QTC VA contractors in C&P - Compensation & Pension Exams, DBQ's and Appeals. Forum

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QTC VA contractors

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witchdoctor

#21

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Posts: 11395

Mar 24 08 12:18 PM

He didn't see anything that was contradicted by the file. End of interview.

He got paid, QTC got paid, you got paid.

Where's the waste?

Member-at-Large
Disturbed Veterans of America

Sideways comment about murdering officials.
Inane quotes to show disdain for everyone but myself.
Flags. puppies, and flowers.
God talks to ME about YOU.
HE told me that HE doesn't like what YOU'RE doing and saying.

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sa lili

QTC

#22

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Posts: 255

May 16 08 10:41 PM

DH had the first claim for PTSD and Depression with a C & P exam at a VA office. The rating given was much less than it should have been, in our opinion. We were given a choice to go through QTC the second time after asking for an increase on his rating. The psychiatrist he saw seemed to be thorough and even offered an additional diagnosis, although that wasn't reflected in the eventual decision. That report resulted in enough of an increase that DH was able to get his IU P & T award. We have a copy of the report the psychiatrist sent in. A local TV news report today suggested that QTC had a 92% customer satisfaction rating. I believe that.

hospitalworker

#23

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Posts: 1

Jun 18 08 1:51 PM

I work for the VA and my job is typing compensation and pensions examinations. These are done on templates. Templates are the easiest way to obtain all the answers that the VA needs to make a decision. If you get a copy of an examination that was not done on a template, it's because the doctor did not want to use one. (As long as the examining physician answers all the questions that are on the applicable template, even though one is not used, the examination is acceptable.) Invariably, these are also the exams that get sent back for a remand.

QTC examinations are NO DIFFERENT than the exams I type. They use the same templates and require the exact same information. QTC is used for one reason only and that is overflow. With all the vets returning from the Gulf, many QTC exams are now being done.

Whether you get a "good" exam or a "bad" one depends on WHO is doing the exam and NOT WHERE it was done. Both the VA and QTC have some very good docs and some not so good ones, just like regular physicians in a community.

If you are not happy with your rating, by all means appeal. Get together whatever information you have to support your claim. My Dad, a WWII vet and a POW of the Japs, spent five years trying to get compensated. All his records were burned up in the St. Louis fire, so he had no hard evidence on which to base his claims. Many of his fellow prisoners were already receiving compensation, however, and they wrote what are called "collateral statements" on his behalf. In that way, Dad finally got his compensation and back pay from the original date he filed.

Okay, I've babbled enough (lunch time) and have to get back to this general medical examination. Hope this answers some of your questions.

cruiser

#24

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Posts: 17618

Jun 18 08 2:23 PM

hospitalworker wrote:
Whether you get a "good" exam or a "bad" one depends on WHO is doing the exam and NOT WHERE it was done. Both the VA and QTC have some very good docs and some not so good ones, just like regular physicians in a community.

This echos what I've been saying for some time now. The quality of the exam depends on the person doing the exam, period. It doesn't matter whether it is a doc who does contract work for QTC or a doc at the VA Medical Center. And remember, just because the doc is at the VA Medical Center doesn't necessarily mean that he/she isn't a contract doc just like the QTC doc who just happens to be using the VA facility for the exams rather than a private office.

Also keep in mind that the "quality" of the exam is determined by whether or not the decision maker gets the needed information and not necessarily whether or not the person being examined believes that it was a quality exam or whether or not the claim is eventually granted, although I assume that if the claim isn't granted most would conclude that it was a poor exam. Sometimes all that a decision maker needs is the result of a lab test or something that can be obtained in a five minute physical exam.

At the end of the day the examination is being done for the benefit of the decision maker and as long as he/she gets what is needed, the exam is a good one. Unfortunately that isn't always the case though. In fact, I have seen many cases where the examiner actually did an extremely thorough physical examination; however, he simply did not put the results into a format that the decision maker can translate into the evaluation criteria. When this happens and the exam is sent back, many veterans incorrectly assume that the decision maker is trying to influence the examiner to say something different. They aren't. They are simply trying to get the info that they need in the format that is required. This is why it is so important that the docs follow the exam outline (or template) that they are given.

Cruiser

TDIUvet

#25

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Posts: 684

Jun 20 08 1:32 PM

cruiser wrote:
This is why it is so important that the docs follow the exam outline (or template) that they are given.

Cruiser

I thought that QTC Contract MDs do NOT follow a template as I earlier suggested ?

Hmmmm ? Oh well.

cruiser

#26

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Posts: 17618

Jun 20 08 3:24 PM

TDIUvet wrote:

I thought that QTC Contract MDs do NOT follow a template as I earlier suggested ?

All C&P examinations are supposed to be conducted in accordance with a worksheet that is designed to insure that the examiner provides the exam results in a format that is consistent with the evaluation criteria that the decision maker is required to use. It isn't really a "template" in the strict definition of the word but rather an outline that shows specific information that is needed along with the format in which that information is to be provided. You were calling this a "template for denial" which is just hogwash.

For example, three docs can measure active range of motion of the knee and even if all three get the same result, it is possible that they can report these results in different ways which then requires that the decision maker either guess at what they mean or return the exam and ask the doc to put it in a different format, or perhaps explain what he is saying. It's much easier to simply give them an outline on the front end that explains how they are to report their findings, but this outline in no way directs them to any particular finding.

One of the primary goals of VA is to have consistency in disability evaluations. If two veterans have similar functional impairment then they should have similar evaluations. Veterans have complained for years about a disparity in evaluations between not only different offices but often within the same office. So VA takes steps to rectify that and look what happens. Now that is being called a VA conspiracy to deny claims.

Also keep in mind that you were associating this "template for denial" as you called it with QTC. Every doctor who does a VA C&P exam uses the same outline to report the examination findings whether it is a VA doc at the VAMC or a QTC doc.

I'm going to be honest TDIUvet, you have made much ado about nothing in the past over this.

Cruiser

gksl4522

#27

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Posts: 1213

Jun 20 08 5:06 PM

Wouldn't it be nice if each RO organization followed the same template.

I live within 9 miles of a VAMC. My son has had two QTC psychiatric exams from the same contractor in the last 5 years. He is scheduled next month for a third with the same contract psychiatrist. The VA paid approx $590.00 per exam and I expect the price has gone up. I have no idea why they would use QTC. VA does a lot of things I don't understand but I finially got a copy of his claim file a few months back to try and shed some light.

My son see's a VAMC psychiatrist about every month. Copies of his visits are in the claim file. I don't know why they would pay anybody since those records are in front of them, but they do. Apparently that is not enough information so they asked for a General Psychiatric Exam. It's like a template but reguardless, it covers everything. History, military history, psych history, current symptoms, activities of daily living, past med history, Personal History, Family history,

MSE = mental status exam, list of items in the file that he considered, whether he did a diagnostic test, employment history, management of funds. Then diagnostic impression, axis list, discussion and GAF. He did this in both exams. We were in his office about 30 min.

He got out of the military in June 2003. Two weeks prior to that he got an extensive psychiatric exam. He was awarded 70%. He then had an exam June 2004 with the QTC. The VA sent a proposal to reduce in December 2004. In January 2005 a DRO reversed the decision with 100% schedular, temporary back to the date of separaton. (nice check)

In December 2005 he has the second exam with the same doc. The VA then sent a proposal to reduce in Sept. 2006. We sent our DRO request and the DRO reversed the decision in Sept 2007. (another nice check) In the last prior exam the QTC examinaer changed the diagnosis and the RO asked him to explain. He said the symptoms were more like his diagnosis according to the DSM IV. (now that is a 30 minute wonder) Nothing else in the claim file.

Now, June 2008 he is scheduled with the same doc for next month. He still sees the same VAMC psych about every month. He has to see a psych contineoulsly since this claim process keeps driving him crazy. Five years of the SOS. lol

If the next one is reduction and runs along the same lines couldn't we say in a NOD that the evidence added to the record is essentially cumaltive and redundant.?? There are more stregent requirement for VA to reduce if the rating is the same for 5 years but I'll need to find out what before we send any NOD. I think they let it slip by them because a couple of weeks ago it went over 5 years.

cruiser

#28

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Posts: 17618

Jun 20 08 5:20 PM

gksl4522 wrote:
Wouldn't it be nice if each RO organization followed the same template.

They do. The Regional Office has no control over them, they are generated by the computer to the examiner. The difficult part is getting the doc to follow the guidelines. As I've said before, getting doctors to follow instructions is like herding cats. They tend to do things their way.

Mental exams are a different animal. With the exception of psychological testing, and even then the tests must be interpreted by the doctor, there are very few "objective" findings for the examiner to report. Neither the examination report nor the evaluation assigned by the decision maker follows any real objective findings. It's almost all subjective. It isn't like you can do a stress test or a pulmonary function test or a blood or urine test to insure uniformity.

Cruiser

bigscontis

QTC exam.

#29

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Posts: 10

Dec 2 08 1:02 PM

The doctor went over me pretty good and I didn't get and increase but I didn't get a decrease either, I did get a bilateral condition between my hip and back, just what I was looking for. I really didn't trust him but he did me right..

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sonicbuffalo

#30

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Posts: 1182

Dec 2 08 5:41 PM

bigscontis: Welcome to VBN.....the best website on the net for VA benefits advice....

sb

oldvet

#31

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Posts: 281

Dec 6 08 9:45 AM

Let me add my 2 cents here about QTC in Northern Virginia. For a long time the VA must have contracted to QTC then they must have subcontracted to a medical center who did the exams. The exams from that place were sketchy and seemed to short change some vets. Now QTC has built a wonderful center of its own that is well staffed and seems much more concerned with veteran's problems and uses the VA format for exams and go into great depth to explain things. Many of us think that there is a difference of night and day here. But as has been pointed out here, much of this is due to the individual doctors who take the time to do the exam and then write it up properly. More Quality control and oversight is probably needed in some cases.
oldvet

sonicbuffalo

#32

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Posts: 1182

Dec 6 08 5:58 PM

Thanks old vet for your blurb about the QTC in Northern Va. Best of luck to you.

sb

ltcolglendavis

#33

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Posts: 499

Dec 11 08 10:19 AM

My experiences earlier this year with QTC in Alexandria follow:

- The parking garage under the Office Complex is a crowded maze and should be avoided if possible, although I'm not a fan of close quarters, crowds, nor confusing levels of parking that seem to have no rhyme nor reason, and even worse -- extensive tracts of empty reserved parking spaces with non-spaces filled by cars that are double and triple-parked -- coupled with my wife as driver and multiple entrances/exits from the facility...

- They stamped our parking ticket, so all of that fun finding a parking space didn't cost anything other than fuel, frustration, and confusion.

- On the second trip [not all completed in one visit because of various specialties involved], we used the Virginia Railway Express to the Alexandria Metro Stop and this worked like a charm -- out of the Metro Station, across the street, through the Plaza and we were there...

- They sent me sheets with specific questions for each condition they were re-evaluating, and it was my impression all used these as guides for screens that were on their computers. They looked like templates to me...

- Their instructions told me that I didn't need to bring any medical files, etc., but I did, and because of my memory and concentration issues, it's a good thing that I did. The Rating Decision quoted the same language contained in some of the back-up records I hand-carried with me, and I'm convinced they wouldn't have contained most of them without those records that I showed to the examiners.

- They seemed to have their own cycle of work between the lab techs; nurses; admin/reception; and the doctors (who seem to only work there certain days and who probably rotate or perform these functions on a casual basis from their normal jobs); but it all flowed and was complete after my second visit to QTC

- The Psych Doctor's opinion of a connection between my symptoms on Active Duty and my diagnosis of Hashimoto's Encephalopathy (formalized about a year after retirement) was primarily responsible for the 100% P/T rating by VA. For seven years I have been unable to find any other PC Doctor; Psych Doctor; or Neruologist who would write me a Nexus Statement. I can't say enough good things about my experience at QTC and I believe they're responsible for my current rating.

Thanks for reading my two cents about QTC.

Glen

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Patrick428

#34

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Posts: 5262

Dec 13 08 1:35 AM

Go Tar Heels!
Closet Vols Fan

I was a Vet Center Psychologist then a C and P examiner for several years. After leaving the VA I went into private practice and was awarded a contract as a QTC provider for Winston-Salem, NC. I will promise you the forms used in QTC are the very same forms used in regular C and Ps. Second, the purpose of a QTC is used because of massive overflow in the VAMC where C and Ps are performed. Third, QTC examinations are not designed to deny any veteran anything. Just the opposite exists. A C and P examiner is to verify the existence of the disorder or medical condition being investigated and check the severity of both. To think a QTC examiner's function is to deny everyone so it takes the onus off the VA is remarkably misguided information. Whether it be a C and P examiner or a QTC it is their obligation to find in favor of the veteran when there is doubt. The VA rules also state if there is doubt it must fall in favor of the veteran.

It is not my place to to churn up anything here, but in most cases where the veteran is griping about their decision is because their case was probably not put together well, lacked vital information, or was pretty weak in the first place. I know in several cases I had to take a double take at a veterans DD-214 just to make sure they were actually in the military by the information they were presenting. It just did not sound correct or common information known by all branches of the military were not recognizable by the veteran even when they could give accurate information about all other things. Remember, C and P or QTC people can only go by what the raters want to know and by what information is being communicated by the veteran. In most cases I did not have to re-ask questions because the information was in the file. This is not to say there are not a few sour grapes in the VA and they do a p*ss poor job. However, you go into any industry or work place and your going to find some pretty p*ss poor employees. We have all said at one time or another. "how on earth did this guy get this job?"

When I joined the police force when I first got out of the military I learned quickly that one bad cop made the rest of us look bad to the public. And it was a tough road to haul getting that respect back. Look at my home state of Illinois and the Governor being investigated. Just because he is an idiot does not mean all state representatives and senators are. Same applies to the VA. We all know one doctor that makes us think the rest are just like him or her.

Patrick

dsraven713

QTC eval???

#35

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Posts: 3

Aug 1 12 10:50 AM

Now this is all new to me. I now have an appointment with the QTC Medical Services, for a medical evaluation. Which is contracted by the Dept of Veteran Affairs (VA).
The part that gets me is that it’s for a huge scar given to me by the VA... during a cancer surgery in 2002.
I was awarded 10% for the scar in 2005, also medically retired in 2005. But, since 2009 I was rated 100% total and permanent with no future evaluations.
So it seems to me as a waste of time and tax payers money for this eval.

dsraven713

#36

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Posts: 3

Aug 15 12 2:10 PM

I was able to get a call back from the DAV a week later on this matter. After explaining this situation to him, and him he pulling up my records. There he stated he say my ratings and that I was permanently 100% disable. He agreed saying I was correct and that it was all in their records. He told me it wouldn’t hurt me to go, they could not reduce my rating or make a difference in any form. So now basically this was going to be a complete waste of time and money. But as instructed by the DAV rep. I kept the appointment and met with the doctor but taking with me the documentation I had. The doctor I saw was very nice and professional, she looked at and measured my scar 11CM (so not small for a cancer removal). She even had questions on why I was there for an old scar from 2002 that was already rated. I explained to her my rare situation were numerous skin cancers began showing up while on active duty. The VA had removed those and pre cancerous polyps telling me I had a Muir Torre syndrome. Which the VA doesn’t test for. The QTC doctor even made notes in my records in reference to the Muir Torre Syndrome. She will forward her documentation to the DAV. At this time I have no complaints on the QTC as she seemed very nice and fair to me. Now this could bite me later but for now it appears all went great. This was at the OKC QTC

Cav1Sgt

#37

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Posts: 4174

Oct 9 12 6:57 AM

This thread has comments back almost four years. Please start a new thread if you have related questions.

This thread is closed.

Cav1Sgt

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