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Monday, August 24, 2009

My C&P Exam. I should've written this last week but ...

I finally had my comp and pension exam on August 20th. For my civilian friends who are following this, it's the exam the VA makes you go through to determine just how "disabled" you really are. Sometimes you luck out and you get a good doctor who is sympathetic to your cause/case whatever you want to call it. Those are the ones who will move heaven and earth to get the VA to decide in your favor.

Sometimes you aren't so lucky. You go in for a physical exam and you see a PA or even an RN. I never understood how a PA or an RN were qualified to give a through physical exam. I suppose on appeal those would be the cases easiest to win but when dealing with the VA even what makes good sense ... well, you can't count on it.

I had two exams scheduled. They never tell you ahead of time what your C&P exam appointments are for. They make you guess. I assumed and you know what they say about "assume" ... one was for orthopedics and the other was for psych. As a reminder, I reopened my claim in October 2008 for an increase in my left knee, service connection for my right knee as a secondary condition, 100% for individual unemployability, aid & attendance and depression as a secondary condition due to my service connected conditions. That's a lot to ask for in one claim.

My first appointment was scheduled at (let me refer to my calendar because of course I can't remember) 10:00 a.m. My friend, JoJo picked me up at 8:00 because the C&P clinic wasn't at the VA Hospital in Tampa although it was somewhere nearby. I'm a freak about arriving early. I use the GPS but even a GPS can be wrong so I always leave extra time in there for GPS errors. The problem with leaving at 8:00 means I have to wake up no later than 6:00 a.m. I'm not sleeping well so I was going on little sleep.

We arrived at the C&P clinic with 15 minutes to spare. I'm glad we left early. I didn't have to wait long to get in. The nurse brought me in for a prescreen. Weight, blood pressure, temp, that sort of thing. I asked her if I was seeing a man or a woman. When she told me I was seeing a man, I felt my skin start to crawl. I told her that I wanted a woman in the room during my exam. It either had to be a nurse or my friend. I didn't care who was there, but I made it very clear that I did not want to be in the room with a male doctor alone.

Surprise, surprise. No doctor. I was seeing a PA. All my medical issues and I was seeing a physicians assistant. I know PA's go through a lot of education. But most of the PA's I know specialize in one area. By no means am I disrespecting PA's. But every other C&P exam I've ever had, I've seen a specialist for each field i.e., ortho, internal medicine, etc., for each issue that I was claiming. I feel that you get a better evaluation that way.

The PA I saw, and if he told me his name I've already forgotten it, was a nice enough fellow. I don't think he did a thorough exam though. As far as my knees go, he didn't ask me anywhere near the questions that I've been asked in previous exams. He didn't take the measurements that previous ortho doctors have taken. I knew more about an ortho C&P exam than he did but I was already so upset I didn't think to tell him what to do. That's right veterans, tell that doctor what to do if you think it will help your case. I should've had him measure how much muscle mass I've lost in my left leg and I was so upset, I forgot. That measurement bumped me up to 40% on my last increase.

When he touched my left knee during the hands on exam, I almost flew off the table. I take meds because it's hyper sensitive. They suspect it's that way because of the 8 times they've had to cut into it. He left that knee alone. I suspect he was afraid he might get kicked somewhere vital. The right knee isn't as bad but it does feel like I'm being stabbed with a knife and there is gravel in the joint. The worse my left knee gets, the worse it aggravates my right knee.

The VA tried to slip a fast one by me. I'm rated at 30% for stomach issues. I have IBS and a history of ulcers both gastric & duodenal. I also have a history of GERD and ulcerative colitis. I did not reopen that claim, but the VA did. In a way, I'm glad the VA reopened it because it's gotten much worse. Since most of it is stress inducted and I'm under a tremendous amount of stress these days .... especially since my claim has been pending for almost a year .... well, you get the pictures. Let's just say the visual I gave the doctor wasn't pretty and I doubt they will reduce my rating for stomach issues.

I'll be almost totally honest. As I related all these issues to the PA, I cried. I was very, very honest with him regarding my quality of life and how my medical and mental health issues affect it. I went all the way down to some very intimate details which I will not share with you, invisible reader. There are some things better left unsaid. The nurse who was in the room with us was so affected by what I was saying that she was also crying. Whether the PA took notice, I don't know. I hardly looked at him. It was too hard to look at this total stranger that I was being forced to tell the most intimate details of my life to.

After a tortuous hour and one half, my physical exam was over. The nurse carried my backpack up to the front for me and told me the psychologist would probably call me back early instead of making me wait until my scheduled appointment time of 12:30. I wanted a cigarette and told her so. Jojo and I went out to have a smoke. When we came back in, the psychologist was waiting for me.

Round two began.

The first thing that struck me about the psychologist was how "mousy" she looked. She reminded me of the skinny kid in the playground who always stood by herself, alone in the corner, mousy brown, stringy, greasy hair, no friends with no one to talk to. I can't tell you anything about her facial features. They are a blank to me. All I can recall are those few features I've already related to you. It's as if her face is a blank slate. Maybe it's because when I got into her office I was physically and emotionally exhausted from the physical. All I wanted to do at that point was crawl into my bed and get some sleep. I could hardly keep my eyes open. I was in a lot of pain, my legs were swollen and hurting, I was crabby as hell and I wanted was to go home and not have to talk about my mental state with anyone.

Unfortunately, if I wanted to finish processing my claim, I had no choice. (I'm running out of steam so bear with me, invisible reader. If I start to make no sense I promise to come back tomorrow and make corrections after I've rested up). It was a very long hour with her as she asked question after miserable question. And to get the service connection, I had to be totally honest with a perfect stranger. I felt exposed. Totally raw and naked sitting there. Talking about wearing your heart on your sleeve. Mine was there and I felt like there were daggers being driven through it. I was also exhausted both physically and emotionally. I think I fell asleep on the psychologist no less than three times during my exam. That was one of the things I complained about though so I'm glad that she was able to witness it. It's difficult to have quality of life when you are sleeping most of it away.

Even as I write this I am struggling to stay awake. It's a com ... shit, I fell asleep and forgot what I was going to write. That's it. I'm done for today. I'm going to try to run this through the spell check and then I will finish it up tomorrow. No sense trying to finish up when I can't even hang onto my train of thought.

I'll be back tomorrow folks.

Until the next time ...

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