hypertension Individual Medical Opinion (imo)

[blueteak]

Has anyone ever requested when submitting evidence on their claim that the VBA attain an IMO for a service connection in their medical record? I am claiming for sleep apnea and there is no diagnosis in my service record for same. However there are incidences of MVP, Hypertension, Dyspnea (none currently SC or have been requested SC). Everything that I have read suggests these elements are related to Sleep Apnea but my opinion would not count as I am not a MD. Apnea was first diagnosed approx 9 yrs after discharge. Period of service was '70-'93. I'm considering asking them to obtain an IMO since I can't afford to pay a private MD for one. I have 16 days left to submit my evidence before the 60 day expiration for submission of evidence to the VBA. Thanks in advance for any input.

[Berta]

I am a little concerned by this:

"I will still have till Dec this year to send any additional evidence on the" etc

Did you send in an I-9? Didnt they ever give you a C & P?

I dont understand the 'year' part.

It is possible that a C & P doctor would in fact help SC the apnea-

but they didnt give you a C & P yet? ???

[blueteak]

donews. Thanks for the additional info.

Berta. Let me try to explain this. Hope I don't confuse you. When I received the VCAA packet, they stated I had 60 days to send in evidence before they would begin determination if I requested and that I still had up to a year from notification to send additional evidence in my case. I have not had a C&P exam for OSA and I might not considering all the info on my OSA is in my VHA record and current (not to say that they won't require a C&P anyway).

[tssnave]

Blue (and Don),

Very interesting. If requesting that the VA send out for an IMO on the nexus works for you please post and let us know. That could be very powerful information to others working their claims.

Thanks for the info and keep us posted,

TS

[free_spirit_etc]

Glad to hear you had a good experience getting an IMO from the VA. I was concerned about that. We considered asking them for one - but then when I read some of the cases - I wasn't sure.

I did see quite a few positive results from the Armed Forces Institute of Pathology. I think for MANY vets - if they actually get a real expert who will tell the truth - it works in the vets favor. But if they get one of their flunkies to do it - forget it.

I was thinking that they are allowed to pick the agency but NOT the person who issues the opinion.

Of course, if the VA is paying the agency for quite a few opinions - the agency will pick whomever keeps that money flowing sometimes.

But I HAVE seen some favorable opinions - again, if they get Good doctor's and the vet really does have an SC condition...it should be easy.

I have seen some where the C&P says one thing - and the vet's doctor says another - and they seek a third opinion through IMO. I am not sure why? With both opinions - if they can't decide between them - the benefit of the doubt should kick in.

I contacted the Armed Forces Institute of Pathology last year - but they informed me they only take cases if referred by the VA.

Free

Blueteak,

Your correct all they can do is say no, so why not ask.

I personally have been told by various people that if I request it, the VA must provide an IMO for nexus. In one of my claims I stated that if they found my evidence lacking I request that they get an IMO as to the cause of my condition.

They did send the case off to an outside doctor and he just so happened to opine that my condition was aggrivated by other service connected conditions. So it turned out in my favor thankfully. I do not know if they did this because of my request or if they got the IMO because of another reason.

But the only reg I can come up with at the moment is this one:

§ 20.901 Rule 901. Medical opinions and opinions of the General Counsel.

(a) Opinion from the Veterans Health Administration.

The Board may obtain a medical opinion from an appropriate health care professional in the Veterans Health Administration of the Department of Veterans Affairs on medical questions involved in the consideration of an appeal when, in its judgment, such medical expertise is needed for equitable disposition of an appeal.(Authority: 38 U.S.C. 5107(a))

(;) Armed Forces Institute of Pathology opinions.

The Board may refer pathologic material to the Armed Forces Institute of Pathology and request an opinion based on that material. (Authority: 38 U.S.C. 7109(a))

© Opinion of the General Counsel.

The Board may obtain an opinion from the General Counsel of the Department of Veterans Affairs on legal questions involved in the consideration of an appeal. (Authority: 38 U.S.C. 7104©)

(d) Independent medical expert opinions.

When, in the judgment of the Board, additional medical opinion is warranted by the medical complexity or controversy involved in an appeal, the Board may obtain an advisory medical opinion from one or more medical experts who are not employees of the Department of Veterans Affairs. Opinions will be secured, as requested by the Chairman of the Board, from recognized medical schools, universities, clinics, or medical institutions with which arrangements for such opinions have been made by the Secretary of Veterans Affairs. An appropriate official of the institution will select the individual expert, or experts, to give an opinion. (Authority: 38 U.S.C. 7109)

(e) For purposes of this section, the term ''the Board'' includes the Chairman, the Vice Chairman, any Deputy Vice Chairman, and any Member of the Board before whom a case is pending. (Authority: 38 U.S.C. 5107(a), 7104©, 7109) [57 FR 4109, Feb. 3, 1992, as amended at 61 FR 20453, May 7, 1996; 66 FR 38159, July 23, 2001]

§ 20.902 Rule 902. Filing of requests for the procurement of opinions.

The appellant or representative may request that the Board obtain an opinion under Rule 901 (§ 20.901 of this part). The request must be in writing. It will be granted upon a showing of goodcause, such as the identification of a complex or controversial medical or legal issue involved in the appeal which warrants such an opinion.

(Authority: 38 U.S.C. 5107(a), 7102©, 7104©,7109)

[Berta]

You responded to the VCAA Election Notice-(the 60 day thing)

Were you able to provide anything the VA said they needed- in their highlighted and underlined statements in the actual VCAA letter?

Yes- Sometimes the VA will get an IMO themselves-in addition to C & P results-I see that done in BVA cases-

but in my opinion their IMO is not an "Independent"one.

[free_spirit_etc]

Maybe I will use this regulation to request the VA NOT to pay for an IMO. ;)

I could actually build an argument on it to try to head them off at the pass - LOL

Let's see - Dr. IMO states ___. His opinion supports and clarifies the doctor notes of Dr. __ and ____, which have already been submitted with the initial claim.

This reasoning follows medically established principles in the field of cancer - as it is the same thing reported in ____., and ____, and ____ - and taught by ___ medical school, and explained by the Armed Forces Institute of Pathology in BVA decisions ___, ____, )____ and ____.

Therefore, this is such common knowledge to the medical community, and fairly common knowledge even to lay persons. As such, I am waiving my right to request an IMO paid for by the VA, under ]§ 20.901 Rule 901, as the issue at point is neither complex nor controversial - and thus does not warrant that any additional medical expertise be required.

:)

Free

§ 20.901 Rule 901. Medical opinions and opinions of the General Counsel.

(a) Opinion from the Veterans Health Administration.

The Board may obtain a medical opinion from an appropriate health care professional in the Veterans Health Administration of the Department of Veterans Affairs on medical questions involved in the consideration of an appeal when, in its judgment, such medical expertise is needed for equitable disposition of an appeal.(Authority: 38 U.S.C. 5107(a))

(;) Armed Forces Institute of Pathology opinions.

The Board may refer pathologic material to the Armed Forces Institute of Pathology and request an opinion based on that material. (Authority: 38 U.S.C. 7109(a))

© Opinion of the General Counsel.

The Board may obtain an opinion from the General Counsel of the Department of Veterans Affairs on legal questions involved in the consideration of an appeal. (Authority: 38 U.S.C. 7104©)

(d) Independent medical expert opinions.

When, in the judgment of the Board, additional medical opinion is warranted by the medical complexity or controversy involved in an appeal, the Board may obtain an advisory medical opinion from one or more medical experts who are not employees of the Department of Veterans Affairs. Opinions will be secured, as requested by the Chairman of the Board, from recognized medical schools, universities, clinics, or medical institutions with which arrangements for such opinions have been made by the Secretary of Veterans Affairs. An appropriate official of the institution will select the individual expert, or experts, to give an opinion. (Authority: 38 U.S.C. 7109)

(e) For purposes of this section, the term ''the Board'' includes the Chairman, the Vice Chairman, any Deputy Vice Chairman, and any Member of the Board before whom a case is pending. (Authority: 38 U.S.C. 5107(a), 7104©, 7109) [57 FR 4109, Feb. 3, 1992, as amended at 61 FR 20453, May 7, 1996; 66 FR 38159, July 23, 2001]

§ 20.902 Rule 902. Filing of requests for the procurement of opinions.

The appellant or representative may request that the Board obtain an opinion under Rule 901 (§ 20.901 of this part). The request must be in writing. It will be granted upon a showing of goodcause, such as the identification of a complex or controversial medical or legal issue involved in the appeal which warrants such an opinion.

(Authority: 38 U.S.C. 5107(a), 7102©, 7104©,7109)