Adequate Medical Opinions

One critical piece of evidence in veterans’ benefits cases is a medical examination, often necessary to establish both a current disorder and a nexus between the current disorder to service or a service-connected condition, such as cause or aggravation.

Adequate Medical Opinions – PTSD Lawyers

In order for a VA medical examination to be adequate it must be thorough and contemporaneous and must consider prior medical examination and treatment. 38 C.F.R. § 3.159(c). In addition, the examination must also describe the disability in sufficient detail so that the Board of Veterans’ Appeals (Board) evaluation of the claimed disability will be a fully informed evaluation. 38 C.F.R. § 3.159(c).

The Court of Appeals

In a recent case before the Court of Appeals for Veterans Claims, El Amin v. Shinseki, a surviving spouse was seeking death benefits after her veteran husband had passed away of hepatic cirrhosis. One of the alleged causes of his death was alcoholism, a nonservice-connected condition. Appellant claimed that her husband’s post traumatic stress disorder (70% service connected) either caused or aggravated his alcoholism, which eventually led to his death.

Previously, the Board of Veterans’ Appeals had relied on a single medical examination provided by VA to denying the claim. The medical opinion stated that the veteran’s post traumatic stress disorder (PTSD) was not the cause of his alcohol abuse.

The Board indicated the medical examination report was adequate because the examiner reviewed the claims file, provided the opinions requested, and gave adequate rationale for his conclusions. El Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). The Court, however, found that the Board’s decision was clearly erroneous.

In remanding the claim, the Court explained the medical examiner had only opined that veteran’s alcoholism was not “caused” by his PTSD; however, the examiner failed to determine whether veteran’s alcoholism was “aggravated” by his PTSD. El Amin v. Shinseki, 26 Vet. App. 136, 140 (2013) Therefore, the Court remanded the case for further review consistent with its decision.