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      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

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burghpitts

Qtc C&p Exam Scheduled

Question

for the end of June here in San Antonio....I decided to look up QTC and there is not alot people who have had a good experience with them. I'm not to sure why but I'm am going through the BDD program so everything I'm claiming is still going on. How was everyones experience with them? What to expect? I have a few joint issue ie elbow, hip, back and some people say they did even get a ROM test.

Thanks!

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burghpitts,

Having a little problem understanding the first part of your post. I live in San Antonio, and have gone through 4 QTC Exams. The first one was with a well known Shrink that spent about 30 minutes with me, and determined that I should be rated 30 percent, and I was by the VA. Then, I had a total physical and what the doctor wrote down on his report does not match what happened during the exam. For instance, they did a eye exam, and I could not see anything without my glasses. On the report I was Superman and could see through walls. Did a movement test, and could not move hardly at all, in fact, the Doctor helped me with my shoes. But, on the report it looked like I could turn myself into a Pretzel. Then, the VA decided that they needed to reevaluate my PTSD, so off to another QTC Shrink, and she was very nice. But, she wrote down on the report that the PTSD was causing my overeating, and I do not believe the VA likes that. I believe they do not like the report that they had hoped would lower my PTSD rating, and it may have big fired. In the mean time a private Neurologist dx me with Parkinson's, so the Va brought down a GP from north of Midland to do the examination. We apparently do not have Doctors here that will accept QTC's fees. This Doctor had a Clerk with him that had to tell him what test he needed to do next. He was a nice guy and all, but, I'm waiting for the report. On a lot of the test he would not allow me to do because he said I was not able to do them. Waiting on the report, should be interesting. Bottom line is that it all depends on the Doctor that you get. Bring a witness if possible. Just have faith, and best wishes.

Papa

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I decided to look up QTC and there is not alot people who have had a good experience with them. I'm not to sure why but I'm am going through the BDD program so everything I'm claiming is still going on.

Thanks!

QTC is just the VBA paying outside contracted examiner's to do exams.

What I am not understanding is that if you are "going through the BDD program",

are you still active duty ? and it seems to me they would already have current medical evidence

of record.

I am not very updated on the entire BDD process.

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You know there are a number of doctors who hire out as IMO's for SSD, Workers Compensation, VA and insurance companies. I do think that for VA, SSD and for federal worker's compensation the more exams they do the more they can earn. They must have some sense of what constitues going over the line in favor of claimants. Workers compensation would send you 200 miles to see a specialist. I don't know if that was because they were shopping for doctors who would accept low fees and do their dirty work or if there was just a shortage. I live in a good sized city and yet they sent me 40 miles. At least the VA does not do that which is to send you 200 miles to get your exam. They pay for it but it is not automatic. You have to claim it. I went to see a plastic surgeon on my own and he charged my insurance 200 dollars to say he could not help me. Why would a doctor want to do a C&P exam and spend 30 minutes with a patient and then have a report written up and get whatever the VA pays? You have to wonder what kind of doctor does these exams? Ancient guys or gals who can't do surgery anymore or who got in trouble and can't pay malpractice? I have had a lot of these kinds of exams over the years and most are just awful with many mistakes, guesses, misquotes and misdiagnosis. When they start to put words in your mouth and "adjust" your statements to support some pre-existing condition or personality disorder DX they should be sued. But, of course, you can't do it because they are protected by law. Then there are the ones who actually hurt you during an exam by bending this or that until it breaks.

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My experience with this sort of thing was a "work related injury" that fell under workers comp. I was set to an examining doctor by state workers comp. The doctor had to be at least 70 or 80, and his office and equipment reminded me of an early 1940's doctor's office I had seen in pictures. (and this was in the middle 1960's). No patients were in the waiting area, no office help or nurses, just the doctor. It's quite possible that all the doctor did was conduct exams for the state. At least he did not show signs of Alzheimer's. His office was in a building with a brick front, about a block from the old state capitol building (Lincoln practiced law there). I suspect the doctors building was about the same age as the old capitol building. All the floors and stairs were wood dark with age, and very worn.

There was a large opera house across the street that was also very old, (1800's) and also had a fair amount of wood structure. It was originally built for vaudeville as well as opera, converted a bit for silent movies, then sound movies, and converted again for wide screen CinemaScope. The orchestra "pit" floor and part of the stage could be raised and lowered, and part of the stage might be rotated as well as raised and lowered. There also was a very old massive "theater" pipe organ console in the lower lobby balcony, with all the whistles, bells, sirens, and other sound effects, such as horses clip clops, screeching hinges, etc. There were multiple sets of pipes, a full set in the lobby, and another set in the area at the back of the theater above one of the multiple balconies. Steam heat in the winter, and cooling with bunkers of ice in the summer when large audiences were present. There was just enough "modern air conditioning" to cool the place when no audience was present.

You know there are a number of doctors who hire out as IMO's for SSD, Workers Compensation, VA and insurance companies. I do think that for VA, SSD and for federal worker's compensation the more exams they do the more they can earn. They must have some sense of what constitues going over the line in favor of claimants. Workers compensation would send you 200 miles to see a specialist. I don't know if that was because they were shopping for doctors who would accept low fees and do their dirty work or if there was just a shortage. I live in a good sized city and yet they sent me 40 miles. At least the VA does not do that which is to send you 200 miles to get your exam. They pay for it but it is not automatic. You have to claim it. I went to see a plastic surgeon on my own and he charged my insurance 200 dollars to say he could not help me. Why would a doctor want to do a C&P exam and spend 30 minutes with a patient and then have a report written up and get whatever the VA pays? You have to wonder what kind of doctor does these exams? Ancient guys or gals who can't do surgery anymore or who got in trouble and can't pay malpractice? I have had a lot of these kinds of exams over the years and most are just awful with many mistakes, guesses, misquotes and misdiagnosis. When they start to put words in your mouth and "adjust" your statements to support some pre-existing condition or personality disorder DX they should be sued. But, of course, you can't do it because they are protected by law. Then there are the ones who actually hurt you during an exam by bending this or that until it breaks.

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John,

You gave me something to think about. They could have made me go 200+ miles more the exam, instead of bringing the Doctor to San Antonio.

Papa

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    • Howdy all,

      The VA DRO denied my claim for an earlier effective date for my sleep apnea. They originally denied it in 2008 but granted it in Nov 2019 secondary to my GERD. I was rated for GERD in 2001. So I had it in 2008. I have attached the 2008 denial, 2018 approval, and the NOD SOC. All of my medical files and the medical articles and VA Citations referenced were in existence in or before Jan 2008. The only new items were the NEXUS letter from Dr Bash and a few extra buddy letters. The original denial states that my medical records show no diagnosis or treatment and only isolated complaints of symptoms. The denial does not even list my wife's or my lay statements as evidence reviewed. I have symptoms listed numerous times in my SMRs:

      a. Medical visit dated 24 Feb 76 for problem sleeping and depression.
      b. Physical exam dated 24 Jan 79 listed frequent/severe headaches" dizziness, and
      nervousness.
      c. Physical exam dated 07 Nov 83 listed frequent/severe headaches.
      d. Physical exam dated 16 Jan 85 listed frequent/severe headaches.
      e. Admitted to hospital 05 Aug 86 for chest pains and anxiety.
      f. Medical visit dated 14 Jul 87 for problem sleeping and morning confusion.
      g. Physical exam dated 25 Feb 88 listed dizziness.
      h. Physical exam dated 07 Oct 91 listed frequent/severe headaches
      i. Physical exam dated 25 Aug 93 listed headache.
      j. Hernia repair surgery dated 22 Ang 94 surgeon had to insert devices of some
      kind in each of my nostrils that went down into my throat to keep rny airway
      open and stop my disruptive snoring.
      k. Physical exam dated 29 Sep 99 listed frequent/severe headaches.

      So could you all take a look and let me know what you think.

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      VA 2008 Denial of OSA Redacted.pdf
      VA Claim Decision Ltr 08 Nov 2018 Redacted.PDF
      • 3 replies
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