VA primary care will not refer to Rheumatologist or MRI

[seminoles]

I don't think this is a systemic VA problem, I have had the absolute opposite experience.  Request a new PCP.  My podiatrist referred me to the rheumotologist.

[pwrslm]

http://www.healthquality.va.gov/

 

Do some research on your condition, find out what they must do, should do, what the standards of care are and then compare it to what they did.  Clinical guidelines are basic care that your PCP cannot deny to you.

As a provider under Obamacare, the PCP is obligated, just as is any insurance provider would be, to insure that you get competent, and proper evaluations for your existing condition.  If you have no other provider, the VA PACT needs to step up and give you the evidence you need to document your current condition for disability concerns, regardless of if you have submitted a claim to the VBA.  I would go so far as to say that, as a provider under the Affordable Care Act, that they (the VA) would be obligated to do so, just like any non VA provider has an ethical obligation to help their patients seek relief from the SSA for a disability without distorting or omitting any facts whatsoever in their examination report. The idea that a medical professional would refuse to treat and/or provide evidence of his/her patient's disability so that patient (veteran) can seek help is repugnant to the VA's mission. If your PCP declines to assist, you have a right to be referred to another physician capable of doing a competent examination.  

I found that the DBQ's in the VA collections that report on the disabilities are like hives to the PACT, they dont want anything to do with it, even though the VA handbooks covering the topic explicitly state that they are obligated to do it, if they have time.  The Catch 22, they dont have time, because the VA is so severely understaffed, so that goes out the window.

The funny part was that the local VAMC had a walk in clinic for DBQ's for Vets, and nobody in my PACT had a clue that it existed, or if they did, they sure didn't clue me in...

Edited June 10, 2016 by pwrslm

[pwrslm]

 

On 6/8/2016 at 9:19 PM, fiasco2g said:

Is there an official way to do this or just call them up and request one?

You can do this through the patient advocate.

[iceturkee]

my two cents, i have a long history of severe back problems and i also have rheumatoid arthritis. the rheumatoid didn't show up in my bloodwork although, one look at my hands would confirm it. but my sed rate was off the charts. that is an indicator for inflammatory arthritis.

 

as for spine mri's, if your problem only presents as mild arthritis at one disc, no doctor (that i am aware of) is going to order an mri. any ortho worth their salt will tell you everyone has a touch of arthritis in their back, mri's aren't cheap. i had one for my lumbar spine 2 years ago and the report was 3 pages long.

 

i share my experience, not to discourage you. but to let you know what i have been through. i am 40 percent for my back. since my spine is not fused, i can't get 50 percent. i also have a confirmed diagnosis of radiculopathy!!

Edited June 10, 2016 by iceturkee

[63SIERRA]

heres the bottom line,, they lie to you and tell you that you dont meet the criteria, because they dont want to find spine related problems.,.. spine related problems are difficult to treat and rarely improve,. and they can usually be service connected... that is the real reason... I fought for 5 years to get an MRI. Then after I got one the VA  radiologist in temple texas lied and minimized my problems... So I went to a private doctor, had him blind read my mri. then let him see what the VA doc wrote, and he was appauled..... his exact words were,,, your va man doesnt know his ass from a hole in the ground, or he is a liar.

[63SIERRA]

heres the bottom line,, they lie to you and tell you that you dont meet the criteria, because they dont want to find spine related problems.,.. spine related problems are difficult to treat and rarely improve,. and they can usually be service connected... that is the real reason... I fought for 5 years to get an MRI. Then after I got one the VA  radiologist in temple texas lied and minimized my problems... So I went to a private doctor, had him blind read my mri. then let him see what the VA doc wrote, and he was appauled..... his exact words were,,, your va man doesnt know his ass from a hole in the ground, or he is a liar.