Optum Serve, has anyone used them?

[Riplip]

Well i've been waiting for the review of my second C&P for a supplemental claim that started February last year. They denied and I added a IMO from my DR. they sent me to another C&P but it wasn't one I needed to attend. That was for LHI. I've been hoping id have my answer soon. I just received an email from Optum Serve (Formerly LHI) and they will be calling me for another C&P exam. I can't even think of what they need to exam now. Guess I can't hope for an answer soon now. WTF. The system is so terrible I don't get it. So frustrated right now. Hope everyone is have a good New Year so far.

[Riplip]

Thank you Mr. Cue. I agree with what you said but since I am not 100 % P&T I am going to let them take advantage of there situation and get screwed over because I don't have the means to fight the way I would like too. I am just really frustrated and I hope after all the BS this takes I get a backpay back to last February when it all started. Yes I have record of treatment. I have documentation and a good IMO. My VSO said they are looking for another IMO. I don't know what that means but I am out of Drs. My VA doctor will not help out in a claim case at all. I have that in a email and my Private sector DR is the one that filled out the IMO. I don't know anyone that has more Drs. than that. 

[jamescripps2]

On 1/5/2023 at 2:49 PM, Mr cue said:

I can't agree with this statement.

I feel your frustration and yes the VA has a new delay tactics these private contractor exams

 

On 1/5/2023 at 2:49 PM, Mr cue said:

I have no frustrations as I have won all of my claims and there is no higher rating to fight for.

To refuse an exam could be fatal and translated by the VBA as you trying to make up your own rules. True, you can certainally do all that you have stated, but you are asking to take the long way around. In reading your prior post, Your tactics, as far as telling the VA what you are going to do, don't exactly seem to be working out very well for you.

Just go with the flow, follow the rules, win your claim, and go home with a pocket full of gold. That is my advice because I have been there and done that!

 

 

 

 

 

[Mr cue]

5 hours ago, jamescripps2 said:

I have no frustrations as I have won all of my claims and there is no higher rating to fight for

Lol happy you feel you got everything. But some us haven't so we fight.

But that have nothing to do with what the veterans posted about.

Now as far as my tactics just like you said they are my tactics and the way I handle things.

 

Just like you feel that veteran shouldn't fight an go with the flow is your tactics.

I have been to the cavc two time remand two times all in 3 years.

Think l am doing good with there delay tactics.

An I am up to smc l&half. Think my tactics have been working for me.

Everyone is in title to there opinion that what wrong now everyone thinks there opinion is gold.

As far as your belief on the exam thing i think It's just that your beliefs. An you are in title to them .

5 hours ago, jamescripps2 said:

To refuse an exam could be fatal and translated by the VBA as you trying to make up your own rules

 

[Riplip]

Update on this. I just received a letter in the mail that I am having another Medical opinion request from the VA. It has been sent to Optum Serve and they have sent it to a Nurse Practitioner in Tennessee to give an opinion on my SC. I've been at this for almost a year and this is the 3rd C&P and why does it hang on the shoulders of a Nurse Practitioner? Nobody needs to answer that I'm just venting. Thats my update. I have no idea when the person is going to make a decision on it either. Thanks

[Whodat]

I feel your pain and want to vent with you. Makes no sense at all. Ordering multiple c&p exams until they find the right examiner to write a better negative report and use that negative report for the denial instead of holding the original examiner. One of the new tactics for delays and denials. VA is aware that most private docs don't do DBQ's and or know that most private docs are not familiar with them. They get an inexperienced NP. We can challenge the exam VA reads the report, don't like it because it looks favorable to the Vet. So looks like VA is challenging the examiner as well.  Then we get a nice letter saying DTA error. They know what they are doing. It's a tactic to buy time and shop around for another contracted company.  Damn shame.

[AFVETSSGT]

@Riplip You can call Optum serve and find out the day the NP is supposed to review it. It will be listed as "appointments you don't need to attend" when you talk with a customer service rep. We were told the day/time my review for 3 different issues was "deferred" back for medical clarification. They will also tell you when they send it back to the VA. Hope that helps!