Long time reader/lurker during which I have received loads of good info! I thought i would ask a question of my own. I am going through a claim for IBS (3rd time), I am considered a Gulf War Veteran and I am trying to claim it under presumptive condition since it has already been diagnosed by the local VA hospital here in Virginia. Following my C&P exam, the VA wants some documentation about Gulf War Illness which I will provide, but I have noticed I have a mysterious second C&P scheduled at the local VA hospital? So far, I have not received any formal information in the mail. Also I see on e benefits that a new request has showed up which states:
Due Date: Not available Status: No Longer Needed
Exam Request - [Contention]
What does Exam Request - [Contention] most likely mean in this context?
Thanks in advance,
This afternoon I have my C&P exam for PTSD secondary to MST, with a contracted provider. I found out Friday evening after work. Fed Ex had delivered the paperwork earlier, but I didn't get a chance to see it until I got home from work.
To say that I am nervous would be the understatement of the year. I am desperately trying to hold myself together. My digestive system is all out of whack. I did spend an hour on the phone last night with a wonderful person from a non VSO group. She is a Marine and has trauma history, so that made the connection pretty easy. She gave me a lot of good tips, if I could only remember them when it's crunch time.
One of my biggest fears is that this will be just like my previous mental health C&P...where that examiner, a VA employee, when straight for the jugular and ignored my heaps of physical evidence. I don't know why I am even doing this. I fully expect to get more of the same....nothing. If I do get granted SC, the shock of that may well kill me...because that goes against the grain of what the VA has given me over the years....tons of grief and denials.
Anyway, just wanted to write this down as some kind of therapy...
No body has to read it, or respond. I'm not here anyway.........
Hello Fellow Vets, I'll try to make this a quick an easy read.
I joined the Navy in July 2008 and served 5 years of continuous duty. By the time I was out I had several issues that were not present at my join date and eventually filed a claim for my benefits. Upon departure from the Navy, I filed a claim and was denied benefits for headaches, depression, a left knee and right knee condition. When I received my decision packet, it stated that these conditions could be granted a rating if found service connection. When I met with the DAV representative, he stated that if I could have my primary care doctor write a letter and say the conditions were service connected I would be able to have it reconsidered. So my Primary Care Doctor who is a medical doctor, reviewed my medical record and she drafted a nexus letter that supported my claim (with proper language *more than likely service connected) for all the conditions I listed above (and others I will have to go back and file for at a later date). In addition, she diagnosed my headaches as being migraines as opposed to just headaches ( after I gave her the symptoms I had been experiencing). I submitted this letter in June of 2016.
In September 2016 my claim went to preparation for decision and then was kicked back and the VA requested a C&P exam. This exam was conducted by a Nurse Practitioner. She opined that my headaches were due to elevated levels of estrogen and that I was cleared from physical therapy in August 2012 so neither condition was service connected.
As I result I dug through my medical record and found evidence of reports of "severe and unusual headaches" on documents that were dated as early as October 2008 before I was ever on birth control. And reports of me complaining of knee pain after I was cleared from physical therapy in the year 2013. Though I found proof that I had been reporting these issues and nothing was being done about it, I also questioned how a science assumption could be made in this matter. If indeed I was suffering from elevated estrogen levels, shouldn't the NP have conducted some sort of blood work? It was not done....EVER.
So my question today is Do you think that the opinion of the NP will out weigh the opinion of my MD ( who is also an employee of the VAMC in Atlanta, GA?
Thanks For your time!
So I just printed my notes from VA PM&R consult for back, hips, knees pain. Dr stated "patient feels it is not connected to hips and knees pain".WTF.I never said that. I'm currently rated 10% R hip, 10% L hip, secondary 10% bilateral knee osteoarthritis,10% lumbar spine osteoarthritis. Dr also stated" patient has several small children at home and does lift them." He forgot to mention that I said it's painful to play with kids but suck it up because that's what dad's do. I m filing for increase to my SC. My question is am I now screwed. SC has already been established, and conditions have worsened. Dr recommendation is to do acupuncture, they denied me Aqua therapy,
So I'm wondering if anyone else has ever had a C&P exam that they do not have to be at?? I did this past Thursday!!! I found out about it because for the past week the ebenifits site has not been working right for me. I cannot check my status or most information that is of a personal nature. I keep getting this error code. I reported it. Talked to a tech on the phone he took all the necessary information and said they would contact me via email. Well that was over a week ago. But I keep checking to see if they have fixed the problem. But they haven't! Anyway I called again an was taking to someone at the 800 # that you would call about status. And I happen to click into the VA appointment area. And Holy SHIT there is an appointment that had been scheduled at 0800 Thursday! And I knew nothing about it. And the appointment indicates it is a C&P appointment!!??? WTF?? And what is really screwy is that I was at the VA on Thursday because I have a standing appointment on Thursdays 2 1400. So I ask this person on the phone what they hell that is all about, considering I was never notified of the appointment and the status appears that it was CANCELED by ME??? And believe me I am really pissed at that point!!!
SO this person explains to me that this appointment was scheduled by the VA and it was a C&P appointment but the type that I don't need to attend. I said REALLY? And can you tell me exactly how they perform an exam without the patient being present?? And this person tells me they use the records they have from the VA??? I told him that was going to be the shortest exam in VA history considering I only go to one area of the VA for a class which wouldn't help in any way with my current claims, so honestly EXACTLY WHAT INFORMATION and who is giving this MEDICAL information that supposedly has anything to do with me and any of the claims I have open at this time? This person said they didn't know and that these exams are a normal part of all claims????
WELL I don't know about anyone else on this site. But I certainly find that rather STRANGE that a Veteran can have a C&P exam done with out being physically present??? I also want to know EXACTLY the who, what, when and where of any medical information that was obtained Thursday morning and EXACTLY how it is to be used as far as any open claim I have at this time with the VA?
Sort of Long
I joined the United States Marine Corps Reserve in July of 1986, and received an honorable discharge in July of 1994. For approximately 45 days in early October of 1986 until late November of 1986, I was stationed at Camp Lejeune, NC with the Warehouse Unit (3051) for training (ACDUTRA).
Several years after my separation from service in approximately 1993, I really began to experience the effects of consuming the contaminated water at Camp Lejeune. My mood changed drastically and I began to have major panic attacks. At one point in 1995 I was even taken by ambulance to the hospital for shortness of breath and the fear that I was having a massive heart attack. During this same year, I was formally diagnosed with suffering from Bipolar Disorder and Manic Depression. The strange thing about it is that I have never suffered from any psychological issues prior to my service at Camp Lejeune and do not have a family history of any psychiatric disorders. Over the next nineteen years, I took medication and occasional psychotherapy for my psychiatric condition. In spite of this my condition never really improved to the point that I felt normal.
Since approximately 1992, I have had literally dozens of jobs. This is true, because my psychiatric condition makes it nearly impossible to hold down a job for any considerable amount of time. I have real trouble concentrating and focusing on things for long periods of time. Due to my educational background, I have been afforded some really good and high paying jobs like the Social Security Administration and school teaching. However, because of my lack of ability to focus, I am unable to sustain meaningful employment for more than a few months at a time. The stress of the workload and my inability to handle authority make it very difficult to remain on any job for very long; as a result, I ultimately quit. I reason that I can do better working alone and for myself and that I’ll earn a lot more working for myself, but that never seems to manifest either. I would say that most of my family members and close friends believe that there is seriously something wrong with me. I have been out of work for a year and a half and drive for Uber from time to time to earn money for gas and auto insurance.
I prefer to spend most of my time alone and have pretty much cut off all contact with friends. I no longer have good health insurance like I did when I was married. Since it is difficult for me to maintain employment, I don’t have regular insurance coverage. As a result, I have not the taken much needed psychiatric medication for approximately four years. Consequently, my alcohol consumption has increased greatly and I weigh more than I ever have in my life.
In my heart of hearts, I truly believe that my condition is the direct result of my exposure to the contaminated water that I consumed while at Camp Lejeune, NC. According to the EPA, the levels of PCE, TCE and other chemicals at Camp Lejeune were at least 1000 times higher than normal. Apparently the Marine Corps was aware of this situation and did nothing to correct it. Hundreds of thousands of Marines and their families have been victimized by this situation.
In 2012, President Obama signed into law the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (P.L. 112-154), which guarantees those veterans who served at Camp Lejeune from 1953 to 1987 for a minimum of 30 days and suffer from any of fifteen identified conditions, free treatment through the VA. I content that I suffer from Neurobehavioral Effects, which is one of the identified conditions. Depression falls within the realm of Neurobehavioral Effects.
Perhaps there is a “light at the end of this long tunnel,” because, a Veterans Law Judge, in his appeal letter stated that my service record confirms that I was stationed at Camp Lejeune for training, which falls within the range of subjects identified as potentially exposed to VOCs during my service and that my VA treatment record shows that I have a history of depression and that I have received treatment from the VA for such. Aside from this I also show a history of being treated for years by outside psychiatrist. As a result, I will be afforded the elusive P&C examination as part of my case; I am finally going to receive the due process that I deserve.
I keep getting denied! What would you do?
I had an interesting and bewildering C&P exam with a Dr. covering three items of evaluation; lower extremity varicose veins, piriformis syndrome (left hip), and lumbar condition with herniation (for a disc bulging 5 mm to the left at L4-L5).
Here is about how it went…
Firstly, I had filled out the summarized history questions for each of the three items. The papers I had diligently filled out simply laid on his desk the entire exam though, and he simply asked me questions as he went through his DBQs. I was very well versed in my medical record and could tell him the brief history (or development) of each condition (along with my medications) in a quick, concise fashion. He was reasonably personable, and he seemed to be pretty pleased with my being quick and to the point (it was towards the end of the day and he was delayed in getting to me). And he seemed to whip through the DBQs with speed. He did inspect my legs for varicose veins (which are really obvious). I was surprised that he didn’t ask if I had aching and fatigue in my legs after prolonged standing or walking or if the compression hosiery I was wearing was helping. He could have found out the answers to those questions if he had read the packet I filled out (he didn’t bother to read that it seemed, nor did I get sense that he read my medical record). I had to specifically say that I had aching while standing for long periods of time, and I didn’t realize I had varicose veins for years until recently. I think he should have asked me that when filling out the Artery & Vein Conditions DBQ at 3B. And I hope he filled that part out…
I also explained how I had hip/low back issues after some long runs and landing weirdly on my left leg while playing volleyball. He had me walk (which is in my case limp, barely putting my left foot forward to step) to the office door and back to see my gait. He had me try to lean backwards, forwards, side-to-side, and twist. I could do all pretty well except the leaning forward to touch toes. I could only lean forward maybe 15-20 degrees. I glanced at his notes, and they almost all looked like they said 30 degrees (normal) except I don’t know what he put for forward flexion (I saw nothing but 30 degrees on the sheet, and I don’t know if he put something down later to give an accurate reflection of my forward flexion). I’m wondering about this because the Back (Thoracolumbar spine) conditions DBQ specifically says in Section III (before 3A) to “Measure ROM with a goniometer.” In fact it says 3 repetitions of ROM (at a minimum) are needed. I only did forward flexion twice, and that was because the first time I leaned over he didn’t seem to like it that I couldn’t lean down very far, and so he stood up and showed me how to lean down to touch one’s toes to demonstrate what he was looking for from me. Again I leaned down about as far as I could without pain (which was not much). I don’t know what he wrote down, and I never saw a goniometer once in the exam. Should he have used a goniometer?
He didn’t examine me at all, as in seating me on the table, having me attempt to perform straight leg raise tests (which is required at step 12) or palpating for tenderness, etc. It was most like a reporter’s interview (aside from him observing me having trouble touching my toes and him encouraging me to try to do it). One thing he did do that I thought was indeed good was to run a pointy object up and down my legs while I was seated. Interestingly, I had slightly less sensation on the left leg, and I told him this.
He also didn’t test my hip flexion, or ankle flexion/dorsiflexion, great toe extension, etc, which is required per the DBQ at step 8A. That seems like that would have been a pertinent thing to assess, especially after observing how small of a step I took with my left foot while demonstrating walking for him. And he was supposed to test for piriformis syndrome (left hip) during this exam, and I even told him that just last week I was also diagnosed by the VA Pain Mgt clinic with IT band syndrome of the left hip for my tension and pain along the outside of the left hip. I have no idea what he put for ROM for my left hip...
He got to the end of the last DBQ form that he whipped through (after skipping what I think are essential parts), and then he finished the exam abruptly saying, “Well, that’s it. That’s all. We are done.” When I asked if there was anything else, he was like “No. That’ll do.”
At the end of the exam, he seem to notice the envelope full of the papers I had filled out along with my medication list I had diligently prepared. He was like, “What’s this”? I was like, “That is for you, which my medication list and everything.” He acted like “Oh,” and seemed to grab it and take it somewhere. I wonder what he did if anything with that. He seemed to be completely done with me at that point.
How can I get record of his notes and when might they become available?
Is this super relaxed approach, and skipping through what I think are required sections normal? Is this anything like how a C&P exam should go?
Is this lack of use of an accurate measuring device going to lend itself to an accurate rating? Should I document that he did not use any accurate measuring device and have my own physician measure my ROM with a goniometer (or would that come later with a VA attorney after the VA denies my claim)?
What just happened? Was I supposed to be somehow more demanding during the exam, and if so how could I have done so appropriately?
Any advice appreciated!
Hey all, would love your feedback...
....I wrote 3 posts giving 10 Tips on getting ready for a C&P Exam.
Here's Post #1: 10 Tips to Help You Keep the C&P Exam in Perspective.
Here's Post #2: Dealing with the C&P Exmainer.
Here's Post #3: Paint a Picture when Talking to the Doctor.
Would love to hear from ya'll....tell me what I missed, where I can do better or give more info....
.....I'm writing another Field Manual for the Veterans Law Blog called the "C&P Exam Field Manual", and I'd like to address as many of your concerns, fears, needs, etc., as possible, to make it the best resource available.
Read the posts, and comment here or directly on the post page on the Veterans Law Blog.
Chris (Veterans Law Blog)
I have submitted a couple of secondary conditions (nerve damage, depression) for my S/C DJD. I expected the VA to reopen the original DJD even though I didn't request an increase. However, I do not understand why they reopened my original claims for hearing loss and hips that were denied right after I got out of service 11 years ago. Is this normal, are they messing with me or am I completely missing something.
I would like to pass along info i learned about the VA OPC in Manila. First some general info i had my first C and P Exam for my first time FDC claim.
Phone number for appointment C and P 02318-8358 or 02-318-8308 to cancel appointment call 02-318-8309 48 hours before or ASAP. toll free number 1-800-1888-8782.You must have an appointment to be seen.You will not get in period outherwise.
Travel benifits are POV travel is at 41.5 cent a mile (1KM is 0.62 miles or 1 mile =1.62 KM) Lodging limited to $30 USD.Meals are $3.00 breakfast $5.00 for Lunch and $5.00 for Dinner. Total of $13.00 a day. Must have receipts for all above items. You will be paid in Peso at the daily rate for that day ie the day you filed your claim.
I had 3 days of C and P exams all days were filled checked in at 0745 left at 4 PM each day. I have to go back next week to Manila i have appointments at Sto tomas university hospital and the VA OPC any one ever been to Sto Tomas any places to eat close by.
The VA staff were great i had no issues at all. Not one single problem. i have heard the stories from friends who deal with QTC contracters in the U.S some good some not so mush. I filed my claim 30Sept 2013 C&P exams in late Nov and early DEC is very fast i know for a fact from friends of mine it is 6 to 9 months waiting on a C&P exam . not in Manila. Myself finish mine in a little over 2 months very good time.
The only problem i had in manila were the Taxi cabs not wanting to use the meter and use bond rate only. I got out off over half the cabs in Manila due to this. 500 pesos from the Airport to the VA i got out of the cab right away. There has to be something said about the lack of honesty of half the white Taxi Cab Drivers in Manila it is a shame when half the taxi cab drivers try to steal from people by trying to charge 500 peso for a 100 peso ride. The white taxi cab drivers that use the meter i thanked them for there honesty. Yes i did this is what needed to be done. I used the white cabs only. Half the taxi cabs do not like it when you take a picture of there plates next time i will take a pic of them and if they try to rip me off put it on face book an see what happens.
I just finished up my C&P exams with the Manila OPC had to go to St Tomas for 5 tests from my last C&P exams in late Nov. The staff at St tomas(STU) was great billing just stamped my loa no questions no problems. The staff that did my test were very knowlageable and professional at all times. There english was spot on no comms problems at all. My thinking on it is that if the VA uses St Tomas why cant tricare and the VA approve hospitals that can be certifed by both VA and tricare oh yea i got in trouble just one time (not realy) in the Navy for common sences thinking that would save time and money of the U.S taxpayer.
The only downside is the Manila OPC WILL NOT SEE YOU UNLESS IT IS SC/ Or C&P Exam NO IF ANDS OR BUTS ABOUT IT.
I was just thinking it is not the VA that is bad at some places it is some people that give
. the VA a bad name you will always hear about the bad ones but the Great and Good not so mush. so that is why i posted this.
I have a copy of my mental health C&P exam FINALLY and the diagnoses is as follows;
296.33 Major Depressive Disorder, Recurrent, Severe without psychotic features.
Remote Memory: Normal
Recent Memory: Mildly Impaired
Immediate Memory: Mildly Impaired
MMPI-2 was administered - It is noteworthy for extreme elevations on scales 1, 2, and 3. This pattern is often referred to as "conversion V" referring to the tendency of the individual to "convert" psychological disturbances into a preoccupation with physical functioning (huh?), to a degree which exceeds what might be a normal focus in the possible presence of very significant medical issues.
In addition to the significant elevation on scale 2 (depression scale), this profile reveals the presence of a sorely depleted reservoir of emotional energy (Man, that sure is true). This scale configuration is associated with a diagnosis of a major depressive disorder. This configuration also indicates the presence of disturbed, ruminative thought processes, as well as vulnerability to excessive use of alcohol. Individuals producing this profile acknowledge that life is a strain, and admit to feelings of depression and despair. They report difficulties with concentration and memory (absolutely) and acknowledge that they worry excessively...
Comment on validity of results: Valid.
GAF score: 53.
Is there total occupational and social impairment due to mental disorder signs and symptoms? No.
If there is not total occupational and social impairment, do mental disorder signs and symptoms result in deficiencies in the following areas; Judgment, thinking, family relations, work, mood or school? No. (SERIOUSLY???)
Is there reduced reliability and productivity due to mental disorder symptoms? Yes.
Examples and pertinent symptoms: The service member is vulnerable to impairments of attention, concentration and short-term memory. He is frequently preoccupied with disturbed, ruminative thought processes. His preoccupation with physical symptoms and concern about his future fuel his depressed mood.
Does the patient have panic attacks? Yes.
Frequency, severity, duration and effects of functioning; The patient reports periodic panic attacks. More than once per week.
Is there presence of suicidal thoughts? Yes.
Attention: Attention disturbance (Easily distracted), attention disturbance (Short attention span).
Based on the VASRD, I'm not sure if this means a rating of 30% or 50%. Any feedback or questions are welcome. Thanks in advance for your help.
I finally got a copy of my C&P exam and I am trying to interpret the results. I'm hoping to get some help understanding what I'm looking at so any and all feedback is appreciated. The ROM results are as follows;
Cervical Spine ROM
Flexion: 0 to 30 degrees.
Extension: 0 to 39 degrees.
Left Lateral Flexion: 0 to 30 degrees.
Left Lateral Rotation: 0 to 60 degrees.
Right Lateral Flexion: 0 to 30 degrees.
Right Lateral Rotation: 0 to 60 degrees.
Is there objective evidence of pain on active ROM? No.
Additional limitation with repetitive motion; Is there objective evidence of pain following repetitive motion? No. Are there additional limitations after three repetitions of range of motion? No.
Thoracolumbar Spine ROM
Flexion: 0 to 60 degrees.
Extension: 0 to 20 degrees.
Left Lateral Flexion: 0 to 20 degrees.
Left Lateral Rotation: 0 to 20 degrees.
Right Lateral Flexion: 0 to 25 degrees.
Right Lateral Rotation: 0 to 20 degrees.
Is there objective evidence of pain on active ROM? Yes.
Additional limitation with repetitive motion; Is there objective evidence of pain following repetitive motion? Yes. Are there additional limitations after three repetitions of range of motion? Yes.
What is the most important factor? Pain.
ROM After Repetitive Motion
Flexion: 0 to 55 degrees.
Extension: 0 to 25 degrees.
Left Lateral Flexion: 0 to 15 degrees.
Left Lateral Rotation: 0 to 5 degrees.
Right Lateral Flexion: 0 to 20 degrees.
Right Lateral Rotation: 0 to 5 degrees.
Time lost from work during last 12-month period: 8 weeks.
Cause: Con leave from back surgery.
I didn't type every last word, I just wrote what I think matters. If I missed something or you have a question, please ask.
The information regarding my cervical spine seems correct as I haven't had any issues with that part of my back until just recently. I'm getting epidural shots now and may need another surgery but that occurred after the C&P exam.
If I'm reading the Thoracolumbar part correct, it seems that I should get a rating of 20% based on the Flexion ROM of 55 degrees or would it be; "Unfavorable ankylosis of the entire thoracolumbar spine......50?" But, since I had spinal fusion of T7-T8, I should get 60% because I missed 8 weeks of work and the VASRD states; "With incapacitating episodes having a total duration of at least 6 weeks during the past 12 months ..... 60"
It seems quite confusing to me, I hope someone can clear things up for me...thanks.
e-Benefits Status Messages
Claims Process – Your claim can go from any step to back a step depending on the specifics of the claim, so you may go from Pending Decision Approval back to Review of Evidence. Ebenefits status is helpful but not definitive. Continue Reading
68mustang posted a question in VA Disability Compensation Benefits Claims Research Forum,I was rated at 10% for tinnitus last year by the VA. I went to my private doctor yesterday and I described to him the problems that I have been having with my sense of balance. Any sudden movement of my head or movement while sitting in my desk chair causes me to lose my balance and become nauseous. Also when seeing TV if there are certain scenes,such as movement across or up and down the screen my balance is affected. The doctor said that what is causing the problem is Meniere's Disease. Does any know if this could be secondary to tinnitus and if it would be rated separately from the tinnitus? If I am already rated at 10% for tinnitus and I could filed for Meniere's does any one know what it might be rated at? Thanks for your help. 68mustang
GlennieHB posted an answer to a question,I have a 30% hearing loss and 10% Tinnitus rating since 5/17. I have Meniere's Syndrome which was diagnosed by a VA facility in 2010 yet I never thought to include this in my quest for a rating. Meniere's is very debilitating for me, but I have not made any noise about it because I could lose my license to drive. I am thinking of applying for additional compensation as I am unable to work at any meaningful employment as I cannot communicate effectively because of my hearing and comprehension difficulties. I don't know whether to file for a TDUI, or just ask for additional compensation. My county Veterans service contact who helped me get my current rating has been totally useless on this when I asked her for help. Does anyone know which forms I should use? There are so many different directions to proceed on this that I am confused. Any help would be appreciated. Vietnam Vet 64-67.
If you are new to hadit and have DIC questions it would help us tremendously if you can answer the following questions right away in your first post.
What was the Primary Cause of Death (# 1) as listed on your spouse’s death certificate?
What,if anything, was listed as a contributing cause under # 2?
Was an autopsy done and if so do you have a complete copy of it?
It can be obtained through the Medical Examiner’s office in your locale.
What was the deceased veteran service connected for in his/her lifetime?
Did they have a claim pending at death and if so what for?
If they died from anything on the Agent Orange Presumptive list ( available here under a search) when did they serve and where? If outside of Vietnam, what was their MOS and also if they served onboard a ship in the South Pacific what ship were they on and when? Also did they have any major physical contact with C 123s during the Vietnam War?
And how soon after their death was the DIC form filed…if filed within one year of death, the date of death will be the EED for DIC and also satisfy the accrued regulation criteria.