Attorney Wants Diagnosis for Secondary Complication to Rated Condition; Must it be through VA?

[Cat4Christ777]

Originally, this secondary condition was claimed as 'migraines,' but while it may begin as a migraine with a complication, the VA can--and has, more than once--made it so much worse (pain-wise). If it does not qualify as a migraine, then my attorney and I need to come up with a different diagnosis. It's definitely a neurological issue, possibly 'occipital neuralgia,' as the condition meets the criteria of its definition, here: https://medical-dictionary.thefreedictionary.com/occipital+neuralgia.

Yes, VHA has been my provider, but they have also been the ones triggering my secondary condition; and once they bring on the extra pain, they IGNORE the cause and focus solely on finding a drug to stop it. I am afraid to ask them to diagnose a condition they cause; and they won't volunteer to bring it up, themselves. They prefer not to deal with issues they cause. The VA Northern California Health Care System (at Mather) has even destroyed medical records associated with one of these episodes they caused.

And, if I ask them to diagnose the secondary condition, they may cause the pain just to 'study it,' and that is UNACCEPTABLE, as that pain is a death sentence for me (as, in my first experience, mentioned above, I was in that severe pain for at least 12 hours, and if VA had not eventually found a drug to treat it, I would definitely have ended my life that night). In fact, after that first episode, I never called, nor went back to, that VA hospital for over 14 years. When I finally called, I discovered that they actually thought I had killed myself. They were surprised I was still alive.

So, I am wondering if I can go to a civilian Neurologist to have them diagnose this condition, instead of letting the VA 'try' knowing they could fail, and that would end my life.

The original, rated condition is 'Right Upper Extremity Radiculopathy Associated with Cervical Spine Degenerative Arthritis Status Post Discectomy and Fusion, C6-7, with Inter-vertebral Disc Syndrome,' rated 30%.

So, what do you guys think: Should I get a private Neurologist to diagnose my secondary condition? I found some local, quality doctors in town (Clarksville, TN).

[Whodat]

Well Cat, I do understand your pain and frustrations. Did you specifically filed as migraines? Is your claim still open? Did you appeal?

 

Stay away from Clark Vegas. 

I was stationed at Campbell twice. 

[broncovet]

Your attorney is correct, to get SC you need a current diagnosis.  And, that has to be made by a medical professional.  

EXCEPT for PTSD, which VA is convinced "only VA docs can diagnose PTSD", ANY medical professional (aka "doctor") can make a diagnosis. 

Dont end your life!  Pain is often temporary!  Even if its permanent, it can often be controlled!  As you already noted, there are alternatives!  Call the Hotline, instead!  https://www.va.gov/health-care/health-needs-conditions/mental-health/suicide-prevention/

 

Dont ask why VA must diagnose PTSD, I have wondered that myself, as I am equally puzzled.    Apparently the courts (CAVC) lets VA get away with that one. 

An alternative that may be less expensive, if your local VA doc wont diagnose it, then another nearby VA doc may.  

I have found a wide variety of skill levels and competence of VA docs.  Some are great, others not so good.  

Its even possible that VA may pay for your medical bills for your private doctor, but usually only when VA can not get you an appointment with VA's neurologist for 30 days.  

There are many, many alternative treatments you can try besides traditional medicine for pain relief.  Find one that works for you.  

 

[ShrekTheTank]

So I had to do this with my Dercum's disease and with my Fibro.  I went outside the VA as they would not say this is what I have or not.  I was getting the run around, so I called a local doctor and they scheduled two hours and at the end they diagnosed me with both of the conditions I thought I had.  They also gave me a drug that has helped me a lot.  

I had to reach outside the VA for these two issues.  As for the rest the VA did diagnose me inadvertantly.  

As Bronco stated above the VA is the only one to do PTSD.  

[Cat4Christ777]

Thank you all for your prompt answers! You have helped me decide to 'go ahead' and contact a private Neurologist. If the VA was going to diagnose this issue, they would have done it back in 2001/2 after my first experience at the VA in Northern California; but they did nothing, preferring to hide their culpability--proving they're NOT about helping their patients.

Whodat, yes, we did claim for migraines, but it was denied. Thought that was weird, since I reported migraines as 'common' in my first experience w/VA in Northern CA; but I suspect (owing to their belief I had committed suicide after that experience), they did not follow up, nor pass on that information in my records, and it appears they destroyed those records (apparently to cover their butts).

Yesterday, I found three possibilities by searching for 'Neurologists in Clarksville, TN' and found these: https://threebestrated.com/neurologists-in-clarksville-tn

Already called the board-certified physician, but his practice refuses to take private patients (require a referral and insurance), so today, I'm calling Dr. Gretchen Campbell of KCA Neurology. I especially like her statement on her 'about' page:

"What we believe

In everything we do we believe in challenging the status quo. We believe in thinking differently. The way we challenge the status quo is in our holistic approach to the practice of neurology in a way that uncovers root cause issues resulting in symptoms.

If you’re the type of person who likes getting to the bottom of things in every aspect of your life, we have the neurology practice for you."

That statement really spoke to me, and happily, her practice accepts private, direct-pay patients. I'm calling her this morning, to see if I can schedule a consult for later this month. I would appreciate your prayers (or crossed fingers, whatever) to help her say 'Yes!'

Thanks again, and I will come back and update with her answer!

--Catherine

Edited June 3, 2022 by Cat4Christ777
forgot to respond to a question.

[Cat4Christ777]

When I called Dr. Campbell's office at about 8:45 a.m. this morning, their phone lines were busy, so their machine suggested texting them, which I did. As of 10:20 a.m., I have not received a response yet. Off to do some grocery shopping, and will update if anything changes in the meantime.

--Catherine Bird

[broncovet]

Catherine...not "all" private doctors know how to do exams "that the VA will (favorably) accept.  

There is certain wording VA needs to service connect you.  Let me try to help.  

Begin with the Caluza elements, required for SC:

1.  Current diagnosis,

2.  In service event or aggravation. 

3. Nexus, or doc opinion that your (current diagnois) is "at least as likely as not" due to an in service event.  

    A favorable medical exam (for va) would contain most, if not all, the following:

1.  CV of the doctor, showing he/she is an expert in his field.  (Medical training and experience), along with things like Board Certifications.  

2. The doc needs to state, "he reviewed your medical records".  Necessary.  

3.  The doc needs an opinion "very close" to Your condition is at least as likely as not due to an event in military service.  (naming diagnosis, and describing the event you think caused your diagnosis).  

4.  He has to have a medical rationale as to "why" he renders such an opinion.  

5.  You need some documentation of symptoms.  

     A favorable medical example "does not" have:

    ...ambigiuos terms, such as, "your diagnosis  MAY be related to service", or "your event "could" be related to service.  

     It really needs to say that, in the doc professional opinion, there is a greater than 50 percent chance its related to service.  No maybe's or could be's.  

     If you are using this to refute a VA doc negative opinion, then it may be a good idea to show the doc the report, and the doc should opine why his opinion is more probative.  Example:  Dr. J, (VA doc) did not test the blood, while your neurologist did blood tests, confirming the etiology and or diagnosis.