Need Help With If Some Things Should Be Included In An Imo

[kate7772]

Received an IMO and the doctor asked that I look it over for errors and let him know.

This is an appeal for kidney disease my husband suffers from and we are claiming was caused by the contaminated water at Marine Corps Base Camp Lejeune (an uphill battle.)

The report looks good to me but I do have a few questions I wanted to ask here before getting back with him.

**It says he reviewed patient's medical records/testimony,lay statements, personnel records but it does not state he saw the service medical records or C&P file. He did see both and references the C&P opinion elsewhere but does not specifically list it. Should these two things be included in the list of what he saw?

**My husband had two entries in his service medical records where he was treated for urinary issues and pain. These were a year apart and after exposure to the water. I thought maybe these would be important to include as the possible start of the problem but maybe not.

**He referred to a reference which lists harmful chemicals known to cause the kidney disease my husband has but also includes in the list other items, such as: lead paint, cigarette smoke, sewage, whitening creams contaminated cereals, etc. I'm not sure these should all be listed. I'm thinking just pull out the chemicals he was exposed to and not leave it open for VA to say "Hey, these other items could have been a factor." We all know many things in the environment can contribute to medical issues but don't want to give unnecessary ammo.

**The opinion doesn't use the exact wording "at least as likely as not" but does say "to at least the 50% level of probability." Is that acceptable to VA?

**This next may be petty but I have a thing about spelling (not that I don't have issues with it also) and there are some in the report, likely typos. Should I ask that these be corrected or is that not a real issue?

Just want to make sure we cover everything and give VA no reason to say something is not included or done right. We also have a statement in my husband's medical notes from his VA kidney specialist, saying that he feels the condition is at least as likely as not a result of the water.

Any thoughts on this? Anything that I should make sure is included before sending the NOD?

Thanks,

Kate

[georgiapapa]

The issues you pointed out are not petty and I agree with your concerns. Since the doctor invited you to proof read the IMO and let him know if you saw any errors, I would point out the items you listed in your post as errors of omission or suggestions to clarify issues in his original IMO.

You could even rewrite your version of a rough draft of the IMO on blank paper using as much of the exact language and content used by the doctor and making changes or insertions in the IMO without changing the doctor's final intent or opinion. This would keep the doctor from having to spend even more time rewriting the IMO since you already had a rough draft available for him. Hopefully the doctor would be receptive to some or all your suggested changes and instruct his secretary or medical assistant to take your rough draft and rewrite it on his letterhead. Even if the doctor refuses to make any changes to his original IMO, at least you will not have any regrets that you didn't at least make an effort to have the doctor make the changes.

[Notorious Kelly]

If he's saying "at least 50%" then he could just say "more likely than not".

I agree that no corrections are petty and it'd be good to provide the doc a detailed list.

[kate7772]

Any other thoughts on this before I contact the Doc.?

Thanks, Kate

[CBaker84]

Any other thoughts on this before I contact the Doc.?

Thanks, Kate

One thing that I did is made a exhibit list of all my visits that were related to a specific symptom or injury. It must have helped, because in the Dr's report for me they seem to have cited each instance for their evidence.

The easier we make it for them, the more they can do! One thing you have left out is the IMO's CV. That should be there so they know who he/she is and how much experience. This can come into play when you have two opinions that don't say the same thing (or one negative / one positive).

[georgiapapa]

Your doctor probably already has a CV which you can attach to the IMO. However, you should refer to the "attached CV" in your actual IMO and also have the doctor sign the CV.