VA Physical Exam(unsure) need advice....

[Malinois1983]

Hello all,

Basically my background is a house borne IED that detonated shattering both femurs and wrist. I also have a TBI among other things including Migraines.

I am not pissed about what the doctor had done in the first 4 hours of my exam. He asked me questions about all my claims, what was wrong, what the pain is like etc. He was thorough with asking how often the migraines were, memory, all of it.

Now is where I get pissed. I dont like people touching me let along pulling and yanking on my legs especially. But since this was a VA exam and it means $$$ in my wallet when Im out I was ok and ready. He starts doing range of motion on all my issues. I tell him it hurts at a certain point and he says now Im gonna physically pull/push you further even though it hurts. I said Sir it hurts really bad please dont go any further but he in insists on doing it anyway. I finally say look it really hurts and he says ok now go back to where it first hurt so we can take that measurement. In the end he takes two measurements for each joint or affected part. I think Ive just been screwed... Umm is this normal?

 

[moneyblind]

The VA doc needs to take readings to the extent of ROM and the point at which pain is inflicted; If he did the job right and wrote everything down correctly, he would state something like "Spine forward flexion: 30; Point of Pain: 15"

By my observations, its the point of pain that is the critical factor; But that all remains on how your VA doc writes it up.

 

[Malinois1983]

The VA doc needs to take readings to the extent of ROM and the point at which pain is inflicted; If he did the job right and wrote everything down correctly, he would state something like "Spine forward flexion: 30; Point of Pain: 15"

By my observations, its the point of pain that is the critical factor; But that all remains on how your VA doc writes it up.

Yeah I saw his numbers, he put ROM w/ Pain begins and then Final ROM with pain...but whats funny is a he told me to touch my toes and I said this hurts and is the furthest I can go....He didnt push or yank on me for that but just for all the others. I have a herniated/bulging disk in my L5S1 and then another at the top of my spine...

 

[Warrior644]

Hello all,

Basically my background is a house borne IED that detonated shattering both femurs and wrist. I also have a TBI among other things including Migraines.

I am not pissed about what the doctor had done in the first 4 hours of my exam. He asked me questions about all my claims, what was wrong, what the pain is like etc. He was thorough with asking how often the migraines were, memory, all of it.

Now is where I get pissed. I dont like people touching me let along pulling and yanking on my legs especially. But since this was a VA exam and it means $$$ in my wallet when Im out I was ok and ready. He starts doing range of motion on all my issues. I tell him it hurts at a certain point and he says now Im gonna physically pull/push you further even though it hurts. I said Sir it hurts really bad please dont go any further but he in insists on doing it anyway. I finally say look it really hurts and he says ok now go back to where it first hurt so we can take that measurement. In the end he takes two measurements for each joint or affected part. I think Ive just been screwed... Umm is this normal?

Unfortunately, your experience with the VA C&P Examination clinician is a fairly dominate occurrence with other military service member; myself included.

From my experiences, some of the VA C&P Examination clinicians do not follow the VASRD criteria for ROM measurements which ultimately affect the military service member potential VA disability compensation rating percentage.

As based upon the VASRD, I would say that there are two primary evaluating factors for VA compensation with musculoskeletal system medical conditions (e.g. in the Spine):

1. Based on Painful motion via Range of Motion (ROM) measurements:

In support of number 1 above, the VASRD states that "the intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint."

2. Based on Incapacitating Episodes for Intervertebral Disc Syndrome:

In support of number 2 above, the VASRD states to "evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25."

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best Wishes!

 

[Malinois1983]

I did call my VA buddy who is a rater lucky me right? So basically he said the Doc was not supposed to do this. If for some reason it comes back that he did this and it affects my disability in a negative way then he said I can request to have another done. I dont think he was trying to screw me because at the end he said hope it all goes well for you and I try to help you guys so I hope you get a good rating. Just kinda uneasy with what he did.

Unfortunately, your experience with the VA C&P Examination clinician is a fairly dominate occurrence with other military service member; myself included.

From my experiences, some of the VA C&P Examination clinicians do not follow the VASRD criteria for ROM measurements which ultimately affect the military service member potential VA disability compensation rating percentage.

As based upon the VASRD, I would say that there are two primary evaluating factors for VA compensation with musculoskeletal system medical conditions (e.g. in the Spine):

1. Based on Painful motion via Range of Motion (ROM) measurements:

In support of number 1 above, the VASRD states that "the intent of the schedule is to recognize painful motion with joint or periarticular pathology as productive of disability. It is the intention to recognize actually painful, unstable, or malaligned joints, due to healed injury, as entitled to at least the minimum compensable rating for the joint."

2. Based on Incapacitating Episodes for Intervertebral Disc Syndrome:

In support of number 2 above, the VASRD states to "evaluate intervertebral disc syndrome (preoperatively or postoperatively) either under the General Rating Formula for Diseases and Injuries of the Spine or under the Formula for Rating Intervertebral Disc Syndrome Based on Incapacitating Episodes, whichever method results in the higher evaluation when all disabilities are combined under § 4.25."

Thus, possessing well-informed knowledge is truly a powerful equalizer.

Best Wishes!

 

[Warrior644]

I did call my VA buddy who is a rater lucky me right? So basically he said the Doc was not supposed to do this. If for some reason it comes back that he did this and it affects my disability in a negative way then he said I can request to have another done. I dont think he was trying to screw me because at the end he said hope it all goes well for you and I try to help you guys so I hope you get a good rating. Just kinda uneasy with what he did.

I appreciate the feedback of confirmation via your VA rater buddy. It's a total shame that we have to continually fight for proper award of DoVA disability compensation. It's just a total shame!

From my experiences, please beware of the DoVA C&P Examination physicians who are very "clever" in hiding their true subjective opinions while administering the C&P examination(s). Some key warnings are when the VA physician makes a comment of "that's rare" and states "I don't rely upon other physician(s) test results...I like to perform my own." The latter tactic is valid, but you won't know the outcome of those test results until receipt of the VA C&P Exam report(s) after the MEB NARSUM is dictated. Afterwards, the NARSUM is completed by the MEB physician and presented to you via your PEBLO within the MEB phase.

Albeit, if time permits, it's always an excellent course of action to request a copy of the C&P Exam results upon completion by the VA C&P Exam physician(s) from your local VA Regional Office; it's free upon showing a valid military ID.

My very unpleasant VA C&P Exam experiences resulted in requesting an IMR and MEB Appeal for a condition which was intentionally misdiagnosed by VA and deemed medically acceptable by the MEB physician. Having prior knowledge of the C&P Exam physician's negative subjective opinions via receipt of the VA C&P Exam results, I was able to compile my objective medical evidence for potential submittal of an IMR and follow-on MEB Soldier's Appeal.

Fortunately, I was successful in my MEB Appeal and the "incorrectly" diagnosed condition was changed and then annotated as "medically unacceptable." Unfortunately, I was not able to reschedule the two C&P Exams because "IDES processing requirement timelines" apparently had higher priority. So, the two extreme unjustifiably written C&P Exam reports will be seen by the D-RAS during the PEB's VA rating phase.

Thus, it's to your extreme benefit to get the medical conditions initially annotated correctly while within the MEB phase. Hopefully, my 1-page IMR memo with a 22-page enclosure (objective medical evidence), and a 7-page MEB Soldier's appeal with a 57-page enclosure (objective medical evidence) will also be reviewed by the D-RAS during the PEB's VA rating phase.

Moreover, I am expecting to receive an extremely "low" VA rating for the aforementioned MEB referred condition. Why? Because the VA C&P Exam physician annotated "yes" after the next lowest category within the summary section which directly aligns to the VASRD's general rating formula. Naturally, this is a huge concern for my family because I potentially don't have any "new medical evidence" in order to submit an one-time "request for reconsideration" of the rating(s) from the D-RAS.

Best Wishes!

 

[Malinois1983]

Hopefully it all works out for you. I saw your timeline and thats crazy. I did speak to Jag today and they said I should be rated by the postion in which pain first started and not the full way that he bent it...

I appreciate the feedback of confirmation via your VA rater buddy. It's a total shame that we have to continually fight for proper award of DoVA disability compensation. It's just a total shame!

From my experiences, please beware of the DoVA C&P Examination physicians who are very "clever" in hiding their true subjective opinions while administering the C&P examination(s). Some key warnings are when the VA physician makes a comment of "that's rare" and states "I don't rely upon other physician(s) test results...I like to perform my own." The latter tactic is valid, but you won't know the outcome of those test results until receipt of the VA C&P Exam report(s) after the MEB NARSUM is dictated. Afterwards, the NARSUM is completed by the MEB physician and presented to you via your PEBLO within the MEB phase.

Albeit, if time permits, it's always an excellent course of action to request a copy of the C&P Exam results upon completion by the VA C&P Exam physician(s) from your local VA Regional Office; it's free upon showing a valid military ID.

My very unpleasant VA C&P Exam experiences resulted in requesting an IMR and MEB Appeal for a condition which was intentionally misdiagnosed by VA and deemed medically acceptable by the MEB physician. Having prior knowledge of the C&P Exam physician's negative subjective opinions via receipt of the VA C&P Exam results, I was able to compile my objective medical evidence for potential submittal of an IMR and follow-on MEB Soldier's Appeal.

Fortunately, I was successful in my MEB Appeal and the "incorrectly" diagnosed condition was changed and then annotated as "medically unacceptable." Unfortunately, I was not able to reschedule the two C&P Exams because "IDES processing requirement timelines" apparently had higher priority. So, the two extreme unjustifiably written C&P Exam reports will be seen by the D-RAS during the PEB's VA rating phase.

Thus, it's to your extreme benefit to get the medical conditions initially annotated correctly while within the MEB phase. Hopefully, my 1-page IMR memo with a 22-page enclosure (objective medical evidence), and a 7-page MEB Soldier's appeal with a 57-page enclosure (objective medical evidence) will also be reviewed by the D-RAS during the PEB's VA rating phase.

Moreover, I am expecting to receive an extremely "low" VA rating for the aforementioned MEB referred condition. Why? Because the VA C&P Exam physician annotated "yes" after the next lowest category within the summary section which directly aligns to the VASRD's general rating formula. Naturally, this is a huge concern for my family because I potentially don't have any "new medical evidence" in order to submit an one-time "request for reconsideration" of the rating(s) from the D-RAS.

Best Wishes!