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94 Cards in this Set
- Front
- Back
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Areas for Gulf or Persian War |
1. Iraq 2. Saudi Arabia 3. Bahrain 4. The United Arab Emirates (U.A.E.) 5. Gulf of Aden 6. Waters of the Persian Gulf, the Arabian Sea, and the Red Sea 7. Kuwait 8. The neutral zone between Iraq and Saudi Arabia 9. Qatar 10. Oman 11. Gulf of Oman 12. The airspace above these locations |
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USC |
US code |
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CFR |
Code of federal regulations about |
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VHA |
Veterans health administration |
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DMA |
Office of disability and medical assessment |
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C&P |
Compensation and pension |
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BVA |
Board of veterans appeals |
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VBA |
Veterans benefits administration |
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USC |
United States code |
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RO |
Regional office |
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VARO |
VA regional office |
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Dates for Persian/ Gulf War? Location? |
August1990-(1991) Continues through a date yet to be prescribed by presidential proclamation or law (3 8CFR 3.2) Southwest Asia theater |
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CFR |
Code of federal regulations |
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Gulf War Illness Symptoms |
Combination of chronic headaches cognitive difficulties widespread body pain unexplained fatigue chronic diarrhea skin rashes respiratory problems etc. |
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Compensation for Gulf War Veterans for disability due to undiagnosed illness & medically unexplained chronic multi symptom illnesses, as well as for certain infectious diseases requires the condition to manifest to a degree of how much percent? By what date? According to which proclamation? |
10% 12/31/2016 38 CFR 3.317 |
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Who determines whether a veteran qualifies to have aGulf War service medical examination? |
VARO |
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The regulatory definition of a Persian golf veteran provided and 38 CFR 3.317 includes service in a large area of Southwest Asia but does not include which two areas? |
Afghanistan or Djibouti |
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Generally VA examinations are ordered for all claims received within what time period? |
Within one year Generally VA examinations are ordered for all claims receive within one year of separation from the military unless the evidence is sufficient for deciding to claim.This includes a general medical examination and any specialty examinations deemed necessary. P4 |
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However, in claims received more than one year after separation from service, a VA examination will ordinarily be ordered for environmental-hazard claims when the evidence of record contains the following three elements: |
Element 1: Evidence of a current diagnosed disability or persistent or recurrent symptoms of disability. Element 2: Evidence that the Veteran was exposed to an in-service exposure event or incident, including a Veteran’s lay evidence. For the purposes of this element, exposure to certain environmental hazards can be conceded on a case-by-case basis. Element 3: Evidence that the claimed disability or symptoms may be associated with the in-service exposure event. |
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Element 2? |
Element 2: Evidence that the Veteran was exposed to an in-service exposure event or incident, including a Veteran’s lay evidence. For the purposes of this element, exposure to certain environmental hazards can be conceded on a case-by-case basis. |
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Element 1? |
Element 1: Evidence of a current diagnosed disability or persistent or recurrent symptoms of disability |
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Element 3? |
Evidence that the claimed disability or symptoms may be associated with the in-service exposure event. |
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What are Presumptive Infectious Diseases? |
Certain infectious diseases are presumed to be service connected for Persian Gulf Veterans if the disease manifests within a year of the Veteran’s departure from the Southwest Asia theater of operations (38 CFR 3.317). |
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Name Presumptive Infectious Diseases For the gulf war? |
These diseases include: • 1. Brucellosis •2. Campylobacter jejuni • 3. Coxiella burnetii (Q fever) • 4. Malaria (special considerations apply to the timeframe for manifestation) • 5. Mycobacterium tuberculosis (no time limit) • 6. Nontyphoid salmonella • 7. Shigella • 8. Visceral leishmaniasis (no time limit) • 9. West Nile virus |
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What is Brucellosis |
Is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked meat from infected animals or close contact with their secretions |
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Other names for a brucellosis? |
Undulant fever Malts fever Mediterranean fever |
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S/S Of Brucellosis |
Fever emphasis on muscular pain and night sweats duration can vary from a few weeks to months to even years in the first stage of the disease bacteremia occurs and leads to triad symptoms fevers sweating often with a foul moldy smell and arthralgia with myalgia |
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Other symptoms of brucellosis |
G.I. symptoms like constipation, diarrhea, enlarged liver, liver inflammation, liver abscess, enlarged spleen also bones and joints like osteomyelitis, Spond a little discitis, sacral iliac us and or Kaytis is common in men although it can be highly variable you can have thrombocytopenia, meningitis, you Vytis, optic neuritis, endocarditis |
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How is brucellosis treated? |
Doxycycline, streptomycin, Ciprofloxacin, rifampin, Bactrim, tetracycline |
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Common complications of brucellosis? |
Infection of the nervous system endocarditis infection of the lining of the heart or mouth liver abscess they can cause long lasting symptoms are similar to (SEID) systemic exertion intolerance disease also known as myalgic and encephalomyelitis chronic fatigue syndrome |
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Campylobacter jejuni |
Causes campylobacteriosis curved rod People can get Campylobacter infection by eating raw or undercooked poultry or eating something that touched it. They can also get it from eating other foods, including seafood, meat, and produce, by contact with animals, and by drinking untreated water.
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Campylobacter jejuni |
Causes campylobacteriosis curved rod People can get Campylobacter infection by eating raw or undercooked poultry or eating something that touched it. They can also get it from eating other foods, including seafood, meat, and produce, by contact with animals, and by drinking untreated water.
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Treatment for Campylobacter |
Although people with Campylobacter infection usually recover on their own, some need antibiotic treatment. |
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Typical Symptoms of Campylobacteriosis? |
People with Campylobacter infection usually have diarrhea (often bloody), fever, and stomach cramps Nausea and vomiting may accompany the diarrhea. |
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Onset & Duration of campylobacteriosis? |
These symptoms usually start 2 to 5 days after the person ingests Campylobacter and last about one week. |
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Sometimes Campylobacter infections cause complications, such as? |
Sometimes Campylobacter infections cause complications, such as irritable bowel syndrome, temporary paralysis, and arthritis. |
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Campylobacter occasionally spreads to the bloodstream and causes a sepsis in? |
In people with weakened immune systems, such as those with a blood disorder, with AIDS, or receiving chemotherapy |
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Q fever |
Other name |
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Malaria |
(special consideration) |
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How is Campylobacter infection diagnosed? |
when a laboratory test detects Campylobacter bacteria in stool (poop), body tissue, or fluids. The test could be a culture that isolates the bacteria or a rapid diagnostic test that detects genetic material of the bacteria. |
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Tx for campylobacter? |
Treatment Most people recover from Campylobacter infection without antibiotic treatment. Patients should drink extra fluids as long as diarrhea lasts. Some types of antibiotics may not work for some types of Campylobacter. When antibiotics are necessary, healthcare providers can use laboratory tests to help determine which type of antibiotics will likely be effective. People who are prescribed antibiotics should take them exactly as directed and tell their healthcare provider if they do not feel better. |
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Some people with, or at risk for, severe illness from campylobacteriosis might need antibiotic treatment? |
These people include those who are 65 years or older, pregnant women, and people with weakened immune systems, such as those with a blood disorder, with AIDS, or receiving |
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When an examination is requested, the examiner should be informed of the Veteran’s service, along with the location and nature of the environmental hazard to which the Veteran was exposed, and given pertinent Fact Sheets (based on Training Letter 10-03, Environmental Hazards in Iraq, Afghanistan, and Other Military Installations) about exposures. The claims file should be forwarded to the examiner for review. The examiner should state whether? P4 |
it is more likely, less likely, or at least as likely as not that a Veteran’s claimed condition is related to the hazardous environmental exposure and support the opinion with a rationale. |
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Which illnesses in the Gulf War/Persian war have special considerations or no time limit? |
• Malaria (special considerations apply to the timeframe for manifestation) • Mycobacterium tuberculosis (no time limit) • Visceral leishmaniasis (no time limit) |
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Other name for Q fever |
• Coxiella burnetii (Q fever) |
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How can you get Q fever? |
Q fever is spread to humans by animals, most commonly sheep, goats, and cattle. It's caused by inhaling dust particles contaminated by infected animals. High-risk occupations include farming, veterinary medicine, and animal research. |
• Brucellosis • Campylobacter jejuni • Coxiella burnetii (Q fever) • Malaria (special considerations apply to the timeframe for manifestation) • Mycobacterium tuberculosis (no time limit) • Nontyphoid salmonella • Shigella • Visceral leishmaniasis (no time limit) • West Nile virus |
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Common symptoms from Q fever? |
Signs and symptoms of Q fever may include: Fever Chills or sweats Fatigue (tiredness) Headache Muscle aches Nausea, vomiting, or diarrhea Chest pain Stomach pain Weight loss Non-productive cough Symptoms can be mild or severe. People who develop severe disease may experience infection of the lungs (pneumonia) or liver (hepatitis). |
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People infected with Coxiella burnetii wIll typically develop Q fever approximately how long after being exposed to the bacteria? |
About 5 out of 10 people infected with Coxiella burnetii will get sick. Illness typically develops 2-3 weeks after being exposed to the bacteria |
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Women who are infected during pregnancy with Q fever may develop? |
may be at risk for miscarriage, stillbirth, pre-term delivery, or low infant birth weight. |
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Symptoms can be mild or severe. People who develop severe disease may experience? |
infection of the lungs (pneumonia) or liver (hepatitis). |
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Women who are infected during pregnancy may be at risk for? |
miscarriage, stillbirth, pre-term delivery, or low infant birth weight. |
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Veterans with service in Afghanistan after ——— are also eligible for presumptive service connection for these infectious diseases. |
Veterans with service in Afghanistan after September 19, 2001 are also eligible for presumptive service connection for these infectious diseases. For both Persian Gulf Veterans and Veterans with service in Afghanistan only, you should use the C&P Persian Gulf and Afghanistan infectious disease documentation protocol to assess these conditions. |
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Under the remarks section of each documentation protocol that you follow, you need to provide a medical statement that says which category of illness the condition or symptoms that you have found fall into. What are the four categories? P 6 |
(1) An undiagnosed illness (2) A diagnosable but medically unexplained chronic multisymptom illness of unknown etiology (3) A diagnosable chronic multisymptom illness with a partially explained etiology (4) A disease with a clear and specific etiology and diagnosis |
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For a category for you are required to provide? Page 6 |
Under the remarks section of each documentation protocol that you follow, you need to provide a medical statement that says which category of illness the condition or symptoms that you have found fall into. (1) An undiagnosed illness (2) A diagnosable but medically unexplained chronic multisymptom illness of unknown etiology (3) A diagnosable chronic multisymptom illness with a partially explained etiology (4) A disease with a clear and specific etiology and diagnosis |
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What is chronic Q fever? |
less than 5/100 who become infected with C. burnetii bacteria develop chronic Q fever. Chronic Q fever develops months or years following initial Q fever infection. People with chronic Q fever often develop an infection of one or more heart valves (called endocarditis). People with endocarditis may experience night sweats, fatigue, shortness of breath, weight loss, or swelling of their limbs. A healthcare provider will need to perform a series of tests to diagnose endocarditis. |
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Prognosis & treatment for chronic your fever? |
Chronic Q fever Chronic Q fever infection requires months of antibiotic treatment. |
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Chronic Q fever is more likely to occur in people with? |
heart valve disease, blood vessel abnormalities, or in people with weakened immune systems. Women infected during pregnancy may also be at risk for developing chronic Q fever.
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Presumptive Infectious Diseases Gulf War |
• Brucellosis • Campylobacter jejuni • Coxiella burnetii (Q fever) • Malaria (special considerations apply to the timeframe for manifestation) • Mycobacterium tuberculosis (no time limit) • Nontyphoid salmonella • Shigella • Visceral leishmaniasis (no time limit) • West Nile virus |
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Shigella |
Shigella is a genus of bacteria that is Gram-negative, facultative anaerobic, non-spore-forming, nonmotile, rod-shaped and genetically closely related to E. coli. |
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For a C&P examination, a flare-up is? |
is generally regarded as any temporary or recurring significant increase in signs or symptoms associated with the condition. If there are flare-ups of a joint or limb condition, you should report the duration, frequency, and severity of the flare-ups as described by the claimant |
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Name the countries involved in the gulf war |
SOAK IQ UAE Saudi Arabia Oman Kuwait Iraq Qatar United Arab Emirates
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Kuwait, Saudi Arabia, Iraq, Qatar, and Oman |
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Name of the infection Shigella bacteria can cause? |
Shigellosis |
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Common symptoms with shigella? |
diarrhea (sometimes bloody), fever, and stomach cramps. |
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Onset and duration of symptoms shigella? |
Symptoms usually begin 1–2 days after infection and last 7 days. |
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Treatment for Shigella? |
Most people recover without needing antibiotics. However, people with severe illness and those with underlying conditions that weaken the immune system should be given antibiotics. Antibiotics can shorten the duration of illness (by about 2 days) and might help reduce the spread of Shigella to others. Washing your hands often with soap and running water and taking other hygiene measures can help protect you and your loved ones from infection |
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Presumptive service connection |
VA will consider certain infectious diseases to have been incurred in or aggravated by service even though there is no evidence of such disease during the period of service. This is known as ______________. |
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When do you provide a medical statement? |
You have to provide a medical statement regardless of which category of illness the complaint falls under. |
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C file |
In general, the C-file could be in paper form, electronic form such as the records in the efolder contained in the, or a combination of paper and electronic forms. You are required to review the entire C-file, whether in paper or electronic form. In addition, you must document that you have done so in your examination report. |
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Which other veterans are eligible for presumptive service connection for these infectious diseases? What date/time period? |
Veterans with service in Afghanistan after September 19, 2001 are also eligible for presumptive service connection for these infectious diseases. For both Persian Gulf Veterans and Veterans with service in Afghanistan only, you should use the C&P Persian Gulf and Afghanistan infectious disease documentation protocol to assess these conditions. |
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VBMS |
Veterans Benefits Management System (VBMS) This can be an electronic or paper form |
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A C-file may contain the following information |
• History of the claimed condition • Service personnel records, including Department of Defense separation form (DD 214) or equivalent • Entrance history and physical examination report • Service treatment records (STRs), including Post Deployment Health Assessments (PDHA) in which the Veteran has indicated what he or she thinks his or her environmental hazard exposures may have been • Exit history and physical examination report • Private medical information the claimant has submitted to the RO or authorized VA to obtain on his or her behalf |
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Sometimes Disability Patterns are also called? |
Disability categories |
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Another name for Chronic fatigue syndrome |
Systemic exertional intolerance disease (SEID) |
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What should you include under the remarks section |
Medical statement/medical opinion Nexus opinion State which Category illness falls into for categories 3 and 4. Nexus opinion is not required for categories 1 or 2 |
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Nexus opinion is required for category three and four. What is a nexus opinion? |
However, for any condition that falls into category (3) or (4), a medical nexus opinion with a supporting rationale is generally required to address whether it is "at least as likely as not" that the disability pattern or diagnosed disease is related to a specific exposure event experienced by the Veteran during service in Southwest Asia. However, you are not required to address whether conditions that fall into category (3) or (4) are otherwise related to the Veteran's service (separate and apart from an exposure event) unless VBA specifically requests that you do so. |
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Which agency determines which veteran receives qualifies for a golf war general medical examination? |
The VA Regional Office (VARO) will make a determination as to whether a Veteran qualifies as having Gulf War Service before requesting a Gulf War General Medical examination. |
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Compensation for Gulf War Veterans for disability due to undiagnosed illness and medically unexplained chronic multisymptom illnesses, as well as for certain infectious diseases, requires? |
that the condition be manifest to a degree of 10 percent or more not later than December 31, 2016 (38 CFR 3.317), although this date is subject to change to a later date as determined by the Secretary of the Department of Veterans Affairs. |
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STR |
Service treatment records |
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Based on the 2006 and 2010 NAS reports cited in a 2011 Notice in the Federal Register, VA determined that a number of conditions, are not subject to presumptive service connection based on Gulf War service. If future evidence links any of these or other illnesses to exposures associated with Gulf War service, VA may establish presumptions of service connection for such illnesses. Name some? |
1. cancer 2. psychiatric disorders 3. cardiovascular diseases, are not subject to presumptive service connection based on Gulf War service |
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The role of both VHA and contract examiners is to? |
The role of both VHA and contract examiners is to gather, evaluate, and document diagnostic and other clinical evidence needed by VBA and BVA. |
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C&P examinations are conducted to provide clinical evidence ? |
VBA and BVA |
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The exam report or documentation protocol from a C&P exam is mainly for? |
VBA |
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How does VBA use the information from the examiner? |
We use the information from the examiner to adjudicate the Veteran or service member's claim. We review all the evidence. We may have everything we need depending on the evidence submitted, but if we need clinical evidence to help us determine, for example, whether a condition is related to service or perhaps the current level of the condition, we will request a C&P exam. We decide the claim based on all the evidence, not just the examination. Then we notify the claimant of our decision. |
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How does VBA decide the claim? |
We decide the claim based on all the evidence, not just the examination. Then we notify the claimant of our decision. |
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How is BVA involved in the C&P examination process? |
Jonathan: We get involved if a Veteran appeals his or her claim determination. If a claim is denied, the Veteran has an opportunity to appeal the decision. We have to determine if a denial was proper or not and in order to do that, we need certain evidence. We look at the C&P examination report to see if the evidence we need is there or if the medical opinion we need is sufficient. If the evidence is sufficient, we make a decision. If the information we need is not there, we remand. That is, we send the exam back for additional evidence that we determine is missing. We might ask for a new exam or a new medical opinion |
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VBA and BVAs Involvement with C&P exam? |
So we've established that VBA request a C&P examination when they need evidence to develop a Veteran's or service member's claim for benefits. Then the examiner conducts the examination to gather clinical evidence and report it to VBA. At that point, VBA uses the examination findings along with other evidence to adjudicate the claim. BVA might be involved if VBA's decision is appealed by the claimant. |
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USC |
United States Code (USC) |
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CFR |
Code of Federal Regulations |
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VSO |
Veterans Service Organization |
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VSR? |
Veterans Service Representative VSR reviews the claim & will request a C&P examination if clinical evidence is needed. |
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What step/ number are you in the C&P process? |
Step 3 |
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RVSR |
For complex claims, a Rating Veterans Service Representative (RVSR) submits the Request. The RVSR is also the adjudicator who decides the claim. |
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RVSR |
For complex claims, a Rating Veterans Service Representative (RVSR) submits the Request. The RVSR is also the adjudicator who decides the claim. |
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Your role in C& P process? |
Your role will be to gather clinical evidence for the claim and report it to VBA. After you complete a C&P examination and report your findings to VBA, VBA will adjudicate, or decide the claim based on all evidence, including your examination report. |
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