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Another c&p exam


Whodat

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Hello again brothers and sisters.

I had just received my notice for my c&p exam and thanks to Hadit, I have done my research.

Now what I have found out and the info that's on the detailed letter, the fnp only shows the state that the fnp was licensed in, not the state where I live and where the FNP is conducting the exam. Is that legal?

I thought that you have to be licensed in the state where you practice.

Thanks. 

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  • HadIt.com Elder

They do but they don't have to list every single state in their letterhead. Your doctor doesn't either. 

Edited by brokensoldier244th (see edit history)
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Its a good question.  I do know we see "lateral" transfers..doctors moving from one VA to another, quite frequently.  I have a family member who is a physician in the military, and Im pretty sure she is a doctor "wherever" she goes, and does not have to have a new license in a new state, or country.  

I have been made aware of instances of doctors working at the VA (or as a contractor), who have had at least one state license revoked.  Its not a requirement for a c and p examiner to be a licensed physician in any state.  I got a C and P exam from an audiologist, and she was not a doctor, for example.  

Many others have gotten C and P exams from nurse practioners.  

In a c and p exam, the examiner is rendering an opininion as "an expert witness".   This does not always mean an MD.  But, to give a c and p exam you should have significant training and experience in the field, not necessarily an MD.    C and P examiners are given a "pass", that is, its presumed the examiner is competent to render said opinions "unless" the Veteran or his representative challenges the competency of the examiner.  

When a Veteran enters an "exam room", he/she often does not know whether this examiner is a doctor, NP, or something else, or even if that "doctor" is a VA employee, trainee, or contractor for VA.  And, Veterans should ask the examiner their name, as well as whether a VA employee or contractor, and at least their "rank" (MD, DO, NP, janitor, etc).  

Its been said a janitor could pick up a white lab coat, maybe a stethoscope, and give an exam..and the Veteran may never know that the examiner was not competent to render a expert witness opinion, and VA likes it that way.  Doctors are expensive and often in scarce supply.  So they often use NP's, PA's, or even an experienced nurse or other "so called" expert, who may or may not have expertise in the condition(s) you applied for.  

I got a c and p exam from a doctor, who admitted to me she was not "versed in sleep medicine".  She may just as well had a PHd in basketball coaching, as I alleged she was not competent to render an expert opinion in sleep medicine, where she had no training or experience.   Still, she got a pass (presumption of competency) until I challenged her competency.  

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Thanks brothers. Just being proactive just in case I need to appeal. Hadit had taught me to research the qualifications of the examiner.

Did my research on her and she is a NP foe 8 years, and her experience with c&p exams is 0 to 1 years. She had her school and training in Indiana as well as licensed there. I live in Mo. But I think that Mo honors out of state license which does make sense. Medical professionals can travel anywhere to treat things like covid. 

I had claimed right shoulder GERD and sinusitis so it shouldn't be too bad for her. 

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  • HadIt.com Elder

W......you got to watch these VA NP's.  I got one for a heart condition exam .  She had no idea what she was doing.  She was training another idiot during my exam. You might get a good one or an idiot.  Just be ready to appeal.  I think they get points for lowballing vets. 

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You are right about at@john999. I was also told to make sure that they have the right DBQ for the exam. That has been one of the problems lately. It's a shame by the way I feel but I feel like filing for a claim is basically preparing to file for an appeal. The claim is in but I am more focused on the appeal. 

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  • HadIt.com Elder

I am probably filing some claims for SMC due to my feet pretty soon. I am pretty sure I will be having to file appeals.  Filing the claim is the first step in the process leading to appeals. I got lucky once in 40 years when I got what I was asking for in the initial claim.  I see you are 90%.  Are you going for 100% schedular.  I was 90% for ten years and finally got the 100% but not actual.  Mine was rounded up to 100%.  I don't think it is possible to get actual 100% unless you have 100% for a single condition.  Good luck with your claim.

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39 minutes ago, john999 said:

I don't think it is possible to get actual 100% unless you have 100% for a single condition.  Good luck with your claim.

John it is possible, but it is not going to be easy. I was rated 90% for two years but the VARO deferred some of my claims and it took them two years to complete before they finally awarded me 100% schedular. This was not an appeal it was just the fact that I had multiple claims going on at the same time and they kept doing multiple ratings until they finally got to my last rating of Fibromyalgia which was rated as 40% which caused my combined rating to be 95 and they rounded up to 100% schedular P & T. Because I filed some many claims at one time, I had to go to many C & P exams and for whatever reason, the VA could not schedule them close together or more than one a day. At that time, I could not travel on my own and I needed VA transportation to pick me up and bring me home to and from each appointment and or exam. The VA finally gave in and granted me 100% schedular with P & T and I have been rated that way for close to two decades.  

Typically, a veteran rated at 90% would need an additional 40%-50% rating to get to the magic number of 95 for the VA to round up to 100% schedular.

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  • HadIt.com Elder

But you never actually get to 100%.  It has to be rounded up.  I got 100% when I had 90% like you.  I had an extra 80% but I never got to actual 100% because it is impossible the way VA math goes.  You can get 100% rounded up like you and me, but the VA keeps dividing the amount between 90% and 100% until the numbers become infinite.  This is how figure it. Not that it matters but it is strange how they do it.  I was TDIU for about twenty years before I got the 100%.  Now I could work but not able and being 72 years old who cares?  You get to a certain percentage and it does not pay to try and rehab yourself.  It is a trap that hurts the disabled.

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