpay.  I couldnt have done it without hadit, and now I can help others with what I have learned.