Get An Independent Medical Evaluation to Support Your VA Appeal

By / January 8, 2017 / Veterans Disability / 2 Comments

When the VA Compensation and Pension Exam underrates your disability, find out why you should seek an independent medical exam and have that doctor fill out the Disability Benefit Questionnaire.

Dear Disability Advisor,

I’m currently appealing a decision based off my C&P exam for an increase.  I asked for an increase on my left knee that is service connected and is rated at 10%.  My left knee buckles and gives out twice a month, it pops every time I walk and has daily pain around the knee.  During that C&P exam she also checked my right dominant hand for an increase.  My right wrist cannot support heavy objects, my hand and fingers get numb every day, but the X-Rays that they had me take aren’t showing there’s a problem.  During the exam I was upset how the VA doctor was handling the exam, for my left knee and my right wrist she was forcing both of them to a certain degree on her measuring device as I was telling her that it was very painful and hurting.  She wasn’t responding to my verbal pain and discomfort at all, so that’s why I think my rating stayed the same.  My question is that I’m currently in the appeal process.  How do I win my appeal for my left knee and my right wrist that is in pain every day?

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Andre

Dear Andre,

This will require an expert opinion from a private physician or board-certified specialist (not employed by the VA) that the current condition is probably or is definitely a result of that incident incurred in the service.  If you rely entirely on the VA to help you establish this service connection, you have a higher probability of losing your case.

If you do not provide this evidence, the VA will either try to deduce from your other no-medical evidence that it is service connected, or the VA may more likely order a Compensation and Pension (C&P) examination with a request that the examiner offer an expert opinion on the service connection.

Most C&P exams do not result in a persuasive diagnosis or evaluation to support the medical disability a veteran is attempting to prove. One needs to pay for an independent medical evaluation. That evaluation must be extensive and thorough and define the specifics of your contention of a disability and the degree of your disability, if so diagnosed. It is helpful to have the physician complete the VA’s Disability Benefit Questionnaire (DBQ) for your medical condition. There are more than seventy DBQ forms. The DBQ appropriate for your medical condition can be found on the VA’s website by searching by topic or by the name of your medical condition.

Sincerely,

Craig L. Ames

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Get An Independent Medical Evaluation to Support Your VA Appeal
3.5 (70%) 2 votes

  • Dear Marilyn,

    A NOD (Notice of Disagreement) starts the appeal process. You may want to consider seeking the services of a VA accredited attorney who can evaluate your claim and determine the merits of a successful appeal. Go to the home website page for the VA, http://www.va.gov, where you will find a link to finding an accredited VA attorney in your state by zip code

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

  • Dear Wayne,

    You need to place in context the purpose of a VA C&P exam. The VA administrative staff determines whether it wants you, as a claimant, to have a medical evaluation via a VA C&P exam. The medical professional who conducts the examination only evaluates the specific matters which the VA claims staff wants reviewed. The purpose of the exam is not for the claimant to provide history of one’s contentions about the background and context of the VA claim. The C&P exam is specifically targeted to certain key elements that the professional has been told to evaluate.

    In your situation, the C&P exam purpose is an objective observation of a claimant to verify limited criteria and not to review, prove, or disprove the entirety of a claim.

    Although you do not state whether the VA has rendered a determination letter to you, the context of your inquiry is suggestive that the VA denied your claim. You need to read and understand all the legal components of a claim denial before you can come to a decision as to whether or not a claim denial is meritorious or not and whether or not to appeal. The C&P exam is only one of multiple factors that are considered in the VA’s coming to a determination of a claim. If you need assistance in understanding the letter, I suggest consulting with an accredited VA attorney.

    Sincerely,
    Craig L. Ames
    Accredited VA Attorney

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