Rationale Question

[AllTheWay]

Greetings to my Hadit family.

I am not the sharpest tool in the shed but the tools that I do have can still accomplish the mission. Someone out there please make me smart and help me understand. Why does the VA require a C&P examiner provide and rationale but the doesn't really consider the rationale especially if it is a rationale in favor for the VET.

I will give an example.

In the past, I have been filing for cervical and lumbar strain due to an incident that happened while in service. (Motor Vehicle Rollover). I have filed for this claim for a total of 4 times. The last denial, I did actually did a NOD which was issued a soc. Yes I lawyered up and its on appeal at the BVA level. All is annotated in SMR's as well as VMR's. The C&P examiner which is a Nurse, basically opined less then likely incurred or caused by the claimed in-service injury, event or illness.   (denial from 21 jump street), then her rationale: although STR notes was treated for an acute neck strain after a MVA,  it is the opinion that the veterans neck pain/ was treated in service  had resolved as there is a pattern of lack of evidence of a continuum of a chronic neck disability in military service and in time immediately after service and that the veterans complaints of neck pain, spondylosis with foraminal stenosis is a separate and distinct process not related to military services.) How does she know that. There were no x-rays or MRI's ordered while I was in the emergency room after the accident. The decision letter stated just that verbatim. I did have my PCP at the VAMC do a IMO and she did put as least as likely but still denied do to no strong rational. I had no further injuries post military for my neck. I even submitted my entry exam. Had multiple injuries in that vehicle rollover, (shoulders and knees). Shoulder just got granted at 20%. Knees got denied.

 

I had reopened claim for knees. which was injured during the same MV rollover. But by getting denied several times, I took a different avenue of approach and filed it secondary to pos planus. The VA examiner had given me that warm feeling that it was going to work but I guess the warm feeling was just gas. That did not go well at all even though she said that she was helping me. She opined that my bilateral knee condition is least as likely no related to pes planus. The rationale was: (The veteran has specific diagnosis for the left knee, as mentioned above(DBQ), and the right knee has a dx of recurrent strain. From the history, these are related to specific injuries in the service and not by the pes plans). Now whats ironic about this is that previous denial  decision letter for the cervical spine stated the the rational but the decision letter for the knee did not.

Isn't this kind of crazy that our VA system is against our vets or am I just crazy. I feel bamboozled.

Like bronco vet all all others had stated do not give up, keep all decision letters and never quit. The VA is looking for any loop hole to deny a claim, esp if you are very close to that 100.

[Richard1954]

15 minutes ago, brokensoldier244th said:

NPs are not any less competent. There are a lot of NPs that practice in the US that were doctors in their own countries but aren't licensed in the US as an MD. It doesn't discount their education or experience. There are a lot of NPs that are content to be NPs so they don't have to carry millions in malpractice insurance- that doesn't make them any less competent, just smart. 

 

Just saying that just because you have an NP doesn't mean you are getting less care. Lots of NPs are more up to date than doctors are on issues because they are required to attend more continuous schooling to maintain their license. Doctors do CE also, but the requirements are less. In many cases id rather have an NP than a doctor, unless I need a specific specialty.

Perhaps,  but most people want a doctor to treatment them not a NP.....  I personally don't want treatment from a NP.. I don't feel they are qualified to treat most serious conditions like my lung or back conditions.  Ask most people and I would bet they would want a Doctor over a Nurse anytime.... Its perception.. and its a personal choice....  Of course no one will every convince me that a NP is better qualified that a medical doctor.... but is all just opinion.

[vetquest]

My NP for my neurologist does a much better job of communication and symptomology than my neurologist.  While he is very smart and thorough his bedside manner stinks. 

[AllTheWay]

Great response from all. Shout out to Berta. I had to pay out of pocket to get an MRI. VA wanted to try different things and different meds for me. As far as what I claimed was lumbar strain. The NP was the one to rationale about spondylosis. Thanks for the Info.

I do want to make it clear. I am not putting Nurses down and my apology if I do offend some of you. I was just asking as to why NP's have more power that Doctors when it comes down to a little things such as opinions and rationales. We all can do this as of today thanks to google. For example, someone stated that spondylosis is an immune deficiency. How do we know that? Google?

I did in any way, shape, or fashion badmouth any NP's. I know quite a few myself. I think that they are great. I do think that their hands are tied behind their backs and just doing what they are told to do. At least the ones that are here at the Detroit VAMC.

I guess that someone here figured out that I am not a young whipper snapper and think that the injuries could be age related. How could we know this? In my case, which I do know for a fact, was an x-ray done on me at the time of the accident? no. Was and MRI done? No. Did I serve over 20 years? yes. Can car tires last for 20 years after being driving for some distance? no. 

 

Someone mentioned about TBI. Filed for that too. Do NP's have any training on TBI's? Thats why TBI and PSTD are done by a Specialist in that field. TBI doesn't just  mean a direct blow to the head. 

Good post. I love the feedback and different opinions.