Imo Per Dept Of Va

[luvHIM]

After a response from Vike17 on another one of my threads, I decided to do a little research today. He made a statement about me perhaps needing to get an IMO or medical statement from a doctor. Well, it occurred to me that they were obviously two different things.

And, according to Department of Veteran Affairs, they are. In fact, a "legitimate" IMO is is obtained through a specified procedure. What has to be the case is that some VARO's are definitely by the book. What some of us have been describing as an IMO and having rejected may be subject to the aforemention. At any rate, the following is what I discovered today and thought I would share it with you guys here, especially those of you who have the experience of having your "IMO" rejected or ignored.

§ 3.328 lndependent medical opinions.

(a) General. When warranted by the medical complexity or controversy involved in a pending claim, an advisory medical opinion may be obtained from one or more medical experts who are not employees of VA. Opinions shall be obtained from recognized medical schools, universities, clinics or medical institutions with which arrangements for such opinions have been made, and an appropriate official of the institution shall select the individual expert(s) to render an opinion.

(;) Requests. A request for an independent medical opinion in conjunction with a claim pending at the regional office level may be initiated by the office having jurisdiction over the claim, by the claimant, or by his or her duly appointed representative. The request must be submitted in writing and must set forth in detail the reasons why the opinion is necessary. All such requests shall be submitted through the Veterans Service Center Manager of the office having jurisdiction over the claim, and those requests which in the judgment of the Veterans Service Center Manager merit consideration shall be referred to the Compensation and Pension Service for approval.

© Approval. Approval shall be granted only upon a determination by the Compensation and Pension Service that the issue under consideration poses a medical problem of such obscurity or complexity, or has generated such controversy in the medical community at large, as to justify solicitation of an independent medical opinion. When approval has been granted, the Compensation and Pension Service shall obtain the opinion. A determination that an independent medical opinion is not warranted may be contested only as part of an appeal on the merits of the decision rendered on the primary issue by the agency of original jurisdiction.

(d) Notification. The Compensation and Pension Service shall notify the claimant when the request for an independent medical opinion has been approved with regard to his or her claim and shall furnish the claimant with a copy of the opinion when it is received. If, in the judgment of the Secretary, disclosure of the independent medical opinion would be harmful to the physical or mental health of the claimant, disclosure shall be subject to the special procedures set forth in §1.577 of this chapter.

(Authority: 38 U.S.C. 5109, 5701(B)(1); 5 U.S.C. 552a(f)(3))

[55 FR 18602, May 3, 1990]

[Hoppy]

In the VA system any medical opinion can be used as evidence. It does not have to go through the process you posted. The process you posted is the proceedure the RO uses when they decided to get an opinion.

Any veteran can get an opinion and submit it from any doctor. Submitting an opinion from a doctor of your choice is your right and if it is written properly and the evidence is strong the VA does make awards based on such opinions.

IMO is being used on hadit to describe both processes.

I recommend that you get opinions from treating doctors at VA hospitals. I also recommend that you work with your SO in getting any report in the proper format for the VA to use as evidence. If you do not like VA hospitals then get one from any doctor who treats you. The problem with private doctors is that I know people who paid for reports in advance and when they got the report the doctor wrote a bogus report.

Edited July 22, 2007 by Hoppy

[Vike17]

Hoppy is correct, this regulation only pertains to the VA and how they need to go about authorization of getting a IMO. In all the years I've been doing claims, I have never seen the VA do this. Generally, if they need an opinion, they'll just ask the C&P doctor to opine.

The veteran can obtain an IMO at any time they wish without any authorization from VA!

Vike 17

[Josephine]

Due to not starting a war here, I will delete my comments.

Josephine

Edited July 22, 2007 by Josephine

[betrayed]

As my niece as told me several times, she places no weight to an IMO secured by the Veteran as the Veteran is paying for the opinion and that doctors will say anything for the money.

She has told me that I could get one, but it would not be of any value to me. She said she places no weight as she has no ideal of the medical records that the Veteran gives to the doctor.

The veteran could change his post medical records and his SMR's to read as he would like.

Only if the VA mails the copy of the medical records to the authorized doctor, then the IMO would carry some weight.

In doing this, then the IMO would be secured by the VA and I have never had any luck in securing an IMO from the VA.

Just my view,

Josephine

Not picking on your niece but......................I think you niece is being adversarial and is giving no benefit of the doubt to the veteran, both which are against 38 CFR Regs. Attitudes like this by raters are what causes 90% of the problems we (the vet) deal with. Its a total bull crap attitude. ;)

[Josephine]

Yes, you are absolutely correct. Guess who has been telling me how to handle my claim for the last 4 years? She is one of the reasons that Veterans are having so many problems.

I have heard, she is good at what she does.

If she was going to sign off on my claim, I ask myself, " why in the hxxx didn't she do it before my first postive C&P came through.

I went into Appeals in June, had my first C&P October 18, 2004, and when the Postive " More Likely than Not" came through, she signs her name on my claim.

Sending me off to another R. O to go around the Mulberry Bush.

She told me she signed off of my claim in 2002.

Bull, only after the first C&P did she come forward.

I don't know why she had to sign off anyway.

I sure as heck don't see that DRO niece but about once a year.

Live and Learn,

Josephine

[Berta]

Hoppy and Vike are correct-

The VA CANNOT ignore probative medical evidence.

I posted the regs on that here-before-

If a medical opinion fully complies with the criteria that VA needs- and the doctor is opining in a field they have expertise in-

NO DRO or rater etc can reject,or ignore this type of medical evidence for a claim.

I have seen many BVA remands because the vet had supplied independent medical opinions that the VA had not assessed.

In some cases the BVA itself awarded the claim based on these IMOs.

It is established VA case law to even suggest that the vet or widow- in many cases-obtain their own independent medical opinion.

I have a vet whose VCAA letter stated this clearly as he needs an IMO to establish his nexus.

I have a widow who the BVA remanded so that she could get an IMO as the BVA determined her VCAA rights had been violated because VA did not suggest this.to get an IMO-

There are countless vets here at hadit over the years who could not have succeeded in their claims without IMOs from doctors who supported a full and complete medical rationale as to nexus and extent of the veteran's disability.

Even the widow Emily here-

was only able to get DIC after a decade when she provided an IMO showing her husband's venereal disease in service contributed to his heart disease that caused his death.

I find your niece's MOS as a VA employee very distressing and also it does not comply at all with her job description as a DRO:

"She has told me that I could get one, but it would not be of any value to me. She said she places no weight as she has no ideal of the medical records that the Veteran gives to the doctor.

The veteran could change his post medical records and his SMR's to read as he would like. "

The doctor has to verify they have the entire SMRS and veterans medical records.

I never met any veteran whatsoever that would even consider changing their SMR or post servuce records because that is fraud.

Where does your niece work as a DRO?

I think you did tell us before-

Her attitude is highly inappropriate as a VA employee.

It is NOT even up to her anyhow to question a IMO- that is what VA doctors do-not DROs.

The VA can award when they receive probative medical evidence of service connection.

In many cases -with a probative IMO the VA will try to find a doctor to go against the IMO.They often-however- award on the IMO-

If VA wants an additional VA opinion-he VA doctor has to give some bonafide medical rational that breaks down the IMO-

Then the VA-if they follow established VA case law- will weigh the IMO opinion for and the VA opinion against.

The Benefit of doubt and relative equipoise is supposed to kick in.

If both opinions have equal merit and weight- the vet succeeds in their claim.

I think you niece should read her own job description:

http://64.233.167.104/search?q=cache:3nC0w...us&ie=UTF-8

There is nothing in this reg that gives her the power to reject IMOs.

And I wonder how many times she defied these regs maybe regarding vets and widows right here at hadit.

You topic IMO per Dept of VA has no basis in fact-this is NOT the VA's take on IMOs:

It took me mere seconds to find a recent case at BVA to support what I stated above:

http://www.va.gov/vetapp07/files1/0706719.txt

The October 1990 VA opinion is essentially inconclusive with

respect to medical nexus. While there are certainly flaws in

Dr. Bash's opinion, as pointed out by the Board in previous

decisions, it is certainly conclusive as to medical nexus,

and it is well explained and defended with respect to the

conflicting opinions. Although Dr. Bash's opinion does not

directly address the apparent 5-year delay in the appellant's

initial infection and his episode of Bell's palsy, in the

Board's view, Dr. Bash's opinion presents a scenario that is

at least as plausible as the June 1996 and March 2000

opinions, i.e., post-service (1988-90) incurrence of Lyme

disease. The Board accordingly finds that the evidence for

and against the question of medical nexus is in approximate

balance. In such cases, the benefit of the doubt must go to

the appellant. It is therefore the Board's conclusion, based

on the evidence of record, and for the reasons and bases

discussed above, that entitlement to service connection for

Lyme disease is in order.

ORDER

Entitlement to service connection for Lyme disease is

granted.

(Dr Bash could not opine on the onset delay-this was what the BVA questioned -however-this is one of many cases at the BVA in which the medical evidence was in approximate balance for and against the claim as thus the VA awarded due to BOD and relative equipoise.

I guess if this vet had your niece as his DRO-he would not have his Service connection today)

Edited July 22, 2007 by Berta