Jump to content
VA Disability Claims Community Forums - HadIt.com Veterans


  • veterans-crisis-line.jpg
    The Veterans Crisis Line can help even if you’re not enrolled in VA benefits or health care.

    CHAT NOW

  • question-001.jpeg

    Have Questions? Get Answers.

    Tips on posting on the forums.

    1. Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery instead of ‘I have a question.
       
    2. Knowledgeable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title.
      I don’t read all posts every login and will gravitate towards those I have more info on.
       
    3. Use paragraphs instead of one massive, rambling introduction or story.
       
      Again – You want to make it easy for others to help. If your question is buried in a monster paragraph, there are fewer who will investigate to dig it out.
     
    Leading too:

    exclamation-point.pngPost straightforward questions and then post background information.
     
     
    Examples:
     
    • Question A. I was previously denied for apnea – Should I refile a claim?
      • Adding Background information in your post will help members understand what information you are looking for so they can assist you in finding it.
    Rephrase the question: I was diagnosed with apnea in service and received a CPAP machine, but the claim was denied in 2008. Should I refile?
     
    • Question B. I may have PTSD- how can I be sure?
      • See how the details below give us a better understanding of what you’re claiming.
    Rephrase the question: I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?
     
    This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial of your claim?”
     
    Note:
     
    • Your first posts on the board may be delayed before they appear as they are reviewed. This process does not take long.
    • Your first posts on the board may be delayed before they appear as they are reviewed. The review requirement will usually be removed by the 6th post. However, we reserve the right to keep anyone on moderator preview.
    • This process allows us to remove spam and other junk posts before hitting the board. We want to keep the focus on VA Claims, and this helps us do that.
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • VA Watchdog

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0

Notice Of C&p Exam


Brandy

Question

Can anyone tell me what GM might mean? This is abbreviated like this after appointment date and time.

C&P/GM

C&P/EYE

I know that the eye is for my husband's eye exam because we claimed diabetic Retiopathy. But I don't know what the GM stands for.

The other question I have is, do the exam doctors really use the examination work sheets that are posted on the VA's website? If so, do they cover pretty much everything on the exam worksheet?

Also, if they require lab work to be done, would they elect not to get labs done if in our records we have lab work dated about 5-months ago?

Link to comment
Share on other sites

  • Answers 20
  • Created
  • Last Reply

Top Posters For This Question

Top Posters For This Question

20 answers to this question

Recommended Posts

Guest jangrin

Hi Brandy,

I think GM in your husbands case is going to mean GENERAL MEDICINE, mainly because DMI and DMII patients have so many secondary conditions. They will probably just do a general physical and eval. everything at once.

The other option might be for GASTROL (something) , did you file for any gastrological symptoms?

Hope this helps,

Jangrin B)

Link to comment
Share on other sites

Brandy, jangrin is correct. GM= General Medicine. It covers anything from DMII to whatever. From there if a specialized C and P is required one will be scheduled. The only thing is does not cover is orthro. Usually the C and P area has several GM docs with one or two covering orthro issues. The reason for the concentration on orthro is that so many of the claims focus around orthro issues and do not need an over all physical.

Link to comment
Share on other sites

Jangrin,

That's what I was thinking too. Yes, my husband has DMI and I filed around 20 or so secondary disabilities. The GM appointment is 15 minutes after another appointment in which they don't give me any clue as to what it is for. Maybe lab work? Yes, one of the secondary conditions is GERD, hernia, gastric ulcers.

Do you know if they will just use the GM exam form or as it says on the GM form they will have to use other exam forms such as Cardiovascular, Endocrine, etc.

Is this general examination a good thing? I don't know if I like the idea because my husband has so many issues I don't think one examiner will be able to cover it. We have sent them ECG's, EKG's, labwork and statements from his doctors regarding his renal failure, hundreds of medical documents just covering the last year. My husband has probably been in the hospital about 7 or 8 times in this past year.

Link to comment
Share on other sites

Guest jangrin

Brandy,

Your husband presents a very dibilitating picture. I too, wish I had found this web site prior to helping my husband file a claim. I would have known that it takes forever, and we would/could have done things differently.

Hind sight it great!!! But we are in this now and we need to gather up all that informatiojn we can. We as spouces continue to be supportive through a very difficult process. I asked some questions on your other forum topic.

Hang In there, it's a learning process.

Jangrin

Link to comment
Share on other sites

Brandy, jangrin is correct. GM= General Medicine. It covers anything from DMII to whatever. From there if a specialized C and P is required one will be scheduled. The only thing is does not cover is orthro. Usually the C and P area has several GM docs with one or two covering orthro issues. The reason for the concentration on orthro is that so many of the claims focus around orthro issues and do not need an over all physical.

Ricky,

This is the GM exam that the VA uses:

General Medical Examination

Narrative: This is a comprehensive base-line or screening examination for all body systems, not just specific conditions claimed by the veteran. It is often the initial post-discharge examination of a veteran requested by the Compensation and Pension Service for disability compensation purposes. As a screening examination, it is not meant to elicit the detailed information about specific conditions that is necessary for rating purposes. Therefore, all claimed conditions, and any found or suspected conditions that were not claimed, should be addressed by referring to and following all appropriate worksheets, in addition to this one, to assure that the examination for each condition provides information adequate for rating purposes. This does not require that a medical specialist conduct examinations based on other worksheets, except in the case of vision and hearing problems, mental disorders, or especially complex or unusual problems. Vision, hearing, and mental disorder examinations must be conducted by a specialist. The examiner may request any additional studies or examinations needed for proper diagnosis and evaluation (see other worksheets for guidance). All important negatives should be reported. The regional office may also request a general medical examination as evidence for nonservice-connected disability pension claims or for claimed entitlement to individual unemployability benefits in service-connected disability compensation claims. Barring unusual problems, examinations for pension should generally be adequate if only this general worksheet is followed.

A. Review of Medical Records: Indicate whether the C-file was reviewed.

B. Medical History (Subjective Complaints):

Discuss: Whether an injury or disease that is found occurred during active service, before active service, or after active service. To the extent possible, describe the circumstances, dates, specific injury or disease that occurred, treatment, follow-up, and residuals. If the injury or disease occurred before active service, describe any worsening of residuals due to being in military service. Describe current symptoms and treatment.

Occupational history (for pension and individual unemployability claims): Obtain the name and address of employers (list most current first), type of occupation, employment dates, and wages for last 12 months. If any time was lost from work in the past 12-month period, please describe the reason and extent of time lost.

Describe details of current treatment, conditions being treated, and side effects of treatment.

Describe all surgery and hospitalizations in and after service with approximate dates.

If a malignant neoplasm is or was present, provide:

Date of confirmed diagnosis.

Date of the last surgical, X-ray, antineoplastic chemotherapy, radiation, or other therapeutic procedure.

State expected date treatment regimen is to be completed.

If treatment is already completed, provide date of last treatment.

If treatment is already completed, fully describe residuals.

C. Physical Examination (Objective Findings):

Address each of the following and fully describe current findings: The examiner should incorporate results of all ancillary studies into the final diagnoses.

VS: Heart rate, blood pressure (see #13 below), respirations, height, weight, maximum weight in past year, weight change in past year, body build, and state of nutrition.

Dominant hand: Indicate the dominant hand and how this was determined, e.g., writes, eats, combs hair with that hand.

Posture and gait: Describe abnormality and reason for it. Describe any ambulatory aids.

Skin, including appendages: If abnormal, describe appearance, location, extent of lesions. If there are laceration or burn scars, describe the location, exact measurements (cm. x cm.), shape, depression, type of tissue loss, adherence, and tenderness. For each burn scar, state if due to a 2nd or 3rd degree burn. Describe any limitation of activity or limitation of motion due to scarring or other skin lesions. NOTE: If there are disfiguring scars (of face, head, or neck), obtain color photographs of the affected area(s) to submit with the examination report.

Hemic and Lymphatic: Describe adenopathy, tenderness, suppuration, edema, pallor, etc.

Head and face: Describe scars, skin lesions, deformities, etc., as discussed under item #4.

Eyes: Describe external eye, pupil reaction, eye movements.

Ears: Describe canals, drums, perforations, discharge.

Nose, sinuses, mouth and throat: Include gross dental findings. For sinusitis, describe headaches, pain, episodes of incapacitation, frequency and duration of antibiotic treatment.

Neck: Describe lymph nodes, thyroid, etc.

Chest: Inspection, palpation, percussion, auscultation. Describe respiratory symptoms and effect on daily activities, e.g., how far the veteran can walk, how many flights of stairs veterans can climb. If a respiratory condition is claimed or suspected, refer to appropriate worksheet(s). Most respiratory conditions will require PFT’s, including post-bronchodilation studies. Describe in detail any treatment for pulmonary disease.

Breast: Describe masses, scars, nipple discharge, skin abnormalities. Give date of last mammogram, if any. Describe any breast surgery (with approximate date) and residuals.

Cardiovascular: NOTE: If there is evidence of a cardiovascular disease, or one is claimed, refer to appropriate worksheet(s).

Record pulse, quality of heart sounds, abnormal heart sounds, arrhythmias. Describe symptoms and treatment for any cardiovascular condition, including peripheral arterial and venous disease. Give NYHA classification of heart disease. A determination of METs by exercise testing may be required for certain cardiovascular conditions, and an estimation of METS may be required if exercise testing cannot be conducted for medical reasons. (See the cardiovascular worksheets for further guidance.)

Describe the status of peripheral vessels and pulses. Describe edema, stasis pigmentation or eczema, ulcers, or other skin or nail abnormalities. Describe varicose veins, including extent to which any resulting edema is relieved by elevation of extremity. Examine for evidence of residuals of cold injury when indicated. See and follow special cold injury examination worksheet if there is a history of cold exposure in service and the special cold injury examination has not been previously done.

Blood Pressure: (Per the rating schedule, hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm.)

If the diagnosis of hypertension has not been previously established, and it is a claimed issue, B.P. readings must be taken two or more times on each of at least three different days.

If hypertension has been previously diagnosed and is claimed, but the claimant is not on treatment, B.P. readings must be taken two or more times on at least three different days.

If hypertension has been previously diagnosed, and the claimant is on treatment, take three blood pressure readings on the day of the examination.

If hypertension has not been claimed, take three blood pressure readings on the day of the examination. If they are suggestive of hypertension or are borderline, readings must be taken two or more times on at least two additional days to rule hypertension in or out.

In the diagnostic summary, state whether hypertension is ruled in or out after completing these B.P. measurements. Describe treatment for hypertension and side effects. If hypertensive heart disease is suspected or found, follow worksheet for Heart. Abdomen: Inspection, auscultation, palpation, percussion. Describe any organ enlargement, ventral hernia, mass, tenderness, etc.

Genital/rectal (male): Inspection and palpation of penis, testicles, epididymis, and spermatic cord. If there is a hernia, describe type, location, size, whether complete, reducible, recurrent, supported by truss or belt, and whether or not operable. Describe anal fissures, hemorrhoids, ulcerations, etc. Include digital exam of rectal walls and prostate.

Genital/rectal (female): Pelvic exam, including inspection of introitus, vagina, and cervix, palpation of labia, vagina, cervix, uterus, adnexa, and ovaries, rectal exam. Do Pap smear if none within past year. If unable to conduct an examination and Pap smear, or if there is a severe or complex problem, refer to a specialist.

Musculoskeletal:

For all joint or muscle disorders, state each muscle and joint affected.

Separately examine and describe in detail each affected joint. Measure active and passive range of motion in degrees using a goniometer. In addition, provide an assessment of the effect on range of motion and joint function of pain, weakness, fatigue, or incoordination following repetitive use or during flare-ups. (See the appropriate musculoskeletal worksheet for more detail.) NOTE: The diagnosis of degenerative or traumatic arthritis of any joint requires X-ray confirmation, but once confirmed by X-ray, either in service or after service, no further X-rays of that joint are required for disability evaluation purposes.

Describe swelling, effusion, tenderness, muscle spasm, joint laxity, muscle atrophy, fibrous or bony residual of fracture. If joint is ankylosed, describe the position and angle of fixation.

Describe any mechanical aids used by veteran.

If foot problems exist, also describe objective evidence of pain at rest and on manipulation, rigidity, spasm, circulatory disturbance, swelling, callus, loss of strength, and whether condition is acquired or congenital.

If there is amputation of a part, see the appropriate worksheet.

With disc disease, also describe any neurological findings.

Endocrine: Describe signs and symptoms of any endocrine disease, effects on other body systems, and current and past treatment. See endocrine worksheets for further guidance.

Neurological: Assess orientation and memory, gait, stance, and coordination, cranial nerve functions. Assess deep tendon reflexes, pain, touch, temperature, vibration, and position, motor and sensory status of peripheral nerves. If neurological abnormalities are found on examination, or there is a history of seizures, refer to appropriate worksheet.

Psychiatric: Describe behavior, comprehension, coherence of response, emotional reaction, signs of tension and effects on social and occupational functioning. (This is meant to be a brief screening examination. If a mental disorder is claimed, or suspected based on the screening, an examination for diagnosis and assessment should be conducted by a psychiatrist or psychologist.) State whether the veteran is capable of managing his or her benefit payments in his or her own best interests without restriction. (A physical disability which prevents the veteran from attending to financial matters in person is not a proper basis for a finding of incompetency unless the veteran is, by reason of that disability, incapable of directing someone else in handling the individual's financial affairs.)

D. Diagnostic and Clinical Tests:

Include results of all diagnostic and clinical tests conducted in the examination report.

Review all test results before providing the summary and diagnosis.

Follow additional worksheets, as appropriate.

E. Diagnosis:

Provide a summary list of all disabilities diagnosed. Include an interpretation of the results of all diagnostic and other tests conducted in the final summary and diagnosis. For each condition diagnosed, describe its effect on the veteran's usual occupation and daily activities.

This basically says that the examiner will cover all disabilities by using the individual worksheets for other conditions except in certain cases. This means that a general medical doctor will be evaluating my husband on his diabetes, kidney problems, hypertension, GERD, Peripheral Neuropathy, Peripheral Vascular Disease, Chronic Congestive Heart Disease, CAD, Hypothyroidism, Bilateral Interstitial Pulmonary Edema, Arteriosclerosis, Edema and Erythema, Anemia, amputation of lower leg, Multiple Gastric Ulcers, Lumbar pain and limitation of mobility involving hip, legs, lower back.

etc.

This is a little scary! How can he do a good job when most of these problems should be evaluated by a specialist in each area of expertise? Do you think they would order a separate exam for the lumbar issue?

Link to comment
Share on other sites

Hello Friends,

Can anyone tell me if I can request a copy of exactly what the RO requested to be examined? I know this is important information. I seen other posts about this and I think from what I read is that you have to wait until after the exam to request this information as well as the C&P examination results. Is this correct?

We have claimed so many disabilities that I am just wondering what exactly the RO asked for. We have submitted to them recent lab work from private doctors and hospitals as well as VA clinic workups.

Thanks.

Link to comment
Share on other sites

Brandy, in the C@P exam report is should say something like this:

medical opinion or restatement of medical opinion, then it ask a question: For example: did the Veterans hypertension have its onset during service or manifest during the first post service year?

That question tells you exactly what they are looking for.

Go to the VA medical records section where the exams were done, Sign a release and and ask for all c@P exams you have had. They will usually print them right there.

Good Luck.

Edited by jstacy (see edit history)
Link to comment
Share on other sites

Guest rickb54

Brandy,

Looks like you got some good answers, I just want to ad one thing.

The va may or may not use the examination worksheets.

I have found that some regional offices now use computer generated forms and they fill in only the fields that they want to answer, when they are printed out, the form only shows the answered questions, and not all the questions.

Link to comment
Share on other sites

Guest jangrin

Brandy,

When my husband just had his C&P exam recently, we couldn't figure out what it was for either. On the appt. notification letter it said, he was to go to the out patient clinic for a C&P exam for "disabilities".

We got to the appointment and we were told it was a DMII exam.

I think there is a phone number on your appt. letter for scheduling. I think you can call the scheduling number and they know what the exam is for. ALso you can always call the 800# general info and ask them what exactly is the exam for.

When my husband went,the nurse that did the disability exam is the one that usually did ALL AO exams. She called it a DMII, the RO called it dsisability. SHe did all DMII and secondarys except, hearing, eyes and Mental.

I think they are calling your husband's exam a "GM exam", because he has many secondarys to the Diabestes and they can cover alot in one exam if they generalize the request, rather than an exam for each condition claimed for rating.

JMO

Jangrin

Edited by jangrin (see edit history)
Link to comment
Share on other sites

Jangrin,

1. But won't that hurt our claim? He has so many secondary's, how can they check them all in one visit?

2. Also, should we take the medical information from years ago that prove he had hypertension right after service? We just found these records and have not submitted them to VA. But I believe that the VA already should have copies in his C-file. This hypertension thing is what I talked to you about in another thread that we may have to file a CUE or 1151 on and I am not sure we should bring it up just yet. They may have enough information being that he also shows hypertension was diagnosed by the local VA clinic years ago.

3. I call the number on the exam report and got answering machine every time. I left a message and they have not returned my call yet.

4. Will the examiner have his C-file when he does the exam? Or will he only have portions of his file?

Link to comment
Share on other sites

Guest jangrin

Brandy,

1. We were at the appt. for almost an hour with the NP (nurse) doing the C&P exam. She did the physical and according to her report (we requested a copy) she covered everything except Mental, hearing, vision. But she did not address gastrointestinal. But she did address the following:

DMII, HBP/HTN, CAD, PN, ED-also medications, history, did the exam and findins and wrote DX in report. Brandy remember the examiner is not there to treat or come up with a treatment regime. They are only there to confirm or deny the presence of a claimed condition. and to list they symptoms so a rater can rate them.

I think they could do alot in the exam. Will they get everything, no I doubt it. But you have to plan on having to appeal some stuff. I still think your husband will be 100% schedular, but you may have to file an NOD on some of his conditions if they do not address them in the rating decision.

I would take any records or reports to the exam with you that you think might help. Personally I would take the reords that prove he has been hospitalized multiple times in the past year. And also the doctors report before and after his leg amputation. (we took 3 reports with us from Social Security-she didn't want any of them told us to send them to the RO). Your examiner may or may not want them, make sure you only give copies. Yes, they are suppose to have copies of the Cfile. Whether they do or not?????

If you filed for hypertension as secondary to the Diabetes (type 1) on the claim for compensation, then yes I would submit the information you have found to not only the doctor doing the C&P but also the RO. However, if you did not list it on the claim. Then hold on to it for your appeal or when you file for HTN.

The thing of it is, right now the claim is in the development stage, after this C&P exam I believe it will go to the raters. Especially if you have signed and returned the "no further evidence" VCAA form to allow the VA to go ahead rate the claim. If you have included HTN on your claim then send in the info now before it goes to the raters.

If you have NOT included the HTN on the claim-I would not at this time add another condition to your claim.

It may stop the rating process and add too much time for what the benefit would be.

I hope this helps,

Jangrin B)

Edited by jangrin (see edit history)
Link to comment
Share on other sites

When I went to my C&P exams done through QTC couple months ago, they sent me to an internal medicine doctor for arthrithis and neuropathy conditions. This was her first time doing any C&P for the VA. I am waiting to see what she wrote in the reports even though she said at exam that i was definitely entitled to compensation?

Link to comment
Share on other sites

Guest jangrin
Jangrin,

Thanks for the information. I will have to go thru the records and make copies of the most recent. I have well over 600 pages of medical reports.

Brandy,

Now you have made sure copies of all those records were sent to the RO in support of your husbands claim. right?

Jangrin

Link to comment
Share on other sites

When I went to my C&P exams done through QTC couple months ago, they sent me to an internal medicine doctor for arthrithis and neuropathy conditions. This was her first time doing any C&P for the VA. I am waiting to see what she wrote in the reports even though she said at exam that i was definitely entitled to compensation?

Did you request a copy of the exam? It seems like you would have received a copy by now, since it has been a couple of months ago since your exam

Link to comment
Share on other sites

I finally got a call back from the C&P scheduler about what my husband's exam's are for. They said the he will be examined for:

1. Injuries to residuals: Wrist, Pelvis and chest/rid fractures with pulmonary contusion/pneumothorax

2. GM - Diabetes and all secondary conditions claimed. i.e. PN, Hypertension, CAD, kidney failure, etc. (this is the one that we thought was for "General Medicine". But it sounds like the RO specified to the examiner exactly what to check for.

3. Eye Exam - Claiming Diabetic Retiopathy

Everyone ever had these type's of exam's? We are just wondering what to expect. For Hypertension I would think they would have to take blood pressure on 3-different days? Howerver, I did read that this may not be necessary if the medical evidence shows a history of HBP. We have submitted records showing diagnosis and readings dating back to 1980's from a VA clinic.

They told me that I would not need to bring any records as long as I have already submitted them to the RO, because the examiner will have my husband's file. I still plan on taking some with us.

Link to comment
Share on other sites

  • HadIt.com Elder

The doctor who does your C&P exam is supposed to have your claim file on hand. Ask him what his speciality is if it is a exam for diabetes. If he is just a retired GP you can appeal a low rating on that basis alone. You are supposed to be examined by a specialist but the VA hardly ever does this since that would cost them money. They hire some 80 year old GP to give you a 10 minute exam.

Link to comment
Share on other sites

The doctor who does your C&P exam is supposed to have your claim file on hand. Ask him what his speciality is if it is a exam for diabetes. If he is just a retired GP you can appeal a low rating on that basis alone. You are supposed to be examined by a specialist but the VA hardly ever does this since that would cost them money. They hire some 80 year old GP to give you a 10 minute exam.

That's a good point John. I will make sure I ask him what his speciality is. This exam for diabetes is supposed to cover all of the major medical issues of my husband's. So it is very important that he knows what he is doing.

Link to comment
Share on other sites

Guest
This topic is now closed to further replies.
×
×
  • Create New...

Important Information

{terms] and Guidelines