s DD789

[DD789]

I don't have a real question per se, but more of an observation.  I noticed that the VA accepts medical decisions from Nurse Practitioners on C&P exams, but I wonder if they give the same weight to Nurse Practitioners who may write nexus letters?

[DD789]

ok..

[broncovet]

In short, if VA hires the examiner, he is good to go.  If the Veteran hires a medical opinion, he must demonstrate the examiner is an expert in the field.

All VA examiners are given a "presumption" of regularity.  This means in the absence of (the Veterans or his representative's) challenge, the examiner is presumed competent, and the results of the exam are presumed valid.  This attorney explains it: https://attigcurransteel.com/veterans-law-updates/va-medical-examiners-competence-presumption-rizzo/

Veterans who hire an IMO or private doctor, however, are given no such presumption of regularity.  

A valid IMO or medical opinion should have the medical professionals CV, to include his education and experience to make an "expert" opinion.  

The examiner need not be an MD, other professionals certainly show expertise in the field.  But the medical professional needs to have expertise in your area.  A PHD in basketball, is not competent to opine on your sleep apnea.  

However, an audiologist with a Bachelor's degree and applicable experience, would be qualified to opine on your hearing loss.  

Its not the "degree" its the competency of the examiner.  He needs to be an expert witness and be able to demonstrate same.  

This means the VA could literally hire a janitor with a white coat and stethoscope to examine you and it would stick unless you oppose it.  

The VA sometimes hires, especially through contractors, examiners with revoked medical licenses to exam Vets.  

Edited February 17, 2021 by broncovet

[GBArmy]

DD789 In theory, at least, they are. But it carries more weight in your evidence if you have at least a doctor to opine their opinion/diagnosis, so whenever possible, go to the higher authority IMHO.

[brokensoldier244th]

9 minutes ago, broncovet said:

In short, if VA hires the examiner, he is good to go.  If the Veteran hires a medical opinion, he must demonstrate the examiner is an expert in the field.

All VA examiners are given a "presumption" of regularity.  This means in the absence of (the Veterans or his representative's) challenge, the examiner is presumed competent, and the results of the exam are presumed valid.  This attorney explains it: https://attigcurransteel.com/veterans-law-updates/va-medical-examiners-competence-presumption-rizzo/

Veterans who hire an IMO or private doctor, however, are given no such presumption of regularity.  

A valid IMO or medical opinion should have the medical professionals CV, to include his education and experience to make an "expert" opinion.  

The examiner need not be an MD, other professionals certainly show expertise in the field.  But the medical professional needs to have expertise in your area.  A PHD in basketball, is not competent to opine on your sleep apnea.  

However, an audiologist with a Bachelor's degree and applicable experience, would be qualified to opine on your hearing loss.  

Its not the "degree" its the competency of the examiner.  He needs to be an expert witness and be able to demonstrate same.  

This means the VA could literally hire a janitor with a white coat and stethoscope to examine you and it would stick unless you oppose it.  

The VA sometimes hires, especially through contractors, examiners with revoked medical licenses to exam Vets.  

No, because a janitor would not have the required credentials to do the exam. VA does not hire janitors to do examination. All the medical people that do exams, at least out of the several hundred that I have seen and read had either experience in that area of medicine (sleep tech, NP that does ortho, whatever) or the contention was such that it could be opined on by any medical professional that has a practicing license. Not every contention requires an expert in the field. I see contentions every day that could be rated on the opinion of a family practitioner- and are- successfully. 

 

[brokensoldier244th]

12 minutes ago, GBArmy said:

DD789 In theory, at least, they are. But it carries more weight in your evidence if you have at least a doctor to opine their opinion/diagnosis, so whenever possible, go to the higher authority IMHO.

THIS I agree with. If you have the capacity or the availability, or, like me my family practitioner is a specialist in ObGyn and stays current but doesn't put "ObGyn" on the door so as to be affordable as a family practitioner * example only- im not female, but you get the gist* , then go to that provider. Ask your provider(s) what their area of practice is outside of general medicine (if you go to a general medical provider). You'd be surprised at what some of them are trained to do, but don't advertise it due to their malpractice insurance spiking through the roof and being passed on to you. 

 

CAS

[Berta]

You can always google the NP or doctor to see what turns up.

Also states have areas whereby disciplined doctors and other medical professionals are listed , if they have had any form of discipline in their professional capacity.

This is my states link for that:

https://www.health.ny.gov/professionals/doctors/conduct/

They developed this data base in 1994. I assumed that my husband's VA wrongful death case (FTCA/1151) would list all of the doctors I had proven, had malpracticed on him..in two separate VAMCS in NY.

But it wasn't until the internet became far more viable than it was in 1994-that I learned that NONE of these VA doctors were ever properly reported to the NPDB ,( National Practitioners Data Bank), which the VA had a mandated agreement with for years,to report deficient doctors, charged through FTCA settlements.

It is through the NPDB that states develop their public list of negligent doctors- private or VA doctors.

Even the GAO made reports on this deficiency that prohibits the public from knowing what type of VA and private doctors and other medical professionals ,have caused the public harm.

The "Our Providers" list .available her under a search will tell you whether your VA doctor is from a federal contractor such as VES, QTC, or LHI, and if they are, that means they are not liable under FTCA. They are only liable under 1151, for any compensable damage they might do to you  regarding your care.

Section 1151 awards made at ROs are not public knowledge.

BVA 1151 awards are absorbed into the General comensation total every year in the annual BVA report.

That way neither the general public or even Congress ( who gets the annual BVA report) has any idea of the true amount of negligence and malpractice VA has paid for, under Section 1151, 38 USC.

Even if I do a base line estimate of what VA has paid me under 1151 ( which was subsequently changed to direct SC death of my husband) it would total Well over 1/4 million-not to include my FTCA settlement- and the actual result is a staggering amount of money they paid for their malpractice on him, yet none of the doctors were disciplined, and none of the 1151 death awards to survivors , unaccounted for by non public  RO awards, but are clearly evidence at the BVA, when denied survivors appealed,and won under 1151... are ever considered enough by VA, to try to hire the best medical personnel they can.

I do believe VA has MANY doctors and nurses, etc of the highest caliber-and I believe VA saves lives every day.

But as I have said before they might work side by side with incompetent medical people-who are detrimental to veterans.

The Fayetteville situation mirrors what I mean....

Medical people were complaining about an impaired pathologist, and even after VA sent him to rehab, he returned and gave VA no follow up info- because he was not rehabilitated at all, and he caused harm and death to ,so far, a non public amount of veteran victims, but he is now in prison.

We all have to have confidence in our health care providers.

 

 

 

 

 

 

 

Edited February 17, 2021 by Berta
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