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Medical Opinion

Medical Opinion. Texas Veterans Commission Fall Conference 2008. Overview. Requester & Purpose of a medical opinion. Information required prior to VA medical opinion request. Recognizing a medical opinion request. Description of the exam. VSO’s responsibility prior to the exam.

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Medical Opinion

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  1. Medical Opinion Texas Veterans Commission Fall Conference 2008

  2. Overview • Requester & Purpose of a medical opinion. • Information required prior to VA medical opinion request. • Recognizing a medical opinion request. • Description of the exam. • VSO’s responsibility prior to the exam. • Exam Do’s and Don’ts.

  3. Requester & PurposeMedical Opinion Requester • VA Regional Office to VA Medical Facility or civilian contractor. Purpose • To provide diagnosis and/or opinion: • Service-Connection. • Entitlement to Individual Unemployability (I/U) • To establish level of severity of disability

  4. Information Required prior to VA medical opinion request Service Medical Records (Service Treatment Records) and/or Service Records AND post service medical records must show: • In service event, injury or disease. • Disability or persistent / recurrent symptoms. • Reasonable likelihood of connection of the current disability & military service.

  5. Recognizing a Request for a Medical Opinion Medical Opinion request is referred to as: • C&P (Compensation & Pension) Exam [Conducted at a VA Facility] • QTC or MC Solutions [Civilian companies contracted by the VA to conduct the exam.] Note: Exam worksheet are identical regardless as to who conducts the exam.

  6. Description of the Exam - 57 Disability Exam Worksheets - Exam worksheets are on public VA website; • www.va.gov • Arrow on “Benefits” on left side. • Select “Compensation & Pension” from drop down screen. • Select “Benefit Information” on left side. • Center of screen is alphabetically, scroll down to “Examinations” & select “Disability Exam Work Sheets.”

  7. Description of the Exam (Cont.) • All exam worksheets have same format; A. through E. • “Review of medical records.” The Physician will review all records; • service medical records, • VA treatment records identified by the veteran, • civilian medical records sent in or received by the VA.

  8. Description of the Exam (Cont.) • “Medical History (Subjective Complaints)” These are medical symptoms. This is the veteran’s opportunity to tell of conditions that will not show on objective testing.

  9. Description of the Exam (Cont.) • “Physical Examination (Objective Findings)” These are medical signs. They are objective and indisputable.

  10. Description of the Exam (Cont.) • “Diagnostic and Clinical Test” These are test that may be requested by the Physician for information not expressly covered in other parts of the exam and determines the severity of the disability.

  11. Description of the Exam (Cont.) E. “Diagnosis” Common diagnosis: • ___ is caused by or a result of ___. • ___ is most likely caused by or a result of ___. • ___ is at least as likely as not (50/50 probability) caused by or a result of ___.

  12. Description of the Exam (Cont.) Common diagnosis (Cont.): • ___ is less likely as not (less than 50/50 probability) caused by or a result of ___. • ___ is not caused by or a result of ___. • I cannot resolve this issue without resorting to mere speculation. (This final diagnosis would require additional information or evidence.)

  13. VSO’s Responsibility !PRIOR TO THE EXAM! • Ensure Veteran contacts you when scheduled for a C&P exam. • Have the Veteran or yourself contact the facility conducting the exam and find what worksheet(s) will be utilized. • Print worksheet from VA website. • Review worksheet with veteran.

  14. Exam Do’s and Don’ts • Do: • Have Veteran write notes and refer to them during the exam if required. • Have Veteran review worksheet with spouse, family member or close friend. • Ensure Veteran understands He/She MUST tell the physician all symptoms (subjective complaints.)

  15. Exam Do’s and Don’ts (Cont.) • Don’ts • Don’t expect the spouse, family member of friend will be allowed in during the exam. (Only under unusual circumstances. Ex. deafness, blindness, communication impairment.) • Don’t try to discuss other ailments / disabilities than the one on the exam worksheet unless they are secondary conditions.

  16. Review • Who request & purpose of a medical opinion. • Information required prior to a medical opinion being requested. • Recognizing a request for a medical opinion. • Description of the exam. • VSO’s responsibility prior to the exam. • Exam Do’s and Don’ts.

  17. Conclusion Two Final Main Points: • This information is not so a Veteran can fabricate or exaggerate his/her symptoms. It is provided so they do not minimize or omit any symptoms. • If the Veteran is adequately informed of what to expect he is more likely to receive the benefits he has earned and we have accomplished our mission

  18. QUESTIONS

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