Are Va Medical Centers Over-Prescribing Narcotics To Veterans?

ncjoe1970 · September 21, 2013

I stopped taking the meds and seeing ANY Psychiatrist period. I was 20% at the time and now 80%, yet TDIU because of my PTSD. Stand your ground and speak your mind. I allowed doctors for far too long to decide my fate. This is YOUR life and well being. I "woke up" so to speak, and stopped being naive. Their human, doctor or not, and not always right. I question everything now, and if I don't get the answers to my questions, I move on. Everyone has their own story and what works for me, may not work for someone else. I will help any vet, anyway I can. What I like about this site is we all can relate one way or another and can help one another better than any VSO.

carlie · September 21, 2013

what will happen to your rating or status if you refuse to take the meds?

Hollis, if a vet is SC'd for mental health - but only at 10 percent,

medications are factored into the rating evaluation.

There are also instances in respiratory conditions

(and some others) that factor medications into the evaluation criteria,

such as steroid usage, and I think diabetes might factor in meds, etc . . .

The bottom line tho, is with the patient - you do not have to take any drugs

you do not want to take - regardless of your reasoning.

Here are some examples:

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=65c087de11077ce8408fe378fbcb0024&rgn=div8&view=text&node=38:1.0.1.1.5.2.111.73&idno=38

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks

only during periods of significant stress, or; symptoms controlled by continuous medication . . . 10

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning

or to require continuous medication . . . 0

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=65c087de11077ce8408fe378fbcb0024&rgn=div8&view=text&node=38:1.0.1.1.5.2.110.67&idno=38

Note (1): When continuous medication is shown necessary for the control of epilepsy, the minimum evaluation will be 10 percent.

This rating will not be combined with any other rating for epilepsy.

http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=65c087de11077ce8408fe378fbcb0024&rgn=div8&view=text&node=38:1.0.1.1.5.2.102.46&idno=38

6601 Bronchiectasis:

With incapacitating episodes of infection of at least six weeks total duration per year 100

With incapacitating episodes of infection of four to six weeks total duration per year, or;

near constant findings of cough with purulent sputum associated with anorexia, weight loss, and frank hemoptysis

and requiring antibiotic usage almost continuously . . . 60

With incapacitating episodes of infection of two to four weeks total duration per year, or; daily productive cough with sputum that is at times purulent

or blood-tinged and that requires prolonged (lasting four to six weeks) antibiotic usage more than twice a year . . . 30

Intermittent productive cough with acute infection requiring a course of antibiotics at least twice a year . . . 10

Hope this helps a vet.

Philip Rogers · September 21, 2013

Carlie - sorry to disagree but meds can't be factored in. I've taken psyche meds 3 times during my 10yr appeal, each time for less than 2 -3 months. I know they mention them in the C&P exam report(s) and in counseling but they are not required. They can't require an amputee to use their prostheses anymore than they can require someone to take diabetes meds, or meds for HBP, or use a C-pap for sleep apnea. They have to rate you on your symptom(s)/condition(s).

pr

Philip Rogers · September 21, 2013

My doc sure doesn't over prescribe. I asked to go from 2-50mg tramadol daily to 3-50mg tramadol daily, for back and knee pain, and was told 100mg a day is the max. B*tch!!! My private doc says he can do up to 500mg a day, with no problem, so I get the one extra I need daily, from him.

I understand, in some ways, because some vets have been caught selling their percocets, etc., or so I've heard on TV, that they bring big money but I don't understand why anyone would risk it. jmo

pr

Jazona · September 21, 2013

The VA gave me benzos way back in the seventies. Worked like a champ. Allowed me to settle down enough to tend to my studies and get a degree in engineering. Then, out of the clear blue, they cut me off cold turkey. I spent the next thirty years to get my benzos back, no deal. Instead, they crammed big pharma's SSRI's. I did the research and low and behold, discovered the big lie. They do nothing but bad. Google tartive dysphoria sometimes.

I spent most of my career working for municipalities and managed to come away with private health insurance. I got a private psychiatrist who reinstated my benzos. Yes, I know, they are addictive. They say I will want more and more. They lie. I've been back on them for well over a year and have no need to increase either dosage or number of dosages. They calm me down so I can function in society. They take away most of the anger. In short, they give me most of my life back.

So, perhaps I am the exception to the rule. I only know that they work for me. If I am taking away time at the far end, I'll accept that in light of what they are doing for me now.

Jaz

carlie · September 21, 2013

Carlie - sorry to disagree but meds can't be factored in. I've taken psyche meds 3 times during my 10yr appeal, each time for less than 2 -3 months. I know they mention them in the C&P exam report(s) and in counseling but they are not required. They can't require an amputee to use their prostheses anymore than they can require someone to take diabetes meds, or meds for HBP, or use a C-pap for sleep apnea. They have to rate you on your symptom(s)/condition(s).
pr

pr,

If medication can't be factored into the evaluation for percentage level of disability,

then can you explain this BVA decision to me where I can understand that medication

is not a factor in the evaluation for percentage level ?

http://www.va.gov/vetapp13/Files1/1310133.txt

Rating Prior to December 1, 2008

As noted above, the Veteran is rated 10 percent for the period prior to December 1, 2008, for his service-connected epilepsy.

VA treatment records during this period and October 2008 VA examination show that the Veteran's disability was manifested

by required continuous medication to control his epilepsy.

Under 38 C.F.R. § 4.124a, Diagnostic Code 8911, such warrants a 10 percent rating.

However, for the period prior to December 1, 2008, there is no evidence of, and the Veteran repeatedly denied, suffering any recurrent seizures.

The Board therefore finds that the Veteran's epilepsy is consistent with a 10 percent rating for the period prior to December 1, 2008.

See Jones v. Shinseki, 26 Vet. App. 56, 61-63 (2012)

(holding that the Board may deny entitlement to an increased rating on the basis of relief provided by medication

when those effects are specifically contemplated by the rating criteria).

As the Veteran's disability specifically entails rating the disability based on the effect of the disability by medication,

the Board finds that denying a rating in excess of 10 percent, in part on that basis, and also because there is no evidence of any recurrent seizures, is not in error.

Rating for December 1, 2008 to December 31, 2008

The Veteran's service-connected epilepsy is also rated 10 percent for the period from December 1, 2008 to December 31, 2008.

As noted above, VA treatment records for this period are not associated with the claims file.

Nonetheless, the evidence of record indicates that the Veteran discontinued his Phenobarbital and suffered between 7 and 14 seizures per week during the month of December 2008. The Board notes that the Veteran is competent to indicate that he has had a seizure. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

The Veteran is also competent to indicate the frequency with which he has seizures. See 38 C.F.R. § 4.121. As the Board finds the Veteran credible, therefore, his reported 7 to 14 seizures per week for the month of December 2008 approximates the criteria for a "staged" rating of 80 percent, but no higher, for the period beginning December 1, 2008 and through December 31, 2008. See Hart v. Mansfield, 21 Vet. App. 505 (2007); see also Fenderson v. West, 12 Vet. App. 119 (1999). A further increased (100 percent) rating is not warranted for the period from December 1, 2008 to December 31, 2008, as there is no evidence of at least 1 major seizure per month over the last year.

Rating Since December 31, 2008

For the period since December 31, 2008 to the present, the Veteran's service-connected epilepsy is rated 10 percent disabling.

VA treatment records during this period and October 2009 VA examination show that the Veteran's disability

has been manifested by required continuous medication to control his epilepsy.

Under 38 C.F.R. § 4.124a, Diagnostic Code 8911, such warrants a 10 percent rating.

However, for the period since December 31, 2008, there is no evidence of, and the Veteran has repeatedly denied, including at the August 2012 video conference hearing, suffering any recurrent seizures.

The Board therefore finds that the Veteran's epilepsy is consistent with a 10 percent rating for the period since December 31, 2008. See Jones v. Shinseki, 26 Vet. App. 56, 61-63 (2012) (holding that the Board may deny entitlement to an increased rating on the basis of relief provided by medication when those effects are specifically contemplated by the rating criteria).

As the Veteran's disability specifically entails rating the disability based on the effect of the disability by medication,

the Board finds that denying a rating in excess of 10 percent, in part on that basis, and also because there is no evidence of any recurrent seizures, is not in error.