Of the 53,500 disability exams conducted by the VA from March to August of 2017, at least 19,800 were deemed unnecessary. That has cost us as taxpayers $10 million, and it could cost us $100 million more over the next five years.

This news comes on the back of the IG report published a few weeks ago.

The record-keeping system that tracks these eligibility exams was not designed to kick out cases of permanent disability, cases involving veterans over 55, and cases that have not shown substantial change over the past five years, as it should have been.

No surprise there.

So, this means VA intentionally designed a system that failed to exclude certain veterans from exams – – instead, giving VA another bite at the apple for a denial or reduction.

We know that VA needs an accurate assessment of what a veteran’s disability rating actually is, and sometimes this rating changes based on recovery and reasonable accommodations in daily living. That much is reasonable to expect, and certainly, bureaucracy is not known for efficient execution of tasks.

But we also know what disability is and how disability works.

About a third of these visits were unnecessary, even by VA standards of necessity. But I think the nature of these disability exams also indicates willful ignorance by the agency to pretend most disabilities stay the same or get worse.

It will not spontaneously improve.

While I understand VA’s need to classify people’s levels of disability for purposes of payment, their expectations are all wrong here.

Wake up, Capitol Hill.

Permanent, worsening disability is a cost of war. We risked life and limb for this country, and most of us have ultimately given away some portion of that to the American cause.

Do not begrudge us your promise to make up the difference.

http://www.mcall.com/opinion/muschick/mc-opi-veterans-medical-exams-unnecessary-waste-muschick-20180731-story.html#

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23 COMMENTS

  1. Going through it now. Visited a VES doctor 3 times already. Just saw one yesterday. Seeing a clinical psychologist for my sleeplessness tomorrow. I don’t know what the purpose of him is. I have obstructive sleep apnea, which I have been trying to get the VA to test and chronic lower back and hip pain, which keeps me up at night. It’s like fighting a losing battle with the VA.

    • I have not had a night sleep for 40 years due to back pain and neuropathy in both feet which is quite painful. Even several types of sleeping pills were of no use. If you ever figure out how to get some sleep, let me know.

  2. And a lot of that waste is because they don’t do it right the first time and get a remand from the BVA which still isn’t done right so it is again remanded by the CAVC. Hopefully, eventually the BVA and CAVC will order the exams out. My SSDI exams, done by private contractors were much more complete and even though not required for SSDI, even the etiology statements were made.

    The CAVES SS report is the best evidence I have in my appeal. There are reports, that I didn’t know about, of the investigator speaking to employers and friends. The VA never did that. The only disability investigation was in the line of duty or not.

  3. I am over 5 years rated at PTSD 100%. Since my rating the condition has worsened to the point four hospitalizations were needed. I am 53. I am also rated for my back injury and hearing. Last week I had to go to another C&P exam to determine if my mental health condition has improved lolz. I have read up on the regs and at 100% disability scheduler rating they must take your medical history into account and a single C&P exam cannot in theory reduce your rating. They have to prove (the burden is on them) that there has been a material change in my condition. I searched high and low for precisely what “material change” means as used by VA and no clue really. However the literature says that any improvement must be under the normal stresses of daily living, working, or seeking work. I cannot work. Since I am 100% rated for PTSD if they did reduce it the next level is 70%. In fact I am told a 100% rating scheduler awarded without appeal on first application is rare. (the proof lined up and luckily(?) I was so badly injured that it required emergency medical care which left a record.

    To be fair by coincidence I also got letters from SSDI who had set up both psychiatric and muscular skeletal specialist to review. For them on deny upon review like this they must prove improvement. Since the last review I smacked the pavement at highway speeds and temporarily increased my total individual bone count 25%. In the case of SSDI they need current records from two years prior. VA had booted me out of care completely after the whistleblower story I was involved in printed. Roseburg even fought Washington DC to assign me a doctor again and the third call to DC they took the unusual step of assigning this case as one of whistleblower retailiation by Roseburg VAMC and declared the senior staff hostile to this patient. The problem was without any treatment records for two years as I fought it SSDI had no choice but to send me to their own docs for review. So VA not only wastes money sent to them… just think about it. I was sent to two shrinks paid by the government to determine the same thing. If VA had complied with federal law and had provided provider those exams never would have been scheduled. See how much corruption costs? HUGE.

    I have become adept at gleaning info about VA and noticed the pitfalls setup for me during the exam. Let me share. Remember, I am 100% rated for PTSD by VA. Not for pain. Not for another anxiety syndrome. Just PTSD. First pitfall they set you up for; they know I have pain so when I told the shrink I never sleep more than two or three hours at a stretch he very casually asked, “Because you hurt?”

    I answered truthfully “no”. Laying down relieves the pain mostly. The pitfall he set me up for was simple – if I had said it was pain then it would mean my sleep problems are not related to PTSD as originally documented. It would mean improvement. Keep on subject at all times.

    The other pitfall was he began asking questions about general anxiety, wanting to know how my life had been impacted by my diagnosed anxiety disorder. Here is the trap again. VA has seperated PTSD from other anxiety disorders recently, so if I had responded that, “Yes I worry and fret all day about everything.” It would indicate that PTSD was not the problem but rather an anxiety disorder that is not (yet) service connected. It is important to focus solely on PTSD in any question as the root cause.

    So SSDI and VA are reviewing me to see if a paycheck keeps showing up. Stress? Of course not. The only thing that could happen is I go homeless. No worries. I just hope my PTSD doesn’t have a major flare up….

    • @Dennis
      I, too, have experienced the Veterans Benefits Administration (VBA) and Veterans Health Administration (VHA) attempting to evaluate my PTSD under the auspice of generalized anxiety disorder (GAD). Whether by conspiracy, willful ignorance, or some other unidentified factor, it seems as though the VHA and contracted clinicians (e.g., Veterans Evaluation Services) I’ve encountered have generally understood the diagnostic criteria related to PTSD, yet the VBA has not, and some VHA providers still refer to my PTSD condition as “anxiety” in clinical notation.

      Under the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), PTSD was categorized as an anxiety disorder, though that changed in 2013 with the development of the DSM-V. Per the American Psychiatric Association, the collective that formulates the DSM, “Posttraumatic Stress Disorder (PTSD) will be included in a new chapter in DSM-5 on Trauma- and Stressor-Related Disorders. This move from DSM-IV, which addressed PTSD as an anxiety disorder, is among several changes approved for this condition that is increasingly at the center of public as well as professional discussion” (“https://www.psychiatry.org”).

      The way I describe to clients the difference between phobias, anxiety, and trauma/stressor-related disorders is fairly simple. With a phobia we can generally identify the stimulus causing fear (i.e., “I’m afraid of spiders,” asserting it is spiders that provoke an emotional reaction). With anxiety we typically may not know what it is that causes an emotional response (i.e., “I get anxious in crowds,” indicating one doesn’t quite know the exact reason a feelings-based reaction exists). With a trauma/stressor-related event we are able to draw a correlation to (an) event(s) that caused a multitude of symptoms to manifest (i.e., “The vehicle I was in was struck by an IED and everyone but me died horrific deaths,” demonstrating an exact origin from which the condition originated).

      I remind mental health providers who evaluate me of this fact and it’s difficult for them to deny my knowledge of the literature as I, too, am an educated, trained, and experienced clinician. Commonly, they understand that treatment for each of the aforementioned conditions may be similar, yet interventions for PTSD are constantly evolving and the literature addresses the disorder with unique methods of treatment. Unfortunately, the VBA personnel who’ve addressed my case throughout the years simply fail to understand this. In my case, and similarly with your experience, the VBA seems to evaluate PTSD under antiquated DSM-IV standards. This, I believe, doesn’t always occur as a simple error.

      There is evidence that members of the DoD and VA have historically misdiagnosed individuals who claimed PTSD, opting rather to diagnose other psychological conditions as a means to save the government money (Post traumatic stress disorder and personality disorders: Challenges for the U.S. Department of Veterans Affairs, Committee on Veterans’ Affairs, U.S. House of Representatives, 110-37. 1, 2007). Overwhelmed with the number of PTSD claims for compensation and pension, and burdened by the constraints related to work productivity, one VA facility psychologist actually urged her staff to reconsider diagnosing veterans with PTSD and suggested to instead consider adjustment disorder (“http://www.washingtonpost.com/wp-dyn/content/article/2008/05/15/AR2008051503533.html”). GAD, personality disorders, and somatic conditions are usual fallback diagnoses in place of a PTSD diagnosis, as well.

      Not a unique occurrence where the VA is concerned, in 2012 Ben identified a scandal concerning the U.S. Army by which a mental and behavioral health professional advised medical review board personnel that diagnosing service members with PTSD could burden taxpayers once the transitioning veterans were out of military service, so alternative diagnoses were issued instead (Is Army PTSD misdiagnosis scandal also fraud?). To me, it would seem as though four hospitalizations for an already-identified PTSD condition falls in line with a 100% rating per c-CFR criteria for mental disorders (Title 38, Chapter I, Part 4).

      Still, you highlighted precisely the summation of my stance by stating, “The other pitfall was he began asking questions about general anxiety, wanting to know how my life had been impacted by my diagnosed anxiety disorder.” I might add one other tactic the VBA has used in reference to my case, one it may try using with you in the future. Some VBA personnel try to invalidate a PTSD diagnosis after a veteran has undergone certain clinical interventions (e.g., medication, psychotherapy, etc.). What does the United States Court of Appeals for Veteran Claims state about this practice?

      According to case law (United States Court of Appeals for Veteran Claims – No. 11-2704 – David J. Jones, Appellant v. Eric K. Shinseki, Appellee, October 26, 2012), a legal precedent was established. The VA cannot consider whether pharmacological treatment, for instance, provides relief when determining the degree of disability by stating:

      “[T]he Board’s [Board of Veterans’ Appeals] consideration of factors outside the rating criteria ([including] relief with rest and medication) could not be a basis for denial” of a medical condition, “nothing in either regulation discusses whether VA should consider the effects of medication when assigning a disability rating,” “the Board has committed a similar error by considering the ameliorative effects of the appellant’s medication,” “Absent a clear statement setting out whether or how the Board should address the effects of medication, the Board erred in taking those effects into account when evaluating the appellant’s disability,” and, “the Board may not deny entitlement to a higher rating on the basis of relief provided by medication when those effects are not specifically contemplated by the rating criteria.”

      Hopefully my words have resonated with you in the form of acknowledgement concerning someone else who has experienced similar treatment by the VA. As well, perhaps the latter legal citation will prove useful to you in the future, if in the event the VBA tries to suggest that clinical interventions automatically indicate the improvement of a condition. Semper Fi.

      • Thank you for your post. I have a hard time understanding a lot of this type of jargon. Due to my traumatic brain injury.

        I have to read thing’s over and over before I can understand what’s being said.

        I understand you. Can you see how the VA took advantage of me for over forty years. I did not know I had suffered a traumatic brain injury until forty years later.

        A neurologist the other day told me all my problems were due to the fact that I am 65 years old.

        I told him so your saying I am this way because I am 65 years old. Yes.

        So I told him, so I have been living with a 65 year old brain. Since 1972 when I was shot in the head while serving this country.

        No reply. Strange hu!

    • Have you checked out the tests they throw at you if they suspect you of malingering? things like M-FAST SIRS and TOMMS are worth a look. TOMMS is the memory test I believe. Things like how many birds can you name in 30 seconds then 5 minutes later repeat them back. The others are not hard and fast questions themselves. They instead tell you how to ask/phrase certain questions. I don’t know whether it’s a good idea to call them on their bullshit or just lay back and watch them be cute. Probably laying back is the best course until a better understanding of the trap arises. I’m sure Sun Tzu has something to say on the matter but fucked if I can remember.

  4. Well, I spent many years with PTSD and damages from the initial innocuatlations of Anthrax in 2001 and 2002 and had to retake them because they didnt have a documenting system and my record was lost and they made me retake them. I began to get lost around the block sometimes not knowing who I was or where I was going and would have to pull off to the side of the road. Many times I was buckled over from PTSD on my job as a secuity officer at night and alone sick and throwing up in my stomach and terrible sinking feelings all the time. After 13 years of service and being dischared for 100% all my joints and my neck deteriorated from heavy work rigging loads and carrying large litter carry patients, I then later started to see faces warp and couldnt figure out what I was seeing exept the Damages from the Anthrax held images of injured soldiers in my mind like a picture that wouldnt go away. Without PTSD my joints alone yielded over 100% disability. The medication made it wose but to look at me, I lost 80 lbs and I look healthy and I try to get healthy but I ache from Arthritis all day long sometimes with chronic pain. The thing with PTSD is that even if there is no pain there, Past pains and situations affect your mind and pain you experienced before may be what you are feeling. I have toruble opeing things due to severe arthritis in my hands from riggin loads and contanstly using my hands, and limited on the time frame of use of my hands. I have trouble writing letter with pencils or pens prolonged but I can type with my palm rested. However, the apprearance may look healthy and people dont see damages except for What they dont experience what I feel everyday. not just the pain but the loniness of not being a well part of society because people judge you .People with PTSD often have social issues of some sort and society is intolerant of those and virtually ignorant. Some of us carry PTSD Cards I talk alot at times but it used to be I couldnt respond to anyone, even if they talked to me. I offended people then when you get on the reverse side of having been bottled up for many years it almost takes a reverse of intolerence of society. Not all wounds are visible I got joints I deal with and do things with but dont complain about the pain because I dont like to dump on others and I like to give of myself and chronic pain can ultimately make you self centered. People juding the VA to me are stupid or the army, They are ignorant, When I got disabled, I had perfect doctors in Place. Your primary care doctor is familiar with you inside and out thorout the military and sometime know you more than your spouse, I had an MRI from head to toe giving me over 200% degeneration in joints in my body including my eyes, their socets and inside my eyes giving me poor vision. People think if you can walk upright or think that if you can walk at all that your not disabled. When I go to theme parks I couldnt even stay up with my family or stay more than three hours walking at a normal speed and when I did it hurt hreally bad all the time. Veterans have an extreme loss of quality of life meaning that sometimes there is no life after death. Soldiers die to themselves and serve others, God ,their country and their fellow man. They sacrifice daily, are up exteme early hours and sometimes till late hours and depending on the unit sometimes without being able to eat properly. On missions they have to leave their family and not come home at night leaving their spouse to care for the kids by themselves and some with no other support and if they dont make it back then they made the ultimate sacrifice on top of sacrifice, One soldier got taken advantage of while away, had a kid on the way and his wife aborted his son he was so happy about and took off with any savings or bonus money he may have recieved and left him while on deployment. Some of their stories wll break your heart and break you down. They struggle with stability, a faithful spouse, and being away from their family on top of coming home with even a lesser quality of life. Some dont get help because of the American pride of Society and they are afraid to tell, “Im Afraid”, or “I’m Weak” Or “I Cant handle it” therefore they go many years not getting the benfits they deserve because of the judgement of society.

    • On top of having a PCM doctor every test, every exam, and everything you every had documented and experience, are presented, reviewed and evaluated by medical doctors, lawyers and judge advocates, the Army isnt stupid and neither is the VA system. Get off your your jealous kicks society, of a price you werent called to nor were willing to pay yourselves, Your not missing anything!

  5. These fraudulent exams led to them stealing half of the half I was getting. I had an exam at one hospital and within another year another c&p so they can steal back what I got. I fought my way up from $250 to $1400 for them to steal half of that. Fucking do-less cocksuckers.

    About time to organize some people and do some nasty shit to the va. Sick and fucking tired of the abuse. I’ve tried getting elected officials involved but it always results in having the VA Barney cops called.

    Fuck socialists
    Fuck communists
    Fuck all the affirmative action anti white darkies infesting the VA’s here
    Fuck Obama
    Fuck VA
    Fuck VSO’s
    Fuck Israel
    Fuck your feelings if I offended you

    I’m tired of the anti white discrimination that goes on in this state. They keep fuckin with me and I’ll make Wong blush in his grave. Fucking garbage ass country I never should have broke my body for.

    One last thing: Fuck trying to type on this site. I’ve never seen on the whole internet a more inaccurate garbage typing software. You need to fix this garbage “Ben” and stop being a bitch.

    Rant out ya rat fuckers.

  6. 08/03/2018

    Dear Benjamin Krause,

    Given the numbers are correct:
    Each year will have 128,400 exams deemed unnecessary at $505.05
    Or a grand total of $23,993,939.39 a year [money lost at the VA/gross mismanagement/Wanton negligence]
    And to project out five years the sum is
    $119,969,697.00 or .12 Billion Dollars [Taxpayers money throw into the wind]

    And you are wondering where the doctors are?

    Sincerely,

    Don Karg

  7. I just had a C&P for neuropathy which was all previously done by the VA and in my records. So they send me to some nurse practitioner that was most likely terminated by a hospital for incompetence and she ask me questions that were in from of her. I could not tolerate that shit and walked out on her

    • Something is temporary. Reread your letter. They review compensation when first granted withing a fairly short time, 1 to 2 years, since I was first compensated at 40%. If they adjust it, it will be down. But it is a requirement for the review and they usually find someone to do the C&P that will undercut the one that got your rating. After that you’ll have a lifetime fight. Mine is 35 years long and still fighting.

  8. I found out i was total and permanently disabled last year. Yet I have a C&P in 3 days. I asked 4 people at their office and the 800 number and no one knows why I have an exam with this T&P. ANY ideas?

    • Same here no one at the regional office could give me an answer. 100% Perment and total since 2001.

      Shot in the head while serving this country in 1972. Everything was fine until I found out I had suffered a traumatic brain injury from me being shot in the head and did not know I had.

      I applied again for my traumatic brain injury to be service connected for the traumatic brain.

      Since I dared to ask to be service connected for the traumatic brain injury that request, must have made someone really mad and forcing me to complete another comp and pension examinations.

      In reality I should have been rated as being total and permanent since I was shot in the head while serving this country 1972.

      God only knows what the VA will do to keep doing thing’s to harm veteran’s. Dirty shame.

      My attorney told me if they do take away anything from YOU. They have to send you a letter to appeal.

      Told if they take any negative action. I am to call them right away and they would step in to help.

      It only took me forty years to find an attorney to help and finely get someone to listen.

      Let us know what you find out.

  9. I am 59 and went through this already two times. Feb 2017 and again in Mar 2018 I had what they call RFE, I guess its requested future exam. Got notice and they wanted to see me at a C&P exam (VES) in 8 days.

    Funny, but that IG report was based on a study that ran from March through Sept 2017 (?). I printed the IG report out, so it was last year, 6 month investigation. But my second exam was in Mar 2018.

    I would consider that they would not have taken action to fix this in just a month or two. But the way it sits, this was 6 months later. I rose cane, smoke was coming from the WH hotline. I was ready to talk to a reporter that does VA stories out of St Pete about this. Then the whole thing went poof, gone. I did the C&P exam in Apr, and in June, they complied with my demands and terminated the RFE lock stock and barrel.

    Wanna bet that they scrub the records that make them look bad?

    • The way I see it, if they did not correct this, then the next 6 months they continued doing the same thing they did during the 6 months that the investigation was going. This would make the $$ double, 20 Million, 12 months.

      The real nature of this is the retro view nobody talks about. How much over the last 10 years was blown because the VA did not follow the properly promulgated rules in accordance with our laws? 200, 300 Million? Go figure. Thats the elephant in the middle of the room.

  10. I would love to know if permanent & major physical disability caused by the VA medical team (doctors/techs/nurses/etc.) subject to additional disability rating. I am blind in left eye due to VA using laser on retina, A strict NO-NO for any doctor & then also med change causing fall to split same eye ball open, E.R. visit to sew up eye ball, & a 2 1/2 year wait to see eye clinic for needed care & finally have appointment through Vet’s Choice/Tri-West. Also have other permanent disabilities caused by VA care. Any one have an answer ?

    • Check out Hadit.com for help with this Meach. You might have a case for 1151 claim, and the FTCA is the federal tort claims act that lets you sue the Govt for this kind of stuff but you need a special lawyer for that. Hadit.com can point you in the right direction, its Vets helping other Vets with claims.

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