Nightmare C N P Exam Today Need Help

[jusus27360]

I had my exam today an it was horrible. I have avasical necrosis in left shoulder which is very painful. Doing the exam she told me to lift my arm which as much as I could, she then stated.that she had to move my arm an she force my arm above my head. I scream in pain an started crying an she said "im so sorry i didnt mean to do that" wtf! She apologized several times stating that she didnt mean to do that. She then question me about a workers comp injury to my righr knee an asked.me if I had gotten compensated I told her yes an she said im going to report this an you will have money taken back I said wrf! My right knee was injured in the military an this workers comp was 20 yrs later an has nothing to do with my sc condition with my right knee. Please tell me what actions I can take. Ive been in so much pain since the exam both physically an mentally. Thanks for any input.

[V6Pony]

V6Pony,

It is common for the VA to use NPs and PAs for all C & P exams except mental health and hearing loss. My C & P exams for Cancer and peripheral neuropathy were performed by an NP. I felt like an oncologist should have performed my Cancer exam and a Neurologist should have performed my exam for peripheral neuropathy. It is not fair to veterans to have VA C & P exams conducted by incompetent examiners. As a result, VA rating officials often deny legitimate claims resulting in long and unnecessary appeals for many disabled veterans.

In my opinion, veterans dramatically improve their chances of winning their claims if they have a thorough IME by a doctor who specializes in the diagnosis and treatment of the condition being claimed and by providing the VA with an IMO from the specialist supporting the veteran's claim. The IMO should follow the format shown on the Hadit website and be supported by reasonable medical rationale. Also, submit the IMO along with the evidence being submitted with the original claim. JMO

GP

Thanks georgiapapa. My NP was so condescending it just really p&&&& me off. I have PTSD anger issues. I know I got smart with her because some of the stuff she said was just unreal. I just could not believe she was that stupid.

Perhaps she was doing this on purpose I don’t know. If the VA condones this I have lost all faith that there is any intent on there part to help you.

My feeling when I left the C&P was to find a way to fight back. Guess this might not be the best choice. I feel now as if I have been violated with no recourse. I’m very depressed about this experience.

[MarkInTexas]

V6Pony,

It is common for the VA to use NPs and PAs for all C & P exams except mental health and hearing loss. My C & P exams for Cancer and peripheral neuropathy were performed by an NP. I felt like an oncologist should have performed my Cancer exam and a Neurologist should have performed my exam for peripheral neuropathy. It is not fair to veterans to have VA C & P exams conducted by incompetent examiners. As a result, VA rating officials often deny legitimate claims resulting in long and unnecessary appeals for many disabled veterans.

In my opinion, veterans dramatically improve their chances of winning their claims if they have a thorough IME by a doctor who specializes in the diagnosis and treatment of the condition being claimed and by providing the VA with an IMO from the specialist supporting the veteran's claim. The IMO should follow the format shown on the Hadit website and be supported by reasonable medical rationale. Also, submit the IMO along with the evidence being submitted with the original claim. JMO

GP

Georgia,

I talked about the C&P I had yesterday afternoon in Houston through Veterans Evaluation Services (VES), which was also done by a Nurse Practitioner, in a different thread, but I'll throw in on here as well. This NP sounded good on my shoulders, back and legs, but sounded doubtful regarding my service connections for cancer.

I already have an IMO on file from my specialist oncologist, who is a licensed doctor, and who has treated me for the past 17 years, service connecting my cancer condition. I also have an IME/IMO report from Dr. Ellis from the Ellis Clinic service connecting the same condition. Buck put my mind at ease a little in the other thread that a rater will or should take into consideration the IME/IMO's from licensed Doctors over that of a Nurse Practitioner or Physician's Assistant.

Anybody else have similar situations where an actual IME and/or IMO from a private doctor trumped the opinion of a VA-paid NP or PA? Also, if this is the case, I would think that it would be advisable for any veteran filing a claim to go ahead and obtain an IME/IMO from a private doctor up front, even if the VA will schedule a later C&P to be handled by an NP or PA, if only to have an ace card in your file. Thoughts?

Mark

Edited July 19, 2015 by MarkInTexas

[Berta]

I deleted the reply I made earlier...too many hijackers.. I got everyone's issues mixed up.

...

[MarkInTexas]

I had my exam today an it was horrible. I have avasical necrosis in left shoulder which is very painful. Doing the exam she told me to lift my arm which as much as I could, she then stated.that she had to move my arm an she force my arm above my head. I scream in pain an started crying an she said "im so sorry i didnt mean to do that" wtf! She apologized several times stating that she didnt mean to do that. She then question me about a workers comp injury to my righr knee an asked.me if I had gotten compensated I told her yes an she said im going to report this an you will have money taken back I said wrf! My right knee was injured in the military an this workers comp was 20 yrs later an has nothing to do with my sc condition with my right knee. Please tell me what actions I can take. Ive been in so much pain since the exam both physically an mentally. Thanks for any input.

I'm partially guilty of the sideline hijack, so I'll help keep on topic. On both my IME/IMO at Ellis Clinic, and with VES yesterday, they had me raise my arms, bend my legs and my back as far as I physically could, and held their hands on me the whole time. I'm assuming that is is partially to keep me stable for safety, and also to see where I tensed up or exhibited pain, which I'm assuming is for their own notes and accuracy and I would imagine also to check for malingering.

Outside of my legs, I don't really recall that the examiner forced me beyond what I could do, albeit with a bit of pain at first, and then allowing me to stop.

I agree that if you are still experiencing pain, you need to go to a licensed doctor for examination and possible treatment for any injuries sustained, or pain that you are still feeling. Make sure you get the examination and treatment record copies, along with a copy of any prescriptions that the doctor issues. Then you need to formulate a written complaint, noting the date, time, location and examiner's name along with the names of any clerks, nurses or other personnel that you can remember.

I could be wrong, but you need to document first.

Hope you get to feeling better, and that you are successful in your claim. Thanks for your service.

Mark

Edited July 19, 2015 by MarkInTexas

[john999]

If the worker's compensation injury and the military injury are not the same injury they have no connection. The C&P doctor is just talking ignorance. You can, in fact, get full worker's compensation benefits and TDIU/100% from the VA if the injuries are not the same. It is only when you have the same injury that you may have an offset. For instance, you have a SC mental disability. It gets worse as a result of being aggravated by your job. You might claim worker's compensation and you might eventually claim TDIU. You would probably have to choose to take either TDIU or total compensation from WC. Now if you hade total compensation from WC injury and you also had TDIU from mental problem you could get both at the same time. If you have WC at the total level and you are getting SSDI then you usually have the SSDI offset. It is complicated but some C&P doctor you have knows nothing and it just a trouble maker. You sure should file a claim for her injuring you during the exam. You should have punched her in the face. "I couldn't help it. When she yanked on my arm then my fist jerked up into her face". When I worked for the post office I knew people who got into fights with the doctors doing exams of their injuries. The doctors would bend an injured limb or something and the worker would kick out or flay away and smack the doctor by accident, of course.

[Buck52]

Mark I can't say its true for all veterans

but from my experience with a NP/or PA The rater and DRO did take my IME/IMO private specialist word or opinion over the VA ENT, he did a more in depth exam better medical explanation and they went with him.

Sometimes the VA C&P Dr's are well qualified and specialized and if the explain the medical rational where the raters or senior raters can better understand it then sure the C&P will probably go to the veterans favor and no need for a private IME/IMO

We just never know what there thinking (raters) what kind of mood there in or what when they rate us...so I'd say if the rater is in a good mood usually that means Approved/ Awarded , if he/she is in a bad ass mood...Denied before they finish ready the C&P Exam.

That's just my Opinion.

..................Buck

...............Buck