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Private Docs Letters

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Is there a form or an outline of what my doctor must say in a letter to get secondary condtions s/c? He is willing to write it but only once. So I need to get everything in the first time.


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Guest terrysturgis

Just received today from my private Doctor. Not sure if it is perfect but it's as good an example as I can provide. Good luck!

Mr. Sturgis is a fifty-seven-year-old man with a history of type II diabetes. He has been found to have this diagnosis connected with his years of service and was diagnosed in the past with lower extremity peripheral neuropathy for the past two years. When he was evaluated by the Veterans Administrations, Dr Mohammed Mohiuddin, he was felt to have reduced muscle power and tone in his hands suggestive of upper extremity neuropathy.

On my exam, he also had about 20% loss of monofilament sensitivity in the hands bilaterally along with mild decreases in strength. Coupled with his symptoms of tingling and numbness in the hand, I think the diagnosis of upper extremity peripheral neuropathy is also appropriate.

He is one of several diabetics currently in my practice and his condition is common.


Dr ___ ______, MD

Board Certified Family Practitioner (1989 to 2005)

Terry Sturgis

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Terry- I think that is a great IMO-

because he referred to his experence as to the other patents with PN.

VA likes to say an IMO doc gives "No Rationale" for their opinion-to go against the claim.

He gave a very good rationale.

This is an important facet of IMOs- you could get an IMO from the Surgeon General of the US of A but VA probably would question even this IMO if their was no "rationale"-

Rationale-a statement as to how this specific doctor has enough background to render a probative opinion.

In the IMO I got from Dr. Bash-

He agreed that the veteran had undiagnosed diabetes in spite of symptoms and test results of same in med recs for 6 years -no diagnosis or treatment- and that the veteran's DMII (from AO-as there was no other etiology for that in med recs)caused the veteran's heart disease , brain infarctions, and death.

He stated he had, as a radiologist ,read thousands of x-rays and MRIs of diabetics and Rod's MRI results of brain were consistent with the clinical record as to the type of brain traumas and damage he had due to diabetes. He referred to autopsy and other stuff too-

point here is- he ruled out any other etiology-or reason for Rod's DMII condition but for AO(you already have an etiology established)

and then he stated his "rationale".

My vet rep felt his opinion as well as an additional one from the former treating VA neurologist should have awarded the claim-with the DRO-

the claim is with an expert VA doc-

who is trying to invent a new disease I guess-

or who is a real doctor and can readily see that vets who fast for 12 hours and have glucose over 126 are diabetic,per VA and the ADA.

Rod fasted for 456 hours (19 days in VA hospitals- paralysed throat ,no food, no water but ice chips) and had high glucose readings.

VA is looking to knock down in an IMO- the etiology factor-and also the doctor's lack of rationale.

Edited by Berta
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Thanks Everyone

I have copied some of the notes and given them to my doctor. I have already fought this same issue in Federal court. What is all seems to come down to each time. They have never heard of SHML therefore it cannot cause this many problems. It is so rare that you don't find a doc that has seen more than one. But my doc as been dealing with me for 10 years. The Nexus letter for my initial claim was written by the doc that is credited with discovering the disease. So I plan to keep fighting until 100% P&T or dead!

Gulf War vets with a diagnosis of chronic fatigue and swollen joints, and changes on MRI should get tested. We have a disporportionate number of vets in my shml support group. ALL had been mis diagnosed for years. Many were thought to have MS that didn't quite fit standard quidelines and a host of other problems.

Does anyone know how to get a new disorder added to the REGs? We have been working on gettingit added to the blue book for SSDI. But I don't seem any process for the VA. Congress maybe?


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Yes, what is SHML? My problems are thought to be post concusive syndrome/mild traumatic brain injury. I have cognitive difficulties but last MRI and CT negative. My fatigue/weakness however is at a higher level than brain injury usually produces.


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