The Top 5 Mistakes VA Examiners Make and How to Address Them

 Posted on January 15,2024 in Uncategorized

Navigating the VA (Veterans Affairs) claims process can be challenging, especially when dealing with medical examinations. While VA examiners are trained to adhere to strict rules and regulations, mistakes can happen. Here are the top five mistakes VA examiners make, as identified in a detailed analysis of the process, and what you can do if you encounter them.

Mistake #1: Ignoring Lay Affidavits

- Explanation: Lay affidavits, such as statements from friends, family, or colleagues about your condition, are crucial. However, sometimes examiners overlook these affidavits.
- Impact: This oversight can lead to denial of service connection or an incorrect rating.
- What to Do: Ensure that any lay statements submitted are considered. If ignored, you're entitled to a new exam.

Mistake #2: Lack of Rationale in Conclusions

- Explanation: Examiners must provide a rational explanation for their conclusions, not just a blanket statement.
- Impact: Without a rationale, the exam is inadequate.
- What to Do: If there's no clear rationale, you're entitled to a new opinion or exam.

Mistake #3: Deciding Nonmedical Facts

- Explanation: Examiners sometimes overstep by deciding on nonmedical facts, especially in PTSD cases.
- Impact: This is inappropriate as their role is to decide on medical facts only.
- What to Do: If an examiner has overstepped, this calls for a review of their decision.

Mistake #4: Relying on Inaccurate Facts

- Explanation: Decisions based on inaccurate facts, like incorrect service records, lead to erroneous conclusions.
- Impact: This can invalidate the exam's findings.
- What to Do: Point out any factual inaccuracies to challenge the examiner's opinion.

Mistake #5: Using the Wrong VA Legal Standard

- Explanation: Examiners should use a "50/50 probability" standard, but sometimes they apply a higher threshold.
- Impact: This misapplication can lead to unfair denials.
- What to Do: If the wrong standard is used, you're entitled to a new exam.

How to Identify These Mistakes:

1. Obtain a copy of your VA C&P report, either through electronic access or by requesting it using VA Form 20-10206.
2. Review the exam report for:
- Consideration of lay affidavits.
- The rationale provided for conclusions.
- Decisions on nonmedical facts.
- Accuracy of factual premises.
- The legal standard applied.

Appealing your VA Claim if You Find an Error:

- If any of these errors are present, file for a higher-level review using VA Form 20-0996.
- Point out the specific mistake made by the examiner.
- Remember, you cannot submit new evidence during a higher-level review; focus on highlighting the errors in the existing exam.

Understanding these common mistakes can empower you in your VA claim process. If you encounter these errors, take action by requesting a higher-level review or seeking further assistance. Remember, you have the right to a fair and accurate VA examination.

Contact Information:
For additional assistance, reach out to ed@vetlawoffice.com or call 1-800-700-4174