Don't understand whar's happening with my FDC

[Lunchbox111]

In 2016 I received SC for lumbar strain (10%) and TBI (10%) and tension headaches secondary to the TBI (0%). In November 2019 I completed the intent to file and on March 26, 2020 I submitted an FDC for an inrease on headache and back and radiculopathy left and right legs secondary to the back. On April 2, VA Received and completed the initial review and on April 3rd I signed the form 5103 notice. A week and a half to two weeks ago I received a letter from the VA typed on April 3rd stating they were going to set me up for an exam. As of today va.gov says it's still in evidence gathering

Request 1

Exam Request - Processing

No longer needed

 

Does anyone know what this means? I'm just confused on whether or not I will be sent for an exam or if it means they no longer need it. Any ideas would be greatly appreciated.

Thank you

[deedub75]

Are you paying Vet Rating Group to represent you?  Did you have in person exams for the DBQs that you submitted with your claim?  The reason I ask is because the VA is cracking down on DBQs that were not completed via an in person exam.  If the examiner didn't say that he or she examined you in person and the examiner is in a different state as you it raises a red flag.  

 

[brokensoldier244th]

They don't "raise a red flag". They get read just like everything else in the files, with a pair of eyes. OCR can't read handwriting hardly at all, and even typed text doesn't always read well, so VA systems don't use it. Its all done with eyes and a lot of CTRL-F. DBQs have always been counted as a lower form of evidence if not done in person, thats not what the new changes with DBQs is about at all. If your doctor fills out a DBQ in person and provides enough evidence on them, with the supporting record the DBQ is treated no different than any other, unless your doctor is a PA or not qualified to opinion on whatever your DBQ is about (a GP doing a cardiopulminary exam, for example, or a sleep study). The reason DBQs are being removed from public view is because veterans, or attorneys, or 'advocates' were sending them to practitioners hell and gone from where the vet was from for specialist opinions on things where the examining doctor was only looking at the existing record and not really performing an exam.

The DBQ for a medical opinion for service connection is its own form all by itself. The Condition DBQs are for determining the existence of a condition and documenting its severity. There are only a very few DBQs for conditions that ask for a medical opinion specifically. Thats why, when they are submitted, they are not always adequate for rating. If the doctor fills out most DBQs as they are written there is no place on them for an opinion with rationale- the doctor needs to write up a statement saying so, and why, using the DBQ and whatever other treatment records they have as the rationale. Just having a DBQ that says you 'have' a condition is not enough. 

When C and P exams are scheduled with a contractor or a VA doctor they get 2 DBQs for most conditions submitted- the 'condition' DBQ and the 'medical opinion' DBQ. If both are not returned, or aren't completed with enough rationale to support them based on the records on hand, and they provide nothing else, or the veteran has nothing else, they are an insufficient examination and it needs to be redone or clarified. If you just hand your doctor a DBQ and they don't render an opinion along with it, its an insufficient exam. 

Edited May 10, 2020 by brokensoldier244th

[deedub75]

11 minutes ago, brokensoldier244th said:

They don't "raise a red flag". They get read just like everything else in the files, with a pair of eyes. OCR can't read handwriting hardly at all, and even typed text doesn't always read well, so VA systems don't use it. Its all done with eyes and a lot of CTRL-F. DBQs have always been counted as a lower form of evidence if not done in person, thats not what the new changes with DBQs is about at all. If your doctor fills out a DBQ in person and provides enough evidence on them, with the supporting record the DBQ is treated no different than any other, unless your doctor is a PA or not qualified to opinion on whatever your DBQ is about (a GP doing a cardiopulminary exam, for example, or a sleep study). The reason DBQs are being removed from public view is because veterans, or attorneys, or 'advocates' were sending them to practitioners hell and gone from where the vet was from for specialist opinions on things where the examining doctor was only looking at the existing record and not really performing an exam.

The DBQ for a medical opinion for service connection is its own form all by itself. The Condition DBQs are for determining the existence of a condition and documenting its severity. There are only a very few DBQs for conditions that ask for a medical opinion specifically. Thats why, when they are submitted, they are not always adequate for rating. If the doctor fills out most DBQs as they are written there is no place on them for an opinion with rationale- the doctor needs to write up a statement saying so, and why, using the DBQ and whatever other treatment records they have as the rationale. Just having a DBQ that says you 'have' a condition is not enough. 

When C and P exams are scheduled with a contractor or a VA doctor they get 2 DBQs for most conditions submitted- the 'condition' DBQ and the 'medical opinion' DBQ. If both are not returned, or aren't completed with enough rationale to support them based on the records on hand, and they provide nothing else, or the veteran has nothing else, they are an insufficient examination and it needs to be redone or clarified. If you just hand your doctor a DBQ and they don't render an opinion along with it, its an insufficient exam. 

In your first paragraph, you explained what I meant about red flags.  If it's evident that the exam was not done in person then that would raise a red flag and, if warranted, an exam would be ordered.  This is why I asked the OP if he hired Vet Rating Group to represent and if his exams were done in person or not.  

I am very familiar with DBQs as I was a VSR from 2013-2015 before I left for bigger and better things.  Don't you work for the VA?  I have a friend who is a coach and he tells me that they are giving much weight to the outside DBQs and I have another friend in a different office who is acting a a DRO right now and he says that the outside DBQs are just another piece of evidence.  He also seems to think that BVA will give more weight to outside DBQs than the ROs.  

[brokensoldier244th]

It's not supposed to vary between offices but hey, what do I know. I just follow the M21 as much as I possibly can. In any case, I don't rate so I don't see/know what happens on that side. I just try to get any and all exams that are necessary, make sure that I have as much info as possible from the vet by digging into what is already available from them and various fed  and non-fed record searches without having to bug them for more info if I don't have to, nothing more. No reason to tie up a claim doing exams for everything if the information is already there. If there is a DBQ we take it at face value in development and after that if it gets kicked back for the veteran to go to an exam because of the quality of the DBQ it wasn't our call, it came from someone else outside my paygrade. 

Maybe im not jaded enough yet. I hope to not be. Its not my job to make things harder than they already are, but with 1000+ pages of regulations, CFR, and M-21, I can even identify places where the reg says one thing in one place and something different somewhere else. Thats why when I type up my stuff I try to add cites to whatever work I did on a claim. It makes me slower, but more attentive to what I consider my personal level of fulfilling what my job is supposed to be. 

[brokensoldier244th]

14 minutes ago, deedub75 said:

In your first paragraph, you explained what I meant about red flags.  If it's evident that the exam was not done in person then that would raise a red flag and, if warranted, an exam would be ordered.  

I misunderstood you, then. I apologize. I was clarifying that there isn't a 'Bloopity Bleep!!!" red flag that pops up. It may be scrutinized further, but its not like I open a claim and there is a system flag or something on it. Thats all I was trying to say. 

[deedub75]

3 minutes ago, brokensoldier244th said:

I misunderstood you, then. I apologize. I was clarifying that there isn't a 'Bloopity Bleep!!!" red flag that pops up. It may be scrutinized further, but its not like I open a claim and there is a system flag or something on it. Thats all I was trying to say. 

No worries.  I'm sorry, I didn't mean a literal red flag.