Gripe With Nurse Practicianers Doing C&p Exams And

[Rockhound]

Now I know why I am of the opinion that NP do not have the experience or training to give professional medical opinions that even at times, a more qualified MD and/or specialist can get wrong when they don't consider, not only all the patients medical history and problems, or compair what they have found to a differential diagnoses as well.

Case in point, the NP is so convinced that my symptoms are so consistant to Allergic Rhinitis and that it is not, in any way related to my SC nasal fracture and deviated septum, that they made no attempt to add that their where other diifferential diagnosis that could and do have the same type of symptoms. Nor do they deem it necessary to give any mention to those NSC problems that I have, that could explain for one or more of these symptoms.

If I take but one of the symptoms, such as the eye symptoms, these same symptoms can be explained away by the fact that I not only have a Autoimmune disease that is know to cause eye problems, an eye problem with dry eys syndrome, and oh yea, I have mild photophoia/sensitivity to light. These problems are not discused or mention away as to how these conditions have no bearing on their opinion that I have Allergic Rhinitis.

Finally, they are so sure of their opinion that felt it was no even necessary to have any test or such to even show what it was that I was allergic to to cause my symptoms, yet the also opinion that I have a history of Sinusits and also Chronic non Allergic Rhinitis, failing to say how either of these conditions can cause the same sympptoms and/or be present at the same time.

Neither of this matters, when my claim deals with how my fracture nasal bone and deviated septom are causing the problems or if not the cause of my present congestion and obstruction problem, they have made my chronic issues significantly worse than what they would normally be in the course of their disease process. It is shown by a differntial diagnoses, that an acquired structural change of the nasal passage, such as would be in the case of a nsal fracture and a deviated septum, cand and does cause these same symptoms of congestion and can make any one of the problems mentioned, worse than they would normally be, such as to make a non chronic nasal condition to become chronic and/or make the symptoms worse.

All this gives rise to my paranoia, that the VA is not their to help us get what is due us, but that they are their for the government, just to save as much money as they possibly same or keep the claims open long enough, in the hopes that we either drop the ball on the claim or die before we can and usually, do get SC in the end, especially those who do have anyone to carry on the claim who would also has a claim in the matter such as a wife and or child.

I'm left with trying to get, yet another IMO, to add to my DRO request and I suspect another year and maybe more time, before I here on it, and even then it would probably still end up being appealed to the BVA.

The longer this goes on, the worse my mental pictue seems to become. I guess its time to think on getting a few days stay at the VA loony ben again, just so when they adjust my medication, I don't have to worry about who or how I am going to manage to take care of myself.

I guess I better go take my meds like a good boy, I was so out of it, I forgot to take them after dinner tonight and I guess it shows. It goes to show how dependant I am on these meds, to at least keep me on a simblance of an even keel.

Good night all and I hope you all have a nice holiday week end,

Rockhound Rider :D B) :o :o

[poolguy11550]

Every state has different laws about such but generally the PA's must be working under a licensed doctor. A good fight against a poor C&P would be to request the supervising doctor to confirm the PA's findings. Hence, its impossible without a re-examination.

A NP and PA both have a license to practice medicine.

[Pete53]

Every state has different laws about such but generally the PA's must be working under a licensed doctor. A good fight against a poor C&P would be to request the supervising doctor to confirm the PA's findings. Hence, its impossible without a re-examination.

Thanks Poolguy glad to see you back.

[rdnkjeeper]

I have had the samethings happen....Just reviewed my last C&P....he murdered the exam.....Like Pete said concentrate on what is wrong with the exam....helping me stay focused!

[darkhorse]

The last exam had that my chronic diarrhea was having a "moderate" effect on my daily functioning. I let her know I was having 3 -4 diarrhea episodes every day with nausea and stomach pain so severe I would be hunched over in pain in the bathroom. I even had to go to the bathroom in the middle of the exam. My VA medical records also backed all this up. Then she puts "moderate." Three to four diarrhea episodes a day with pain and nausea isn't moderate but severe in my opinion. She said my C-file wasn't available for review. This was for an increase. It's VA medical records so has the medical history right there in front of her on the computer. Why wouldn't she have my file anyway. It had been two months this exam had been sheduled. She didn't even want to look at my VA doctors opinion I handed her.

DH

Too often I have heard of VA taking a C&P NP or PA's word over an MD's or a specialist's in an IMO. It's ridiculous.

But really it's moot when they are blatantly falsifying the C&P exam results anyway. A janitor could make the report and what difference would it make? My last exam was a complete farce. Range of motion testing? Push it through and don't stop because I yelled. More than once.

There report went on to:

Say there's no halus valgus on the radiology report... when there is.

Say there's no callosity on the feet... when there is.

Say there's no tenderness of the feet yet I have been diagnosed with plantar fasciitis. Well, that could be argued not to be "tenderness," that's pain! Oh wait. There's none of that either.

Say he began falling because of work in 2008 when I have been falling much longer (fall risk noted in records) and I haven't worked since 2008....

The list goes on, and on, and onnn. I rebutted that C&P with some 30 pages of contradicting records from my medical files that they alleged to have examined. I don't know if a DRO or anybody else will read my rebuttal, but they sure as heck will read that C&P exam report! :P

A janitor, heck! A monkey could have given that report.

I need to go soak my head in a bucket I'm so mad again right now....

[Testvet]

my advice is to get all of the doctors or NPs medical baord records from the state and it lists what their specialties are in my case the VA had used a NP, a radiologist, a regular MD and their regular C&P doctor as "cardiac specialists" to opine that my coronary problmes were not in any way related to my PTSD, I had a board certified pyschiatrist and a Professor at UCLA who wrote an IMO stating he felt my PTSD had either caused or aggravated my cardiac and hypertension and then I had 3 board certified cardiologists IMO's that stated the same thing so when the BVA Judge saw the print outs on the VA experts he was impressed that my homework was so thorough I love openness in government you can find VA doctors listed thru the state boards as well one of their quacks the x ray doc moved from Columbia to Savanah South Carolina listed it all for me their experts are usually NOT experts

[Notorious Kelly]

Good idea to research the docs.

I noticed Social Security doc who denied me is only licensed for "administrative" medical in Oregon.

Further research on the folks who drink our blood might be revealing.