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What is an IME for a VA Disability Claim?

What is an IME for a VA Disability Claim?

What Happens When You Apply to Receive Benefits From the VA?

If you are a Veteran with a service-related disability, you can file a claim with the Department of Veterans’ Affairs (VA), who will then decide whether you qualify to receive disability benefits. The VA’s disability benefits program exists to help support Veterans suffering from physical and psychological disabilities that are connected to their service in the military. Many US veterans leave the military with one or several physical or mental disabilities. These conditions can significantly impact a Veteran’s ability to find work, have a healthy social and family life, and, in many cases, even complete everyday tasks.

When you file a claim with the VA for disability benefits, you will start the process by filling out an application, which you can print and mail or drop off in person at your regional VA office. This application gets the ball rolling with the VA, prompting them to review your claim and move towards a decision. Before they reach their decision, though, there are a few more steps to take.

After you have filed your claim, your regional VA office will have you come in for a Compensation & Pension (C&P) exam. The C&P exam gets the VA acquainted with your military medical records, your symptoms, and the impact of your disability on your everyday life. The data and information gathered by the VA during a C&P exam play a key role in the outcome of your claim. If you fail to show up for your C&P exam, the VA will deny your claim by default.

What Happens Next?

After you take a C&P exam, the VA will move forward with your claim. Your C&P exam serves as the basis for the VA’s disability rating – the percentage between 0 and 100 the VA attributes to your disability. A higher rating indicates a more severe disability. The highest VA disability rating – 100% – is typically given to Veterans who suffer from extremely severe disabilities or have multiple conditions at once. 

The higher your disability rating from the VA, the higher your monthly compensation will be. With a 100% disability rating, Veterans with severe disabilities can have the means to support themselves and their loved ones, even when debilitating physical or psychological conditions have made them unemployable. In many cases, the VA will give a 100% disability rating to a Veteran who is so severely disabled that they qualify for a status known as Total Disability Individual Unemployability (TDIU). TDIU is attributed to Veterans who are physically or psychologically impaired to the point that they cannot support themselves financially.

Based on the results of your C&P exam, the VA will determine what the most fitting disability rating is for you. If the VA rejects your claim after you receive a C&P exam, your C&P exam may indicate that you are not disabled severely enough to qualify for monthly benefits. In other cases, the VA may deny a claim because a Veteran’s C&P exam does not show conclusive evidence that there is a link between the Veteran’s disability and military service. 

The VA Denied My Claim – Why?

If the VA denies your disability claim after a C&P exam, it’s natural to feel frustrated. You might feel that the VA is out to get you or that the Department is flawed at the core. However, it’s important to remember that the VA is not perfect, and sometimes mistakes are made in the process of reviewing a Veteran’s claim. The VA is not your enemy – but sometimes, to get the outcome you need and deserve, you may need to dispute their decision.

Before we get into steps that you can take to get a different decision from the VA, let’s take a look at the key reasons that the VA might bar you from receiving benefits or give you a lower disability score than you deserve. 

Sometimes, the VA will deny a claim based on a lack of sufficient medical evidence. Whenever a Veteran makes a claim, the VA is looking for conclusive signs that verify the severity of the Veteran’s disability. If a C&P exam does not present black-and-white evidence to the VA to confirm that a Veteran is suffering from a severe service-related disability, the VA will likely deny the claim. 

The VA may also deny a claim based on a lack of a verifiable connection between a Veteran’s military service and their disability. Even if a C&P exam indicates that a veteran is suffering from a severe physical or psychological disability, the VA cannot grant them benefits without a connection to their military service. There are some exceptions to this rule – situations where the VA presumes that a specific disability is connected to a Veteran’s military service – but in most cases, the VA needs to be able to confirm that a disability is service-related before granting benefits.

What Is an IME, and How Can It Help Me Get a Better Outcome From the VA?

An independent medical exam (IME) is an alternative to the VA’s C&P examination. This type of exam is performed by a doctor who is unaffiliated with the VA. If the VA denies your claim, you can request a decision review from them, a process that can involve getting an IME to present further medical evidence to the VA.

You can request a decision review based on any VA decision that you disagree with – if the Department denies your claim, or if they approve your claim but rate you too low. During the decision review process, a Veteran has the right to get a second opinion from a private doctor in the form of an IME. The results of the independent medical examination can then be presented to the VA as part of the decision review.

What if I Have a Psychological Disability?

If you are a Veteran with service-related mental health issues, it can be especially difficult to get an accurate rating from the VA. Because psychological problems are often harder to diagnose, measure, and quantify than physical disabilities, the VA is more likely to evaluate a Veteran’s psychological condition inaccurately. Luckily, you can get an IME from a private psychologist to help you make a case to the VA that they should change their ruling on your claim.

In an IME for a psychological disability, a private doctor can establish a connection between Veterans’ psychological problems and their military service. In addition, if the VA has ruled that there is not sufficient evidence to diagnose a Veteran with a psychological disability, an IME can present the VA with an authoritative second opinion.

Veterans with debilitating psychological problems should never get left behind when it comes to getting the disability benefits they need and deserve from the VA. If your claim was denied or you were given a disability rating that is too low, getting an IME from an independent psychologist can play a key role in getting the VA’s decision changed.

What if My Appeal was Denied?

The VA review process can go through multiple stages, with multiple different appeals going on at the same time for different conditions. If, at the end of the decision review process, the VA has still not reached a decision that you think is accurate, you can continue to dispute their ruling by making another appeal. 

Making an appeal to the VA involves getting represented by an attorney who can help you present evidence to the VA confirming you deserve a different VA disability rating. The VA appeals process can happen in stages, starting at your regional VA office and moving up from there. VA appeals can move up to higher level courts if necessary.

If you received an IME and presented additional evidence to the VA, but still have not received the disability rating you deserve, it’s time to make an appeal. When you need to fight a VA decision, you should contact the Veterans at Berry Law. Some of our attorneys are Veterans themselves and have years of experience battling the VA and supporting fellow Veterans through the appeals process. 

When you need to appeal your VA claim, an attorney at Berry Law can help you compile evidence, formulate statements, and prepare you for your medical examinations so that you can get the disability benefits you earned. VA benefits can be a major game-changer in your life and the lives of your loved ones – don’t settle for any less than you deserve. Call Berry Law today for a free case evaluation.

Sources:

https://psycnet.apa.org/record/1996-00417-008

https://www.jstor.org/stable/2136705

https://europepmc.org/article/med/9298498

Berry Law

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

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