HLR difference of opinion

[XIbodybag]

After filing an HLR I spoke with the senior rater during the informal conference and it updated and opened a supplemental claim stating a "difference of opinion has been asserted for sleep apnea".  A records review was ordered and completed December 14th and now I'm still waiting.  

 

To my questions... does a difference of opinion mean the reviewer believes it is service connected? what leads to a difference of opinion getting sent for a records review as opposed to the reviewer just overturning the previous decision?  I had already uploaded an IMO and completed dbq from a provider so why didn't the reviewer just use that?

[XIbodybag]

2 hours ago, brokensoldier244th said:

Likely because you have two different opinions, one favorable, one not, therefore that has to be resolved.  A difference of opinion doesn't mean SC, as raters can't make medical based decisions they can only go off of what is in front of them. If there is a difference of opinion between two examiners it has to be resolved, meaning the rater ordered the exam asking the tiebreaker to answer a specific question that wasn't addressed, or that was root of the opposing opinions. 

10 4, but if their are two opposing opinions aren't they required to give the benefit of the doubt to the veteran?

[brokensoldier244th]

If they are in equipose yes, but then im not a rater and I don't have it in front of me. There are claims where the opinions are are not in equipose depending on what each opinion has available to them as the body of evidence, or if an opinion is completely opposite of the evidence of record. 

 

[Rattler]

17 minutes ago, XIbodybag said:

10 4, but if their are two opposing opinions aren't they required to give the benefit of the doubt to the veteran?

That's the way it's spose to happen. Don't count on it.  I would SWAG method (Scientific Wild Ass Guess) Is they are compare them to see what is more relents.

[ShrekTheTank]

They can put weight where they want it and give their reasoning.   This is why we have the BVA and the CAVC to fight these issues.  

[brokensoldier244th]

True, but then not all medical opinions have the same weight, either. I get a few every so often from Chiropractors writing off on systemic non-mechanical conditions, or Social workers diagnosing PTSD, or examiners that are 8 states away and don't have the records in front of them from the veteran or us, or don't cite anything at all except "in their opinion.....". *shrug*. 

[Mr cue]

Well the VA is suppose to explain why that are not accepting medical evidence.

They just can not listed all the medical opinion.

This how you get benefits of the doubt.

Good and bad evidence.

But many rater feel that don't have to follow this law.

They will just talk about the negative medical opinion that may have gotten.

An not address your favorable evidence

This is also how you also get equipoise