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NWvet

C & P Physician Specialty = Pediatrics?

Question

Appealing a denial and got an appt thru QTC (Seattle). The physician is a Dr. Mark Magdeleno who is listed as a pediatric internist.

I assume that since these exams follow the questionairres available here http://www.vba.va.go...ms/disexm34.htm  that they simply pull from a pool of local physicans they have on contract.

Can't say it builds much confidence in the result.

Any suggestions/experiences that might help?

The shoulder was injured on active duty (tendonitis) & treated by PT (late 80s/early 90s). Since then was in an auto accident (2003) that resulted in whiplash (therapeutic massage & PT again for shoulder & private dx of thoracic outlet syndrome). Given I was an aircrew member (non-rated mission crew) we learned not to complain (gotta keep flying) and so I didn't complain in the intervening time between the first injury. The shoulder was denied as service connected at my initial claim when I left active duty. So trying to establish nexus/chronicity (the shoulder has limited ROM/ arm & hand are weaker than previously). My IMO wasn't willing to tie things in given I had turned 50 (claimed it was degenerative). So this is somewhat a wing & a prayer at this point (no $ for more IMOs).

Anyway, back to the original question -- any comments/thoughts relating to the specialty of this C&P physician or the upcoming exam?

Thanks & Aim High!

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Appealing a denial and got an appt thru QTC (Seattle). The physician is a Dr. Mark Magdeleno who is listed as a pediatric internist.

I assume that since these exams follow the questionairres available here http://www.vba.va.go...ms/disexm34.htm that they simply pull from a pool of local physicans they have on contract.

Can't say it builds much confidence in the result.

Any suggestions/experiences that might help?

The shoulder was injured on active duty (tendonitis) & treated by PT (late 80s/early 90s). Since then was in an auto accident (2003) that resulted in whiplash (therapeutic massage & PT again for shoulder & private dx of thoracic outlet syndrome). Given I was an aircrew member (non-rated mission crew) we learned not to complain (gotta keep flying) and so I didn't complain in the intervening time between the first injury. The shoulder was denied as service connected at my initial claim when I left active duty. So trying to establish nexus/chronicity (the shoulder has limited ROM/ arm & hand are weaker than previously). My IMO wasn't willing to tie things in given I had turned 50 (claimed it was degenerative). So this is somewhat a wing & a prayer at this point (no $ for more IMOs).

Anyway, back to the original question -- any comments/thoughts relating to the specialty of this C&P physician or the upcoming exam?

Thanks & Aim High!

What specifically was your claim for. Either way you should have a excellent arguement as to the qualifications of the examining doctor, but you're going to have to discredit them. That might not be to easy.

JMO,

Bergie

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A Pediatrician is just a specialty the Docs pursue after medical school. ALl docs are eother MD's or DO's. There is only one opinion that will override one and it is a specialist opinion in the field your issues are in.

J

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Wanted to followup after my original post. Had the appointment today.

While QTC sent me to the wrong location -- paperwork said to go to Tacoma, but the physician was in Tukwila today. The office personnel at both locations were very attentive and made sure that I had the information to get to the right place. It was the first time in some time I've felt respected in this process -- unfortunately that also includes the VSO who messed up paperwork, failing to send some documents and sending letters for his eyes only to the VA. To this point it's seemed like the process was nearly pointless -- essentially defeated before anyone decided to listen. But these folks took immediate action to call the other office, coordinate the report of the misdirection and handle the additional claim for the additional mileage, plus told me what to expect in terms of when that check should arrive. One lady drew out a map for me and explained it so I could get there. In short, though the paperwork was wrong, they did what was necessary to get me to the right place. Once there -- an hour later given traffic -- the office personnel also worked to get me seen right away.

It was hard to know what to expect. As usual with C&P exams -- you can get someone at the VA hospital who treats you like you're scamming and will make sure they make a point of making the process difficult, or you can get someone who simply is taking on these jobs as an add on to their normal work -- so it can be a jerk or someone who cares and isn't determined to write "deny" on your record regardless of their findings.

I made a conscious decision today to not allow the frustration of being in the wrong place get to me -- and not to blame those who were simply doing their job in the office -- it wasn't the fault of that staff. And though I tried to get to the other location as quickly as possible, I also decided I could really only get there as fast as traffic allowed. It wasn't in the cards to be there early as I was for the other location. As I drove I also decided the physician was not something I could control either. If I treated them with respect, I could only hope they would do the same for me.

Though I do not know the outcome of the physician's report, I can simply say that it was the first physician in a C&P exam that I felt was "on the vet's side". He was cordial, thoughtful, had obviously read my paperwork and stated from the start that he felt it was pretty clear that my shoulder tendonitis from my 1989 injury was related to today's issues and had nexus. I honestly could not believe what I was hearing. Someone cared.

His exam was brief -- 10 minutes or so after the verbal, then it was on to x-ray for 2 views, and I was done.

Office personnel made sure I had the information needed to deal with their regional office mistake and answered my questions. Even a fellow leaving the office gave me a quicker way to get back to the freeway.

Even with the mis-direction, it left me feeling like someone smiled on me today.

I can only hope that other vets have similar experiences there -- without the mis-direction -- and that my appealed claim factors in what hopefully is the necessary nexus/chronicity verbalized by Dr. Magdeleno -- who seems to be a physican, who -- independent of his pediatric specialty -- cares.

Thanks for listening -- Aim High!

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