Final C&p Summary So Miserable

[Jayg]

Well, for those who have been following my C&P woes, I finally have got the, well, final C&P report. Not surprisingly it follows the same trail of falsification, misdirection, misstatement, omission and plain incompetence! And... as a clincher, they say that my claim for secondary conditions is not even possible!

First the ridiculous if superfluous.

They say I am a ' GED' but in fact I'm a high skool grad

They say I had a tonsillectomy in 1985 but 1960 would be closer to the mark.

There's other silly stuff like that.

I'm not gonna try and regale y'all with the whole bloody thing, just some of the high-lights...

The concede I have health problems in some degree that they have not done before. My doctor actually called and asked if I wanted back surgery. But at nexus they balked.

In a nutshell, they say that my problems are all the result of my employment. Not entirely unfeasible. I was a factory worker, machinist, and those trades are physically demanding. I just hold that my health followed a path already laid. They say it's not possible. More on that in a moment.

One of my problems is pes planus. They reported I have no evidence of abnormal shoe wear. See image of boots below. Those are what I wore to the exam. (This photo and pics of 2 other pair boots so worn are on file with VA btw)

Jayg - Sorry, but it was brought to my attention that this photo

has your name and SSA number on it, so I have deleted your

photo of the boots.

See if you can cover or edit out that portion

and re-post it, if you would like.

It is good evidence that your shoes certainly show a difference in

the wear patterns of the soles.

carlie

They reported I have no special shoe inserts or shoes. False. I have special inserts (and wore them that day) authorized by VA and part of my records!

Thanks Carlie! I grabbed the wrong pic!

Here's the right one...

Also at issue are ankle conditions. "He does not use an ankle brace." I do and sure did that exam day!

A lot of simple misdirection. I was given a scooter because I can't stand or walk for long but here they say I was given it "due to back pain."

Knees: Some of this is plain ridiculous. Under "summary of joint conditions" for my knees (as one example) Giving way is yes but instability is no- weakness is no but my records indicate concern over the weakness of my knees and inability to raise me- flare ups of joint disease is 'no' but I have severe debilitating arthritis and the condition does not interfere with the motion of the joint?!?!?!

Treatment is listed as medications, NSAIDS and there are no side effects- they forgot to mention the baclofen, tramodol, mirapex, methadone and what the heck do they mean there are no side effects when I have complained (on record) about dizzyness, balance problems, short term memory loss, dozing off...

Repeatedly... "are there effects of the problem on the usual daily activities?---"no" No. No? No?!?

All that is much of a muchness but, now, it gets really ugly. I tried to brow beat my doctor into making some sort of nexus comment sometime back and all he would go was to write:

"flat foot which contribute to lower back and knee pain."

Not worth much as it goes, actually, essentially useless but they must have felt it had some potential because their report says "a physician assistant student noted that his flat feet may have contributed to his low back and knee pain." annddd... "additionally, he did not claim any foot pain related to pes planus until seen by a physician's assistant student who related the left ankle and pes planus to his other orthopedic complaints. That statement was erroneously perpetuated in the computer system."

Whooeee! Is that a load of Crap!

I remember whenm that was entered. My doctor mis prescribed a dose of medicine to double it's correct strength. It was when mentioning that to him I asked for the comment. I have a copy of it on file for the first time on record in:

PROGRESS NOTE

STANDARD TITLE: PRIMARY CARE TEAM NOTE

DATE OF NOTE: MAR 11, 2008@08:27 ENTRY DATE: MAR 11, 2008@08:27:44

AUTHOR: LAST NAME, FIRST NAME EXP COSIGNER:

URGENCY: STATUS: COMPLETED

Then follows the day's notes concerning my visit.

Then it is "signed"

"/es/ First name Last name MD

Physician, Primary Care Service

signed: 3/11/2008 08:52"

No physician's student assistant anywhere on record this day. At least, that's how it printed out on April 10, 2008. I think I'll request records for that visit again.

Anyway, enough is too much. Here you have the idea of the whole sorry mess. I have a feeling some feces is going to impact upon the rotary oscillator but I don't know if I can avoid becoming buried in the fallout!

In closing, their summary says in every case that it is " not medically feasable" that my claimed conditions are secondary to my SC condition. (only the ankle. They omitt and reference to the flat feet or combined effect.)

However, I do have an IMO on file at VARO that states it is "more likely than not" that it is a result of SC conditions.

There are also many studies that say otherwise too.

For what it's worth, I am not the only one having problems out of this office. A friend with a long, similar history was remanded to BVA. His VARO is to neither hear or receive anything involved with his case, he is to send all his records to DC. He allowed BVA is already moving quicker and have granted his condition @ 0% but they're sending him out of area for another C&P.

Is that standard procedure?

One* last* thing...

The summary says "a standard medical opinion was requested.

Providers restatement of requested medical opinion. This is not the medical opinion itself." <_<

Then lower down it says:

(NONSTANDARD EXAMINERS MEDICAL OPINION)

say whut???

Edited September 24, 2009 by Jayg
Picvture of boots removed as it had SSN and Name on top of pic

[LarryJ]

"I call it a tie and resolve reasonable doubt in favor of the vet."

And, that is as it should be.

[rentalguy1]

ummm, i wasn't joking...

I've (almost) always been treated fairly by the VARO (not the VAMC). I would like to have a wall to wall counseling session with some of the raters that I read about though.

[cannoncocker]

"pfffttt.....if they're gonna deny a vet's claim anyway at least they could get the satisfaction of knocking the taste out of a rater's mouth"

Ahem. :) And I wouldn't say we "monitor" the board. Individuals on our own time who have inside knowledge of how things work do come here to try and help from time to time. I can't contribute much, because this really is an excellent resource. The old hands usually respond with the right answer (or close enough to right for government work as they say), so I don't have much to add. Of course, sometimes I don't know the answer either, and don't want to risk confusing anyone.

I understand the frustration. Getting a bad exam back sucks, both for the vet and for the rater. I've gotten back exams that I was sure were going to lead to grants, but the doctor refused to give a positive nexus opinion. If the exam is adequate, there's not much I can do. The veteran on the other hand can tell us what's wrong with the exam "He just talked to me, I never even took my shirt off, he never actually examined me!" and they can get another exam, and/or they can get an independant medical opinion. I treat IMOs on a level playing field with the VA doctors. If the private doctor reviews the same records, and backs up his rationale for why HE think the condition is secondary to a SC condition (ESPECIALLY if he's a specialist), I call it a tie and resolve reasonable doubt in favor of the vet.

I don't know the answer either, and don't want to risk confusing anyone: I like the way you think already. got my IMO with SMR's refrence etc and the correct diagnosis and is at least as likel due to military service so i'll fight this till the cows come home.

I don't worry about watching what I say. I wouldn't ever say anything here i wouldn't tell the VA administrator.

I welcome all advise, I'll just be more circumspect on what i act on.

Like I said I have family problems so I was preoccupied so it was nobodies fault. i should have been more focused, that's all.

the neurologist, qualified neurologist, didn't even do the slr test because she said it wasn't really relevant or more outdated. but the C&P GP said I was negative when he didn't even think about doing one. Now modern neurologists use MRI's and pin pricks, looking for numbness in certain locations which tells them exactly what nerve roots are involved, tuning fork type instruments.

That dude sucks and I can assure you after this is won, qtc and the va will know. the neurologist from the same area never heard of him so it's not like he's a mogule in the nerology industry!

PS Rental is over my head/and this ain't my thread, Larry is a ok with the doubt should go to the vet, we'll check the validty of that since i have them nailed to the wall on that. No wiggle room. Either that is right or not.

Edited September 25, 2009 by cannoncocker

[Pete53]

The VA employees and also VSO's who come to Hadit are much appreciated. We usually are dealing with people who offer an insight that is very valuable for many with claims.

James and other VA employees and Service Officers are welcome here and sometimes the news is not what the Veteran wants but at least its helpful to win or to accept what is there.

Cannon I think you were a casualty of something that really was not your doing. I hope that your Brother gets treatment that will help him live a long and productive life.

If you leave Hadit more than likely will still be here with some of the same people. Don't forget your password.

Pete

[Jayg]

"PS Rental is over my head/and this ain't my thread..."

I'm sorry. I don't want to be ugly or anything here but, right now I really need for the focus to stay on this, "my" thread please. My case is hitting critical mass and coming to a head, finally. I realize threads sometimes take their own life and follow different courses than those started on. But events directly influencing me as detailed in this thread are happening right now. The changes are not different enough to warrant posting a new topic with this stuff reprinted.

As noted elsewhere, since I initially posted this a request for a "personal hearing" (not DRO hearing) has been made by me (on Jim Strickland's advice) and IRIS said another DRO (since the one that did my hearing got transferred) has made a decision since receipt of this miserable, lying, misleading C&P report. See my next comments lower down this reply...

"pfffttt.....if they're gonna deny a vet's claim anyway at least they could get the satisfaction of knocking the taste out of a rater's mouth"

Ahem. :) And I wouldn't say we "monitor" the board. Individuals on our own time who have inside knowledge of how things work do come here to try and help from time to time. I can't contribute much, because this really is an excellent resource. The old hands usually respond with the right answer (or close enough to right for government work as they say), so I don't have much to add. Of course, sometimes I don't know the answer either, and don't want to risk confusing anyone.

I understand the frustration. Getting a bad exam back sucks, both for the vet and for the rater. I've gotten back exams that I was sure were going to lead to grants, but the doctor refused to give a positive nexus opinion. If the exam is adequate, there's not much I can do. The veteran on the other hand can tell us what's wrong with the exam "He just talked to me, I never even took my shirt off, he never actually examined me!" and they can get another exam, and/or they can get an independent medical opinion. I treat IMOs on a level playing field with the VA doctors. If the private doctor reviews the same records, and backs up his rationale for why HE think the condition is secondary to a SC condition (ESPECIALLY if he's a specialist), I call it a tie and resolve reasonable doubt in favor of the vet.

There have been a lot of references to an "IMO". I brought an IMO to the table for the DRO hearing back in March. I provided the doctor with my entire C-file, military medical records, private medical records, X-ray films, various suportive medical studies and OSHA and other occupational health cautionary reports I have culled and personal statements.

In his IMO, he cited some from all these references giving dates and quotes from the cited events sufficient to demonstrate he had actually read them. His recitations were much more accurate than the C&P team's. He also cited studies he found on his own research.

These studies clearly demonstrate that it absolutely IS "medically feasible" that my present health conditions can be, in the physician's words,"as likely as not" and "more likely than not" in some instances (mine is a multiple issue claim) to my service connected conditions.

There's another thing this unseen DRO should have considered concerning this final c&p report. This whole mess started some months ago with a basic C&P exam. That examiner requested additional exams and statements from concerned VAMC personel but in the meantime issued an initial report. It too was a lying sack of canid feces. I sent in a "rebuttal" that contradicted nearly every negative statement with evidence directly from my VAMC or VA C-file records- 30 pages of records. That rebuttal should have left not "reasonable doubt" no doubt but fully no doubt that that report was inept, inefficient, that records they said reviewed clearly weren't reviewed very carefully and that many statements were literally just plain false. (by example, "no Hallus Valgus is noted on radiology report." BUT radiology report does say, "mild Hallus Valgus." One more example, statement was made that I had no "special shoes or shoe inserts." BUT, I submitted the pages from my records where special shoe inserts were ordered and photos of the worn inserts I was wearing the day of the exam. No wonder the NP said she didn't need to see them when I offered to pull them out of my boots for her. This is how practically the whole report was.

So. IF, this unseen DRO bothered to read the evidence in my admittedly voluminous file, they should grant my claim. But, why do I think that isn't going to happen. :)

[JamesBreckenridge]

If the rater or DRO who decides your claim denies your claim despite a well-supported medical opinion by a comptetent doctor, that rating decision is going to HAVE to address that medical opinion and WHY the decision maker is going with the VA C&P exam and medical opinion instead. Usually when we do that, we use "this doctor is not a specialist in the field" or "the doctor did not have access to the veterans full claim file and service treatment records." But in this case, you don't have that problem.

If I had a ten-volume claim file sitting on my desk, and I need to make my production for the day, I'm not going to spend precious time coming up with a way to defeat a medical opinion by the independent doctor. If anything, I'm *glad* that this other doctor has given me the evidence (helpfully dated!) and medical opinion for a grant! I'm not allowed to make a medical decision, but I am allowed to resolve reasonable doubt in favor of the veteran if I get conflicting medical opinions.

Hang in there, this may yet be a grant. If you don't win at the RO level, you may win at BVA.