Inadequacies in Medical Opinions for VA Decisions

One of the most common problems with VA decisions is that the adjudicators rely on medical opinions that contain errors.  VA should never rely on medical opinions for VA decisions that contain errors to deny a veteran’s claim for compensation benefits.  In cases where VA has provided a medical opinion and the examiner made an error, VA is under an obligation to return the report as inadequate and obtain a new opinion.

Errors in medical opinions come in all shapes and forms.  Sometimes, the examiner overlooks a key fact.  Other times, the examiner doesn’t use the appropriate equipment or fails to perform adequate clinical testing (this is sometimes the case in PTSD examinations).  As an advocate, one of the first things I do upon receiving a veteran’s file is to review all VA examinations for possible errors.

Wise v. Shinseki

The U.S. Court of Appeals for Veterans Claims, the court responsible for reviewing unfavorable decisions from the Board of Veterans’ Appeals, recently addressed a situation where an examiner acknowledged in her report that she lacked psychiatric training, where the opinion that she was providing would presumably require such training.  Obviously, an examiner should possess specialized expertise; otherwise, the opinion has no more value than if you or I provided the report.  The Veterans Court sharply criticized the Board for relying on such an opinion.  The case is Wise v. Shinseki, and it was issued on April 16, 2014.

In short, it is critical that all medical opinions that VA relies upon adequately assess the veteran’s medical condition.  VA should not rely on medical opinions that don’t adequately assess the veteran’s medical opinion.

More Information: VA Medical Examinations

• The Importance of a C&P Examination
• C & P Examinations: The Unexpected Reevaluation
• Veterans Disability Compensation Ratings