Letters Written By Va Providers

[lugnut]

I asked my MH DR. if he would write an opinion as to my condition, his take on the history,etc, etc.

He told me that he had done so in the past, but had received a letter stating that he must refrain from doing so or face losing his VA job. They told him it was a conflict of interest for him to opine in a matter relating to the VBA. Anyone else ever heard of this?? It seems to me that VA is telling us that we must go "outside the system" hire a private Dr. be diagnosed, then get an IMO/IME from that person. Is that the way others read this??? I suppose I can get my progress notes to send in, but that isn't the same as an IMO. I'm kinda lost here.

[ArNG11]

Unfortunately that is the truth. They fall under this dilemma. Who is paying them? I have to say though at least he or she told you. That give's you a means to find and outside medical opinion, however, if it was written down on record and you have a copy of it, hmm I dare say that is a good " IN YOUR FACE" piece of evidence. Folks they can only ignore and break the law if you let them. Fight! We have tools. We have knowledge. We as veterans are not taking handouts or concessions. We are entitled to benefits according to law and regulation for the sacrifices we made for this country. REMEMBER this. It will motivate you to pursue what you are rightfully entitled to. Be precise for what you claim and have the supporting documentation to back it up. Don't ask for little things that you know are not due to your service. that can't be proven. It questions your character and they will exploit that even if you weren't meaning to. JMO

[Notorious Kelly]

If you're lucky and get referred to an outside source they may be more receptive to writing as letter;

My non-VA neurologist was supportive and wrote one for me, although her first draft did not use correct verbiage.

Don't leave it to chance; give them an example of the specific wording necessary to make a difference. Otherwise a seemingly supportive letter can be worthless as evidentiary value.

Be clear that you're not trying to put words in their mouth but that certain elements need to be present or the document is of no help.

Good luck!

[justrluk]

Also, consider that the VARO may request records from your providers within the VA system through the VA system. Not directly, but through their notes in your file. I've downloaded my notes, etc. and am amazed that they are pretty much verbatim of what was discussed in the office, a review of my history, etc. I have found no real discrepancies.

[carlie]

YES THEY CAN WRITE SOMETHING UP AND PUT IT IN YOUR MEDICAL RECORDS !

Print them out a copy from the link if you want.

http://www1.va.gov/v...asp?pub_ID=1790

d. Medical Statements to Support VA Benefits Claims.

When honoring requests for medical statements by veterans for VA claims adjudication,
care must be taken to avoid conflict of interest or ambiguity.

(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure.
As a result, they may not feel comfortable in stating causality of a current condition.
However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record,including their current functional status.
All pertinent medical records must be available for review by VBA.
NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process.

(2) Requests by a veteran for assistance in completing a VA disability claim are to be referred to VBA through official channels;
however, the clinician, if requested by the veteran, must place a descriptive statement in the veteran’s medical record regarding the current status of the veteran’s existing medical condition, disease, or injury, including prognosis and degree of function.
This may then be requested by VBA for the purposes of making a claim determination.

[GuaymasJim]

I disagree somewhat with OPs. Please read the following VA Directives. You can Google both. I can see a problem with the time it takes to fill out a DBQ as they are sometimes extensive.

VHA DIRECTIVE 2008-071
October 29, 2008

d. Medical Statements to Support VA Benefits Claims. When honoring requests for medical statements by veterans for VA claims adjudication, care must be taken to avoid conflict of interest or ambiguity.
(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. As a result, they may not feel comfortable in stating causality of a current condition. However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record, including their current functional status. All pertinent medical records must be available for review by VBA. NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process.

VHA DIRECTIVE 2013-002

(a) A “no wrong door” philosophy must be adopted to accommodate Veterans bringing a DBQ to a VHA facility. Veterans may ask their Primary Care Providers (PCPs) and Specialists to complete a DBQ for conditions which are already diagnosed and documented and for which the PCP or Specialist is treating the Veteran. DBQs can be completed during a routine office visit when there is sufficient time and the medical information is available. DBQs can also be completed outside of an office visit, or an appointment can be scheduled for completion. A DBQ completed by a PCP or Specialist is considered by VBA as medical evidence to support the Veteran’s claim.

The emphasis in both citations is mine.

I have requested and received both of these. The doctor refusing on "conflict of interest ground" is, in a word--WRONG.

Take a copy of these Directives with you. I would give a lot of thought before forcing a doctor to comply. You could very well piss them off; and pissing off someone you are asking to do something on your behalf--provide a statement or DBQ favorable to your claim--may not be the best tactic and may backfire. Possibly the proper sequence is to request him/her for him or her to fill out the DBQ; and if you run into resistance settle for a comprehensive statement in your VA medical records. Another is to fill out the DBQ or write out the statement yourself based on your knowledge of your conditions/treatment/medications and your medical records; and then ask your provider to edit and sign it. I would have copies of pages from your medical records showing each treatment, procedure, diagnosis, prescription, etc. to say him time. I would also explain--"less likely", "at least as likely", and "more likely"

as not.

I hope you prevail.

[GuaymasJim]

Carlie, you posted while I was writing! I don't think it will have any veteran from reading the same important material twice!