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

[4MR05C]

Hi Berta, Thanks for your response. Your primary concern seems to be whether or not my semsamoid bone removal was done while I was in the military and the answer is "Yes!" The bone was removed while I was on active duty, on base at the Fort Campbell hospital.

Those are the ONLY SMRs that I actually have. The Army has lost practically ALL of my other records. (Yes, I requested rev=cords from St. Louis) All I got back from them was a DD214, my entrance to the military papers, my orders sepearating em fromt eh military, my orders separating me from the inactive Ready Reserves and my medical records show ONLY this one surgery. It's the weirdest thing.

So, to answer your question, yes, it occured when in the Army, yes, they have a record of it, and I would think that the "continuous condition" question would be affimrative as they removed a bone... and it has not grown back!

Btw, the ache/pain from the sesamoid bone removal DOES cause me to supinate, which is the turning of the foot the OTHER way, I walk on the outer portion of my foot... yours is on the inner.

[free_spirit_etc]

I think the continuous part would have more to do with was your problem continuous, or did it become progressively worse. That can be especially difficult to prove in claims where there has been a long time between service discharge and filing a claim. They will often try to say your condition is from intercurrent causes. If you can show you injured your foot in service, and the doctors say you have a current disability and that it stems from the foot injury, you will be fine. But if they say something else (either that you don't have a current disability or that it isn't from the injured foot) then you will need to get a private doctor that is willing to write a statement in support of your claim.

I wonder why they didn't have the same doctor that assessed you knees and hips assess your ankles.

[4MR05C]

There's been no other surgery/injury to that foot... it's all from the surgery while int he military. I'm beginning to believe that I will definitely have to get a private specialist to look at my claims. The VA's attitude seems to be that if you went to med school then you can exam anyone for anything... sigh...

Edited October 21, 2013 by 4MR05C

[free_spirit_etc]

You should be able to get a copy of the C&P exams from the VA. In fact, I would recommend it. Even if they are favorable, the RO sometimes distorts them. I am thinking those might be available on ebenefits; but I am not sure. They didn't have ebenefits when my husband was alive - and I don't think it is available for dependents. You should be able to get copies of the x-ray reports from the VA also.

They fact that the foot doctor has to fit you for special orthotics for your shoes should be in your favor on the claim.

[4MR05C]

I've requested an appointment to review my claim file and get a copy of it, we'll see what they have to say.... I'm supposed to get notification of the appointment via the mail, if I don't get it by next week, I'll go back and ask for it again! (I don't live far from the VARO) and no, there's nothing on e-bennies that will show the report. I have reviewed my medical reports from mthealthevet and there's one C&P exam on it... no more, and I have done at least 5!

[free_spirit_etc]

You should also be able to get copies of the C&Ps / x-ray reports / etc. directly from the center that did them.

Is the C&P exam that you have access to favorable?