DBQs Submitted - Now They Want C&P Exams

[Top G]

I’m a retired US Marine of 20-years service, and currently have a 90% service connected disability rating as of 2009.
 

Last week I submitted my 6 BDQs for an increase in my disability compensation. Within a day of my submission of VA forms, they evidently reviewed all 6 DBQs and are now asking that I schedule for C&P exams through VES. 
 

Can I tell the VA that I do not want to go to their exams and ask that they review my claims of my DBQs signed by a medical doctor…and use my submitted medical  records from both my outside doctors and VA doctors?

 

I just feel like it’s not necessary as I’ve already done what was initially asked and don’t want this taking even longer of a time. I feel they have all they need to base their judgement. 
 

Appreciate input/recommendations from those more knowledgeable on this than I am. 

[pacmanx1]

17 minutes ago, Top G said:

Can I tell the VA that I do not want to go to their exams and ask that they review my claims of my DBQs signed by a medical doctor…and use my submitted medical records from both my outside doctors and VA doctors?

The answer to your question is yes, you can ask the VA to do this, but I would suggest that you just go to the exams. Reason being is that there may be an employee that ask the question as to what you are trying to hide. The VA want their own medical examiners opinion's and rationale's because they feel that veterans build good rapports with their treating doctors and that the doctors would lie to help the veteran. Like any medical professional would lie to help a veteran get unwarranted benefits.

You’ve played the game this long. Continue to play the game until you get the benefits you seek and let the VA do whatever they need to do to award your claims.

3.326 Examinations.

For purposes of this section, the term examination includes periods of hospital observation when required by VA.

(a) Where there is a claim for disability compensation or pension but medical evidence accompanying the claim is not adequate for rating purposes, a Department of Veterans Affairs examination will be authorized. This paragraph applies to original and supplemental claims as well as claims for increase submitted by a veteran, surviving spouse, parent, or child. Individuals for whom an examination has been scheduled are required to report for the examination.

 

[Vync]

DBQ's are only a part of VA disability claims. Keep in mind that the "Caluza" requirements must be met to determine if a vet qualifies to be service connected (SC). These generally include:

1. Event/injury or a "presumptive" requirement while in service, or an existing SC disability
2. Current diagnosis.
3. Medical opinion connecting 1 and 2.

The purpose of the DBQs help to back up #2, plus help the VA employees determine the rating percentage for each disability if you win SC.

Your examiner may still need to provide the medical opinion connecting 1 and 2. Some examiners can fit this into the limited space of the "Remarks" field of a DBQ while others might note their opinion on a separate letter or in your medical records. Some examiners have no clue this is needed, which is often a trigger for the VA to request C&Ps.

When the VA gets your claim and DBQs, they are supposed to go through them to determine if there is adequate information to proceed. If there is not or if there are other questions, they can refer you for C&Ps. They can also refer you for C&Ps if the DBQs are old, but I do not know the age threshold for this.

Internally, the VA used to use a "Medical Opinion Disability Benefits Questionnaire" form which was where VA C&P examiners noted their medical opinion. This form was internal to the VA and does not have a traditional VA Form number. I have no idea if they still use this form today.

[MilvetHD]

I’d counter that doing so could have the opposite of your intentions, which I understand to be you want to “hurry” the process. For one, the VA is always going to do what the VA wants and there isn’t much we can ever do to expedite the process. Secondly, your DBQ’s could very well be discounted and have the opposite effect, which in turn could lead to appeals and etc.  So in short, it’s probably best to do as requested. 

[El Train]

In my experience, I've gotten roughly half of my claims approved with outside nexus exam letters and DBQ's.  Half was enough for 100% P&T SMC-S.  The other half could've been approved if I wanted to appeal.  I had C&P exams for everything.  The outside DBQ's or nexus letters does keep them a little more honest if they know they have other evidence to contend with.  If they even read them.  More than likely your outside DBQ's from a forensic MD or specialist MD will be worded better than the VA's nurse practitioner who removes skin moles.  My private DBQ and nexus for PTSD/TBI was absolutely kick ass.  It was never mentioned in my C-File by raters or other Psyc Dr's looking at my claim.  I know it had to be considered since I went from 50% to 100% for PTSD/TBI without a ton of treatment records.

Don't do what I did and walk in with the DBQ's and throw it on the examiners desk.  If you piss them off, you will have a bad C&P exam.  Keep them on the low down and let the rater compare them.  This would've shaved a year off my rating.  Had to contest the bad C&P exam which in turn caused two extra exams.  But they got it right in the end.  Good luck & SFMF!

[Top G]

All 6 of my recently submitted DBQs are for SC rated medical conditions from 2009, which have gotten worse as documented by my VA doctors and outside doctors. 
 

A medical doctor filled out all 6 forms in their entirety. I think this is why I’m so frustrated. I recall for my initial 2009 ratings it took so long with all the medical appointments and taking so much time off from my new job…just not ready to do this all over again for what I feel has already been done through the past 13-years of documentation and DBQs. I’m just ready to tell them enough already. Just go off what I’ve filed.  

[Dustoff1970]

If you don't go to their almost mandatory C&P exams you have a lot to lose IMHO.  I have almost always over 30 years had to attend C&P exams in order to win my claims and appeals even with very strong favorable and supporting medical evidence. 

Very recently I was awarded 60% for GERD due to PTSD and 10% for Tinnitus within 20 days of my filing the claims with the VARO.  The GERD CP exam was less than one hour and only consisted of VA medical records review and taking my oral and written statements of severe symptoms.  Very friendly QTC nurse examiner.

The Tinnitus exam was with another friendly QTC audiologist that was 1 hour.  Done and finished. No big deal. No DBQs were submitted by me only my VA and Army medical records (copies only).

My comment is not legal advice as I am not a lawyer, paralegal or VSO.

Edited August 2, 2022 by Dustoff 11