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How to Get your VA C-File


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    • New Va Pain Medication Policy
      I've responded on this thread in the past, and would like to update.  After 7 years of successful pain management; I took some advice from the message board and reached out to various "up the chain" types...and thought the Director of Pain Management at VA Palo Alto, CA had actually re authorized me back into Veteran's Choice program where I was being treated for my pain for 3 subsequent visits, was on the road for treatment for a procedure that VAHC had not even mentioned, (all of this after VA had "red flagged me as DRUG SEEKER")understand I have never deviated from requesting increase, missed appointments. Nothing.  Today, I get call from same Director of Pain Management, since I have not heard from Vet Choice about the reauthorization, that I was mistaken, he could offer me nothing but traveling the 40 miles to his clinic and of course that would be NO Opioids. I cannot travel the normal transportation route, and he assured me he had listed me, as Undue Travel Burden, but he would still not reauthorize. Have a nice Day! So, you tell me- how with all these qualifiers; and my Severe Pain that the Spine Specialist in my Community has agreed to treat Veterans, is only 3 miles from my home; has more compassion than those treating Veterans? Did I mention, that my Opioid meds has not changed in 7 years? Is anyone in Washington listening? Honorable Dr. DavidJ. Shulkin, your New Veteran's Choice guidelines don't mean anything to these people that have to care for us Veterans.  I was a Medical Officer for 9 years caring for thousands of brave Men and Women who served this Wonderful Country and I am appalled at the service and the way I am spoken to by the staff at the VAHC and told if you want Narcotics "Go Buy a Health Care Plan."  I say to them- without my Service to this Great Nation they would not have a job, and now they are talking to us like we are their BURDEN? If not for us, willing to Wear the Uniforms and guarantee their freedoms, they couldn't get a job except working at a County Teaching Hospital. 
    • Choice Program
      I've responded on this thread in the past, and would like to update.  After 7 years of successful pain management; I took some advice from the message board and reached out to various "up the chain" types...and thought the Director of Pain Management at VA Palo Alto, CA had actually re authorized me back into Veteran's Choice program where I was being treated for my pain for 3 subsequent visits, was on the road for treatment for a procedure that VAHC had not even mentioned, (all of this after VA had "red flagged me as DRUG SEEKER")understand I have never deviated from requesting increase, missed appointments. Nothing.  Today, I get call from same Director of Pain Management, since I have not heard from Vet Choice about the reauthorization, that I was mistaken, he could offer me nothing but traveling the 40 miles to his clinic and of course that would be NO Opioids. I cannot travel the normal transportation route, and he assured me he had listed me, as Undue Travel Burden, but he would still not reauthorize. Have a nice Day! So, you tell me- how with all these qualifiers; and my Severe Pain that the Spine Specialist in my Community has agreed to treat Veterans, is only 3 miles from my home; has more compassion than those treating Veterans? Did I mention, that my Opioid meds has not changed in 7 years? Is anyone in Washington listening? Honorable Dr. DavidJ. Shulkin, your New Veteran's Choice guidelines don't mean anything to these people that have to care for us Veterans.  I was a Medical Officer for 9 years caring for thousands of brave Men and Women who served this Wonderful Country and I am appalled at the service and the way I am spoken to by the staff at the VAHC and told if you want Narcotics "Go Buy a Health Care Plan."  I say to them- without my Service to this Great Nation they would not have a job, and now they are talking to us like we are their BURDEN? If not for us, willing to Wear the Uniforms and guarantee their freedoms, they couldn't get a job except working at a County Teaching Hospital. 
    • getting run-around by dental clinic
      In part, I agree, and in part do not! Turns out that the VA has a mantra about least cost when it comes to treating veterans. Private providers do have a profit goal to attain. It comes down to what the patient prefers, and what is the best for the patient. (Not the VA, provider, etc.)  
    • PTSD with questions
      I was actually thinking the sleep apenea and fibro secondary  to the back, I can't sleep but about 3 to 4  hours  a night my pain increases.  I know it is from being overweight  that once I hurt my back in the AF I was not able to exercise and the weight joined me so with the sleep apenea and fibro has made life almost miserable an then two months ago I was diagnosed with type 1 diabetes. Can the c-file be requested from ebenefits? Thank you for your quick response.  
    • PTSD with questions
      Rita, Welcome to hadit. You are at the right place.  There are NO dumb questions other than questions about how to succeed with a false/fraudulent claim. PTSD due to MST is covered by several knowledgeable veterans here.  They will chime in shortly. The evidence requirements are different than combat PTSD.  I don't believe they are any easier or harder, but they are different.  If you are suffering from PTSD resulting from events that occurred during your military service, file a claim for it.  I have never even heard of SA or fibro being secondary to PTSD. I am not certain if either could be an adequate stressor for PTSD.  Increased chronic pain from a SC condition can certainly be the basis for an increased rating. I did not claim PTSD until 40 years after I left active duty.  I was "boots on the ground" in Vietnam with combat awards, so my claim was really a walk in the park for me.  The 30% award did nothing to my monthly compensation, but I wanted all of my bases covered so that my wife will have no problems with DIC when I croak. C-File is your DVA claim folder.  It would be wise to request a copy right away because it takes a while for the VA to provide c-file copies.  Your military records may well contain evidence in the manner of behavioral changes after the event regardless of whether or not you reported it.
    • Aortic valve /ihd
      He also has an appeal in for increase in diabetes ,. He is on Lantus solar star pen and humalog quick pen.  Private dr filled out DBQ and wrote a prescription for restricted diet and activity.  Also filled for renal failure third stage secondary to diabetes.  Private nephrologist filled out DBQ with a diagnosis of diabetic renal failure type2. And diabetic nephrology.  Both were denied.  I don't think they read anything .  They said they did not feel his diabetes had progressed that much.  His aid 8.1.  They said renal failure was denied because he had no proteinuria in his urine sample.   And you had to have proteinuria in your urine to be renal failure.  I was reading online kidney foundation, that you do not always drop proteinuria.  And we were reading over the cp file again and it ask if the veteran had diabetes on it and they did not even check it. And on one spot on it it said his bun was 19 and said it was high.  Then on another spot it said bun was 19 and said it was normal.  It did have gfr at 40 and said low.  But it is like the gfr was just kind of over looked or ignored completely.  And that is the number one way, according to national kidney foundation,  to check if kidneys are dysfunctioning.  They said there was NO dysfunction of the kidneys.  Now on the DBQ from private dr says there is kidney dysfunction.    I picked up all his labs since he has had renal failure, and all the gfr are to low.  Some as low as 34.  Thanks everyone .  And Berta I'm so sorry you had to go thru all that stuff with the va..  And sorry for your loss.
    • Knee Condition
      Can the va refuse to increase my rating since my issue has worsened outside of the military? I am in a profession which requires carrying equipment and a vest. So without a doubt the weight has had an effect on my knee. I reported the injury to my work as well. Not sure if this can effect my claim. I'm thinking about revoking my claim through my employer. Since it is cared through from the VA. At the time I wasn't sure if it was related to my previous patellar injury. 
    • Aortic valve /ihd
      Berta he was seeing a private cardio.  And I kept asking him if he had ihd and he kept saying no.  And after the surgery I saw on his one piece of paper said cad, so I ask if it was the same, and he said yes.  You are right he did not get to 60 overnight.  But maybe his mets were lower because of the valve problem .  I know the surgeon told me and our daughter his heart was enlarged.    Now I think it was in 2009 he had lung embolism, and they could not say where the clot came from.  I'm suspecting it came from the heart.  He only goes to va for cp exams.  We have tricare and Medicare?  
    • PTSD with questions
      I have been going to mental health care at my local VA, I have been out of the service for 20 or more years and he recommended that I file for PTSD, based on what I have told him. I do not have anything in my medical records from active duty to confirm this nor witnesses since I did not report being raped. How in the world do I file for this? I am also service connected for my back and am seeking an increase due to excessive pain and wanting to include sleep apenea and fibro as secondary conditions would that go with my back or would I list as secondary to the PTSD. Dumb question but what exactly is a c-file is that my military health file?   Thank you all in advance for your help.
    • C&P Re-Exam - REPHRASED
      Your ok   Good news is coming

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USNDW

C&p Exam Gone Bad, Really Bad

8 posts in this topic

After calling the Claims Management Office, and them getting the DRO who has my file for over 2 years working my NOD appeal, I finally get a C&P exam for inflammatory arthritis (SeroNegative). I think they doubled in the Housebound or Aid & Attendance exam at the same time.

My wife, who is my VA Caregiver, takes me down to the VA Hospital for my exam. We get there and my wife is freaked out about the number of Veterans there trying to get care. We were just on time, not early, and as soon as we sat down they called my name. We walked into the exam room and here we go.....

The doctor introduced himself to me, shook my hand and as my wife was walking in the room he asked "who are you and why are you here"? She said that she was my wife and was there because she was my caregiver. The doc asked what a caregiver was. I started to explain and he looked at me, cut me off, and asked my why I thought I had Rheumatoid arthritis? I started to explain that I don't think I have RA, but a Rheumayologist diagnosed me with Sero Neg RA, as I was still talking he told me to ge changed into a gown, so I did and he asked the exact same question. I can barely do one thing at a time so in the middle of taking my clothes off I stopped and said, "Once again, I don't think I have RA, I have doctros who" and he cut me off again and said continue getting undressed. So my wife started to explain the diagnosis and treatments and he asked her to be quiet saying that this was my exam, not hers, he was examining me and if he wanted her input he would ask her for it.

I have problems getting things over my feet, like socks, and a knee sleeve I wear under my brace. My wife stepped up to help me take off the sleeve and the doc pretty much yelled "stop touching him" she responded that I needed help getting this sleeve off and he again went on his little spiel that this was my exam and he had to determine whether I could get my self dressed. She looked at him and told him there were things I needed help with when getting dressed and undressed and that was one of the reasons she was my caregiver.

I was done undressing at this point and he asked to hop on the table. I don't do a whole lot of hopping anymore, so my wife helped me get on the table and the doc didn't like that either. I had to ask him to pull out the leg rest because I cannot leave my right leg hanging over the edge. He asked why not and I explained I had complex regional pain syndrome, Nerve damage, and that it would be very painful to hang it over. My wife explained that I had chronic pain. The doc looked at her like she was crazy. He started his exam which was pretty lame, no measuring instruments, no recording. He asked if I had swelling and I sad yes in my hands, and he said where in your hands, I said My whole hand, he said point to it so I pointed my right index finger at my knuckles on my left hand and showed him, then he said "use your finger like a pointer and show me" I had to yell "I AM"!!

So we were done with that part and he said get dressed. My wife stood up to help me with my knee sleeve and he again went ballistic on her. She turned around and told him that I needed help with certain items, the doc responded that he would be the judge of that not her and that he needed to examine me to see if I can do these things. Once again she said he cannot get this over his foot and we already know this I take care of him everyday. The doc asked her if she felt insulted and she said yes. He recommended she go to the waiting room. I was standing basically in disbelief. This examiner was treating both of us like idiots and wasn't listening to a freakin word we were telling him. She sat down in the chair and he asked her to go to the waiting room, I told her go ahead, knowing that this freakin crazy ass doc could make comments in a report that might hurt our benefits.

When she stepped out he asked if she was mad at him so I told him she was because you are not listening to us. He looked at me and said you did it though. I asked what did I do, and he said got dressed by yourself. I explained that no I hadn't my wife had placed the sleeve over my foot, and he said it again, "see, you did it all alone" so I raised my voice and said "did you hear me? I just told you that she helped me and you are not listening to what I am telling you". Apparently that finally got his attention and he began asking real medical questions. I told him to refer to my chart and records from my file. He said he didn't have a file, all he had was access to my VAMC records which are scant because I use private care.

I explained that the RO should have sent him my file to review and that in the file there were records to support the diagnosis of SeroNeg RA, and treatment records, along with all the testing, lab work, X-rays, MRI's and a Nuclear Bone scan that showed turnover in every joint. This really got his attention. He asked if I had any of those records and I began handing him the records I brought that verified all this and records from several other doctors who agreed with the diagnosis and treatment. He made copies and then started asking about my medical history and medications.

It wasn't until that point that he actuall acted like a doctor. He said he had not received any file on me but he would look for one. I went to the Nurse to get vital, BP 160/105, getting ready to stroke out. My wife is in the hallway crying with a couple of Veterans comforting her and telling her to go the patient advocate's office, which she did. While I went to X-ray and labs she went to speak with them.

I guess she got someones attention because the next morning the C&P Department Head physician called me and asked me what happened. I tried to retell the story as well as I could and she was shocked. She apologized more than once and then explained that this examiner was not even a C&P examiner, he worked in Rheumatology and she really didn't even know who he was, but she kept apologizing. Finally after much discussion we came to the conclusion that he did not know he was supposed to have my C file and the only thing he saw was the very few records the VAMC has which has nothing about arthritis and my other medical conditions. She informed me she would track down his report, find my C file, get the X-ray and lab reports, review my medical records to determine the question as whether I have SeroNeg RA and if I do need aid and attendance. I explained that my wife was approved to be mu caregiver and those qualifications are more strict than Aid and Attendance. She agreed and said she would let me know if she needed anything else.

So, the point is, if the doc hadn't been a jackass, and if he had just been polite and performed a routine exam, there is no way he would ever have saw my medical records, and there certainly is no way that the C&P Chief would have became involved in the case. I am not going to tell him thank you for being an A-hole to my wife, actually I filed a complaint with the Senators office and they were on top of that.

Beware of exams where the examiners don't have your records. Never assume they do, because they might not.

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Sorry to hear you got a JERK for a Doc. Your wife did the right thing by going to the Patient Advocate and you filing a complaint with your Congressman. We need to do more of this and do it on a regular basis. In fact, we may just need to get the media involved as well. I would also consider filing a compaint with the VA's IG office.

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I am just so sorry for your experience. My heart broke reading your post. Certainly it has turned out for the better, but to have to go through that - I can't even imagine. For your blood pressure to be that high after that exam speaks to the stressful situation and pain you were put through. What a nightmare. Some of these "specialists" have such a "god syndrome" that they forget to be freakin' doctors!!!!!!!!! Burns me up!

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After calling the Claims Management Office, and them getting the DRO who has my file for over 2 years working my NOD appeal, I finally get a C&P exam for inflammatory arthritis (SeroNegative). I think they doubled in the Housebound or Aid & Attendance exam at the same time.

My wife, who is my VA Caregiver, takes me down to the VA Hospital for my exam. We get there and my wife is freaked out about the number of Veterans there trying to get care. We were just on time, not early, and as soon as we sat down they called my name. We walked into the exam room and here we go.....

The doctor introduced himself to me, shook my hand and as my wife was walking in the room he asked "who are you and why are you here"? She said that she was my wife and was there because she was my caregiver. The doc asked what a caregiver was. I started to explain and he looked at me, cut me off, and asked my why I thought I had Rheumatoid arthritis? I started to explain that I don't think I have RA, but a Rheumayologist diagnosed me with Sero Neg RA, as I was still talking he told me to ge changed into a gown, so I did and he asked the exact same question. I can barely do one thing at a time so in the middle of taking my clothes off I stopped and said, "Once again, I don't think I have RA, I have doctros who" and he cut me off again and said continue getting undressed. So my wife started to explain the diagnosis and treatments and he asked her to be quiet saying that this was my exam, not hers, he was examining me and if he wanted her input he would ask her for it.

I have problems getting things over my feet, like socks, and a knee sleeve I wear under my brace. My wife stepped up to help me take off the sleeve and the doc pretty much yelled "stop touching him" she responded that I needed help getting this sleeve off and he again went on his little spiel that this was my exam and he had to determine whether I could get my self dressed. She looked at him and told him there were things I needed help with when getting dressed and undressed and that was one of the reasons she was my caregiver.

I was done undressing at this point and he asked to hop on the table. I don't do a whole lot of hopping anymore, so my wife helped me get on the table and the doc didn't like that either. I had to ask him to pull out the leg rest because I cannot leave my right leg hanging over the edge. He asked why not and I explained I had complex regional pain syndrome, Nerve damage, and that it would be very painful to hang it over. My wife explained that I had chronic pain. The doc looked at her like she was crazy. He started his exam which was pretty lame, no measuring instruments, no recording. He asked if I had swelling and I sad yes in my hands, and he said where in your hands, I said My whole hand, he said point to it so I pointed my right index finger at my knuckles on my left hand and showed him, then he said "use your finger like a pointer and show me" I had to yell "I AM"!!

So we were done with that part and he said get dressed. My wife stood up to help me with my knee sleeve and he again went ballistic on her. She turned around and told him that I needed help with certain items, the doc responded that he would be the judge of that not her and that he needed to examine me to see if I can do these things. Once again she said he cannot get this over his foot and we already know this I take care of him everyday. The doc asked her if she felt insulted and she said yes. He recommended she go to the waiting room. I was standing basically in disbelief. This examiner was treating both of us like idiots and wasn't listening to a freakin word we were telling him. She sat down in the chair and he asked her to go to the waiting room, I told her go ahead, knowing that this freakin crazy ass doc could make comments in a report that might hurt our benefits.

When she stepped out he asked if she was mad at him so I told him she was because you are not listening to us. He looked at me and said you did it though. I asked what did I do, and he said got dressed by yourself. I explained that no I hadn't my wife had placed the sleeve over my foot, and he said it again, "see, you did it all alone" so I raised my voice and said "did you hear me? I just told you that she helped me and you are not listening to what I am telling you". Apparently that finally got his attention and he began asking real medical questions. I told him to refer to my chart and records from my file. He said he didn't have a file, all he had was access to my VAMC records which are scant because I use private care.

I explained that the RO should have sent him my file to review and that in the file there were records to support the diagnosis of SeroNeg RA, and treatment records, along with all the testing, lab work, X-rays, MRI's and a Nuclear Bone scan that showed turnover in every joint. This really got his attention. He asked if I had any of those records and I began handing him the records I brought that verified all this and records from several other doctors who agreed with the diagnosis and treatment. He made copies and then started asking about my medical history and medications.

It wasn't until that point that he actuall acted like a doctor. He said he had not received any file on me but he would look for one. I went to the Nurse to get vital, BP 160/105, getting ready to stroke out. My wife is in the hallway crying with a couple of Veterans comforting her and telling her to go the patient advocate's office, which she did. While I went to X-ray and labs she went to speak with them.

I guess she got someones attention because the next morning the C&P Department Head physician called me and asked me what happened. I tried to retell the story as well as I could and she was shocked. She apologized more than once and then explained that this examiner was not even a C&P examiner, he worked in Rheumatology and she really didn't even know who he was, but she kept apologizing. Finally after much discussion we came to the conclusion that he did not know he was supposed to have my C file and the only thing he saw was the very few records the VAMC has which has nothing about arthritis and my other medical conditions. She informed me she would track down his report, find my C file, get the X-ray and lab reports, review my medical records to determine the question as whether I have SeroNeg RA and if I do need aid and attendance. I explained that my wife was approved to be mu caregiver and those qualifications are more strict than Aid and Attendance. She agreed and said she would let me know if she needed anything else.

So, the point is, if the doc hadn't been a jackass, and if he had just been polite and performed a routine exam, there is no way he would ever have saw my medical records, and there certainly is no way that the C&P Chief would have became involved in the case. I am not going to tell him thank you for being an A-hole to my wife, actually I filed a complaint with the Senators office and they were on top of that.

Beware of exams where the examiners don't have your records. Never assume they do, because they might not.

USN,

Yea for stand your ground !

It's apparent that the exam instructions were either incomplete

in error, scheduled for and given by the wrong doctor, from the get-go.

I feel really sorry for what you and your wife had to endure

YET

I also feel a bit of empathy for this jerk of a doctor.

It does read like once he took a moment to hear you out, he changed his attitude

and began to admit something did not seem right, like not having your file/records.

I feel that both you and your wife responded appropriately and took swift action to

correct this mess that had been created.

Hopefully this C&P department head does a complete follow thru and gets some

positive results or at a minimum a correct C&P exam rescheduled in a

VERY TIMELY MANNER.

I do want to point out that isn some specific instances - examiner's are not

provided with medical records as a review of them does not relate to the issue at hand -

which I feel is not your case at all.

Hang in there, I hope for your best interest.

JMHO

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Thanks for your kind words.

After speaking with the C&P Doc I really did think about the examiner who is a Rheumatologist and based on my VAMC medical records was thinking WTF? are you doing here?

But his attitude from the very start towards my wife was just uncalled for. She didn't interrupt him and when he asked her a question, and she responded, he did the same thing to her, just cut her off. If he would have listened (2 ears 1 mouth) and let us answer his questions he probably would have realized he wasn't given my file.

I did explain to the C&P head that it appeared he did not have my file, but still, there is no call for that attitude towards a Veterans spouse, and she agreed.

While I was sitting in the waiting room waiting for my vitals to be taken there was another Veteran pissed off. Apparently he drove almost 2 hours, got to the VA 1/2 hour before his appointment at 0830. At 0830 a Veteran showed up who was supposed to be there at 0800. Instead of having him wait because he was late, the made the guy who was on time wait. He complained a little bit at first, but when I was sitting there over an hour later he said they had 2 other appointments go in before him. That whole trip was freakin crazy.

Beware to those who might end up in the same situation. I could see where some people could actually get violent in this scenario

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Weird.... they wouldn't even let my wife come in with me for my CP.

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Were you accused of fraud because you have a college education? I was at a C&P. I was also told that my behavior while waiting for the exam differed greatly from the actual exam meaning I was faking it according to my C&P. I had another C&P where the doctor had a list of questions designed to ask "Have you stopped beating you wife yet" over and over until they could DX a PD. I had a C&P where the doctor said he could not determine if I was TDIU because I was unemployed at the time. This is the reason the IMO/IME is the most useful tool in the tool box. Really, you need doctors in private sector that work for you as advocates. Almost all private psychiatrists and psychologists will do this to a greater or lesser extent. I did have an IME that was so good that the VA just incorporated it directly into my rating decision word for word.

John

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usn...outstanding the way you handle this situation..senator etc..reiteration to the numb skull md examiner of how your body functions

or malfunctions . i have been in those situations and you want to go off but know that does not help and it could even be a sucker play?..too bad we can't request an immediate toxicology test on the examiner at the time.hehe...usn you did good it will work out for you. you are a tough guy

and will prevail

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