tdiu Tdiu Advice Request

[cowgirl]

How does a IMO describe years of 'unemployability' due to mdd? My thoughts go something like this...

" In my determination, this patient xxxxx is currently diagnosed with xxxxx. .....a VA rated condition of ....that permanently affects ,,,,, ability in getting and maintaining a job in their skill field that provides constant pay, above poverty level.The patient has been diagnosed with ------- since 19__ and continues to see me for this condition"

Any other thoughts? thanks.cg

[Berta]

It would be good to get an IMO that said it a little differently Cowgirl-'the veteran, due to her service connected disability, is unable to attain and maintain substantial and gainful employment.'Then they would give their medical rationale for that- the meds you need for SC have side affects prohibiting employment, your work history shows considerable time off for SC illness, employers statements show disability related problems with co-workers or work out put-stuff like that-It would be good too if an IMO doc can state there was continuity of symptoms and treatment during the period of unemployability consistent with the sc disability.It would be good to get an IMO that said it a little differently Cowgirl-'the veteran, due to her service connected disability, is unable to attain and maintain substantial and gainful employment.'Then they would give their medical rationale for that- the meds you need for SC have side affects prohibiting employment, your work history shows considerable time off for SC illness, employers statements show disability related problems with co-workers or work out put-stuff like that-It would be good too if an IMO doc can state there was continuity of symptoms and treatment during the period of unemployability consistent with the sc disability.

[cowgirl]

Okay, thanks Berta, need a cup of coffee? or did ice get on the line? Great to see the response twice! I get the whole concept much better now that you put it this way. Bless you! cg'up!

It would be good to get an IMO that said it a little differently Cowgirl-'the veteran, due to her service connected disability, is unable to attain and maintain substantial and gainful employment.'Then they would give their medical rationale for that- the meds you need for SC have side affects prohibiting employment, your work history shows considerable time off for SC illness, employers statements show disability related problems with co-workers or work out put-stuff like that-It would be good too if an IMO doc can state there was continuity of symptoms and treatment during the period of unemployability consistent with the sc disability.It would be good to get an IMO that said it a little differently Cowgirl-'the veteran, due to her service connected disability, is unable to attain and maintain substantial and gainful employment.'Then they would give their medical rationale for that- the meds you need for SC have side affects prohibiting employment, your work history shows considerable time off for SC illness, employers statements show disability related problems with co-workers or work out put-stuff like that-It would be good too if an IMO doc can state there was continuity of symptoms and treatment during the period of unemployability consistent with the sc disability.

[Dean]

Berta, you forgot about the more likely than not line. An IMO doctor would put ( more likely than not faster ) than a definite answer. This is also what they like to see on things. This way it is not disputed easily.

The patient X had X worng with her and it more likely than not - caused everything that you need it to say.

[Wings]

x

x

x

How much proof do I need on a claim?

VA law requires "as likely as not." Doctors are used to stating opinions to a medical certainty. That is a much higher burden of proof. Show your doctor the following chart. It may help.

continunum of causation-- burdens of proof

standard ---------- how much --------- context

as likely as not ---------at least 50% ------- verteran claims

more likely as not---------- more than 50%-----civil trials

clear and convincing------ about 75% ----civil juvenile court

to a medical certainty===about 80%------ court doctor opinion

beyond a reasonable doubt----- about 90%----criminal trials

beyond a shadow of a doubt-----100%------ignorant doctors

How do I give an opinion for nexus (relationship to a military incident?

When asked to give an opinion as to whether a condition is related to a specific incident during military service, the opinion should be expressed as follows:

1. “is due to” (100% sure)

2. “more likely than not” (greater than 50%)

3. “at least as likely as not” (equal to or greater than 50%)

4. “not at least as likely as not” (less than 50%)

5. “is not due to” (0%)"

[cowgirl]

Thanks Wings; glad you got me covered once again and always humble here at Hadit. cg!

x

x

x

How much proof do I need on a claim?

VA law requires "as likely as not." Doctors are used to stating opinions to a medical certainty. That is a much higher burden of proof. Show your doctor the following chart. It may help.

continunum of causation-- burdens of proof

standard ---------- how much --------- context

as likely as not ---------at least 50% ------- verteran claims

more likely as not---------- more than 50%-----civil trials

clear and convincing------ about 75% ----civil juvenile court

to a medical certainty===about 80%------ court doctor opinion

beyond a reasonable doubt----- about 90%----criminal trials

beyond a shadow of a doubt-----100%------ignorant doctors

How do I give an opinion for nexus (relationship to a military incident?

When asked to give an opinion as to whether a condition is related to a specific incident during military service, the opinion should be expressed as follows:

1. "is due to" (100% sure)

2. "more likely than not" (greater than 50%)

3. "at least as likely as not" (equal to or greater than 50%)

4. "not at least as likely as not" (less than 50%)

5. "is not due to" (0%)"

[jbasser]

A least as likely as not will work for the VA raters. The 50 percent puts the claim in Equipose and the Benefit of the doubt rule should Kick in. As long as there is no negative evidence.