Getting A Medical Opinion From Your Client's Treating Physician

31 Aug 2017

Veterans often overlook one source of very valuable medical opinion evidence: the treating physician. To be sure, it is often difficult to obtain written opinions from treating physicians. As for VA physicians, many VA medical facilities have an unwritten policy discouraging treating physicians from providing opinions in VA claims. Moreover, VA physicians are busy and do not have much time to give outside their normal schedules and responsibilities. As for private physicians, they too have tight schedules and often require compensation for their time in preparing opinions, compensation most disabled veterans can ill afford.

Nonetheless, some VA physicians are willing to go on a limb to help their patients. And some private physicians are willing to write an opinion without compensation. In short, veteran service officers and representatives should always have their clients ask their treating physicians if they would be willing to write an opinion in support of their VA claims.

In such cases, the veteran's representative needs to make the treating physician's job as easy as possible. To this end, preparing a brief memo or sample letter for the physician is essential. At the outset, your clients should tell their physicians that a memo or sample letter will be provided to assist them in writing their opinions. That is where a veteran's representative comes in.

In preparing a memo or sample letter for the physician, the representative must tailor it to the veteran's claim. With claims for service-connection, an opinion linking the present disability to service is most needed, what is commonly referred to as the "nexus" element. Thus, the memo should ask the physician to provide a favorable nexus opinion, and more importantly, to provide a rationale for this opinion. The rationale is key. VA adjudicators do not give much weight to bare conclusions; they want to see some analysis supporting the opinion.

A veteran's representative can assist in this regard by searching on-line for medical articles establishing a direct link or statistically significant correlation between the veteran's incident in service (injury or exposure) and the veteran's present disability. The memo should provide website links to these medical articles.

In the case of increased rating claims, the representative must be familiar with the criteria listed under the specific diagnostic code of the VA rating schedule. Representatives should first discuss with the veteran all the symptoms he or she has experienced in the last few years, going over the list of criteria/symptoms listed for higher ratings under the diagnostic code. Then, the representative needs to review the relevant VA C&P examination report(s) to determine if one or more of the discussed symptoms are not noted in the VA report(s). The memo for the physician should then ask if the veteran in fact experiences the missing symptoms, those experienced by the veteran but are not included in the VA examination report(s).

Practice Pointer

As a standard practice, representatives should explore the possibility of obtaining a medical opinion from a client's treating physician. In this regard, the veteran needs to emphasize to his/her physician that the preparation of the opinion will not take up much time and that a memo or sample letter will be provided to guide the physician in writing the opinion. The memo or sample letter must then provide information tailored to the veteran's claim to ensure that the physician writes a favorable and well-supported opinion.

VLG's Bulletin is an educational resource for VSOs. These Bulletins will discuss how court decisions, statutes & regulations can be applied to the advantage of your clients' claims.