Sam N.

Thanks for the info Vnyc! I had the same thought as you because the DBQ the examiner submitted was lacking. It talked about gout as if I was filing as a stand-alone claim, and did not address my claim in relation to my to conditions I attributed it to. Because the examiner signed the DBQ, I just assumed it was the only document he submitted, but you're saying that the examiner could have completed and signed two separate forms, with one being hidden from the VSO's view?

So a quick update to my denied claim for Gout secondary to DMII. I went to see a VSO today, and they provided me a copy of the DBQ the C&P examiner filled out. And of course the verbiage from the decision letter and the DBQ does not match. For one, it mentioned in the decision letter the the examiner opined that my claimed condition was less likely than not(less than 50 percent proximately due to or the result of either of your service connected conditions. However that statement is not written any where on the DBQ. Furthermore it is not even suggested that that is what the examiner intended it to mean. The decision letter goes on to say that my chronic kidney disease was diagnosed three years after after my gout. Again, the doctor did not write that on the DBQ, nor is the statement true at all. So needless to say I will be appealing, but I was thankful the VSO printed out the examiner's DBQ for me. So for everyone reading this, ensure you get the examiners DBQ and compare it to the decision letter to see if they properly align. Lastly the info I received from these postings were very helpful, so thank you all so much!

I am in a similar boat as you. I provided the VA with an IMO from Dr. Aniase and it was denied. Mine was gout secondary to DMII, but the VA reviewer took the word of the C&P examiner over my IMO letter. I read somewhere online that when it is a tie, one saying at least as likely and the C&P examiner saying, less as likely, that it should be ruled in favor of the veteran. Is this an incorrect assumption? Also the VA's rationale is full of mistakes. First they say there is no literature that supports Gout being secondary to DMII, but Dr. Aniase did provided literature that supports a connection between gout and DMII. Either way I will appeal this ruling.

Thanks for your input, and I do understand that my opinion does not matter much. I guess I could have made my question a little clearer, because I do realize some things are tougher to connect as secondary than others, but is there any precedent in connecting my condition as secondary with the assumption that an IMO or nexus letter will be required. I guess I am thinking that if there is clear medical evidence that that two are related, perhaps just an IMO would do, or if not then I would have to get a nexus letter or maybe even both. Either way I do appreciate your response.

Hello folks! I need your expertise! I am rated 10% for DJD of the spine under code 5237. However, I had some xrays done and it said that I have mild to moderate degenerative cervical disease. My question is since code 5237 covers spine or cervical disease, could I just submit a claim for an increase or would I need to submit a claim as secondary to DJD of the spine? Also I am having shoulder pain, and think this is somehow connected to the cervical disease, so would I submit this as secondary to cervical or secondary to DJD of the spine? Thanks in Advance! Sam N.