New Va Rule: Physicians No Longer Need To Co-Sign C&p Exams

[pacmanx1]

NEW VA RULE: PHYSICIANS NO LONGER NEED TO CO-SIGN C&P EXAMS

NEW VA RULE: PHYSICIANS NO LONGER NEED TO CO-SIGN C&P EXAMS A physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner. This should expedite the claims process.

by Larry Scott, VA Watchdog dot Org

I am not sure if this is good or bad.

It certainly could speed up the claims process.

However, I already hear complaints from many veterans that they don't want mid-level practitioners, such as a NP or PA, doing their C&P exam ... they want a doctor.

Now, in many cases, doctors are being taken completely out of the loop.

VBA's Fast Letter 10-32 is posted below.

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DEPARTMENT OF VETERANS AFFAIRS

Veterans Benefits Administration

Washington, D.C. 20420

September 1, 2010

Director (00/21)

All VA Regional Offices and Centers

In Reply Refer to: 211

Fast Letter 10-32

SUBJ: Removal of Certain Co-Signature Requirements and Ordering Specialist Examinations

Purpose

A joint workgroup of the Veterans Benefits Administration (VBA) and the Veterans Health Administration (VHA) identified several initiatives to expedite compensation and pension (C&P) examinations. This fast letter implements one of these initiatives by liberalizing signature requirements for VHA clinicians performing C&P examinations.

Examination Report Signature Requirements

Effective immediately, regional office and center staff may accept examination reports signed by a nurse practitioner or physician's assistant that are not co-signed by a physician. This change in signature requirements does not apply to examinations conducted by specialists, such as mental health, dental, audiology and optometry.

The M21-1 Manual Rewrite (MR) requires that a physician signs all original examination reports (see M21-1MR Part III, Subpart iv, Chapter 3, Section D, Topic 18, Block a, or

M21-1MR III.iv.3.D.18.a). Law does not mandate this policy, and it can unduly delay processing C&P examinations. In VHA, an individual physician accepts legal responsibility for the unsigned work of a mid-level practitioner, such as a nurse practitioner or physician's assistant. As a result, a physician's co-signature is no longer required for a C&P examination performed by a mid-level practitioner.

We will update the MR to reflect this change.

Specialist Versus Specialty Examinations

Please note that a specialist is only required in limited situations such as dental, vision, hearing, and psychiatric examinations, as indicated by

M21-1MR III.iv.3.A.8. For all other types of examinations, a generalist clinician may perform the examination. For example, an office may order a cardiac examination, but it should not generally request that a cardiologist (a specialist) conduct it.

Questions

E-mail questions concerning this letter to VAVBAWAS/CO/21Q&A.

/S/

Thomas J. Murphy

Director

Compensation and Pension Service

[john999]

Now you can expect your cardiac or brain tumor to be examined by a PA who does not know his/her ass from a hole in the ground. Thus the VA is prostituting good exams to save money and speed up denial process. What pigs! Congress sits by and the VSO's cheer them on! Disgusting.

[jbasser]

This is real good. This bears the eqauivalent of urinating on a forest fire.

Beating around the bush on issues like this is really going to help.

The C And P exams are not the problem. It is the system as a whole. It needs to be did away with and re-invented.

Until that is done, Wheels will continue to spin. Wow the VA has discovered fusuion technology. A never ending process.

They need to implement continuous improvement goals , not band aides.

J

[john999]

As broken down as some of us are we veterans really need to take things in hand somehow. Nobody is going to do it for us. Trading information here at Hadit is really great. There are 22 million vets and yet we have to stand still for this crap?

[Pete53]

No review at all just what the VA wanted.

[john999]

I think it will open the VA to even more appeals. I had a PA do my cardiac C&P. A cardiologist who never read it signed off on it. It was a joke. No testing at all. The PA just guessed at various things such as METS. I appealed and got stress tests. I went from a 0% rating based on the dumb PA's exam to 60% on appeal. You know that insurance companies use PA's and nurses to do disability exams and they overturn exams done by cardiologists. Maybe the VA is trying for this ability. Now PA's and NP will do all the exams. The VA will have PA's doing neurology exams. They will just smack you on the head and ask if you feel it.

[brokensoldier244th]

I had a C and P for peripheral neuropathy three weeks ago and the end result (according to her) was that there was not enough clinical evidence to support the PA making an opinon for that or ED. She had my C file and brought the highlights and my own doctors notes with me to the C and P.

Yippee. i love PA's. I have a nexus letter for ED because of my DDD....but apparently no clinical evidence. Awesome.

Edited September 19, 2010 by brokensoldier244th