Upcoming C&p Examination

[DICK HILL]

I received a package from a VA contractor (Logistics Health Inc.) saying they have set me up for C&P examination with a Nurse Practitioner on 28 April 2015. The Contractor said the C&P exam is scheduled for one and one half hours. The following is the services VA has instructed the contractor to perform:

Medical: 90 minutes patient time; 75 minutes admin time

DBQ MUSC Back (Thoracolumbar Spine)

DBQ MUSC Foot Conditions, Including Flatfoot

DBQ MUSC Hip and Thigh

DBQ NEURO Peripheral Nerves

Med - Medical Records/Cfile Review - FILL FIRST

CPT 99090 - Analysis of clinical data stored in computer (Claim File)

CPT 99205 - Level 5 E/M, new patient (60 Minutes)

CPT 99354 - Prolonged service, first hour

DBQ Medical Opinion: Foot Conditions

DBQ Medical Opinion: Hip and Thigh

DBQ Medical Opinion: Peripheral Nerves Condition

I am wondering why they are asking for another DBQ and medical opinion on my feet. I had a foot C&P (not sure you can call it an exam - exam took 12 minutes) at the Frank Tejeda clinic on

2 February 2015.

Other than the foot C&P mentioned above and a C&P exam for hearing several years ago, this is all new to me.

I was wondering if anyone could tell me what this C&P exam might or will consist of. An hour and a half does not appear to be sufficient time to actually perform any tests such as Electromyogram (EMG) Nerve Conduction Studies, ROMs, etc.

Your thoughts will be appreciated. Dick Hill

[vern2]

Suggest download the DBQ's for the various issues, also c & p clinicians guide for those issues. If you have supporting documentation, bring 2 copies, and make a note of what you give them, though should already be in your c-file.

Be prepared, take notes during the exam. If this slows down the exam, remember it is your claim and I view the VA C & P as an adversary-, they are not out to help you. Have you claimed all these contentions, or these are unclaimed issues that the VA is bringing up? Good luck.

[georgiapapa]

Dick,

I seriously doubt you will receive EMG or NCS tests at your C & P exam. My exam for peripheral neuropathy in my lower extremities consisted of an NP breaking an oversized Qtip in half and jabbing me in the feet and legs with the Qtip while asking "can you feel that?"

It was a joke. Fortunately, I had brought copies of my EMG and NCS tests reports to the exam that were performed by my private doctor. I think bringing copies of all of your relevant medical records to your exam can help. My examiner did review the records and used the info to complete her questionnaire. Do not depend on the VA providing the examiner with your records.

Personally, I do not think an NP is qualified to perform an exam such as yours. If the exam does not go your way, I would suggest getting an IMO from a private specialist to countermand the C & P exam report if necessary. JMO

Take care.

GP

[DICK HILL]

Vern2 - Thanks for your response.

These are issues I filed a claim for last October. I asked for increase for degenerative arthritis of the Thoracic and Lumbar Spines currently rated at 10 percent and increase for Plantar Fasciitis currently rated at 0 percent. Claim contentions read as follows:

Disabilities Claimed: DEGENERATIVE ARTHRITIS OF THE THORACIC AND LUMBAR SPINES (Increase), PLANTAR FACIITIS (Increase), PES PLANTUS (BILATERAL) SECONDARY TO PLANTAR FASCIITIS (New), HIP OSTEOARTHRITIS SECONDARY TO DEGENERATIVE ARTHRITIS (New), LUMBOSACRAL RADICULTITS (RIGHT SCIATICA) SECONDARY TO DEGENERATIVE ARTHRITIS (New), LUMBAR STENOSIS WITH RIGHT FORMINAL STENOS SECONDARY TO DEGENERATIVE ARTHRITIS (New), LUMBOSACRAL SPONYLOSIS WITHOUT MYELOPATHY SECONDARY TO DEGENERATIVE ARTHRITIS (New), DEGENERATION OF LUMBOSACRAL INTERVERTEBRAL DISC SECONDARY TO DEGENERATIVE ARTHRITIS (New), CERVICAL SPONDYLOSIS WITOUTH MYELOPATHY SECONDARY TO DEGENERATIVE ARTHRITIS (New), DISPLACEMENT OF CERVICAL INTERVERTEBRAL DISC WITHOUT MYELOPATHY SECONDARY TO DEGENERATIVE ARTHRITIS (New), SPINAL STENOSIS IN CERVICAL REGIONS SECONDARY TO DEGENERATIVE ARTHRITIS (New).

All claimed items were diagnosed last year by a spine doctor and foot doctort. Hip osteoarthritis was also diagnosed during active duty in 1987 as right hip DJD. Lumbosacral radicultits was also diagnosed while on active duty in 1987 as sciatica in the right lower extremity. Both well documented while on active duty and treatment continuity since retirement in 1988.

Again, thanks for your response. Dick Hill

[DICK HILL]

Thanks for your advice

georgiapapa

I have never had EMG and NCS done by anyone. I do not think an NP is qualified to perform an exam such as mine either. However, I called the facility where the exam will take place and they said the NP is highly qualified in all areas pertaining to my claims. I did review the NP's bio and it does look like she possesses several unique skills. Dick Hill

[georgiapapa]

You are welcome.

[rootbeer22]

Folks

It seems that qualifications to do CP exams have very very wide limits in terms of whom is can do them. I had a nurse do a large number of my exams and there's no possible way that she could have been fully qualified to conduct all of those exams at a high level of .expertise?. But, certainly the results can be held against you or me which does not seem very fair even if they are not fully backed up by education or schooling that supports the expertise required? I found out today that some key evidence was left out of one of my CP exams because they were not loaded or scanned in the VBMS system so the raters could see it? It's actually very depressing at this stage to see what is happening with my claim after all of the dedicated work I put into it. My wife tells me to continue to have the faith until the final letter arrives....and I'm doing my best to see what happens...