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Recent YouTube Videos from Dr. Finnerty

The VA’s current disability rating structure for sleep apnea should continue as there is nothing evidence based to replace it with, and the current rating system also serves as a cost-effective public health campaign promoting the identification of sleep apnea and adherence to gold standard treatment with PAP therapy.

The VA’s proposed changes to the sleep apnea rating would incentivize failure and drive-up associated healthcare costs and disease burden. Our Veterans deserve better. You can read the full text of Dr. Finnerty’s public comments on the VA’s proposed sleep apnea changes.

Hot to get a nexus letter:

Dr. Finnerty’s thoughts on how the VA interprets the duty to assist compared to Social Security disability when it comes to exams

How does ADHD impact VA disability claims?

Social Security disability for mental disorders like PTSD (you can be unemployable with the VA and also have Social Security find that you are unable to work)

Is it fraud… or an ethical forensic specialist?

Here is a snippet of text from the VA’s website taken 6/30/2024 (which, though recently updated, still doesn’t fully recognize the future of telehealth such as through PSYPACT):
Indicators of potential inauthenticity include, but are not limited to, the following:

  • The non-VA provider identified on the DBQ
    • has contact information that is unverifiable or contains discrepancies, or
    • is located an unreasonable distance (generally, more than 100 miles) from the Veteran’s place of residence, yet the provider reported
      • regularly seeing the Veteran as a patient, and/or
      • that the examination was completed in person.
  • The privately completed DBQ contains
    • information that conflicts with the overall evidentiary record, particularly concerning details that impact the outcome of the claim, or
    • signs of improper alteration (for example, inconsistent appearance of text and formatting, such as the examiner certification and signature section being visually different than other sections of the DBQ).
  • VA determines the privately completed DBQ is insufficient for rating purposes and orders an examination, but the Veteran refuses to report for the examination. 


  • The presence of one or more of these potential indicators of inauthenticity does not automatically mean that a privately completed DBQ is inauthentic or fraudulent.  However, the presence of one or more of these indicators may call into question the authenticity of the information provided and may warrant additional development, as discussed in M21-1, Part IV, Subpart i, 3.A.1.f, and/or referral for possible fraud review.  This is necessarily a case-by-case determination.
  • The distance between the non-VA provider’s location and the Veteran’s place of residence should not be considered an indicator of potential inauthenticity, as described above, if the Veteran
    • lives in a remote area, such that driving more than 100 miles to see a health care provider would not be considered unreasonable, or
    • regularly or periodically travels more than 100 miles to see the particular health care provider for a specific reason (for example, to receive specialized treatment at a cancer center or research hospital).
  • A privately completed DBQ should not be routinely rejected or automatically deemed potentially inauthentic or fraudulent solely because it supports entitlement to a maximum schedular (or other increased) evaluation for the condition, unless such a disability picture is clearly inconsistent with the overall evidentiary record. 


  • Claims processors have a duty to evaluate and weigh all evidence of record, including privately completed DBQs.  If it is determined that a privately completed DBQ contains indicator(s) of inauthenticity that are substantive enough to deem it potentially inauthentic or fraudulent, claims processors have the authority to assign low or no probative value to the privately completed DBQ. 
  • If a privately completed DBQ is erroneously deemed insufficient and the Veteran fails to report for an examination that was requested on the basis of the DBQ being inadequate for rating purposes, then the privately completed DBQ should not be assigned lower probative value.