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Getting An Independent

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Berta

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Independent Medical Opinions can often be the only way a veteran or widow can succeed on a VA claim.

Opinions obtained from private treating doctors are often free yet most independent medical opinions are needed from doctors with full expertise in the field of the disability can be very costly.

However an award can easily absorb this cost with a few comp checks or the increases in comp that the claimant might never obtain without an IMO.

A Valid IMO must contain the following:

The doctor must have all medical records available and refer to them directly in the opinion.

In cases involving an in-service nexus- the doctor needs to read and refer to the SMRs.

Also the doc needs to have all prior SOC decisions from VA particularly those referencing any VA medical opinions or a copy of the actual C & P results.

The doctor should define their medical expertise as to how their background makes their opinion valid.

In other words a psychiatrist cannot really opine on a cardiovascular disease.

An internist cannot really opine on a depression claim.

The doctor must have some valid medical expertise that makes his/her IMO valid.

The doctor should state their opinion in terms of “as least as likely as not”, or “More than likely” as to the present disability and the nexus to the veteran’s service medical records or other SC disabilities, if the medical evidence warrants them to agree with the claim.

They should then refer to specific medical evidence to support their conclusion.

They should rule out any other potential etiology if they can-but for service as causing the disability.

They should briefly quote from and cite any established medical principles or treatises that support their opinion.

They should point out any discrepancies in any VA examiner’s opinion-such as the VA doctor not considering pertinent evidence of record in the veteran’s SMRs or Clinical record.

They should fully provide medical rationale to rebutt anything that is not medically sound nor relevant or appropriate in the VA doctor’s opinion.

They should attach a full Curriculum Vitae if possible or list their expertise within the opinion and tell VA of any special medical background they have that also makes their opinion valid. (For example, how long they have treated patients with the same disability, any articles they have written, or symposiums attended etc,)

It helps considerably to identify pertinent documents in your SMRs and medical records with easily seen labels as well as to list and identify these specific documents in a cover letter that requests the medical opinion.

A good IMO doctor reads everything you send but this makes it a little easier for them to prepare the IMO as to referencing specific records.

Send the VA and your vet rep copies of the signed IMO.

And make sure your rep sends them a 21-4138 in support of it- you also- can send this form (available at the VA web site) as a cover letter highlighting this evidence.

PS- Mental disabilities- make sure the doctor states that you are competent to handle your own funds- otherwise, if a big retro award is due-the VA might attempt to declare you incompetent and it takes times to find and have the VA approve of a payee.

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"I have a BVA appeal pending on GERD,.....What should I do? Just proceed with the appeal, then re file another claim of SA? "

Could he prepare an IMO to support the GERD claim and then add his medical rationale as to the secondary?

Send a copy of the IMO to the BVA under your BVA docket number and waive further RO consideration on that claim.

Then ask the VARO for the sleep apnea as secondary to the GERD.

The BVA wont have jurisdiction over the sleep apnea part of the claim or that part of the IMO but by the time the BVA decision comes, the newer SA claim could sure still probably be in progress at the RO level and you would have an IMO that covers the apnea as secondary as well as the GERD.

Others might disagree with this so weigh what they say here too as to filing the new claim for SA as secondary to GERD..

I guess I am counting on the VA being so slow that I expect the BVA decision (hopefully an award) to come faster then how long a newer claim could take.

How long has your claim been at the BVA?

The biggest problem here is getting the GERD SCed.

Make sure the IMO doc refers directly todated medical entries in your SMRs for the GERD claim.

Edited by Berta
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I understand what your saying Berta, I just hate to muddy up what is in progress. If I submit another claim, will it slow down my BVA appeal? If feel extremely confident based off of the "record" it will show I should be SC for GERD already. I am getting an IMO to solidify my claim, and if in the process the etiology of my SC for GERD happens to be sleep apnea, should I file another claim after my BVA appeal or before it. Thats what i was wondering. I don't know how the BVA operates and if they see another SC condition that is not yet SC, will they look at that as well. you answered my question, thanks

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“Thats what i was wondering. I don't know how the BVA operates and if they see another SC condition that is not yet SC, will they look at that as well.”

They might 'see' it, but they will not make a decision on it.

Unlike the VAROs, the BVA has a queue system.

So I dont think a new claim, filed at a RO level, would impact at all on the queue.

I was at the BVA with claims pending at the VARO level and the BVA mentioned them in my BVA decision but they were' held up' in affect only for the time period that the BVA actually worked on the BVA claim.(maybe 6-8 months)

They were ,in fact, held up by the RO regardless of my BVA appeal.

I almost forgot I had a BVA claim in 1995- 1996 too, but that did not hold up 2 claims and the awards I got from the RO in 1997-1998 on a different basis of claim.

Under the Archives at the SVR radio link is a show I did recently on how the BVA works.

http://www.hadit.com/svr.html

Unfortunately one hour is not long enough at all to really explain the BVA and how they think.

These are all lawyers who,in my opinion, have their finger on the pulse of the VA claims process.

The BVA is a fascinating entity and ,in my opinion, the only part of the VA claim system that knows what they are doing. They focus solely on VA case and evidence in preparing their decisions.

If the claimant's Duty to Assist rights have been impaired in any way, hey will try to resolve that issue with a remand.Although a remand adds more time to a claim, those DTA rights are often critical to the outcome.

I have read BVA decisions for as long as they have been on the net-maybe 15 years and I have only seen a handful of decisions in the past 10 years that I felt should be appealed to the CAVC.

While BVA might not be perfect, it is, for many, the fairest shake they will get from the VA and the BVA will definitely read their evidence.

Even though I just won my AO death claim, I discussed another potential claim with the NVLSP lawyer I was assigned and am going to file it with the evidence attached to the claim ( it is a no brainer and the evidence I have comes from a Top VA cardiologist in DC ) and also I am attaching right away Waiver of further VARO consideration as I have no faith in my RO and want them to send it to the BVA as soon as they deny it.

With the recent hearings on the backlog, 'potential 'hold ups or 'how long will it take' questions have become moot points.

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