C&p Exam Scheduled

[Sidney56]

I have been scheduled for a C&P(psychological) exam the 16th of this month. The exam was

ordered by the AMC for an appeal I have for Increase/IU for a diagnosed TBI medical

discharge. I am seeking an increase for secondary mood disorder. I am currently being

treated by VA psychiatrist. On my last visit she entered the following information in

her notes:

Mr. xxxxx is a Navy Veteran has known hx of:

I. mood disorder secondary to medical condition/secondary to TBI 1975

following closed head injury/coma; & subsequent cognitive disorder;

II. deferred;

III. medical_CT head 7/17/09 read no acute changes/nl; known renal insuff,

ED, HL, HTN, hx thrombosis, chronic airway obstruction, colon polyps-

per CPRS;

IV. no acute stressors identified, enduring health issues;

V. present GAF - 45

Moods reported as "same", " I stay to myself"/ variably depressed, isolates,

or irritable, dose not sleep well even since start of temazepam 15 mg hs wishes

to try alternative med. He denies physical altercations with other persons since

last seen April 20th though recalls punched hollow door 1x. Denies auditory

hallucinations currently, suspicious+. Denies SI/HI. Although 30 day supply

not renewed recently pt reports the medication has come in the mail-that he did

not run out and he has enough at home, reports compliant with regimen, spouse or

cousin organizes in pill box for pt. Continues to pursue VA claim. Has tentative

plan to come with spouse next appt.

Will the C&P examiner see these notes? The C&P exam and my psychiatrist are located

at the same VA hospital that I go to.

For anyone that has experienced one, what does this psychological exam consist of?

Neurology has approved a fee basis consult to be scheduled with outside specialist

for headache treatment. Appointment has not been scheduled yet.

Oh yea, I have been unemployed for 4 years because of this condition. I submitted form

for Increase/IU in 2006.

Edited August 3, 2010 by Sidney56

[john999]

I would wait until I got a copy of the exam and then get your own doctor to write a report for you. These exam doctors (C&P) often low ball the vet. You just cannot depend on the VA to give you an honest shake. Did you apply for TDIU?

[Sidney56]

I would wait until I got a copy of the exam and then get your own doctor to write a report for you. These exam doctors (C&P) often low ball the vet. You just cannot depend on the VA to give you an honest shake. Did you apply for TDIU?

Thanks for the reply John. I have a Veterans Advocate very well known in this area for successfully helping vets

with their appeals, but I don't think that he submitted a request for TDIU. I do know that we did submit a

4138 with supporting medical evidence that warrants IU. As we know, this isn't always how things work with

the VA. I am suppose to see him tomorrow and I will ask about the TDIU.

Maybe this is the reason he did not file for TDIU and instead filed 4138 with increase/IU.

Remember 4.16B which states if a vet is unemployable due to a SC condition they he/she is entitled to IU. I interpret that to mean if you have evidence of being unemployable due to SC condition that is an inferred claim for IU. The VA may not infer IU unless you are 70%, but that is not what the regulation actually says. VBM notes a hypothetical case where vet has bad smell from SC foot condition. Social worker notes this is a bar to employment. This is an inferred claim for IU. This according to VBM.

The VA increases the disability rating to meet 4.16a if you can show you are IU even if your rating was 10% when you filed for IU. The VA seems to want to do anything to avoid awarding a IU claim just on part b. I think this is because that would include many vets who are on SSD or under employed with ratings below what 4.16a calls for now. It is just part of the game. The main thing is that an unemployable vet gets his/her IU.

I have been told that the hospital that I will have the exam at, is suppose to be the worst place to receive

a C&P due to the fact that the doctors are known for not siding with the vet, regardless of what supporting

evidence you may have. I wish this wasn't true, but the facts speak for themselves. I also know that facts are

just that, and can be changed. Sure hope so. This has been a long and stressful ordeal!!

Right now, I'm just glad to even get an exam after the case has been sitting at the AMC for over a year. If I can

survive all the meds that I am taking, maybe I'll be able to see this thing through to the end. At least my family

will have some type of comfort.

Edited August 4, 2010 by Sidney56

[Sidney56]

Found this post on the board from an earlier date. I think it was posted by quibbly.

Trying to make sure that I am as informed as possible about my pending exam.

Is this the same exam that I am scheduled for?(psychological exam)

http://my.clevelandclinic.org/neurological...evaluation.aspx

What is a neuropsychological evaluation?

A neuropsychological evaluation is a formal assessment of mood, personality and cognitive abilities (e.g., memory, concentration and problem solving) that is conducted by a certified neuropsychologist.

Research shows that many people with movement disorders, psychiatric disorders or acquired brain injuries demonstrate changes in their mood, personality and thinking skills (such as attention, memory and planning). These changes may be subtle or dramatic and may reflect the underlying disease process or side-effects from treatment.

What does a neuropsychological evaluation do?

This type of evaluation determines if a person’s thinking skills, mood and personality have been affected by a neurological disorder. A neuropsychological evaluation also does the following:

* Establishes a baseline so that changes in thinking skills, mood and personality can be monitored over time to provide better treatment

* Helps the patient and family make decisions about work and other responsibilities

* Educates family members about how the brain disorder has affected the patient’s thinking skills and personality so they can better help and understand

* Provides information for a physician in order to help with medication selection to reduce side effects or improve cognition

What is involved in neuropsychological evaluation?

There are two parts to the evaluation:

1. Interview (1 to 1 ½ hours): A neuropsychologist interviews the patient and a family member separately to determine how the neurological disorder is affecting the patient’s life.

2. Neuropsychological testing (3 to 4 hours): A neuropsychology technician administers tests measuring concentration, memory and a range of verbal and visual abilities. The testing is usually completed in one visit.

[Guest Cliph]

I have been scheduled for a C&P(psychological) exam the 16th of this month. The exam was

ordered by the AMC for an appeal I have for Increase/IU for a diagnosed TBI medical

discharge. I am seeking an increase for secondary mood disorder. I am currently being

treated by VA psychiatrist. On my last visit she entered the following information in

her notes:

Will the C&P examiner see these notes? The C&P exam and my psychiatrist are located

at the same VA hospital that I go to.

For anyone that has experienced one, what does this psychological exam consist of?

Neurology has approved a fee basis consult to be scheduled with outside specialist

for headache treatment. Appointment has not been scheduled yet.

Oh yea, I have been unemployed for 4 years because of this condition. I submitted form

for Increase/IU in 2006.

The examiner should have these notes available. However, you can get a copy yourself and take it to the C&P, just in case. All it takes is your signature. Go to your nearest VA facility, ask for help with the Release of Information Form and, when complete to Send it to the ROI Clerk at the VA Hospital.

[Sidney56]

Just wanted to clarify to John that a 21-8940 was submitted on 1/08 and was denied because I did not meet the qualifications

for IU. They also stated that I missed a scheduled C&P exam to determine IU, but I was never notified of the exam. I appealed/NOD

and it was sent to AMC and they clarified that I was never notified and ordered a new C&P which I am scheduled for Monday morning.

Maybe the forces to be are at work, because this time I have been seeing my VA Psychiatrist for awhile and she stated in her notes

that I am unemployable because of the meds that I am taking for my mood disorder which is listed as secondary to my TBI in her Axis I. She gave GAF 45 in Axis V.

After the exam Monday, will the results be sent to the AMC and they will make a decision, or sent the VARO(hope not) for a decision?

I know if the decision is favorable it will be sent back to the VARO for rating. Correct?

Thanks for the reply John. I have a Veterans Advocate very well known in this area for successfully helping vets

with their appeals, but I don't think that he submitted a request for TDIU. I do know that we did submit a

4138 with supporting medical evidence that warrants IU. As we know, this isn't always how things work with

the VA. I am suppose to see him tomorrow and I will ask about the TDIU.

Maybe this is the reason he did not file for TDIU and instead filed 4138 with increase/IU.

Remember 4.16B which states if a vet is unemployable due to a SC condition they he/she is entitled to IU. I interpret that to mean if you have evidence of being unemployable due to SC condition that is an inferred claim for IU. The VA may not infer IU unless you are 70%, but that is not what the regulation actually says. VBM notes a hypothetical case where vet has bad smell from SC foot condition. Social worker notes this is a bar to employment. This is an inferred claim for IU. This according to VBM.

The VA increases the disability rating to meet 4.16a if you can show you are IU even if your rating was 10% when you filed for IU. The VA seems to want to do anything to avoid awarding a IU claim just on part b. I think this is because that would include many vets who are on SSD or under employed with ratings below what 4.16a calls for now. It is just part of the game. The main thing is that an unemployable vet gets his/her IU.

I have been told that the hospital that I will have the exam at, is suppose to be the worst place to receive

a C&P due to the fact that the doctors are known for not siding with the vet, regardless of what supporting

evidence you may have. I wish this wasn't true, but the facts speak for themselves. I also know that facts are

just that, and can be changed. Sure hope so. This has been a long and stressful ordeal!!

Right now, I'm just glad to even get an exam after the case has been sitting at the AMC for over a year. If I can

survive all the meds that I am taking, maybe I'll be able to see this thing through to the end. At least my family

will have some type of comfort.

Edited August 14, 2010 by Sidney56

[Sidney56]

Just wanted to give an update on the C&P exam I went to yesterday.

Only lasted approximately an hour.

This was probably the most informal and easiest exam I have taken

to date. The psychologist was very personable and empathetic. I don't

rely on this as to some positive outcome, just was comparing her to

some of my past examiners.

She stated that this was a review exam from the last Mental C&P I

had taken at the regional office. She told me that she had read my

psychiatrist notes and was familiar with my case. This one was given

at a vamc near my home.

The questions were the normal:

" How are you feeling today"

"How is your sleep"

"Any S/H ideas"

etc.

She asked to speak with my wife alone while I was taking a 20 question

depression questionnaire, which she said she was giving only to satisfy

the RO that the test was given. She asked my wife had she considered

admitting me to a adult care facility, which she answered with an astounding

"No"!

She also told her that I would have been rated at my last C&P if I had

answered all the questions that the examiner asked. This really pissed me

off because, if I didn't answer a question(due to all the meds), my wife

answered them.

She stated that she would get the report typed up yesterday and send it to

the rater or RO as soon as possible. Told you she was nice. :)

Now on to the next waiting game.

Edited August 17, 2010 by Sidney56