Rightardia has written some articles on the C and P exam and one of them is top rated on Google search engine: see http://rightardia.blogspot.com/2010/06/how-to-handle-veterans-affairs-c.html
Normally the C and P office will call you first to schedule the C and P exam. Find out who the physician is. Be aware that the 'physician' could be a physician's assistant (PA) or a nurse practitioner (NP).
If you get someone who is not a real board certified and licensed physician, don't fret. You can schedule an complimentary appointment with a board certified and licensed physicians in your state.
Have the physician perform a physical exam for your condition . You can either mail the physical in by certified mail or hand carry it to the Veteran's Center in the VARO.
Put a transmittal letter on the private physical exam that highlights the credentials of the private physicians and their licensing and certification. This complementary physical can save the day during a De Novo review or a Board of Veteran's Appeals hearing.
Submit the complimentary physical either immediately before or after the VARO C and P physical is completed.
It is also a good idea to review the Progress Notes of the C and P physicians and critique them. The C and P 'doctor' may not only make factual errors, but also watch for errors of admission. Bring your spouse of significant other to sit in on the physical because two heads are better than one.
There is a sample letter in the earlier article that shows you how to do this. If the veteran has sensory or psychiatric problems, the spouse or significant other should attend under auspices of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act (1973).
Once you have talked to C and P, they should send you a letter officially advising you of the physical. Check out the credentials of the examiner with the state department of health or the department of professional regulation.
In most cases the VA physicians may not be licensed in you state or be board certified. If the 'physician' is a PA or NP, it will be easy to discredit them in front of the Board of Veterans Appeals judge with the physical from your board certified and licensed certified physician.
If the C and P physician does a bad job during the physical, you can challenge their credentials. Here is the format for a challenge letter.
I am formally a challenging IAW Case: Rizzo v. Shinseki, CAVC No. 07-0123; Fed. Cir. No. 2009-7026 the education, knowledge, experience, or training of a Doctor/C and P physician's assistant/ nurse practitioner, _____________ on _________________, to provide evidence in my case. _____________is not board certified in endocrinology nor is he licensed in the state of Florida according to the Florida Department of Health.
I request “affirmative evidence” be provided to the Decision Review Officer and The Board of Veteran Appeals when required that establishes the individual’s competence and qualifications to provide the expert evidence submitted.
__________ has little or no experience with ____________ conditions, he performed an incomplete examination on me, and made errors of omission and significant factual errors in the examination report.
Specific statements and examples have been submitted to the ____________ VARO at attachment 1. In addition, I also provided an alternative _____________ exam from my (specialist), _______________ , at my own expense that the VARO, DRO and BVA should be using to make determinations about my condition.
sincerely,
Watch out for bait and switch C and P physicals. C and P may call you about a physical for a respiratory issue, but the physician may start questioning you on a different medical condition.
If you run into this, tell the physician that a mistake has been made and that you want to talk to the supervisor of physicians or chief of patient care.
Rightardia suggests you verify what the appointment is for when you check into the C and P section. Try to get problems like this squared away before you enter the examination room.
Also, look for the c-file. It is supposed to be in the examination room.
After the C and P exam is completed, get a copy of it and write a letter that describes any factual errors or errors of omission.
Errors of omission are important because you may tell the physician important facts about your condition that should have been entered in the progress notes.
Write a letter that identifies any factual errors or errors of omission and have it entered into your c-file though the veterans center or mail it to the local VARO with a return recept.
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