Ray Cobb: 0:01

Blog Talk Radio.

J Basser: 0:05

It's time for the Exposed Vet Radio Show. The Exposed Vet Radio Show, we discuss issues affecting today's veteran. Now here's your host, john and Ray.

Ray Cobb: 0:18

Hey, good evening everybody. John's taking the night off tonight. His son is getting ready to graduate from the University of Kentucky. Well, I think about two or three degrees. He has some honors. So John had to go over there tonight and, I think, attend a banquet. So congratulations to him and his son and what they've accomplished so far, looking for a good future for that young man, very, very smart, very intelligent. My co-host tonight is over in West Tennessee, a little west of Nashville, not too far. It's within Stone's Throw, as we say down here in the south, and that's James Cripps. James, welcome aboard.

James Cripps : 0:59

Well, I appreciate the invite, Ray.

Ray Cobb: 1:02

Yeah, and our special guest tonight, our VIP, is Stephanie. Stephanie is in charge of Valor for Vet. Am I correct there, stephanie?

Bethanie Spangenberg: 1:15

So, Ray, you always get my name.

Ray Cobb: 1:17

Yeah, bethany, I'm sorry, I'm saying Stephanie, that's all right.

Bethanie Spangenberg: 1:21

You know. What's funny, though, is my mother's name is Stephanie, so I'm used to the Stephanie, bethany or Brittany. I answer to all of them, oh okay. It's Bethany Spangenberg, with Valor for Vets.

Ray Cobb: 1:34

Okay, and I think tonight you're going to start off talking a little bit about S&P exams, is that right? No, I'm sorry we're going to talk about my mind just went blank in.

James Cripps : 1:55

C&P exams.

Bethanie Spangenberg: 1:58

C&P exams from contractor exams, the do's and the don'ts. There's a militarycom report that came out that we can talk about. There's, you know, all different things that we can cover tonight's show.

Ray Cobb: 2:16

All right, let's get started C&P exams. When I had my first one, I was scared to death. I didn't have any idea what was going to happen. I was scared to death.

Bethanie Spangenberg: 2:24

I didn't have any idea what was going to happen. So that's a familiar feeling, especially because the VA tends to call veterans for exams when they're not necessary. And you know, some investigation reports or follow-up reports have said, yeah, the VA tends to order examinations, or the raters at the regional office tend to order exams more frequently than they should and they're supposed to be kind of slowing down on that, trying to be able to rate the veteran for what is in the file versus having them come in for another exam. So typically when you get a letter in the mail, if it's with the contractor that's doing the exam or if it's with the VA, you'll get a letter to report for the exam. Some of them even say not to report to the exam. So just depends on what, what condition they're looking at and they should disclose that in the letter that they send to you. So that kind of gives you a heads up on what topic will be discussed.

Bethanie Spangenberg: 3:28

So now your first comp and pen. What exam was that for? What were they evaluating you for then?

Ray Cobb: 3:36

My first one was diabetes. Military-connected Agent Orange in the United States, military-connected Agent Orange in the United States and, of course, at that time, the only person. Well, as a matter of fact, when I went for my C&P exam the first time, no one had received it, and then James became the first to receive his Agent Orange exposure in the United States. And then my CFP. I had two CFP exams and the second one. They were about a year apart. I think they sent me for one before I went to the board. They sent me for one at the beginning, when I first filed the claim, or shortly thereafter, and then my next CMP was a little bit before I went before the board okay, so we're really the same.

Bethanie Spangenberg: 4:31

Each like was your experience the same when you went for those, since it was for the same condition?

Ray Cobb: 4:39

and now they it wasn't. The second one asked more like how do you know you were exposed to Agent R's. And then both the common question that they both asked did we have any history of diabetes in our family? We have any history of diabetes in our family? Ah, you know, that's kind of one thing that they were reaching out after. Then the rest of that was what is my blood sugars doing? What's my highs, what's my lows? Have I found anything that would cause it to go up? Or was there? What could I do to when it went up? What could I do to get it down?

Bethanie Spangenberg: 5:36

Questions of that nature.

Ray Cobb: 5:39

Now, about what date or time frame was your first comp and pen? Oh, 2006. And it was until recently all my.

Bethanie Spangenberg: 6:03

CMPs have been done by VA nurse practitioners. Okay, the reason I ask is because when so I've been, I was in-house doing compensation and pension exams from about 2011 to 2013, and it was about that timeframe that they really opened up what we now call DBQs. Prior to that, they referenced them as worksheets and it wasn't really targeted for the legal schedule and we just collected basic history and examination information. It wasn't something specific regarding how many low blood sugars or specific questions about insulin and how many shots per day. We were just to document, almost as if it was a clinic exam. And even prior to those worksheets.

Bethanie Spangenberg: 6:51

You look at DBQs historically, a lot of the older exams I can say probably 1980s, early 1990s they were actually really thorough from the medical perspective but again, they weren't tailored to the rating schedule. They were more of a comprehensive examination and assessment by the physician and I really appreciate reading those old reports because I'm like man, that's a really good assessment of a clinical condition and so to see that transformation of you know the older exams and what was done and as they brought in the worksheets and then as they brought into the DBQs, so your first C&P exam, if that was 2006,. They didn't have DBQs then. So a lot of the questions may have been broader questions like just tell me about your blood sugars or what was your something not specific to rating? That's why I asked that question. It's kind of understanding the history behind those changes.

Ray Cobb: 8:03

Yeah, that's a.

James Cripps : 8:04

You know, Bethany.

Ray Cobb: 8:06

Go ahead, James.

James Cripps : 8:11

I submitted my claim and I went four years all the way to the Board of Veterans Appeals with no C&P exam. They would not order a C&P exam because I was claiming exposure inside the continental United States and the VA and the DOD said we never, ever used Agent Orange inside the continental United States. So they expected my claim to be just thrown out at the board. But the judge recognized, you know that I had ischemic heart disease, although that was before ischemic heart disease was recognized. I had to claim it as secondary to diabetes. But I had the diabetes, I had the chloracne, I had the heart disease, I had the neuropathy and the judge picked up on the fact. You know this guy's got chloracne and that's a bowel marker. So those claims were awarded without a C&P examination. The first C&P examination I ever had was years later lost the use of two feet, even had a psychological claim granted severe anxiety and depression, without a C&P exam. So times have changed.

Bethanie Spangenberg: 9:42

They have, they really have. That's interesting. You went four years without even just talking to any examiner whatsoever.

James Cripps : 9:51

Right.

Bethanie Spangenberg: 9:52

You know that evidence would have been valuable to have.

James Cripps : 9:57

I wanted. I begged for a C&P exam. It's in my records that I was just begging for one and they just refused to give me one. They wasn't obligated to give me one because they said it wouldn't make any difference in the claim.

Bethanie Spangenberg: 10:14

Now what time? Frame was that.

James Cripps : 10:17

That was 2001. In 2009, I submitted the claim in 2005.

Bethanie Spangenberg: 10:22

I submitted the claim in 2005. I'm assuming, I guess, as far as from there you went to the board and what happened from there with your claim?

James Cripps : 10:42

It was awarded at the board.

J Basser: 10:44

It was a partial grant.

James Cripps : 10:48

They granted what they could grant and then they sent it back to the regional office and said pay the man for what we have granted and send him for C&P exams. On the other issues they sat on it six months and sent it right back to the AMA without doing C&P exams. So the AMA headed it off. They saw what was happening. It was bias in the claim and they went ahead and warded the others without a C&P, without a CNP.

Bethanie Spangenberg: 11:33

But at the Board of.

James Cripps : 11:35

Veterans Appeals. I had 13 nexus letters.

Bethanie Spangenberg: 11:37

That takes a lot of doctor shopping. I have no doubt yeah.

James Cripps : 11:44

I've got a friend and he was just notified today of an upcoming C&P exam. It said expect a letter and it's either going to be on aid and attendance or it's going to be on loss of use of two hands. Aid and attendance is pretty well straightforward. It's just making sure he has to have help with his activities and daily living. What can he expect on a loss of use of two hands? That's not going to deal with loss of motion but grip and strength. What can he expect out of that exam?

Bethanie Spangenberg: 12:35

Do you know what the loss of use of both hands is tied to? Is it tied to neuropathy?

James Cripps : 12:40

Is it tied to diabetic neuropathy Is it tied to Diabetic?

Bethanie Spangenberg: 12:44

neuropathy. Okay, so it's going to be. To be honest, it should be the standard diabetes exam, because the standard diabetes exam asks the examiner to test the upper and lower extremities. So I'll be surprised because typically your loss of use with diabetes will come in your feet first and then they go into your hands.

James Cripps : 13:12

He already has lost use of two feet.

Bethanie Spangenberg: 13:16

Perfect. So that helps his claim. So what he should expect is they should do inspection of his hands. They're going to see if he has soft sensation. So they'll take like a cotton ball or tissue and run it through on his fingertips and up his arm. They may even do like a sharp doll, like they'll have a sharp object or a doll object that they'll press on the hand to see if he can feel. They should do a cold, like something cold, to see if he can feel whether it's cold or hot. They'll do his range of motion. They will do his strength testing. That is a comprehensive exam. Some examiners will do the bare minimum, some of them will do range of motion, strength testing and then they try to grade whether it's mild, moderate or severe neuropathy on the hands. So he should be. If it's done the right way, he should be in and out in about 45 minutes. If they cut him short it'll be like 20. Yeah.

James Cripps : 14:22

I have lost the use of two hands granted and lost the use of two feet. I had C&P for loss of use of two feet. I did not have a DBQ or an exam for loss of use of two hands.

Bethanie Spangenberg: 14:41

So for your feet, what did they determine the severity to be?

James Cripps : 14:47

Severe.

Bethanie Spangenberg: 14:50

And they didn't look at your hands at all.

James Cripps : 14:53

No.

Bethanie Spangenberg: 14:57

If there's veterans out there and they're listening and you know that your neuropathy and your feet are severe and you're going for your DBQ, ask them about your hands, say, well, what about my hands? I have the same or similar symptoms in my hands and you can say they're about the same, maybe they're not as bad. But you need to bring that to their attention because the examiner who is doing an evaluation for diabetes, it is in their form to look for neuropathy of all four extremities, not just the lower. So in that instance, if you are concerned with neuropathy, bring it up. Excuse me, you need to either file for it so that way they address it, or look at your old records to see if there's anything documented in the DBQ, because that's concerning.

Ray Cobb: 15:57

That would be something as a representative that I would want to look at.

Ray Cobb: 16:00

In 2014, or 15, excuse me, 2015, I went for my first foot drop in my right foot and secondary to diabetic neuropathy, and they did check my left foot, which at that time was fine, but they never checked my hands. And then, I think a year later, I had to go back for the other foot and finally got loss of use of both feet about 14 months apart, but they still never. My hands are bothering me now, but my rating is so high I don't even fool with it. Should they have checked my hands at that time when they were checking me for foot drop?

Bethanie Spangenberg: 16:45

Yes, they should have. They should have.

James Cripps : 16:52

You know, that kind of explains my situation, because I won my lawsuit two feet at the Board of Veterans' Appeals. Then I went back for loss of use of two hands. That was awarded at the court and they paid me back to the same date of loss of use of two feet, which was a 10-year total back pay.

Bethanie Spangenberg: 17:30

It's good that they finally discussed it, so I guess what they were saying there.

James Cripps : 17:35

Yeah, I guess what they were saying there is. It should have been inferred at the same time as loss of use of two feet been inferred at the same time as loss of two feet.

Bethanie Spangenberg: 17:52

Yeah, because your hands are going to be, the blood flow is typically better because they don't have the resistance that your feet do. So for your blood to get back from your feet back up to your heart, it's more work, it's further distance for your feet back up to your heart, it's more work, it's further distance for your feet. So that's why diabetics tend to get the neuropathy in their feet first and then they develop it in their hands. If a diabetic has a mild neuropathy, clinically we're not going to suspect that there is neuropathy in their hands. It's not until the neuropathy gets progressively worse in the feet that we get concerned with the neuropathy in the hands. But if there's a patient that I know has severe neuropathy in their feet clinically, I'm absolutely going to look at their hands and inspect and see what changes are going on with their hands.

James Cripps : 18:40

Actually my hands are clawing. That's not good. I had an EMG years ago on my hands. I went to a hand specialist and he said Mr Cripps, I don't think there's anything wrong with your hands. He said, but I want you to go see my specialist. And he sent me for an EMG on the hands and the guy did the EMG, stuck all the needles in me and did his testing and he didnít say anything. But he followed me back out to the desk to make my return appointment or settle up or whatever it was.

James Cripps : 19:22

I had to go back to the desk for and he walked up behind me and he reached down and with some kind of instrument I never saw what he had he snagged the palm of my hand and ripped up on it and I knew he did something. And I looked at my hand and it was bleeding and he said I apologize for that, I had to do that. But he said now I can tell you, your hands are not going to get any worse. Must have been some kind of nerve or something that he poked or prodded or ripped. I don't know what he did, but it convinced him that that hand didn't have much feeling in it.

Bethanie Spangenberg: 20:10

That almost sounds like he didn't believe you, so he had to poke you hard enough to make you bleed.

James Cripps : 20:17

Well you know the doctor that sent me to him. When I got up off of the table he said Mr Cripps, you asked me for an opinion. I said, and he said you know Mr. Cripps, I don't think there's a damn thing wrong with you, but I want you to go see my specialist. Well, he sent me to see three specialists and I got a letter from all three of them, so actually he did me a favor.

Bethanie Spangenberg: 20:48

I guess he had to learn the hard way. I don't know who's the victim here.

James Cripps : 21:01

I guess he just thought I was a whiner, I don't know.

Ray Cobb: 21:05

About the time that James was going through that, I was really chasing him. I was right behind him just by a few months, going through all these type of things, and I think it was 100% correct that what was really interesting back during that time frame is that they didn't believe us because there wasn't. You know, James was the first agent orange exposure, Mine was the second, just a few months later and nobody else had had it so and the others were assumptions for being in Vietnam, and the others were assumptions for being in Vietnam. And I think you know I've ran into a lot of doubt where you know, some folks even just call me a liar.

Bethanie Spangenberg: 22:00

Yeah, you know, I actually I have. You know I work with a lot of clinicians in this space and I have a lot of clinicians that ask me questions about the disability because they really don't understand how the VA disability works. Even clinicians inside the VA don't understand how the disability claims process works, how the disability claims process works, and so sometimes it's the conversation of look, they're not. These veterans aren't standing here with their foot to the ground demanding that it was 100% caused by service. So the clinicians that if clinicians are trying to understand from that perspective, saying that there's absolute proof that Agent Orange caused something, they have the wrong mindset Because regardless whether or not they believe they're a veteran or not, the standard is not 100%, not 100%.

Bethanie Spangenberg: 23:00

So what I tell those clinicians is I say listen to their story, document their symptoms and let the compensation and pension examiners handle their role. You are their primary care doctor, you are their orthopedic specialist. Document their symptoms. It is not your place to try to 100% prove that this happened. And I feel like a lot of veterans when they talk to their doctor about even you two having the stateside exposure where they don't believe you. I feel like those clinicians get wrapped up in like well, we have to have 100% absolute proof that this has caused it. We have to have 100% absolute proof that this has caused it.

Bethanie Spangenberg: 23:43

And so they start to make you into like whiners or like you're telling tall tales, and I feel like a lot of veterans face that when they go to the VA or to go to their providers and so if that's their mentality, you know they've got the wrong perspective and they really just need to focus on the clinical care and let the competent take care of itself.

James Cripps : 24:10

Well, you know, in my case I have chloragny and the only way you can get chloragny is dioxin exposure. So it was, you know it dictated my exposure. Actually it was a biomarker. The environmental clinician said it's a telltale sign. Without that, I don't know. I think they would have wrote the heart disease as to intercurrent causes and diabetes the same thing. But the chloragny and the chloragny is what I had the 13 diagnosis of, because I knew that was going to be a critical factor that turned their heads and made them think, hey, this is not a whiner. You know, where did he get this chloracne? How can we explain that away? They couldn't.

Bethanie Spangenberg: 25:11

And I'm glad that you were able to get that service connection and what we see today. We don't see a lot of the chloracne in the day-to-day clinic stuff, lot of the core acne, and in the day-to-day clinic stuff there's actually a whole group of people involved with the VA, the they call it the risk, the war-related illness and injury study center and that is dedicated specifically to war exposures and chemical exposures.

Bethanie Spangenberg: 25:39

So they can take a lot of not only Agent Orange and these burn pits but a lot of the other chemicals that have been exposed to our military people and they put out a lot of information to educate other clinicians. But day to day that chloracne is not something we're seeing. But veterans have to fight that battle. The comp and pen examiners have to make that opinion and I don't know that all the comp and pen examiners are qualified to render those opinions. So I'm glad you're able to get that. I think there's. I bring that up because I want the limitations to be known and I say that so that veterans don't give up. I say that just because one clinician doesn't believe you or they're not listening to you, that there is other resources available for you to talk with someone or get that opinion from someone that's listening.

James Cripps : 26:45

Well, the acne was not on my entrance exam, but it was all over my ETS exam. Okay, so it happened in service. No doubt about it.

Bethanie Spangenberg: 26:58

And it was bad.

James Cripps : 27:02

When I was transferred to Germany from Fort Gordon I couldn't even lean back in a sedan seat, couldn't stand it. But I had no idea what was causing it and to this day I have pretty bad chloracne and I'm 76 years old.

Bethanie Spangenberg: 27:23

You know, I'd really appreciate seeing some of those pictures. Do you have older pictures of what it looked like?

James Cripps : 27:30

I do on my website.

Bethanie Spangenberg: 27:33

Okay, I'll have to look into it.

James Cripps : 27:40

It's pretty revealing. I'll tell you, I've never seen another case like it and, as you know, there are no new cases. There will never be any new cases, I don't guess, unless it comes from a chemical factory or something like that.

Ray Cobb: 27:58

Yeah, it's not around anymore. Bethany, I know that when you were talking about the doctor's caring, I had no idea that Agent Orange existed and I'd been out of the service quite a few years and I'd gotten back into the va medical because of diabetes and I go in down to nashville to the clinical emergency. My diabetes was over 500 and they checked it and, uh, it actually, while I was there, got up to 700 and something. And and it actually, while I was there, got up to 700 and something. And this ER doctor comes in and he's looking at me and he looks at my chart. He says where were you in Vietnam? I says, well, I wasn't in Vietnam. He said you had to be. And I said, no, sir, I wasn't in Vietnam. And he looked at my chart and flipped it two or three pages. He says well then, where were you exposed to Agent Orange?

Ray Cobb: 29:02

So doctors had been putting it in my notes and at that time we didn't have VAgov, we couldn't go look at our medical notes unless we went and got them, you know. And so I said, oh, that's easy. I was at Fort McKellips, alabama chemical headquarters, and he said have you put in for it? And I said no, he said well, when you leave here today, you go down to Building 8 and you turn in a claim for Agent Orange exposure. And I did, and that was the beginning of it. Wow. But he took the time to look over my records and I think all he had was paper records because he had papers there in front of him. He wasn't looking on a computer, he had papers in his hands flipping the pages. So that was a while back. Thank goodness we do have the computers nowadays.

Ray Cobb: 29:58

But he didn, they paid attention.

James Cripps : 30:02

I was unaware of my exposure, even though I actually sprayed it every day for a year and a half. I was just killing weeds. Agent Orange was the furthest thing from my mind and in 2004, I saw the word for the first time, chloracne, and that intrigued me. The acne part of it, because I had acne so bad for so many years. So I looked it up, I did a little research on chloracne and what convinced me that I actually had chloracne is the butterfly formation on the face. Chloracne never involves the nose and I never had a pimple on my nose. I get to thinking. So I went to see a skin specialist and he said, yeah, no doubt my Agent Orange exam by the clinician. He recognized what it was, but I used that four years that they refused to give me a C&P exam to get those 13 opinions. I had to nail it, I had to prove it and I knew I was going to have to prove it or lose it. But the chloracne, I think, is what actually won the case.

Ray Cobb: 31:48

Bethany. Another question I know nowadays our C&P exams are done by contract. What do you see in that area? Do you see that as an improvement or a disadvantage.

Bethanie Spangenberg: 32:05

So there's a couple of things. I'm kind of sitting the fence for some of the contract exams. I'm concerned with a recent article that came out. So my thoughts originally when they started moving to the contract exams was that I preferred them to be contract only because inside the VA the compensation and pension examiner they can do a very poor job and they're still getting a full-time paycheck with benefits, and so the quality of their work doesn't necessarily mean that they're going to move positions. They're not going to take them from comp to pen and put them into primary care and those compensation and pension examiners. Production isn't necessarily priority for them. And I say that because when I was there I took over for someone and I reduced their time in half and I would look at a case and I would say, well, I can determine this without doing an exam. I could write an opinion, I can review the report and I don't ever have to talk to the veteran or do the case and it makes my numbers look good and those numbers reflected directly on the chief of staff. So my production was good and it made the chief of staff happy. They had some quality measures in there. They had some quality measures in there, but the quality measures weren't necessarily clinicians reviewing other clinicians' work.

Bethanie Spangenberg: 34:06

It to me was more prevalent in the contract side of things. I know that they brought the contract examinations on to meet the need. With COVID it kind of shut a lot of it down, but with the PACT Act they've more than doubled the need for contract exams and our company was actually approached to be a subcontractor to do these exams and so I found out what their expectations were, you know what kind of reimbursement they were giving, what the requirements were, and so it kind of opened my eyes up to what is happening, actually happening on the outside. So there's other companies. So we didn't end up doing it because we would have to shut down the access to our veterans directly. So we decided, you know we're not going to go that route, we are going to stay with what we're doing and find a different means of getting exams. So did you, ray or James? Did you guys read the article recently from military? It was put out like a week ago from militarycom. No, I didn't.

James Cripps : 35:22

About what.

Bethanie Spangenberg: 35:24

About comp and pen exams.

Ray Cobb: 35:27

No.

Bethanie Spangenberg: 35:29

So there was a report and so Senator Elizabeth Warren pushed for answers by May 14th from the VA. And so in the article it's talking about how the contract examiners are not reviewing service treatment records. They are shredding evidence because they don't have a means of getting it to the VA. So veterans are walking paperwork into their exam and rather than getting it to the VA, they're shredding it, and I've heard about that for a while. It talks about the quality concerns regarding the examinations being done at like medical spas or in hotels or like co-working spaces and non-medical facilities. So those are concerns, and so I was interested in hearing that information and I kind of wrote some of my frustrations out and I was going to even put a blog post out about this article because, being on our side and understanding trying to provide an exam for a veteran, the cost was our concern.

Bethanie Spangenberg: 36:47

If we're providing a product directly to the veteran, we need to try to fit what the veteran can afford. Veteran can afford, and unfortunately that cost was astronomical, especially after COVID. So I could not find an examiner to spend six hours and pay them $1,000 to do exams, and if you break that down hourly that's. I mean I'm talking about a nurse practitioner or a PA spending a day doing six hours, that's six exams, and so the cost has gone up astronomically. And then I see this cost that the VA is putting out to these contract examiners and the cost that the government is reimbursing the contract examiners is not going to cover the cost of doing an exam in a medical facility.

Bethanie Spangenberg: 37:45

So the quality I would say is reflective of the money that's being reimbursed to the examiners, because the money is not significant for me to go into a medical facility and rent a space to do these exams. The other caveat is if I'm in a clinic and I'm like, okay, I want to open up my clinic to do these disability exams, well, it takes me one hour to do a back DBQ. So the back DBQ I see one exam for an hour where, if I'm in the clinic, I can see four patients in an hour for a follow-up visit and the insurance will reimburse me significantly higher than the VA would. So why am I going to lower my medical practice revenue by filling that space with a comp and pen exam when I can make four times as much money by seeing my patients in the clinic? So it's not ideal for the practice and then for the individual clinicians it's and then for the individual clinicians it's how can we optimize our reimbursement, and still get the job done Does that make sense.

Ray Cobb: 39:09

Yeah, yes, hold on.

James Cripps : 39:10

You know the VA, the last C&P exam that I had and I guess the last one I'll ever have. The VA wanted a retrospective opinion of when I would have been due are one paid in attendance. They sent me to a chiropractor's assistant to do the exam. I had my scooter but I couldn't get into the building because there were steps to go up to get into the building. I managed to get into the building and the meeting was held in a closet. It couldn't have been no more than six by eight, if even that big. My wife answered most of the questions and the examiner said that my wife wasn't present. He did note that I ambulated into the building.

James Cripps : 40:23

I had no other choice. But he was also sharing this closet with a State Farm agent.

Bethanie Spangenberg: 40:30

Oh my gosh, I couldn't believe it yeah. I mean, but that's the perfect example. So the examiner is trying to optimize their availability, the space that they have available to them. The cost for me to rent even a an exam room from a chiropractor cannot be. There's no value at the end of the day, when I've done my exams and then I've paid out what it costs to rent the medical facility.

James Cripps : 41:09

This guy could make money at 50 bucks a pop doing C&P exams. Didn't take him 10 minutes.

Bethanie Spangenberg: 41:18

Oh, then that's a quality concern.

Ray Cobb: 41:25

Bethany, have you heard anything about these contract people being sent the wrong C&P forms to fill out? I know that happened to me on my last one.

Bethanie Spangenberg: 41:41

I haven't heard that. I wonder if that's because of the request that came down from the regional office. That's what that sounds like.

James Cripps : 41:56

Yeah, I think the writer defines the DBQ, don't they?

Bethanie Spangenberg: 42:03

Yeah, the writer's supposed to say that's not your choice.

James Cripps : 42:06

The writer chooses the DBQ.

Ray Cobb: 42:08

Right, yes, yeah, I know that the lady that did my C&P. She said it happened all the time. I had to go back to her for a second one and that one lasted an hour and a half and was really in-depth and that was for my R2. So, Bethany, you mentioned a minute ago about a back. You're sorry about doing a back C&P. I think we have a caller. Let me see if I can get him to join us. He's from over there where james is, I believe, in that area. See if we can get him to come up for you there. Caller, are you calling concerning your back and neuropathy in your feet?

James Cripps : 42:55

uh, yes, just that would be me.

Ray Cobb: 42:57

Okay, that's good, got the right one there. Yeah, we have Bethany on.

James Cripps : 43:06

Tell Bethany what's going on and what you'd like to know. Well, I was diagnosed with drop food and I've had back issues all the way through. It's noted in my military record not diagnosed. And it's noted in my military record not diagnosed, but just the fact that they just give me Darvon and muscle relaxers for about six years or so of my military time and nothing was ever done. So I ended up with drop foot. So I'm looking to find a way to get the connection for my injuries that were just working injuries, not necessarily a falling off of something or something like that. So the fact that it's noted in my record is that any way that could be taken as connection.

Bethanie Spangenberg: 44:01

So I love to hear that you were treated for your back and prescribed medications for your back in service. So that is very valuable. When I look at these, from the compensation and pension trying to form a nexus there's a few other questions I want to know and understand and pension trying to form a nexus there's a few other questions.

James Cripps : 44:21

I want to know and understand what was your specialty in the military? I was in engineering. I was an engine man on board ship. I overhauled, repaired and worked on extremely large diesel engines, as well as the pump and rigging and winches and stuff that go along with a salvage ship. I was on a sea tug Ocean going tug. Yes, go ahead.

Bethanie Spangenberg: 44:45

How often did you?

James Cripps : 44:46

lift anything over 50 pounds.

Bethanie Spangenberg: 44:49

Daily Okay.

James Cripps : 44:49

Every day yeah.

Bethanie Spangenberg: 44:54

Pretty much every day. You said you had no particular or specific injuries to your back.

James Cripps : 45:02

But what did you do when you got out of the military?

Bethanie Spangenberg: 45:08

I got out of the military and went into heating and air conditioning. Okay, and how often did you have to lift anything over 50 pounds when you've done the heating and air more or less than you did in the military?

James Cripps : 45:21

A lot less. Yes, very much less Okay.

Bethanie Spangenberg: 45:26

And when you got out of the military.

James Cripps : 45:28

I'm sorry. No, go ahead, I'll let you finish. In the heating and air conditioning. You always had someone to help you. You had someone else to lift the other part of it, so you didn't have to lift over 50 pounds very often.

Bethanie Spangenberg: 45:49

Okay, and just for understanding of like I follow medical history and how things were treated like over time what dates of service like? When did you get out?

James Cripps : 46:00

I got out in 73, went in in 65.

Bethanie Spangenberg: 46:04

Okay.

James Cripps : 46:06

Almost eight years Okay.

Bethanie Spangenberg: 46:09

And then, when did you first seek treatment for your back after you got out of service?

James Cripps : 46:18

It was just off and on, wasn't right away.

Bethanie Spangenberg: 46:26

I guess I'm trying to get an understanding of like okay, when I hit 40, I had to go see my primary care doctor and they gave me more muscle relaxers or something along those lines of your history about how things had continued.

James Cripps : 46:45

Well, I didn't see many doctors. I didn't go to the VA. I didn't think I had a right to go to the VA after they said that you had to have service-connected disability or injury and it just didn't stack up for me to understand that part of it. But I went pretty often, but I didn't once twice a year.

James Cripps : 47:12

It was a much easier job than what I was doing in service Okay and which came first Much easier job than what I was doing in the service Okay, and which came first the drop foot or the discovery of you having arthritis in your back? Knowledge of it drop foot came first, but I've always had a back injury or back problem.

Bethanie Spangenberg: 47:38

Okay, so I would appreciate looking at your medical records because, or even if you don't do something like us, I still encourage you to apply From an occupational standpoint.

Bethanie Spangenberg: 47:52

If you're lifting something more than 50 pounds on a regular basis without assistance for eight years and then you transition to a job that let me back up and you were treated for back issues in service that is very prominent in your history and then you take the fact that you transition to something that's less labor intensive and that you have assistance with.

Bethanie Spangenberg: 48:16

If there's something that you know is going to give you troubles with lifting or maneuvering, that toll on your body is much greater from the military service than it ever would be in your occupation post-service. So you take that time in service, your duties in service, your symptoms in service and years later you now have drop foot and back issues. I would encourage you to apply for a service connection for your back and your neuropathy or your drop foot. So I think you've got a. You know I can't always say a good chance, but I like your chances. So they're more likely than not going to be service-connected, just based on your history and what I know from my practice in both medicine and occupational health and competent. So I would absolutely encourage you to go 100 miles an hour and fight for that claim.

Ray Cobb: 49:21

Yeah, and. James is there and he can help you go right through it. He can take you right down the path.

James Cripps : 49:28

Yeah, he needs an access letter, can he?

Bethanie Spangenberg: 49:33

get denied first on this one, because I like that he's got it documented in service.

Ray Cobb: 49:40

In other words, get denied.

James Cripps : 49:42

He's not filed for it.

Bethanie Spangenberg: 49:44

Yeah, I'm not filed for it. Filing if you get denied will help you out, because the fact that you have it documented in service and when you go to write your statement, you put in there that you were lifting more than 50 pounds, 50 pounds plus every day and what you were doing you need to make sure that's very clear.

James Cripps : 50:03

Yes, okay.

Ray Cobb: 50:06

Great Thanks for the call. Appreciate it, Bethany. We've got another thing. Thank you, Bethany. This is what James does in his area down there, and he's extremely good at it. And, james, I think you've got a great story to tell us tonight. A phone call you got this morning, didn't you?

James Cripps : 50:28

Well, it actually was about 2 or 3 o'clock this evening. A lady called. She was crying. My wife actually answered the phone. She wanted to know if this was the phone number of the guy that won the first Agent Orange claim at Fort Gordon. She got on the phone and she said her husband had won his Agent Orange claim at Fort Gordon after a seven-year battle and she said it was your story and your inspiration that spurred us on to fight this thing and not quit.

Bethanie Spangenberg: 51:11

That's awesome.

James Cripps : 51:15

It's a warm feeling really to be able to change somebody's life. We like to hear those stories, we like to know what we're doing. She had just found my website and she listened to the Exposed Vet broadcast two or three broadcasts ago when we were talking about Fort Gordon after my last WRDW broadcast down there. But anyway, she said I'm going back to your website. That's a huge website and it is. There's a lot of information there. But yeah, we're always glad to hear that we're not just wasting our time, that somebody's actually benefiting from what we're doing.

Bethanie Spangenberg: 52:10

That's exciting. You know, I'd like to take a minute to share a story, if you don't mind.

Ray Cobb: 52:17

No, go ahead please.

Bethanie Spangenberg: 52:20

I think in any profession, you know, you really need to be humble and appreciate what you know and what you don't know. And if you don't know, you know, be able to, you know, tell the person you're working with hey, you know, I'm not sure, but let me find a resource. Or, you know, I encourage you to seek other resources. So back several years ago, I thought I wanted to do the representation thing we're talking gosh six or seven years ago, right when I first became accredited, and then, when I got into it, they started doing the changes to the AMA. First it was RAMP and then they messed up RAMP and then they turned it to the AMA and that's been a hot mess. So I decided you know what, I'm not going to do this and I turned my veterans over to an attorney that I have known for a long time. You know I can't help you at this point because I don't feel like they're going to listen to me.

Bethanie Spangenberg: 53:24

I for your claim, and this is one particular woman I said I know this, I know you have this claim, I believe your story, I believe in what the evidence is showing, but I need to give you to somebody else and I found out this week that she was finally granted and she was retroactively paid for that whole time period. And even though she's no longer with me as me being her representative, she was still able to get that service connection, and so that's still a win. That's still a win for me, because I knew she had the disability, I knew it was related to service and she didn't get there with anything that I did from the medical standpoint. The legal evidence was there for her, and so I was not able to carry her to the finish line, but I knew somebody who did, and six years later she's crossed the finish line and she got a retroactive pay. So that's so exciting to share in that good news and that life-changing event. So I just wanted to share that, oh appreciate you doing that.

James Cripps : 54:34

Every time they win, we win again.

Ray Cobb: 54:36

Yep every time. And I don't know of anything that makes me feel any better than when a person says do you realize how you've changed our life? I had a gentleman just a few weeks ago. Same thing. He was at 40 percent and I told him one simple little thing. When he told me he had been fired because he couldn't get along with others, I said will your employer write you a letter to that effect? And he said well, I guess he will. He turned it in and within three weeks he had gone from 40% to 100% on his PTSD because he could not work with others.

Ray Cobb: 55:20

And you know, I mean he worked for the state of Tennessee and he took care of the grounds at the state park. You know he drove a tractor and mowed the grass and things. So it wasn't exactly a record high-paying job. And now he's making more than he did when he worked for the state and he had been with the state long enough to be able to take an early retirement. So a great change in his life and a change for his wife as well. That's awesome. That's what it's all about. We're down to less than four minutes left in the program. Tell us a little bit, bethany, about your webpage and exactly what all you do and how people can reach out and get in touch with you.

Bethanie Spangenberg: 56:12

So my company is Valor for Vets. We are a team of medical experts that provide nexus letters and we've been doing it as a team since 2015. Next year will be our 10 years. We really focus on understanding the requirements of the VA and really trying to put the quality factor above the VA's expectations. So we also provide a few of the DBQs that can be conducted by ACE and we work with veterans, vsos and attorneys that are accredited agents. So if you want to visit our website, there's a wealth of information on our website regarding medical conditions as well. Our website is VALOR V-A-L-O-R, the number four vet V-E-T dot com.

Ray Cobb: 57:02

And I like one thing on your web page that I enjoyed but this is just a personal when you I looked on your web page and I saw where you could find out about your company and he actually got a video where you're talking and you're telling how you developed your company and how you found it.

Ray Cobb: 57:19

And that's really strong guys. If you're you know, a lot of times we hear names and doctor's names or whatever, but it doesn't tell you how they got it. If they have a degree, it doesn't even tell you where it came from. But in her webpage it takes you step by step and it's a beautiful webpage and easy to find things and easy to get through. Bethany, and I appreciate that being there, and I have recommended to several veterans here in the Middle Tennessee area to look into it and to see what's going on and get in touch with you if they think that you can help and guys, it doesn't hurt to reach out and if she can't help, I'm sure she'll tell you so or, like she said earlier, direct you in the right direction and that's what it's all about.

Bethanie Spangenberg: 58:08

And we actually just added recently an option to ask a medical expert a question. So if there's something you know and that's at no cost, so if you have, just like the caller came on tonight if he wants to explain his story, you know, night, if he wants to explain his story, you know, I can kind of give what little bit feedback I did and encourage you or guide you in the next step or in the right direction so you can go on our website and fill that out.

Ray Cobb: 58:32

Yeah, great, james, tell us about. I love the name of your webpage VA, the Redneck Way. I mean that, just that suits you perfect. I'm telling you.

James Cripps : 58:42

I mean that suits you perfect. I'm telling you, tell them how to reach you. Yeah, you can communicate with me or get a hold of me, or read a whole lot. There's a lot of information there on how to win your claim, how to submit your claim. It's kind of inspiring. And that's VATheredneckwaycom.

Ray Cobb: 59:09

Spell it just like it sounds, vatheredneckwaycom and folks, I have a local radio station that I do every Tuesday morning, 9 o'clock Central Time. You can go on the Internet and go to WZYX Radio and click on the live and you can hear it live, or you can look down and find where it says recorded and you'd be able to listen to the previous recorded shows for the previous four weeks. With that guys, we're out of time. Bethany, a special thanks to you for coming on tonight. I thoroughly enjoyed it. It's a topic that's always interested me. On tonight, I thoroughly enjoyed it. It's a topic that's always interested me. And with that we will be shutting down on behalf of John James and Bethany. This is Ray Cobb saying goodnight and have a great evening.

J Basser: 59:55

You have been listening to the Exposed that Podcast. Any opinions expressed on the show are the opinions of the guest speakers and not necessarily the opinions of Exposed that, Exposed Thatcom or Blog Talk Radio. Tune in next week for another episode of the Exposed that Podcast. Thanks for listening.

Ray Cobb: 1:00:18

I'm sorry just a second. I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry, I'm sorry.

Bethanie Spangenberg: 1:00:30

I'm sorry.