C.f.r Governing Patients Rights During C&p

[Josephine]

Just need a little help and thanks,

I have searched, but cannot locate rights of patients concerning C&P'S?

It has been brought to my attention, that my rights were violated when I had my last C&P with the two Psychiatrist when they would not allow my husband to be present. I call it an interrogation, not a C&P.

It was stated to me by the Patients Advocate that it was their Prerogative to not have anyone present.

I placed a complaint within 3 days of the C&P and all letters were notarized and delivered to the Patients Advocate. He did all within his power.

I received a letter from the Hospital Administrator that I could seek the services of the General Council, if I did not like the way that this C&P was conducted.

What did the General Council do, Nothing.

Is there any C.F. R. code pretaining to this?

Thanks and Always Grateful,

Josephine

Edited February 24, 2007 by Josephine

[Josephine]

OK.. the clinicians guide does not state that a veteran can have someone present during any examination...but for psychiatric illnesses it does suggest the possibility of a social examination:

13.11 What is the value of and best way to use the Social Work Service?

a. A study by the social work service examines significant experiences related to family interrelationships, education, psychosexual development, employment, military history, and the onset of medical or psychiatric problems. They are examined in terms of their effect on the veteran’s psychosocial development and functioning.

b. The social study will assist the examiner in developing an appro¬priate diagnosis; in evaluating the degree of social, psychological, and industrial impairment; and in assessing the veteran’s potential for improved social functioning and employment.

c. A social study can help to clarify:

The nature and sequence of events that may have affected the veteran’s life.

The physical and social situation, and especially the interpersonal relationships, past and present, that have perceptibly affected him/her.

Social and psychological situations that may have brought out abnormal functioning which has a bearing on the cause and nature of the veteran’s maladjustment.

Information about the veteran’s behavior patterns.

Response to stressful situations.

Competency .

d. Social data are particularly useful in helping the examiner solve diagnostic problems such as differentiating between a transient personality reaction to an acute or special stress and an anxiety

SOOOOOOOOOO............ I'd INSIST that such a study be performed since the physician/psych whatever cannot formulate a complete picture without it... I'd at least inquire into it...

I'm still a lookin

sixthscents,

Thanks, I see no mention of it anywhere. Could you, if you have time, sent me the link from the guide that you pasted this info from?

thanks.

Josephine

Edited February 26, 2007 by Josephine

[sixthscents]

Looks like I'll be up for a bit tonight... so I'll dig some more... here's the link for the below reference though:

www.warms.vba.va.gov/Admin21/GUIDE/Cliniciansguide

.doc - 670k - June 20, 2002

happy happy joy joy

[sixthscents]

OK a big paste... but I bolded the important bit...........

SOCIAL AND INDUSTRIAL SURVEY

Name: SSN:

Date of Exam: C-number:

Place of Exam:

A. Demographic & Information and Sources

Note the location of the interview/exam.

List demographic data, including age, gender, marital status, and other relevant data.

List service connected disabilities.

Discuss capacity to manage financial affairs (if an issue).

Verify accuracy of veteran's name, address, phone number.

List informants or sources of information, such as claims folder, medical record, veteran, family members, employers, neighbors, friends, physician, or other persons.

If S&I Survey is done in the community, list the collaterals residing in the home, their ages and relationship to the veteran, a brief description at the household appearance and overall home environment.

B. Appearance & Response to Interview

Appearance - Describe the veteran's size, build, general physical appearance and dress, noting any distinguishing features or characteristics.

Indicate if s/he was alone or interviewed with others.

Make personal observations as to attitude, openness to interview, reality testing, physical or mental difficulties in communicating. Does s/he find the interview stressful or threatening? Is s/he cooperative and friendly or guarded and withdrawn? Observe eye contact, facial expressions, and attention span during interview.

C. Disabilities

Include disabilities listed on Form 2507 for which the exam is requested and any other complaints or conditions expressed by the veteran.

List of current medications.

D. Brief Pre-Military Social History

Include where the veteran was born, his/her family configuration, education, etc.

E. Military History

Date the veteran entered military service and branch of service.

Where s/he completed basic training.

Military occupation(s).

Primary assignments and where stationed.

Any special training received in military.

Combat experiences.

Sexual trauma while in military.

Injuries or illness incurred while in military.

If claim is for PTSD, include a detailed account of the traumatic experience(s).

Relationships with peers, superiors, subordinates, etc.

F. Prisoner of War (POW) Data (if applicable)

1. Capture Data

a. Injuries/wounds incurred when captured and any treatment received.

b. Captors - Date and place captured.

c. Internment - List names of camps where interred and dates of internment, psychological conditions, physical conditions, methods used to control prisoners.

d. Work - Physical & psychological conditions of work.

e. Diet - Daily meals, including types of food, quantities, regularity of meals.

f. Illnesses or Injuries incurred when captured or while imprisoned and any treatment received.

2. Information from Veteran's Significant Other(s)

a. The significant other's relationship to the veteran.

b. Whether s/he knew veteran before or after capture.

c. Any changes observed.

d. General comments on impact of POW experience.

G. Chronological History of Adjustment Prior to Service or Stressor (if applicable)

Evidence of disorder in infancy, childhood, or adolescence, especially antisocial behavior (reference DSM-IV).

Activity patterns: friendships and social relationships.

Family: describe relationships.

Significant issues in school, community, or work area.

Pre-military traumatic events. Provide details, if possible.

H. Chronological History of Adjustment After Service or Stressor

Changes in personality or interpersonal relationships.

Work performance.

Emotional difficulties: Describe onset and details, including time, nature, and severity.

Onset of any other type of symptoms, such as physical.

Legal issues, such as involvement with authorities or courts.

Substance abuse history Describe use of drugs, alcohol, prescription medications, and tobacco.

Psychiatric treatment history.

I. Post-Military Social Adjustment

Describe all marriages and divorces, loss of spouse or significant other through death, and birth (and death if applicable) of all children.

Describe nature of friendships and social relationships, including group memberships.

Describe the veteran's living situation.

Note any significant post-military adjustment problems, including illness or injury.

J. Industrial Adjustment

Veteran's occupation(s).

All education and training.

List all employers and positions, including:

Earnings

Dates of change(s) in employment

Length of time with specific employers

Periods of unemployment

Relationship with co-workers, supervisors, and subordinates

Highest paid position.

Attitude toward employment.

Is the veteran working at an occupation or position that is below his/her education and training level?

Is there evidence that the veteran's pre-traumatic level of performance was above his/her post-traumatic level of performance? What is the documentation of this?

Is there evidence service connected disability(ies) impacted the veteran's decision to retire? Discuss. (For example, did the veteran choose to take an early retirement with financial loss in order to reduce the stress experienced in the work environment because the stress was aggravating the service connected disability(ies)?)

Has an employer made official or unofficial accommodations to handle veterans disabilities? Document any evidence of internal transfers, re-assignments, etc.

K. Present Social Functioning

Identify Stressors in any of the following categories:

Primary support system or group

Social environment

Educational problems

Occupational problems

Housing problems

Economic problems

Problems accessing health care

Legal system or criminal problems

Other

Appearance: Describe dress, speech, mannerisms, scars, facial expressions, and body movements (assessment based on observation listed above).

Relationships: Describe all relationships, including with whom and duration of relationship. Describe physical intimacy, including frequency, level of satisfaction, problems with intimacy, and any impact of medical or psychiatric conditions on performance.

Lifestyle: Describe how the veteran spends his/her time, including interests, hobbies, employment, typical day and week, and eating and sleeping patterns.

Mental Status: Describe, including evidence of confusion, memory problems, thought processes or disorders, and mood/affect. Describe the veteran's functioning in the areas of cognitive, emotional (mood) and judgment.

GAF Score (if available)

L. Capacity to manage financial affairs (if an issue)

NOTE: Mental competency, for VA benefits purposes, refers only to the ability of the veteran to manage VA benefit payments in his or her own best interest, and not to any other subject. Mental incompetency, for VA benefits purposes, means that the veteran, because of injury or disease, is not capable of managing benefit payments in his or her best interest. In order to assist raters in making a legal determination as to competency, please address the following:

What is the impact of injury or disease on the veteran's ability to manage his or her financial affairs, including consideration of such things as knowing the amount of his or her VA benefit payment, knowing the amounts and types of bills owed monthly, and handling the payment prudently?

Does the veteran handle the money and pay the bills himself or herself?

Based on your examination, do you believe that the veteran is capable of managing his or her financial affairs? Please provide examples to support your conclusion.

M. Summary & Conclusions

Summarize the specific effect of disabilities and the impact on employment.

Summarize the specific effect of disabilities and the impact on social functioning.

NOTE: Refer to medical, psychiatric and/or neuro-psychiatric report(s), as appropriate.

link: http://www.vba.va.gov/bln/21/Benefits/exams/disexm57.htm

[sixthscents]

OK........ sheesh..... still looking nothing in CFR 38, or M21-1....

[Josephine]

OK........ sheesh..... still looking nothing in CFR 38, or M21-1....

Thanks Josephine,

I try to warn all veterans to never enter a room with two psychiatrist, no matter what the sex. The General Council told me to be removed by the security guard before I ever do this again.

Thanks again,

Josephine

Edited February 27, 2007 by Josephine