Increase to 100% without C&P exam

[1454th Solider]

At a current rating of 70% for Unspecified Anxiety disorder with MDD, is it possible to get a increase without a C&P exam? The IMO rationale & DBQ were added as evidence. I have been getting Mental health treatment at the VA since my last award also.

[brokensoldier244th]

Who filled out the IMO and DBQ? If you are already SC you don’t need an opinion for an increase. You just need the dbq and your treatment to show that you have profound difficulties in pretty much all function areas. 
 

have you looked at the criteria?

[1454th Solider]

27 minutes ago, brokensoldier244th said:

Who filled out the IMO and DBQ? If you are already SC you don’t need an opinion for an increase. You just need the dbq and your treatment to show that you have profound difficulties in pretty much all function areas. 
 

have you looked at the criteria?

My private PHD Pyshc. doctor filled out the DBQ and he opinion on my anxiety disorder because the VA C&P examiner gave me or added Unspecified Anxiety Disorder to my award on my initial MDD  secondary to tinnitus claim. 

[pacmanx1]

7 hours ago, 1454th Solider said:

At a current rating of 70% for Unspecified Anxiety disorder with MDD, is it possible to get a increase without a C&P exam? The IMO rationale & DBQ were added as evidence. I have been getting Mental health treatment at the VA since my last award also.

Anything is possible with the VA, with that said, I filed a claim for Sleep Apnea, and I had my VAMC doctor write me an IME/IMO and the VA still ordered and sent me to a C & P exam. I asked the C & P examiner why did the VA make the C & P exam since I already had a favorable opinion and he said he did not know and wrote that the VA, that he agree with my already favorable medical opinion.  Just be prepared if you have to have a C & P exam. 

[broncovet]

The VA has discretion on whether or not to order a c and p exam.  Two example of when one isnt needed:

1.  If you already have sufficient evidence for an award, that is, diagnosis, in service event, and nexus, as well as your symptoms documented.  

2.  If a C and P exam wont make any difference..such as if you dont have the requisite service, or lack an in service event.  

[1454th Solider]

5 hours ago, broncovet said:

The VA has discretion on whether or not to order a c and p exam.  Two example of when one isnt needed:

1.  If you already have sufficient evidence for an award, that is, diagnosis, in service event, and nexus, as well as your symptoms documented.  

2.  If a C and P exam wont make any difference..such as if you dont have the requisite service, or lack an in service event.  

Thanks Broncovet I'll be ready either way..

[pwrslm]

Claims may be decided on ACE, acceptable clinical evidence, that already exists in your VA Claims file/VA medical file, or documentation already submitted. (https://www.navao.org/wp-content/uploads/2017/01/DMA-Fact-Sheet-16-005-ACE-Process-12-16-16.pdf)

LSI contacted me for a C&P, but I knew the info they needed already existed in my VA Med Records. I pounded the phone, demanded answers, and pointed out that LSI was not capable of providing any new or material information beyond what was already in my file. 2 days later, LSI called to cancel the appointment. The VA directed cancellation. I pointed out correctly that LSI was in it for the $$, and that the necessity for another medical opinion by a less than qualified "medical professional" was a waste of tax dollars.  You do not have to roll over, use the phone and present the case. If there is proof enough to make your claim, it is a waste of tax dollars to inject another opinion. 

(Note that ACE cannot be used for MH evaluations)

Edited August 19, 2021 by pwrslm