Shrink Say She Will Get A Veteran A C&p Only If He

[Hoppy]

As many of you are aware I was trained in industrial injury claims. No competent attorney would take a case to court with one medical exam from the employer’s doctor or agree in advance to base the entire claim on a report written by a doctor chosen at random without even giving any consideration to the logic or reasons cited by the examiner.

The RO has told the veteran that to re-open his claim he needs to get new and material evidence. The veteran then goes to his VA shrink. The shrink has not been cooperative and now is trying to blackmail the veteran into agreeing to lock himself into a C&P examiners determination in exchange for her effort to get him a C&P exam.

I really think that this shrink is trying to stop this veteran from getting involved in a long drawn out battle because she thinks that the battle is compounding his condition. I cannot argue that this is not true. We all know how frustrating a battle with the VA can get.

I do not think this shrink realizes how messed up the C&P exams can get. Additionally, what this shrink does not realize is that we never intended to depend on the C&P process to begin with. Trying to get a C&P was plan “B” from the get go. Plan “A” is to get an IMO.

Getting an IMO from a doctor chosen at random is also a problem. I have been of the opinion that industrial injury and Social Security attorney’s work closely with doctors who are favorable to the plaintiff. These lawyers only get paid when they win. They are not going to send their claimants to see doctors who write reports favorable for the defense. I have actually sat in the offices of attorney’s that were on the phone telling doctors what the reports need to address.

I recently talked with a social security attorney who has agreed to refer me to his doctors. I will keep hadit posted on how this goes. If this works out then I would suggest that people seeking IMO’s get referrals from a SSD attorney. Choosing doctors at random can be problematic.

[LarryJ]

What Sharon says, is, obviously, correct.

And, even if the psych doc COULD influence the RO to get this vet a C&P, then him having agreed to accept what the C&P examiner said, does not necessarily indicate what the RATER will have to say, nor does it become a matter of legal record that he DID agree to accept what the C&P turned up.

Me thinks that the psych doc is full of BS.........but, of course, that's just my opinion and not necessarily that of the management of this station.....

[ruby]

Ruby,

I agree, I had no problem with some VA doctors. Using the VA is hit and mis at best. Doctors can have a bias like anybody else.

Hoppy,

right now I hate the VA system, really bad for several reasons, most of my doctors are very good but there have been a couple of depts that I have gone off on due to thier uncompassionate and bias treatment with certain types of Vets.

If it were me right now I would say OK, I'll do it. Then if they denied I would say sorry I have to fight this.- Your nuts right and you have the right to change your mind thats part of PTSD.

I believe what she is going to do is write notes that would possibly be new and material evidence and then you would file based on this new information--Take it and run. Don't get hung up on what deal your making, there is nothing she/he can do if you change your mind. I would hope you win this time.

I would also get a IMO in this case along with her statement. Hoppy pm me for additional info on some information that I can't say online.

When I had my C&P the doc said there are 3 other levels my claim will go to before approval, even if she writes a good C&P it can be denied at any level.

I haven't found out if they approved my PTSD claim-I really don't care other then my stressor is verifable and it will piss me off if they deny but I don't care what they think, there are more ways to skin a cat then they could imagine. I am really pissed at the VA.

[Hoppy]

Sharon,

Your input is much appreciated. As I stated the RO is requiring new and material to re-open. The same clinician originally decided to write a statement asking the RO to give him a C&P without even reading the SMR. I wrote the clinician and told her that unless she could direct me to a documented record of a clinician obtaining a C&P by writing such a letter I felt her actions would do nothing other than delay the processing of this claim. We found another doctor in the VAMC who forced her to read the SMR.

After she read the SMR I asked her to write a statement that based on her review of the SMR that due to the fact that a military psychiatrists had diagnosed the veterans breathing condition as the result of a psychiatric condition that there was a reasonable possibility that a DSM IV diagnosis could be developed by a C&P examiner. This is a very low evidentiary standard. It is the standard that would re-open the claim.

The veteran told me today that she has refused this request because she was of the opinion that he was pre-disposed to develop the condition prior to service. She says she will write a note to give to compensation and pension. I have not asked her to write notes asking for a C&P. I asked that she provide a medical opinion. It will be interesting to see what she comes up with next.

The same clinician has diagnosed the veteran with panic disorder. Panic disorder is an AXIS I condition in the DSM IV. This clinician is was off base. I did not ask her to address etiology of the condition. She is offering adversarial disputes based on her misconception of the requirements of adjudication.

This clinician is not only trying to establish an adversarial position they are doing so by going outside the DSM IV. Her argument is not that this veteran should not be service connected. Her argument is that the VA should not service connect any panic disorder that has a likelihood of developing due to a predisposition. I really doubt she is aware of the evidentiary standard required by presumption of soundness.

To understand how adversarial this clinician has become it requires an understanding of how panic disorder is diagnosed. There are many "theoretical" etiologies for panic disorder. Theoretical diagnostic criteria were disallowed with the publication of the DSM III. The DSM II and the psychodynamic diagnostic criteria was so flawed that the DSM III required that clinicians base there diagnoses on a medical model. The medical model abandoned theoretical and etiological consideration when making a diagnosis. This case becomes very simple under the medical model. This veteran meets the diagnostic criteria under a medical model for making a diagnosis. I will have no problem getting a favorable IMO. Additionally, panic disorder is considered a chronic condition that can re-occur at any time even if it initially responded to treatment. It is just a question of how much this veteran will have to pay out of his pocket to overcome a complete screw up by the RO and this clinician. The veteran lives in his van on SSI.

There are 60,000 cases involving panic disorder on the BVA's website. I have found numerous cases awarded on one tenth of the evidence this veteran has in his SMR. The problem is compounded by the fact that the RO is refusing to schedule C&P's because he previously filed a claim for PTSD that was abandoned. We notified the RO that this is a different claim and requested a C&P. However, they cited the original PTSD claim that was denied without the veteran submitting any evidence. They are not asking for a post service diagnosis. They are asking for evidence that the condition he had in the military was a chronic condition. They stated that the SMR does not support a chronic condition. The SMR was written prior to the addition of panic disorder to the DSM.

I really doubt that an adjudicator can read the SMR and make a reliable determination that the symptoms noted represent an acute condition rather than a chronic condition. This SMR needs to be reviewed by a clinician who will stick to the diagnostic criteria of the DSM IV and fully address any issues as to pre-service pre-dispositions. I am rather certain I can cause the VA to schedule C&P's on appeal. However, I was hoping to find a VA doctor who would become proactive for this veteran. I have seen claims won in short periods of time without lengthily appeals just because one doctor became proactive for the veteran.

Larry,

Me thinks you a are right.