C & P Tomorrow Conducted By An N.p.

[vaf]

My husband has a complicated health history, he's currently rated at 100% schedular, effective August 2003. The C & P tomorrow is related to remands that have been pending for several years, right now at the Board as a result of a joint remand from the Court. They are for endocrine disorders currently rated at 60% and for spine (cervical and lumbar), currently rated at 20% and 40%, respectively. We appealed for EED's back to the initial date of application, that being August 1993.

I'm unsure as to what good a current-day C & P will do to address the basis of these two particular remands.

I am very concerned about this. The N.P. reports to the non-board certified, full-time VA doc in Internal Medicine who conducted my husband's last C & P in 2003 -- she fabricated statements he didn't make and wrote other assorted fiction. Obviously, neither is an endocrinologist or orthopaedic M.D. specialist. Also, what if the claims file isn't there, if it's still at the Board?

Is this perfectly legal and in compliance with the regs?

[Berta]

The whole file should have been remanded back with the claim from the BVA.

It would help you to access the actual blank C & Ps they are doing:

http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

I think the cervical lumbar C & P changed since his last decision- not sure-

if it did and the change is more favorable to him the VA would have to consider that.

PS- this is the one you need and it did change November , 2003-this is the one they will be giving him now:

http://www.vba.va.gov/bln/21/Benefits/exams/disexm53.htm

Edited January 2, 2008 by Berta

[vaf]

Thank you Berta. I've got the downloads on the applicable and updated C & P guidelines, and I'm hoping that the claims file has reached the VAMC here. If it is not there, however, and keeping in mind the lack of credentials of the examiner in both endocrinology and orthopaedics for a Board ordered C & P, would my husband have adequate grounds to challenge the examination if it does not go in his favor? If so, would they be found in 38 CFR anywhere, or would they be contained in the Clinician's Guide itself? This is really odd, particularly because the only care my husband receives at the VAMC on a regular basis is from his endocrinologist, an excellent one at that, who is not performing the C & P.

[Pete53]

You should verify that they have in their possession the entire "C" File. I feelings are mixed when the VA uses a Nurse Practitioner. Does that mean an IMO from a Nurse Practitioner would carry the same weight?

[Josephine]

You should verify that they have in their possession the entire "C" File. I feelings are mixed when the VA uses a Nurse Practitioner. Does that mean an IMO from a Nurse Practitioner would carry the same weight?

The VA regulations state that a PhD Clinical Psychologist carries the

same weight as a Psychiatrist, but as we can see, in

my claim so far, no way!

Always,

Betty

[Berta]

Yes you can challenge their credentials- but too soon to know if you will need to-

"This is really odd, particularly because the only care my husband receives at the VAMC on a regular basis is from his endocrinologist, an excellent one at that, who is not performing the C & P."

They should give weight to this doctor's clinical record on your husband.You can use his/her notes in the med rec to rebutt anything negative from the C & P.

As well as anything at all that shows he should be rated higher.

It might go OK.

Hard to imagine (but it happens all the time) that a C & P for endocrine problems is not being done by an endocrinologist -

it is like asking a proctologist to do a C & P on Traumatic brain injury. an exam on the wrong end.

[Josephine]

Yes you can challenge their credentials- but too soon to know if you will need to-

"This is really odd, particularly because the only care my husband receives at the VAMC on a regular basis is from his endocrinologist, an excellent one at that, who is not performing the C & P."

They should give weight to this doctor's clinical record on your husband.You can use his/her notes in the med rec to rebutt anything negative from the C & P.

As well as anything at all that shows he should be rated higher.

It might go OK.

Hard to imagine (but it happens all the time) that a C & P for endocrine problems is not being done by an endocrinologist -

it is like asking a proctologist to do a C & P on Traumatic brain injury. an exam on the wrong end.

Berta,

I really liked your comparison. Right on!

Always,

Betty