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Comp & Pen And Pain Killers...


hedgey

Question

I know this might belong in the C&P forum, but the question involves painkillers and that seems to be a hot topic these days, so I figured it might be more general...

I have a C&P this week, a two parter, and one is for an increase to my rating for the Reflex Sympathetic Dystrophy in my feet. When I got rated back in 2009 for an increase and to make it bilateral, the examiner asked me how far I could walk and I replied not very far without having to stop... She said, "oh but you could walk a quarter mile, right? Just down the track at a school, right?" So I said, yeah, but I wouldn't enjoy it...

So of course in my paperwork she said I could walke more than 1/4 mile unassisted. Well, anyway, I was just really grateful that they SC'd my 'other' foot as secondary to my original one foot injury, so I let it go. A quarter mile without stopping? Not in years, my dears.

ANYWAY, I see a private podiatrist and private Primary Care. My podiatrist gives me shots occasionally, but she advised me to see my PC for oxycodene to help when the pain was very bad. She has experience with the VA and told me not to bother asking them for pain reliever beyond OTC stuff.

So yes, my PC was more than willing to prescribe Percoset, first with 5/.325acetominiphen then with 7.25/.325. I only take it when the burning and pain is so bad I really can't take it. I've managed to make a script for 120 tablets last from January 14th until last week (going in today for new script).

I did tell my VA Primary that I had the prescription, and it's in my records (at the lower dose).

My question is this: Should I make a point of telling the C&P examiner that I'm taking Percoset to manage the pain? It seems like this should support the level of severity of the pain I'm living with, but the VA is quirky. I'm a bit afraid they might go all "the Vet is getting DRUGS from a private doctor!!! DRUGS!!!" Yeah, drugs that actually work, and that I take so sparingly that I still suffer (believe me, it's awful).

What do you all think? Is doctor prescribed Percoset going to help my cause or should I just not mention it (unless asked, of course).

Also, I use a cane every day, but have no callus to 'prove' it. Handwashing is one of my OCD compulsions, but then so is applying hand lotion. My paws are clean and softy-soft!!

Well, wait, there is a small callus below my pinky ....

I have to go wash my hands now.

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  • HadIt.com Elder

The examiner will know if you are on Narcotic meds anyway with the matching system.

Dont hide it. Let them know. The Tylenol in these drugs worries me. This stuff can really crash a liver.

Basser

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  • HadIt.com Elder

I always approach my C&Ps for pain issue as if it was the 'worst' day, and answer my questions as such. All my private docs stuff gets given to, or uploaded to VA as part of a claim so they are all on the same page-ish.

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  • HadIt.com Elder

If pain is part of our claim I would be going to the VA pain clinic. I would have the VA prescribe my pain meds for me. I get pain meds from the VA every month. This involves them having me fill out a questionnaire rating my pain from 1-10. I rate my pain at between 7 and 8 every month without the pain meds. With the pain meds it is a 3, so they are doing me a world of good. I am documenting my benefit from pain meds because I say that they improve every function of my life.

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That is the catch, Hedgey, is we don't know what they're putting in records until after it's done.

I am dismayed at the inaccuracies and selective entries still being made. They are doing what is best for them and not the veteran.

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My VA primary care has never offered to send me to the pain clinic and when I asked about it, she blew me off. This was after telling her about getting percoset from my private primary. However, the nearest pain clinic is at the VAMC, in the city 75 miles from here. My VA primary knows about my PTSD and how much I try to avoid the VAMC, so maybe she thinks she's helping me.

I really don't want to go to the VAMC, ever. It's making me physically sick knowing I have to go down there on Thursday to my Comp & Pen. :(

Thanks for the advice. I'll tell the examiner about the percoset. It really makes sense. Besides, if I didn't it would be dishonest, and that's not what I want.

I hate being afraid all the time.

thanks for your help!

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  • HadIt.com Elder

The VA has a duty to address and treat your pain!!!! They started me on morphine about 8 years ago. Now the VA says "I" have an opiate dependence problem. I say they have a drug pusher problem since they are they ones who have had me on morphine, methadone, fentanyl, and oxycodone for years. If you are P&T what are you going to the VA for a C&P for anyway? You have a new or worse problem no doubt? I had a C&P for worsening DMII a few months ago. The doctor told me Vietnam vets get fat on purpose to get compensation for DMII. That is a Nazi way of thinking that there is no cure for except termination.

John

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  • Content Curator/HadIt.com Elder

Prior to a C&P, I heard advice to try and make the visit without relying on pain meds. It was challenging, but made sense. The Deluca ruling helped implement the ROM/pain rule, otherwise they would rate folks based on whatever their full ROM was, not when pain started. Eventually the VA will send out the DEA letters and mandate opiate contracts which make things worse. Might as well get rated on reality vs fiction.

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Hi everyone,

Well, I got through the comp & pen okay. I think it went as well as I could hope. It was good that I brought my copies of the DBQ's.

The examiner did not have a copy of the DBQ my podiatrist had submitted, nor did the file contain any of my podiatrist's records. I gave the examiner a copy of my podiatry DBQ as well as a statement that my podiatrist had written for me the week before.

What makes me think it went fairly well was that the examiner was very gentle with my feet. Rather than the thumping and yanking I'd experienced from examiners in the past, she was very slow and gentle, no trying to force me to exceed ROM beyond pain, etc.

She went by my podiatrist's DBQ while filling out the DBQ for the examination - which is what the examination was all about. She just filled out an electronic DBQ, mostly just copying what my podiatrist had said.

I did tell her about the pain medication my private doctor had prescribed. She entered that I needed percocet everyday to manage the pain beyond the Cymbalta and Naproxin the VA prescribed.

If anyone is wondering why I want an increase to conditions that are already service-connected, especially since I'm already TDIU, it's because I don't trust the future VA to continue providing care for non-SC conditions. While I have "residual pain in foot" service connection, it's at only 10% each foot. There is no question that my condition has worsened and will continue to deteriorate. Someday soon I will no longer be able to ambulate. I want the VA to acknowledge the level of my disability accurately, especially if I will soon have to rely on VA care for mobility, etc.

I hope I'm wrong, but I foresee a VA healthcare system that is limited by service-connection and by rating. I already need daily pain intervention, walk with a cane or a walker, and have a lot of trouble with stairs. I expect my ability to walk will be sharply limited within a few years.

Like I said, I hope I'm wrong.

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  • Content Curator/HadIt.com Elder

Did the examiner have the "deer in the headlights" look on their face?'

I am so glad for you that the examiner accepted your documentation. I always hated having a C&P exam because I knew I would leave feeling much worse than when I arrived. It sounded like you had a doc who cared enough to be gentle with you.

I really hope you are wrong, but you never know nowadays.

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