C&p Exam For Problems I Did Not Submit Claims For!?!

[sleeper692]

I got a call today from VBA to schedule another C&P exam. When I asked what the exams were for, he said they were for my requested increases for arthritis and sleep apnea. The funny thing is, I have never filed a claim or an increase for either one of those things. In fact, I've been examined at a previous C&P as well as by a rheumatologist for arthritis (because I have pain that is similar but I lack any signs of inflammation). After both exams and a battery of blood tests, they both reported that there were no findings in my lab reports that indicated I have arthritis.

I have a NOD in for insomnia as a sleep disorder for connection under the Gulf War presumptives. I never mentioned sleep apnea. My neurologist *suggested* I might have sleep apnea and sent me to a sleep study. That was just a few days ago and they said I had very little problem with my breathing during sleep.

In both cases, I have already had recent exams done by specialists and they haven't found arthritis or sleep apnea. I don't understand why I would have another C&P exam for things that they already know are going to be negative since they have full access to my medical records.

Is it normal for the raters to just pull things out of......thin air....and create a claim on my behalf? Am I missing something here???

Edited October 14, 2011 by sleeper692

[Ryguy]

Ok, so I'm back from my C&P Exam. The physician assistant calls me in, and she wants descriptive details of the issues that i experience with my service connected disability. She then tells me that it seems my left foot is worst than my right foot, but she's dumbfounded as tooo why i'm experiencing so much pain, she said maybe I have some sort of pain illness. I was like OK. She was very opinionated throughout the whole exam, then she moves on to evaluate my back (mind you, i'm trying to maintain my coolness as she has my life at stake here), She did the different flexions and makes her little comments on how my forward flexion is bad, it seemed the more nicer I was to her, the more pleasant she got, after 1 hour of evaluating and her documenting the different flexions, she wanted to know why my doctor notes didn't make mention of my feet issues on my last few visits, I told her the doctor gave me pain meds for both issues, she said ok, Then she huffed and puffed about the new exam worksheets, and how much she hated them, and how she needed a break. Then she said, ok, your done, I'm just going to sit here and write notes for your exam, and she told me I was welcomed to sit there while she wrote the notes. I told her I would just pick up a copy of the notes after a few days from the VA's Medical Record Department, She said ok, have a great day, I thanked her for her time and told her I appreciated her listening to the symptoms I experienced, I have mixed feelings about the claim for increase, I did tell her I had no idea how this was requested but I just showed up for the appoitnment, she said, "THE VA is unorganized and it sounds like something the va would do. I smiled, and walked out.

Isn't that wild and weird. I just hope this helps my claim, its just awkward that this claim came about and I not once requested this.

What do you think?

[sleeper692]

Ry.

It sounds like she treated you fairly and did her job. I would think that her dissatisfaction with the system may even work in your favor. You'll know in just a day or two if you can get down to the records office at your VAMC and get an update on your medical records. I mean, at least she actually did an exam! It sounded like she was paying attention and picking up on everything she should have and then some. From your description, it sounds like she was trying to give you a fair shake.

I just got a copy of my C&P exam today (the one I started this thread about). I'm so pissed I could scream. This doc totally hosed me on the "arthritis" claim and completely, and I mean COMPLETELY ignored the claim for polyarthralgia that was diagnosed on a previous C&P exam. He even stated so. Unbelievable. He did, of course, state the obvious: I don't have any form of inflammatory arthritis but he refused to consider osteoarthritis and never ordered any x-rays. Instead he cited x-rays that were over a year old. Then he completely ignored the directions that told him that, if inflammatory arthritis was ruled out, continue with the exam for joints. No exam for joints was done. No exam was done, period.

Then, for the sleep apnea, he said that the only indication I had were notes from a sleep technician describing positional sleep apnea. Then when asked if my polyarthralgia (aka chronic body pain) was a cause of my sleep disorders, he ignored that the sleep technician wrote that I had problems sleeping due to chronic pain. Then, after listing that I have hypersomnolence (I fall asleep very easily during the day) that it would not affect my work. Really? If anyone knows of any jobs that require sleeping, please fill me in. I would be an excellent candidate.

The only intelligent thing he said was that the rater should wait for a signed review of my sleep study by a medical doctor.

Looking at the rating schedule, I might get 30% for the hypersomnolence due to sleep apnea if they will tie it to the Gulf War presumptives. This doc said it was less than likely it was service connected. Once again, hosed by ignorance of Gulf War Illness. And they wonder why I'm suicidal. Geez.

The fact that this guy totally threw my claim for polyarthralgia out the door is ludicrous. This pain, which was previously diagnosed and has been treated for in the past 18 months, was just totally ignored and it just happens to be one of the biggest medical issues I face on a daily basis.

And he decided all this before I even walked into the room. What a jerk!

Edited November 2, 2011 by sleeper692

[Ryguy]

hey i was wondering how many days did it take before your exam report was ready to be picked up? I called and the medical records person keeps telling me its awaiting a signature and its not ready yet..... You know i'm freaking out over every minute because i'm anxious to see what the report says. Its only been two days but i would have expected it to be done by now.

[NJBB62]

It took me 2 weeks before I could get my copy

[sleeper692]

I realize my answer may be a little late but it may help the next guy down the line. I used to go to the VARO and do a FOIA request for my C&P exam and that would take 2 or 3 weeks. This time I went to the local VA hospital records and simply requested a records update about three days after my C&P. Sure enough, the C&P exam was in the update and am I ever glad I got it.

To go back to the original topic of why I was getting C&P exams for things I didn't request, here is what happened:

First, I was getting an exam for Rheumatoid Arthritis when none was claimed. What happened was that my service officer had requested that my polyarthralgia (joint pain) be rated as RA since there is no direct rating for polyarthralgia. This is directly in accordance with VA directives. Apparently the rater was new and misunderstood and ordered a C&P exam for RA. The doc blew it off and didn't even do an exam and pencil whipped the whole thing.

Then, for sleep apnea, for whatever reason, they confused insomnia with sleep apnea because there was mention of an upcoming sleep study. To top it all off, I had the exam for sleep apnea before a sleep specialist could interpret my sleep study so the C&P examiner pencil whipped this exam too. Now I have been diagnosed with obstructive sleep apnea and have a CPAP.

I had to take my medical records and a copy of the C&P exam to my VSO to show her how ludicrous the whole thing was. She got on the phone right away and nipped the whole thing in the bud. Then my claim went immediately into decision mode. Now its once again gone back into development mode and I imagine I will have to go see another C&P doc for a fresh exam since my VSO challenged the total incompetence of the previous one.

What I don't understand is that it doesn't take a rocket scientist to look at my medical records and see the diagnosis of sleep apnea and the prescription for a CPAP then tie it in with my request for sleep disorder under the Gulf War presumptives.

I'm not sure this could get any more frustrating.