Corruption

[rigo]

Dear Josephine and boar members, this is quite long so I`m going to doit in 2 parts

This is a correspondence between a Winston Salem Regional Office Adjudication Officials of the Department of Veterans Affairs dated after December 27, 2001 appears to approve alteration of a disable veteran`s medical records so that the claim is denied. ( I call them the memos of death ).

Green Nancy, VBAWSAL

To: Blake, John, BVAWSAL

Subject: QTC examination on COVA case

The case of xxxxxxxxxxxxxxxxxx is on remand from COVA for evaluation of the right knee. He is represented by none less than Hugh Cox, attorney at law. Examination was done by Dr Stabler on 12-27-01. Dr Stabler foun pain, stiffness, occasional swelling, flareups, use of brace, limitation of flexion to 90 degrees, "fair" weightbearing with use of cane, and x-rays evidence of traumatic arthritis called "moderate" by the radiologist.

Dr. Stabler concludes: "There was no disability of the right knee at this examination." "Disability secondary to the Knee condition is slight to none." As per our discussion, I can rate on the evidence and ignore the conclusion, as I would certainly do except for COVA and Hugh Cox. In this case, though, I think we cannot do that without triggering another remand. Can QTC fix this end furnish a medical statement correlating the conclusion with the findings? Thanks.

N. Green M.D.

This VA message raises disturbing questions about the integrity of medical compensation and pension examinations by QTC medical officials who examined veterans at the direction of the Winston Salem Regional Office of the U.S. Depatment of Veterans Affairs. Both Dr.Green and Mr. Blake were officials of the Adjudication Division of the Regional Office at the time of the incriminating e-mail.

Because, the this message, the QTC physician named above (Dr Stabler) issue an Addendum" to his original report. The addendum-change was even less favorable to the veteran than the original QTC medical report. The claim was subsequently denied.

There is an appearance that Dr. Green used Mr. Blake as a clandestine communication means to influence the QTC physician to tamper with the original evidence so that the veteran`s claim could be denied. Because Dr Green and Mr Blake worked at the Adjudication Office of the Winston Salem Regional Office, they were agents of the U.S. Government with a statutory obligation of duty to assist the veteran with his or her claim in accord with Manio v Derwinski, 1 Vet. App. 140, 144 (1991) ("Rather than defending against the claims of veterans, the Secretary has a statutory duty to assist claimants during the course of the ex parte and non-adversarial claims resolution process at the regional office and before the BVA.")

Is Dr. Green`s communication so potentially biased as to obstruct justice for the veteran and his counsel, as to tamper with witnesses without knowledge of the veteran, or as to conspire with others to sabotage the veteran`s claim? Where the veteran`s civil rights violated under 42 United States Code 1983? Dr. Green was not just a physician, but she was a "judicial" and adjudication official working for the RegionalOffice and acting under "color of law for the purpose of assisting the veteran with non-adversarial evidence to insure fundamental fairness as follows,":

"Information in VA records which are used by the Department in making any determination about any individual will be maintained with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the Individual in the determination." Cited from VA Adjudication Manual M-1 at section 9.15.

In this case, the veteran was never informed of the Dr. Green communication with Mr. Blake and its detrimental effect on the veteran`s claim until someone within the RO revealed this "hidden" information in 2003 to the veteran.

The courts have held that procedural fairness in an administrative proceeding generally requires an adequate opportunity to know the evidence to be relied upon and to rebut it. See Wirtz v. Baldor Elec. Co., 337 F 2d 518, 528 (D.C. Cir. 1963).

"We caution, however, that the permanent removal of documents from a claims file without notice to the claimant may raise concerns regarding procedural fairness, particularly in view of the possibility that such documents, including BMAO`s, may be favorable to the claimant in some instances. Accordingly, if the Board considers it appropiate to permanently remove documents from claim files, we recommend that procedures be established to ensure that claimants are given adequate notice of such removal, and to ensure that documents which are favorable to the claimant or otherwise relevant to the Board`s decision are not removed from the claims file." VAOPGCPREC 14-98

Will cont. letter with reply from VA Rigo

[rigo]

CONTINUATION

Response of the VA to the charges of tampering/changing respons to a medical evaluation:

HUGH COX ATTORNEY AT LAW

321 EVANS ST

SUITE 102, POX 154

GREENVILLE NC 27835-0154

Dear Mr. Cox

On October 10, 2003, we received your letter dated October 9, 2003, in which you requested a copy of a medical response submitted to the VA by QTC Medical Services. We have forwarded your request to our Release of Information section so that they may handle your request.

In this letter, you also raised concerns regarding our handling of QTC medical reports. You enclosed a sanitized copy of a VA e-mail which you suggest shows proof that the VA personnel directed a QTC medical examination to alter a medical opinion in order to deny the veteran`s claim.

We have reviewed the e-mail as well as your interpretation of the content of this e-mail which you have posted on your internert web page. We did this to attempt to understand how you believe this e-mail could be evidence of wrongdoing on part of the VA officials here at the Winston Salem Regional Office or of QTC medical oficials.

In response to your letter, we will reiterate several facts from the e-mail itsel, provide a possible explanation for our actions and exlain the reasons for those actions.

The e-mail from Dr Green to Mr. Blake contained several facts regarding the veteran`s claim:

The case involved a veteran whose case was remanded to the regional office from the

U.S. Court of Appeals for Veteran`s Claims for evaluation of his right knee.

The regional office received a medical examination report that was prepared on or about

December 27, 2001 by Dr. Stabler

The report indicated that Dr. Stabler found pain, stiffness, awelling, flare-ups, use of a brace, limitation of flexion to 90 degrees, "fair" weight bearing with the us eof a cane, and x-ray evidence of traumatic arthritis called moderate by radiologist.

Dr. Stabler concluded that "there was no disability of the right knee at the examination"

Dr. Stabler also stated that a disability secondary to the knee condition was slight to none.

From the e-mail, we noted that the issue of the remand was the evaluation of the right knee.

Please note that because the identity of the veteran is not known, we do not know the level of

disability assigned to the veteran`s disability at the time of the e-mail and therefore do not know how

Dr. Stabler`s conclusion would have affected the veteran`s VA disability evaluation.

The e-mail to Mr. Blake appears to identify a problem with the medical report that was submitted

to the regional office by Dr. Stabler. In it, Dr. Green suggested to Mr. Blake that the medical

findings listed on the report did not logically correspond with Dr. Stabler`s conclusion that,

"there was no disability of the right knee at the examination". She requested that, "QTC fix this [discrepancy] and furnished a medical statement correlating the conclusions with the findings".

When the VA identifies inconsistent examination reports, VA procedures state that we are not

allowed to deny a veteran`s claim or reduce the veteran`s evaluation. We are required to return

the inconsistentreport to the clinic or th the health care facility director with a statement setting

forth the deficiencies to be remedied. At that time of the e-mail, local procedures dictated that

Mr. Blake be made aware of problems regarding medical exam reports In turn, Mr. Blake was to

forward the request for clarification of the medical examiner`s conclusions to the appropriate

medical facility.

Dr. Green evidently identified a discrepancy between the doctor`s findings and the conclusions.

Procedures state that we are not allowed to deny a veteran`s claim when a discrepancy is identified.

In the e-mail, Dr Green suggested that based on the findings, she could make a decision on the veteran`s claim without considering Dr. Stabler`s conclusions that the veteran had no right knee disability.

Based on her comment, it is possible to assume, but not known for certain, that she planned to grant the veteran an increased evaluation for his knee based on the doctor`s findings alone, but knew that

procedurally, this will not be correct. She therefore appropriately followed procedural guidelines and submitted her request that the medical examiner provide a clarification of the examination report.

Since we do not know the identity of the veteran, we are unable to conduct a review of the file to

determine what the medical examiner stated in his clarification of the exam report.

We have been unable to address your accusation of obstruction of justice, tempering of evidence and conspiray beause the identity of the veteran is unknown. However, we hope that you appreciate our

explanation of the procedures that we believe our officials followed in this case.

If you will like us to conduct a more detail review pf this case or refer this to the Office of the Inspector

General to ensure that our actions were in acordance with the law, please provide us with the veteran`s

name and the claim number. Pease send copy of this letter with your reply.

L. W. Henderson

Veteran`s Service Center Manager

Interestingly, the RO officials did not voluntarily refer the matter to any investigative agency such as the

VA Inspector General and took the position that the e-mail was evedently an effort ("possible to

assume") by Dr. Green to "increase" the veteran`s rating

ADVICE TO THE VETERANS:

Veterans who are medically examined by QTC officials or physicians need to be alert to any "addendums"

issued by the QTC officials after an initial examination. The veteran should seek all communication

(written or otherwise) between the RO and the QTC examiners.

A GUIDE FOR VETERANS FACING QTC EXAMS

1. Make certain that you write down the full name of the physician who examines you. If the examiner is

not a physician, make certain you know the examiners credentials.

2. Try to obtain a business card from the examiner.

3. One valid way to accomplish obtaining the examiner`s business card and credentials is to suggest

to the examiner that you trust the examiner, and that you would like to consult him about your own

medical condition. Independent of the QTC exam. This tactic may cause the examiner not to be

suspicious about your inquiry of his or her identity.

4. Try to find out if the examiner is Boar certified in any medical field or has any speciality for which

he is recognized or licensed.

5. Write out the text of what you need to tell the physician about your disability and medical condition.

It is very important that you get across all symptoms of your disability to the examiner. Even better,

you should write out the symptoms you have and give a copy of those symptoms to the examiner at

the QTC examination.

6. Fill out one of the medical care questinaire named "Medical Care Questionaire to be completed by

client". Immediately after the exam.

7. Take notes during the exam as to what test are being performed . Physicians will usually tell you the

name of the device or test used in the exam.

8. Be certain to note the time (and date) the exam actually began and the time that the exam ended.

9. Ask the examiner if the examiner has a copy of your claims folder (c-file) from the Department of

Veterans` Affairs. The Department of Veterans` Affairs always gives preference to the VA physicians

or QTC physicians because the VA will claim that the VA or QTC physicians actually read your claims

folder before the examinaton. The physician will not let you examine or read the claims folder, but it

is appropriate to ask the physician if he has a copy of the claims folder and if he will show you the

folder itself so that you can be confident that your name is on the c-file. Please note how thick the file

is. The purpose of this information is to gather evidence about whether the examining QTC physician

actually read or examined your file before the examination.

10. Please give the physician a list of your medications, your job in the past fifteen years, and a pain

questionare to place in your Veteran`s claim folder (c-file). Please use this documents as an

opportunity rather than a burden so that you can enhance your chances of the QTC phyicians

actually knowing your condition, your medications, your symptoms, whether you work or not, and

any abnormal sensations such as pain. Rigo

[Pete53]

Fr a long time I have felt that QTC was there to weed out Veterans from getting their claims approved. Its outrageous that they can come back with addendums later to shoot down a valid claim.