Got An Imo Locally

[Jayg]

Howdy all. I found a doctor that gave me a 'more likely than not' on connecting my arthritis to my sc conditions (flat feet and ankle injury). I gave the good Dr. a copy of Strickland's sample letter and he tried to follow it but he didn't get it right in detail. I had fore warned him that VA was fussy as all get out and he told me to let him know if it needed altered so there's no problem on that end.

He gave me three lightly filled pages with information scattered about and omitted a lot of detail, providing mainly broad statements/impressions. Too, I hadn't brought the full battery of my records since at this first visit, I hadn't actually expected the letter. His office people really had no idea what I was asking of him so I just expected to explain what I wanted and to see if he would do it. He accepted the idea, looked at what I had brought and gave me an exam. then produced the 'letter.'

What I'm wanting to do is spoon feed him the finished product as near as I can so he pretty much just has to fill in the blanks, as it were.

That's where you good folk come in. B)

Please bear with me as this is long but I really need input here.

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This is his, I guess call it opinion or cover letter with my edits for him in Italics. The next two are his additional pages. Some information useful, some needs amended and some omitted as potentially harmful or just needless. In the end, it all needs shuffled into a whole... This is what I'm hoping you all can help me with. Something fit to set VA back on it's heels. And this is in time for my Hearing in March.

Edited February 5, 2009 by Jayg

[Bonnie]

I went to a private doctor that I picked out of the phone book. I had been rated as incompetent. One hour and two hundred dollars later I had a letter that he wrote using an example letter from watchdog. The VA accepted it and I am rated competent thanks to the psych. doctor I went to. The whole process took less than two months. I don't understand why anyone would spend thousands for an IMO. BONNIE

[Pete53]

Most Docs won't mess with helping Veterans by doing IMO's. Its a time thing they make a lot more money being a Doctor.

I think that you were lucky it took me over 2 years to find a Doc who would write a Medical Opinion that overrulled a Hearing Officer in Waco.

[Josephine]

I went to a private doctor that I picked out of the phone book. I had been rated as incompetent. One hour and two hundred dollars later I had a letter that he wrote using an example letter from watchdog. The VA accepted it and I am rated competent thanks to the psych. doctor I went to. The whole process took less than two months. I don't understand why anyone would spend thousands for an IMO. BONNIE

Bonnie,

That is wonderful news. Congratulations!

Betty

[Jayg]

Most Docs won't mess with helping Veterans by doing IMO's. Its a time thing they make a lot more money being a Doctor.

I think that you were lucky it took me over 2 years to find a Doc who would write a Medical Opinion that overrulled a Hearing Officer in Waco.

Waco, huh. That's where I'm going. Well, this one is from a foot and ankle specialist. I'm getting another from a doctor of internal medicine with a background in occupational medicine.

[retiredat44]

Congratulations on the IMO, "Jayq". It sounds like you have a doctor that wants to help you. I plan to get IMOs for my appeal. I am waiting for the VA denial letter. My file date is July, 2008. Best wishes for a successful outcome with your claim.

I was turned down last year. I originally filed for my 50% to be increased to 100%. I filed around June 2009. I was denied around October 2009. I had an IMO/IME and submitted it in repsonse to my Denial in an Appeal two weeks after I recieved the denial.

I have a VSO helping me. My IMO was around $1,600. It was very extensive and was the size of about 2 phone books. I was getting the IMO during the summer of 2009, and this was while my first application in 2009 was still in the process, but was not complete and ready to submit until October 2009, just in time to submit with my appeal.

I am still awaiting for a decision on my appeal.

note: I am shocked to see people with 100% that look far healthier than I am. Of course I do not know their medical histories, though sometimes they tell me some details. But, still, if I was on the same scale, and they got 100% I should get 500%. Just my feeling on how some people get rated.

Some people just get 100% without a fuss, others suffer for many years and never get more than 50%.

Only thing you can do is live and try. IMHO

I wish I could tell you all that's wrong, but I would crash the hadit.com server..

[acesup]

How you approach a private doctor may help.

I've scored 5 out of 6 nexus letters so far with private docs...but, my claim is just now at the end of the VCAA period, so I don't have any decisions. I am fairly confident though, because I have either "as likely as not" or "more like than not" opinions.

I have a couple of secondary claims and a couple of direct SC claims in the works. I have gotten IMEs and IMOs from some highly credentialed M.D.s, mostly specialists. Only one of them was a doctor who has actually been treating me for any length of time. The others examined me and my records.

I don't think I'm just "lucky". I read a lot of information on all of these vet forums, and also from the self-help claims guide that one vet's wife has put together. I studied my SC disability and its' etiology, probable complications, etc. I studied all of my meds and their side effects. I put together a folder full of info and a sample format for each condition, for each doctor.

Taking a tip from either the self-help vet's guide mentioned above, or from the vawatchdog site, I don't remember which, I did NOT mention to the office help or the nurses at any of these offices that I wanted any opinions or whatever from the docs. I don't think I was wrong to be crafty, I'm paying the bill, and I don't need some flunky to tell me "Sorry, we don't do that."

At almost every appointment, I was asked at some point by these types about what I had in the binder I was carrying. I simply stated it was some personal medical history info that I brought in case the doctor wanted to see it. I sure did not say "Oh, it's my SMR and VA C-file, plus a sample nexus letter like I want the doctor to write." Tiring of such questions, last time I just had a chubby manila folder tucked into a skinny newspaper.

In each case, I discussed my history with the doctor, then my theories and research as to why and how the specific SC disability I'm suffering was likely or more likely secondary to it. I opened my records and offered to show them to the doc. I showed him the summary of my SMR and C-files that indicate which document on whatever date applies to the subject. I then explained about the VA claim and the nexus opinion process, and presented the nexus letter.

Only one physician, a wimpy neurologist, balked at assisting me, He finally agreed to do more research and get me some sort of nexus letter at a later date, but I'm not holding my breath.

All of the others were eager and willing to help. I think it boils down to a FEW IMPORTANT THINGS that you can reap from these vet forums (and if you were ever a Boy or Girl Scout, from your scout training):

1. Know your claim, your disability, your meds and their potential side effects, etc. I have found two great online resources for medical and drug info: the National Institue of Health (nih) site, and the US Food and Drug Administration (fda) site of drugs.com.

2. Be polite to the doctor. (Be polite to his staff, too, just don't let loose lips sink your ship; consider your mission, and apply the old classified info "eyes only" and "need to know" policy.)

3. Be clear and not too wordy in discussing your claim and your request for help with the doctor. He has other things to do, time is money. Don't waste a lot of time.

4. Be prepared. Not just mentally, but also with your records and such. Have them organized. Be able to flip immediately to anything that the doctor wants to see in your records. Have your idea of the perfect nexus letter in your hand later in your discussion. He'll probably want to look at it. He'll probably critique it, add to it, maybe find something that isn't quite factually agreeable to him. Offer to re-type it with his changes included. He'll probably just change it and sign it, or hand it to his office help and have them fix it up while you wait.

If you are prepared, you probably won't be nervous and blow it. You'll likely either get a nexus letter or he/she will tell you what you need to include/exclude to get their signed agreement.

Dress neatly. Be positive. Don't complain about anything, they hear enough of that.

Be honest and be real. The doctor is not likely to agree with some far-fetched wild idea that your SC broken pinky caused your diabetes. If you can't find and print out some established medical research linking your condition to a real, established active duty medical event, or some strong evidence that links a secondary condtion to your SC disability or the meds you take for it, you probably aren't going to get a doctor to put his professional reputation on the line over some wacko theory.

I'm hoping to win SC mostly for some conditions that should have been SC a looooong time ago. If I do, it will mostly be due to what I have learned on this and a couple of other vet sites. I used to be stoopid, I had no idea about how to present a successful claim, and I was at the mercy of VSOs and VAROs that kept all the ccards (rules and procedures) up their sleeves. I was just the way the system wanted me to be.

Maybe I still am stupid, but thanks to these vet websites, I'm armed (with a little knowledge) and dangerous (a little knowledge can be a dangerous thing).

Wow, got kinda carried away, this is by far my biggest post ever. LOL Thanks for the help and the ears.