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It May Look And Sound Like A Duck But Might Not Be

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Okay the intent of this post is to get folks to chime in with suggestions so this letter can be revised with some logic and objectiveness. However keep in mind this letter is going to be sent out by the veteran who had this experience and is trying to get help for his condtion. He is service connected but when doctors make false statements they can injure you for the rest of your life. So he feels he needs to set the record straight and help him self. We are our best advocates and I am trying to help him as well to finish his letter. So feel free to make suggestions. Thank you in advance. There are some very good doctors at the VA. So this is not saying that there isn't hopefully the point is also being made that when things occur like this instead of just complaining you need to let the appropriate folks no so that it wont happen to others and perhaps it can get fix and provide you with appropriate care and documentation should you ever decide to file a claim.

Well here is the letter- all suggestions appreciated.

Attn: Hospital Administrator

950 15th St,

August 11, 2010

Dear Hospital Administrator and Department of Neurology

I am retired serviceman from the US Army and a service connected disable veteran that have been receiving care through the XXXXX VA. I am writing this letter to share my concerns and shock after receiving care through your neurology department by Dr. Wolf. My health and neurological function has been deteriorating over the past few years. I am 70% service connected for several spinal conditions and have been seen for much back and neck and neurological complaints, pain, numbness to my limbs that are becoming more unbearable. I am having a lot of loss of functioning to my left side that seem to be getting worse. Also I have been having bladder issues as well. Recently I had an MRI done that had been requested by Dr. Wolf after being referred from an emergency room visit. Although I am not a medical person my recent MRI C – Spine results seem to explain to me why I have been having these problems and why I am getting worse. I had one in the past 12/23/08 that showed Cervical spondylosis with bulging disk an osteophyte complex to C5- 6 and other injury, narrowing ect. Keep in my mind I served 20 years in the Army and had been involved in a couple of accidents during my military career that possibly caused me injury. My current MRI C- spine (Jun 21, 2010) shows narrowing of the sagittal diameter of the lumbar canal, L1 spurring L3, bulging disk with hypertrophic facet and ligamentous changes, L4/L5 disk degenerations with loss of signals and bulge and herniation of the disk with severe left foramen stenosis. Moderate to severe spinal stenosis L4-5, Now the rest of it you can read yourself on the MRI report. Next the cervical injury keep in mind I have physical atropy that you can see by looking at me. I have a large hump near my neck area that cause me to look like a hump back. My MRI of the cervical area explains a lot of the tingling/numbness, migraines, LUE weakness that I am having. It showed Cervical Canal stenosis, and mod to severe foramen stenosis C6-7. Lots of Degenerative Disc Disease with IVDS narrowing , loss of signal a bulging disk at C3 and C4, then another bulging disk at C5 with mild cervical canal stenosi with severe left foraminal stenosis and another bulging disk at C6/7 with canal stenosis there and moderate right foraminal stenosis.

It also showed that my brain is now extending downward 7 mm into my spine which is diagnosed as partial Chiari Type 1 malformation. So now you talking my brain.

So after consulting the Chiari Institute and getting second opinions the normal standard of neuro treatment I have learned for someone in my condition seems to be along the line of surgical treatments and some other tx. None of which was offered to me through the VA or per Dr. Wolf. Instead what I got was something along the lines of malpractical statements, lies, fraud and inconsistent progress notes. It was also noted that there is flow void in the major proximal intracranial arterial vascular pedicles. So I guess he just going to wait for me to stroke out. How about the Polyps they found around my right maxillary sinus with dextro deviation of my nasal septum. He didn’t even take the time to address those issues or the possible cyst around my kidney that was picked up by the MRI. Well if anything is cancerous I guess he could care less just let me die. No references no referrals to deal with those issues that showed up in the MRI. What ever happen to ethics? There seems to be some issue with my distal left vertebral artery. Where talking an artery here. You would think there would be some concern. Please read my MRI radiology report.

Where I am going with this is that I ordered a copy of the my records and lo and behold I was in awe at statements in (7 pages!!!) made by this blundering mad scientist namely Dr. Wolfe that offered no real treatment plan for my type of injuries other than increasing my Gabapentin and then turned around and lied and said I had no neuro deficits. First I would like to ask him how did he come to the conclusion that my canal narrowing was CONGENTAL. Did he compare it to my medical records from birth or did he consult with my parents who are no longer with us. When I joined the military I had no spinal injuries or anything congenital with my spine. Now after I fell off a deuce truck with full gear and had some other accidents its taken its toll. My service record will show that when I gave them my civialian medical records upon entry that I had no congenital spinal diagnosis. So where is Dr. Wolf getting this from? Please advise. Now he had nothing to suggest for treatment of the Chiari Malformation which from research from the Chiari institute can be caused as the result of Cervical stenosis which I have. So he needs to go back to school and get an update on causes and treatment. Which he really didn’t provide any for me just let me walk around with my brain leaking into my spine (right tonsil descension) and now I have vertigo and migraines and other major problems. How can he determine my pain. Pain is owned by me. I have told them about radiculopathy I have been having for years all the docs I have seen know I have it and yet Dr. Wolfe still wrote (possible radiculopathy). Maybe if he was to suffer and maybe break his leg then we all might consider that he is possibly in pain. If he is not sure about something why even note it to give the impression.

I have never complained of ulnar pain or have had any problems with my ulnar bone so how the heck does he come up with ulnar neuropathy. If he did the research like I did trying to figure out why I am suffering like this he would find that 90 percent of my problems are due to my spinal stenosis, herniated and bulging disk, Chiari Malformation. I found from the medical journal how cervical stenosis can cause weakness in the arm and pain in the shoulders. I didn’t see them mention ulnar this is not mechanical or due to some amount of stress that I am doing to myself. The cervical spinal bulging and stenosis could have also contributed to the Chiari Malformation I which I have learned from researching the Chiari institute studies. Chiari and cervical stenosis and damage to the disk can also contributed to migraines and vertigo. So he needs an update. How could Dr. Wolf have noted such FRAUD AND LIES in the progress notes. Statements such as I have no related neuro deficits or radiculopathy less likely or probally asymptomatic are totally inconsistent with my complaints and symptoms. I keep telling these folks about my pain and symptoms I am having and instead of offering any relief or treatment plan all I get is notes such as those mention above as my health continues to deteriote. If this is where we are at on care for veterans this is totally unacceptable and UNBELIEVABLE AND A TOTAL DISERVICE TO VETERANS.



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Does this vet have access to medical care outside the VA? The letter is fine. I just wish the VA doctor was fine. If the vet has medicare he should use it. If the vet is considering any spinal surgery at the VA I would think twice. I would find another way. The VA may promise you the moon, but end up killing you anyway. I am serious about that. I have had lots of discussions with the VA about my care. In general they are awful and dangerous to the health of vets. VA patient care is a scandal. Every time you go to the VA you roll the dice. If it is for a serious condition you may roll craps.

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THIS IS ONLY A DRAFT. It still has to be revised and I have not run spell check as yet. I was trying to help him get his thoughts on paper. Geeze.

Well, actually, the letter is not fine. There are misspelled words, run-on sentences, etc, to numerous for me to try to correct at this time (I've got to go to the store). If, IF I get a chance later on today, I'll be more than happy to take a stab at it. Okay?

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The vet could file a Section 1151 claim as well-if

1.the medical records (such as the MRI) reveal this vet had conditions that the VA failed to treat and that

2. he became further disabled by their medical error in failure to either properly diagnose and properly treat.

The Section 1151 claim should be sent to the VARO he deals with and maybe a copy should even go to the director of this VAMC. However it is almost impossible at this point to know if the VA malpracticed on him

And it is difficult to opine on a letter regarding an exam without seeing the actual exam results from the doctor,can you scan and post the doctor's medical opinion here?

Has he tried to find the doctor's credentials on the net? Did this doctor have full medical expertise to opine on his MRI and condition? I dont even know if this all results from a exam for a claim or was for something else.

"flow void in the major proximal intracranial arterial vascular pedicles."

The flow is void because an MRI cannot detect flow movement.That statement means nothing as far as indicating he could have a stroke.

Does he have the full MRI narrative? There should be one in his medical records.

An MRI narrative on my husband was considerably long and detailed.But it took me a lot of time to study the medical stuff in it.It helped me prove malpractice.

But I wish I had gotten a IMO from a Neuro doctor though at the time because the research I had to do (pre internet) was very time consuming.

An IMO from a Neuro would define his condition clearly, and could support a Sec 1151 claim if there is any basis for one,

I am not even sure why he is writing this letter because I dont know if this is due to a C & P that denied his claim.????

or just questioning the exam and treatment????

I discussed my husband's 1151 which I re opened-with the Director of the local VA.I was too angry to write him a letter, and our meeting was not pleasant. They even called the VA cops on me.

Then some months later I found that he was the first VA doctor to agree with my medical claims of malpractice and he supported that in a Peer review (which the VA promptly lost for almost ten years)

and he gave a full medical rationale based on the medical evidence (some that I had called to his attention at the meeting)

that the VA did NOT provide proper care.

My point is he might have a better resolve by requesting a meeting and bringing his concerns to the director.

I don't think this letter should be sent.

He should make sure the director documents the meeting in his med recs.

I regret I was so angry at the meeting I had but I did calm down enough to get my points across and I had part of the clinical record with me.I had to request a prior meeting with this director to get my husband better PTSD care.That result was good and I was not angry then.

Anger doesn't help us maintain our focus.If a vet has a valid complaint and the Patient's Advocate has been unable to resolve it then a meeting should be requested with the director.

It is possible that VA isn't giving him the proper care but I think it would take an IMO from an outside neurologist to determine that.And I agree if he has Medicare-he should get out of the VA system.

Sometimes the best way to deal with stuff like this is to get an IMO that definitely can detail the medical conditon and even support an possible 1151 claim, if there is basis for one.

Is there any question regarding the veteran's nexus of his disabilites here?

"Now after I fell off a deuce truck with full gear and had some other accidents its taken its toll. My service record will show that when I gave them my civialian medical rec" etc

Has he fully established a proven inservice nexus for why he has this disability?

Has he been rated for it and is this for an increase in rating?

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Don't cop a tude on me. I was trying to be nice. I was responding to what you asked:

"Well here is the letter- all suggestions appreciated."

Maybe I shoulda said: AT LEAST RUN SPELL CHECK, before you ask me to make SUGGESTIONS!

I do not have time for this, nor the patience!

This person asked for help with this letter. She did not ask to be nit picked. Please remember that not all folks have engineering degrees and are doing the best they can do with the abilities they have. I know some folks are suffereing from VA Burn Out, but a little tact could go a long way.

It is Hadits mission to hlp Vets. Lets keep on target here.



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