Is this practicing medicine? Do you need an SP and Med Mal?

[ventana]

hired indirectly by a company (patient actually pays you - before you review their medical records)

to review their medical records and write a letter they can use to support their VA disability claim.  

Never meet the patient, never lay eyes or hands on the patient, not offering any medical advice or treatment options.

I can see arguments both sides.....

[EMEDPA]

I would say no. You are basically a medical editor , compiling a chart summary for a third party. You do no exam, order no tests, and prescribe no tx. I have actually done this before(but it was a volunteer position to help some folks navigate and deal with the VA system). 

[sas5814]

Interesting......

what you are describing is a Nexus letter. This happened which caused that and, in my opinion, is a result of pts military service. I don't think it is practicing medicine any more than giving a deposition would be.

 

That said, now having a better and growing understanding of the VA disability system, I'm dubious of the actual value to the veteran. With few exceptions the conditions you might be describing are going to be evaluated by a contracted VA examiner who sends the findings of the exam to another person who decides if the condition is service related and, if so, what degree of impairment should be granted.

3 people in the process. patient, examiner, reviewer. I am not sure how much weight an outside reviewer, particularly one paid by the patient, would have. I could be wrong  but that is my sense of it.

I know... that wasn't your question. Sorry...my brain wanders around on its own sometimes.

 

[ventana]

53 minutes ago, sas5814 said:

Interesting......

what you are describing is a Nexus letter. This happened which caused that and, in my opinion, is a result of pts military service. I don't think it is practicing medicine any more than giving a deposition would be.

 

That said, now having a better and growing understanding of the VA disability system, I'm dubious of the actual value to the veteran. With few exceptions the conditions you might be describing are going to be evaluated by a contracted VA examiner who sends the findings of the exam to another person who decides if the condition is service related and, if so, what degree of impairment should be granted.

3 people in the process. patient, examiner, reviewer. I am not sure how much weight an outside reviewer, particularly one paid by the patient, would have. I could be wrong  but that is my sense of it.

I know... that wasn't your question. Sorry...my brain wanders around on its own sometimes.

 

good assessment, yes nexus letter.  

 

[TDIowa]

As a recently retired VA disability examiner when I would see these nexus letters I would usually ignore them and make my opinion with disavowing the nexus with a counter rationale.

Let me clarify though some of the nexus letters were totally based on opinions only. No medical rationale would be given. Example: The Veterans back pain from his service 30 years ago has caused his degenerative arthritis in his back. No medical rationale would be given. With  the Veteran not being seen for back pain until recently. Really????

Other nexus given made would no sense at all. The Veterans knee pain has cause his sleep apnea. No not really. His Sleep Apnea is caused by 37 BMI and his addiction to cigarettes.

Another nexus is secondary connections. Ankle pain causing knee pain or hip pain or back pain. A VA examiner has a well  known medical rationale, with quoted medical sources that disavows the nexuses. 

Don't get me wrong I wasn't a heartless examiner. I wrote many favorable opinions. Its just that the VA disability system favors quantity over quality. The system is broke. And when the scammers of the world figure out they can take advantage of its mismanagement they come out of the wood work

If you keep in mind that what you are doing is medical evidence based not opinion then you will be fine.

[ventana]

9 hours ago, TDIowa said:

As a recently retired VA disability examiner when I would see these nexus letters I would usually ignore them and make my opinion with disavowing the nexus with a counter rationale.

Let me clarify though some of the nexus letters were totally based on opinions only. No medical rationale would be given. Example: The Veterans back pain from his service 30 years ago has caused his degenerative arthritis in his back. No medical rationale would be given. With  the Veteran not being seen for back pain until recently. Really????

Other nexus given made would no sense at all. The Veterans knee pain has cause his sleep apnea. No not really. His Sleep Apnea is caused by 37 BMI and his addiction to cigarettes.

Another nexus is secondary connections. Ankle pain causing knee pain or hip pain or back pain. A VA examiner has a well  known medical rationale, with quoted medical sources that disavows the nexuses. 

Don't get me wrong I wasn't a heartless examiner. I wrote many favorable opinions. Its just that the VA disability system favors quantity over quality. The system is broke. And when the scammers of the world figure out they can take advantage of its mismanagement they come out of the wood work

If you keep in mind that what you are doing is medical evidence based not opinion then you will be fine.

that is my worry about this whole scene, just want to help those that need and deserve help. No desire to be part of a disability mill trying to get everyone's rating increased.