17 December 2012

VA Practitioners Refuse to Release Medical Opinions

They really care - I haven't met a VA physician, PA, nurse practitioner, nurse or other medical professional who wasn't totally committed to my care - truly professionals. I recommend them highly and have taken the time to express my appreciation in many forums.

HOWEVER, there is a total breakdown when it comes to my VA doctor offering a medical judgement about my military illness or injury. Despite VA regulations clearly describing the limited manner in which a practitioner may assist a veteran, every single time I have asked for an opinion or comment regarding my many illnesses I have been refused! Even when I print out the VA regulation for them, I am told to my face they simply are forbidden to do so.

Net impact: the VA itself doubts the veterans' claims as to service-connection because the VA doctors won't speak up and provide an opinion - a medical nexus - as would a civilian doctor. Without the veteran's doctor giving an opinion, the veteran faces the highly skeptical VA rating officer who freely denies claims due to lack of medical support. The VA uses itself to stack the deck against veterans! A funny quirk - the VA permits its staff to provide second opinions...just not as to cause.

FIY, here is the regulation regarding veterans requesting medical opinions from their VA practitioners:

VHA DIRECTIVE 2008-071 October 29, 2008 3: 
d. Medical Statements to Support VA Benefits Claims. When honoring requests for medical statements by veterans for VA claims adjudication, care must be taken to avoid conflict of interest or ambiguity. 
(1) Determination of causality and disability ratings for VA benefits is exclusively a function of the Veterans Benefits Administration (VBA). VHA providers often do not have access to military medical records, and may not be familiar with all the health issues specific to military service, such as environmental exposure. As a result, they may not feel comfortable in stating causality of a current condition. However, this does not preclude VHA providers from recording any observations on the current medical status of the veteran found in the medical record, 
including their current functional status. All pertinent medical records must be available for review by VBA. NOTE: VHA continues to provide compensation and pension (C&P) examinations and reports as requested by VBA, as part of any new disability claims or review process. 
(2) Requests by a veteran for assistance in completing a VA disability claim are to be referred to VBA through official channels; however, the clinician, if requested by the veteran, must place a descriptive statement in the veteran’s medical record regarding the current status of the veteran’s existing medical condition, disease, or injury, including prognosis and degree of function. This may then be requested by VBA for the purposes of making a claim determination. 

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