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]

OUCH!!!!!!!!!!!!!!!!!

Maybe if you dropped 75 pounds of something on the gynecologist's foot, she would get more of a sense of what you were talking about.

Watch out for your knees - they will be the next thing to go....

Edited October 21, 2013 by free_spirit_etc

[4MR05C]

No, they're already gone... I've already been examined for them... and x-rayed for them and ROM tested for my hip too. My foot injury happened in 1982... the damage is done.

[free_spirit_etc]

Seriously, on the knee thing. As for me, I am not military. But growing up on a farm, I had my share of injuries.

Oddly enough, I cracked my ankle jumping off a big pile of straw and landing on a cow's foot. It healed, I guess, but I always had a bit of a limp. Ironically, when I was younger, no one seemed to notice the limp except for a guy who was blind. Whenever I would walk with him, he would say "You have quite a limp there, don't you?"

But, my shoe on one foot would always pull over to one side. Now both do.

I would recommend that you NOT wear shoes that are very worn. I know I am a lay person, and not a gynecologist... but from my experience, once a shoe is worn it PULLS your gait over. If you keep wearing them you will start feeling it in your knees. Once you change shoes, the knees improve fairly quickly.

People will tell you if you have the RIGHT shoes they will support you - That has NOT been my experience. I don't spend much on shoes anymore. When a kind I like is on clearance, I buy a bunch. Then I can just toss them out when they start pulling me over.

[free_spirit_etc]

Who examined your knees, an ear, nose, and throat specialist?

LOLOLOLOL

[4MR05C]

. I know I am a lay person, and not a gynecologist...

!

Who examined your knees, an ear, nose, and throat specialist?

LOLOLOLOL

LMAO... I don't know, I guess I should check!

[Berta]

“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. “

Is the injury that caused the sesamoid replacement clearly documented in your SMRs?

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."

But your VA med recs should reveal Yes you did see a podiatrist.

I have severe pronation ,diagnosed by my podiatrist and must wear orthonics. My ankles ache if I dont wear them.I have to wear braces too to do yard work.I am a civilian but I know how painful these issues can become.I am not aware that a sesamoid bone removal can cause the type of issue you have. But I am not a doctor.

Custom orthotics wear out When was last time you got a podiatrist to check them?

Also wearing prescribed orthotics, I noticed, has had no impact at all on my shoes. They dont wear out anymore on one side so my podiatrist never looks at my shoes anymore.

“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! “

Actually this C & P doc you had did many of the things my podiatrist did at my first exam.

He did a lengthy work history (I have worked all my life and predominately on concrete and that is the cause of my pronation.) Was this C & P doctor aware of the shattered sesamoid bone, your primary claimed condition?

I feel you will need an independent medical opinion from a podiatrist to support the medical nexus, if any, to your ankles problems, and a clear diagnosis of your foot condition.Was this doc aware of the orthonics? Did you show them to her?

You will also need evidence that either the surgical removal was done while you were in the Mil or that you had an inservice injury that somehow caused the primary condition that you claimed.

Also a lot of time has passed since you got out and you might have to prove this condition has been continuous since your service.

“I did have x-rays taken “Do you know the results of the X rays?

I dont see a basis here for filing a complaint against this doctor because I dont know what diagnosis you have. Then again, if you feel she missed something in your med recs , and was not wualified to perform this exam, tell the VA that..

I think if you had mentioned seeing the VA doctor and the orthonics ,maybe things would have gone better for you.Then again the C & P doc should have known you did if they reviewed your med recs.

Arch and ankle issues might seem just irritating at first but they can lead to full blown back,hip, and knee issues. The toe problem might have caused a balance issue, causing further distress to your ankles.

But that would take a podiatrist to determine.

Do you have evidence of documented continuous medical care for these foot problems since 1984?

Edited October 21, 2013 by Berta