Did you get a flawed C & P exam-what you can do

[Berta]

You can immediately ask for a different doctor to do the exam.

When I say 'flawed', I mean the examiner did not have the expertise to opine on your claim, 

or the doctor did not have any of your medical  records, to include SMRs in many cases,

or the doctor failed to consider any other probative evidence that you moght have brought with you to the C & P yet the doctor didn't want to see it---

or the examiner LIED. There are probably many more reasons why an exam can be flawed.

This AM I received a call from OAWP-VA-DC, as to the ongoing investigation they are doing based on my other complaint .

I have more evidence to send to them-we went over some of the evidence they already have- it is solid to support my complaint-It is a different issue than this post is about-

But then I mentioned to the Triage manager the C & P situations I see so many of you here are dealing with.

I told him of 2 of my C & P exams (posthumously done on my husband) and am waiting until Jan 15, 2019 for a copy of one of them-to adequately prepare a OAWB complaint. on that matter, which affects so many veterans....and I am sure I am not the only survivor of a vet who has had this problem consistently with the RO I deal with.

He was shocked at what one SOC C & P examiner had stated..... I told him this was only one of many C & Ps they did- all wrong, to deny my claims. (all awarded since-yet not the point))

Would anyone here be willing to follow up my next complaint on the C& P problems many here have?

If it took a costly IMO/IME to get a full reading of your evidence, and then attain an award, tell them that.

If  your are in financial diffculties and cannot possibly afford an IMO/IME, tell them that.

If they lied about your condition , tell the OAWB that- and give evidence to show that they lied.

Be prepared to attach the C & P exam to the email you send to them, and attach any other evidence you feel they might need.

I told the OAWB Triage  manager I  have seen many C & Ps over the years that are highly erroneous and deny many valid claims . Claims that will add to the backlog and if they are valid they should never even be in the appeals process at all.

If you prepare a complaint, specific only to the C & P problem, you can refer OAWB  to my complaint ( Berta Simmons, NY ) that will be at OAWB on the 16th of this month.I am waiting until the 15th to see if VA will send me a C & P exam I requested.Whether I get it or not the complaint will still be filed on the 16th.

I do not really have a dog in this fight because so far I won any claim VA gave a lousy C & P on.I only needed the IMOs I have for one claim.

Something needs to be done about this situation.That wont happen with one complaint from a dead veteran's widow. The only evidence I have is my own personal

letters and C & P exams from the VA, And the info from NVLSP and GAO-which covers all veterans but  is general, and not specific to what many of you really go through with C & P exams,   that are geared to what the VAROs want-

                                                                     and that is - to deny the claim.

 

 

 

 

 

 

 

 

 

 

 

 

Edited January 8, 2019 by Berta

[Richard1954]

6 hours ago, SEALVET-33 said:

How do you request a new exam on the same day? Doesn't it take the C & P examiner 3 days for them to finish the one they did? How soon would we be able to get a copy of the exam after it was finished?

I  don't  think you can actually request a new exam until you get the denial of  the claim.. Then you appeal and  have to find a way to discredit the examiner by going after the examination report, pointing our why the examiner was wrong.  In the appeal request a new examination from a qualified examiner... If a contractor did the exam , it will not make it to your medical records at the va ,,, and you will have to request a copy of it from the regional office.... 

[wirat]

In my case with a painful scar the C&P examiner failed to note that it was painful although I told him it was twice. I was subsequently rated as service connected but at 0%. So instead of filing a NOD, or any kind of flaw/error complaint,  I immediately filed another claim on Ebenefits for an increase because the scar is painful. Literally put "painful scar" in writing on the claim for increase and submitted the same medical evidence as for the initial claim.

The next day, my new claim for increase was gone and merged into my current claim in progress along with other shoulder issues I have. So it seems they got the message and I assume will schedule another appointment for a C&P exam just to cover the painfulness of the scar for an increase.

At least this way (immediately filing for an increase) I will not have to go through and burn up time on an appeal (NOD), I will not have to go out and pay for my own IMO at this time to fight it, and will hopefully get the proper rating. Oh - and since they merged it, the date of claim for the increase is not two months later, but the date of my original claim. That surprised me.

If they consider what I have and still get 0% then fine, but I at least want all the symptoms considered in the rating which is what the 1st exam did not allow.

Edited January 23, 2019 by wirat

[Berta]

Thank you to anyone who will complain either to the White House Hot line or to the Accountability Office, even better yet to both-

and for any of our lawyer members out there who read hadit-this could be the basis for a Class Action Case:

If a veteran or their survivor has to pay for a costly IMO/IME to refute a poorly done C & P exam, and is awarded based on the IMO/IME- (which be will the first good read your VA medical records you will ever get, and includes a thorough reading your SMRs if needed for the claim,) you have been "damaged" by the cost of the IMO/IME, because VA did not give you a proper C & P exam.

Vets without the ability to get a real doctor's medical opinion/exam, and they can be very costly, are doomed by the exam - the cause of most of our denials. They too have been "damaged" by VA and if they subequently do get an award, without the IMO/IME, the4y have been damaged by surely not getting the proper EED in  the first place.

And Many give up at some point-and that is what the VA wants.

 

 

 

 

 

 

 

 

 

[63Charlie]

One ARNP for QTC directly contradicted the medical evidence in the claims file .

 She stated that I had no diagnosis for chronic fatigue syndrome, and based her rationale in rendering an unfavorable medical opinion on the basis of no diagnosis for this condition.

To make this clear, I submitted the medical diagnosis for chronic fatigue syndrome made by my treating MD at the time I filed my claim.

During the C&P exam, she had asked me directly if I had a diagnosis for this condition, and I replied, " Yes, and that my medical record showing a diagnosis of chronic fatigue syndrome was submitted when I filed the claim."

Claim denied.

Appeal filed.

[63Charlie]

On a different C&P exam for erectile dysfunction my claim was denied because the examiner falsely stated that my erectile dysfunction preceded my depression and anxiety disorders.

The claims file service treatment records show I was treated for depression and anxiety in 1979.

The claims file establishes the onset of erectile dysfunction decades later due to the medical care and diagnosis I received  by the VA for this condition in 2008.

Claim denied based on a unfactual C&P opinion.

Appeal filed.

Edited January 23, 2019 by 63Charlie

[63Charlie]

9 hours ago, Berta said:

Thank you to anyone who will complain either to the White House Hot line or to the Accountability Office, even better yet to both-

and for any of our lawyer members out there who read hadit-this could be the basis for a Class Action Case:

If a veteran or their survivor has to pay for a costly IMO/IME to refute a poorly done C & P exam, and is awarded based on the IMO/IME- (which be will the first good read your VA medical records you will ever get, and includes a thorough reading your SMRs if needed for the claim,) you have been "damaged" by the cost of the IMO/IME, because VA did not give you a proper C & P exam.

Vets without the ability to get a real doctor's medical opinion/exam, and they can be very costly, are doomed by the exam - the cause of most of our denials. They too have been "damaged" by VA and if they subequently do get an award, without the IMO/IME, the4y have been damaged by surely not getting the proper EED in  the first place.

And Many give up at some point-and that is what the VA wants.

 

 

 

 

 

 

 

 

 

Here is the VA response to my complaint:

MacAfee-ONeill, Cristina C. <Cristina.MacAfee-ONeill@va.gov>	3:26 PM (4 minutes ago)
to me

 

 

 

 

 

 

 

 

The Office of Accountability and Whistleblower (OAWP) protection has completed review of your submission and determined that the matter requires further review; however, it does not fall within OAWP’s scope.

 

Your matter has been sent to VHA’s Client Relations Team.  You should be receiving a confirmation from the Client Relations team within 14 calendar days.  Additional information or follow-up questions can be directed to the Client Relations Team at VHAClientServicesResponseTeam@va.gov.  

 

Your interest in improving the Department of Veterans Affairs is greatly appreciated.