tdiu I Just Got My C&p Results......i Dont Get It?

[magnolia_318]

Hello Everyone,

I am new to the forum and this is my first time posting. I find many of your stories sadly familiar to mine. I am currently service connected for Myasthenia Gravis and recently Pericarditis, got this from allowing the VA doctors to operate on me. I got my C&P results this week from my C&P exam for Myasthenia Gravis, a neuromuscular disorder. Of course the C&P doctor stated that I was fine despite all the apparent signs and symptoms of my disease. BTW, the examiner was 1 hour and 45 minutes late due to car problems, the exam only lasted 7 minutes, the doc did not touch me and told me I was free to go and did not perform and exam until I insisted. However, that is not why I am posting. I requested an increase to extreme muscle weakness in my triceps, double vision and calf muscle weakness. I seems like the doctor basically copied my neurologist notes and passed them on as her findings as there really was no exam done. In the header of the C&P exam results it stated that she only used the physical exam to come to her conclusions, but that's not possible. The docs notes basically stated that I was fine with only mild weakness noted. However, the last section of the docs notes are the " MEDICAL OPINION SUMMARY " which stated:

MEDICAL OPINION SUMMARY

----------------------

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: Is the veteran able to maintain substantial

gainful employment based only on his service connected myasthenia gravis.

b. Indicate type of exam for which opinion has been requested: Neurology

peripheral nerves.

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE

CONNECTION ]

It is at least as likely as not that veteran is able to maintain substantial

gainful employment based only on his service connected myasthenia gravis.

Vet has complaints about primarily ocular and mild generalized weakness.

So if I am doing so fine, Why is it "at least as likely as not that veteran is able to maintain substantial

gainful employment based only on his service connected myasthenia gravis."

I dont get these people. They are so underhanded and contradictary. I also looked in my medical record for the first time, my mistake, and noticed that my neuro was telling me one thing and notating another. Things like "oh you are really weak" but his notes would say my overall strength was 4/5. However, I digress. So what do you guys think is going to happen next in regards to this C&P exam. BTW, I never requested TDIU.

[Pete53]

Welcome to Hadit

[Navy04]

Welcome aboard and sorry to hear of you troubles, but it don't look good to me. You have to realize that some conditions the VA just don't rate good. Due to either lake of knowledge or the fact that it is a rare condition to rate. For Example I have sever hearing loss in both ears, well documented for years, yet they are at 0%. You really just don't know with the VA, sometimes in works in our favor, but most of the time it works against us.

[Vync]

I agree with Navy04. It sounds like the examiner phrased it backwards or just came in from working the night shift. However, in math class they taught us the communicative property.

VA jargon "least as likely as not" = 50/50 for/against, or relative equipoise. This usually is the cutoff required to grant service connection.

So let's look at it again from our relative equipoise lenses:

"It is at least as likely as not that veteran is able to maintain substantial gainful employment.."

1. You are 50% likely to maintain gainful employment..

2. You are 50% likely not to maintain gainful employment..

I am really not sure why they chose to phrase it as such, but if the VA gives you a denial I would pop the relative equipoise logic and see what they say.

Good luck dude, and welcome to Hadit!

[magnolia_318]

I have had very bad experiences with the VA health care system:

• I was told that I have anemia and needed a colonoscopy/endoscopy procedure do to determine if I was losing blood internally. After the test was done, I went in for the results and the doctor told me that they found nothing. About 1.5 years later, at an unrelated appointment, another doc asked me how my Celiac disease was doing. I told him I didnt have Celiac. He said yes you do, they found out that you have it when they did the endoscopy 1.5 years ago. Surprise.
• I went to the ER numerous times for the pericarditis they created while cutting open my chest to remove a gland to help my ""mild"" myasthenia gravis weakness. Everytime I went to the ER I was told they didnt find anything specific on the X-rays or lab work and that they were going to assume that it was pericarditis because the symptoms matched that diagnosis. I reviewed my record recently and found out that everytime I went to the ER they found something was wrong and never told me. For example: suspected atrial injury, left ventricular dysfunction w/ more than 50 percent ejection fraction which is actually associated with sudden cardiac death, EKG readings that specifically pinpointed pericarditis, elevated cardiac enzyme and the list goes on. This stuff cant be legal
• I went into a myasthenic crisis while on vacation and had to be hospitalized for 3 days. My neuro at the VA actually coordinated everything and got me admitted to a private hospital in that state and had the VA pick up the tab. I was praising the ground he walked on until I read my medical record recently. His notes stated "I got into trouble with my myasthenia while on vacation, however, my symptoms improved with rest." REALLY??? How can the VA get away with blatantly false statements?
• My previous C&P exam was right after this crisis. I walked into the exam not being able to talk due to severe slurred speech and a drooping soft palate, choking on my own saliva because I couldnt swallow due to throat muscle weakness, limping due to calf muscle weakness, and one eye closed due to eye muscle weakness. However, the C&P examiner stated in his notes "my speech was coherent and intact",even though he had to ask me to repeat myself numerous time to understand anything I was saying, and that my upper extremity strength was a 4/5 and everything else was normal. WOW. I was actually readmitted to the hospital 2 days later.

However, being that I have had two thoracic surgeries, been through mestinon, cellcept, prednisone, immuran, IVIG, and am now receiving plasma exchange, similar to dialysis, once a week on top of immuran and im about to move up to rituximab. How are they justified in saying that I'm fine and only suffer from ""mild"" weakness. Mild weakness is not treated with plasma exchange once a week!

Sorry for the long winded post. I'm frustrated. I just need to formulate my next plan of action to overcome this BS C&P exam. Also, doesn't the " It is at least as likely as not that veteran is able to maintain substantial gainful employment" rule on behalf of the veteran when it comes to TDIU?

[magnolia_318]

Thanks for the response Vync. It helps to clear up the VA jargon.

[john999]

If you have other insurance don't depend on the VA for your care. It is suicide for many conditions. If that is all you have then you need to use the system to get the most out of it. Are you more than 40 miles from your nearest VA hospital? If I was I would get help via private sector doctors. This new law may give you a leg up if the VA takes too long for treatment. These guys could not even do a simple tooth filing for me. They made glasses for me when I had a cataract with 20/800 vision in my right eye. Medicare paid for cataract surgery when the VA refused to do it. They pulled a tooth and then refused to replace it with an implant telling me I did not need that tooth which was a bald faced lie. There are vets out there who have medicare and, yet, they use the VA to have brain surgery. Yes, they save money, but some medical student, or resident is operating on their brain. Somebody that takes that chance really needs brain surgery.

For your claim you need an independent medical opinion from a specialist who is on your side. You have to pay for it, but it is worth it. Without IME's I would still be getting 30% instead of being P&T for the last 13 years. The VA has diagnosed me with things I don't have and missed DX'ing me with the things I do have. You just cannot trust them even if your PCP has the best of intentions since the VBA does not have good intentions. Their only intention is to save money at your expense.

John