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Corpsman8404

Working with PCP/VSO's

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Good morning everyone! First post.

I have switched my PCP to a VA doctor, and have my first meeting with him on Oct 5th. My assumption (you know how that goes) is that using the VA PCP would benefit me in my claims.  My question is, how do I go about telling them that, "look, here is my goal".  
I'm not asking to "lead" him, but I'd like to tell him my issues and have some comfort in knowing that he will help with IMO/Nexus letters, et cetera?

I will be mentioning Headaches, my TMJ issues, and my upcoming sleep study on the 27th of Oct.

As well, I meet with my VSO's on the 28th to discuss these issues and to even try to bump up my PTSD to 70%.  It will be the first time I "meet" them, since they have done everything in the background.  (Virgina Dept of Veterans Services).  With them, I'd like to discuss "here is my plan, here are the numbers I'd like to try and reach on each issue, and how can I get there?".

Is this reasonable? This may be common sense to most of you, but I want to do this right, and thus far I have went from 20%-70% within this year with the signature items below.  With the right numbers on Sleep, TMJ, and Headaches I am shooting of course, for 100!
Thoughts?

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17 answers to this question

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Welcome to Hadit!

If you are requesting an increase, asking your new doc to fill out a DBQ should be what you need.

If you are looking to SC something new, VA docs may or may not help. Some VA docs refuse and say that is the job of C&P docs.

Good luck!

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Good morning everyone! First post.

I have switched my PCP to a VA doctor, and have my first meeting with him on Oct 5th. My assumption (you know how that goes) is that using the VA PCP would benefit me in my claims.  My question is, how do I go about telling them that, "look, here is my goal".  
I'm not asking to "lead" him, but I'd like to tell him my issues and have some comfort in knowing that he will help with IMO/Nexus letters, et cetera?

I will be mentioning Headaches, my TMJ issues, and my upcoming sleep study on the 27th of Oct.

As well, I meet with my VSO's on the 28th to discuss these issues and to even try to bump up my PTSD to 70%.  It will be the first time I "meet" them, since they have done everything in the background.  (Virgina Dept of Veterans Services).  With them, I'd like to discuss "here is my plan, here are the numbers I'd like to try and reach on each issue, and how can I get there?".

Is this reasonable? This may be common sense to most of you, but I want to do this right, and thus far I have went from 20%-70% within this year with the signature items below.  With the right numbers on Sleep, TMJ, and Headaches I am shooting of course, for 100!
Thoughts?

This is tricky.  Personally what i do is this.  I have also been working on my headache claim.  By that i mean i have them, however just looking at the VA records its been a non issue.  however i have mentioned them in the past but nothing is done other than "you are given IB for your back that should help with the headaches" with no mention in the exam notes.  So what i do is i schedule an appointment with my PCP (VA) specifically just for that.  This way its not a i have 4 main issues, one is headaches and its barely mentioned, it is now the MAIN ISSUE of the day.  Plan appointments that way and also utilize the secure messaging and myhealth e vet "event log" to help with your claim history.

So for appointments now i go into secure messaging and write down all the issues i have been having with say headaches.  i write alot down tthere, frequency, when they were worst, when i had to lay down, when i had to leave work, etc.  Why? well your secure messages are now record within the VA system and you can print them off for use in your claim as evidence.  This is also helpful because (and maybe you havent experienced this, but i have) in the exam notes it may not mention something important at all like having to lay down.  or the exam notes may read "patient reports migraines.......blah blah....no report from veteran on adverse economic effects due to loss time at work"  This may be innocent and they just forgot, but i have evidence that is untrue.  without that the rater will only see the doctor saying you said you were fine at work.  by attaching the messages to the exam notes i nyour evidence lists (as well as writing notes in the exam notes pointing towards this) you can point it out that yes in fact i deeeeed mention it. 

I also for all my disabilities record in the myhealthevet "medical events" log any and all symptoms i experience for any of my disabilities or any realy "not good" event for my health.  you never know when you might find out you have something and they want to stiff you because it was never mentioned.  with the log you can show yes in fact i have written it down for the record.  i use it mainly as a headache log but also to log down days of depression, anger outbursts (ptsd) as well as issues with my feet or lately cramping and pain in all my joints (no sc for that it is newish to me...yay...).  Anyways i use this as evidence later or to help out with a IMO/IME if i get it.

Dont go in there and sound like you are trying to get them to write up stuff that will be used ina claim later, thats a good way to sour the relationship.  Just write them a message via secure messaging and request an appointment.  this way its all neat and tidy. 

As far as writing up a nexus letter, i wouldnt rely on a PCP for that for 2 reasons.

1) they ar enot a specialist in anything and if the VA sees its favorable they will just schedule your C&P with someone that "outranks" them in that specialty and shoot it down.  unless you get a NP you will lose.  i recommend saving up and getting an IMO/IME if you can.  its worth it. and in the end its best to save up for 6 months to pay for one, than just hope what you have works and then end up spending years in DRO hearings, BVA and CAVC appeals.

2)  While they are required to provide a dbq etc, they can still get out of it and/or shitcan it and if the latter it will be a bad one in your record.  If you have a good relationship with your PCP thats different, but there is a healthly load of unwritten understanding for PCP's to not do things that can help you on the claims side. 

 

save up, get an IMO/ime, use the PCP, in regards to claims help, as a recorder only.

 

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USMC_VET gave good advice: A headache log made a big difference when I filed and won SC for migraines.

You might be able to get SC for TMJ if you have evidence showing an injury or surgery to your jaw while in the service. TMJ is rated on limited vertical range of motion or alternatively for limited horizontal range of motion. I'm SC for TMJ due to a botched surgical procedure when the Army removed my wisdom teeth. The VA dental clinic made me a bite guard that I wear at night which helps with the grinding/bruxism. There are cheap over the counter ones, but I chewed through those quickly. I added this because it is the only thing that helped prevent me from grinding my teeth down to nothing.

Do you have chronic heartburn? This is often overlooked. I ask because it is pretty common to develop heartburn if you take motrin/NSAIDS daily for a long time. You can file a claim for it as GERD, but the official rating is for hiatal hernia. If you plan to file for it, expect a test for h. pylori. If positive, the VA will blame it on that. If negative, they will probably send you for an upper GI to confirm it.

Of course, for both conditions an IMO in your favor would be preferable.

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Are you working full time?   Remember, VA compensation is designed to compensate the Veteran for the average loss in earning capacity.  If you make 300,000 per year and are working full time, its hard to justify above the rating you are now.  

If you are not working, then consider seeking IU.  

Remember, too, the VA requires you have a diagnosis for SC, but compensates you only on SYMPTOMS, not diagnosis.  

That is important because some VEts make the mistake of applying for every little hangnail that is asymptomatic.  Asymptomic conditions are not compensated, so my view its no point to apply for them.  

If you are seeking compensation for Migraines, you need to show how they effect your work.  Do you take time off for migraines?  How often?  Ditto for PTSD..do your doc appointments cause you to miss work?  How often?  Do you get mad at work?  If you look at the criteria for mental disorders, they will clearly show up in working and social life in the higher levels.  

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Vync-  Thanks for the info, I will surely look through this site and the net for DBQ info, et cetera. :biggrin:

 

Devil Dog-  Good info in regards to the headache log.  Much of my headaches are due to stress levels and grinding my teeth at night as well (bad bruxism). The TMJ also makes my headaches pretty constant along with neck pain. I am waiting on my med records/dental records for to preview for instances of it noted.  As a Corpsman years ago, I wrote off headaches as hangovers and pretty much sucked down Motrin like candy (which also was for knee).  For years I have used Goody's powders 2-3 days per week. I am assuming to "secondary" the headaches, sleep problems, and even the grinding/stress/TMJ to PTSD as a means forward with this? Thanks for the pdf also, I will look into that as well!

i explained that as well to my VA docs who asked why i hadnt mentioned them in the sparing visits at the va from 06-11.  I drank a lot in those years, like all the time so i always figured they were hangovers or leftovers from the day before etc.  when i finally quit i realized they didnt get better and it wasnt the drinking.  however this didnt stop the neurologist consult at the VA from basically saying it was a load of bs however they used the words "recent subjective reporting" and it "not even being mentioned until 2015" (which isnt true she only looked at the records in her state since i got here in 2015 and not back to 2011, 2013.  Anyways im ranting on this, a recent pain in the ass. 

Keep on the logs, keep getting documentation.  go online and start the application for benefits TODAY so that your intent to file is sent out and your retro date is locked in back to today.  Oh and Doc in my signature line is the link to the site i run that has a few more free ebooks (they are all free) on different subjects.

Edited by USMC_VET

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Vync-  Thanks for the info, I will surely look through this site and the net for DBQ info, et cetera. :biggrin:

 

Devil Dog-  Good info in regards to the headache log.  Much of my headaches are due to stress levels and grinding my teeth at night as well (bad bruxism). The TMJ also makes my headaches pretty constant along with neck pain. I am waiting on my med records/dental records for to preview for instances of it noted.  As a Corpsman years ago, I wrote off headaches as hangovers and pretty much sucked down Motrin like candy (which also was for knee).  For years I have used Goody's powders 2-3 days per week. I am assuming to "secondary" the headaches, sleep problems, and even the grinding/stress/TMJ to PTSD as a means forward with this? Thanks for the pdf also, I will look into that as well!

Edited by Corpsman8404

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