Did you get a bogus C & P exam?

[Berta]

I have posted this info here many times but it I almost impossible to find under a search-

If you get a bogus C & P exam, you can request a better exam.

By "Bogus" I mean:

Was the examiner, when you googled their name, not qualified to do the type of exam you got?

For example a male vet here with a leg disability- maybe PAD, got a negative C & P exam done by a Gynecologist.

A few years ago I got a C & P exam ,I think regarding my husband's HBP. and the examiner stated it was an "in person" exam. By then my husband had been dead for over 20 years. The issue was resolved under CUE, because of other evidence.Claim denied, three weeks later awarded.

Also, if the examiner did not have your records ( I got a C & P exam thrown out due to that crap) or if the examiner had your records but obviously did not take the time to read them properly, you can request a better exam pointing out their errors ad what the examiner overlooked.

Another C & P result I got long ago, had the name of the doctor in the decision ( they dont put there names in decisions anymore) and after I called the doctor, both he and I realised the most important evidence I had , was deliberately withheld from him-- an autopsy.-That caused a denial of my 1151 DIC claim.

Within a short period of time I received a FTCA award for wrngful death and sent it to my VARO and the y denied again by refusing this time to consider the info from the General COunsel.I made a quick hone call to the OGC, and then received a copy of a letter the OGC sent to the VARO prdering them to award the 1151 claim. The award came soon there after.

The Regional COunsel of the VA wanted to settle with me a few months after getting my SF 95 under FTCA. He had received a VA Peer Review that suported all of my charges.The RC, the reviewer, and even the Peer review disappeared from the VA and I had to start all over again with the OGC in DC.

I had so much evidence od malpractice by then, that  I didnt need that positive VA review, but it's disappearance caused my FTCA case to take  about 2 years longer.

I found the "non existent " per OLMA ( VA Office of egal and Medical)6 page review ----at the very bottom of my C file years later and I used it in 2010 for my AO IHD death claim.

The only C & P examiner I ever needed an IMO for was an Endocrinologist. It was a diabetes claim, so she was the right type of opiner to use.

But I sent Dr Bash (my IMO doctor) the medical errors she had made in two separate opinions on my diabetes death claim, and he stated in one of the IMOs how her opinion was medically "inaccurate." ( I would have used the word ridiculous-maybe I did on appeal, as it was ridiculous as well as medically inaccurate)

If you feel you have a strong basis to request a new C & P exam,you should try to do that without even waiting for a denial that you might well need to expect.

The C & P exam controls the outcome of most of our claims.

 

 

 

 

 

 

 

1.VES Phone 1-877-637-8387;  https://www.vesservices.com/?page_id=37

Veterans Evaluation Services

PO Box 924089

Houston, Texas 77292

2.LHI Logistics Health, Inc.

328 Front Street- South

La Crosse, Wi 54601

 

https://logisticshealth.com/our-company.aspx

mailto:information@logisticshealth.com

3.QTC Quality ,Timeliness, Customer Ser

Contact info here:

https://www.qtcm.com/about-us/contact-us/

4. White House Veterans Hot Line:

 

855-948-2311-if that number is still in service

 

Some Veterans here have taking steps to get a new and proper C & P exam.I hope they chime in.

A bad C & P exam will force a denial and many exams can be corrected by taking swift steps.

As a widow of a SC vet ,every single posthumous C & P exam the VA ever did was Wrong medically.

 

 

 

 

 

 

 

[El Train]

Good advice Berta.  I filed a formal complaint about a C&P examiners exam to the VARO head person.  Within a few months, I had a two extra C&P exams for the same condition.  They dismissed the original bogus C&P examiners exam as 'not making any sense'.  Got my claim approved to 100% P&T.  I can say the VA took my complaint very serious.  I hope the initial claims examiner was relieved of her C&P exam duties.

I will say this, 'don't piss off a C&P examiner', like I did originally.  Even if they are rubbing you the wrong way.  It won't go well.  Be very polite in a military manner.  Yes Maam, no Maam, Thank you for your time Maam.  

[GBArmy]

Good job by you, El Train. I agree, you go further (most of the time) if you keep your mouth shut. Just give the examiner enough rope and if they do you wrong, itemize in your formal complaint why you got the short end of the exam. If they smell a rat, they may cover up some of what they did wrong. Don't be the smartest guy in the room. 

[Miken2c74]

I did the same. I challenged an exam also, it worked for me.

[Buck52]

This is good for new veterans  to let them know  if they find anything wrong in there claim and needs attention  its good to let them know   or challenge them   95% of the time we veterans are correct.

[Horan]

in regards to exams, I filed my claim in March 2020 for Non Hodgkin's Leukemia related to expose to benzine and was scheduled for a va scheduled exam 3 hours away in July. I planned to go etc and then was notified that there was no requirement to be present, she would do it records review. I has her name from the documents mailed to me and she was an RN who worked in CVS quick clinic. Hmmmmm, cancer claim with a NEXUS letter, buddy statements, etc and it goes to an RN working at CVS. OK Maybe but thought I should have been there. Haven't a clue what she said or how she could possibly override my oncologists opinion so I asked for a copy in writing from the VA in late July.

VA makes it a Freedom of information act claim and it now appears on MYVA site as Gathering evidence, review and decision just like my claim from March. Thought I'd be able to get a copy of the PDQ she did so I can have it analyzed and prepare for appeal if I need it. Guess they don't just send me a copy separately, another long process using Freedom of Info process.   tried to contact VA and he prior to force her to meet with me but no response on that. My guess is she isn't qualified to evaluate my disease. Just venting all. Happy 2021

[GBArmy]

Horan You may be correct on her qualifications, or lack thereof. What you had was called a paper audit/review of evidence in your file, called A.C.E.. Very common, especially during this Covid19 deal. If you want you could check with a VSO who can view your file thru VBMS system and tell you what her report on the dbq says. If it is denied, submit a letter to the RO immediately saying she wasn't qualified because she didn't do x, y,z. If you don't have that kind of argument, appeal when you get the decision letter, either HLR or BVA. Welcome to the hamster wheel called VA disability claims.