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Supplement Claim and LHI exam


Ken Dillon

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VA seems to have lost my NOD on my Cervical Spine, so I put in Supplement claim. As of two days ago I am schedule for another exam by LHI this week, its states for Cervical neck and a new IMO that I submitted, so my question is why would they state in heading new IMO. This makes 3 IMO I have submitted, one from family doctor and one from the surgeon that performed the fusion, any ideas? or am I looking to deep in to this?

Just one more question for you, on my last exam performed by VES on my Cervical Spine I have copy of exam but the Heading States Medical opinion disability benefits questionnaire , when I look online there is a Cervical questionnaire that has range of motion.The one I have does not just his opinion.

 

Thank You

Ken

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6 hours ago, Ken Dillon said:

VA seems to have lost my NOD on my Cervical Spine, so I put in Supplement claim. As of two days ago I am schedule for another exam by LHI this week, its states for Cervical neck and a new IMO that I submitted, so my question is why would they state in heading new IMO. This makes 3 IMO I have submitted, one from family doctor and one from the surgeon that performed the fusion, any ideas? or am I looking to deep in to this?

Just one more question for you, on my last exam performed by VES on my Cervical Spine I have copy of exam but the Heading States Medical opinion disability benefits questionnaire , when I look online there is a Cervical questionnaire that has range of motion.The one I have does not just his opinion.

Who really knows why VA does what they do? It is just a part of their games. One of my last LHI C & P exam was for my claim for sleep apnea. After discussing it with my VAMC Rheumatologist, I filed a claim for sleep apnea secondary to my service-connected fibromyalgia, my doctor wrote my IMO, the VA then scheduled me and sent me to a LHI C & P exam. When I went there, I played dumb and asked the examiner why I was there and she told me the VA wanted her opinion if my sleep apnea was secondary to my service-connected fibromyalgia and I told her that I just had an IMO from my treating VAMC doctor, and I did not know why the VA would need her opinion. I then gave her a copy of it and after she read through it, she said that she did not know why the VA made the appointment. She then wrote a statement that my sleep apnea was definitely secondary to my service-connected fibromyalgia and that I already had a positive IMO and that she agreed with my treating doctor’s opinion and when my claim was returned to the VA, they granted it within thirty (30) days. No argument, no fight and I was ready to go to the BVA, but I did not have to.

Some doctors do not like going against other doctor’s opinions. Not saying that this is your case, but it never hurts. What most veterans don’t understand that once a veteran has a positive IMO in their records, even if they get a negative IMO, the veteran still wins. The veteran may have to file an appeal, but the veteran still wins.

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VA has to have specific info on Cervical spine disabilities to rate it. If the IMO and Surgeons statements you submitted did not contain all of the info they list on DBQ's, they will request the C&P to get those answers. Alternatively, if the info you submitted contained everything that is requested in the DBQ, the C&P would be unnecessary. IF the VA has acceptable clinical evidence sufficient to rate the issue, they should not request the C&P. Look at the new evidence you provided and compare that with the DBQ for cervical spines and you should be able to answer this question.

 

The IG dinged the VBA for unnecessary C&P exams in 2018. If you suspect that the exam was duplicative and not needed, consider filing an IG report on this. VA needs to follow the rules, and reporting this type of issue would go a long way to get them to wise up and train their RO's to insure that C&P exams are actually necessary. 

Edited by pwrslm
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