VES SERVICES

[PACBRED]

Has anyone had a C & P exam with a nurse practitioner that wasn't interested in your disability but was looking for ways to state that your condition has improved? I've always had chronic lower back pain and was recently awarded 40% in 2016. After receiving that rating I then pursued IU and of course they set me up for a C&P exam. So after spending the morning with the nurse practitioner the exam lasted less than 30 minutes. So she had asked me to do certain movements which I was unable to perform and she did not measure or use any device to conclude her decision. So after weeks of waiting for the results I receive a letter stating that I had a normal range of motion. I was highly upset and was furious with the outcome. I then submitted evidence that my condition has not improved. I am also collecting Social Security disability due to my lower back and I sent them proof that I am no longer employed since 11/2016 and they sent me a form to give to my employer?? Go figure.... So they proposed to reduce my lower back % from 40 to 0. It is now a year and they have not reduced my lower back rating. So just recently I receive a call from the C&P clinic to have another examination for my lower back. So I asked the receptionist the same question is it a doctor that will be performing the examination? She stated no it will be a nurse practitioner. I informed the receptionist that I do not wish to have a nurse practitioner give her medical opinion due to the previous np and her medical opinion. So she told me to contact the Regional office to schedule me another C&P exam with a non va medical facility for this lower back C&P exam. So I receive an email from VES Services stating that I have a c&p exam with one of their medical providers at this facility. So it happens to be my old VA primary care Doctor who is no longer practicing at the VA clinic but with this VES Services agency. My concern is if I know this Doctor isn't a specialist for  my lower back why bother going through with this examination knowing that she was a primary care physician and not a back specialist ? I tried calling several chiropractors to see whether they can perform my C&P exam on my behave rather than the VES Services and they all seem to say that they don't do that examination. So now I'm concerned that they are really trying to reduce my 40% to 0. Does anyone have any suggestion or advice to this matter or have gone through with this process??? I have until next week to find a back specialist who is willing to perform the C&P exam before attending this VES Service examination. Anyone help.

[GBArmy]

Seems like you have to get an independent medical opinion, or exam, from your own specialist which can show how bad your back really is. You had one c&P and they knocked you down, you asked for a re-schedule because they were going to give you an exam by another nurse which they have agreed to, and now they want you to get an exam from another non-specialist. They don't have to go along with another request for change. They have built a case that you just complain on the exam, who, by the way, they can have anyone do it they wish. I don't see anything else you can do. If you get a favorable exam from your own expert, you should win on approval. Find someone ASAP, and bring it with you when you go for your C&P. If you had a reasonable relationship with you old doc, maybe he can give you a favorable with your new evidence. If not, you appeal again.

[ShrekTheTank]

@GBArmy is right on about what you need to do.  One thing though do not miss a C&P exam!  They will reduce you if you do not show.  So you have an opportunity to see a doctor you saw prior?  This could work for you.

https://www.vba.va.gov/pubs/forms/VBA-21-0960M-14-ARE.pdf

here is the form they will use to rate you!  Be your own advocate in the room understand what they should be doing to confirm you back condition.  If they are not doing something on the DBQ ask about it and see if they just missed it.  Also bring your doctors notes!  I assume you go to the VA?  If so you can go to blue-button and print all of your back conditions to show them as they have no idea, but don't print out everything, just what is pertinent to your back.  

I just had my C&P Monday and the NP tried the oh you are already service connected, and I stated yes, but the RO did not code my disability correctly.  Then I went on to show her the remand and the new code and what was stated under the new code, and what the judge was looking for.  She stated everything and I was satisfied when I left, but this could have gone very poorly if I was not prepared.  

Two more pieces of advice.  Remember when doing you ROM and flex it is when you start to feel pain you tell them, and not suck it up.

Last you do have the option to go see you C&P officer at the VA hospital, it is their job to make sure you are satisfied with your C&P.  They can get you a different provider for a new C&P(I know I just did this on my last one).  

Edited May 15, 2019 by shrekthetank1

[paulstrgn]

@GBArmy and @shrekthetank1 bring evidence to your exam. When I go for my back I bring a copy of my MRI and copies of x-rays, I just tell them in case they want to see them. All but one of them have been happy that I brought them along.

When I am called by QTC/LHI/VES and I don't like the doctor or NP that they want to schedule me for I ask is it possible to be seen by someone else, they have always said yes and it does not count as a re-schedule. I am just very friendly with them when I ask.

Like shrekthetank1 said when they use their tool you want to stop as soon as it hurts, only suck it up if you want a bad rating. Also as I have read on this site, you want to tell them about your worse day.

Good luck with your C&P.

[Berta]

"I am also collecting Social Security disability due to my lower back and I sent them proof that I am no longer employed since 11/2016 and they sent me a form to give to my employer?? "

If you are sure they have notice of the SSDI award, it looks like they intend to reverse that proposal to reduce.

"I have until next week to find a back specialist who is willing to perform the C&P exam before attending this VES Service examination"

You might not need a specialist----why not wait for the decision-but make sure the C & P doc knows of the SSDI award.

"So I receive an email from VES Services stating that I have a c&p exam with one of their medical providers at this facility. So it happens to be my old VA primary care Doctor who is no longer practicing at the VA clinic but with this VES Services agency."

You just confirmed info I have been trying to find-are VA doctors becoming contractors?

The VA is putting contractors into every VAMC. I have been trying to find out if QTC,VES, and LHI hires former VA medical professionals. Loma Linda has 442 health care providers currently who are from contractors, and who work at the Loma Linda VAMC but are not VA employees.

The VA is doing this, in my opinion, to reduce their malpractice statistics. Their true statistics are not public, and higher than what the public knows.

This means that a veteran, or their survivor , if their medical care involves proven malpractice, cannot use Section 1151/and/or FTCA to be properly compensated for any injury or death the VA has caused, via negligence and malpractice, if the medical errors were done by contractors who work for the VA.

I say do NOT miss the C & P exam.It might go better than you think.

You can file a Provider complaint at the White House Hot Line 

1-855-948-2311 on the first examiner, who caused the proposed reduction.

Also you can file a complaint with the Office of Accountability-I will find their email addy and post.

"Does anyone have any suggestion or advice to this matter or have gone through with this process???"

Yes- the VA performed posthumous C & P exams on my dead husband many times.When a veteran is dead they have to review their entire medical records.And in my case a 6 page autopsy.

Every one of those denials  was wrong and a foolish  attempt to overcome their malpractice , 

They failed.

C & P exams are set up to deny claims. VA pays for them, so it is quite clear no Contracting firm will bite the hand that feeds them.

I filed a provider complaint with the White House last week. 

 

They failed. 

 

 

 

 

 

[Berta]

OAWP Anonymous Toll-Free Disclosure Hotline: (855) 429-6669

OAWP Email: vaaccountabilityteam@va.gov

When Veterans start making a big stink about these lousy C & P exams, something might be done.

 

 

[sgtdjusmc]

15 hours ago, PACBRED said:

Has anyone had a C & P exam with a nurse practitioner that wasn't interested in your disability but was looking for ways to state that your condition has improved? I've always had chronic lower back pain and was recently awarded 40% in 2016. After receiving that rating I then pursued IU and of course they set me up for a C&P exam. So after spending the morning with the nurse practitioner the exam lasted less than 30 minutes. So she had asked me to do certain movements which I was unable to perform and she did not measure or use any device to conclude her decision. So after weeks of waiting for the results I receive a letter stating that I had a normal range of motion. I was highly upset and was furious with the outcome. I then submitted evidence that my condition has not improved. I am also collecting Social Security disability due to my lower back and I sent them proof that I am no longer employed since 11/2016 and they sent me a form to give to my employer?? Go figure.... So they proposed to reduce my lower back % from 40 to 0. It is now a year and they have not reduced my lower back rating. So just recently I receive a call from the C&P clinic to have another examination for my lower back. So I asked the receptionist the same question is it a doctor that will be performing the examination? She stated no it will be a nurse practitioner. I informed the receptionist that I do not wish to have a nurse practitioner give her medical opinion due to the previous np and her medical opinion. So she told me to contact the Regional office to schedule me another C&P exam with a non va medical facility for this lower back C&P exam. So I receive an email from VES Services stating that I have a c&p exam with one of their medical providers at this facility. So it happens to be my old VA primary care Doctor who is no longer practicing at the VA clinic but with this VES Services agency. My concern is if I know this Doctor isn't a specialist for  my lower back why bother going through with this examination knowing that she was a primary care physician and not a back specialist ? I tried calling several chiropractors to see whether they can perform my C&P exam on my behave rather than the VES Services and they all seem to say that they don't do that examination. So now I'm concerned that they are really trying to reduce my 40% to 0. Does anyone have any suggestion or advice to this matter or have gone through with this process??? I have until next week to find a back specialist who is willing to perform the C&P exam before attending this VES Service examination. Anyone help.

yes I have had that experience. I went to a board certified surgeon with the DBQ. Probative value wiped out the ridiculous VA determination.