On The Legal Side Couldn't This Be A Conflict Of Interest...

[rpowell01]

Its my understanding that an RO is suppose to send veterans to have an independent C&P exam. If an RO is part of a system say as in St Pete, the Bay Pines system, how can they send a veteran to have a C&P exam in the Bay Pines Region only and not other regions such as Tampa or lets say Orlando. Wouldn't this be a conflict of interest because the word independent?

I am just curious about this because I see the RO using doctors in their system is a conflict of interest.

[Philip Rogers]

Their key to getting around this, is that they may use their employees, on their days off, thus making them "independent examiners" and they are paid separately and probably receive a 1099 tax form, for the exam service.

pr

[harleyman]

I think exam doctors are paid as independent contractors. Pay based on the number of examinations completed with reports. I think VA treating doctor's are paid based on the hiring quidelines and they are entitled to federal benefits as well. I am not sure exam doc's get federal employee benefits or not (I suspect not). GOOD Question. Any answers would clear up some of the muddle.- H

Veterans, unfairly, get no choice in who the VA picks to examine them. So, is this an independent examiner, not in my perspective. So if VA has their hired and paid for examiners, the Veteran (like Carly says), needs to eat bread and water for a while, to hire thier own independent examiners.

I know in workers compensation cases in most states, when there is an Independent examination needed for an injured worker, the workers compensation company in most states is required to offer a list of 3 to 5 doctors for the injured worker to pick from to do the exam. This is called and AME. Agreed Upon Medical Exam. VA could take a lesson from the AME approach. As long as all the doctor is not ultimately afiliated in some way with the VA.

I find most doctor's are afraid to stand or make a contrary opinion when the government is involved as they are afraid of audits, IRS interference, and that if they disagree with the VA , the gov't won't send any more business their way. Those doctors don't realize the gov't doesn't really care about thier opinion, they just want to process claims.- IMO

[free_spirit_etc]

I didn't think C&P exams were considered Independent Opinions. I thought Independent Medical Opinions were obtained more at the BVA level. Sometimes you will read BVA decisions where the Board will refer the case to an outside medical expert for an opinion. But this is only "required" when a case involves controversy or complexity. Actually, based on the way the law reads, it doesn't even look like it is required. It is just something that is available, and up to the judgement of the Secretary.

38 USC § 5109 - Independent medical opinions

(a) When, in the judgment of the Secretary, expert medical opinion, in addition to that available within the Department, is warranted by the medical complexity or controversy involved in a case being considered by the Department, the Secretary may secure an advisory medical opinion from one or more independent medical experts who are not employees of the Department.

(b) The Secretary shall make necessary arrangements with recognized medical schools, universities, or clinics to furnish such advisory medical opinions. Any such arrangement shall provide that the actual selection of the expert or experts to give the advisory opinion in an individual case shall be made by an appropriate official of such institution.

© The Secretary shall furnish a claimant with notice that an advisory medical opinion has been requested under this section with respect to the claimant’s case and shall furnish the claimant with a copy of such opinion when it is received by the Secretary.

Edited September 29, 2013 by free_spirit_etc

[john999]

In Tampa they use residents from the USF medical School or maybe even medical students. I had mental health exams done by very young doctors over the years and now realized they were from medical school who were doing residency at the VA next door. They manage to absorb the anti-veteran bias from older C&P exam doctors. I did have exam for PN done by VA neurologist who is daughter of my private psychiatrist. I wonder if this was a conflict.

[free_spirit_etc]

I just looked - and Independent Exams / Opinions can also be requested by the RO - but the request has to be approved by the Compensation and Pension Service. So it looks like Independent Opinions are very different that C&P exams, or VA medical opinions. There doesn't seem to be any law that states the medical opinions obtained by the VA have to be Independent. In fact, they have to jump through additional hoops to prove that an Independent Opinion is necessary.

§ 5.92 Independent medical opinions.

(a) General. When warranted by the

medical complexity or controversy

involved in a pending claim, an

advisory medical opinion may be

obtained from one or more medical

experts who are not employees of VA.

Opinions shall be obtained from

recognized medical schools,

universities, clinics or medical

institutions with which arrangements

for such opinions have been made, and

an appropriate official of the institution

shall select the individual expert(s) to

render an opinion.

(b) Requests. A request for an

independent medical opinion in

conjunction with a claim pending at the

regional office level may be initiated by

the office having jurisdiction over the

claim, by the claimant, or by his or her

representative. The request must be

submitted in writing and must set forth

in detail the reasons why the opinion is

necessary. All such requests shall be

submitted through the Veterans Service

Center Manager of the office having

jurisdiction over the claim, and those

requests which in the judgment of the

Veterans Service Center Manager merit

consideration shall be referred to the

Compensation and Pension Service for

approval.

© Approval. Approval shall be

granted only upon a determination by

the Compensation and Pension Service

that the issue under consideration poses

a medical problem of such obscurity or

complexity, or has generated such

controversy in the medical community

at large, as to justify solicitation of an

independent medical opinion. When

approval has been granted, the

Compensation and Pension Service

shall obtain the opinion. A

determination that an independent

medical opinion is not warranted may

be contested only as part of an appeal

on the merits of the decision rendered

on the primary issue by the agency of

original jurisdiction.

(d) Notification. The Compensation

and Pension Service shall notify the

claimant when the request for an

independent medical opinion has been

approved with regard to his or her claim

and shall furnish the claimant with a

copy of the opinion when it is received.

If, in the judgment of the Secretary,

disclosure of the independent medical

opinion would be harmful to the

physical or mental health of the

claimant, disclosure shall be subject to

the special procedures set forth in

§ 1.577 of this chapter.

(Authority: 5 U.S.C. 552a(f)(3); 38 U.S.C.

5109, 5701

Edited September 29, 2013 by free_spirit_etc

[free_spirit_etc]

Where is everyone reading that C&P exams are supposed to be "independent?"