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C&p Exams From Contract Doctors

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Hoppy

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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.

Hoppy

100% for Angioedema with secondary conditions.

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I have an IME scheduled (in Southern Ca, from a doctor) in a couple weeks. When I had my first claim it was approved without any IME at all. That was for 50%. My father got 100% no questions asked and I am much sicker than he was. I will have to pay around $1,000 for an IME. This doctor wil only take cash, no credit cards) I carry the records in, and the doctor will review up to an inch (I have about 1 foot so I have to assemble a 1" package from those).

Not in appeals, since I got 100%, and some of it was winning an 1151 negligence, which the VA turns out does not give ful benefits if you win 1151 negligence they squirm and legal loophhole you and your family out of many benefits, really crapp nasty bunch running the va benefits, they wil backstab and scre wyou even if you win you lose. May 2021.

01-01-11_My_Medical_Records2.jpg

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I have an IME scheduled (in Southern Ca, from a doctor) in a couple weeks. When I had my first claim it was approved without any IME at all. That was for 50%. My father got 100% no questions asked and I am much sicker than he was. I will have to pay around $1,000 for an IME. This doctor wil only take cash, no credit cards) I carry the records in, and the doctor will review up to an inch (I have about 1 foot so I have to assemble a 1" package from those).

I mean an IMO, not sure if the doctor will do any IME at all, and I don't see how that would help, the doctors at the VA all know me extremely well, but none will write a Nexus letter.

Not in appeals, since I got 100%, and some of it was winning an 1151 negligence, which the VA turns out does not give ful benefits if you win 1151 negligence they squirm and legal loophhole you and your family out of many benefits, really crapp nasty bunch running the va benefits, they wil backstab and scre wyou even if you win you lose. May 2021.

01-01-11_My_Medical_Records2.jpg

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Grunt Daddy

You can go ask, but it may well not be done yet. It depends on how long the examiner takes to "write it up". Some do it right away, while others sometimes have to have their boss read it and approve it.

Go to your VA hospital's Release of Information desk, and they should be able to tell you if it is there or not. If it is there, you should be able to get a printout of the exam right then and there..for free.

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I mean an IMO, not sure if the doctor will do any IME at all, and I don't see how that would help, the doctors at the VA all know me extremely well, but none will write a Nexus letter.
dont know if this will help you but what i did on ime was use my medicare card and found a medicare doctor who before i went to see him said that his imo ime were part of his fee he did not charge extra and that doctor helped me with my VA issues

medicare card i got with ssd works good for me i only go to see him rather than va unless its for c and p and if it is for c and p i bring full ime from him to give to c and p doctor understand this c and p exams are not fair they are a sham to down grade and low ball vets

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Had another C&P exam/farce at a VAMC just yesterday.

For range of motion testing, if the limb didn't move enough to suit, she pushed or pulled, sometimes hard. Twice she brought me up the table with the stabs of pain.

A "crap shoot" implies some degree of possibility of getting somebody decent. That's not too likely in my ao. :angry:

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