Negligence By The Appeals Management Center

[Josephine]

I faxed copies of the personnel records to the AMC, May12, 2006 and July 13, 2006 and someone did not post or lost these records. I have the proof that they received both fax.

December 20, 2006 the NARA notified the AMC these records could not be located.

I found out by one of the Telephone operators January 23, 2007.

I faxed the administrative records again to the AMC January 23, 2007.

The Remand

7. After the above development has been completed, the veteran's claims file should returned to the board of VA psychiatrists who participated in the April 2005 examination for clarification

of the provided opinion. They should be requested to review the record and reconcile their opinion as to etiology in light of the evidence added since their examination of the veteran, including the May 2005 statement of Dr. Bxxxx C. Cxxxxx and the January 2006 statement of Dr. Mxxxxx Pxxxxx.

The Appeals Management Center sent my records back to Dr. Lxxxxx and Dr. Bxxxx at the Sxxxxx Veterans Medical Center. I received a letter from the Appeals Management Center stating that the file was going back to them for review. I have a copy of the review of Dr. Bxx and Dr. Lxxxxx dated October 26, 2006.

The review states:

10/26/2006 Addendum Status completed

After review of the May 2005 letter of Dr. Cxxxxxx and the January 2006 letter of Dr. Pxxxxx, the board finds no additional evidence that would alter the initial conclusions.

/es/Lxxxxx Lxxxxx, MD

Staff Psychiatrist

Signed: 10/26/2006 10:27

10/26/2006 Addendum Status completed

Regarding the above addendum, the entire C-file was reviewed, in addition to the two addition letters as required.

10/26/2006 Addendum Status completed

I have reviewed the C-file and all new information provided since the exam dated April 12, 2005, including the letters of Drs Pxxxx and Cxxxxx. I concur that the board finds no additional evidence that would alter the initial conclusion.

/es/Gxxxxx M. Bxxxxx MD

Staff Psychiatrist

Signed: 10/27/2006 14:23

Dr. Bxxxxx and Dr. Lxxxxxx state in the above opinion that they reviewed the veterans complete C-file and I would like to know how they did this, being that The Appeals Management Center, state the Rater, has been waiting for the Personnel Records, since November and has the copy that I sent to The Appeals Management Center January 23, 2007 ?

The Board of two psychiatrist did not have the the opportunity of my personnel records. VA examination in April 2005 resulted in a diagnosis of an anxiety disorder, not otherwise specified, and it was felt by the veteran that the examiner in the absence of available service personnel records, no opinion regarding etiology, of the veteran's anxiety disorder could be provided.

The Board of Two Psychiatrist did not have the benefit of seeing the veteran’s personnel records from the military. They did not see the veteran’s request for transfer to another duty station or the discrepancy made by Dr. Lxxxxx that the veteran denied any article 15’s, as she would have seen the veteran did not have any article 15’s. The veteran was not a behavior problem, as Dr. Lxxxxx stated of this veteran.

Will they have to give the benefit of the doubt to the veteran?

Thanks,

Josephine

[carlie]

§ 3.102 Reasonable doubt.

It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships.

(Authority: 38 U.S.C. 501)

[50 FR 34458, Aug. 26, 1985, as amended at 66 FR 45630, Aug. 29, 2001]

[Josephine]

§ 3.102 Reasonable doubt.

It is the defined and consistently applied policy of the Department of Veterans Affairs to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. It is not a means of reconciling actual conflict or a contradiction in the evidence. Mere suspicion or doubt as to the truth of any statements submitted, as distinguished from impeachment or contradiction by evidence or known facts, is not justifiable basis for denying the application of the reasonable doubt doctrine if the entire, complete record otherwise warrants invoking this doctrine. The reasonable doubt doctrine is also applicable even in the absence of official records, particularly if the basic incident allegedly arose under combat, or similarly strenuous conditions, and is consistent with the probable results of such known hardships.

(Authority: 38 U.S.C. 501)

[50 FR 34458, Aug. 26, 1985, as amended at 66 FR 45630, Aug. 29, 2001]

Thanks Carlie,

Perhaps with the first C&P being the More Likely than Not and now this flawed mess of a C&P, here is hoping they do give me the doubt law.

Always,

Josephine

[Guest jangrin]

Hi Josephine,

You wrote the following,

The Board of Two Psychiatrist did not have the benefit of seeing the veteran’s personnel records from the military. They did not see the veteran’s request for transfer to another duty station or the discrepancy made by Dr. Lxxxxx that the veteran denied any article 15’s, as she would have seen the veteran did not have any article 15’s. The veteran was not a behavior problem, as Dr. Lxxxxx stated of this veteran.

specifically, ,Dr. Lxxxxx that the veteran denied any article 15’s,

Josephine, it has been my experience in the past that this is not a direct contradiction about your records, nor is it a personal attact from this doctor about article 15's.

When doctors are writing IMOs, IMEs and QMEs they usually do a fairly indepth patient history. During the exam the doctor might ask.

(for example).....

1.Have you ever been in a car accident previous to the accident your are seeing me about?

your answer is. NO.

In his report he writes, The patient denies any previous car accidents prior to the one for which he is currently recieving treatment.

2.Have you ever had any sugeries?

you answer, NO.

In the report the doctor writes, The patient denies ever having any previous surgeries.

3.While in the service did you ever receieve any ARTICLE 15s?

Your answer, NO.

The doctor writes, The patient denies ever recieving an Article 15 during her time in service.

Denies = The patient has not previously experinced this before.

Denies, does not = I asked the patient and she said no, but I think she is lying.

Now lets take this a step further,

Sir do you have pain in your knee when sitting?

The vet replies, NO, but I have pain when walking to my mailbox, and I have pain when I stand for long periods of time.

The doctor writes in the report,

The patient denies having pain while sitting. He states he has some pain when standing or walking. The pain does not interfer with the patient's daily acitivities, because he is mobile and ambulatory. I reccommend the patient continue with his current course of treatment and pain remedies. BLAH BLAH BLAH

Rating 0%- Does not interfer with activities of daily living and range of motion is full

If the answer was, "hey Doc, this knee is really painful, to the point where it gives out when I walk to my mailbox, it keeps me from being able to play with my kids (grandkids), I have to hold on to the chair when I stand. And the pain keeps me from being able to sleep, and I can't drive becasue of the medication. YOU NEVER SAY THE WORD, NO, NOT EVER

The point is, this is limited function, and the condition is causing an adverse effect on the patients well being, loss of sleep, loss of being able to handle business or personal affairs due to being unable to drive, BLAH BLAH BLAH

I hope you get what I am saying. Be specific, pause and take a momment before you answer to comminicate what you want, not what you think they want to hear.

My point is, you have to be very clear in your answers and very aware of how things can be left out if people want them to be out. Thats why if possible you need someone with you or you need to tape record the doctors appt. Sometimes things are left out because of the time it takes to report fully and acurately, or maybe the doctor just didn't like the person during the exam. If a doctor doesn't like the person, how much benefit of the doubt are they going to give you in the report.

Some of the best advise here at Hadit is the advise to be nice and amicable during these exams. I hope this post helps you understand how the people are taught to report on patient history.

JMHO,

Jangrin

[Josephine]

Hi Josephine,

You wrote the following,

The Board of Two Psychiatrist did not have the benefit of seeing the veteran’s personnel records from the military. They did not see the veteran’s request for transfer to another duty station or the discrepancy made by Dr. Lxxxxx that the veteran denied any article 15’s, as she would have seen the veteran did not have any article 15’s. The veteran was not a behavior problem, as Dr. Lxxxxx stated of this veteran.

specifically, ,Dr. Lxxxxx that the veteran denied any article 15’s,

Josephine, it has been my experience in the past that this is not a direct contradiction about your records, nor is it a personal attact from this doctor about article 15's.

When doctors are writing IMOs, IMEs and QMEs they usually do a fairly indepth patient history. During the exam the doctor might ask.

(for example).....

1.Have you ever been in a car accident previous to the accident your are seeing me about?

your answer is. NO.

In his report he writes, The patient denies any previous car accidents prior to the one for which he is currently recieving treatment.

2.Have you ever had any sugeries?

you answer, NO.

In the report the doctor writes, The patient denies ever having any previous surgeries.

3.While in the service did you ever receieve any ARTICLE 15s?

Your answer, NO.

The doctor writes, The patient denies ever recieving an Article 15 during her time in service.

Denies = The patient has not previously experinced this before.

Denies, does not = I asked the patient and she said no, but I think she is lying.

Now lets take this a step further,

Sir do you have pain in your knee when sitting?

The vet replies, NO, but I have pain when walking to my mailbox, and I have pain when I stand for long periods of time.

The doctor writes in the report,

The patient denies having pain while sitting. He states he has some pain when standing or walking. The pain does not interfer with the patient's daily acitivities, because he is mobile and ambulatory. I reccommend the patient continue with his current course of treatment and pain remedies. BLAH BLAH BLAH

Rating 0%- Does not interfer with activities of daily living and range of motion is full

If the answer was, "hey Doc, this knee is really painful, to the point where it gives out when I walk to my mailbox, it keeps me from being able to play with my kids (grandkids), I have to hold on to the chair when I stand. And the pain keeps me from being able to sleep, and I can't drive becasue of the medication. YOU NEVER SAY THE WORD, NO, NOT EVER

The point is, this is limited function, and the condition is causing an adverse effect on the patients well being, loss of sleep, loss of being able to handle business or personal affairs due to being unable to drive, BLAH BLAH BLAH

I hope you get what I am saying. Be specific, pause and take a momment before you answer to comminicate what you want, not what you think they want to hear.

My point is, you have to be very clear in your answers and very aware of how things can be left out if people want them to be out. Thats why if possible you need someone with you or you need to tape record the doctors appt. Sometimes things are left out because of the time it takes to report fully and acurately, or maybe the doctor just didn't like the person during the exam. If a doctor doesn't like the person, how much benefit of the doubt are they going to give you in the report.

Some of the best advise here at Hadit is the advise to be nice and amicable during these exams. I hope this post helps you understand how the people are taught to report on patient history.

JMHO,

Jangrin

Believe me this has been a personal attack by these two doctors. When I receive a clinic appointment for treatment and end up having a C&P instead with a man and women Psychaitrist refusing to allow my husband to be present and then types up a bunch of lies about me. I will not sit still and take it. I will attack her with any means possible.

One medical record said she is a Gravida 3 Para 3, but the patient claimed only two children. ( I have enought sense to know that I only have two daughters)

She took an overdose of aspirin in 1965 when she was pregnant with her first child.

She states that her anger causes difficulty for her, such that she struck her oldest child when she was 2 weeks old after the infant soiled her blouse. ( Angela was two years old, when I smacked her)

At one time, she locked one of her children, who was 9 years old at the time, out of the house for some time. She frequently threw food on the floor in anger. ( I have never thrown food or tried to destroy my home)

She recounted a history of violence towards her husband but stated that now she has a close relationship with her children. ( This is a plain pure lie!)

She said that she never “wanted to talk about it” in terms of discussing it with her private physicians”. She still breaks dishes and throws objects. (Lie again!)

Crying and screaming, she also kicks holes in the walls of her house. She also has broken furniture in her fits of anger. ( Lies and more Lies!)

She acknowledged that this is a long-standing pattern.

Regarding her history of treatment, she stated that she has a standing order for Valium at the pharmacy and now takes 5 mg. every four hours as needed, and frequently takes more than six a day. In one of her e-mail reports, she stated “ I chew Valium pills like there will be no tomorrow”. She denies taking any other psychiatric medications. When asked what happens when she runs our of Valium, she replied,” I don’t run out”. ( I go to the doctor for more meds, just like everyone else)

She denied any self- inflected injury and any history of eating disorder symptoms according to her. ( to me this is a slap in the face, because it is pure lies) She sure didn't check me or ask me) Eating disorder_ She may have her opinion as to my size considering I am a severe diabetic). She denies any article 15"s, although her records state that she does. (Pure lie) She didn't see any for there aren't any!)

This are no more than pure lies on the part of this lady psychiatrist and I will not allow her to slander me. If the AMC doesn't do something with her changing my medical records the Virginia Board of Health will.

I have a statement from the nurse at the VAMC that saw me after this appointment and she has recounted it all and signed it.

That will be my next step.

I shall know shortly, as my claims file is with the Claims Adjustor at the AMC.

I had my first C&P with a More likely than Not and then 5 months later repeat the examination for same.

When you are sent for a C&P examination to give you a personaltiy disorder and to get rid of you, this is the best way to do it. There was no reason for this examination within 5 months of the first C&P and you are not allowed to take a tape recorder with you and if the doctor will not allow anyone to be in the room with you, what is your choice.

Always,

Josephine

Edited February 8, 2007 by Josephine

[Guest jangrin]

Hi Josephine,

As I wrote, JMHO.

There are many other issues with your claim, and I am certainly on your side regarding this C&P exam you had with the (2) VA shrinks.......

I am just trying to say that when people read the report, they do not necessarily read what YOU are interpreting. The AMC or BVA may have a totally different point of view when reading the report. You certainly are the best judge of these (2) and their professionalism (OR LACK OF) professionalism. Especially about not allowing your husband in the room during the exam and the fact that you were hypnotised, etc.

I am just saying there are "certain types of verbage" that is the "standard" in medical report writing. And in the reports you have posted and shared here at Hadit, this particular statement (about the Article 15s) has come up a few times. Although you interpret this to mean, they (the 2) accused you of lying, there is another way that it may be interpreted by professionals (judges and attorneys) would will simple say to themselves when they read the report--- "oh, she never had an Article 15".

No insult or finger pointing here, I know how you have struggled with this whole process. I AM ON YOUR SIDE..., just wanted to help you be prepared for people not reacting to these statements the same way you do. It does not indicate a lack of concern on thier part, only a difference in training, when reading the report. Thats all I was trying to say.

Hang in there Josephine.

Jangrin

Edited February 8, 2007 by jangrin

[Pete53]

With a good IMO the benefit of the doubt should be established. I think that Josephine really has a better case than to fall back on benefit of doubt but it is a good backstop.

The strongest opinion should be the Dr that saw you while you were in the Service. After all he saw you and treated you when your symptoms started.

Sometimes Veterans forget how important thier military medical records can be and don't forget the prescriptions issue to help build your case.

Josephine I know that its hard waiting to get the answer but one day you will get it.