C&p Exam Done By Nurse?

[cowgirl]

Getting C&P exam for hopeful increase. Does a Dr need to do this exam? thanks,cg

[Pete53]

I think that many here think that they will beed a specialist and the fact is any MD opinion will do. MD is the last word. If there is a conflict between MD's than a specialist may do.

In the early 90's the VA used a lot of Social Workers evaluations and assessments to grant Service Connection.

[vaf]

Many here get an independent medical opinion from a specialist prior to the C & P and bring it in with them to give to the examiner. When this happens, reference to it is supposed to be made in the C & P summary. A board-certified physician specialist compared to a nurse practioner's opinion, I believe, would make for a good appeal, should it come to that.

C & P exams at the local VAMC are mostly done by Internal Medicine docs, non-board certified, and Nurse Practioners. We challenge them when they drop the ball.

[sixthscents]

I was lucky in that my Neuro C&P was done at the Nashville VAMC. They use interns from Vanderbilt Univ. for it, and I had an intern and the head of the teaching department (by chance) for mine. The funny thing is they wanted him first to check on a pilonodial cyst.... Imagine if you would a board certified Neuro INSTRUCTOR looking at my rump. I laughed when he mentioned it, told him I was sorry and dropped drawers to show him my 2 cysts. They were there, and draining (nasty - sorry) He was, well miffed to say the least, and then when he went over the labs tests, and the exams, and did an abbreviated physical, (no deep tendon reflexes in knee or foot...hmmm guess there something wrong there huh?) He basically said, "I'll make sure this is done right". He then put on his eval "I feel certain that Mr. Smith's condition is severe, chronic and will in fact probably worsen over time rather than improve.".. he went on to use words like "permanently paralyzed nerve" and "severe damage that is non-reversable with current medical knowlege". I was very very lucky. The VA rolled over on that and just gave up. They have pretty much done the same ever since. All because they had a Neurosurgeon look at my rump! HA!

When I went for an increase in SMC do to the inevitable worsening of my condition, I ended up in front of a well "jury" I guess. They had a chair set out in front of a desk, about 10 feet away, and there were 5 people behind it. 5. It was bizarre to say the least, but 2 of them I already knew from the Ortho department. I did their walking around, etc. and one of the ones I didn't know asked me to "try and run"... I just looked at him, shook my head and sat back down. Result - increase approved. Thats what bumped me up to 170%, since they rated me 100% for loss of use both legs below knee. I still had the lumbar, cervical and rest it only took the place of the ratings for the legs themselves.

So, I do believe that a specialists opinion is a boon in a well documented and proven case. If the VA is just trying to get basic info tho, I'd guess a nurse would do fine. It really depends on what they are trying to discover. I would be leery of going to a non-specialist for something like Neuro though. I'd probably get an IMO first by a Neuro doc. In either case I'd be prepared like you said to fight, and if the bullet goes unspent whos to say it was wasted?

[vaf]

Sixth, we got 10% for excision of one pilonidal cyst, however, it had to be operated on twice.

Don't see this particular item here that often, so I thought I'd mention it if someone can use the information.