C & P Med Exam Not By Dr. But Nurse Practitioner

[halos2]

Have any other vets had their medical C & P exams done by nurse practitioners versus Dr.? Mine was and there were so many errors and descripencies in the exam..she lied and I called her up 2x and she said "she didn't write that and they must have gotten records mixed up" yeah sure than why didn't she correct them!

Turned her into pt advocate and found out she was fired from doing C & P exams but moved to an undisclosed area of the hosp to work. FOIA officer said it took her 3 days to find the nurse pract in the hosp and she said "it was in 2005 I don't remember!"

SO I sit and wait for my dear BVA to proceed.

2 medical physician IMO's done but they believe the va's nurse pract. Funny how they did not have all the information I told in my personal hearing about her and the faulty exam on my trancripts! Anything I said about the va exams, providers, etc. were not on the transcript at all.

Have any others had similiar experiences they are fighting with because of non Dr exams? There is so much more I could write but I would like to hear if others have had this occur to them, and their advice or actions that may have helped them in their battle. :P

[SeattleShay]

Sounds like the MD who did my C&P, a FMG (foreign medical grad) who was waiting to take boards, now no longer with VA after flunking their boards.

But........VA said still a "good" C&P cause this clown had graduated from med school. :P

[halos2]

SO we sit and suffer because of their incompetence. Wow what an injustice. It is a shame the VA hires any Dr who graduates any medical school to administer "care"? to vets...no license is required just a diploma that they graducted a medical school.

Why is it vets are treated worse then the general population...other hospitals and clinics make sure the physicians are licensed or licensed pending but overseen by a licensed Dr till they pass their boards but the VA no way.

Why does the VA think substandard care is ok for vets? Don't know the answer but still utalize my independent non physicians too. ;)

Sounds like the MD who did my C&P, a FMG (foreign medical grad) who was waiting to take boards, now no longer with VA after flunking their boards.

But........VA said still a "good" C&P cause this clown had graduated from med school. :P

[jbasser]

Nurse practitioners and Physicians assistants are the Norm Now. They are cheaper than MD's.

On the bright side, They are still medical professionals and can offer opinions as they are licensed to practice medicine.

Some of these people actually know what they are doing. Im sorry your experience turned out negative.

J

[Ricky]

My civilian cardio group uses PA's. Most of them seem to know more than the doc's do. At least they will sit with you and fully discuss your concerns where the doc is wham, bam, pay the lady out front. I don't really want a VA PA or NP doing a C&P on me which is used to outweigh a statement from my neurologist but that is the way the game is played. Even if the NP or PA can't speak neuro the rater, so giblet head off the street that was working as a admin assistant last week thinks they can and will use what ever they write up to out-weigh a 30 year board certified neuor treating doc. So no matter what it is always a no win situation for you.

[allan]

It is a shame the VA hires any Dr who graduates any medical school to administer "care"?

The roots between american Dr's and the VA run deep, since over 60% of them are trained at VA facilities. These training VAMC's are tied to universities where students train on Vets.

They are also tied to research on veterans and the funding that comes with it.

Im generally assigned PA's for primary health care. Most I've had in and out of the Dept of Advocacy have provided good health care.

My first general medical C&P was performed by a NP who spent the last 15 yrs working at the VAMC in drug rehab. I was one of her first C&P's she performed. What a rude and nasty personality. She slammed the door in my wifes face & told her she could not be present. She lied about that I found out later.

She wasn't competant enough to include the results of my spinal radiology/lab reports or provide an opinion. I sent in a letter to the RO pointing this out and requested another C&P be performed.

The VARO rating board ordered another one and had specific questions as to service connection for each issue. This C&P came back fully favorable from their examiner that had all the records before him, adding "I hope this answers the boards questions?"

After recieving this favorable C&P with opinion, the rater set this asside and two months later, ordered an IMO from one of their consultants at a different VAMC stating," couldn't get an opinion from the other VAMC as to service connection. They flat out lied, according to my c-file.

They took am IMO without an examination, over one with.

They took the opinion of a consultant over their own C&P examiner who had been doing this for yrs, & who had all the military records and performed an examination.

What ever it takes to get the denied claim to read like a denied claim on the SOC.

Ask to have another C&P performed by another examiner. They do!

[pakeboy]

I just had a C&P Wednesday and mine was a PA. I also filled out the paperwork so I can get a copy of my C&P. If I get lowballed, I'll ask to get examined by a DR.

[Pete53]

I would ask or demand a C&P by a Medical Doctor. Its a patients right so why not a Veterans?

[yoggie2]

Halos2, I had a Nurse Practitioner do my medical exam (C&P) and it was a train wreck. My wife went with me as well and we both thought at first it was some elses exam it was done so poorly and it was enough to get a denial........

Edited July 12, 2008 by yoggie2 (see edit history)

[Teac]

If I were to recive notice of a pending C/P exam, the first thing I would do is call the examing office and ask if the person doing the exam is a doctor, PA or nurse practitioners. If I am told the person is not a doctor at that moment, I would request another appointment with a qualified doctor. You do not have to subject your self to a exam by anyone who you feel is not qualified to treat your problem. Just because the va regional office has set up the exam does not mean you wavor your rights to be examined by just anyone. If you do reschedle for this reason the va regional office can not legally hold this against you. So exercise your rights and request a doctor, and rechedule the exam. Once we make it known that we will not accept anything less than a qualified doctor the va will stop trying to save money on these exams at the veterans expense, or the va may just stop the exams alltogether and take the words of the attending physicians... again JMHO

[carlie]

VARO & the rater decides who is qualified to do your C&P, only in specific cases such

as a hearing impairment or Psyc are specialist required.

If you try to tell VARO you won't go to a C&P without it being done by a Doctor -

MD or whatever, and you don't show up for the C&P ----

Well you pretty much just insured your own denial.

jmho,

carlie

[Teac]

VARO & the rater decides who is qualified to do your C&P, only in specific cases such

as a hearing impairment or Psyc are specialist required.

If you try to tell VARO you won't go to a C&P without it being done by a Doctor -

MD or whatever, and you don't show up for the C&P ----

Well you pretty much just insured your own denial.

jmho,

carlie

I disagree... been there done that... ask for a doctor and they must provide a doctor...

[carlie]

Claimants don't order C&P's -- rater's order C&P's.

It's in the regs. - that's what we have to work with.

Subpart IV - Chapter 3 -- Examinations --

http://www.warms.vba.va.gov/M21_1MR.html

jmho,

Hope this helps a vet.

carlie

Edited July 12, 2008 by carlie (see edit history)

[MRRRR5]

Carlie, I believe Teac is correct based on the the 2nd Edition by John Roche, which he quotes that it is required by "federal law" that a physician (doctor) performs C&Ps.

He further states that although the VA commonly violates this requirement, it is grounds for an appeal based on a flawed C&P.

[carlie]

Doesn't matter to me who believes what - Regs and Laws are all I have to go by.

Perhaps others will come in with their thoughts.

My thoughts remain:

Raters order C&P's - not claimants.

Raters decide what qualifications are required of a C&P Examiner - not claimants.

As I posted before, there are only a few areas that require Examiner's to be any type of Specialist,

some are Audiology, Neurologist, Mental Health etc...

A NP or PA is allowed to do other C&P Examinations --- a Doc is not required to do most

Examinations -- they only have to sign off on them.

If anyone can find a Rule - Reg - Rating Decision - BVA Case or Court Case

to substantiate a different opinion I would be interested in reading it.

A C&P Examiner provides no medical treatment - just an Examination for Comp & Pension Purposes.

jmho,

carlie

Edited July 12, 2008 by carlie
sp (see edit history)

[MRRRR5]

Carlie,

you make a great point that I failed to consider; doctors actually signing off on the C&P exam. :P

[carlie]

Teac,

Remember -- a C&P Examiner is not there to treat any of your medical problems be it physical or mental.

jmho,

carlie

[Teac]

Teac,

Remember -- a C&P Examiner is not there to treat any of your medical problems be it physical or mental.

jmho,

carlie

You are correct, they do not treat, but by law you still have the legal right to refuse an examination by someone who you do not want to examine you. I have done it twice, and when you request a doctor they must comply.

[carlie]

You are correct, they do not treat, but by law you still have the legal right to refuse an examination by someone who you do not want to examine you. I have done it twice, and when you request a doctor they must comply.

Please post ANY RULR OR REG to substantiate this as I myself would most certainly prefer

to have a LICENSED DOCTOR CONDUCT ALL OF MY C&P Examinations. This could be of great

help to me and MILLIONs of Claimants, so I await your response.

carlie

[yoggie2]

Teac, I'm with you on this one. I will request a Doctor next time and as you stated I believe most of the time they will TREAT you as a patient or as a patient expected to be treated. This nurse practitioner flailed her arms all around and said can you do this? and me and my wife looked at each other like she was crazy.

[carlie]

I just want to read any requirement that shows a Claimant may insist that only a Doctor

may conduct their Comp and Pension Examination and VA must comply. As I feel this would

be most helpful to Millions of Veterans.

WE ALL OF COURSE WANT A DOCTOR - but I really need ANYONE to show me a way that

we can REQUIRE this of VA.

This would make me very happy.

carlie