diabetes Va Oig Audits

[Berta]

http://www.vawatchdog.org/09/nf09/nfjun09/nf062609-1.htm

I havent digested all this info here at Watchdog yet-

this is one of the Prime reasons there is a backlog.

Not only has VA defied the VCAA of 2000- but this is as you all know- one more way to deliberately deny a claim-to provide a faulty C & P exam.

In BVA remands ther BVA clearly states in English what a C & P exam must contain when they ordered another C & P to be done.

One good way to combat a faulty C & P if due to a BVA emand is to respond to the SOC it generates by using line by line the remand and what the C & P examiner didnt do right.

Sometimes one doesnt need to use medical terms that point out the inaccuracies in a bad C & P- often common sense works too.

I wonder if the OIG knows (I am sure they dont have any records on this) how many vets get IMOs that eventually make their claim succeed- which proves that the C & P results were all wrong.

An IMO doctor is obligated to read your medical records thoroughly.

it is their ethical obligation to consider all of the information they have and base their opinion on it.

This doesnt happen at a C & P-and I see more and more these days at the BVA how C & P exams overlook or ignore pertinent information.

The fact that IMOs can overturn a decision is proof positive that these lousy C & Ps are deliberate yet the vet has to bear the burden of a IMO cost.

This is unfair and an outrage.

If you cannot obtain an IMO you need to attack any lousy C & P line by line.

In my claim their were glucose readings that were taken for my huband in the early morning hours.

These readings were critical to my claim

(undiagnosed and untreated DMII)

yet two C & P examiners questioned the times of the readings-saying they could have been early in the AM or 12 hours later after meals.

My rebuttal to both C & Ps included the fact that the med recs were obviously documented in military time- something that 2 VA physicians had failed to comprehend.

I guess they werent veterans.

They also failed to read enough of the medical records generated when these readings were done to see that my husband had not had any food for weeks ,was totally paralyzed at that time and was on a feeding tube-an obvious common sense point that prevented him from leaving the VAMC to go to the canteen or MC Donalds to get some food and therefore the glucose readings , done around 7 AM over 6 weeks of while he was hospitalized- were far from normal as glucose only raises with food intake ---

unless one has diabetes mellitus.

The BVA got the point.The C & P "experts' didnt have a clue.

You need to have the actual C & P report to combat it- it can be parsed in the SOC.

If an examiner writes a report that ignores probative medical evidence, this is a faulty C & P.

This is why I suggest to always respond to a SOC.

I never went to the BVA in my past claims because I kept arguing with the C & P examiner's statements.

This time I supported my claim and a rebuttal to the final C & P exam by sending my rebuttal directly to the BVA as well as the VARO.

Although I had IMos, the BVA referred to the very first piece of evidence I had sent in 2003 attached to my initial claim that a C & P doc misinterpreted so that VA would deny.

It was the first evidence I found in the medical records that suggested my husband's true medical condition-DMII due to AO.

I also attached as evidence a Medicon Lexicon definition of the medical symbols in that record.

The BVA found this was compelling- yet for 6 years the RO ignored this critical evidence.

which my IMos did not mention.

If the VA had provided me with a competent and unbiased C & P examiner in 2003,this claim could have been awarded years ago.

BTW the examiner was an Endocrinologist-

yet completely ignored the evidence of diabetes in the med recs.

It shows me that even if Rod had lived in spite of their initial malpractices that I had proved-they would have caused his death anyhow.

In my opinion- it is negligence and malpractice when a C & P doctor can deliberately avoid established clinical medicl records to opine on a claim-knowing it will then be denied by the RO.

Is this the same way they clinically treat and medicate veterans?

If the VSO outfits want to have more wins under their belts, they will push for

major changes in the way C & Ps are performed.

But I dont foresee that happening for a long time-

meantime every veteran has to definitely respond to any negative C & P exam-

and if the RO doesnt not react to your response (they used to years ago but forego that now to take their EP code and make it appear they worked the claim and it is set for the BVA-when they really didnt work the claim at all)

then for sure the BVA will take note of your responses to their SOCs if you have provided a common sense and medical argument that rebutts their so called "expert" medical opinions.

If you believe fully that your evidence should award your claim- a costly IMO might be the best investment you ever make- easily absorbed costwise by comp checks you might never see without this IMO.

If the RO deliberately doesnt read the IMO- then for sure the BVA will.

[Josephine]

Berta,

This is oh, so true.

Without my Indpendent Medical Opinion, I would still be loosing my claim

due to a faulty C&P and that darn " Personality Disorder".

Thanks so much

Josephine

[Berta]

I will never forget what you went through Josephine.

What gets me is that most IMO docs certainly end up supporting our claims with the same evidence that we used as claimants.

But the VA is supposed to consider competent lay evidence.

VA did consider all of my competent evidence in the past but only IMOs got me over the hump this time.

I dont think I got dumber in all those years- I have a more profound medical background now then I did then -as to DMII and cardiovascular disease.

VA simply does not seem to care or even read our evidence at all these days-unless we raise hell.

You were right about your claim all along- they should have given you an MD diploma with the Award Letter!

[Josephine]

Berta,

Thanks for the compliment, but the credit goes to you and other members on

this site.

I took all of the knowledge on this site and put it to work.

I am forever grateful for all of you.

Thanks,

Josephine

[john999]

I had a C&P exam for a heart condition secondary to DMII. It was done by a PA. I knew it was BS. I went and looked at what is required testing to do a good C&P for a heart condition. This PA did none of the required testing. She just made guesses based on what I told her. She guessed my METS on the fact I told her I could walk three blocks. I got the necessary testing done and appealed. I went from 0% to 60% on appeal. I think the PA should be in jail.

[Ricky]

I had one for an increased claim on HTN. When I got called back to the intake room the lady told me she had to take my BP three seperate times. The first reading was 258/135, second one was 251/137 and the third one was 259/134. She recorded these and said she had to call the ER cause she was worried about me.

About three mins later the C&P doc called me in. He took my blood pressure one time. When I asked him what it was he said "its a little high". He then asked me acouple of questions about my meds and my private treatment. He then told me that was all and said the ER wanted to see me.

The ER hooked me up to a bunch of stuff and gave me some type of liquid BP med. When they got the BP down to 200/120 they told me to report to my private doc as soon as possible because he needed to adjust or change my meds.

My claim was denied. The rating decison stated that the C&P doc recorded my BP at 110/90, 115/92 and 112/90. Hmmm he only checked it once......

I had and used the intake form and ER findings to beat the claim. So yes you gotta watch those damn C&P guys for they know not what they do!!!! I had the nurse burn me a copy of the intake form that day....glad I did cause for some reason it never made it to my medical records file. That was two years ago and it is still not in there.