Phoenix&Ruby

Thanks for your response. FYI VA examiner determined that the DC should be changed from DC 5202 to DC 5010-5201 was on shoulder injury - VA cited decision based on XR evidence of traumatic arthritis, none of humerus.  Meanwhile, also appealing  prior decision on gout…..so odd that they would even mention arthritis.   I read  VA made proposal to change DCs (was in Federal Register) and it looks like this DC is one that they are targeting to change.  Getting assistance to get Ortho Eval to fight it now.  Thanks.

Hi,  wanted to ask your opinion on this.  I see that you are very knowledgeable and have helped so many Vets. 

Appealing va decision on gout secondary heart transplant.  Lawyer hired to help with appeal.  Provided draft IMO letter but the doctor in an internal specialist, not endocrinologist or cardiologist or transplant doctor.  The IMO doc advised he cannot support heart only kidney.

 Feel that the IMO should address the cardiac issues, too.  Had gout diagnosed while in service. Also SMR show complaints of severe headaches, gallop beat and separation exam notes prior complaints of chest pain and tightness in chest.  IMO draft also does not provide any argument to original denial of gout made by adjudicator 20 years ago. Your recommendations?