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    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

HadIt.com Anniversary 24 years on Jan 20, 2021

Question

May-
1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)
2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc. 
July-
3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)
August-
4. New exam from QTC, went well, probably around 70 percent 
5.  VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August. 
September- 
6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years). 

I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out. 

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There was a contradiction between the two doctors examinations and their findings- this happens also if your private doctor opines in your favor and the VA examiner doesn't, or vice versa, especially

By statute it should, but it really depends on what doctor A vs doctor B said and the rationale provided. I know its a popular opinion, but doctors don't usually outright lie on their exams. They get

Pretty much, yeah, except we don't call. We get the pending counts from all the contractors every day uploaded into the system and so it assigns based on distance and overall case load- except that at

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  • HadIt.com Elder

There was a contradiction between the two doctors examinations and their findings- this happens also if your private doctor opines in your favor and the VA examiner doesn't, or vice versa, especially if the two exams are close together within a few months. In sending it back to the first examiner they would have sent questions with it that need to be answered that either weren't addressed the first time, or that were in the 2nd exam that they want answered by the first examiner. 

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On 9/11/2020 at 5:14 PM, brokensoldier244th said:

There was a contradiction between the two doctors examinations and their findings- this happens also if your private doctor opines in your favor and the VA examiner doesn't, or vice versa, especially if the two exams are close together within a few months. In sending it back to the first examiner they would have sent questions with it that need to be answered that either weren't addressed the first time, or that were in the 2nd exam that they want answered by the first examiner. 

Is it possible that the “tie goes to the runner” could go into place here?

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By statute it should, but it really depends on what doctor A vs doctor B said and the rationale provided. I know its a popular opinion, but doctors don't usually outright lie on their exams. They get paid either way and so have no stake in providing a negative vs a positive exam. They get paid by having the exam assigned, not by the result. By the time they see it the contractor has already been billed- just by the form coming into them.

All they are doing is observing the condition, and if necessary, opining on whether it is SC or not. That is more based on ME (for example) annotating your medical records so as to make the relevant evidence as easy to find as possible out of the hundreds of pages that are in your file. Its a lot easier for the doctor to miss things if they are not called out specifically- thats a lot of what I do when Im working on a claim, actually. I don't have an opinion- and I don't evaluate evidence (im not a rater). If you went from "not SC, no evidence of...." to "holy shit, he's so broken he's about to fall apart" in the span of a few months, one of the other of them made a bad call or didn't see something in the medical files. That's why they are asking for Dr. #1 opinion/rationale again, most likely. Either they didn't evaluate something they should have, or they didn't provide an opinion as to why they think whatever they thought. 

What I DO do is annotate the page(s) on which certain things are noted. That time you went to sick call for X, Y, Z, or that injury that required some sort of medical intervention. I find that stuff in your records, annotate it, and then send it to the doctor on the exam request remarks "Hey, doc..look at pg 20-22 psych notes, pps 48, 49, 62, 115 shows progression and original DX..." etc. They have the records that we notate for them, so, if you have a lousy VSR (it happens, I won't deny it) that rushes through things and doesn't annotate well then the doctor has to go through all of it on a snipe hunt. Its a lot easier and faster for them if its already called out in the notes that I send them. (its also a lot easier for me on claim forms if the veteran can give at least an approximate time/date that something started or something happened- even "Spring of 95, I think...." is better than nothing. It gives me a place to start that isn't Pg 1-pg 395)

 

Im a little slower than many VSRs. I like the challenge of finding this stuff. KIM that while records may have been scanned in for most all era's of veterans at this point a lot of them are still a mishmash of hand written vs digital/typed. SO, CTRL-F is not always my friend because 'search' won't find handwriting in a PDF. Its just not that good yet. I have a medical dictionary, and another one that is just the symbols that doctors generally use, with abbreviations. While handwriting won't get found on a PDF, I CAN search for things on the form like 'field' headings or form numbers (DD214, DD2807), so I can search for "hearing" or "audio" and at least hit every form that has a field with that name. Its still slow, but its a lot faster than scrolling through all 300+ or more pages, too. I do a combination of both- I scroll and I also 'search', trying to catch whatever instances I can of whatever you claimed. 

 

 

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