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Getting An Independent Medical Opinion

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Berta

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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

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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

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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.

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noelmc

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

Seaman

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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

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When my husband did research on the whole VA process for his Master's in Sociology --he really stressed the point that a lot of the problems come from no one being accountable.

So what if everything gets messed up -- no one gts held accountable for that.

What is the quote - Every snowflake in an avalanche pleads Not Guilty."

So increasing accoutability is a GREAT step in getting the process working better. If the people providing the "service" know they are responsible for their acions / or lack thereof.

The sad thing is that the actions - decisions - etc. Affect people's LIVES..

I think that gets lost in the shuffle.

That, alone, should make people at least FEEL accountable. Knowing that they are doing something that affects people's lives.

On a different note -- I also hear so many student's stories of how their advisors gave them incorrect information about which classes to take, etc. And when the error is discovered -- sometimes a couple of years later - AFTER the student spent their time and money on the mistake -- the advisors just have an "Oh welll.." attitude about it.

I keep thinking if the students could / would sue the schools / advisors for the errors -- I bet LOTS of the errors would stop REAL QUICK.

Accountability..

Free

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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Free,

I always admire everything that you post.

I really appreciate all of the excellent insight that you gave me to send to the AMC.

I would have never thought of what you stated.

Always,

Josephine

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Thank you Josephine. I am honored. I have been wondering about you - and how you are doing. I am finding I liked being a wife MUCH more than being a widow.

This VA system is hard to figure out. Just when you thnk you have figured it out - you run across one more piece of information that negates what you thought you had figured out.

My husband taught Sociology. I teach Communication. One of the Ethics of Communication that I have trouble getting my younger students to understand is:

The ethics of comunication are guided by the principle of CHOICE..... mening people have the RIGHT to information that affects the choices they make. Any communication you withhold or distort or etc. that makes someone make a different choice than they would have if they would have had the appropriate information - is unethical.

I also teach them that information IS power. People who want to empower you -- will give you the information you need to make your own decisions. People who want to control or limit your decisions (or make them FOR you) will try to withhold information).

I do find that the VA can overwhelm you with cut and paste information - but not always be upfront in giving you the information you REALLY need.

Free

Free,

I always admire everything that you post.

I really appreciate all of the excellent insight that you gave me to send to the AMC.

I would have never thought of what you stated.

Always,

Josephine

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Free,

I am so sorry about the loss of your husband and I know it it more difficult than I can imagine. I have been married for 42 years and would be lost without my other half.

He has had to put up with my mouth for years, and this VA stuff gets to him at times.

When I wrote my last letter to the AMC, there are statements all through of things that you guys and gals on hadit have made me understand.

Sometimes, you are so emotionally involved in your claim, that it takes an outsider to see the facts as they are.

Do take care and God Bless,

Josephine

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Free -your post really hit a chord with me.

Before my daughter joined the military she did a high school essay on the Veterans Administration.

She contacted the Veterans Affairs Committee and Bob Filner and other Senators and Reps replied to her questions.

Of course this essay did not fully get into the claims process although it was an overview of the disability system. It was due as the last essay for the course.

During this time I was fighting a battle with the VA-ironically that battle ended days after she graduated and left for Lackland and although she could document for the essay what the VA is supposed to do for disabled vets and widows the reality was she was seeing the failures of the system in action with me and saw it prior to that with Rod's claim.

Lack of Accountability is certainly the problem-and no oversight at all over regional offices.

Something else you said-too-

I am soon to graduate from American Military University-should need only 3 credits (a science course)

they had a policy change that I was unaware of-this January-

it meant my 70 or more credits still don't get me closer to my degree as they are saying I need 2 labs with my science courses- a policy change that is not reflected in my original student degree program-well long story-

I have fully complained to the Dean of AMU and have told them I will write to the AMU President by next friday of the results are not acceptable to me---

I was never given any student counselor at all-I had to contact the VA counselor myself but that was only for Chap 35.

I never questioned that-because I am a civilian- 99% are mil students at AMU-

and I am Honors Student-

but now I realise that the school should have contacted me immediately when this policy changed and this has adversely affected me particularily seeing that my degree is almost finished.

Schools of higher ed have Deans of the Departments, Registrars, and always a President and CEO-

they also have to have an affirmative action program- in most cases.

No student should accept an unfair assessment of their degree program that occurs to any unfair policy change etc.

I have fighting my problem over 2 labs credits-

I already have an A in the science course -need to take the exam-

they thought they could withdraw me and start me all over again and add on the lab- I said NO WAY-

2 pissant lab credits are nothing for me to earn-

the point however is- I was told I was the ONLY student affected by this policy change and as a civilian they still should have given me an advisor but never did.

There are definite steps a student needs to take when stuff like this occurs.

Otherwise they will be paying more tuition for courses that they really might not have to take.

All knowledge benefits a student- that isnt the point- it gets back to accountability of Higher Ed people who control our time and our money-

just like the VA

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Wow! It would seem like if you are THAT close that the policy change wouldn't even affect you. Usually the policies grandfather people with a certain number of credits when something changes.

But then again - knowing the answer is not required anymore for people to give you an answer. People just rattle off anything they THINK might be the answer...

And especially since you are the only one this applies to -- they might not even know.

But a point it also - that even if you appeal and win -- all the stress and time and energy they take up because they gave you the wrong information is uncalled for.

I have had so many students complain because they had to pay for classes and found out they didn't need them.

I found out that though they don't offer to refund your money (and they CAN'T refund your TIME) -- they often WILL - IF you appeal. The last student who dropped my class because she found out she didn't really need it like the advisor had told her -- I encouraged her to appeal for a refund.

She did. She later told me she got the refund -- and no one seemed impressed by her story that the advisor had misinformed her. They just acted like "Oh, well, that happens all the time - here is your money back...."

BUT -- it still COST her A LOT more -- the time she spent in an uneeded class - the fact that she now had to go ANOTHER semester because by the time she found it she was in classes she did NOT need - it was too late to get into classes she DID need....etc.

It is all uncalled for... When I went to college - advisement was not REQURED -- a student had a CHOICE -- Now they REQUIRE the student to be advised before signing up for classes -- but the advisors are NOT accountable for what they advise.

It ticks me off!

I get to take classes at the community college where I teach for $2 a credit hour. I tried to sign up for a Pottery class in the Art Department.

The advisor wouldn't approve my request because they didn't have a college transcript in my STUDENT record that showed I had Freshman English (my transcript was in my EMPLOYEE record).

I kept saying _ I TEACH here -- you should be able to ASSUME I have COMPLETED FReshman English!

The advisor kept saying -- Yeah.. but we need evidence.

I said -- I TEACH here!!

GADS! I guess their standards for pottery students were HIGHER than their standards for Instructors.

Free

Free -your post really hit a chord with me.

Before my daughter joined the military she did a high school essay on the Veterans Administration.

She contacted the Veterans Affairs Committee and Bob Filner and other Senators and Reps replied to her questions.

Of course this essay did not fully get into the claims process although it was an overview of the disability system. It was due as the last essay for the course.

During this time I was fighting a battle with the VA-ironically that battle ended days after she graduated and left for Lackland and although she could document for the essay what the VA is supposed to do for disabled vets and widows the reality was she was seeing the failures of the system in action with me and saw it prior to that with Rod's claim.

Lack of Accountability is certainly the problem-and no oversight at all over regional offices.

Something else you said-too-

I am soon to graduate from American Military University-should need only 3 credits (a science course)

they had a policy change that I was unaware of-this January-

it meant my 70 or more credits still don't get me closer to my degree as they are saying I need 2 labs with my science courses- a policy change that is not reflected in my original student degree program-well long story-

I have fully complained to the Dean of AMU and have told them I will write to the AMU President by next friday of the results are not acceptable to me---

I was never given any student counselor at all-I had to contact the VA counselor myself but that was only for Chap 35.

I never questioned that-because I am a civilian- 99% are mil students at AMU-

and I am Honors Student-

but now I realise that the school should have contacted me immediately when this policy changed and this has adversely affected me particularily seeing that my degree is almost finished.

Schools of higher ed have Deans of the Departments, Registrars, and always a President and CEO-

they also have to have an affirmative action program- in most cases.

No student should accept an unfair assessment of their degree program that occurs to any unfair policy change etc.

I have fighting my problem over 2 labs credits-

I already have an A in the science course -need to take the exam-

they thought they could withdraw me and start me all over again and add on the lab- I said NO WAY-

2 pissant lab credits are nothing for me to earn-

the point however is- I was told I was the ONLY student affected by this policy change and as a civilian they still should have given me an advisor but never did.

There are definite steps a student needs to take when stuff like this occurs.

Otherwise they will be paying more tuition for courses that they really might not have to take.

All knowledge benefits a student- that isnt the point- it gets back to accountability of Higher Ed people who control our time and our money-

just like the VA

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