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

[dav_marine72]

Hey Delta,

Thanks for your advice below. I had been 70% for some time so dependents are all set. I was denied by SS twice and I have my appeal with a lawyer now. As far as 100% before 2009 I may get it based on the schedule anyway. I just had my back, right testicle pain, right and left feet remanded from the U.S. court with a 2000 appeal date. Since my mental and spine have been the same for the last 3 years or so I hope when the remand comes back I will get 100% back to at least 2007. I do see a pain clinic outside the VA. Since this L3-S1 fusion seems to not have worked and actually made me worse I have the spinal stimulator option. The pain clinic really only gives me narcotics. I am hoping now without the stress of work I can start doing holistic stuff like meditating, yoga, etc. I have been under so much stress the last three years to support my family. I worked 40-60 a week dying just to support them. Thanks for your words.

[tssnave]

DeltaJ,

The link to the C&P exam (ie, the VA regulation) as well as the text that illustrates that a mental health C&P examiner does NOT have to be a PhD if it is a review exam is in your post where you state:

"I READ SOMEWHERE ON HADIT THAT ALL MENTAL HEALTH EXAMS HAVE TO BE SIGNED BY A DOCTOR AND THAT THIS PHRASE IS FOUND IN V.A. REGULATIONS. DOES ANYONE KNOW WHAT REGULATION NUMBER THIS IS FOUND IN?"

To make it easy, I'll post the link again:

http://www.vba.va.gov/bln/21/Benefits/exams/disexm37.htm

If it's an itial C&P then yes, you get a PhD shrink, but if it's a review C&P then you can have any number of other folks do the C&P exam.

Hope this helps,

TS Snave

[Rockhound]

Yes we do have a free clinic here and a one that bills on a sliding scale according to your ability to pay, however, they will not see you if you have other resources, such as the VA or Medcare and/or are being seen by another Dr. due to the limited funds they get to opperate are for those with the most need. To be seen for a medical claim such as a claim for dissability and compensation from the VA is outside their preview of services offered.

Rockhound Rider B)

Rockhound,

Have you tried to find out about any local free medical clinics? How about your local county social services mental/physical health clinics?

The reason I ask is that our paper just ran an article on two free medical clinics and I didn't realize how many services they offered. They don't check to see if you're illegal or not and look simply to help the patient. I mention that because it speaks of an attitude of simply helping when help is needed and not looking at extemporaneous stuff other than what the patient needs. You may find a sympathetic doc at a free clinic.

Also, have you tried your local county mental/medical services? I have used them in the past when I was between insurance and while it rivals Army sick call on a holiday weekend, they also have very helpful folks who work there once you actually get past the waiting room and into a treatment room.

Have you contacted your local DAV, VFW, other vet orgs to ask them if they have anyone they know of who's willing to help?

Have you called local churches and asked if they have a military ministry and if so do they know of any local docs that would help?

Do you have a non gov't assitance center (we have a huge one here that is community run but not gov't run) like a community center or a church resource center that could help?

The phone and phone book may be your best friend right now. At every turn, ask whoever you're talking to if they have any ideas or other places they can think of that you could call. You'd be surprised how plugged in some of these folks are.

Lastly, have you contacted your local paper and asked if they could write a story about your situation and in doing so request assistance from a local physician who could help?

Have you written and/or called all the ENTs in your area asking if they would see you and accept small payments until your claim is determined? Ask to speak to the office managers and see if someone will give you a break.

I know how frustrating it is to be in your position - I had to call over half a dozen shrinks before I found one who had the ability and willingness to write an IMO for my psych claim. It was spendy but paid for itself after 2 months at 100%. If the VA had read their own C&P report it would have saved me lots of $$, time, and frustration but we all know the VA could give a rip about my time, money, or frustration.

I believe in IMOs and hope you will continue to try to get one.

Good luck and keep us posted.

TS Snave