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

[Berta]

Good, at least your complaint went somewhere=

OAWB has a Triage team that assesses how to handle these complaints.Please let us know the results.

You can still call the WH Hot line if you do not get a sufficient follow up from VHA-

My complaint started out regarding something that had nothing to do with me at all-

filed with the WH, and the OAWB contacted me.Two other issues are now before them-that can impact all veterans and their survivors, and did impact me.

Only recently did  my past C & P problems crop up with the OAWB.I deal with their Triage manager.

Maybe about 2 weeks ago he had asked me 2 questions-

The OGC could have answered one of them very fast but they did not respond to my call- it took me  many hours over many days ,on the internet to find documemtatioonwhat he needed to know.

The second question he had asked if the past C & P exams they did on my dead husband were relevant to the most important main issue  I raised with them. I had to pull them out- they are all awful- and I realized Yes, those C & P exams were highly relevant to the other issues.

Within a few hours after he received copy of a 1996 C & P  and also a copy of a C & P exam in a 2015 decision, 

he gave me a Case file number and is sending my stuff he has to someone else there.

Our complaints are triaged, as yours was.

From 1995 to 2015 I have evidence that I told the OAWB appears that my RO has targeted me.What I have sent them so far- over the past months-shows their multiple deliberate attempts to not only deny my VA claims but also to manipulate the Regional Counsel, and the OGC regarding my FTCA wrongful  death case.

It was only by  sheer determination, constant  study of VA cases laws and regs, and being able to access overwhelming medical evidence of malpractice -did I succeed in the FTCA matter and all the other claims they initially denied.

 

Be prepared to scan and attach your C & P exams to any responses from the VHA,if they request them.

Oddly enough, I learned recently of a 'nexus' between my current CUE issues , and GC Pres op 08-97-that might open another  VARO barrel of worms.

The VHA might be the best place to send C & P complaints to-but -in my case, those C & Ps I sent seemed to be the final evidence to support my original OAWB complaints, and evidence  on other VERY serious matters.

I handled these issues just as I did with my claims. I used documented evidence from the VARO and the OGC.

They can acess my entire C file if they need to.

 

 

Edited January 24, 2019 by Berta
added more

[wirat]

FYI, I think my issue will be resolved. I posted earlier that I went for a C&P exam for a scar with this male nurse (contractor) wearing a gown with "Dr." stitched in it. He measured the scar, I went over how it was painful and he examined it and acknowledged.

Two months later I get the rating of service connected, but 0%. I look at his exam report and he checks "NO" in the painful question. I complained through LHI the contract company this must be an admin error, and he flat out denied there was any pain associated with the scar even though I brought it up during the exam in detail and checking for pain is part of the exam anyway.

I immediately filed for an increase for painful scar since it was at least rated as service connected now (it would be difficult for him to not determine that since this was all done in a military hospital while on active duty).

Today I had the increase C&P exam with a real VA doctor at a VA clinic and had my wife present in the room. He measured and did the same exam, I told him the same issues with the pain and he agreed. I asked and clarified what he would report. He gave me his measurements and I made sure to ask about the painful scar reporting part and he said yes, it will be rated as a painful scar there is no question. 

So hopefully in two months or so I will see it rated properly and go from there. I would expect it to be rated at 10% now because that is what it should have been if the 1st quack they sent me to was ethical.

Edited January 24, 2019 by wirat

[john999]

I remember getting a C&P from a psychiatrist that said in his report that he believed I was faking because I had a BA degree in psychology.  I did get a new exam on that one, but the new exam doctor was a friend of the former exam doctor and screwed me even worse.  I also had an exam for a heart condition as secondary to DMII.  The exam resulted in me getting a 0% rating.  I simply appealed the decision based on evidence and the incredible poor exam.  I got a 60% rating.  So really just by appealing I went from 0% to 60% and an award of  Housebound.   When in doubt file your NOD and appeal it.  You know the majority of vets don't even file an appeal on these low ball decisions.   Who knows how many vets have been screwed out of millions of bucks just because they did not file an appeal.  I know it cost me when I first got out of the army.

[Buck52]

I had a examiner take my C-file from the comp office and take it to the clinic I had my C&P he said he took my C-file home with him and read my records, he noted I had a hearing test at the time I ETS and therefore my hearing was not going to be service connected because my hearing wa sok at the time I got out.

I can't prove it but I truly think this examiner took some pages out of my C-file   because some are definitely missing...they don't show up in my updated Cfile  on the CD that give us now.

This examiner mention to me that I see your requesting an Increase..I said yes sir my hearing is a lot worse..he said well Just so you know its not me that makes that decision...but in the back of his mind I know he was thinking the hell its not  I'll get this veterans benefits taken away and his Service connection Severed...he tried but was not successful

I learn years later they are not suppose to take your C-FILE HOME they can read it in the clinic at the VA if your C&P is done at the VAMC which this one for me was..

Anywayz .I had to get a private IMO/IME to rebutt what this examiner mention in his report   took me 5 years to Appeal and finally win.

Had I'd known about him taking my C-File home with him    I would have reported that  but I didn't know??

Edited January 25, 2019 by Buck52

[Berta]

Wirat got his issue resolved this way:

" I complained through LHI the contract company this must be an admin error, and he flat out denied there was any pain associated with the scar even though I brought it up during the exam in detail and checking for pain is part of the exam anyway."

I never thought of that- com-plaining directly to the contracting firms- GREAT IDEA!

THANK YOU Wirat!   I have seen many complaints here over the years on these C & P exams.

Complaining to the VA might get a better C & P- or it might not-

But I sure hope others will follow your lead.

I suggest that anyone complaining drectly with the contractor to get documentation from them as best as you can and send a copy of your complaint to your RO as well to get it into the record .

LHI Logistics Health, Inc.

328 Front Street- South

La Crosse, Wi 54601

https://logisticshealth.com/our-company.aspx

mailto:information@logisticshealth.com

----------------------------------------------------------------------------

QTC Quality ,Timeliness, Customer Service

 

Contact info here:

https://www.qtcm.com/about-us/contact-us/

I am struck by this page for interested medical providers and their promise of “Low Legal Risk”-

https://www.qtcm.com/providers/

this is where many VA doctors and nurses etc (who do not work for the VA at all) are providing many of you diagnosis and treatment they have “low “liability for.

 

VA pays so much out now on malpractice , not to include the figures they hide on it, as they did with my FTCA settlement that they seek contractors who prevent us from using our 1151 and FTCA rights if they harm or kill a veteran... because these contracting doctors etc, do Not work for the VA.

I forget the other contracting firm's name-I put all of this info here months ago and cannot find it.

What a scam.

 

 

 

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[wirat]

15 hours ago, john999 said:

john999-... When in doubt file your NOD and appeal it.  You know the majority of vets don't even file an appeal on these low ball decisions.   Who knows how many vets have been screwed out of millions of bucks just because they did not file an appeal.  I know it cost me when I first got out of the army...

I could not agree more! I was inexperienced and trusting of the VA (geez!) when I first got off active duty and learned later how I was bamboozled. Partly my fault for not perusing everything, but mostly because I trusted the system. 

The recent faulty C&P exam for my scars was a real eye opener for me and it mortified me in a way because reading that report was an assault on my integrity and it lowered my faith in the entire VA system.

I'm on guard from here on out though, I will tell everyone from this day on, the VA is NOT going to act in your best interest, you must research everything, save every record, only provide copies, memorialize everything, take notes, bring a witness to your C&P exams if you can (yesterday I brought my wife in there), research the providers they send you to before you go, and lastly, DON'T BE AFRAID TO *TACTFULLY* ASK QUESTIONS/CLARIFY DURING THE EXAM AND VERIFY WHAT THE DOCTOR IS GOING TO REPORT. Speak up - it's the only chance you will have to communicate findings with the provider.

*Remember this = Once you leave that room, it will be the VA cube dwellers falling back on what the practitioner wrote in the exam, and personally, I don't want to find out two months later that I thought he/she would report "X" when it turns out they reported "Y" instead.

I see now a system compartmentalized like this not only separates functions to provide impartiality, but more often allows the VA to practice willful blindness by falling back on the practitioners report as tying their hands.

I think if you can have a witness present (just for support) it may change the demeanor of the C&P exam because now the practitioner is aware there is someone else in the room witnessing everything. I felt this way with my wife present. 

Personally, I believe every C&P exam should be audio recorded. It would protect the integrity of the process for both sides, keep everyone honest, and create a memorandum of record that could be reviewed later to resolve disputes. It is done in all sorts of legal proceedings, court, depositions, etc. this is no different. A C&P exam may be a medical related event, but it is merely a step in a regulatory/legal discovery process and as such should be treated as evidence.

Edited January 25, 2019 by wirat