Why Some Private DBQ/Medical Nexus Rebuttals Fail Before They're Even Submitted

本站添加: 2026-05-30

[00:00:00]Hello and welcome to Raider HQ Afterdark. I'm your host, Raider. And in this video, before I get started, I would like to humbly ask that if you do find my videos to be educational, supportive, helpful in any way, shape, or form, please like and subscribe the videos if you want to and share with a friend. It does help the channel to grow, but more importantly, it helps to put out good information in a vast sea of deep water misinformation because that ocean is deep. Um, but anyway, so today's video, what I wanted to talk about is I want to talk about private DBQs and medical opinions because I seem to be running into this quite a bit. um where the scenario that happens is you, the veteran, decide that you're going to get a private disability benefits questionnaire or medical opinion from a doctor. Now, the source of this doctor doesn't matter, but you want to get a private medical opinion or a private disability benefits questionnaire filled out by a nonVA person or even by a VA provider that's not associated with the veterans benefits process. So, that's the scenario that we're talking about.

[00:01:11]You go through the doctor, you know, sometimes you pay, sometimes you don't pay, doesn't matter. It's irrelevant.

[00:01:17]But you get a private DBQ and/or medical opinion. You submit that with your claim. And then what happens is the VA disqualifies that DBQ or medical opinion most of the time, rightfully so, uh because there's something missing.

[00:01:36]There's something insufficient about it.

[00:01:38]because a lot of private doctors, nonVA doctors, they don't know what needs to be in there. But let's say that they disqualify it and you actually go to the VA examiner and the VA examiner comes, you know, their results are drastically different than what you either paid for or didn't pay for, but your private DBQ medical opinion at night and day, completely different. They said to Grant, the VA doctor says to deny. So, what do you do in that situation? Now, what I've been seeing and what the questions that have been posed to me constantly is, do you think I should get a rebuttal from the first doctor, from the private doctor that filled out my private DBQ and or medical opinion? And I found that question and I continue to find it very it makes me tilt my head and kind of squint my eyes a little bit because I'm like, "No, no, you shouldn't get a rebuttal."

[00:02:40]And the the subsequent question to me is why why wouldn't I get a rebuttal?

[00:02:45]Because why don't I have the doctor that filled out my original DBQ uh combat the the negative medical opinion? Why don't why don't we share that information? And if I'm just being speaking plainly to the veteran community currently, when the VA disqualified your private DBQ for legitimate reasons or illegitimate reasons, it doesn't matter.

[00:03:10]They stopped listening to what that provider had to say. when they disqualify a VA DBQ and or medical opinion, it means that that person has no value. Their opinion, medical or otherwise, has no value. So, if there's issues, like if there's issues that caused the VA to disqualify the original DBQ or medical opinion, those same issues will be there whenever the rebuttal happens. So, what I don't want to have happen is veterans pay for an upfront DBQ or medical opinion and let's say that it's great. Let's say that medically it's absolutely perfect.

[00:03:58]Well, if it gets disqualified, what'll happen is sometimes the veteran will go back and go get a rebuttal from the same company or same organization or individual and they'll pay again.

[00:04:11]But if the VA denied it the first time, there's a 100% chance they're going to deny the rebuttal because that the the medical opinion is not worth the paper it's written on. And I need to make this distinction.

[00:04:26]The majority of the time, it's not that it's medically insufficient, it's that the document is administratively insufficient.

[00:04:38]So, if you do not understand why the original DBQ was disqualified, getting a rebuttal won't paying for a rebuttal, especially, you should never pay for a rebuttal from the same person or organization until you figure out why they denied it to begin with because you're just throwing your money away at that point.

[00:05:03]I mean, this is not an embellishment or anything like that. If they say that, hey, look, the NPI numbers wrong, like the NPI number's inaccurate, well, unless they correct that inaccuracy, they'll still disqualify it.

[00:05:19]Like, there's a lot of different inauthentic type criteria here. Um, but when a a review of the DBQ raises questions of authenticity or improper alteration, determine whether additional development is necessary, sometimes they won't get that development to try to fix what's wrong with it. Like if an examiner does that thing that I hate where they they combine two different um theories for service connection into one where they say that it was either the result of or aggravated by because both of those statements cannot be true at the same time but they they combine them together which just annoys me beyond all recognition because I've disqualified for that. I've disqualified private DBQs for that reason because I couldn't get in touch with the examiner or the examiner refused to change it. So I'm like, okay, well then, you know, all right, you don't want to change it then, um, you don't want to pick one or the other, then it's not sufficient. That's the way that goes. Um, and they have to document the reasons and whatnot. But see, if you don't, if the person that you're going through or if you're filing this yourself, you have no way to know if the claims processor actually disqualified the DBQ the way that they should. There should be some kind of notes or some kind of um justifiable reason that is articulated in your claim. If you don't know what that is, it is nearly impossible for you to determine how to fix that. Because sometimes private DBQs and medical opinions don't need a rebuttal. They just need you to fix the original reason as to why they were deemed insufficient to begin with. So, you can sometimes call the 1-800 8271000 number and if it's in a VBMS note as to why they disqualified it, hopefully the staff member will read that to you. If not, then you might have to go to a free VSO or something along those lines to see if they can gain access to it. But there isn't always a guarantee as to the fact that the raider articulated why it was deemed insufficient. Now, there's many different reasons why a DBQ can be deemed insufficient. It can be for like authenticity reasons. Maybe the examiner's NPI uh registry page doesn't match their credentials, like their credentials don't match what they actually are now because they haven't updated it in six years. That's a vulnerability. So, how would you fix that? You'd have the provider go and update the page and then resubmit the documents with a supplemental claim.

[00:08:14]But there's oftent times the raiders don't take issue with the medical content unless it's copy and paste nonsense. That's a completely separate reason why it gets denied. If like I used to deny DBQs and medical opinions because they never spoke about the veteran. They just gave me a book report and said scientifically it's possible that the vet that the veterans and that's as far as they would get into the veterans medical records that the veteran's COPD could have caused them to have knee pain. Like okay but you're how how in this veteran's case does that happen? Like why is it why is it true in this veteran's case? So unfortunately they wouldn't be persuasive. So they would have an insufficient rationale. So the the private DBQure medical opinion would be medically insufficient because they didn't provide a sufficient rationale.

[00:09:10]But when we're talking about the different um authenticities, you can't get around the 100 mile rule. Like if you geographically live more than a 100 miles away from the person that's filling out the form, they the the VSSRs and raiders oftent times misapply this one. You can't fight that. Um, unfortunately, like the only way that you can try to fight it is by reinforcing the fact that you do not regularly see the the the provider. The veteran doesn't regularly see the provider as a patient. This was just a one-off. This was uh you paid or you saw them for um what do you call it? Uh to reconcile or to review your clinical evidence.

[00:09:59]uh the examination was completed in person. So as long as it was like a tellahalth thing then you know it should be fine. But the main point here is are rebuttals worth it? And the answer overwhelmingly is no. They're not because once a DBQ or medical opinion it typically it's the medical opinion right typically individuals are trying to get something service connected and the medical opinion is what gets overturned and the exam the VA examiners typically say no where the private medical opinion said yes and a rebuttal showing that how the science of the the doctor stuff um it it's not persuasive because the author of the rebuttal has already been deemed to not have probitative value. So in my personal opinion and there's a lot of caveats to this that it's situational in some instances but are rebuttals to disqualified medical opinions worth paying for? My answer is no. They're not.

[00:11:11]um just just based upon how the internal process works. Like if if you disqualify a piece of evidence, submitting something from the same author doesn't it's not persuasive. So unless they fix it, but if they do fix it, then I would like if they fix whatever the deficiency was in their medical opinion or their DBQ, then I would probably submit a supplemental claim and say, "Hey, look, this is what was found to be wrong with the private medical opinion beforehand."

[00:11:46]Um because if it's true, like if what is tr what was insufficient was true, then it was then the VA acted appropriately by disqualifying it. And what you should do is fix that disqualification, what disqualified it, and then submit a supplemental claim. But anyway, that's about all I got for you in this one. I just kind of wanted to address the private DBQ opinion rebuttals because a lot of veterans are paying money like $500 $800 for rebuttals that are going to go straight into the trash can. They just are like it's not debatable. It's not negotiable. If they were if the if the first DBQ is deemed insufficient, then subsequent DBQ stuff is just going to be just as insufficient unless they fix the reason why they were determined to be insufficient. And if it's 100 miles, you can't fix that. Uh it doesn't matter how good because it has nothing to do with the medical evidence.

[00:12:43]Sometimes it has nothing to do with the medical evidence. sometime like I have seen very good private DBQs and private medical opinions that were just oh chef's kiss they were the best thing ever like they were the best thing ever but because of an administrative fauxawa they um you know they were disqualified and and unfortunately that's the way the VA works but anyway guys that's about all I got for you in this one um we'll talk to you later