Echo Procedures For C&p Exams

[carlie]

Two weeks ago I had a C&P exam due to instructions from my BVA remand.

The examiner was to review all evidence, order any test they deemed necessary and opine

as to if my SC'd respiratory conditions are aggravating my NSC heart conditions.

The examiner in my opinion was quite good.

He ordered a new Echocardiogram to determine my surest level of

Pulmonary Artery Pressure (PAP). He said this was needed to help

him write his opinion.

I was scheduled for a Echocardiogram last week.

Here I am laying on the table doing the test - (the echo is just like a ultra sound procedure) and I asked the tech -

hey, this test will give the examiner a reading for my PAP right ?

The tech told me NO - I said get your supervisor.

I was told by the technician and her supervisor that there is new policy in

doing Echo's ordered by the C&P examiner's.

They will now be doing 2 types of Echo's.

1) Is an INCOMPLETE echo test that will provide the ejection fraction (EF).

2) A COMPLETE echo that will provide the EF and the Pulmonary Artery Pressure

(PAP).

The supervisor continued on to tell me that the C&P examiner had ordered an echo for me

(BUT that the C&P examiner probably did not know about this above change in policy yet).

The echo department decided I would get an INCOMPLETE echodue to AO - IHD.

I said OH NO - This is BS - and the supervisor told me that's all they could do on me

and I needed to speak with my service officer - I told her I represent myself.

I continued on stating I am not AO - I am Not IHD.

I am here due to a BVA remand - she said she already knew this.

I quickly and concisely stated:

The C&P examiner needs to know my current PAP

and you are not going to provide the correct test for this.

Your results will go to the examiner - then his C&P results to the RO,

the RO will deny and pass it back to BVA - I will be notified of the Denial,

I will tell BVA I had an inadequate exam - BVA will again remand to the RO,

the RO will send me for an ADEQUATE exam and I will end up right back her.

I told her by doing an inadequate exam she personally will be costing me another 2-3 years of not getting my benefits !

The supervisor told the tech to call the C&P examiner and tell him what

the veteran is saying - with the I must be lying attitude.

The tech went away for about 10 minutes, came back in and said -

well you are going to get the COMPLETE echo to include a PAP reading,

and DR. XXX didn't even need to pull you up on the computer - he knew

who you were.

I told her that the examiner had discussed this at length last week

and that's exactly why he ordered this specific test.

Anyways - I just want other claimants to be aware there are now (supposedly)

2 different levels of echo's being done at VAMC's in relation to C&P exams.

How about all the vets that will go thru BS like this - not knowing at all

what is supposed to be done and what, in reality is actually being done.

They will have absolutely no clue.

[jbasser]

Anyone with a suspected or service connected lung disorder, Including Sleep Apnea needs these test done as Pulmonary Hypertension can pop out of nowhere. The main cause is the Heart has to pump blood through the lungs and a weakened lung state causes the heart to work harder.

The symptoms are Shortness of breath with a palpitations.

There are 2 medical tests that can diagnose this. An echo that measures Pulmonary Artery Pressure and A Cardiac cath.

Having this dreaded disease really sucks.

J

[Papa]

I have this dreaded disease of talking prior to the brain cllicking in . When I went to have my ECHO test done, I ask the Techican if he needed to crank up the machine or will someone need to pedal to get it going, he did not find it amusing. But, the equipment looked so old. He put these props on me, and they kept falling off. He would fix one, and another would fall off, etc. I need to find out what my rating will be before I take any action. Like someone said, its all about the money.

Papa

[halos2]

Carlie, good thing you are versed in the tests ordered and persistent enough to stand your ground. Too bad for all the vets who don't know what tests they are to receive and may only get some half-azz one's.

[Berta]

Years ago I somehow obtained one page of the M21 that VA physicians use.

I think I got it from documents inside the VAMC medical library.It was hard to get VA permission to even go in there but they let me in for 20 minutes and I thnjmk that is where I found it and got them to copy one page. It was very critical to my FTCA claim.I have not found good access to the VA Physician's M21 since.

I am trying to find the VA Clinicians Guide they use or anything that would show how a ECHO Doppler could become an incomplete test and why.

The Doppler is what they use on the weather channel.

Is it possible the VA still uses some old pre-Doppler ECHOs that would not reveal PAP ????

I would think the Doppler would reveal Anything like PAP. I am still getting through a vast explanation of the Doppler ECHO by Braunwald because Carlie raised some serious points here that could affect other veterans.

John does the PAP part of the ECHO have to be separately requested? WOuldn;t Pulmonary artery pressure be significant to any ECHO results?

Edited February 6, 2011 by Berta

[jbasser]

The Techs are trained to look at all 4 chambers of the heart. Then they place the transducer to another area to check Pulmonary artery pressure.

The doppler info is located here.

John

http://www.webmd.com/a-to-z-guides/doppler-ultrasound

[carlie]

I want to find out the difference in an Echo and a MUGA test.