Confused With Latest C&p Exam

[4MR05C]

Hi all,

I'm new to this website as a member; but I've been here many times to read up on stuff in regards to my claim. I have a question that I'm hoping some of the more experienced members here can help me with, because I'm concerned that my last exam, which was yesterday (yes, a Saturday) was not done correctly, or by a competent doctor.

A little background first.... I have filed my first claim (since separating from the Army in 1984) in May of 2012. There has yet to be any decision on my case.

I have been to 5 previous C&P, none of which have been on a Saturday. This was at the local QTC offices here in Atlanta. This exam was for my claim for a secondary condition of my ankles (they are painful and occasionally, I limp from not being able to put a lot of weight on them.) The primary condition is that I had a shattered sesamoid bone totally removed from my right foot (its like a ball bearing at the big toe joint) which was not replaced with anything. Over the years, I have developed a way of walking that takes the pressure off that joint by walking on the OUTSIDE of my foot and shifting my weight to the other foot whenever possible, which I contend has caused my ankle problems on both sides.

Now, on to yesterday's exam: First problem: I brought in a pair of flip flops that I have been using this summer to walk in, she refused to exam them, saying that "those are going to do that." Well, no, cause it shows a clear wear pattern on the outside of my shoe.

Second problem, she wanted to see the shoes I had just taken off, well, these shoes are relatively new as I bought them last winter/spring and have not worn them much, she looked at them (entirely disregarding me saying "I haven't worn those much" and said "There's no wear pattern here." Well, duh, I haven't worn them much!

Third problem: When she asked if I had been to doctors about this, I forgot that I had been to see the podiatrist at the VA, for my foot issues (I don't think he made any notations on my ankles, he was more interested in coming up with a custom prosthetic for the bottom of my foot.) that when she asked me if I had gone to the doctor to see about my ankle, I said "No." to which she repeatedly said to me "So they hurt but not enough to go to the doctor?" (in an incredulous tone). My ankles have an ache damn near constantly, but not sharp stabbing pains all the time AND I have a VERY high pain threshold... (I had stitches put in my hand last year and the doctor hadn't numbed my my hand properly, so for at least a couple stitches, I felt the needle go in...and out and in and out - I didn't punch the doctor or anything.. I just gritted my teeth and let him finish. He even said that he was impressed that I could tolerate such pain). so, back to the lady doctor, she rudely cut me off when i tried to tell her that I have a high pain threshold and started scribbling on her notes (my medical records were NOWHERE in sight, btw) while I was trying to talk to her.

Fourth problem: She used her hands to rotate my bare feet around and around, and kept saying "give them to me" to which I explained that she was hurting me so I was resisting her), she just kept insisting that I ""give them" to her and didn't stop trying to twist my feet around.

Fifth problem, Now, I don't know what "repetitve use test" really is, but she never asked me to do any lifting of my heels or standing on my tip toes, she just asked me to walk about 6 feet from the chair I was sitting in to the wall of the exam room and back (three trips total chair to wall, turn, back to chair, and then back to the wall). That as the extent of the repetitive use exam.

Sixth problem, she eyeballed my feet/ankles when she asked me to push them down, wasn't there supposed to be a measurement taken?

Seventh problem: She looked at my feet from the back... while I still had my shoes ON. (isn't there supposed to be an exam from the back with shoes off?

Eighth problem: She did take out the goniometer and measure when she asked me to pull my feet up, and when I did, she asked (again in an incredulous tone) "Can't you get them to go higher?" To which I said "No." Also when she was doing the measuring, (the one and only time that she actually measured anything) she measured my left foot from the outside ankle bone and the right foot from the INSIDE (with out adjusting the alignment goniometer).

Ninth problem: She asked me how my ankles affected my work to which I relied that I was a student and ddn't stand on my feet all day but I had to walk arcross campus and that I had stairs to climb, but I also said, most of the day, I sit (which is the truth). Then she asked "Well, how did it affect your previous job" to which I said "Well, I was a paralegal" and she jumped in with a "So, you sat then too." And I saw her mark a BIG "O:" with a line through it (I'm assuming this was for how my ankles affected my ability to work).

Tenth problem: She's a gynecologist!!!! How is a gynecologist supposed to rate an orthopedic problem (and no, she has never been qualified as an expert witness or anything like that for ortho, I checked on-line.)

I did have x-rays taken and the x-ray tech asked me if I had had a recent injury to my ankles because they looked swollen to her, and I said, "No, that's just the way they are, all the time."

So, now that you've read this small book... what can I do to make sure my claim is done correctly and that I am examined fairly? (Which I do not feel happened here.)

Do I even have grounds for a complaint? Should I complain now or wait until I get a decision of some sort? Any help would be greatly appreciated. Thanks!

Btw, I found this online as a guide on how to test ROm in ankles: https://www.med.unc.edu/surclerk/medselect/resources/suggested-readings-for-subspecialty-clinics/rheumatology/Foot%20exam%20reivew_11-4-09.pdf

Edited October 20, 2013 by 4MR05C

[free_spirit_etc]

I am sure others will come along and give you lots of great advice -- hopefully if she writes a sucky report you will be able to get the exam considered inadequate. But I do want to say I am SO sorry this happened to you. You do not deserve to be treated that way!

[4MR05C]

Hi,

Thanks for your supportive post! I'm sure someone will come along in a day or two, you guys all seem to be so helpful!

[free_spirit_etc]

Considering how snarky you reported she was, I would not expect a supportive report. But maybe she was just in a bad mood because she is a gynecologist and they had her doing feet that day...

Can you ask the doctor who you see for your feet to write an opinion? Or at least state something about your ankles in your medical records?

Do you have any other shoes besides flip flops that are really worn? Maybe you could take a picture of them and send it to the examiner with a statement that reiterates that the shoes you wore to the exam were new, but you want her to see the normal pattern of wear on your shoes for her report.

On second thought - if the podiatrist fits you for a prosthetic, there should already be a record of your uneven walk.

I would certainly be tempted to call the VA and ask for pain meds and tell them that you have hardly been able to walk because you are in so much pain after the C&P doctor pulled and twisted your ankles....

[4MR05C]

LOL, my ankles do hurt today...

What I can't figure out is why would a gyno be in any way qualified to do a ROM inspection on my ankles? Maybe I'm wrong but in my mind that's like asking a dermatologist to do heart surgery.

I'm in the Atlanta VAMC which (if you haven't seen the coverage) isn't well known for being a great (or even good) VAMC, so if I get denied, I'll likely go to a civilian for a write-up.... yes, it'll cost money, but if they are going to do crazy things like this... it will be money well spent.

Edited October 21, 2013 by 4MR05C

[free_spirit_etc]

It is so disheartening to read so many stories where the C&P examiners are snarky and rude to the veterans. Somehow, they seem to consider their job to be to expose all SC claims as fraudulent or something.

I was just talking to someone at school the other day who had been a paramedic at the local military base. Somehow, they had her doing discharge physicals. She began telling me how retirees were trying to get over on the system by trying to get things documented in their records, etc. etc. etc. So here folks are retiring from the military, and being examined by someone who thinks they are trying to "get over on the system" and is going to make sure she doesn't document anything that she thinks will help them do that.

I guess it is the Air Force's way of saying "Thank you for your service. Now move right along...."

[4MR05C]

That's just sad.

I read something (on the other site like this one) where a C&P examiner (on his personal blog) wrote of all the times he "caught" someone being untruthful. Well, guess what, MOST of us are not doing that.

Personally, a teletype (which weighs in at about 75 lbs) was dropped onto my foot from the back of a full size truck.... the ONLY reason I didn't have to have toes amputated was because I had sprung for (paying out of my own pocket) and decided to wear THAT day, a pair of steel toed jump boots. The bone that shattered was where the steel toe bent in. They have the surgical records for my surgery!