3/6/2023 0 Comments Nexus letterShe followed Step #3 above and explained her work in more detail: Here’s how that looked in a recent expert opinion we submitted to the VA – this is only the CONCLUSION the doctor reached. So when we have a medical expert offer an opinion, we ask him/her to review the VA C&P Exams and if there are any contrary conclusions, explain how those affect the doctor’s opinion. I don’t trust the BVA to properly weigh evidence. The BVA will have to resolve who is right by weighing the evidence. On the other side of the scale is the veteran’s independent medical opinion making exactly the opposite conclusion – that the veteran’s condition IS related to service. That exam concludes a veteran’s medical condition is not related to service. On one side of the scale used to weigh evidence is a VA C&P Exam. Here’s how the “Dueling Expert” situation arises: Did you know that DROs are “going away” under the new VA Appeals System? Read all about Appeals Modernization here. I don’t like going to a DRO hearing or the BVA with a situation called “Dueling experts”. 4) The doctor must explain any contrary opinions in the file. Lay evidence is the magic bullet, and medical evidence is the rifle – for an independent medical exam to be helpful, you are going to need a lot of lay evidence. In these situations, it is helpful to have a wealth of lay evidence about your symptoms and limitations in the file. The doctor has to explain WHY he or she reached that conclusion. It’s not enough to say that your Sleep Apnea is at least as likely as not related to your military service. The doctor has to explain why he or she reached the conclusion she reached. Same thing for an independent medical opinion. Remember back in grade school math class – we could get all the answers right on our homework or on a test, but our teacher didn’t care because she wanted us to “show our work”. 3) The doctor must explain his/her conclusion. Keep in mind, though, that any phrase other than “at least as likely as not” is going to confuse the VA. It’s a more substantial conclusion of medical causation, and the VA docs will have to work overtime to discredit that opinion. Those laws require they show prove a medical nexus using a different legal standard: a “reasonable degree of medical certainty”.Īnd if they want to use that phrase, go for it. Medical experts are used to dealing with medical causation issues under the various state laws. These are hard words for medical experts to understand – and I mean that with 100% seriousness. That you have put enough evidence into the record to support your claim. These magic words are the ones that show the VA – and later the BVA – that you have met your “Burden of Proof”. Second, take this 3 hour video training course and learn how to get a copy of your C-File from the VA – and, more important, how to USE it when you get a copy. You should probably ask for updated copies at least once a year. So, add this to the list of reasons you need to get your C-File.įirst, understand the reason that you NEED a copy of your C-File. Therefore, the VA says, the opinion is not credible. Here’s the VA’s thinking: if your doctor did not review your entire Claims File before making an expert opinion, he or she made an opinion based on less than all the information. (Of course, I’ve also seen the VA rely on C&P docs who make conclusions and state that they did NOT review the C-File – the point is, it’s a “hoop” you have to jump through that the VA does not). I’ve seen the VA sink more independent medical exam opinions because they lacked this simple phrase. If that happened to you, I want you to ask this question: Did your VA Independent Medical Opinion have All the “Magic Words”: 1) “I reviewed the Veteran’s entire C-File”. Maybe they said it was because the opinion was based on your statement of your medical history and you lack credibility. Or they didn’t give it any weight because it lacked probative value. Maybe the VA said that your medical opinion letter was not competent evidence. So they have their treating physician write a statement that their medical condition is at least as likely as not related to military service.Īnd then – months or years later – they get a decision from the VA denying your claim. They realize that a medical nexus letter – an independent medical opinion can often be the difference between winning and losing a claim or appeal. They know the VA wants some sort of proof that their medical condition is related to service. Or, about asking your treating physician to write the opinion?Įither way, there are some questions you are going to need them to answer.Ī majority of veterans fall into a common trap. Are you thinking about paying a private medical expert to offer an opinion whether your medical condition was related to service?
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