I unloaded and loaded cargo plans on the flight line (Air Transportation 2T231). The audiologist that wrote my nexus letter came to the same conclusion you did; the rater didn't properly consider the IMO letter. The IMO documented the review of my STR, which the rater implies below was absent. The IMO is willing to do a rebuttal letter if the HLR is denied, which seems like the next logical step. Thank you, everyone!
The medical opinion we received from the VA Medical Center was more persuasive than your private physician's opinion because it was based on a thorough review" of your military and /or personal history and contained a more convincing rationale.