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 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.
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.
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.
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.
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.
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