R i g h t a r d i a: Disability Benefits Questionnaires

Thursday, January 14, 2016

The importance of VA secondary condtions.

When a Veteran files the initial claims with the Veteran Administration, he usually files for a primary medical condition. Besides filing the online VONAPP (www.ebenefits.va.gov)or the VA Form 21-52.

The evidentiary requirement are rigid and Rightardia has recommended using the Disability Benefits Questionnaires (DBQ) to make sure all the "T" are crossed and the "I's are dotted.

It is important that the doctors check the box indicating the Service Medical Records (SMR) have been reviewed. A nexus statement connecting the military service to the medical condition must also be written in the remarks.

In the example below, a serviceman loses his pituitary by being exposed to radiation or chemicals in an industrial environment. Hypopituitraims is the primary condition, but the vet could also lose adrenal, thyroid and sexual function. Hypopituitarism cal also cause anosmia (loss of sense of smell ) and diabetes insipidus. All of the latter are secondary conditions.

Many Army solders were exposed to agent orange in Vietnam which led to many cancers and heart conditions. For example a veteran could revive an award for non-Hodgins lymphoma. With chemo-therapy, the vet might survive. But there are a lot of residuals or secondary conditions associated with non-Hodgkins lymphoma.

If the vet develops any of these conditions, they should file for a secondary condition. Filing for a secondary condtion has some big advantages.

38 CFR § 3.310 says:

"When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition."

This means the effective date of the secondary condition is given the date of the primary condition. In addition, the doctors does not need to review the SMRs or write a nexus statement. The doctor must indicate the secondary condition is a consequence of, and linked to the primary condition.

The vet may use a DBQ to document a secondary condition. Some DBQs are written to identify secondary conditions, other are not. A doctor's letter my suffice for a secondary condition. The letter should show:

A diagnosis for a compensable condition
A link between the secondary condition and an already service connected condition

You may think the primary condition would have a higher disability rating that secondary, but it is usually the other was y around. In fact the 38 CFR makes it clear that secondary condition may have a higher disabiliy rating than the primary.

sources:

http://www.vba.va.gov/pubs/forms/VBA-21-526-ARE.pdf
http://www.benefits.va.gov/COMPENSATION/dbq_ListByDBQFormName.asp
http://www.rightdiagnosis.com/n/non_hodgkins_lymphoma/complic.htm#complication_list
http://vets.yuku.com/topic/12131

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Tuesday, April 3, 2012

Veteran Affairs DBQ's are superb

Rightardia like the new Veterans Affairs Disability Benefits Questionnaires.

These can be filled out online by doctors or downloaded and completed by typing medical data into them. In the past many government forms could be filled out and printed, but not saved.

This meant that the document had to completely retyped if changes were needed. This is not the case with the DBQ. You can now save the documents in PDF or text format.

Most people would probably rough out one of these documents and take it their primary care doctor or specialist for completion and signature.

However, you could also take this form to to your VA Medical Center (VAMC) or Community-Based Outpatient Clinics (CBOC) as well. You could ask either your primary care doctor or specialist to complete a DBQ for you.

The Major recently got a ruling form the VA Regional Office and noticed references form his Compensation and Pension exams in the ruling but none from the VAMC specialist physician. .

Unfortunately most of the C&P clinicians at a very large VA facility in Florida are not doctors. There are more Physicians' Assistant or Nurse Practitioners.

When the Ratings Veterans Service Representative (RSVR) review the Claim file (c-file), he or she primarily considers the C&P physical, rather than the patent's Computerized Patient Record System (CPRS) entries from the hospital or clinic.

If you have a condition that requires the diagnosis of a specialist, this will likely result in a lowball rating.

The solution is to ask the VAMC specialist to compete a DBQ. To this, you must first coordinate through your primary care physician who can complete a DBQ as well and forward a second DBQ to your specialist.

The Major just went through a Decision Review officer (DRO) review and the DRO asked for a DBQ. We recommend you work with your VAMC physicians to get a DBQ to counter the superficial diagnoses that is a likely outcome from a C&P exam.

We also recommend you go to the Freedom of information Act (FOIA) office and get a copy of the C&P exam to recalma it. You will probably see numerous errors of omission and commission.

Rightardia has been hard on the VA system in the past.but we are seeing big improvements since Obama became president and General Shinseki took over the VA helm.

The VA is a becoming the model organization in the federal government.

We suspect he DBQs will make claims easier for the veteran and also for the RSVR's to rate. These forms were first used for new presumptive Agent Orange claims.

Rightardia suspects the DBQ will become the primary means for substantiating claims in the future for both VA and private physicians.

Perhaps the C&P exams will also become optional with the advent of the DBQ.

See the latest DBQs at http://benefits.va.gov/TRANSFORMATION/dbqs/ListByDBQFormName.asp

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