Expertise Of My Board Certified Internist

[Josephine]

item 6. of my remand from the BVA states Dr. P should be contacted and asked to provide the basis for this diagnosis of the veteran, and whether he has any medical training or expertise in treating or evaluating psychiatric disability.

My doctor, as everyone knows is a Board Certified Internist and has been my doctor for the last 29 years and does treat my anxiety, depression and headaches.

He has written a letter, his third letter to state to them how he diagnosed my illness.

His expertise.

This one is the big question.

My daughter is 100% disabled Bipolar. 3 years ago, she decided she wanted to end her life.

She was at my home the day before and I asked her why she was staring at her meds.

She said that she thought that she wanted to take them all.

She lives 50 miles from my home and the next morning, she calmly called me and said mom I took that bottle of pills and just wanted you to know.

I knew that she had 17 or 18 Klonopin, her reqular neurontin and lithium and other meds.

I ask her if she had told her husband, she said she was going to go now and tell him.

I called the rescue squad and when they and the police arrived, she was unresponsive.

She was immediately taken to the Emergency Room, as the story goes, the E. R. Doctor, called in my Dr. P, to whom was on call.

He treated her and saved her life and had her admitted to ICU and the next day transported to a mental hospital for a week stay and for shock treatment.

She went to the hospital and picked up all of those records and wants me to turn them in to the BVA Appeals Management Center, as she owes her life to Dr. P.

She wants them to see that he does have expertise in Psychiatry.

What do you all think? I value your opinion, Do I turn these records in per her request.

Josephine

[john999]

Josephine

If it was me I would get a board certified psychiatrist to write an IMO for me. The VA is going to take shots at your internist by comparing his training with their psychiatrists. It would be the same as comparing the creditials of a internist with an orthopedic surgeon to resovlve an issue of a broken bone. Whose opinion are they going to take? Even if a psychologist vs a psychiatrist at the VA the psychiatrist will win. Your internist needs to state his credentials for making psychiatric diagnosis.

[Josephine]

Josephine

If it was me I would get a board certified psychiatrist to write an IMO for me. The VA is going to take shots at your internist by comparing his training with their psychiatrists. It would be the same as comparing the creditials of a internist with an orthopedic surgeon to resovlve an issue of a broken bone. Whose opinion are they going to take? Even if a psychologist vs a psychiatrist at the VA the psychiatrist will win. Your internist needs to state his credentials for making psychiatric diagnosis.

John999,

There isnt a psychiatrist around that will tackle a claim of 42 years. Had I had the psychiatric records when I first filed in 1978, then there may have been a prayer of locating one. They all state, that there is no way that they can state that my anxiety is due to my service, after all these years. I had never read those military records myself until 2004, when I secured them from the archives.

The BVA wants to do know" What was the reason for my early discharge"? What was the reason that I was an unsuit?

I contacted Dr. Bash's partner and it will be 8 weeks before he can get back to me and my claim is progressing through the management center.

All Board Certified Internist does have training in psychiatry but not to the degree of the nuts at the medical center. He has stated this in his letters to the BVA and Management Center.

The Psychiatrist that I went to before Dr. P is deceased and actually Dr. P is not the one that originally diagnosed my anxiety.

My first doctor in 1965 and began treatment in 1967 for nervous anxiety was a graduate of Harvard Medical School and he was not a Psychiatrist.

I haven't heard a thing about him from the BVa. He is alive and could write a letter, but then again he is not a psychiatrist.

My daughters Psychiatrist, said that he would not tackle those many records, for I have a trunk full.

I am hoping for a new C&P, as requested, as the last one certainly wasn't a fair and just examination.

Thanks so much,

Josephine

Edited October 6, 2006 by Josephine

[huskerfanfl]

Josephine,

There is no doubt that you are fighting an uphill battle. I hate to say it, but the internist having training in psychiatry will not equate to the expertise of the psychiatrist at the VA any more than my normal doctor, who is an internal medicine doctor, would have the same credence as an orthopedist when it comes to joint problems. Has my regular doctor had training in regard to joints? Yes, but he knew that I needed to go to an orthopedic doctor when I needed to have my knee worked on.

[Berta]

I agree with these comments.

A good Independent medical opinion from a psychiatrist should entail not only a full assessment and rationale but also the MMPI, the Weschler, Shipley Institute test, Trial-Mosing, the Hand test and maybe a few other psychiatric assessment tests.

These tests are the best of all to assess anxiety, depression, and PTSD and numerous other disorders.

At least the MMPI should be done.

These are extensive and can take hours to perform but they are bonafide medical evidence of trauma and anxiety, etc. but often reveal the full extent of it and can be very helpful in a proper rating.

After they gave my husband 6-7 tests like this- his SC was increased to 100% as the tests revealed his PTSD was 'catastrophic', as his shrink stated and his stressors had already been proven.

[Josephine]

Josephine,

There is no doubt that you are fighting an uphill battle. I hate to say it, but the internist having training in psychiatry will not equate to the expertise of the psychiatrist at the VA any more than my normal doctor, who is an internal medicine doctor, would have the same credence as an orthopedist when it comes to joint problems. Has my regular doctor had training in regard to joints? Yes, but he knew that I needed to go to an orthopedic doctor when I needed to have my knee worked on.

huskerfanfl,

I know exactly what you are saying and I could go to a psychiatrist for treatment now, but what about the 42 years of treatment that I have had since discharge.

The Va. does not mind that the first doctor in service to treat me in the Navy was only a General Practioner.

He gave me my first Librium for my nerves or anxiety as they call it today and caffergot for a headache and sent me to two navy psychiatrist to see if his treatment was corrrect.

This is what lead to my early discharge.

My treating physician in the navy ( he only remembered me as I baby sit for him and is wife) wrote a letter stating that he gave me the librium for anxiety and the caffergot for a headache.

He has the highest of credentials!! Mayo Clinic.

My problem is the lady psychiatrist lied and changed all of my military and private medical records to give me the personlity disorder that she wanted me to have.

The BVa caught the lies and state the examination should go back to the medical center for a rationale of the decision that nothing bothered me in service.

Do I turn her in to the Board of Medicine for the State of Virginia, now or later?

Thanks as I value your opinion,

Josephine

Edited October 6, 2006 by Josephine

[huskerfanfl]

Josephine,

When I was in the army, I was a tanker by the way, we would be assigned an objective that we would need to take on the battlefield, either in actual combat or training for combat. While we would have liked to get right to the objective, that was not and normally is not viable. The way I see it, your objective is to get the VA to pay you back disability for the mental illness you suffered those many years ago. As in combat, while you may want that right now, it may not be feasible, you may need to take a piece of ground which will enable you an easier access to your objective. In this case, it may be that you might want to concentrate on getting VA compensation in the here and now, fro this day on and then use that as a starting point to get the money for the 42 years. It would probably be easier to tie it all together. So while seeing a psychiatrist now who may not go back 42 years seems like a bad idea on the surface, it can in fact be an intermediate objective, a means to an end if you will.