Private medical opinions (DBQs) for VA disability claims are frequently disqualified when examiners conflate secondary service connection (38 CFR 3.310A) and aggravation (38 CFR 3.310B) in a single opinion, as these are legally distinct theories that require separate analysis; examiners must select one theory and state it is 'at least as likely as not' that the condition is due to that specific cause, rather than using ambiguous language like 'proximally due to' or 'aggravated by' which reduces the opinion's probative value and often triggers VA examination deferrals.
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VA Disability Claims: Why More Private DBQs Are Triggering Exam DeferralsAdded:
Hello and welcome to Raider HQ After Dark. I'm your host, Raider, and in this video, I want to get back to the basics once again. And we're going to talk about private medical opinions for things that aren't service connected that you're trying to get service connected for. And we're going to get back to the basics. And the reason why is because the secondary medical opinions from all of the claims that I've been screening for born accredited claims, anybody that is submitting a private DBQ appears to be the majority of the time getting them disqualified.
Not really because you live over a 100 miles away from somebody. It's mostly based upon for the secondary um theory for service connection.
It's because of how the examiner worded they're at least as likely as not. And it appears to be kind of a trend that they're that the raiders are kicking it back for a VA examination because the examiner keeps saying proximally due to or aggravated by or in a different. So that's one way that they do it that the raiders take an issue or they say the result of the service connected condition or aggravated by the part that gets that's causing the raiders to disqualify the private medical opinions the secondary medical opinions is when they conflate two separate theories for service connection.
It's either secondary to the primary condition or it's aggravated by the the service connected condition. It's lazy of the examiner to not pick one. The examiner has to pick one and then submit they're at least as likely as not when they do this or nonsense. It's like saying, well, it the veterans migraines could be caused by the PTSD or terra or this or that or this.
There's no certainty there. The examiner basically says, I can't get to an at least as likely as not because you have to pick one thing that it's at least as likely as not due to.
Now medically it might be true that it could be both of those at the same time. The problem is legally it cannot. So legally they have to pick one and then they have to say it's at least as likely as not that this is due to that. They can't have two separate theories in there. It's the Ghostbusters rules. You can't cross the streams. You got to pick one or the other. And I know that examiners don't understand that 38 CFR3.310A and 38 CFR3.310B are two separate I mean with a Grand Canyon level difference between them but they keep nonchalantly smashing them together and that's what's causing a lot of you to have to go to new CMP exams and probably not having good outcomes from it. So, the reason why I'm doing the video today is because I've tried making videos for examiners to listen to this, but they don't want to. And I, you know, how I can tell that they don't want to is because I'm I'm actually seeing YouTube content creators that also DBQ and medical opinion companies within the last 30 days, they're still including that language. So now I'm talking to the veteran community because there are there are two providers that I know of that um I've been helping out with that they are actually following the right way to do this so that way their stuff doesn't get disqualified p just for the language that they chose because it can get disqualified for that. But I'm trying to educate the veteran community that if you purchase a an examination review from one of these companies that does DBQs, you know, they're not your private doctor. They're somebody that formally does it for money. You need to honestly review what they wrote. And if they say secondary, approximately due to, or uh aggravated by, that's a no-go. You need to have them pick one or the other based upon the evidence because it it actually detracts from the overall validity of the DBQ or of the medical opinion. I keep saying DBQ, but of the medical opinion. It it it lowers the probative value of it because it makes the examiner seem like they don't know what's causing it. there's no at least as likely as not nothing because it can't be due to two separate theories at the same time or if it is then they need to say what caused it like what caused like that's the purpose of a medical opinion is to determine cause and Johnny can have died in 2000 of natural causes and in 2017 also died from being murdered okay so they need to pick one because That's the logical confliction that the raider has because VBMSR will not allow a raider to select multiple theories for service connection why it's granted and it causes them a conflict because if you say yes to two separate theories that can't be true because if something was aggravated by something else well that's determined based upon when the primary condition was service connected. If the primary condition was service connected before the secondary condition ever existed, well then it couldn't have been aggravated by that thing, now could it?
Because the primary condition existed before the secondary condition. So that's where 3.310A comes into effect, right? It it it depends on when things were diagnosed.
So, it it boggles my mind that um the DBQ community, the medical opinion community, keeps doing things that disqualify the private medical opinion instantly. Just disqualify them. And guys, I'm looking at deferrals on your claims. All of you that have signed up with us that I've already been doing reviews on and I've had a couple of discussions with you guys about this. Now, I'm a gentleman.
I'm not going to name names of companies. You can do whatever you feel like doing. But I pointed out to a couple of veterans so far, hey, look, this is a garbage medical opinion.
Factually garbage. And it's not me saying that. It's the raider saying that. Like the raider disqualified it and said this is nonsense.
Utter nonsense from a VA standpoint.
And I'm just pointing this out because I don't want you guys to spend money on things that are that is a waste of money because there's two different things that could happen.
If the private medical opinion wasn't persuasive enough, but it was used as evidence in your claim, we can potentially fight that.
But if they disqualified the whole thing and didn't use it as evidence or anything like that, it's not worth the paper it's written on. We can't fight that. The the raider has the authority to basically call something inauthentic.
Uh authenticity, credibility, and sufficiency. Those are the three reasons why they can disqualify something. And if they give a reason and they point it out why they disqualified it, I can't win that argument. So, this is to help you veterans if you want to win and potentially overturn a denial based upon the fact that they didn't use your private medical opinion or DBQ or whatnot.
Whenever the medical examiner says those words, I don't have a leg to stand on.
I can't argue against that because it's true. They shouldn't have said that that way. They should have picked their words more carefully and and frankly it's a lazy way like and I know that some of them will say well we know the law here.
Sure you do. That's why your stuff keeps getting disqualified time and time and time and time and time again. But veterans just I'm informing you so that way you can respectfully be kind, be nice. If you see them say like the result of or aggravated by, have them change that. Pick something based upon the evidence. Side one way or the other because there's two the criteria for both of those are completely different, mind you. And I've done videos on this, but just have just try to if you're going to spend money on something, the product should at least have a fighting chance to win. And currently, a lot of them don't. So anyway, that's my um PSA for the veteran community. You can do with it as you wish. Obviously, I'm I know that some people are going to come back and say, "Well, that's not true. We got a we have 112% success rate." Um, cool. That's not what I'm seeing. I don't know. I Yeah, but anyway, that's about all I got for you in this one, guys. We're getting back to the basics here. You need to police your private medical opinions and DBQs for accuracy so you have the highest likelihood of success because examiners are meant to do medical associations. They're not meant to know what it is that they're saying and whether or not it meets the legal criteria. Anyway, Raider
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