Imo Per Dept Of Va

[luvHIM]

After a response from Vike17 on another one of my threads, I decided to do a little research today. He made a statement about me perhaps needing to get an IMO or medical statement from a doctor. Well, it occurred to me that they were obviously two different things.

And, according to Department of Veteran Affairs, they are. In fact, a "legitimate" IMO is is obtained through a specified procedure. What has to be the case is that some VARO's are definitely by the book. What some of us have been describing as an IMO and having rejected may be subject to the aforemention. At any rate, the following is what I discovered today and thought I would share it with you guys here, especially those of you who have the experience of having your "IMO" rejected or ignored.

§ 3.328 lndependent medical opinions.

(a) General. When warranted by the medical complexity or controversy involved in a pending claim, an advisory medical opinion may be obtained from one or more medical experts who are not employees of VA. Opinions shall be obtained from recognized medical schools, universities, clinics or medical institutions with which arrangements for such opinions have been made, and an appropriate official of the institution shall select the individual expert(s) to render an opinion.

(;) Requests. A request for an independent medical opinion in conjunction with a claim pending at the regional office level may be initiated by the office having jurisdiction over the claim, by the claimant, or by his or her duly appointed representative. The request must be submitted in writing and must set forth in detail the reasons why the opinion is necessary. All such requests shall be submitted through the Veterans Service Center Manager of the office having jurisdiction over the claim, and those requests which in the judgment of the Veterans Service Center Manager merit consideration shall be referred to the Compensation and Pension Service for approval.

© Approval. Approval shall be granted only upon a determination by the Compensation and Pension Service that the issue under consideration poses a medical problem of such obscurity or complexity, or has generated such controversy in the medical community at large, as to justify solicitation of an independent medical opinion. When approval has been granted, the Compensation and Pension Service shall obtain the opinion. A determination that an independent medical opinion is not warranted may be contested only as part of an appeal on the merits of the decision rendered on the primary issue by the agency of original jurisdiction.

(d) Notification. The Compensation and Pension Service shall notify the claimant when the request for an independent medical opinion has been approved with regard to his or her claim and shall furnish the claimant with a copy of the opinion when it is received. If, in the judgment of the Secretary, disclosure of the independent medical opinion would be harmful to the physical or mental health of the claimant, disclosure shall be subject to the special procedures set forth in §1.577 of this chapter.

(Authority: 38 U.S.C. 5109, 5701(B)(1); 5 U.S.C. 552a(f)(3))

[55 FR 18602, May 3, 1990]

[Josephine]

But if you add more opinions that SUPPORT your claim, especially if someone will actually point out why the one agaisnt your claim is mistaken -- the weight will have to shift - unless they get more evals that are agaisnt your claim.

Free,

I was of the opinion that the little white lies that they placed into my C&P were the reasons that these quacks were calling this a personality disorder.

I looked up the Histrionic Personality Disorder :

Diagnostic criteria (DSM-IV-TR)

The Diagnostic and Statistical Manual of Mental Disorders, a widely used manual for diagnosing mental disorders, defines histrionic personality disorder as a pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. is uncomfortable in situations in which he or she is not the center of attention

2. interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

3. displays rapidly shifting and shallow expression of emotions

4. consistently uses physical appearance to draw attention to self

5. has a style of speech that is excessively impressionistic and lacking in detail

6. shows self-dramatization, theatricality, and exaggerated expression of emotion

7. is suggestible, i.e., easily influenced by others or circumstances

8. considers relationships to be more intimate than they actually are.

What do I need to do? Why did they pick this one for me????????????

Josephine

[free_spirit_etc]

Is that the diagnosis they gave you?

What report did you get from your treating physician? Did they write an opinion for you that discredited the VA opinion? I am usure why ___reported ___ as in my ___ years of treating the patient - that was never a problem.

And again, if you can get another doctor to back your favorable reports and discredit the unfavorable one - it should really help.

I would also wonder about the other people present during the eval. Did they also write reports? Did they all sign off on the report?

Free

But if you add more opinions that SUPPORT your claim, especially if someone will actually point out why the one agaisnt your claim is mistaken -- the weight will have to shift - unless they get more evals that are agaisnt your claim.

Free,

I was of the opinion that the little white lies that they placed into my C&P were the reasons that these quacks were calling this a personality disorder.

I looked up the Histrionic Personality Disorder :

Diagnostic criteria (DSM-IV-TR)

The Diagnostic and Statistical Manual of Mental Disorders, a widely used manual for diagnosing mental disorders, defines histrionic personality disorder as a pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. is uncomfortable in situations in which he or she is not the center of attention

2. interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

3. displays rapidly shifting and shallow expression of emotions

4. consistently uses physical appearance to draw attention to self

5. has a style of speech that is excessively impressionistic and lacking in detail

6. shows self-dramatization, theatricality, and exaggerated expression of emotion

7. is suggestible, i.e., easily influenced by others or circumstances

8. considers relationships to be more intimate than they actually are.

What do I need to do? Why did they pick this one for me????????????

Josephine

[Josephine]

Free,

Sure is. That is it and that is why I stay so upset about this examination. My doctor is so busy that he doesn't really have time to fool with their nonsense, but I did get this out of him.

This letter is written as an addendum to a previously written letter dated 4/4/04

It is written after I reviewed records from a compensation and pension exam by Dr. Christopher Mxxx. I have also reviewed another compensation and pension exam from 4/12/ 05, by Dr. Leh.

I have treated this patient since 1979. Moreover, I have had multiple family contacts with her mother - and with her sister through the years.

It is my considered medical opinion that she does not suffer from a personality disorder.

Some of the facts listed in the latter consultations from Dr. Leh. are patently incorrect.

True, I am not a psychiatrist, but I am a board certified physician in internal medicine.

Her primary diagnosis is that of a chronic anxiety disorder.

As for the male psychiatrist. He only received the examination, he did not sign it.

Only Dr. Leh, the lady signed it.

This is the second letter that he wrote:

To Whom it may Concern:

The above is currently undergoing an appeal process with The Board of Veterans Affairs.

The basis for my previous noted diagnosis of this veteran was based on personal interaction, history taking and physical exams going back to 1979. I am aware of the fact by reviewing all of the military records of the veteran that the patient was treated with Librium and Cafergot while in the military service 1964, presumptively for treatment of anxiety and associated migraine headaches by Dr. B. C. followed by two psychiatric consultations thus leading to her early discharge.

This veteran has been on anti-anxiety medication from 1967 to date making it plausible that I am correct. I have maintained all of the veterans civilian records from 1965 to date and her military records to date.

As I stated previously, it is my considered medical opinion that he subsequent problems with anxiety depression have been of significant magnitute to adversely affect her overall health and result in disability. It is also my considered medical opinion that those problems had their origin in service during her time of military service.

I have no specific training in Psychiatry by I have the usual level of expertise that would be expected in an internist, board certified, in 1976, and actively practicing internal medicine since that time.

I graduated from the University of Florida Medical School in 1973, was board certified in internal medicine in 1976 and have remained in adtive practice since that time.

Sincerely.

Dr. P

Josephine

Edited July 28, 2007 by Josephine

[free_spirit_etc]

Josephine,

Those seem to be very supportive of your claim. Most general doctors can and do make referrals. With you doctor being that supportive of your claim, is there someone who he can refer you to - a psychiatrist / psycologist that will do some testing and write an opinion? Someone who won't sell you out.

It would be especially strong if a psychiatrist / psyhchologist could write that they reviewed your history, and even the unfavorable exams -- and did this that and the other test - and declares that you do NOT have a personality disorder - but that you do have ____, which seems to have began in the service.

Another option to get an opinion would be to check out some couseling services that are specific to WOMEN. Especially some that provide victim services. They might be able to refer you to someone that understands the dynamics of "victimology" and can therefore use THAT expertise in their opinion.

Often, when women have been victimized - they exhibits symptoms that lots of people will blow off as "insignificant" or try to attribute to "personality flaws" of the person - rather than see them as SYMPTOMS OF the victimization.

For instance, young girls who have been sexually abused often start acting out sexually. Instead of seeing this as a SYMPTOM of sexual abuse, people will see it as the REASON she was sexually abused.

So when you have a young girl that enter the service that is presumed mentally sound - who gets grabbed by the neck and is so scared that she peed her pants -- that starts showing signs of chronic anxiety AFTER that -- you kind of have to wonder how people can try to explain it away as a "personality disorder."

Unfortunately - the more you try to convince them that it isn't a personality disorder - the more they start becoming convinced that it is one.

So you don't want the VA thinking 'Man - this lady acts nuts. The VA doc must be right." You want to find someone who can give you the right weapons to fight the battle with.

I was even wondering about some of the "second opinion" websites - that offer second medical opinions -- and drug recommendations. I am not sure how helpful they might be.

Here is a link to an online psychological service that has an online psychiatrist.

http://www.etherapistsonline.com/

Free

Free,

Sure is. That is it and that is why I stay so upset about this examination. My doctor is so busy that he doesn't really have time to fool with their nonsense, but I did get this out of him.

This letter is written as an addendum to a previously written letter dated 4/4/04

It is written after I reviewed records from a compensation and pension exam by Dr. Christopher Mxxx. I have also reviewed another compensation and pension exam from 4/12/ 05, by Dr. Leh.

I have treated this patient since 1979. Moreover, I have had multiple family contacts with her mother - and with her sister through the years.

It is my considered medical opinion that she does not suffer from a personality disorder.

Some of the facts listed in the latter consultations from Dr. Leh. are patently incorrect.

True, I am not a psychiatrist, but I am a board certified physician in internal medicine.

Her primary diagnosis is that of a chronic anxiety disorder.

As for the male psychiatrist. He only received the examination, he did not sign it.

Only Dr. Leh, the lady signed it.

This is the second letter that he wrote:

To Whom it may Concern:

The above is currently undergoing an appeal process with The Board of Veterans Affairs.

The basis for my previous noted diagnosis of this veteran was based on personal interaction, history taking and physical exams going back to 1979. I am aware of the fact by reviewing all of the military records of the veteran that the patient was treated with Librium and Cafergot while in the military service 1964, presumptively for treatment of anxiety and associated migraine headaches by Dr. B. C. followed by two psychiatric consultations thus leading to her early discharge.

This veteran has been on anti-anxiety medication from 1967 to date making it plausible that I am correct. I have maintained all of the veterans civilian records from 1965 to date and her military records to date.

As I stated previously, it is my considered medical opinion that he subsequent problems with anxiety depression have been of significant magnitute to adversely affect her overall health and result in disability. It is also my considered medical opinion that those problems had their origin in service during her time of military service.

I have no specific training in Psychiatry by I have the usual level of expertise that would be expected in an internist, board certified, in 1976, and actively practicing internal medicine since that time.

I graduated from the University of Florida Medical School in 1973, was board certified in internal medicine in 1976 and have remained in adtive practice since that time.

Sincerely.

Dr. P

Josephine

[Josephine]

Free,

I sent an email to one of the Psycologist on their staff to see if they could give me the MMPI test on line.

It is worth a try.

thanks.

Joephine

[free_spirit_etc]

Josephine,

Did you ever hear from them? Can they help?

Free

Free,

I sent an email to one of the Psycologist on their staff to see if they could give me the MMPI test on line.

It is worth a try.

thanks.

Joephine