Very Sloppy LHI C&P Medical Opinion

[Vync]

For my supplemental heart claim, the VA's RVSR sent a request to LHI to specifically perform a cardiac/heart DBQ and offer an opinion whether SC migraine medication caused any heart condition. An LHI nurse practitioner called me last week to do a phone C&P and asked about atrial fibrillation, my heart attack last year, and the residual impact. They confirmed having received the medical opinion from my non-VA board certified neurologist regarding the heart attack being "more likely than not" caused by my SC migraine medication. Prior to submitting their medical opinion, they said they had to do more research.

This morning, my VSO looked in VBMS and found the LHI medical opinion focused solely on atrial fibrillation, completely failing to opine on the heart attack. Because my claim is still open, an IRIS request was placed asking the VA to send the medical opinion back to LHI due to being inadequate by failing to opine regarding the heart attack.

Fortunately, my claim was still open and the decision letter had not been sent. On va.gov, it still ironically says "We do not know your status", but it has been like that for weeks. I would not be surprised if the RVSR goes ahead and closed my claim based on the sloppy C&P performed by LHI just to get it out of their inbox. If they do that, then I would be forced to send yet another supplemental or HLR to address yet another case of the VA failing to consider evidence and ignoring laws, regulations, internal rules/policies, and it would put my claim back into the 125+ day hopper.

This one should be won via relative equipoise. The VA has a nurse practitioner's "less likely than not opinion" with no medical rationale addressing the merits vs. my board certified non-VA neurologist's "more likely than not" opinion with strong medical rationale. So far, there is no predominate medical evidence against SC, so I am hoping they would at least get this one right at some point.

After thinking about what has happened, I also put in a complaint to the WH VA Hotline. The VAMC C&P contractor I had last year screwed up their exam by failing to consider evidence. The LHI C&P examiner I had last week also screwed the recent exam by failing to consider evidence. It seems like a recurring pattern. If they are doing this to me repeatedly, then they are likely doing this to other veterans.

[GBArmy]

Vync It sounds like they are trying to get you on the hamster wheel again, doesn't it? I like the IRIS question/complaint; save that response whether positive or negative also.Your doc is at least equal to the VA's opinion; eventually, you should win out. It would be nice if you can do it this go round though. One question I have is are both LHI examiners working out of the same office/facility? Not the same doctor both times?If so, maybe that could be part of your appeal if you have to do this again. Question that facilities track record for being incompetent. 

[Vync]

@GBArmy Possibly. I think a lot of it has to do with the lack of accountability. Since 1997, I have experienced C&P exam after C&P exam that was substandard or contained one or more errors. The sad part is it is nearly the same exact errors over and over again.

In this case, I had a local VAMC contractor cardiologist last year perform a heart exam and a Cushing's exam. Of course, they opined less likely than not. The heart exam ignored my request to examine any meds I take for SC disabilities and they instead focused on just one. In effect, they disregarded verbal lay evidence I provided during the exam. The Cushing's exam was a joke. They just looked at my non-VA endocrine specialist's medical opinion that said I had iatrogenic (when taking steroids) Cushing's and the physical symptoms, despite some of my tests being negative. That same VAMC contractor cardiologist instead contested the lab results saying they were normal, but completely disregarded the iatrogenic part and physical symptoms. They didn't even bother to order labs to confirm anything.

This time, the LHI examiner was from Washington D.C. and a completely different person.

I'm hoping I don't have to appeal this. The VA was notified through multiple means prior to completion of the rating decision. I'm hoping that would be sufficient to avoid having to appeal if they screw it up too.

 

 

[Miken2c74]

I had an IMO performed by an Orthopedic Surgeon and a VA exam through VES with a Practioner   who has a practice in

Hypnosis, Homeopathy, Rehabilitation, Natural Medicine, Anti-Aging Medicine, Orthomolecular Medicine. Does it sound like his expertise should outweigh an Orthopedic Surgeon. I don't think so either

[GBArmy]

Mike Some of the stuff that veterans go thru with the VA you read on hear are unreal.  It's more about the process than doing what is right.

[Miken2c74]

Tracking @GBArmy. It is almost unbelievable. It is almost like the process/evidence is to much to read for VA. Its like they read part of it that gives them a feeling and then they apply that to the decision without reading the rest of the story.

[Buck52]

Vync quoted

''This one should be won via relative equipoise.'' (YES)

with a  BOARD CERTIFIED Doc they take his/her word over a N.P Any-day.

you will win this .

personally I hate the LHI EXAMS  /vs QTC, But again in my opinion its the luck of the draw as to what type of examiner we get. ff they can read or not??

They need to fix this as to where we can get it done right the first time and not have to appeal and wait...actually it cost the VA to do it this way ,  when you win it  more retro out of the VA Pockets  but when did the VA ever make any sense.

Those NP THINKS THE VETERAN WILL NOT APPEAL.

Most of the time  this type of exam back-fires on the VA and the veteran gets more than what he was filling for.

hopefully for you Vync it will end that way for ya buddy.