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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?
I suggest you post this in the main forum.
You need, in my opinion, an IME from a cardio doctor.
The IMO/IME forum holds the criteria for a strong IMO.
If an IMO ( probably you need an IME- a one to one medical exam)
does not follow the IMO criteria, the VA will reject it.
There is certainly a association between heart disease and gout:
But a real cardio doctor would have more updated info.
Others will help in the main forum if you post this there.