IME and Physician conflict of interest

[OldJoe]

Instead of continuing a thread that dealt with CUE and beating a dead horse I thought it wise to start a new thread.

In the pursuit trying to fixed my messed up claim I finally have found a physician that does IMEs

Here is how he responded to my email explaining my situation:

<...>

"I read your email. It does sound like you could use some assistance. 

A bit about myself. I do perform IMEs for civilian cases but I am also employed by a company that is contracted by the VA to perform similar disability assessments. I will have to check with my employer to see if your case presents a conflict of interest."

<...>

Of, all the flipping luck!!!

I responded and explained further my situation.

Hopefully he responds soon.

That said, I need any advice possible on what I should do next.  I know this could be a blessing or this could be a curse, I don't know which...

[ArNG11]

Buck it all makes sense.  This is sad but true, can't serve two masters, either you serve one and not the other or you serve none.

Buck I'm sure you know this, but I feel I should mention it this for all our information sake.  Per protocol, doctors, nurse, any medical staff are supposed to document your visits and results.  You can get most of your information from eVet and/or by the freedom of information office.  Personally when I had care at the VA, I used eVet.  Any C&P exams that were done at the VAMC would also show up.  It was great, didn't have to bother anyone or get aggravated by some yahoo telling me I couldn't have access then and now and had to wait.  

I'm serious about this point, I used to and even still do in private practice records my visits.  Not just because some organizeations are scandalous but because there is so much information that you go over with your doc that you forget and not recall everything.

I don't see the problem in this, however, when an entity wants to keep things in house, those actions make a whole lot of sense.

Conflict of interest, plain as day huh?

[ArNG11]

Gastone give or take how often are you successful with your VA doctors helping you with your claims, or for that matter for helping you stay informed about your treatment options and managing conditions?

I like to point out the scandolous crap the VA often pulls, however, I cannot dismiss when a VA doctor and or clinician do what is right for the health of the patient.

[ArNG11]

23 hours ago, OldJoe said:

I know we all go into "conspiracy mode" when the VA pulls lame brain stunts like this, but is there some reasoning to the logic? 

I know this is the VA we are talking about they would send a Vulcan into an epileptic fit, probably would be considered inhuman and cruel punishment to even let one within 500 feet of a Vulcan.

Did you get anywhere in your pursuits?

[OldJoe]

Well, first my issue is with my back not sleep apnea, though I have since been diagnosed with it from civilian physicians.  Though there may be a service connection or secondary connection I am not going to try for it at the moment, I need to fix this mess before I start the next claim (yes, at least 2 more, will talk about them later).

Start on hadit wondering about a possible CUE in my initial rating but after a bit had the notion of going that way kind of squelched.  Not there aren't some cute glaring holes in their rational, but the way they wrote the initial rating, with the generic statements there was no way I could win on a basis of CUE.

The there this big problem, the initial rating was 20 years ago and I didn't file a NOD.  I simply didn't have any new information to give the VA, I didn't know anything about nexus letters, IMO, or that the VA was filled with such high quality people [sarcasm].  Since my back didn't hurt "that bad" I would take care of it in the traditional way, heating pad and anti-inflammatory medicine.

When I tried to reopen 3 years later, having absolutely no clue what I was doing, I made all of the exact same mistakes again, but it cost me over $3,000 I really couldn't afford but did pay it off after a while (was going to school for my degree).  What sucked is that we did have insurance at the time but they considered it "preexisting". (Hmm, rocket science here folks; where then could it have come from?  Hadn't performed any strenuous jobs or work other than carrying books since the AF.  Of course that part was brought up, not that it would have mattered)

Fast forward to now; have records of continued care since 2006 when my back got bad enough I had to start doing something about it.

I joined the AF in 1984 became a SP discharged in 1995. 

I can post scans of the original records but I will spare you that unless you really want it to see that I am not lying.  Here is a synopsis of all the entries for my back:

i.    17 September 1990
ii.    20 September 1990
     1.    Profile to not carry more than 10 lbs
iii.    4 October 1990
iv.    7 January 1991
v.    24 March 1991
vi.    27 March 1991 last entry in medical records for back pain
     1.    Notes that it is recurrent, mild scoliosis, conditions under which flareups occur, and the only mention of xrays I can find in my records.

Shortly after this I started working as Security Escort Dispatcher (Whiteman AFB).  The heaviest thing I had to lift was a large cup of coffee, a telephone handset, and an occasional ream of paper.  All of which mostly performed from the sitting position. 

We all know if I was one of those types that continued to go to sick call I would have been drummed out for malingering.  Heating pad and Tylenol when I did a little too much.

Got out of AF in 30 June 1995, have letter from VA stating they received my application for benefits but because of backlog would get top it as quickly as they could.  Like every other vet, I trusted the VA to be honest and true to their word.

Here is my full intiail rating, unedited.

 

 

 

 

 

Edited June 10, 2016 by OldJoe
didn't want PDF

[OldJoe]

As to where I stand in my pursuits...

Well, I hope I now have a lead on a good medical examiner.  They are still reviewing my records to see if they can help me.  The long it takes for them to get back with me on this the the more anxious I get.  The next specialist that can do an IMO/Nexus is in St. Louis.

I am in the process of getting my C-File, Faxed the request night before last and mailed it today complete with copies of the confirmation sheets. 

Did you know that the "Evidence Intake Center" does a call back and sends its own confirmation fax to your fax?  After a few minutes I got a telephone call, answered it and it was a fax tone.  Hung up, and they (it) called back, I quickly reconnected the fax and out popped the fax from them stating they had received my fax.

Why didn't I have a copy of my c-file before I filed?  Didn't realize how important it was and my VSO did ever respond to my inquiries about needing to get my c-file.

Why did I file before I got my Nexus letter?  Well, my VSO after I had gone through several doctors trying to get a nexus letter but refused up and submitted my claim.  I found this out when I had emailed him in order to find out if he had any ideas on who I could go to for a nexus letter.

His response to all of this, summed up...  "Lets see what they say", after getting denied and wanting to get on the ball with the appeal, he told me to call him to set up an appointment to start the process.  I called him and sent emails.

Still haven't gotten a response back.

Needless to say I found another service rep from DAV.  Only time will tell if he is any good for what I need.

So, right now I am behind the curve in regards to where I need to be, but I am hoping that the backlog will actually play in my favor and I can catch up to where I need to be.

Right now I am in the process of reading the very exciting, nail biting adventures recorded in past BVA decisions in case time runs out.  Better to have a case built out of a well formed pile of match sticks than to go in to see the DRO rep with nothing more than a stupid look on my face.

I am unfortunately one of those people that can manage to mess up a nocturnal lucid hallucination of erotica without even trying (there are ladies present).

[OldJoe]

And, I am not worried about different conditions being posted on this thread.  You taker 90% of the issues listed here on HADIT the only real difference is names, sex, race, and specific conditions.

Sounds like a lot but, when you think about it everyone's problem revolves around the same thing.  Then when we think we got it figured out they go and change the tune again...