Dealing With Doctors Reports

[Hoppy]

The recent posts between Berta, I and hollywoodnc concerning doctors reports has motivated me to put up some pro’s and con’s I ran into. And when I say pro’s and con’s what I mean is that there are some doctors who are real pro’s at being a con’s. The best part is the second to last paragraph.

When my claim started through the system in the mid 90’s there was no requirement that a VA doctor had to write reports or make notes in the medical file as to their opinion about service connection issues. In 2000 there was a new directive requiring primary care doctors to make an assessment of whether or not they thought medical diagnosis noted in the SMR were related to current diagnoses.

Great, now we get to talk to primary care doctors who do not want to get involved in the first place. And they are being forced by the VA to get involved. These primary care doctors have no training as to how they should form their opinions. I had one primary doctor who tried to lump me in with the general population and give statistical guesses as to the chances of my condition actually being caused by something never mentioned in my SMR. You can’t lump somebody into a general population when they are already known to have the disease you are trying to say they do not have. The fact that I had the disease was undisputable by stacks of doctor’s reports. If I had done something like this in a research or experimental design class when I went to college I would have got a big “F”. Can Primary doctors rebut diagnoses made thirty years ago based on theory and speculation. Can they make up new diagnoses without running tests or treating you for only one or two appointments when the military doctors had seen you numerous times over periods of many years. Can they make verbal statement disqualifying your claim and refusing to assist without even writing up the basis of their opinions. Guess what they think they can. A primary doctor did it to me. I think any doctor who does this should be put in jail. They are circumventing the system and jamming their maverick BS decision down your throat.

Now for current C&P exams. The RO appears to have the option of determining if your C&P exam will be performed by a physician’s assistant or the head of the department. The hospitals claim that C&P exams are performed by staff physicians only. I have had numerous C&P exams over the years. I had one performed by a physician’s assistant on my knee who did not know how to properly perform a drawer test. This test had been done on my knee at least 25 times by other doctors including two surgeons who operated on my knee. I could perform the test if I were able to lay on a table sit on my foot and pull on my knee at the same time. I had seen this physician’s assistant working the walk in clinic for years. I had never seen him in ortho. I was so pissed I walked straight over to ortho and told them that the RO schedule me a C&P exam and some guy who works in the walk in clinic did the exams. I demanded that the clinic schedule an appointment with one of there surgeons. They did it, the doctor put the results in his notes and I sent it off to the RO. When the DRO scheduled a C&P on my angioedema claim it was performed by the head of the clinic. The result was a good exam.

To answer some of the question I addressed above I can tell you what I learned from a Workers comp claim I had in the State of California. My union scheduled me with an MD/JD. This is a guy who went to both medical school and law school. He was certified to run a hospital. My employer was listening to reports from a physician who was under diagnosing my condition. What really ticked my MD/JD guy off was that they performed no post surgical MRI’s to see why I was having ongoing problems after the surgery. He gave me a quick primer course on what he had to do and what I had to do for the court to give weight to his opinion.

I had to come to appointments until he said I was done. He had to treat me for at least as long of time as the surgeon who my employer was listening to did. The courts took the opinion of a treating physician over an examining physician. He did not want the court to perceive him as an examining physician. He had to run the post surgical MRI’s. He had to have reports, records from my surgeries. He could only base his opinion on his treatment and the reports.

In the case of Jim S, where the C&P examiner saw him for about a half hour and blew off the diagnosis made by military doctors and invented a new one without even giving a clue as to how and when the new diagnosis occurred and the RO bought it without any questions, somebody should have went to jail. This is glaring evidence that the VA system stinks and you have to be on your toes with these guys. This sh__ is worse than communism. I had to throw that in. It is one of my favorite sayings when I am confronted with BS.

The reason the VA system stinks can be illuminated by comparisons to workers comp. The advantage about the workers comp system is that the doctors and lawyers actually talk to each other about how they can best serve the claimant. They specialize in serving claimants only. When you are required to get opinions from primary doctors or C&P doctors for any reason, you lose this advantage and can get a doctor who has an extreme bias, or minimal abilities to think through legal aspects of medicine, and or feels an obligation to save the tax payers money. I am of the opinion that it takes a special breed of doctor to write good reports. Attorneys can runs circles around doctors when it comes to the process of making a decision that will be given weight by the courts. I personally told the DRO to schedule an exam with a VA doctor because he wanted to schedule an exam with a contractor. I was afraid that the contractor would think that he had to write reports favorable to the VA in order to get ongoing business from the VA. Thus, causing even more delays. I figured I would take my chances with a staff VA physician because they get paid for showing up to work. Disallowing veteran’s access to medical examiners that are known to the veteran to be working for the benefit of the veteran only, is the single biggest disadvantage to the VA system. Bad reports can be overcome. It just takes years of delays and you need to get somebody like Berta to work over the doctors.

I will give my opinion on the board. I was a printer and plumber by trade. My disabilities made it impossible for me to finish my college education and sustain myself over the years. I could have never guessed how important several years of college would have benefited me in my old age. I had to learn how to take on doctors and lawyers to survive. Several years of education in the UC system is the only thing that made it possible. For reasons noted in my other posts I spend my time at home or in places where the air is clean and the prevailing wind is onshore. Going to the VA is like playing Russian Roulette for me.

[Hoppy]

Oh yea and once again thanks to Alex and Adora who added to the arsenal of information I used in my old age and gave me the best advise around at the time. I still remember and possibly could find some copies I made of the discusions between Alex and LL about my claim.

[Berta]

Hoppy- just to add- some VA doctor's opinions I received in past claims bordered on the ludicrous-

anyone could easily see that the reports were biased and medically unsound in light of all of the evidence-

One Va doc was pressured by VA in doing his report -I had a big fight with him when I got the SOC and then I found out he had not been given the most important evidence. We made up 2 years ago and he agreed with and supported my present claim but felt that his opinion would not fly with VA because I knocked down his last two or three bad ones-

This is a shame- this is a good VA doctor- a good man -who suscumbed under VA pressure and was denied

the full evidence, and it made him render opinions that were worthless but yet-

if I had not taken him on at the time- I would have lost my claim-due to his opinions.

this ticks me off- VA knows there are vets who are still unaware they can get copies of C & p results and be fully prepared to combat negative med statements in them-even before the SOC arrives-

The full C & P results should legally be attached to the decision or the SOC.

If we have real due process -we would have the Rights of Discovery-

what info VA has -we get a copy of too without having to request it-and vice versa-

There really are excellent people at the VA at every level-but the comp system has biased them and even good VA doctors are often compelled to be negative right from the git go on compensation C & Ps.

Even if they provide completely erroneous med findings and opinions in C & P reports (the same doctors who you hope treat you with accurate medical care) they have no one to oversee and challenge their medical mistakes in C & Ps- like the American Medical Assoc- because they are umbrellaed by the fed gov.

I say take them on if you get an improper assessment due to a C & P exam.

Take the time to study med books and treatises on your condition and fire back at them.

If the VA doc is wrong say they are wrong!-

I cut a VA med opinion down to shreds 2 months ago-

I bet the doctor is actually a good one- but she gave the VA what they wanted-and I know for a fact she was pressured-yet

it was a piece of cake to destroy that opinion.

If you have the medical evidence, on your side- their opinions that deny the claim can be challenged very successfully.

Edited April 15, 2006 by Berta

[john999]

VA C&P doctor said in his report that I was faking mental/emotional disorder because I had a degree in pyschology. This is the kind of reports you get from the VA. It took years to get that report thrown out and replaced by my doctor's opinion.