Myth-Busting Series : Only VA Doctors Can Write Medical Opinions.

0:01Leah Bucholz Hey guys, one of the biggest misconceptions that veterans hear is that only VA doctors can write medical opinions. That's just simply not true. So unfortunately, believing this misconception has caused many veterans to delay filing claims, giving up on obtaining strong medical evidence, or assuming that their case has no chance of success. Today, I'm going to explain what the VA actually requires, who is legally qualified to write a medical opinion, and why the quality of the opinion matters far more than where the provider works. Let's bust this myth wide open.

0:37 Okay? So welcome back to our Myth Busting VA Claims Series on the channel where we separate VA facts from fiction and help you better understand the medical evidence behind your disability claim. I'm Leah Bucholz. I am a former Army physician assistant, former VA C and P examiner, I'm the founder of Prestige Veteran Medical Consulting. Every week, I review medical evidence for veterans across the country, and this is one of the most important misconceptions that I personally encounter.

1:07 So let's start with what the VA actually requires. So this is like a great question that I get asked constantly. So the first thing every veteran should know or understand is that the VA does not require a medical opinion to come from a VA doctor. There is no law or regulation that says the next letter has to be written by a VA provider. Your treating physician locally can write it or even any physician at all that you're seeing.

1:39 Maybe subspecialty physician like orthopedics. Instead, the VA looks at something called competency. So in other words, is the health care professional qualified through their education, training, knowledge, or experience to provide an opinion on medical issues, the medical issue being discussed. That is the legal standard. So depending on the condition, medical opinions may appropriately come from physicians, physician assistants, nurse practitioners, psychologists, psychiatrists who are also physicians, right?

2:16 So audiologists, optometrists, right? A physical therapist may write you an opinion. They might not be able to do a DBQ, but they can write an opinion, right? And many other licensed medical professionals practicing within their scope. Okay? So notice that nowhere on that list does it say they have to work from the VA. The real question is not, do they work for the VA? The question rather is, are they qualified to provide this opinion? So what does competency actually mean? So the word competency gets thrown around a lot in VA claims, but many veterans misunderstand what that actually means.

2:59 So competency isn't about where someone works. It's not about whether they're employed by the VA and it's certainly not about whether they've treated you for years. Can that be helpful? Of course. But even VA examiners, usually that's a VA compensation and pension examiners only see you one time. So competency means that the provider has the education, training, knowledge, and experience necessary to offer an opinion on the specific medical issue. For example, if we're talking about hearing loss, an audiologist may be the most qualified person to discuss this. If we're talking about PTSD, that opinion may come from a psychologist or a psychiatrist. If we're discussing orthopedic conditions, a physician or a PA physician assistant with experience evaluating musculoskeletal conditions may be entirely appropriate. The provider's qualifications should match the medical question they're answering.

4:02 VA examiners are not magic. They're not the end all be all. So here's another misconception. Many veterans assume that because someone works for the VA, their opinion automatically carries more weight. That's not how it works. A VA examiner has the same medical license they had before they started working for the VA. Working for the VA doesn't suddenly make someone a better clinician. Likewise, working in private practice doesn't make someone less qualified. As someone who has actually performed C and P exams, I can tell you that the VA isn't looking for a specific employer. They're looking at the evidence.

4:47 And the strongest evidence is usually the opinion that is most medically sound and the best supported, not simply the one written by a VA provider. So what makes a medical opinion persuasive or nexus letter persuasive? This is where veterans should focus their attention. Not to the title after someone's name, not on whether they work for the VA, but on the quality of the opinion itself. A strong medical opinion should do several things.

5:21 First, it should accurately identify the veteran's diagnosis. Second, it should review the relevant medical history and service history. That doesn't necessarily mean reviewing thousands of pages of records, although the claims file is often very helpful. It means reviewing enough information to understand the medical picture. Third, it should explain the medical reasoning.

5:46 This is probably the single most important part, the rationale. Anyone can write something, and I've said this a million times, anyone can write, it's my opinion that the condition is related to service. That's just the conclusion. A persuasive credible opinion explains why. What medical principles support that conclusion?

6:07 How do the veterans records support it? What does the medical literature say to support it? How do those facts all fit together? Good medical opinions connect those dots. Finally, a strong opinion. So if there are conflicting medical records, they shouldn't just be ignored, right? Bad facts need to be included, okay? They should be explained explained in a way that you can still say, despite these things, right? This is still why it makes sense. So, let's bust a few more myths, okay?

6:46 Here are a few more misconceptions that I hear all the time. Myth number one, my VA doctor refused to write a Nexus letter, so my claim is over. Absolutely not, right? Many VA providers simply choose not to write medical opinions. That doesn't mean your claim lacks merit. Myth number two, okay? My primary care doctor has treated me for years, so their opinion will automatically carry the most weight. That's also not necessarily true. Your primary care provider may know you very well, right? But if your claim involves a highly specialized medical condition, someone with expertise in that specific area may provide a more persuasive opinion.

7:30Myth number three The VA has to accept my doctor's opinion. So, no, unfortunately that's not true. The VA has to consider all competent medical evidence. Then, they weigh that evidence alongside everything else in your file. That's why a well reasoned and thought out opinion is so important.

7:51 So, myth number four, the longer the report, the better. Like, this is comical to me. So, sometimes I see reports that are, you know, two pages that get the job done or a page or a few sentences in your medical record from your VA doctor, or from your treating doctor. So, the length of the report is definitely not the most important factor. I've seen a 20 page report that says very little.

8:15 I've also seen those concise reports that are incredibly persuasive, because every sentence serves a purpose, all right? Quality always beats quantity. So, what have the court said? Right? The courts have addressed this issue as well, right? One important case, Mieviz Rodriguez v. Peak, okay? In that decision, the court explained that the value of a medical opinion comes primarily from its reasoning, not simply from the credentials of the provider or whether they reviewed every page on the claims file. Another important case is Stefa v. Nicholson.

8:53 The court explained in this case that an adequate medical opinion must contain enough medical analysis for the VA to understand why the provider reached their conclusion. This goes along with a lot of what we've discussed today. So, in other words, the opinion has to explain itself. There has to be a rationale. Simply stating a conclusion is not going to be enough, right?

9:15 So, here are some red flags to watch for, all right? So, whether you're obtaining a private nexus letter or medical opinion or reviewing one already in your VA file, watch for these warning signs. One sentence conclusion with no explanation. Opinions that don't discuss your actual medical history, providers offering opinions outside of their area of expertise. Now, I'm talking about like a chiropractor doing a PTSD letter, right?

9:44 Generic templates, language that would apply to anyone, medical opinions that fail to explain the reasoning behind the conclusion. Those are all things that can reduce the weight of the VA can give an opinion. So, here's some final takeaways. Let's just bring it all together. Let's wrap it all back up.

10:03 So, the myth is only VA doctors can write medical opinions. The truth is the VA accepts medical opinions from qualified healthcare professionals who are competent to address the medical issue being discussed. The most persuasive opinions aren't determined by where someone works, they're determined by whether the provider is qualified, whether they consider relevant evidence, and whether they clearly explain the medical reasoning behind their conclusions. If you're evaluating a nexus letter or medical opinion, don't focus on the employer. Don't focus solely on the letters after someone's name.

10:45 Focus on the quality of the analysis because that's what truly makes an opinion persuasive. So, I hope this helped clear up one of the most common misconceptions in the VA disability system regarding Nexus letters or medical opinions. If you found this video helpful, please like this video, subscribe to the channel, and share with another veteran who might have heard this misconception as well. Also, let me know in the comments what's another myth you guys have heard that you'd like me to bust in a future episode. I'm Leah Bucholz, thank you again for your service and I'll see you guys in our next Myth-Busting VA Claims episode and please like and subscribe.

11:24 All right, I'll see you guys later.