C&p Exams From Contract Doctors

[Hoppy]

To those concerned folks who have an opinion about QTC exams.

My training as an insurance investigator that specialized in disability compensation claims that were filed under labor law (Workers Compensation) occurred ten years before my battle with the VA. As a result of my training I developed opinions on the subject matter of C&P exams that I started posting on hadit over ten years ago. The focus of my posts was that I thought that any exam that was written by a doctor would favor the party who paid for the exam fee.

The idea that a doctor would favor the party paying the exam fee was the dominating attitude within the workers comp system. As such no plaintiff attorney would ever allow a case to go to court with opinions written only by the employer’s doctors. Even if the opinions appeared to be favorable the attorney would only know if the reports were fully favorable by obtaining an opinion from a doctor who had established a commitment to supporting plaintiffs. This commitment to the plaintiff was so strong that the plaintiff attorneys who I worked with would only get reports from doctors who did plaintiff evaluations only.

We were told in school to choose sides when entering the profession. Either you worked for defense attorneys or plaintiff attorneys. Flip flopping was not recommended. The attorneys who represented me in my workers comp claims did not do defenses. The entire office represented workers only.

When I was at a DRO hearing the DRO told me that he was going to schedule a C&P exam with a contract doctor. My gut reaction was to immediately object and ask for an exam by a VA clinician. I was afraid that the contract doctor might be of the opinion that he needed to write reports that were favorable to the party paying him. I am not saying that the VA has told these doctors to write denials. I am saying that the doctors might have the misconception that they needed to have a VA bias to keep getting referrals.

The VA runs a non adversarial system that has shown over the years that were individuals within the system who were in fact adversarial. As such the DAV and other service organizations were able to get rating procedures changed to protect veterans from maverick adjudicators who had become adversarial. As of yet I have seen no specific steps to protect veterans from what I call “anti-compensation doctors”.

I ran into several of these doctors at VA clinics when advancing my claims for compensation. I interpreted their lack of interest in my claim and their less than factual opinions as adversarial. The fact that I won my claim based on one doctor’s report proved that there were three doctors who were “anti-compensation” doctors who failed to assist me with my claim. I have read many BVA decisions whereby VA C&P examiners who were so bent on denying benefits that the BVA had to explain in their decision that the doctor had over stepped their authority. In one sense this shows that veterans who have the determination to get IMO’s and appeal to the BVA have a chance. However, the VA has the cart before the horse. More needs to be done on the front end to get good C&P reports for the veterans.

There is no question that these “anti-compensation” doctors not only perform C&P exams they work in clinics at the VA hospitals. I have a very wide definition of an “anti-compensation: doctor. An anti-compensation doctor is one who fails to take extraordinary steps to diagnoses and research all avenues available to assist a veteran with a claim. Any doctor who under diagnoses fails to diagnosis or who has otherwise been rebutted or written a single report that was found to be deficient in any level of adjudication within the VA system should be identified on a public board with the specifics of the report made available to any veteran with an active claim for benefits with the VA. The VA seems to think that internal self policing is adequate. I have disagreed for over ten years and have suggested that public releases of information would be necessary to allow veterans to take the steps necessary to protect their interest in VA claims.

In my case, I was able to convince the DRO to schedule the exam with a VA clinician. I would rather take my chances with a doctor who got paid to show up to work whether or not he wrote reports favorable to the VA. As it turned out the C&P exam was written by a VA clinician who had worked at the VA for over twenty years. He was the head of the clinic. I really do not feel he was afraid of losing any pay for writing a report favorable to a veteran. As it turned out it worked in my favor.

The idea of basing a VA compensation claim on a doctor chosen at random by the VA or by a veteran who thinks he found a doctor at a VA clinic who is willing to help makes me want to hurl. The best solution is to have a pool of doctors that is known by the advocates for veterans to write favorable and thorough reports on behalf of the veterans. Good plaintiff attorneys have such a pool.

[Maurice]

My contract C&P Doctors did a great job for me. They wrote the truth and I got what the VARO say I should get..........................

[Hoppy]

jayg,

My point is that anti-compensation doctors can be anywhere in the system. I had three VA clinic doctors refuse to assist. Each had their bogus excuses. Eventually I won my claim with a letter written by the head of immunology at a VA hospital. I never had a C&P exam. From a medical point of view my claim was a slam dunk. The condition I developed in the military has no cure. It took me five years to get a doctor to look at my SMR. The RO refused to schedule a C&P. This all occurred prior to the VCAA at a time when the VA required treating clinic doctors to write nexus letters.

In a secondary claim I also had a treating clinician write reports that were later reviewed by a VA department head who performed the C&P exam that was required by a DRO. Both exams were both favorable. I have helped veterans and read BVA cases where veterans who ran into the types of problems that I ran into with the first three doctor I tried to get involved in my claim.

The problem with the VA is that getting a fair exam is what the plaintiff lawyers would call a crap shoot. Lawyers get really peaved when you refer to a system of justice as a crap shoot. Unfortunately, VA claims have been turned into a crap shoot.

[carlie]

Hoppy,

I agree.

C&P's and claims are both crap shoots,

especially when you factor in VAMC PA's doing C&P's.

jmho,

carlie

[john999]

Out of many VA C&P exams over the years I have received maybe 2 or 3 that were decent. The bulk were inadequate, incompentent or even hostile. It is a crap shoot. You go to the contract doctor and then you get a copy of the exam and get your own IMO. Unless the C&P doctor gives you a very friendly exam get ready to get your own doctor. If you have any serious medical condition and can afford it I would have long standing relationships with my own private doctors. I have been seeing the same psychologist for 30 years and the same shrink for ten years outside the VA. If I need an opinion I got it.

[navydoc2]

Sounds like they (VA) are the ones messing with the Vet. The Vet is just trying to get their due benefits.

Billy

It kinda reminds me of an insurance company who's first response is to deny, look for other things to blame it on, call whatever they can preexisting prior to service, give the lowest benefit when you haveto. hmm come to think of it thats exactly how they act.

[john999]

gruntdaddy

I think you can go in and sign the paperwork to have it sent to you when it is ready. I think it is too soon to get a copy, but who knows?