What is the weight of the C & P Examiner diagnosis compared to the VA diagnosis?

Question

 

Hi Jim I was glad to find your website! My husband has a 90% service-connected rating for a TBI you received as a Marine in Okinawa among other issues and that was begun in October last year. We had a claim in for around 4 months for PTSD among other mental health disorders and he was sent to a C & P exam with a neuropsychologist who diagnosed him with cognitive disorder due to TBI. She did not think he had PTSD though the VA themselves tested him and diagnosed him PTSD from Okinawa which is why we put the claim in. He is also a survivor of Camp Lejeune and they denied our claim in the beginning for neurobehavioral effects which include neuropsychological and cognitive function. His neurologist at the VA who is an incredible doctor in diving accidents has told us that because of his diving accident in Okinawa he would be more susceptible to any cognitive disorders from the toxins at Camp Lejeune where he stayed for a year or two and he tested him for neural behavioral disorder and he passed with flying colors and high scores on that. All these evidences  are in his file and I also doubled up and made sure they were in the claim and. I've been told that they have sent is claim back to the VA to find corroborating evidence for the claim of PTSD and all other mental disorders. He has suffered with what they diagnosed as bipolar depression at the VA and he had a Nexus statement from the psychiatrist on the more likely than not affected during military time but they denied that on the first claim also. My husband's trying to go forward to get to 100% with this current claim. My question is what is the weight of The c&p Examiner diagnosis compared to the VA diagnosis? Thanks for any insight you might have :-) 

 

Jim's Reply

 

Psychological diagnoses differ from physical diagnoses in many ways. A physical diagnosis is usually pretty clear...a broken leg is a broken leg no matter what name you try to hang on it. Psychiatric diagnoses aren't as clear and that causes a lot of overlap in diagnoses of mental health issues. Whether a given symptom (sleeplessness or agitation for example) is caused by PTSD or by TBI or a combo of both isn't something we can take an x-ray of. Opinions differ depending on who is doing the diagnosing and their skill set. A surgeon will look for something curable with a knife where a psychiatrist will try to offer therapy to a similar patient.

 

The value of any testimony will vary depending on the credentials of the person offering such testimony or evidence. As a rule the opinion of the C & P examiner is the most valuable to the rater. The rater will believe that the examiner has followed a routine and a standard that is trusted whereas all the other evidence may not be as reliable.

Ultimately it's a crap shoot as to how the rater will use all the data in front of her or him. The best you can do is to hope they will see it as you do and if not...you appeal.