For many veterans, a Compensation & Pension exam can be one of the most stressful parts of the VA disability claims process. Receiving a denial based largely on that examiner’s opinion can be frustrating. That’s why it is important to understand the reasoning behind the opinion and whether the evidence relied upon actually supports the examiner’s conclusion. The Court of Appeals for Veterans Claims case McCray v. Wilkie, 31 Vet. App. 243, 257 (2019), shows why the reasoning and evidence behind a VA medical opinion can matter as much as the examiner’s ultimate conclusion.
What Happened in McCray v. Wilkie?
In McCray, a veteran sought service connection for hearing loss after significant noise exposure during military service. The Board of Veterans Appeals denied his claim after relying heavily on a negative VA medical opinion. The Board denied his claim after relying on a negative VA medical opinion.
The examiner relied, in part, on a medical report addressing delayed-onset hearing loss. The report stated that delayed effects were unlikely, but it also acknowledged that definitive studies had not been performed and that insufficient evidence existed to determine whether permanent noise-induced hearing loss could develop much later.
What Did the Court Decide?
The Court found that the Board needed to address those qualifying statements when determining how much weight to give the examiner’s opinion. Because it failed to do so, the Court sent the issue back for further consideration.
The Court collected several factors from prior cases that can affect the adequacy and persuasive value of a medical opinion. McCray added another important consideration: whether the medical literature the examiner relied on contains qualifications or contradictions that weaken the examiner’s conclusion.
What Does McCray Mean for Your C&P Exam?
A negative C&P opinion may appear convincing simply because it comes from a medical professional, but the conclusion is only one part of the opinion. The facts considered, the examiner’s reasoning, the medical principles used, and the evidence relied upon can all affect whether the opinion is adequate and persuasive.
Because so many different aspects of an examiner’s opinion can be scrutinized, an unfavorable C&P opinion may present multiple grounds for challenge, including:
- Whether the examiner understood the veteran’s relevant medical history;
- Whether the examiner had the expertise necessary to address the medical question;
- Whether the examiner relied on accurate and sufficient facts;
- Whether the conclusion is supported by a clear, reasoned medical explanation;
- Whether the opinion contains internal inconsistencies or contradictions;
- Whether the medical principles relied upon were properly applied to the veteran’s individual circumstances; and
- Whether medical literature cited by the examiner contains limitations, qualifications, or contradictory information.
If an examiner cites medical research, do not assume the examiner’s description of that research tells the whole story. McCray shows that limitations, qualifications, or contradictory statements within the source itself may weaken the medical opinion.
VA examiners can make mistakes, overlook important evidence, or rely on incomplete reasoning. You should carefully review any negative C&P opinion rather than treat it as the end of the claim. If VA denied your claim based on an unfavorable medical opinion, we can help determine whether you can challenge it and which review option makes sense for your case.