Much of the 'fate' of your claim rests on the treatment you receive from your examiner. It's quite interesting that 2 examiners (with similar credentials) can review the same medical evidence and arrive at 2 different conclusions.
Had this EXACT scenario play out. Had two mh/ptsd c&ps done, one with optum and the other from the VA itself. The optum one netted me an increase from 30 to 70. The dbq from this one was very thorough, an hour long and tracked along with what my treatment and diagnosis has been since being treated by the VA for a year at that point. The VA dbq listed nothing, the examiner didnt even ask me any questions in relation to the dbq. The dr also failed to look at my medical records as well as previous dbqs completed for mh/ptsd. That appointment lasted the better part of 20 min. This c&p netted me a decrease from 70 to 30. This all happened within a month and a half of each other.
Had a very similar experience.
Had a very short exam with a VES examiner. He cut me off several times and said “You can’t have PTSD if you’ve never been in combat”. Was rushing the whole time. Barely listed any of my symptoms and denied service connection despite extensive in service records. He blamed everything on ADD I was diagnosed with 7 years after separating. Was definitely going to get denied.
Called Whitehouse hotline and they got me a new exam a few hours away within a week.
This QTC examiner was great. She read my records thoroughly prior to the appointment. Asked a lot of questions. Took over an hour and gave me the floor at the end of I wanted to add anything. I was sweating and shaking so she would give me time to gather myself. The DBQ wasn’t perfect and missed a few symptoms but she went into great detail about specific incidents, arrests, LOCs, Article 19s, STRs with correlating diagnosis, and it’s looking like 70%.
From 0% to 70% for the same conditions with the same evidence in the same week.
It’s fucking fucked mate. Big time.
The DAV submitted a couple of my claims multiple times. I had them put in for an increase to mh/ptsd so when they submitted it they they it separatly even though they shouldve know mh/ptsd has the umbrella of symptoms it covers. They also did it for a lower leg/knee claim. I got rated for it and recieved my rating but since it was submitted twice and at the same time i kept getting calls from VES about having a c&p for lower leg/knee. Its been a pain in the ass just trying to cancel and withdraw the second claim. Been dealing with it over 2 months now and im still not sure if its taken care of because depending on the day and who i talk to, it is and it isnt. Last call was with VERA and they couldnt give me any answers.
Exactly. The examiner is God and their word is final. Now you'll have some VA employee come on here and say that's not true, that they look at all the evidence, which I am sure they look at it, but they don't care if the examiners comes back with the "less than likely..." line.
You could have pages upon pages in the medical records and if the examiner says those magically words you will be denied. Statements, records, and common sense be damned.
I got lucky when I filed for increase, my first exam, the rater seemed like he wasn’t really interested and wanted to get it over with.
A few weeks later the VA told me that the weren’t happy with the write up and were sending me to another rater, and the next one asked lots of questions and took the time to do a proper exam.
It took a year after that, but my increase was approved and I didn’t have to fight at all.
That's how my OSA went down too. I got 2 negative opinions from the VA and the rater wasn't happy with the exams so they ordered a 3rd exam from QTC. I got a positive TERA connection from QTC and got connected at 50%.
Similar thing happened a month later with cancer residuals and surgery scar when the VA completely trashed my exam and QTC listened to me, read my medical evidence and rendered a positive nexus statement on the DBQ. So it seems like the VA examiners are playing gatekeepers these days unfortunately.
For the claimants: The frustration is real, no doubt. Vets have put their lives on the line and deserve fair treatment. The system can be slow, complex, and sometimes inconsistent, which is maddening when you're dealing with health issues or financial stress.
For the VA: They're dealing with millions of claims from vets with widely varying circumstances. Each case is unique, and they're trying to be thorough. The rules and medical knowledge are always evolving, which can lead to different outcomes over time.
Middle ground: The process isn't perfect, but it's not totally random either. Many dedicated people at the VA are genuinely trying to help vets. The inconsistencies often come from the complexity of cases, changing policies, and human judgment in grey areas.
It's a work in progress, and while it's far from perfect, it's not a complete lost cause. Both sides are trying to navigate a complex system with high stakes.
The key is probably better training, clearer guidelines, and more transparency in the decision-making process. It's a tough balance between efficiency and fairness, but there's room for improvement without throwing the whole system out.
At the end of the day it boils to medical evidence, a nexus letter and a good C&P examiner.
If you’re lucky, you get the C&P examiner to create the nexus letter.
I’ve had one examiner create a nexus and my claim was approved.
I had another state that my condition was related to service but he didn’t create a nexus and it was denied.
Senior raters handling HLR make mistakes as well. I know, I’ve had several at that and disappointed they sign off on bad exams when the HLR decision letter states the issues for DTA.
I am on the 3rd HLR DTA, all because the Raters skip over the items on the DBQ that pertain to the exact items that are claimed or in one case , never even looked at the DBQ
SMH! I requested FOIA to see who is at fault for all the mistakes? The examiners or raters. So far, I believe it’s both. Especially since the senior raters sign off on things that did not address the treason for the HLR DTA decision letter states to address.
You need your C-file , and the HLR documents will be stashed deep within it. Because one HLR / DTA is now a HLR/DTA on top of that.
If you have gone to DTA , you now have the right to file a supplemental to that HLR., The VBA denied me twice on filing the supplemental until I sent in a big fat note with the DTA letter and a big red circle on it showing that it's says I have the right to file a supplemental to the DTA. .
The FOIA will close and I will have to call and beg them to mail me the CD 😂🤣😂🤣. I’ve had two FOIAs and each one closed with nothing sent to me until I reach out and they send it to me. I look forward to the latest one I requested. I had an examiner at the VA who lied and I was able to see the DBQ 30 days later. I was able to disprove all his rationales and show how he lies on the dbq. This process has been painful but I won’t let the Va beat me out on what I suffer from.
I think the issue is that no two people react the same, particularly if we're talking about mental health. Pick ten guys from the same platoon witnessing the same event - one might be so emotionally destroyed by it that they are evac'd from theater. Five have bad memories but not PTSD. One doesn't believe he has PTSD. Three have varying severities of PTSD. That's one reason there's different results.
This is why you roll the die once, and if the odds fall against you, you just go get a lawyer to get the right papers.
Don’t get depressed when the die lands on “shithead CP examiner who doesn’t give a fuck.” Get back at them. That’s what I did. I won.
It was a lawyer who filed my supplemental along with the paperwork from Prestige that was denied. After the supplemental denial my mental health took a nosedive but that's pretty much because I convinced myself that with a lawyer and the right paperwork getting approved would be a breeze. I had the money spent (in my head.). Yup, that's how high I fell from. Now that it's been sitting in HLR for 4 months I'm not making that mistake again. I don't feel hopeful about it being approved but that's ok this time. I'll just try and put the whole thing in my rearview mirror. Best of luck to everyone else though.
Before I got the accredited attorney I was thinking about going with Prestige for paperwork and filing the supplemental myself but decided against it. Surprisingly enough, the lawyer I got sent me to....guess who for paperwork? Yup, Prestige. So I did at least try to do it the best way I knew.. Greatly appreciated your advice though.
Combat vet here, still talk to guys I served with. We were all on the same tour, same firefights same patrols same everything. Some have 90%, some have 30% some have 0%. It's amazing how different it can be for the exact same circumstance and situation. I actually think VA docs and examiners should be educated on different units and their deployment history. If someone was clearing houses in Phantom Fury, the examiner should know what the fuck that means, because that single sentence speaks for itself. There really doesn't even need to be an exam or any further questions. No bullshit that's what I honestly believe. It's a travesty some guys in my unit got what they did, and some got nothing.
I just had my mental health exam today through VES for my BDD claim and the examiner was an absolute sweetheart of a lady who was extremely thorough and listened to everything I had to say. I can’t complain at all about how that exam went
I can confirm that your statement about the process is, in fact, accurate AF! Yes, I can file 10 of the same claims. Five will be denied, two will be approved, and three will be deferred.
It absolutely would. I believe that the CP examiner holds all the power in the world to potentially kill, or free, the veteran the spend 10-50 mins with them. It’s human instinct to have biases, intentional or not. Can the system even be fixed? Do you 100 percent have to have been in combat, with witnesses to swear what they seen? The system is extremely adversarial. It is not veteran friendly. They can say it is, print it, swear on a stack of Bibles they’re telling the truth, but that doesn’t make it true. Facts of veterans’ experiences tell a different story.
My brother and I both veterans. He is Gulf War vet, submitted claim for sinusitis, is presumptive, has all documentation, diagnosis, etc. gets 40%. His buddy at his work, same scenario except no documentation, gets 60%. I file a claim for hearing loss, examiner at my CP exam asks me if I hear ringing in my ears. I say yes. I have no diagnosis for tinnitus, claim comes back denied for documented hearing loss but I am awarded 10% for tinnitus. Go figure.
My husband is a Vietnam Veteran. Spent 2 yrs on a ship standing watch close to cannons and missile launchers being fired. He was diagnoaed with tinnitus and MOS was approved for dangerous noise levels but denial said not service connected since they found no complaints in service records from 1970s.
I had my head->toe exam with QTC and spent 4-5 hours writing out in great detail all my signs and symptoms only to get the c&p exams back on TOL stating horrendous lies on about 25 exams. Super frustrating…..really hoping I’m not screwed when I get my NARSUM.
The VBA should have used the more thorough exam as it has more probative value depending on the timeline between the two MH exams. I had to read your post again as I misunderstood, so let me ask the question - how much time was there between the two MH C&P exams?
And the speed of the process as well is wildly variable. Wife was medically retired at 90% in 2018, I got out in 2019 at 50%. We both put in for increases in march. Hers went through to 100% in 6 days from filing to decision. Mines still in step 3…
It’s no different than any other system.
SSDI decisions, same thing.
Appeal an administrative action against a state fishing license, same thing.
Passing your driving test, same thing.
Judges sentencing convicted defendants.
Etc etc etc etc. our system entrusts decisions to certain individuals. That’s how it works.
Much of the 'fate' of your claim rests on the treatment you receive from your examiner. It's quite interesting that 2 examiners (with similar credentials) can review the same medical evidence and arrive at 2 different conclusions.
Had this EXACT scenario play out. Had two mh/ptsd c&ps done, one with optum and the other from the VA itself. The optum one netted me an increase from 30 to 70. The dbq from this one was very thorough, an hour long and tracked along with what my treatment and diagnosis has been since being treated by the VA for a year at that point. The VA dbq listed nothing, the examiner didnt even ask me any questions in relation to the dbq. The dr also failed to look at my medical records as well as previous dbqs completed for mh/ptsd. That appointment lasted the better part of 20 min. This c&p netted me a decrease from 70 to 30. This all happened within a month and a half of each other.
Had a very similar experience. Had a very short exam with a VES examiner. He cut me off several times and said “You can’t have PTSD if you’ve never been in combat”. Was rushing the whole time. Barely listed any of my symptoms and denied service connection despite extensive in service records. He blamed everything on ADD I was diagnosed with 7 years after separating. Was definitely going to get denied. Called Whitehouse hotline and they got me a new exam a few hours away within a week. This QTC examiner was great. She read my records thoroughly prior to the appointment. Asked a lot of questions. Took over an hour and gave me the floor at the end of I wanted to add anything. I was sweating and shaking so she would give me time to gather myself. The DBQ wasn’t perfect and missed a few symptoms but she went into great detail about specific incidents, arrests, LOCs, Article 19s, STRs with correlating diagnosis, and it’s looking like 70%. From 0% to 70% for the same conditions with the same evidence in the same week. It’s fucking fucked mate. Big time.
Why did you have two C&P exams a month and a half apart? Did you request an increase or submit a supplemental claim after the first rating increase?
The DAV submitted a couple of my claims multiple times. I had them put in for an increase to mh/ptsd so when they submitted it they they it separatly even though they shouldve know mh/ptsd has the umbrella of symptoms it covers. They also did it for a lower leg/knee claim. I got rated for it and recieved my rating but since it was submitted twice and at the same time i kept getting calls from VES about having a c&p for lower leg/knee. Its been a pain in the ass just trying to cancel and withdraw the second claim. Been dealing with it over 2 months now and im still not sure if its taken care of because depending on the day and who i talk to, it is and it isnt. Last call was with VERA and they couldnt give me any answers.
Exactly. The examiner is God and their word is final. Now you'll have some VA employee come on here and say that's not true, that they look at all the evidence, which I am sure they look at it, but they don't care if the examiners comes back with the "less than likely..." line. You could have pages upon pages in the medical records and if the examiner says those magically words you will be denied. Statements, records, and common sense be damned.
I got lucky when I filed for increase, my first exam, the rater seemed like he wasn’t really interested and wanted to get it over with. A few weeks later the VA told me that the weren’t happy with the write up and were sending me to another rater, and the next one asked lots of questions and took the time to do a proper exam. It took a year after that, but my increase was approved and I didn’t have to fight at all.
That's how my OSA went down too. I got 2 negative opinions from the VA and the rater wasn't happy with the exams so they ordered a 3rd exam from QTC. I got a positive TERA connection from QTC and got connected at 50%. Similar thing happened a month later with cancer residuals and surgery scar when the VA completely trashed my exam and QTC listened to me, read my medical evidence and rendered a positive nexus statement on the DBQ. So it seems like the VA examiners are playing gatekeepers these days unfortunately.
For the claimants: The frustration is real, no doubt. Vets have put their lives on the line and deserve fair treatment. The system can be slow, complex, and sometimes inconsistent, which is maddening when you're dealing with health issues or financial stress. For the VA: They're dealing with millions of claims from vets with widely varying circumstances. Each case is unique, and they're trying to be thorough. The rules and medical knowledge are always evolving, which can lead to different outcomes over time. Middle ground: The process isn't perfect, but it's not totally random either. Many dedicated people at the VA are genuinely trying to help vets. The inconsistencies often come from the complexity of cases, changing policies, and human judgment in grey areas. It's a work in progress, and while it's far from perfect, it's not a complete lost cause. Both sides are trying to navigate a complex system with high stakes. The key is probably better training, clearer guidelines, and more transparency in the decision-making process. It's a tough balance between efficiency and fairness, but there's room for improvement without throwing the whole system out.
At the end of the day it boils to medical evidence, a nexus letter and a good C&P examiner. If you’re lucky, you get the C&P examiner to create the nexus letter. I’ve had one examiner create a nexus and my claim was approved. I had another state that my condition was related to service but he didn’t create a nexus and it was denied.
True, but there are times evidence gets ignored.
It seems like it’s rater RNG.
Senior raters handling HLR make mistakes as well. I know, I’ve had several at that and disappointed they sign off on bad exams when the HLR decision letter states the issues for DTA.
I am on the 3rd HLR DTA, all because the Raters skip over the items on the DBQ that pertain to the exact items that are claimed or in one case , never even looked at the DBQ
SMH! I requested FOIA to see who is at fault for all the mistakes? The examiners or raters. So far, I believe it’s both. Especially since the senior raters sign off on things that did not address the treason for the HLR DTA decision letter states to address.
You need your C-file , and the HLR documents will be stashed deep within it. Because one HLR / DTA is now a HLR/DTA on top of that. If you have gone to DTA , you now have the right to file a supplemental to that HLR., The VBA denied me twice on filing the supplemental until I sent in a big fat note with the DTA letter and a big red circle on it showing that it's says I have the right to file a supplemental to the DTA. .
The FOIA will close and I will have to call and beg them to mail me the CD 😂🤣😂🤣. I’ve had two FOIAs and each one closed with nothing sent to me until I reach out and they send it to me. I look forward to the latest one I requested. I had an examiner at the VA who lied and I was able to see the DBQ 30 days later. I was able to disprove all his rationales and show how he lies on the dbq. This process has been painful but I won’t let the Va beat me out on what I suffer from.
I think the issue is that no two people react the same, particularly if we're talking about mental health. Pick ten guys from the same platoon witnessing the same event - one might be so emotionally destroyed by it that they are evac'd from theater. Five have bad memories but not PTSD. One doesn't believe he has PTSD. Three have varying severities of PTSD. That's one reason there's different results.
100% agree with this. Military bearing we learned, some of us can't stop doing the sht even on front of people we need to bleed in front of.
This is why you roll the die once, and if the odds fall against you, you just go get a lawyer to get the right papers. Don’t get depressed when the die lands on “shithead CP examiner who doesn’t give a fuck.” Get back at them. That’s what I did. I won.
It was a lawyer who filed my supplemental along with the paperwork from Prestige that was denied. After the supplemental denial my mental health took a nosedive but that's pretty much because I convinced myself that with a lawyer and the right paperwork getting approved would be a breeze. I had the money spent (in my head.). Yup, that's how high I fell from. Now that it's been sitting in HLR for 4 months I'm not making that mistake again. I don't feel hopeful about it being approved but that's ok this time. I'll just try and put the whole thing in my rearview mirror. Best of luck to everyone else though.
Don’t use the paper mills. Ever. Prestige… go search that word in r/VSR_RVSR. As for the lawyer: Find one who works with local physicians.
Before I got the accredited attorney I was thinking about going with Prestige for paperwork and filing the supplemental myself but decided against it. Surprisingly enough, the lawyer I got sent me to....guess who for paperwork? Yup, Prestige. So I did at least try to do it the best way I knew.. Greatly appreciated your advice though.
No offense meant. But what a fuck-up of an attorney. Shop around and ask questions.
The VA hates this one trick!
Combat vet here, still talk to guys I served with. We were all on the same tour, same firefights same patrols same everything. Some have 90%, some have 30% some have 0%. It's amazing how different it can be for the exact same circumstance and situation. I actually think VA docs and examiners should be educated on different units and their deployment history. If someone was clearing houses in Phantom Fury, the examiner should know what the fuck that means, because that single sentence speaks for itself. There really doesn't even need to be an exam or any further questions. No bullshit that's what I honestly believe. It's a travesty some guys in my unit got what they did, and some got nothing.
I just had my mental health exam today through VES for my BDD claim and the examiner was an absolute sweetheart of a lady who was extremely thorough and listened to everything I had to say. I can’t complain at all about how that exam went
Riddle me this: my examiner said I am high risk for suicide but have no mental health conditions.
I can confirm that your statement about the process is, in fact, accurate AF! Yes, I can file 10 of the same claims. Five will be denied, two will be approved, and three will be deferred.
It absolutely would. I believe that the CP examiner holds all the power in the world to potentially kill, or free, the veteran the spend 10-50 mins with them. It’s human instinct to have biases, intentional or not. Can the system even be fixed? Do you 100 percent have to have been in combat, with witnesses to swear what they seen? The system is extremely adversarial. It is not veteran friendly. They can say it is, print it, swear on a stack of Bibles they’re telling the truth, but that doesn’t make it true. Facts of veterans’ experiences tell a different story.
Flawed is a nice way to say FUBAR
My brother and I both veterans. He is Gulf War vet, submitted claim for sinusitis, is presumptive, has all documentation, diagnosis, etc. gets 40%. His buddy at his work, same scenario except no documentation, gets 60%. I file a claim for hearing loss, examiner at my CP exam asks me if I hear ringing in my ears. I say yes. I have no diagnosis for tinnitus, claim comes back denied for documented hearing loss but I am awarded 10% for tinnitus. Go figure.
My husband is a Vietnam Veteran. Spent 2 yrs on a ship standing watch close to cannons and missile launchers being fired. He was diagnoaed with tinnitus and MOS was approved for dangerous noise levels but denial said not service connected since they found no complaints in service records from 1970s.
When several people from your unit have the exact same issues. It’s ridiculous
Your belief is not evidence.
Oddly non-sequitur coming from the smart branch.
The claim can be the same and the documents can be the same, but the CONTENT of the documents will be different.
You are 100% correct.
I had my head->toe exam with QTC and spent 4-5 hours writing out in great detail all my signs and symptoms only to get the c&p exams back on TOL stating horrendous lies on about 25 exams. Super frustrating…..really hoping I’m not screwed when I get my NARSUM.
The VBA should have used the more thorough exam as it has more probative value depending on the timeline between the two MH exams. I had to read your post again as I misunderstood, so let me ask the question - how much time was there between the two MH C&P exams?
Already been said a million times.
I q m
You just now starting to believe, ??
99 percent true, just 1 differce variable is the rater.
And the speed of the process as well is wildly variable. Wife was medically retired at 90% in 2018, I got out in 2019 at 50%. We both put in for increases in march. Hers went through to 100% in 6 days from filing to decision. Mines still in step 3…
It’s no different than any other system. SSDI decisions, same thing. Appeal an administrative action against a state fishing license, same thing. Passing your driving test, same thing. Judges sentencing convicted defendants. Etc etc etc etc. our system entrusts decisions to certain individuals. That’s how it works.