ICC Veterans affairs Third Party Administrators

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ICC Third Party Administrators 
Please call: (316) 683-0170, NY  1 (845) 751-0023, DC 1 (202) -386-6193

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Doctor (s) who work for the veteran's hospital are the cause of veterans delay in receiving benefits. At the same time, Service Center Claims Managers and Divisional Managers are the cause of veterans delay in processing claims for benefits .

 The truth is, when doctors attend medical school,their exams do not consist in essay form, but rather,true and false, multiple choice,and fill in the blanks.  Doctors do not know the proper way to write so that a legal decision can be properly evaluated in terms of service connected,aggravated,a-symptomatic which became symptomatic etc.....  

Service Center Managers and Divisional Managers are not attorneys and lack the legal skills to train RVSR (s) and DRO (s) in soliciting the proper questions to doctor (s) so that a decision can me made for veteran's benefits promptly.  As a result of substandard education, veteran's  claims have turned into a bottleneck causing claims to be delayed for years.   

In the case :  UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS NO.10-3031 KHADIJAH EL-AMIN, APPELLANT, V. ERIC K. SHINSEKI,  SECRETARY OF VETERANS AFFAIRS, APPELLEE.  Click Here  is a prime example of substandard work in the veteran's administration.

 ICC is doing its part to assist the Appeals Board in rendering the proper decision by going back and obtaining the factual evidence the appeals broad requires.  ICC specialize in obtaining the appropriate information without delay and can save million of dollars to the government by expediting the proper investigation,obtain thorough IME's or medical opinion that are not incomplete,tainted or biased.  The example below will cut delays in processing claims,avoid on going wrong decisions to include veterans filing endless Appeals.  Our examiners have over 30 years experience processing and investigating benefit claims. Our turn around time is less than 60 days. This will save the Government millions of dollars  in administrative cost.    

 

 ICC's  Example of Obtaining the appropriate Medical opinion and or IME that will satisfy the Review Board.  

 

   REQUEST  FOR MEDICAL OPINION OR IME 

 

FACTS 

Mr. El-Amin served on active duty in the U.S. Marine Corps from September 1966 until May
1969 which included his service in Viet Nam. The record reflects that,during his lifetime, Mr. El-Amin was diagnosed with and treated for drug and alcohol abuse and hepatitis C.

Mr. El-Amin died in October 2006, and his death certificate lists the cause of death as hepatic cirrhosis. At the time of his death, Mr. El-Amin was receiving VA disability benefits for posttraumatic stress disorder (PTSD) with a 70% disability rating. Mrs. El-Amin seeks benefits for the cause of her husband's death asserting that her husband's service-connected PTSD either caused or aggravated his alcoholism, which in turn led to the cirrhosis that caused his death.

The following questions and medical opinion require a definitive answer supported by a rationale conclusion for each answer:

1.   Are you a board-certified Gastroenterologist MD or Hepatalogist MD?  If not, what area of the medical profession are you certified in?

2.   Are you a board certified psychiatrist MD?  If not, what area of the medical profession are you certified in?

3.   Based on your answers to questions 1 and 2, what qualifies you to render an equal opinion in regard to the diagnosis of PTSD and cirrhosis of the liver?  Please state your medical experience dealing with these two combined diagnoses in your medical practice.          

 

PTSD, Alcohol, Cirrhosis of the Liver, Death

1.   Are there any medical records to show that Mr. El-Amin drank alcohol prior to entering military service in September of 1966?  If yes, please state the doctor who documented the medical file prior to Mr. El-Amin entering the service or on his entry examination.

2.   Are there any medical records to show that Mr. EL Amin drank or was treated while in the military for drugs or alcoholism?  If yes, please state the doctor(s) who documented this diagnosis in Mr. EL-Amin's military medical records and the dates that he was diagnosed for alcoholism and drug abuse.

3.   After reviewing Mr. El-Amin's military records, in your opinion, did Mr. El-Amin use drugs and alcohol during the time he was in Vietnam between 1966 and 1969 to cope with his stress?  If yes, do you believe, more likely than not, that this stress affected Mr. El-Amin's liver to any degree?  If not, state why.

4.   Are there any military records to show that Mr. El-Amin was on any medication for stress while in Viet Nam? If yes, please name the medication, state the doctor who prescribed that medication and give the dates inclusive of the diagnosis to support subscribing such medication.

5.   On what date was Mr. El-Amin diagnosed with PTSD?  Please provide the name of the doctor who diagnosed Mr. El-Amin to reflect a disability rating of 70% which is identified under VA Code 38 C.F.R. § 4.130, DC 9411 and reads as follows:  Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships ...................................... 70%

 

6.   Based on your review of Mr. El-Amin's medical records,did suicidal ideation and obsessional rituals,panic attacks and or depression cause him to drink alcohol excessively which aggravated his PTSD and which in turn led to the cirrhosis that caused his death?  Please state your conclusion with a rationale in support of your response using one of the following legally recognized phrases:

a) _____ is caused by or a result of _____
b) _____ is most likely caused by or a result of _____
c) _____ is at least as likely as not (50/50 probability) caused by or a result of _____
d) _____ is less likely as not (less than 50/50 probability caused by or a result of_____
e) _____ is not caused by or a result of _____
f) ______I cannot resolve this issue without resort to mere speculation

7.   Based on your review of Mr. El-Amin's medical records, name the medications that were subscribed to him for his PTSD and state how often he was required to take such medication.

8.   If Mr. El-Amin was on medication for his PTSD,is there medical evidence that the residuals of that medication aggravated his liver and led to the cirrhosis that caused his death?  Please state your conclusion with a rationale in support of your response using one of the following legally recognized phrases: In other words state why in a narative essay.  

a) _____ is caused by or a result of _____
b) _____ is most likely caused by or a result of _____
c) _____ is at least as likely as not (50/50 probability) caused by or a result of _____
d) _____ is less likely as not (less than 50/50 probability caused by or a result of _____
e) _____ is not caused by or a result of _____
f) ______I cannot resolve this issue without resort to mere speculation

9.   Are there any medical records that you reviewed which showed that Mr. El-Amin was ever treated for alcoholism by any doctor?  If yes, please state the name(s) of the doctor(s), the dates when Mr. El-Amin was seen and any diagnosis.

10.  After reviewing all of Mr. El-Amin's medical records,are there any records which show that Mr. El-Amin had liver problems before his death?  If yes, please state the doctor who diagnosed his liver problem (s) and on what date he was diagnosed.

11.  Was Mr. El-Amin ever treated for liver problems at any time?  If yes, please state the name of the doctor who treated him and on what date (s) he was treated.  Also, please list the name of any medication that was subscribed for his liver problem and the date (s) when it was prescribed.

12.  Based on your review of all of Mr. El-Amin's medical records, if there medical evidence  that the combination of medication for PTSD and any medication for a liver condition combined with drinking alcohol aggravated and/or accelerated Mr. El-Amin's condition so as to cause the cirrhosis that led to his death? Please state your conclusion with a rationale in support of your response using one of the following legally recognized phrases:  Support your answer why in essay formate  for a) through-f) 


a) _____ is caused by or a result of _____
b) _____ is most likely caused by or a result of _____
c) _____ is at least as likely as not (50/50 probability) caused by or a result of _____
d) _____ is less likely as not (less than 50/50 probability caused by or a result of _____
e) _____ is not caused by or a result of _____
f) ______I cannot resolve this issue without resort to mere speculation

  

13.  Based on your professional opinion, could the doctor treating Mr. El-Amin for PTSD have known prior that Mr. El-Amin had a liver problem and was an alcoholic during the continuation of his prescribed medication for PTSD?

14.  Based on your professional opinion, did the risk of prescribing medication to Mr. El-Amin outweigh the benefits if the doctor had prior knowledge that he was drinking alcohol and had liver problems that could lead to cirrhosis and cause Mr. El-Amin's death?       Yes    or    No. Please state why  with supportive evidence to justify your answer.  

 

MEDICATION GUIDE

1.   In your professional opinion,did the medication guide which comes with the prescribed medication given to Mr. El-Amin by the doctor treating him for PTSD state the risk of complications if a patient had liver or kidney problems? Please obtain a copy of the appropriate medication guide for the type of medication and read it before answering this question.

2.   In your professional opinion, should Mr. EL-Amin have taken the subscribed medication for PTSD if he had liver problems?  If Yes, why?. If No , why not?

 

CONCLUSION

If the medical records are absent or have incomplete medical-narratives to answer the aboue questions, would this be standard practice in the medical field to have incomplete records and diagnosis?  Please state your opinion and why .    

 

 When the Appeal Board wants a claim expedited,  Call ICC. We will have the answers in 60 days.  

        ICC  Veterans Appeal Adninistrators 1 (316) 683-0170 or New york 1 (845)-751-0023 

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