tinnitus New Guy C&p Issues

[mokrors]

On 31 Jan 2007 (prior to my retirement physical) my local VA advocate filed an initial claim with the VA based upon information contained in my service medical records. I then underwent a retirement physical and follow-on medical/specialist consults in Feb 2007; I retired effective 01 Mar 2007. I am now preparing a second claim (amended or new) based upon information from my retirement physical and subsequent consults.

My question(s) come from my experiences during my initial C&Ps; these exams took place over 3 days at the Miami VA Hospital in May 2007. I have yet to recieve VA determination on my initial claim.

1) How do you know you are dealing with a real Medical Doctor or at least someone that is smarter than are you? My "doctors" had nameplates that indicated they were "Doctor X/Y" however, I did not get the impression that they were very knowledgeable in the subject areas that they were evaluating. I am curious as to whether or not the VA is obligated to staff C&P exams with MDs and or appropriate specialists or if they have the right to substitute PA and or Nurse Practitioners.

2) Is the VA responsible for reviewing your service medical records prior to a C&P or is the Veteran supposed to know them in depth and be able to quote them? All three C&P examiners asked me in depth and well dated questions none of which I could answer without looking through my service records (which were in the doctors/examiners possession). I understand that time is money however in my mind it is criminal for the VA to expect a veteran to instantly recall 30 years of service related maladies when the "Doctor" has a 3 inch folder sitting in front of him which details all events. Is there a right/wrong answer/solution to this issue?

3) When one is undergoing VA testing for Gross Hearing Loss and Tinnitus and the Doctor/Audiologist/Specialist asks, "Do you want an appointment for hearing aids?" – How should one reply? Is the proper assumption here that the VA will pick up treatment costs prior to final SC determination or what?

4) When a C&P Doctor/Specialist asks, "Why are you not taking medication for your high blood pressure?" and you have never been officially diagnosed with such problem - "what should you say?" In addition, what should you expect from the VA?

5) Based upon the above can the VA prescribe medications and or fit a veteran with hearing aids prior to the VA determining SC disability? I am still waiting on a SC disability response from the VA based upon my initial claim and subsequent C&P exams (3) before I file my second/amended claim. My second claim will encompass everything observed during my retirement physical and subsequent consults.

All relevant input will be greatly appreciated.

[Berta]

Welcome aboard veteran-Have you received an acknowledgement of your claim as well as a VCAA letter with an Election Notice?1. this question is one many here ask too-I hope these doctors spoke English (not a politically correct statement but many here know what I mean) an also documented fully the C & P results.The blank C & Ps are all here at hadit and these a good to use to make sure they do what they are supposed to do during the exam. For example- only an audiologist can give a hearing exam-of you get a bad C & P from anyone not a "real' doctor, you can challenge it-2. Yes they are supposed to look over your SMRs carefully to establish a basis for their "nexus" statement-whether the disability claimed is more than likely or as likely as not due to your service.I am concerned that the doc mentioned your BP was high and yet not medicated- something to ask your regular doctor about-You can obtain the written C & P results by wriring to the Records Access Officer where the exams were done and request a copy of them. Give them your c file number on the letter and the dates of the exams.If you are in NY- 7 months without a decision is nothing-if you deal with our ROs.

[Guest jangrin]

Mokrors,

Thank you for serving our country, welcome to the Hadit fambly.

In answer to your question, as t whether or not they are allowed to substitute NP's or PA's for doctors at the C&P exams, the answer is, "yes".

The VA ca put whoever they think is qualified to conduct the examination. My husband went to the exam for DMII,CAD,PN,the entire exam was done by a nurse practitioner.

The VA is supposed to be responsible for placing qualified people in positions to do exams such as an MD, or PHD. It would be ideal if the people doing the exam knew the feild or requirements for disability when they did the exam. But I must say, there are many here at Hadit, that have had less than fully informed medical professionals doing their C&P exams. To the point where the VA professional did the exam and rendered an opinion without even having a copy of the Vets medical records. So it seems the VA can do just about what they want to do, after all what is their penalty for not doing it right?

Jangrin

[vaf]

Flawed C & P exams - - my favorite subject. The VA can grab practically anyone with a pulse who they themselves designate as adequately educated and experienced enough to conduct a C & P in any area. This is where the veteran must challenge a C & P exam as flawed when it's obvious the examiner either didn't follow the C & P guidelines, or is obviously ill-prepared by lack of credentials and experience to conduct that exam.

At the VAMC in our area, the VA doesn't even have to tell the veteran where the examiner went to school, or what their credentials are, or in what state they hold those credentials, because the examiner doesn't have to be licensed in the state in which they are working for the VA. Believe me, we've tried. They don't have to tell you whether the examiner is a P.A., an N.P., an R.N. or a doctor, don't have to tell you if they're board certified or anything else. You just have to take their word for it.

I can also tell you, having worked in a hospital with a medical school attached, that I discovered residents conducting C & P exams at the local VA hospital during their rotations there who had let their state medical licenses expire, in some cases for almost a year. The VA didn't discover it, I did, and then was promptly told to keep quiet and just fix the situation.

This is where an independent medical opinion from a board certified physician specializing in the condition being examined comes into play, to counteract the damage that flawed C & P exams create.

When you have undergone what you believe is a flawed exam, you should immediately visit the Patient Advocates office at the VAMC saying so, plus write a letter to the Regional Office in your state that describes why you feel the exam was flawed and asking for another one conducted by a physician who is board certified, and specializes in that field. You may not get one, but at least you've created grounds for an appeal down the road, should your claim not go your way initially.