Need Some Guidance

[mssoup1]

My husband has several claims in to the VARO. Some remands from the BVA, some new claims as a result of the BVA hearing. He had C & P exams set up for all of these claims and he went to each. One of the C & P exam reports was horrendous. Nothing in the report was at all accurate. Wrote the report based on a condition that my husband does not now have or never has had. What happened to what he was supposed to be writing the report on? We can't figure that out. He also had another C & P exam, by the same examiner, whereby he never even bothered to write up a report at all. During the examination, the examiner really seemed to be speaking in our favor, but that is as far as he got. Never wrote anything up. I did get the results of the inadequate C & P exam and discovered that nothing had been written up on the other exam. I sent this information to the VARO and explained in detail to them why these were inadequate exams and should not be used in deciding his claims. I also told them that we did not want this same examiner to redo the exam. Never heard anything. Called the VAMC and talked with someone affiliated with the Directors office in charge of the C & P examiners. I explained the problem and she told me that I would be contacted back by someone in that office. Never heard anything from them. I wanted to file a complaint against this examiner, as this is not the first time he has done this. Well, after several calls to the VARO during the last few weeks to find out where his claims stood, I then sent an e-mail thinking I would get more information. Well, I did, to a degree. Here is what they had to say:

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Mr. ,

Your remanded appeal is awaiting the processing of your new claims. With one exception, we have received the examination reports for your claimed conditions. The exception is the skin condition. We asked the VAMC for completion of the inadequate examination. They responded that because of your expressed disappointment with the examination, they were asking us to have another VAMC complete the examination. We replied that we had no such authority, that their manual said that this is their responsibility. Their manual says that they must find a facility willing to accept the examination and that you, the veteran, must agree to travel to the other facility. I assume that they will contact you soon on this matter.

Veterans Service Center Manager

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First, I am upset that I never heard back from the Directors office at the VAMC. Think I will call them again tomorrow and tell them that we want an appointment set up to speak with them. Secondly, since my husband just had another complete knee replacement (NSC), he could in no way be sent to another VAMC in an area that would be that far away. He couldn't make the trip. Also, from the response that I received back from the VARO (as I showed above), neither the VARO or the VAMC knows what they are doing. They assume I will be contacted. When? In the next century. Also, there were two inadequate exams, not one, but according to the reply from the VARO, they only spoke of one. How was the other inadequate exam handled? I am so frustrated with this whole system that I could scream. I have been dealing with some of these claims for over 6 years and those are remands back from the BVA back in February 2005.

Questions for the group:

Should I call the VAMC tomorrow and set up an appointment to speak with the Director over the C & P examiners in order to complain about these inadequate exams being done by this examiner and also about the problem my husband would have in making a long distance trip at this time to go to another VAMC for something that should have been able to adequately been done here?

How do I go about finding out what happened to the exam that was written up, but was considered inadequate based on the fact tht the exam was reporting on a condition my husband doesn't have and was not what the C & P exam was set up for?

Should I get the VARO involved with the problem in sending my husband to another VAMC?

Since my husband would not be able to make the long distance trip, how would he be able to get a new examination and would this go against him in any way? It kinda sounded like in the VARO reply to me that my husband would have to agree to travel the distance to another VAMC for an exam.

We have had other claims held up because of this examiner. He is not out to assist the veteran in any way. In fact, I think he does everything he can to help get the claim denied. We have filed other complaints in the past due to the inadequate exams that this examiner is giving. Why is he still employed there?

Any help or assistance on what direction I should take would be geatly appreciated. I am getting more frustrated and worn down as each day goes by. Trying to cope with my husbands needs with his knee replacement, along with his other problems, taking care of everything else by myself, along with my health problems, I don't need all of this on me as well.

Sorry for the ranting, but where else can you go, except HADIT, to be able to do this and everyone understands what you are going through.

Thanks for any help you can give me.

mssoup

[mssoup1]

Berta,

Thanks for the reply. He has been prescribed various meds over time for his PTSD, trying to get the right one which would work for him. I specified what these meds were in the claim letter to the VARO, along with copies of his exam reports showing the med and where his psychiatrist stated that it could cause ED. I highlighted all of this so they would not have to look at the entire report. I got computer printouts showing that those meds can cause ED. His psychiatrist even put in writing in her notes that these meds can cause ED. All of this was sent to the VARO. Even with this information, they requested a C & P exam, which was the one that was inaequate. I took this same information that I had to the C & P exam, but the examiner didn't even want to see or hear about it. He was very adamant about that.

While the C & P examiner did state the current med he is on does cause ED, he stated that he was taking it for a prostrate gland problem whichi he is not service connected for. First of all, he does not have a prostrate gland problem, period. It was prescribed for his PTSD and is documented in his records by his psychiatrist. I don't know where the examiner got the idea that my husband has a prostrate problem to even relate this med to. Since the examiner did state that this med does cause ED and my husband is taking it, I would have thought this in itself should show a nexus between his taking this med and his PTSD. After all, the C & P was to get an opinion on whether or not the meds he was taking for PTSD could cause ED.

At the current time, I don't know where this claim stands. The person from the VAMC who called me yesterday told me she would look into this and call me back. She was not aware of this problem, only the claim for his skin, but she would find out from the VARO where this stood and if they needed another C & P she would get it set up through the Urology Department, but that she would call me back. Again, I did not hear back from her.

This lady from the VAMC who called me used to do C & P exams at our local VAMC. My husband has had her do exams on him before. We have even complained before about the exams she gives. She is one who seems to come up with all of this off the wall stuff that she can to try and write up in an exam report which would result in a denial for the veteran. She is not a doctor. I think she is only a nurse. She would give the exam, then state in the report that the doctor agreed with her opinions. This being the same doctor that we just got through complaining about on these recent exams. These two were the only two that the VAMC had to do general C & P exams and they seemed to work together with one another. Whatever one said, the other seemed to agree.

On his skin exam being inadequate, she stated that she would get with the VAMC and get another C & P exam set up for him ASAP. The VARO had already requested another C & P exam for this, but never mentioned anything about another C & P exam for the inadequate C & P exam for ED.

I think sometimes you could give the VARO the world as evidence and they would find some statement to put in the letter to use as their reason for denial. This is whether the statement made sense or not. Once they send you a denial and it doesn't make sense, the ball is in your court again to rebutt their statement. Anything to prolong the claim.

I have sent them medical reccords to support his claim, SMR records if they applied, computer printouts to clarify the claim, letters from myself, letters from the Vet Center, opinions from IMO's, quoted the code that applied and they will still send a letter of denial based on some ungodly reason that makes no sense at all. It is like they have something in for us and are doing every thing they can to continue to shift the folder from desk to desk to hold his claims up.

We can't seem to win for losing. Again, some of these claims are remands back from the BVA, are over 6 years old and we are 1 year along since the remand was issued back to the VARO.

Talking about being frustrated. These claims should have been decided long ago. Just when we think we are getting to the last leg of the dedision making process, something surfaces out of the blue to hold the claim up and causes me additional work and stress, which I don't need. I just want them to get it right and make a valid decision. My husband cannot assist me with his claims, we have a lousy SO, so I have to handle all of this myself. We cannot change SO's now because we are in the middle of an appeal and I don't think this is a wise move. But, I have always had to take charge of his claims myself because we have never been lucky enough to get an SO that was of any help.

Hope I didn't rant too long, but it does help sometimes to rant to someone else and maybe they can read between my lines I write and give me some advice that I didn't think of. You have been most helpful to me and I really do appreciate all of your time that you have allocated to me. Also, thanks for the link.

Again, thank you for listening and giving me your time and knowlege in helping me.

mssoup