Question:

Hi Jim - I recently filed a claim for MST related PTSD and Hypothyroidism. I attended my C&P exams and thought both providers were professional and thorough (surprise). I had my first exam for PTSD and the second was for Hypothyroidism. The VA lost my medical records but luckily I provided enough information in my separation exam that I was granted C&P exams (I believe that is why). My primary care provider also wrote a very detailed letter supporting my diagnosis and providing an opinion. My question is - a few days after my exam for hypothyroidism the VA scheduled another exam for "behavioral health and a DBQ for Mental Disorder except PTSD and Eating Disorders". Why would they schedule another mental health exam so soon? It has only been 4 weeks since my PTSD exam. I thought it was strange so I searched the internet and found you. Thank you so much for your time and thank you for taking the time to answer so many questions.

Jim's Reply:

I can't accurately explain why VA does what it does most of the time. This is one of those times. I'm really happy to hear that your examiners were professional in their actions. I recall my own series of exams and 1 of maybe 6 was concerned enough to do the task correctly.
 

We know that VA practices overkill when it comes to C & P exams. The fact is that most C & P exams aren't at all necessary. VA has a process called ACE that should be the first step and never is.
 

I've always thought that this is because the companies doing C & P exams are owned by former (retired) VA executives. The contracting company is paid by the exam so the more the merrier. Yeah, that's pretty cynical of me isn't it? We can hope I'm wrong but this is VA we're talking about so anything is possible.
 

Another reason is the VA propensity to practice CYA at every step. Overkill in data collection is the word of the day, every day.
 

If a rater is responsible for marching your file through the process of adjudication that person wants the file to be as complete as possible prior to the moment of the final decision. If any possible data is left out, whether it is actually necessary or just repetitive, the person monitoring the process will be criticized.
 

I can't tell you just why it is that you have another exam scheduled. What I can leave you with is that no matter how onerous or silly the process may seem, never miss a scheduled C & P exam. Don't reschedule if it's not convenient...find a way to be there. If you miss an exam VA is likely to default to a denial.
 

Always be prepared with copies of any documents that may be helpful but recognize that the examiner isn't required to receive them. Never try to secretly record the encounter with your phone but do make mental notes of anything that seems out of place and them make written notes so you won't forget. If your claim is denied for any reason, the blame is usually traced by to an inadequate C & P exam during appeal.
 

Finally...read this document so you know a lot of what the examiner knows when you enter the room. Good luck!