hypertension Why Imo "is" Being Rejected?

[allan]

Why IMO "is" being rejected?

I had a new PCP assigned recently.

According to my records, a pain level of "1" was entered without asking me what level I was experiencing.

"No pain" was also entered, and the Dr stated, "sustained action opoid medication no longer needed".

He said I would have to get "all" my pain meds from the local Dr from now on & pay for it myself. He commented verbally, that's what happens when you go "outside" the VA for medical opinions & pain medication.

He than accused me of trying to double up on two completely different pain prescrptions, in the same month, by going through two different Dr's at the same time.

He accused me of not notifying the VA I was receiving a VA banned medication,(oxycontin/long lasting_20mg),

and failing to sign a, "release of information" form for my private Dr to get copies of my records & prescriptions. When I told him I keep an up to date hard copy of all my VA med records & faxed what was requested to the private Dr.

His reply was, "vets can alter records to say anything". (Does that sound familiar?) According to him, only VA can send VA medical records to my private Dr.

He states, "thats the only way VA can be sure the records the Dr receives are authentic".

Medical records by this new PCP also state, "patient does not have hypertension or diabetes as previously diagnosed." No medical bases or explanation was given.

The Dr also stated, "patient has no voiding problems and no bowel problems." Than he declined to fill a prescription for guards and said, "the Dr that diagnosed me with MS didn't even examine me."

My voiding problems are currently rated 20%SC for residuals of an inservice testicular mass, epididimitis/orchitis/orchalgia. This has been in effect for over 10 yrs.

He states,"occasional nausea" & refilled the 24X7 prescriptions for meclizine & ducosate.

He also asked if I paid for the IMO, or did the VA. He didn't like it when I said I did.

Betty fought with them for over a week trying to get them to pay for it, but finally gave up & paid for the slow release & the breakthrough pain med herself.

When I left the clinic, I knew I wasn't going back untill I get some medication that will keep me out of jail.

I called mental health at the VA, they said I couldn't get an appointment until I speak with my PCP for a referal.

So I ended up calling the patient advocate & requested a change of Dr's form.

These boneheads have been treating me for MS & chronic pain, since 94' & I've had a solid diagnoses since 2005.

Not sure what their trying to pull, but I bet none of it is legal.

Pure harrassment.

Thanks for alowing me to post this update.

Allan

PS....has the VA stopped treating vets diagnosed with multiple sclerosis by an IMO?

[Testvet]

it use to be illegal to put ANY false information on a government document, military, postal service etc, I am sure there are the same applicable laws for the VA now just find the US Attorney that will prosecute it....thats the hard part

[Josephine]

The only thing that I can do is to make sure that ever shred of medical information is available for the rater, and hope that they take the time to read all of the false information.

Otherwise, I believe that your hands are tied.

Josephine

Edited August 6, 2007 by Josephine

[allan]

Hello folks,

Thanks for all the replies.

>Allan- do you mean he is knocking an MS opinion and diagnosis from my honey? Dr. Bash-?

I have something that can put this guy's underwear in a knot-

I'll follow your advice Berta & send it in. However, I don't see this Dr giving any more weight to it, than he did Dr Bash's diagnoses. Spokane Dr have repeated stated they don't have to reconize any dr's opinion outside of the VA system & it's not likely to change. Their attitude is, they do what they want.

My PCP is at the new clinic in Wenatchee, WA

He is the only Dr there for now, but that is supposed to change this fall.

This Dr demanded copies of the local Dr’s notes, justifying the prescription for long lasting Oxycontin. That took several days to be done.

Than, when we stopped by the clinic after providing what he “demanded”, the clinic staff said the Dr added that we had to produce all the prescription records including costs, from all the private pharmacies we have gotten the medications filled at, over the last 90 days.

We were lucky it was only two, but it took several more days to produce these records. The Dr said to make another appointment, when we delivered all of this private information at the clinic.

After spending all this time & stress, at this appointment, the Dr said he was not going to prescribe any pain medication & that it is not even legal to get treatment for pain from two different doctors at the same time. The VA Dr said we would have to make the private Dr my primary care provider for pain management or pay for pain management treatment from a “pain clinic”.

We set up an appointment with the local Dr & explained how expensive it was for us to continue paying out of pocket for the monthly appointment, plus the full cost of the pain prescription. Around $300 a month, on a $1200 a month total income. I said VA should be paying for all of this & asked him to prescribe a different pain medication, because the VA Dr said long acting Oxycontin was banned across the country at VA facilities.

I stated, the VA is still my primary care provider & responsible for my pain management & that, I had not released the VA from this responsibility & that all the health issues in my records he claims I no longer have, are pending claim issues before the BVA. I was not aware I had previous diagnoses for diabetes. The VA has not treated me for it if I do.

He later told to my daughter,(who is still furious at me for loosing control) that he moved to Wenatchee to make a change for Veterans.

I totally lost control & than left the building before those nice security folks showed up & offered to say good by to me.......off the property................again.

My daughter came out to the car about 15 min later. Shaking & screaming at me, she said; “don’t say a word! Just sign this *%^$*&^)thing.

Betty & my daughter, both broke down over this later. It took a few days to get them to talk to me. Both are very angry with me for not being silent, while this guys acts like the new show in town.

I am not going to stand by and be silent, or let another vet to be harassed.

Everyone in that little clinic, (with no one else ever in the waiting room, waiting for an appointment when I show up), heard what was said.

After listening to this crap & pleading with him, he was generous enough to tell her he would consider filling the prescriptions next month, since we have already paid for them this month.

After getting my family to dance to his tune for a few weeks & beg for my care, he is going to consider prescribing something next month.

That certainly is his choice.

News story?

It already has been.

This Dr asked me to be in a news article on my first appointment with him, when the clinic opened back on 13 June 2007.

He had the media with cameras ready in the waiting room when I showed up for the appointment.

The Dr did not want me talking to the reporter. He said we needed to focus on health care, & the family was already giving me the hand signal for cut it out, so I let it drop. Although, I think the look on the Betty’s face could have meant something else.

The reporter said they been there for some time & I was the third vet through the first day of the new clinic. The reporter said he was hoping to take a photo inside the clinic with a Veteran, but the others had declined.

I was front page in the Wenatchee World news, on 14 June 2007.

I sure would like to send a hard enough message to VA health care staff in Washington state, to put a stop to harrasing vets that get IMO's from Dr Bash. In order to do that, It will take something to make an impression strong to stop a common practice by VA staff.

Allan

PS…. I tried to get an appointment at mental health in Spokane. Mental health said I could call & make an appointment anytime when they saw me for MS, brain injury & PTSD a couple yrs ago. However, when I called Friday, they said I would have to pay my own way to Spokane as a walk in or see Dr Ray again & ask him to refer me.

Told them I need something to keep me calm down enough before I could see the clinic Dr again. I have been getting sleep every two or three days.

Allan- do you mean he is knocking an MS opinion and diagnosis from my honey? Dr. Bash-?

If so email me -do you still have my email addy?

I have something that can put this guy's underwear in a knot-

and I agree that contacting the OIG is in order too-

http://www.va.gov/oig/contacts/hotline.asp

I have an idea that might work without calling the IG- but then again- you might want to anyhow.

I will open my PM doo dad for you-

[allan]

Stretch,

>I was very curious about what was going on with you.

A few days before all of this took place, I had divorce papers filled out & ready to sign. So things arn't doing that good. My bodys been having trouble adjusting from oxycontin, back to morphine. The wife has put more distance between us over screwing up two weeks of trying to get me set up in this new clinic. Both daughters are completely discusted with me.

I'm staying to myself & taking it one day at a time.

[Berta]

Allan-there are many issues here-

"sure would like to send a hard enough message to VA health care staff in Washington state, to put a stop to harrasing vets that get IMO's from Dr Bash. In order to do that, It will take something to make an impression strong to stop a common practice by VA staff"

You would want that to go directly to Deputy Secretary Gordon Mansfield and send a copy to the General Counsel-VA-

But I am confused however by the IMO and what it would even have to do with this doctor-

in any event something just stood out to me very vividly:

"I was not aware I had previous diagnoses for diabetes. The VA has not treated me for it if I do."

I watched a glorious sunset last night.The man who should be here with me enjoying this beautiful environment I live in is dead due to exactly what you just stated.

If your medical records show diabetes and the VA has not treated it, and it is at a ratable level,you should file a Section 1151 claim.

and even a FTCA claim too- unless the SOL has run out.

Hyperlipidimia, heart disease, strokes, visual disturbances, skin problems, candidiasis ,HBP, PN - the list is endless as to the manifestation of DMII as well as the Glucose readings in the med recs.

In 1997 the ADA changed the DMII glucose criteria.

"A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes"

Also the HBIAC test can show diabetes.

The VA has traditionally consider any glucose readings at 105 and 110-depending on the VAMC- as indicators that show potential of abnormal glucose values.

Unfortunately many vets only get blood work with their glucose levels checked a few times a year if that-after hours of travelling to and waiting around at a VA clinic- and are probably hungry by the time the glucose test is done and it does not accurately reflect how their body system is handling glucose as they have digested their breakfast already-

A VA endocrinologist in my case did an opinion on 3-4 medical records on Rod and -Dr. Bash clearly stated and supported with medical rationale how "medically inaccurate" her report was.

As a Neuroradiologist he was able to assess the MRIs , Xrays, Echos and based his opinion on treating and assessing "thousands" of diabetics and found Rods end organ disease and death was directly due to his "longstanding" and untreated DMII from AO in Nam.

If your records-if there is evidence of diabetes -under ADA guidelines- and VA has not treated you for it- you could have a basis for a Sec 1151 claim.

I can understand anger but action is better-

when we get angry we cannot really think straight-

A good vet rep could assess the Sec 1151 potential if you want to pursue that.

And every VAMC has a medical director who should be sent a complaint in writing as to anything you feel has been inappropriate care by VA.

I took a local vet to the VAMC one day as his wife was fed up with him-

he would manage to create a scene every time he went-

and I too know what it is like when the VA calls in the cops-

he promised me he would not start acting up if I went with him to try to talk to the PT rep about his problem.

But he did and I went over to the pay phone in the clinic lobby and called his wife and told her to come and get him- and I left him there.

You are alienating the very people whose support you need- your family-

it is none of my business but you mentioned all this here-

getting this angry about it all is not going to get anything resolved.

If you do file a complaint - calm down before you write it-

the vet I mentioned - he would write long long letters to our Congressman full of

anger and hate-at the VA-

one letter revealed something interesting-

He told the Congressman he would get angry as soon as he crossed the little bridge into the VA grounds.

that meant to me- he was determined to find something to get mad about before he even got there-

His wife refuses to go there with him anymore and ironically the VA saved his life a few years ago.

We here are all in hyperspace -it is your family right there with you -that can be your best support system, and your rock and comfort zone.

And they are more important than some VA doctor giving you a hard time.

Edited August 6, 2007 by Berta

[Bound4heaven]

Greetings,

I just wanted to share a victory story that might be of some help here. Less then a month ago I had a clinic visit with a nurolgist at the VAMC. After the visit I felt uneasy about this Dr, and so did my wife. He made some comments that were not approporiate. I contacted the records release dept and faxed them a relaese form. I received the clinic notes and just as we thought. This quack entered information that was false and very misleading.

I shot off a personal letter to the Dr in question requesting he correct the information he had entered as I laid it out ABCD. I also sent a letter of complaint to the Patient's Advocate at the VAMC and A letter to the Chief of Staff.

I received a call less then a hour ago from the dr in question acknowledging he has indeed made several mistakes and would be correcting them. Victory!!!!!!!!!!! I believe this Dr would not have done it if it wasn't for my wife being there and my involvenment getting the Patient Advocate & Chief Of Staff Involved.

Don't allow anyone to put false information in your medical file. The informatuion this Dr added would have hurt me on an increase.

The doctor who did your clinic visit needs to be stopped. I would encourage you to send him your concerns and send the same concerns to the patient's advocate and Cheif of Staff of the VAMC you saw this guy at. I will be praying for you. God bless you.

Bound4Heaven