My DH had his first C & P Exam last week in a VA-contracted independent audiologist. The exam was cursory at best. We’ll be writing for our one free copy of the exam since the VA has a duty to assist him. I’m sure this was an “insufficient exam.” For example, the examiner didn’t ask any questions about the functional effects of his hearing loss and tinnitus. In fact, she didn’t ask about tinnitus at all.
However, the evening before the exam, I did a little poking around in Google and found some slides by VA employee, Kyle C. Denis, Ph.d. to review. Whoa! I told my DH that he needed to proactively report to the examiner that he had tinnitus because if he didn’t speak up, the VA instructs examiners to say the veteran denied tinnitus!
The VA’s tinnitus instructions of “don’t ask, don’t tell” is far from what one would expect from an institution that deals with veterans’ health.
- VBA worksheet was changed because almost all people have a history of tinnitus. The pertinent question is whether or not there is current complaint of tinnitus.
- The appropriate way to inquire about tinnitus is to ask about the current complaints without asking specifically about tinnitus or ringing in the ears.
- Audiologists should not use history forms or questionnaires that prompt for a history of tinnitus, ringing in the ears, or head noises.
- VBA feels that if a Veteran has tinnitus that is disabling they will report it when asked about his/her current complaints. However, if tinnitus is a claimed condition or VBA specifically asks for information regarding tinnitus, then you MUST respond to the issues. Otherwise, the exam may be returned as incomplete or inadequate.
And, “If the Veteran does not report tinnitus as a current complaint during the history, then indicate that the veteran denied tinnitus as a current complaint in the medical history.” Shady, shady, shady…
The slides were presented to other Joint Defense and VA (JDVA) audiologists at lovely vacation spots. They offer useful summaries about topics like “conceding noise exposures,” Fast Letters, case studies, speculation, medical opinion templates and much much more! There’s something for everyone so save to your Google Drive, dropbox or other cloud storage while their available online. (For Nod, the 2013 slides contain summaries about a few relevant BVA docket numbers, legal cases which are important for audiologists to know about: Ledford v Derwinski, Dalton v. Nicholson Hensley v. Brown, and Martinak v. Nicholson.)
2010 C & P Conference Slides (long link required):
2011 C & P Conference Slides:
2012 Slides “Navigating the DBQ Audiology Questionnaire”: http://www.myavaa.org/documents/conferences/JDVAC-2012/JDVAC2012-April2012/Dennis%20AVAA%20DBQ.pdf
C & P Updates for 2013 Conference:
Don’t worry–they’re not stressing themselves with depressing veteran hearing problems at these educational events. What the heck are our military audiologists were up to at a recent conference? Recognize your VA audiologist in these photos? If so, I’m not sure if you should rely on him/her for medical opinions.