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IME and Physician conflict of interest

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OldJoe

Question

Instead of continuing a thread that dealt with CUE and beating a dead horse I thought it wise to start a new thread.

In the pursuit trying to fixed my messed up claim I finally have found a physician that does IMEs

Here is how he responded to my email explaining my situation:

<...>

"I read your email. It does sound like you could use some assistance. 

A bit about myself. I do perform IMEs for civilian cases but I am also employed by a company that is contracted by the VA to perform similar disability assessments. I will have to check with my employer to see if your case presents a conflict of interest."
<...>

Of, all the flipping luck!!!

I responded and explained further my situation.

Hopefully he responds soon.

That said, I need any advice possible on what I should do next.  I know this could be a blessing or this could be a curse, I don't know which...

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Of all the flipping mistakes, thank God I called to check on the status of my records request.

I found out I sent my request to the wrong place.

I should have sent it here:

     Evidence Intake Center

 

     P.O. Box 4444

     Janesville, Wisconsin 53547

Anybody know if this is correct?  With my luck I will find out this "Evidence Intake Center"  is also known as the "Secure Shredding Facility".

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I don't think they have the brightest people working at the call center.

I started off asking for the address so I can get a copy of my c-file.

The operator asked why, I told him so I could review it because I am filing an appeal on a claim.

The operator then effectively states that I am asking how to submit a NOD and gets ready to explain how to do that.

I tell him no, I want a copy of my c-file, my claims file.

Operator says he is confused.

I explain to him I want a copy of my c-file, claims file for everything that I have ever submitted a claim for to include all the medical records, temp files and everything.  Where do I need to send the request to?

Finally he gives me the above address.

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On 5/31/2016 at 1:01 PM, OldJoe said:

That said is there anything being done about IME/IMO this seems to be getting a bit ridiculous that in a "non-adversarial" system that a vet has to get a IME/IMO just to stand a chance of getting properly assessed (even low balled).

And the more I seem and hear it sounds like IME/IMOs will soon start to be discounted because all the vets are doing them just a standard practice when filing a claim.

Then where are we going to be?

"will soon start to be discounted " That's been going on for some time! The VA, unless forced to do otherwise, has often taken the less favorable opinion (usually from a VA examiner) even when the examiner is marginally qualified, over the favorable one from a fully qualified physician. (I.E. Board certified specialist, etc.)  On appeal, the BVA usually catches this. But, it's occasionally necessary to have more than one favorable IME/IMO to counter an unfavorable in house opinion and C&P.  One of the "reasons" the VA uses is calling an expert opinion "Speculation".  After all, an opinion given decades after a nexus event is less probative than a more contemporary one. It's all in the evidence.

I really get upset when the VA calls for a C&P that is clearly not needed, due to sufficient medical records and test results. At one point, the VA RO was trying to make me take a treadmill stress test, even though the medical records, test results, etc. showed that such a test was extremely hazardous to me, and the VA's own regs and guidelines said that a stress test was not to be given. On appeal, via Nehmer (the VA failed to place my name on the Nehmer list, etc.) the appeal results politely said that the VARO screwed up, and that the existing medical evidence was conclusive without the C&P and stress test.  The fact that the VA was trying to force me to drive over a hundred miles over snow covered two lane roads in Georgia to attend the C&P was not even mentioned. There were two other VAMC locations that were closer or easier to get to that had the ability to do the C&P, including the VAMC across the street from the VARO.

 

 

Edited by Chuck75
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14 minutes ago, Chuck75 said:

The fact that the VA was trying to force me to drive over a hundred miles over snow covered two lane roads in Georgia to attend the C&P was not even mentioned. There were two other VAMC locations that were closer or easier to get to that had the ability to do the C&P, including the VAMC across the street from the VARO.

 

 

I know we all go into "conspiracy mode" when the VA pulls lame brain stunts like this, but is there some reasoning to the logic? 

I know this is the VA we are talking about they would send a Vulcan into an epileptic fit, probably would be considered inhuman and cruel punishment to even let one within 500 feet of a Vulcan.

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Old Joe , I quite disagree.  At least in my experiences.  The VA totally discounted a well rationalized medical opinion which supported service connection using service medical records and medical rationale.  In my instance, my back and sleep apnea claims.  

In the both these claims the OBGYN opinion was favored.  Her opinion used no medical rationale, was not an expert in the field, and the very opinion contradicted itself with stating a breathing device was not used ( CPAP) for sleep apnea, yet to discount the fatigue associated with Hypothyroidism stated that with CPAP use I wake up refreshed, so no higher rating for hypothyroid. No service connection for sleep apnea, because no use of breathing machine and no complaints in service.

While I rather enjoy getting on the bashing session of criticizing  the VA claims practices, I cannot dismiss how these actions are more than just coincidental.  JMO

Heh in regards to the Evidence Intake Center.  That is the address that was given to me according to the region I am associated with, however, no green card receipts have been sent back.   I'm starting to wonder if this new process isn't just another kink in the hose.

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8 hours ago, Chuck75 said:

"will soon start to be discounted " That's been going on for some time! The VA, unless forced to do otherwise, has often taken the less favorable opinion (usually from a VA examiner) even when the examiner is marginally qualified, over the favorable one from a fully qualified physician. (I.E. Board certified specialist, etc.)  On appeal, the BVA usually catches this. But, it's occasionally necessary to have more than one favorable IME/IMO to counter an unfavorable in house opinion and C&P.  One of the "reasons" the VA uses is calling an expert opinion "Speculation".  After all, an opinion given decades after a nexus event is less probative than a more contemporary one. It's all in the evidence.

I really get upset when the VA calls of a C&P that is clearly not needed, due to sufficient medical records and test results. At one point, the VA RO was trying to make me take a treadmill stress test, even though the medical records, test results, etc. showed that such a test was extremely hazardous to me, and the VA's own regs and guidelines said that a stress test was not to be given. On appeal, via Nehmer (the VA failed to place my name on the Nehmer list, etc.) the appeal results politely said that the VARO screwed up, and that the existing medical evidence was conclusive without the C&P and stress test.  The fact that the VA was trying to force me to drive over a hundred miles over snow covered two lane roads in Georgia to attend the C&P was not even mentioned. There were two other VAMC locations that were closer or easier to get to that had the ability to do the C&P, including the VAMC across the street from the VARO.

 

 

Chuck.

I have seen this "Nehmer list" mentioned a couple times, and it sounds like something I missed also. I filed on April 04 1983 and remember Berta mentioning Footnote 1 claims. Is this what you are talking about? I filed before those 1985 dates to those ??? dates, but it is hard to believe the law would allow a veteran to not be compensated on the grounds he filed too early. In brief, what is the Nehmer list? is it the 150,000 that the VA was looking for, and still haven't found 500 or so? Who is suppose to be on that list and how would you know? Sorry about all the questions,   :-(  Thank you.

Victor

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