The first email can be short. It should tell the physician what condition is disputed, what medical question counsel needs answered, and whether the engagement is a screen, a record review, or a signed opinion. Do not send Veteran identifiers, C-files, or medical records through the public website or ordinary email. First agree on scope and a secure transfer method.
Start with a one-page assignment
Name the claimed condition, the specific direct or secondary question, the decision or C&P opinion that prompted review, the requested deliverable, and any real deadline. If several conditions are involved, rank the questions. Flag the facts counsel believes are disputed, but invite the physician to test them against the source record. A desired outcome is not a medical question.
Provide the material sources, not just a summary
Once transfer is arranged, include relevant service and post-service medical records, diagnostic studies, operative reports, DBQs, C&P opinions, rating decisions, and lay statements. Include adverse evidence and plausible competing causes. If a large C-file is supplied, an index and a short chronology help navigation, but the physician must still verify the original sources that carry the conclusion.
Identify what is missing
Tell the physician whether a key imaging study, specialist report, service record, or interview is unavailable. An incomplete file can sometimes support a narrow opinion; in other cases the correct recommendation is development before a report. If counsel needs a rapid screen, say so. Screening and a final signed opinion are separate scope decisions.
Agree on the workflow before transfer
Confirm the fee basis, expected volume, deadline, transfer method, and counsel contact for factual questions. Counsel can review a draft for an unanswered assignment question, factual correction, or missing record. The physician remains responsible for the reasoning and signed conclusion, including an unfavorable or unresolved answer where that is what the evidence supports.
A practical first-contact example
“We need physician review of whether the documented cervical condition is medically related to the reported service injury and whether the 2025 C&P opinion addressed the 2008 imaging. We can provide the complete C-file and indexed imaging through our secure portal. Please advise whether a screen or signed opinion is appropriate, the fee, and your available deadline.” This gives a useful assignment without sending protected details through the public form.
What not to do
Do not send only favorable excerpts while withholding a known contrary opinion or post-service injury. Do not ask the physician to sign a conclusion before the source record is reviewed. Do not assume every condition in a large file belongs under one fixed price or turnaround. A concise index of the disputed materials helps, but the final report needs a complete enough record to test the competing explanation.
Valor's law-firm workflow explains the engagement steps. See forensic record review, case selection, and focused C&P review for related decisions.