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]

[Berta]

Jay- as a former psychology major who switched to military decision making-for degree-you are SOOOOOO RIGHT here-

Luckily AMU accepted all of my psyche class credits-

well put-one of my best friends is a psychologist-

he is from India-there was no way he was willing to became an MD.

He had enough problems studying and learning English.He sutudied in England , got here and found that Americans dont speak English like they do in England.

Even when he became clinical psychologist here in USA (and he is an excellent psychologist)

he still had to acclimate himself to the way Americans are-

Our social background here was nothing like his-he had to adapt to American ways of thought before he could affectively treat patients in a psychiatric hospital.

he is a vet too- Indian Army- calvary and sword training-

An MD- is a medical doctor- a psychologist is Phd-

big difference.

A psychiatrist is a MD.

Edited July 23, 2007 by Berta

[Josephine]

I called Mary Flynn, one of the lawyers working with the Court of Veterans Appeals and she told me according to VA regulations the Clinical Psychologist is given the same weight as the Psychaitrist.

She stated the R. O does not always follow this guideline, but they do at the BVA and the Court of Veterans Appeals.

From the way you speak of the " Psychiatrist and how the brain functions, then we can assume the " Psychiatrist knows exactly how to do " Hypnosis". The Psychologist would not be capable of doing this correct? He would not the specifiec training as the Psychiatrist?

In my eyes the " Psychiatrist" at the VAMC that I went to is no more than a puddle of xxxxxx.

I am not saying that all Psychiatrist are this way, but I quit going to them myself for they were pushing too many pills at me and we weren't working at what was causing the problems that I needed so much medication.

I have a letter typed to turn them in to the Commonwealth of Virginia Enforcement Division of the Board of License.

The " Truth is the Truth" and a "Lie is a Lie". I will not allow those two quacks to change my medical records.

I will not sit back and let them slander me.

Thanks.

Josephine

Edited July 23, 2007 by Josephine

[Jay Johnson]

I called Mary Flynn, one of the lawyers working with the Court of Veterans Appeals and she told me according to VA regulations the Clinical Psychologist is given the same weight as the Psychaitrist.

She stated the R. O does not always follow this guideline, but they do at the BVA and the Court of Veterans Appeals.

From the way you speak of the " Psychiatrist and how the brain functions, then we can assume the " Psychiatrist knows exactly how to do " Hypnosis". The Psycologist would not be capable of doing this correct?

In my eyes the " Psychiatrist" at the VAMC that I went to is no more than a puddle of xxxxxx.

I am not saying that all Psychiatrist are this way, but I quit going to them myself for they were pushing too many pills at me and we weren't working at what was causing the problems that I needed so much medication.

I have a letter typed to turn them in to the Commonwealth of Virginia Enforcement Division of the Board of License.

The " Truth is the Truth" and a "Lie is a Lie". I will not allow those two quacks to change my medical records.

We shall both loose. I will not sit back and let them slander me.

Thanks.

Josephine

This is just a misconception on how one should seek treatment in terms of mental disorders. One should only go to a psychiatrist for medicine....it is not their job to give you therapy or try to fix you through unproven psychology methods. A psychiatrist should only be assessing your problem and finding the right combination of medicines to alleviate your symptoms. However, some psychiatrists will offer therapy as well as meds, but NO insurance on earth is going to pay 10x more for therapy from a psychiatrist when they can pay 10x less for a therapist/psychologist.

This is a fundamental flaw in our medical coverage in this country because insurance will typically not pay for someone to see a psychiatrist AND a psychologist at the same time. So, most folks are left paying out of pocket for one or the other. As for my wife, we try to see her psychiatrist only for meds and as infrequently as we can to save money (every other month mostly).

Also, a psychiatrist works for YOU, not the other way around, so if you feel that one is over-medicating you and unresponsive to your complaints then fire him/her and find someone better. Every person reacts to meds differently and a good psychiatrist should be attempting to medicate you as little as possible while still having a therapeutic effect.

As for giving a psychologist the same weight as a psychiatrist - I would want to see BVA/CAVC cases that actually give two diverging opinions exactly equal weight when one is an MD and one is not. It makes no sense that any evaluating body, be it government or otherwise, would apply equal weight to two opinions that have vastly different educational backgrounds. Comparing a psychologist to a psychiatrist is like comparing george bush to eintstein:-)

Of course, that isn't to say that psychologists are idiots, but there's a reason why the average psychologist earns as much as a factory worker with a high school diploma while a psychiatrist earns 200K/year.

[Josephine]

Jay,

I don't know your age, but I am posted mine several times and yes, when I did see a Board Certified Psychiatrist in 1975, he indeed did prescribe medication for me as well as therapy.

I have the medical records to prove that he did both.

I know that insurance changes, but this is just my experience.

I do not know any other veteran that went for their first C&P with a Clinicial Psychologist who did make the diagnosis of " generalized anxiety not otherwise specified with depression" with a " More Likely than not " that this veterans anxiety began in service his rationale behind this decision.

Then before 5 months had passed being sent to a Board of two Psychiatrist for a C&P for Same.

I believe that everyone that has posted on Hadit just went for the one examination and their claim and the C&P was adjudicated by the Rating Team or a DRO.

This did not happen in my case.

The first C&P was never adjudicated.

I can find lots of cases at the BVA where the Clinical Psychologist made a ruling and the veteran was awarded service connection and some were not.

I have never seen one against the other either. Strange isn't it" I ask myself this a lot.

No rhyme or reason, they certainly did not disqualify the C&P by the Clinical Psychologist.

Josephine

Edited July 23, 2007 by Josephine

[Hoppy]

"The VA will allow a psychological diagnosis from A PHD in clinical psychology."

Hoppy,

I don't mean to be rude here, but I have a fair amount of education in this field and I think there are some misconceptions as to what a psychologist is and what education is required. A "PhD" is a doctorate in philosophy. If a psychologist has a PhD they can actually spend very little, to no, time in clinical psychology. A doctorate that emphasizes clinical psychology would be a PsyD, which many psychs have.

For ratings purposes there is a HUGE difference between a psychiatrist and a psychologist because a psychiatrist is taught the physiological basis for mental disorders and how to treat said physiological problems with pharmaceuticals. A psychologist can only make an observation of symptomology and diagnosis accordingly.

Let's put it this way - If I gave you several books on the theories of freud, erickson, piaget, etc and you spent 3 years studying them, would you really know any more about why and how something like PTSD works? Now what if I taught you how recent research in brain lateralization (how one side of the brain communicates with the other...IE - hemispheres) has shown that some forms of hallucinations and fears/anxiety could be due to one side of the brain perceiving the other as a foreign body? What if I taught you the physiological reasoning behind most disorders like elevated dopamine due to reuptake disorders between neural transmitters and how to prescribe medicine that alleviates that problem?

In other words, psychology, in general, is nothing more than "theory" that is unproven and relies heavily on subjective observations; whereas, psychiatry follows the medical model and assumes that there is a physiological basis for "mental disorders". Psychiatry is far from always being correct either, but they have FAR more education about human anatomy and how the brain works than ANY psychologist....a psychologist is nothing more than a therapist/social worker who had the time/money to go to school for 1-2 more years.

[Hoppy]

Jay,

It is not a question of rude. I just post my experiences. I was very successfull at prevailing in my claim. In so doing I reversed and had the opinions of three psychiatrists thrown in the trash. The report that trashed the psychiatrists was written by the PHD. For rating purposes the HUGE difference in my claim was made by the PHD. The PHD wrote a much more comprhensive report that was based on better research and a better understanding of the DSM. I think the important thing here is that I was awarded service connection based on the opinion of a Phd who claimed to be a clinical psychologist. Additionally, the psychiatrist was not in the VA loop to even make a diagnosis.

What I explained to you is standard operating proceedure when a veteran walks into a VA hospital and requests a diagnosis for the purpose of service connection. The VA assigns a team that includes a psychiatrist and a psychologist who has a PHD in clinical psychology. The diagnoses were made by the PHD. I was not in a PTSD program. Thus, I do not know who makes the diagnoses in those programs.

You don't have to give me any books. I have read Freud, Erickson Piaget, etc,. Additionally, I got "A"s in all those upper division theory classes. I had no real need to go to a university. My family was making way more money than a college grad by owning and operating printing businesses. However, I studied psychology because I was misdiagnosed while on active duty. Keep in mind that the disease that I am service connected for was called "angioneurotic edma" by psychiatrists for 150 years. It was listed in the DSM I, II, III as a psychiatric condition. After my discharge they changed their minds. And wouldn't you know they did not even tell me. Eventually, the psychiatrists figured out that they had the horse before the cart and dropped the diagnosis from the DSM IV. Angioedema is a medical condition.

I know at least a dozen veterans who are servcice connected for PTSD. Medication has not been the main issue in their claims. The issue in their claims was the symptoms that exsisted untreated for decdades and totally disrupted their lives. I have heard that there was a push by the VA to make PTSD veterans take medication or risk changes to their rating. I am not sure this is still going on. I do not expect that veterans who have had PTSD untreated since the Viet Nam war will be excited to hear about this. The folks I know do not trust the VA or their doctors.

The difference between the training of a PHD and a psychiatrist would have needed to be an issue in my claim before a problem would occur. Medication is not an issue in my claim. Angioedema has no known cure. Unless they cure the angioedema relieving any psychological symptoms would endanger me. The next event of angioedema could kill me. Medications can trigger angioedema. Bruce Lee (Actor) was killed by a similar reaction to medication. I have been in an ER about 20 times. Stress and hypervigelance works for me not against me. My attorney has read the medical reports and advised me not take medication until his doctors have made an assesment.

It has been a long time since I read the M-21. It was my recollection that a PHD who did their post graduate work in clinical can make a diagnosis for VA purposes. If I am wrong please post the VA reg disallowing the opinion of a PHD. The point of this post is whether or not psychiatrists have such a monopoly on the diagnostics that phd's are not allowed in the VA game.