Success !

[Hoppy]

This is a success story. However, I am posting in claims and research because I have a lot more to say about the process than just a statement that we won. Also before I get started and bury a question I have in what will be a long post I will ask the question now.

Does anyone know of the process for having a compensation and pension examiner reprimanded or barred from performing compensation and pension examinations? The compensation and pension examiner wrote a report that was adversarial. He wrote an opinion that stated that the veteran's symptoms in the military were caused by a nonservice connectable condition that predated service. His opinion directly contradicted as existing opinion of record. More importantly it is an accepted medical principle that the cause of the veteran symptoms in the military cannot be attributed any single etiology. There were other errors and presumptions made by the clinician.

The fact that a veteran has the ability to rebut or otherwise present evidence in support of the claim does not excuse an individual who is bound by professional standards of doing a professional job. A labor law attorney I previously worked with presented this argument against a professional involved in a workers compensation law suit. I am very interested in pursuing a complaint against the clinician. If you have any ideas please advise me. If this were a workers compensation claim or civil claim the complaint will be filed with presiding judge.

Now for the success story and how the long battle unfolded.

When I first met the veteran he was homeless and living in his car. I tried to get them to go to the VA hospital and see a social worker. As time went on I realized that he was diagnosed in the military under the DSM II with a non-service connectable personality disorder. After reading the service medical records it was obvious to me that under the DSM-IV he would have been diagnosed with a service connectable panic disorder. For the purpose of obtaining a compensation and pension examination we obtained an opinion from the primary care Dr. The primary care Dr. reviewed the service medical records and determined that his current diagnosis of panic disorder was related to the symptoms in the military. This should have been sufficient to get a compensation and pension examination. Unfortunately, the claim was denied without any exam. This forced me to obtain a report from another clinician. I wrote a brief summary of the history of the claim and sent it to a qualified specialist who worked as a staff clinician at a VA hospital. Fortunately this clinician became interested in the case and reviewed all the records. The clinician wrote a very favorable and strong report.

The new report did in fact cause the regional office to schedule a C&P exam. Unfortunately, the C&P examiner made some wild guesses about the nature of the veteran's lifetime battle with panic disorder. What is most bothersome is the report took advantage of speculative theories and flawed conclusions based on invalid experimental designs. The report ignored any symptoms that could be explained by individual differences of symptoms that are known to occur in service connectable conditions that had been diagnosed by treating clinicians and are a matter of record. The most apparent aberration was the problem of assigning a single etiology to the veteran symptoms. Had the etiology been correct the condition would have been considered to have existed prior to entry into the military. The manner in which this was stated gave the false representation that an unconfirmed theory had somehow been validated. I'm of the opinion the examiner did everything he could to write an adversarial report that would result in a loss of benefits. It appears that the DRO gave weight to the opinion of the examiner who was the staff clinician at a VA hospital rather than the C&P examiner.

The good news is that a DRO service connected the veteran at 50%. I have not seen the decision yet. However, I am very sure that the award was based on the report I obtained from the VAMC staff clinician. We do plan to file for an upgrade. The veteran has not worked in four years and has been receiving Social Security for the panic disorder for the last two years.

Edited June 1, 2010 by Hoppy

[john999]

Pete

I saw a doctor at the VA in 1972. I went back in 2007 and he was still there. He was middle aged in 72. He must be 90 years old and he still examines vets.

[halos2]

Hoppy, the liar biatch NP who did my C&P yrs ago lied all the way to the bank not only on my C&P exam but many,many others too. :D She was permanently removed from ever doing C&P's at this VAMC ever!! ;)

Pt advocate, VSO, Director of C&P exams(DR), 2 other NP at hosp all requested new C&P as thay told VARO NP was disciplined and expelled from this area of hosp exam section, but never got a new C&P for this original claim since 03...case went on to BVA, remanded back to VARO but not heard a word...

Sad but true I am still fighting it, but how many other vets did she screw their cases and they never did/know what to do...VP FOIA officer even tried to get me a new C&P exam too, with no justice yet!

SO I still sit and wait, and wait...and she is hidden in another area of the hosp as her spouse is an administrator there...where is the justice here?? B)

[Guest terrysturgis]

Hoppy, THANKS for helping that Veteran on a difficult claim. Like Pete said, 50%, It ain't done yet. Congrats! Terry

[Rockhound]

Great news Hoppy: I'm glad to hear that you have been able, yet once again, to help a Veteran, who without your help would have continued to fall through the many cracks, of the VA system and probably would have remained as one of the many homeless Veterans still out there.

If I hadn't received the help from you and the other carring individuals like yourself, I myself, may have ended up as one of the many homeless Veteran's out their.

Good luck to this Veteran and congrats for your win and wishing for many more.

Rockhound Rider :D

[Chu Lai69]

Wonderful work Hoppy!!!!

I am of the opinion that a lousy C & P report that fails to consider the evidence properly borders on downright malpractice.

If we had the same rights as anyone involved in civil litigation-the practice of lousy C & P exams,to save VA money ,would be called to task- by thousands of us I am sure.

The very fact that real doctor's IM0s overrule so many of these C & P reports proves my point---they are tainted reports to begin with in many if not m,ost cases- just to give lip service to a denial that has probably already been determined.

Is the SSDI exactly for what is now SC? If so I suggest you ask them to reconsider and send them the SSA award letter. (They should have had that already)

That is what we get Berta when the VA contracts outside of the VA for examiners that are trained to do what the VA wants them to do!!

[Commander Bob]

<!--fonto:Calibri--><span style="font-family:Calibri"><!--/fonto-->The good news is that a DRO service connected the veteran at 50%. I have not seen the decision yet. However, I am very sure that the award was based on the report I obtained from the VAMC staff clinician. We do plan to file for an upgrade. The veteran has not worked in four years and has been receiving Social Security for the panic disorder for the last <!--fontc--></span><!--/fontc-->two years.<!--sizec--></span><!--/sizec--><!--fontc--></span><!--/fontc--><!--fontc--></span><!--/fontc-->

Congratulations, Hoppy. I am sure the vet would have fallen through the cracks, if not for your helping hand.

Thanks for helping a vet.