When Independent Medical Examination (IME) and How an IME Can Support a VA Disability Claim

When Independent Medical Examination (IME) and How an IME Can Support a VA Disability Claim

If you were injured during your military service or if you developed a condition that is related to your time in the military, you may be entitled to monthly disability benefits for your service-connected disability. 

In order to qualify for these benefits, Veterans must meet three requirements:

  • The Veteran must have a current disability
  • The disability must be caused by an in-service event or stressor event
  • There must be a medical link or nexus connecting the disability to the in-service event 

The Department of Veterans Affairs (VA) has a statutory duty to assist Veterans in proving these elements. But these factors all hinge on the accuracy and thoroughness of medical examinations and reporting. 

How Does a C&P Exam Affect a Veteran’s Benefit Determination?

When a Veteran applies for VA disability benefits, the VA may schedule a Compensation and Pension (C&P) exam if the evidence presented to the VA shows: 

  • Some evidence a current disabilities or symptoms of  disability
  • Some evidence of an in-service event, injury,  or disease
  • An indication that the current condition and in-service event may be related

If the Veteran can establish those three things, but there is not enough evidence to grant service connection, the VA will schedule the Veteran to meet with a VA-approved doctor for a C&P. These doctors can be VA doctors or contractors through places like QTC or LHI.  At the C&P exam, the trained VA doctor should do a thorough physical exam and ask questions about the Veteran’s condition to determine if they are eligible for VA benefits. 

The VA doctor then sends their report to the VA, which is reviewed by VA adjudicators to determine if the Veteran qualifies for benefits and, if so, at what disability rating and starting at the effective date. Like all doctors, some C&P examiners are amazing while some can provide inadequate opinions. Most of the time, VA doctors can provide adequate opinions that genuinely help Veterans to get their claims granted. But there are few that provide inadequate or unfavorable opinions that could result in a denial of benefits. 

Why an Independent Medical Exam (IME) Can Be Important

If you submit to a C&P exam offered by the VA or a VA contractor, and your benefits are denied, or your disability rating is lower than you deserve, you have options. If you feel like you’re receiving inadequate or unfair treatment from VA medical examiners, you are entitled to seek a second opinion from a doctor outside the VA system. 

One of the first steps you can take to protect your rights is scheduling an independent medical exam (IME) with a doctor of your choosing.

A true IME will involve a healthcare professional who has no affiliation with the VA and has never met the Veteran before. If the IME medical professional has no prior relationship with the Veteran or the VA, their opinion is more likely to be impartial and objective.  The VA must consider any second medical opinion or outside medical evidence from an IME exam when addressing an appeal of your Veteran disability claims. But if you have already attended a VA-Approved C&P, the VA may give more probative weight to the VA’s C&P. Meaning, they will rank the opinion by the VA doctor above the opinion of your private doctor. Also, submitting an IME does not mean the VA will not require you to go to a VA C&P. You also likely have to pay for any IME opinion you receive, while VA opinions are free. 

If your benefit application is denied or you receive a disability rating below the level you believe you deserve, you can appeal the VA’s decision. You can challenge the adequacy of your examination via a higher-level review or appeal to the Board of Veterans’ Appeals. Or you can submit supplemental medical information that may provide crucial evidence to help you counter the VA’s findings and receive the maximum benefits you are entitled to. 

Some Private IME Doctors May Fall Short

Similar to all professions, not all doctors are created equal. The VA relies on medical exam reports to make decisions about the Veteran’s degree of disability and impairment related to their service-connected condition. This is the basis for granting benefits and setting the correct disability rating. 

Finding a doctor who will perform a thorough and affordable evaluation can be challenging. 

The doctor who performs your IME exam must be familiar with the VA requirements and standards that apply to your disability. The VA depends on information contained in its Disability Benefits Questionnaire (DBQ) to assess Veteran disability claims. This form is written to correlate with the VA regulations and help evaluators assess each disability claim.

The DBQ can be lengthy, and many private doctors may choose not to complete the form due to time constraints or a lack of understanding of the VA claims process. It is essential that your IME doctor use the correct forms and fully complete the DBQ or your disability claim may be denied or undervalued.

Using an IME to Challenge Disability Ratings and VA Claim Denials

Even though the VA process is designed to help Veterans, many Veterans are and feel that they are mistreated during the claims process, particularly in medical examinations. A common theme is that the VA’s doctor didn’t listen or had already made up their mind before performing the medical exam. Sadly, some Veterans have stated, “The doctor talked to me for two minutes and said I was fine.“

Fortunately, you are not limited to the opinions of the VA’s doctors or the evidence contained in the VA’s file. You have the right to obtain your own IME exam for a separate healthcare professional’s opinion if you believe your claim was denied unfairly or your disability rating is inaccurate. 

Sometimes, a deserving Veteran must take an aggressive and proactive stance to protect their legal right to receive disability benefits. This is when you deserve a team of VA disability benefit lawyers fighting for you.

If You Have Questions About Obtaining an IME Exam, Berry Law Can Help

At Berry Law, we are skilled at incorporating any new evidence into an appeal, including any relevant documentation from IME physicians who treated your condition at any point. 

When we build a strong legal argument to support your appeal, we focus on evidence that confirms the service connection and elaborates on the symptoms, diagnosis, and disabling effects of your condition. Our proactive and thorough approach to IME medical evidence has paid off for clients in all types of VA claims, including claims for post-traumatic stress disorder (PTSD).

Please call (888) 682-0751 or contact us online to speak with veterans disability lawyers at Berry Law and learn more about your VA disability options. We are Veterans fighting for Veterans throughout the United States. We offer decades of experience helping Veterans like you resolve VA claims and appeals.

John S. Berry, , Lawyer for 
Military Sexual Trauma
John S. Berry, , Veterans Disability Attorney
Berry Law

The attorneys at Berry Law are dedicated to helping injured Veterans. With extensive experience working with VA disability claims, Berry Law can help you with your disability appeals.

This material is for informational purposes only. It does not create an attorney-client relationship between the Firm and the reader, and does not constitute legal advice. Legal advice must be tailored to the specific circumstances of each case, and the contents of this blog are not a substitute for legal counsel.

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