The Importance of Private Professional Medical Opinions for Your Veterans' Benefits Claims

Obtaining a private professional medical opinion can mean the difference between you getting veterans’ benefits for your disabilities or not. You may think that getting an opinion from your VA doctor is sufficient; however, getting a private physician’s medical opinion is almost always better than relying on medical opinions prepared by VA doctors.

Whether you are trying to get service connected, an earlier effective date, or an increased evaluation, it is important to get a private physician’s medical opinion and get it to the VA as soon as possible.

In order to obtain a good private professional medical opinion, it is important to first have a diagnosis of your disability or disabilities. This establishes greater credibility for your claim, informs the VA that you currently suffer from the claimed condition and allows your private physician to consider possible service connection for a clinically diagnosed condition.

After being diagnosed, whether your condition is PTSD, diabetes from Agent Orange exposure, GERD, TBI, or some other disability, it is best to make it as easy as possible on your doctor to determine the probability of your condition being related to your military service. The following information is useful to physicians who are providing you with an opinion:

  • The standard of proof for service connection is the benefit of the doubt. Benefit of the doubt means that it is “at least as likely as not” that the claimed disability is related to military service. (This will give your physician a point of reference from which they can establish their opinion for service connection for your condition).
  • The VA claims file, which typically includes the records the VA has in relation to your military service, usually the service medical records and other VA correspondence. You can obtain this information from your local VA Regional Office. Ensure that your physician reviews your claims file or at a minimum your service medical records (SMRs) and states in their medical opinion that they have reviewed your claims file or (SMRs). (This gives greater credibility to the opinion your private physician provides).To make it easier on your physician, go through the claims file yourself and mark pages relevant to the claims for which you are seeking an opinion. Also, provide a summary of the pages you marked and the relevant information. (This will cut down on the time your physician has to spend looking for related medical history).
  • Request the physician clearly use terms that include the benefit-of-the-doubt standard. For example, “In my professional medical opinion, it is at least as likely as not that Mr. Smith’s diabetes is related to his service in the military.” (This clearly shows that your private physician’s opinion meets the VA’s standard for granting disability benefits. Using other language may cloud the issue).
  • Request the physician provide rationale for their opinion. While scientific proof is not required, some rationale as to how the physician arrived at their conclusion is necessary to giving greater credibility to the opinion. BVA or VARO may not rely on your private physician’s conclusion if it is not supported by the required analysis.For example, a medical opinion is inadequate if the conclusion consists of only a statement that the veteran’s disability is at least as likely as not related to military service with no rationale supporting that conclusion. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (“[A] medical opinion . . . must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions.”); see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (“Neither a VA medical examination report nor a private medical opinion is entitled to any weight in a service-connection or rating context if it contains only data and conclusions.”)
  • In order to enhance the likelihood of being granted service connection, an earlier effective date or an increased evaluation, it is important to obtain a private professional medical opinion. While it may not be sufficient by itself, it is another piece of evidence that helps in the further development of your veterans’ disability benefits claim.

Veterans’ benefits law attorneys at the Berry Law Firm are trained to assist you in successfully obtaining a good medical opinion from your private physician. Please contact us today at (888) 883-2483 and let us help you further develop your claims for veterans’ disability benefits.