Jump to content
VA Disability Community via Hadit.com

VA Disability Claims Articles

Ask Your VA Claims Question | Current Forum Posts Search | Rules | View All Forums
VA Disability Articles | Chats and Other Events | Donate | Blogs | New Users

  • hohomepage-banner-2024-2.png

  • 27-year-anniversary-leaderboard.png

    advice-disclaimer.jpg

  • donate-be-a-hero.png

  • 0

Supplemental confusion

Rate this question


wood78221

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. 

Link to comment
Share on other sites

Recommended Posts

  • 0
  • Moderator

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. 

Link to comment
Share on other sites

  • 0
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?

Link to comment
Share on other sites

  • 0
  • Moderator

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. 

 

 

Edited by brokensoldier244th
Link to comment
Share on other sites

  • 0
5 hours ago, brokensoldier244th said:

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. 

 

 

Thank you for the detailed response. The issue I take with my exam from May was the fact that I had 2 pages of notes of stuff I wanted to discuss and he left most of those "things" out of the report to the VBA. He also mentioned that I said everything was "going okay" at work...this was a lie, I never said that. I ended up filing a complaint with the contractor against him. The rep that called me from the contractor said he could of gotten me another exam but the claim closed so quick it was too late. 

When I filed the supplemental I basically laid out all this stuff in writing. This examiner's incompetence cost me my rating. If he would of even GLANCED at any of my treatment records he would of seen more evidence that would maintained or even raised my rating. Its frustrating. The suspense date is set for today on the claim so maybe I will know something soon. 

Edited by wood78221
Link to comment
Share on other sites

  • 0
  • HadIt.com Elder

wood78221 

''Quoted''

''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. ''

i Would just be guessing here  but  the VA calls around for these examiners and finds one that is not that busy and can see you   , they try to get a veterans C&P ASAP.  ves was just most likely the ones that could do it the earliest.  why you got the same examiner is anyone's guess?

Now what would concern me is why?  and why not use the QTC examiners report?

If its a matter of what Dr they believe   its usually the specialist and the Dr that goes into the most details  and the Dr credentials/experience ect,,,,ect,,,,

I had a VA Dr rip me apart at a C&P  lasted about 4 minutes and I had to get a private IMO/IME to clear up his mess and lies , and I used a Specialist for this  he had better Credentials then the VA Dr and gave a more through explanation and went in to greater medical details.

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Guidelines and Terms of Use