Deficient C & P exams what to do

[Berta]

A deficient C & P exam will prompt a denial- as many of you know-

As Asknod mentioned recently, the C& P exam sheets do not ask for a nexus statement-

that means the examiner is not required to search through your SMRs etc, to find a nexus-----that information has to come from you (in most cases).

This has been a problem for vets for DECADES, and has gotten worse.

 

https://www.nvlsp.org/news-and-events/press-releases/nvlsp-dismayed-over-gao-report-on-va-disability-exams-and-the-need-for-impr

(I was dismayed the NVLSP was dismayed and emailed them- the fact is many vet orgs probably do not recognise that as a problem, and/or they dont have the time or interest to help the vet get a lousy C & P exam rectified. They get paid whether you succeed or the claim fails.

My former state reps were surprised that I had insisted a vet get an IME.They asked me to help him and this is what he needed.His claim at that point succeeded.

They never suggested IMO/IMEs--years ago---maybe they do now. ????

The Gao report is here:

https://www.stripes.com/news/veterans/gao-finds-va-contractors-not-meeting-timeliness-accuracy-standards-on-exams-1.556460

 

I suggest you certainly should complain if your C & P exam as deficient or not prepared by a medical professional who has expertise in the field of you disability-

I would think they have contact info on whatever you get advising you to where and when to go for the exam.I think there i more detailed info here somewhere but cant find it-

Main Contractors:

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/

--------

VES

https://www.vesservices.com/?page_id=1537

Or complain to the White House Hot Line :

1-855-948-2311

Or get an IMO/IME.

Many C & P exams do help vets- they could provide medical evidence for a proper  and higher rating, if that is what the claim is for. And apparently not every vet has a problem with their exam.Otherwise  we would see more complaints here then we do now-

I hate to say this again but ,in many cases that lousy C & P exam can only be overcome by a non VA doctor, who is willing to prepare an adequate IMO/IME.

I think the fact that disabled veterans are forced to spend their money to obtain a fair shake from the VA, ia a Disgrace  and often it is the only thing that can help a valid claim succeed.

The worse thing of all is to do Nothing!

I read that the cost of the C & P exams has gone up from $400 each to $900 each.

It would make common sense to me if the VA was willing to pay up to 900 bucks for any IMO/IME a veteran has to get.The veteran would have to pay the balance- but what a difference it could make-The GAO report clearly reveals the $900 is not worth it in most cases.

But VA does not deal with common sense.

 

 

 

 

 

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

[Buck52]

I find now days when veterans go to a C&P the examiner don't read all the pertains relevant  probative evidence that would certainly be in favor of the Veteran , the rater gets the report and denies the Vet...and the Vet has to pay out of pocket to rebute the c&p report and  this is happening more and more.

(This is just my opinion)  when a Veteran is introduced to the C&P Examiner  if the examiner and the Veteran don't hit off right away   usually this leads to a Bad C&P Report,  it sure seems that way from my 20 year experience dealing with C&P Examiners.

[Berta]

Buck, I have had almost 25 years of dealing with lousy posthumous C & P exams.

My husband has been dead for almost 25 years, and he had 2 claims pending when he died.The day he died, he had called the 800# for a status, after a call 6 months prior ,the VA had said they should have a status in 6 months.

The cl;aims had not moved at all.

I strongly suggest that any of you who have life insurance, make sure the spouse knows they might need some of that cash when you die , to get an IMO.

My husband almost wished they would deny his claims because the waiting was so stressful- at least a denial could be fought-and as ill as he was, he would have prefered to  fight something, instead of  having no decision at all.

Every posthumous exam I got was awful.Wrong on every fact of his claims.Deliberately geared to a denial.

Your spouses have to speak for the dead, in situations that involve DIC and/or accrued benefits, and they have to know how to fight back. Often that will take an IMO, based n the full medical record of the veteran.

A C & P exam I got recently, done in his lifetime, surprised me, as this info I got had never come with my request for his VA medical Records.

One statement the Neuro doctor made is missing, and she still works for VA and I am going to contact her about it--the local VAMC is also trying to find out if there was more to this exam. I don't feel I really need it for my CUE claims, but then again, I have never left any stone unturned.

Widows and widowers deal with enough as it is, but the VA can make their life miserable and they have to be tough and also be fully informed of what the pending claims are for, ( regarding accrued)and how to succeed in DIC as well.

I was waiting for an eye doc appt and started talking to a vet's widow. I was going to give her a hadit card to come to our site, but she told me she was receiving DIC because she read and re read everything the VA sent to her, got a lousy Posthumous exam, had all of her husband's records, and then got an IMO right away. 

The veteran  had told her in his lifetime that she might need to do that.

The IMO doc broke down every medical error in the C & P results and provided a strong  medical nexus that no one in the VA would have done.

 

 

[Richard1954]

I have received a few exams under the contractor LHI...One last January and one last month.  I received a rating for the condition I claimed in January, but have yet to receive an increase in rating for an exam conducted a month ago. Ironically, I see on Ebenefits a 0% rating for scars on my knee due to surgery I had by the VA in 1996 for my service connected knee condition, but all indications are that the actual ratings for the knee injury were not increased I have not received a letter yet. Ebenefits also shows a claim deferred although I don't know why since I was not scheduled a C/P exam and it was a VA doctor that diagnosed the condition, and indicated it was caused by my use of prescribed steroids for my lung condition.  Now when I received the most recent exam the examiner (another damn NP,) stated to me that she had not reviewed my records because there were over 100,000 pages ( been dealing with the va for 33 years) that it itself is grounds for appeal.

I had an exam from a NP who actually did the exam at the VA Hospital this was some time back and the examiner did all kinds of stuff to deny my claim, first she wrote a bogus statement to deny claim, then 21 days later she added an addendum with a new reason to deny my claim and  quoted part of a sentence from a document  to justify her opinion.    This backfired on the witch when I found the documented she cited and proved she had only quoted a part of the sentence. I was awarded the claim based on a second c/p exam. 

Just trying to make a point.  VA examiners and contracted examiners will  Screw you every chance they get.  Until recently I never saw the need for an independent medical opinion,  but we are not dealing with the same va that I dealt with for many years,  now we are dealing with people that do everything they can to deny a claim they even go out of their way,  to come up with reasons to deny a claim.. In fact, it use to be easier to approve a claim than to deny a claim, that isn't the case anymore. Get the Independent medical opinion,  and you will likely  win the claim .

 

[Oceanbound]

Majority of my C & P exams result in denials. And I started fighting back with why am I getting denied, REAL IMOs and IMEs and they still tried to out rank them at the Regional Office with INCOMPETENCE. At the BVA they said RO aka "the circus" will continue to drop the ball. Had I not lawyered up. I would have filed them with CUE for each claim with a Writ of Mandamus as the cover page.

1) Denied you because you don't have your C-file. How can you do a book report if you don't have you book. This is why they denied you.

2) After receiving your C-file, which took me 9 months to obtain via the regular route instead of filing a FOIA and getting it in a month, go over it and create a table of contents. So you and your private physicians/specialists doesn't have to nor want to go through hundreds of pages that isn't relevant to the specific item your seeing that expert.  Doc here's my c-file compact disc, printed table of contents, and printed pages that are numbered to the c-file page number that pertain to the reason I am being examined for. 

3) First impressions matter. Nobody cares if you like carrot cake or lemon crunch cake, why are you here? I fell into the original I submitted the one page generic form to the VA that the VA gives you, that said these are what I am claiming. That weight was the same as a tree leaf. You want to go in there as Iron Mike Tyson and TKO them in the first round, or be Nolan Ryan striking you out with a 100 mph fastball you couldn't see go past you into the catchers glove and the ump saying you're outta heeere--as the secret boys are watching that baseball game from the satellites in space since the 1960s throw fast balls in real time.

4) Everything in Life has a secret strategy guide, you have to find it, and then pay the 7 bucks. Prime example the greatest video game of all time for 1986 taught you about life and was named Legend of Zelda. This game only gave you a small booklet. And in the game you truly learned how life really is--you have to do things your self and ask/seek for help when you're stuck. So you want to beat the game right off the bat and head off to Death Mountain--Level 9. Denied access because you don't have the master sword/12 hearts etc. To get the Mastersword you need 12 hearts. This small booklet doesn't hold a blue/red candle compared to the Strategy Guide. 

5) Seek treatment with private doctors. VA physicians lie and not insured like private physicians. The VA knows about you having Agent Orange, Anthrax, Burn pit exposure, Camp Lejeune Water Contamination, Cancer, Drug toxicity, Gulf war syndrome and the disease that will occur with the next conflict 15 years from now that will likely occur in South America, and does not have to tell you you have it, nor have the need to cure you because they will lose out on their ten cent bonus per veteran. Private doctors won't delay seeing you or treating you months and years until you're dead. With the Internet, you can find any one you want and be better educated about your symptoms which physicians want. So they can further dig into your illness with more specific questions and find out what it is.  Not just "I don't know" doc thats why I'm here. Then you get mad because the physician is going to have to do the chest x-ray, check your vitals, do basic things you can avoid and not waste both your time.  Symptoms over laps with other ailments can you tell me about throwing strikes? Are you talking about baseball or bowling? If you know your symptoms, you can know and tell Dr. House that is it not Lupus, and rule out the generals and get to the bottom line and get the result you both want.