diabetes Getting An Independent Medical Opinion

Berta · May 2, 2007

I cannot find prior IMO posts I made as to this important criteria-

I also find I am repeating to vets what I already posted weeks ago----

This is the last time I will post this-

I copied it from what I posted yesterday here at hadit under IMO post

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Old WebBoard Name: Berta

Service Connected Disability: widow of 2 vets, 2 HD each and mother of USAF vet-my daughter

I just spent quite a bit of time looking for that post-I cannot find it-and it was fairly recent-

here it is again:

An Independent Medical Opinion from a private doctor should contain certain elements:

1. The doctor must state that he or she has reviewed the SMRs (if needed)they arent needed if presumptive disability-and all available clinical records- and in my case and sometimes others- other VA documents pertinent to the claim.

The doctor needs to have a background and expertise consistent with the claimed disability.

2. The doctor should provide a statement as to this expertise.

Such as I will use what my IMO says" I have interpreted thousands of CT and MRI scans on patients with this patient's type of disorder (meaning my husbands undiagnosed DMII) and have correlated my findings with the clinical record." (Dr. Craig BAsh)

Also he attached a 9 page Curriculum Vitae.

3. Competency: He expands here on his knowledge of VA case law and regs, as well as in the second IMO- knowledge of the VA's recent expert opinion and also states he used current medical data, conversations with me, the veteran's lay statements in the clinical VA records( such as "They are killing me- I am dying of thirst"nurses note during hospitalization etc.as well as the autopsy , MRIs, ECHO etc.

4.

Discussion: here Dr. BAsh lays out 5 specific very strong points to prove his statement that the VA doctor's statements in the SSOC were "medically inaccurate".

5.Nexus statement: He then provided the Nexus statement.

The veterans exposure to Agent Orange was confirmed and the veteran had no other etiology for DMII but for his service in Vietnam.

"It is my opinion that his demise, due to cardiovadcular disease and infarcts (meaning the strokes Rod had) was caused by his Agent Orange induced diabetes."

He then referred to his initial IMO in which he made seven additional specific points in that IMO to service connect Rod's death-he also incorporated a former VA Neurologists opinion I had obtained in support of his first IMO.

Also in both IMos he used references to medical treatises and ADA literature.

Along with these IMos I sent the VA ADA info and clear medical association of Rods heart disease and Brain trauma due to dmii-undiagnosed and untreated.

Also in my initial claim- and in anything else I submitted I clearly reminded VA that the VA already admitted to multiple incidents of malpractice that all caused Rods death and that I state that the DMII was one of those initial multiple deviations in care and it was therefore "more then likely" they failed to diagnose DMII when they failed to diagnose heart disease, strokes, and his HBP as well and did admit to that.

I also sent Dr, BAsh significant medical info regarding another issue but I intend to get a pathologist for that IMO. If needed.

My long point- and I hope this post can be found be search-

is that this is the criteria for IMOs.

A clear medical rationale for the opinion supported by medical fact and experience and a strong Nexus statement.

To add- this is the "more than likely", or "at least as likely as not" statement you need for the nexus factor.

And keep in mind -if a doctor opines that it is more then likely that your present disability is related to your service-the doctor in 99.9 case was not an eyewitness to your stressors or inservice injury etc that caused your disability.

They must fully refer to the SMRs in this statement-or to something that would show your disability is consistent with the diagnosis as due to service.

PTSD vets getting IMOs must still fully provide a stressor that can be verified unless they have PH or combat awards that denote stressor is consistent with combat-and then the VA will usually still verify the stressor.

--------------------

When thousands of Americans faced annihilation in the 1800s Chief Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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Berta

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HadIt.com Elder

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Posts: 13,150

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From: Beautiful hills of NY

Member No.: 868

Old WebBoard Name: Berta

Service Connected Disability: widow of 2 vets, 2 HD each and mother of USAF vet-my daughter

There is an IMO format here at hadit under Getting an IMO-

the nexus statement should be part of it-meaning

a good medical rationale as to why the disabilty is due to service-

--------------------

When thousands of Americans faced annihilation in the 1800s Chief Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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Find Member's Posts Apr 30 2007, 04:31 PM Post #4

Seaman

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Berta,

Would you be willing to look at an IMO to see if it contains "all the right moves" ? If you will could we do it off the forum because of all the private information.

Thanks

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Blue Original IPB 2.2 Patriot_Games (Import) header English Lo-Fi Version Time is now: 2nd May 2007 - 07:04 AM

Edited May 2, 2007 by Berta (see edit history)

Pete53 · May 2, 2007

Berta:

Thank you very much. The information is important.

Berta · May 2, 2007

Pete -someone has been moving claims posts from other forums but that dont appear in claims research-where they should be-

such as the vet who asked about a writ of mandamus in the wrong topic---

I noticed a few of my replies have disappeared lately too-

Also sometimes vets will ask a question and then return to the board days later and ask it again as they either forgot the topic or where they asked the question-and it means we have to answer all over again-

I turned my PM thing off because I sure have very limited time here as it is and also a few new members, instead of posting a question-PMed me right off the bat for one to one help-

I just deal with too many veterans issues off the board as well as school and the farm business to have time for that.

And whatever we can answer in the public forum often helps more than one vet.

I not anti social at all -just that my time is limited.

free_spirit_etc · May 3, 2007

Good info - and interesting.

Concerning the RO would couldn't read IMOs - you would think that since Diabetes has a STRONG AO connection (one of the strongest) and it is pretty much common layman knowledge that it really causes wear and tear and not nice things on ALL of your body organs and systems - it wouldn't be THAT danged hard for them to connect the dots that have already been connected for them.

I have read some of Dr. Bash's opinon excerpts. Though he uses a lot of medical evidence -- he is pretty easy to understand.

Free

I cannot find prior IMO posts I made as to this important criteria-

I also find I am repeating to vets what I already posted weeks ago----

This is the last time I will post this-

I copied it from what I posted yesterday here at hadit under IMO post
HadIt.com Elder
Group: HadIt.com Elder
Posts: 13,150
Joined: 29-March 06
From: Beautiful hills of NY
Member No.: 868
Old WebBoard Name: Berta
Service Connected Disability: widow of 2 vets, 2 HD each and mother of USAF vet-my daughter
I just spent quite a bit of time looking for that post-I cannot find it-and it was fairly recent-

here it is again:

An Independent Medical Opinion from a private doctor should contain certain elements:

1. The doctor must state that he or she has reviewed the SMRs (if needed)they arent needed if presumptive disability-and all available clinical records- and in my case and sometimes others- other VA documents pertinent to the claim.
The doctor needs to have a background and expertise consistent with the claimed disability.
2. The doctor should provide a statement as to this expertise.

Such as I will use what my IMO says" I have interpreted thousands of CT and MRI scans on patients with this patient's type of disorder (meaning my husbands undiagnosed DMII) and have correlated my findings with the clinical record." (Dr. Craig BAsh)

Also he attached a 9 page Curriculum Vitae.

3. Competency: He expands here on his knowledge of VA case law and regs, as well as in the second IMO- knowledge of the VA's recent expert opinion and also states he used current medical data, conversations with me, the veteran's lay statements in the clinical VA records( such as "They are killing me- I am dying of thirst"nurses note during hospitalization etc.as well as the autopsy , MRIs, ECHO etc.

4.
Discussion: here Dr. BAsh lays out 5 specific very strong points to prove his statement that the VA doctor's statements in the SSOC were "medically inaccurate".

5.Nexus statement: He then provided the Nexus statement.
The veterans exposure to Agent Orange was confirmed and the veteran had no other etiology for DMII but for his service in Vietnam.

"It is my opinion that his demise, due to cardiovadcular disease and infarcts (meaning the strokes Rod had) was caused by his Agent Orange induced diabetes."

He then referred to his initial IMO in which he made seven additional specific points in that IMO to service connect Rod's death-he also incorporated a former VA Neurologists opinion I had obtained in support of his first IMO.

Also in both IMos he used references to medical treatises and ADA literature.

Along with these IMos I sent the VA ADA info and clear medical association of Rods heart disease and Brain trauma due to dmii-undiagnosed and untreated.

Also in my initial claim- and in anything else I submitted I clearly reminded VA that the VA already admitted to multiple incidents of malpractice that all caused Rods death and that I state that the DMII was one of those initial multiple deviations in care and it was therefore "more then likely" they failed to diagnose DMII when they failed to diagnose heart disease, strokes, and his HBP as well and did admit to that.

I also sent Dr, BAsh significant medical info regarding another issue but I intend to get a pathologist for that IMO. If needed.

My long point- and I hope this post can be found be search-
is that this is the criteria for IMOs.

A clear medical rationale for the opinion supported by medical fact and experience and a strong Nexus statement.
To add- this is the "more than likely", or "at least as likely as not" statement you need for the nexus factor.

And keep in mind -if a doctor opines that it is more then likely that your present disability is related to your service-the doctor in 99.9 case was not an eyewitness to your stressors or inservice injury etc that caused your disability.
They must fully refer to the SMRs in this statement-or to something that would show your disability is consistent with the diagnosis as due to service.

PTSD vets getting IMOs must still fully provide a stressor that can be verified unless they have PH or combat awards that denote stressor is consistent with combat-and then the VA will usually still verify the stressor.
--------------------

When thousands of Americans faced annihilation in the 1800s Chief Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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Berta
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Find Member's Posts Apr 30 2007, 04:47 PM Post #3
HadIt.com Elder
Group: HadIt.com Elder
Posts: 13,150
Joined: 29-March 06
From: Beautiful hills of NY
Member No.: 868
Old WebBoard Name: Berta
Service Connected Disability: widow of 2 vets, 2 HD each and mother of USAF vet-my daughter
There is an IMO format here at hadit under Getting an IMO-

the nexus statement should be part of it-meaning
a good medical rationale as to why the disabilty is due to service-
--------------------

When thousands of Americans faced annihilation in the 1800s Chief Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
Full Edit
Quick Edit

noelmc
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Find Member's Posts Apr 30 2007, 04:31 PM Post #4
Seaman
Group: Seaman
Posts: 14
Joined: 27-November 06
Member No.: 1,591
Berta,
Would you be willing to look at an IMO to see if it contains "all the right moves" ? If you will could we do it off the forum because of all the private information.
Thanks

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Blue Original IPB 2.2 Patriot_Games (Import) header English Lo-Fi Version Time is now: 2nd May 2007 - 07:04 AM

Berta · May 3, 2007

Free- that is exactly what my rep said the DRO said-

that she -the DRO- could not read my IMOs-

so he claims he asked her to get a VA Medical opinion.

The subsequent SSOC stated this never happened- She (The DRO) again stated my sole evidence had been internet print outs and a VA "expert" opinion was rendered after a conference with my rep-and she referred to in the SSOC.

She learned how to read the VA opinion but she didnt understand mine?

I think my rep the week before -when I asked him to make sure she had these IMOs (actually it was 2 )

took the IM0s out of my file and 'lost' them.

After over 2 years on their POA I was finding out that my claim had been messed up from the day I filed it-this rep did not even know they held my POA and he handles the DRO reviews.

The local rep lied to him and said I was not even on their POA for 2 1/2 years.He never sent the RO or this rep confirmation that I was.

They have held my POA since 1997 and he said in Feb 2003 that I didnt have to sign anything because the POA was still in affect.

The Rep at the RO's phone call to me after the DRO conference was unexpected because I always got email from him-(after raising hell about my POA status)-no documentation of what he said-

until I got the SSOC- he shows he lied.

Now I wouldn't believe him if he told me it was dark out last night.

Believe me I will not accept this and am taking every step I can to make sure this POA-New York State Division of Veterans Affairs- doesn't pull this crap again.

Subsequent mail from the Divisions director states I could expect the same treatment with my third IMO.

I sent that info to his boss -the Governor of NY.

free_spirit_etc · May 4, 2007

Yeah..it is just amazing that it is so HARD for them to figure out with the AO and Diabetes connection you have. Diabetes is just SO hard on the body (even when it is properly diagnosed and treated). It is not like you are trying to connect something that has no medical backing.

And the VET REP thing -- Though the are really almost an arm of the VA - they are considered separate. I have seen cases where the vet gave their appeal to the vet rep who did not send it in on time -- yet the BVA considers the appeal untimely because the vet rep is not the VA -and therefore though the veteran did what THEY were supposed to do - they are denied. It would be different if you were hiring a private attorney who messed up -- but you are using someone in the interconnected system -- so it would still seem like if THEY messed up they could equitably toll --

But in your case it doesn't seem like they "messed up" - it looks very intentional..

Free

Free- that is exactly what my rep said the DRO said-
that she -the DRO- could not read my IMOs-

so he claims he asked her to get a VA Medical opinion.

The subsequent SSOC stated this never happened- She (The DRO) again stated my sole evidence had been internet print outs and a VA "expert" opinion was rendered after a conference with my rep-and she referred to in the SSOC.

She learned how to read the VA opinion but she didnt understand mine?
I think my rep the week before -when I asked him to make sure she had these IMOs (actually it was 2 )
took the IM0s out of my file and 'lost' them.
After over 2 years on their POA I was finding out that my claim had been messed up from the day I filed it-this rep did not even know they held my POA and he handles the DRO reviews.

The local rep lied to him and said I was not even on their POA for 2 1/2 years.He never sent the RO or this rep confirmation that I was.
They have held my POA since 1997 and he said in Feb 2003 that I didnt have to sign anything because the POA was still in affect.
The Rep at the RO's phone call to me after the DRO conference was unexpected because I always got email from him-(after raising hell about my POA status)-no documentation of what he said-
until I got the SSOC- he shows he lied.

Now I wouldn't believe him if he told me it was dark out last night.

Believe me I will not accept this and am taking every step I can to make sure this POA-New York State Division of Veterans Affairs- doesn't pull this crap again.

Subsequent mail from the Divisions director states I could expect the same treatment with my third IMO.
I sent that info to his boss -the Governor of NY.

Berta · May 4, 2007

Free-you are right-

I received treatment under their representation that was guaranteed to hinder my claim.

They can be sued- it is the next decision on my claims (at rating board now) which will determine what I do next about them.

If my IMOs and additional medical evidence again remains ignored-I have enough evidence already to prove they are liable for that in the past -and even since I have tried to mitigate the damages-myself with resubmissions of it-

if the evidence again isnt even mentioned in the pending decision -it means the VARO does not have it - in spite of numerous assurances from my POA-that they do-

and my POA will be sued.

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