Another Bogus C&p

[Hoppy]

I have been assisting a veteran who was diagnosed with GERD 9 months after discharge. The veteran has continued treatment with the VAMC since discharge and has received diagnoses of GERD and prescribed medication continuously. He has had several Barium swallows and UGI exams showing the presence of reflux. He went to a C&P and the C&P examiner wrote a report saying there was no objective evidence of GERD. His claim was denied based on this bogus C&P. I got involved and wrote a letter in support of the claim and got the C&P thrown out and the BVA remanded for a new C&P. I was disappointed because I thought there was sufficient records to show continuity since discharge. However, it was some progress to get a new C&P.

The remand stated that there was evidence of a current diagnosis of GERD and ask the new exam to address whether or not there was a nexus. The veteran was scheduled two exams. he went to a barium swallow exam then ½ hour later he saw the c&p examiner who was supposed to address a nexus.

The C&P examiner said there was no current diagnosis of GERD “at this moment”. !/2 hour earlier the barium test confirmed the diagnosis of GERD. The C&P examiner failed to address nexus as asked in the remand..

The C&P examiner offered no logic disputing the ongoing diagnoses of GERD provided by treating clinicians. Rather he said that the current subjective symptoms could be caused by a temporary flare of esophagitis.

The fact that he said the current symptoms “Could” be caused by a temporary flair of esophagitis does not sufficiently rebut the established diagnosis of GERD. Additionally, the word could is not sufficient to establish that it is more likely than not that the temporary flare is a dominating symptom pattern.

These doctors are idiots. The inability to establish a diagnosis “at the moment” because the symptoms “could be caused” by a temporary flare of esophagitis is a total cop out. I guess the entire history provided by treating conditions has no weight because this C&P examiner came up with an explanation based on events that “could” be occurring. By the way esophagitis does not show that a symptom is regurgitation. I have been reading a lot of GERD cases where the BVA has been throwing out bogus C&P exams. We are going to try and get another C&P or an IMO.

[Pete53]

They don't want to pay.

[USNDW]

The question is "What exactly can we do about it"????????????????????????????????????

I have had 2 C&P exams within the last 2 years that ended up pretty much the same way. In one report the C&P examiner actually contradicted herself in 2 consecutive sentences.

1 sentence said that the Veteran seemed to have very good recall about symptoms and issues.

The next sentence said the Veteran was reading from notes he and his wife had made to make sure he didn't forget the symptoms and conditions?

I scratch my head and wonder if this person really spent 6-8 years getting educated so they could make such statements without being a stand up comedian.

The next C&P exam boiled down to a VA Rheumatologist claiming that I had no symptoms of swelling, painful and swollen joints, stiffness, degenerative joints, when my medical record over the last 7 years contains more than 25 records from more than 5 different physicians and specialist and they describe the swelling, degenerative joints (multiple & bilateral) Nuclear bone scan results, MRI's, X-rays.

So what exactly can we do about this problem that exists and exists Nationwide?

I am going Monday to sit down with a Congressional Aid to discuss several issues I have been having with the VA. 1 of those are bonuses for VA VR&E employees. After being told the ILP program doesn't exist and that the VA doesn't purchase products for ILP Veterans by 2 different counselors with over 20+ years of experience, I don't think it is reasonable that ANY VR&E employees receive a bonus.

If an entire Regional Office does not know that the VBIA changed the ILP to allow for a Veteran to be in the ILP for an indefinite amount of time if necessary, then they do not possess the BASIC knowledge to perform their responsibilities.

During this meeting I am going to produce the C&P examination reports, medical records from my C file and records I provided the examiners with so the Aid will be able to see the contrast in the reports and what is actually in my medical records. I don't know how many of you can, but from now on every opportunity I have I will show SOMEONE who may actually giva a crap about Veterans that these examiners (and VA employees) are either incompetent, or they are LYING.

I would think a 70 year old rheumatologist who treats Veterans on a daily basis can read an X-ray report, a Nuclear Scan report, and can read medical records well enough to comprehend their content (especially when they are highlighted)

Another section of the report states that no other joints are involved other than those that are already service connected. The Nuclear scan shows increased uptake and X-rays offered evidence of degeneration in both ankles, both shoulders, elbows, hips, feet, and hands. Only the left shoulder and left hand are service connected.

In another sentence the report says there is no sign of synovitis, even though I provided 3 surgical reports that noted synovitis and fibrous tissue.

I could go on, and on, and on, but I think you all get the point. Only being in the VA system now for 4 years, it seems to me that the number of Veterans who are complaining about C&P exam reports is increasing. My personal experience was that in 2008 I had several C&P exams and it seemed that 4 out of 5 were on the money when it came to referring to my medical history and diagnosed conditions that were supported with test results. Since then it seems that no matter what is in the medical record the C&P examiners are denying the conditions exist. Maybe if enough Veterans bring this issue to the surface and provide evidence so Congressmen/womenor Senators don't think we are a bunch of "Crazy Veterans" some questions will be raised to these examiners and this nonsense will stop

[deanbrt]

Glad to read this. I have felt the C&P exams are a crap shoot for some time. He deserves your help.

[john999]

This is why you need an IMO Fund. I tend to agree with Pete53 on the VA's motivation. I have had quite a few C&P exams over the years for various things. All but one were just sort of like what I got on my entrance exam into the Army: fast, incomplete and inaccurate. I like to get a copy of the C&P and then explain to a doctor what I want to do and what things are important for him to rebutt. Doctor's don't obey me word for word, but it is usually obvious that the VA's exam is a joke. Psychiatric exams are a total crap shoot.

[Chuck75]

I'd Really, Really like to see the VA get hammered in Federal Court for fraudlent practices and medical malfesance.

It would take very deep pockets, likely some sort of class action, and a real criminal investigation.

(Not likely to ever happen, as history shows.)

I'm over 60, and know from past generations experince with the VA, that this sort of thing has been going on at least since WWII, and possibly farther back than that.

WWII aftermath. Terminate low percentage disabled veterans benefits, say they are now healthy, so that they can be recalled for the Korean war.

Korean War Take advantage of the militarys poor record keeping to deny obvious claims, There are still a few examples being fought.

Vietnam War. Both the military and the VA did everything they could think of to avoid recognizing or paying for service related injury and conditions.

(To the point that records were ignored, "lost", or even shredded. Military exit exams - seperating military members were actually threatened with transfer to the equivilent of "Mickey Mouse" companies while there medical conditions and so forth were "evaluated" at length. And it just goes on.

Some of my ancestors and distant relatives fought as far back (on both sides, yet) as "The War For Independence", and in most of the wars since.

[Chuck75]

In my personal opinion, VA doctors, particularly those doing C&Ps, do not have the best interests of the veteran/patient at heart.

For some,VA employment was the last available option.

Others simply do what they are told to do, which is usually to meet VA's internal practices and goals, whatever they may be.

(Don't upset the bureaucrats, unless you want to be looking for another job.)

The majority of the "good" VA doctors I've had in the past -

Went back into private or clinical practice.

Transferred (so I'm told) to other VA areas, usually across the country.

Or just don't work for the VA any-more.

I have been assisting a veteran who was diagnosed with GERD 9 months after discharge. The veteran has continued treatment with the VAMC since discharge and has received diagnoses of GERD and prescribed medication continuously. He has had several Barium swallows and UGI exams showing the presence of reflux. He went to a C&P and the C&P examiner wrote a report saying there was no objective evidence of GERD. His claim was denied based on this bogus C&P. I got involved and wrote a letter in support of the claim and got the C&P thrown out and the BVA remanded for a new C&P. I was disappointed because I thought there was sufficient records to show continuity since discharge. However, it was some progress to get a new C&P.

The remand stated that there was evidence of a current diagnosis of GERD and ask the new exam to address whether or not there was a nexus. The veteran was scheduled two exams. he went to a barium swallow exam then ½ hour later he saw the c&p examiner who was supposed to address a nexus.

The C&P examiner said there was no current diagnosis of GERD “at this moment”. !/2 hour earlier the barium test confirmed the diagnosis of GERD. The C&P examiner failed to address nexus as asked in the remand..

The C&P examiner offered no logic disputing the ongoing diagnoses of GERD provided by treating clinicians. Rather he said that the current subjective symptoms could be caused by a temporary flare of esophagitis.

The fact that he said the current symptoms “Could” be caused by a temporary flair of esophagitis does not sufficiently rebut the established diagnosis of GERD. Additionally, the word could is not sufficient to establish that it is more likely than not that the temporary flare is a dominating symptom pattern.

These doctors are idiots. The inability to establish a diagnosis “at the moment” because the symptoms “could be caused” by a temporary flare of esophagitis is a total cop out. I guess the entire history provided by treating conditions has no weight because this C&P examiner came up with an explanation based on events that “could” be occurring. By the way esophagitis does not show that a symptom is regurgitation. I have been reading a lot of GERD cases where the BVA has been throwing out bogus C&P exams. We are going to try and get another C&P or an IMO.