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DOES THE WINSTON-SALEM REGIONAL OFFICE MANIPULATE QTC EXAMINATIONS?

HISTORY OF QTC: The April 23, 2006 front page of the Los Angeles Times contained an investigative article  by writer Walter Roche about QTC's financial relationship with the Department of Veterans Affairs. SEE: http://articles.latimes.com/2006/apr/23/nation/na-contractor23 . See also: http://groups.yahoo.com/group/raybdavisjr/message/1133 for QTC responses to the Walter Roche reporting. Ray Davis, a veteran, has a superb website at http://groups.yahoo.com/group/raybdavisjr/ .

This website invites credible and documentary evidence involving QTC, the Winston-Salem Regional Office, and Nancy Green, M.D.  Contact hughcox@hughcox.com  .

This VA correspondence (email below) at Winston Salem Regional Office between adjudication officials of the Department of Veterans Affairs dated after December 27, 2001 appears to approve alteration of a disabled veteran's medical records so that the claim would be denied. Read on.

#1 disturbing email from Dr. Nancy Green

     This VA message raises disturbing questions about the integrity of medical compensation and pension  examinations by QTC medical officials who examined veterans at the direction of the Winston Salem Regional Office of the U.S. Department of Veterans Affairs. Both Dr. Green and Mr. Blake were officials of the Adjudication Division of the Regional Office at the time of the email.

    Perhaps as a result of this message, the QTC physician named above (Dr. Stabler) issued an "Addendum" to his original report. The addendum-change was even less favorable to the veteran than the original QTC medical report. The claim was subsequently denied.

To read the first QTC exam by Dr. Stabler  issued on December 27, 2001 (before the email above), see:

Note the attached QTC x-ray report dated 12/27/2001 available to both Dr. Stabler and Dr. Green. This veteran previous suffered two fractures of the right fibula and another of the right tibia requiring metal be surgically inserted and later surgically removed. The right knee x-ray showed moderate posttraumatic arthritic changes with mild patellar chondromalicia. In spite of this objective x-ray evidence, Dr. Stabler concluded that the veteran had "no disability" of the right knee.

After the Dr. Green email, Dr. Stabler issued an addendum medical report dated February 6, 2002. To read that document, see:

Apparently to satisfy Dr. Green, Dr. Stabler then advanced an opinion that if the veteran had anything wrong with his knee, it was "due to volition rather than mechanical inability". Dr. Stabler appeared to imply that the veteran's right knee problems were "faked" by the veteran in spite of the x-ray report of moderate posttraumatic arthritic changes with mild patellar chondromalicia that were in close proximity to the three fractures of the right leg.

    There may an appearance that Dr. Green used Mr. Blake as a clandestine communication means to influence the QTC physician to change the original evidence so that the veteran's claim could be denied. Because Dr. Green and Mr. Blake worked at the Adjudication Office of the Winston Salem Regional Office, they were agents of the U.S. Government with a statutory obligation of duty to assist the veteran with his or her claim in accord with Manio v. Derwinski, 1 Vet. App. 140, 144 (1991) ("Rather than defending against the claims of veterans, the Secretary has a statutory duty to assist claimants during the course of the ex parte and non-adversarial claims resolution process at the regional office and before the BVA.").

    Is Dr. Green's communication so potentially biased as to obstruct justice for the veteran and his counsel, as to tamper with witnesses without knowledge of the veteran, or as to conspire with others to sabotage the veteran's claim? Were the veteran's civil rights violated under 42 United States Code 1983? Dr. Green was not just a physician, but she was a "judicial" and adjudication official working for the Regional Office and acting under color of law for the purpose of assisting the veteran with non-adversarial evidence to insure fundamental fairness as follows:

    "Information in VA records which are used by the Department in making any determination about any individual will be maintained with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the individual in the determination." Cited from VA Adjudication Manual M-1 at section 9.15.

    In this case, the veteran was never informed of the Dr. Green communication with Mr. Blake and its detrimental effect on the veteran's claim until someone within the RO revealed this "hidden" information in 2003 to the veteran.

    The courts have held that procedural fairness in an administrative proceeding generally requires an adequate opportunity to know the evidence to be relied upon and to rebut it. See Wirtz v. Baldor Elec. Co., 337 F.2d 518, 528 (D.C. Cir. 1963).

    "We caution, however, that the permanent removal of documents from a claims file without notice to the claimant may raise concerns regarding procedural fairness, particularly in view of the possibility that such documents, including BMAO's, may be favorable to the claimant in some instances. Accordingly, if the Board considers it appropriate to permanently remove documents from claims files, we recommend that procedures be established to ensure that claimants are given adequate notice of such removal, and to ensure that documents which are favorable to the claimant or are otherwise relevant to the Board's decision are not removed from the claims file." VAOPGCPREC 14-98

     Interestingly, the RO officials did not voluntarily refer the matter to any investigative agency such as the VA Inspector General and took the position that the e-mail was "evidently" an effort ("possible to assume") by Dr. Green to "increase" the veteran's rating.  

    ADVICE TO VETERANS: Veterans who are medically examined by QTC officials or physicians need to be alert to any "addendums" issued by the QTC officials after an initial examination. The veteran should seek all communication (written or otherwise) between the RO officials and the QTC examiners - such as the email above.

#2 disturbing email from Dr. Nancy Green

 The link above demonstrates how a VA physician can communicate directly with QTC and suggest that the QTC physician change his favorable opinion for the veteran so that Dr. Green could continue to deny the claim. The veteran was never aware of the behind-the-scenes communication until discovered years later when a copy of the email was inadvertently placed in the C-File. Although the QTC exam was conducted on October 15, 2001, the Dr. Green email was not transmitted to QTC until January 9, 2002. Veterans should carefully examine the C-File for QTC "addendums" initiated by VA employees like Dr. Green and John Blake.

#3 disturbing email from Dr. Nancy Green

Dr. Green, a VA physician at the Winston-salem RO, openly and wrongly criticized the North Carolina Division of Veterans Affairs for seeking 100 percent service connected benefits when the veteran was already receiving Individual Unemployability for the same amount. Veterans who have 100 percent cannot be reduced after a number of years and the veteran's spouse and dependents have a better chance of benefits when the veteran dies. Unemployability can be reduced at any time.