Helping Doctor To Write A Nexus

[Capt.]

Hello All,

Ok,,,, I am going to get more IMO's from several doctors. I already have at least 3 . Most of the Hadit group know the importance of IMO's as well as myself. It is not illegal for a veteran to write an IMO for a doctor for him/her to sign as long as the doctor agrees with it and it is factual and supported by evidence/test. It is his or hers opinion. For the sake of helping me and others who will or are at some point going to get an IMO lets hear from some of you who have had success on the their SAMPLE type IMO that is PROVEN to work or has already succeeded in RO or BVA cases in the past. OR EVERYONE GET TOGETHER AND COME UP WITH A NEXUS THAT IS JUST GOING TO KNOCK THE VA OUT COLD WITH NO WIGGLE ROOM. Also the legal phraseology of the nexus with the ever important acceptable terms such as .....

1."is due to"= 100%

2."more likely than not"= greater than 50%

3."at least as likely as not"= equal or greater than 50%

WHICH ONE IS THE BEST to use for VA , RO, DRO, BVA, COVA, APPEALS.

I have used the bottom one but my IMO's have also said "AS least as likely as not" without the AT least as likely as not". Is this a legal problem and grounds for the VA to ignore IMO?

I believe this to be a great help to the Veterans and I am in the process of writing an Independent Medical Opinion (IMO) or in this case a Medical Opinion(MO) for my VA doctor and several more to sign , which they have agreed to...... I almost had heart failure when I asked and got a yes they would sign it , even when I said I would word it for them.......

OK HADIT family here it is ......plain and simple..... THE BIG GREEN LIGHT.....

SO Everyone can play this one ....what works and what is best? The Veteran writes the IMO/MO and the Doctor agrees to the wording and opinion and signs it.

Lets see what some sample letters that are indefenseable by the VA , should look like from some of the successful Vets here.

Any VA lawyers out there reading this..... PLEASE write a sample letter that will

win in the BVA / COVA Appeals process. Or for that matter even an initial decision.

Lets please try and keep this to the main points ....

Best legal phraseology of the 3 choices and why.

Sample IMOS from members here at Hadit that will propel the claim in a favorable ruling by the VA.

You can write one up that has not been submitted to the VA , so if everyone writes one we can glean and use bits and pieces and come up with one that will be great for Veterans wanting to get their IMO or even VA doctor to use.

This should be interesting and beneficial not just to me but to all Veterans.

Thanks again to our family here at Hadit.....

NEVER GIVE UP .....God Bless,,,,,,C.C.

[kw34]

Hello Berta and Josephine,,,,,Josephine that is one fine nexis....really covered all of the bases , and it shows some hard work. You had a knowledgeable and fine doctor that was a major asset to your case.

Berta some of the reasons given by the VA are:

"You submitted records showing numerous soil, groundwater, and other studies that were performed at Fort Greely, Alaska. The details of each of these studies will not be discussed."

"A statement by Dr. XXXXX dated Jan30,2006 reported , " Mr.xxxxx duties of fire fighting details, adn heavy equipment operator and being stationed at Ft. Greely put Mr. XXXX in direct contact with chemicals, agents , weapons adn materials. Dr XXXX reported he believed it was at least as likely as not that your sensory neuropathy condition is related to exposure to toxic chemicals, agents, etc during military service. Dr XXXXX fruther indicated , there is no other etiology or logical reasons for his numerous health problems and diseases and the numerous, well documented chemicals, agents including nuclear, at Ft.Greely can be the only cause tho this numerous health problems. Dr.BBBBBBB also submitted a medical opinion indicating it was likely that your neuropathy was due to your exposure to toxins during you military service. Dr. BBBBBBB indicated Ft. Greely was a test and storage site for several types of toxic materials."

" Statements from Dr. XXXXXX and other physicians regarding the casual relationship between your medical conditions and exposure to chemicals , toxins, etc., during service are based on your owon account of being exposed to these agents and or results of studies you brought in n toxic wastes to which you reported being exposed to while in the military service in the 1070's Further , the opinions are base on your reports of being stationed at Ft. Greely for 18 months working as heavy equipment operator as billeting manager for housing."

"Although your service records confirm you were stationed at Fort Greely, Alaska, your primary duties, are shown as clerk typist, and administrative specialist. In summary, the medical opinions provided are based on the premise that you had actual exposure to numerous chemicals and toxins while stationed at Fort Greely performing military duties. However this is not supported by the military records. There is no evidence showing you were exposed to any of the claimed chemicals or toxins during military service. Therefore , the medical opinions provided have no probative value since exposure to the chemicals during service is not shown by the evidence of record."

"Therefore , the medical opinions provided have no probative value since exposure to the chemical during service is not shown by the evidence of record."

This is the basic denial on all claims with " See issue 1" on all of the rest.

The nexus I have are also qualified with the same Dr. you have used Berta and another with lengthy Vitae's for both. Some of the notes are also by 2 VA docs with mention in Progress Reports.

I have a lawyer now but do not know if this is a going to be easy. My lawyer wants a notice to reconsider at DRO before my one yr deadline with appeals.

I am going to get another opinion and nexus that is going to be expensive , but hopefully this will add some more.... I just hope I can outlast these paper shredding rascals........by the way my lawyer said my SMR's are missing some records....... whatever that means.

Thanks for all of your help Berta and Josephine , John and Cowgirl and Tbird ....this hopefully will show other veterans what to be prepared for and how to fight the battle with a broken system. NEVER GIVE UP.... God Bless, C.C.

Capt,

No expert but just offering some advice I hope can help. In the USAF I have two secondary AFSC (MOS in the Army) maybe your DD-214 is not updated to show your primary duty position at that you held at the particular time. We had cut training where we did additional duties that I am not sure if the additional training was documented anywhere except training records. I remember admin troops working as cops when there were shortfalls. Like Berta said you can spend a million dollars but if the official documents say you were working in the orderly room and not civil engeneering from what I have learned from my on experence and from my time with the experts here at hadit the va will take the path of least resistance thats denial. Whatever document that you can produce that can show your secondary MOS was heavy equipment operator in my humble opinion might be where you should start and save your self some money.

kw34

[Capt.]

Hello KW,,,,thank your for your reply and yes I have not only 2 buddy statements noting that I was stationed later at Fort Greely with Post engineers heavy equipement operator but also 2 US Army certificates of Outstanding Achievment Awards for Heavy Equipment Operator and signed by the head of Post Engineers. They just ignored all that so its back at them in the NOD. Now comes the morning report request we are waiting for which will prove without a doubt....unless they shredded them. They know I operated heavy equipement ....it just let them have more stalling time to it. Nothing new with their tactics as they use it on all and I just need to keep reminding them of the evidence and the exposure. Wishing you and the family a Merry Christmas.....God Bless....C.C. NEVER GIVE UP

[Berta]

Bill- it is the proof of exposure that the VA needs to have.

I have been involved in the AO issue since 1991.

When the AO lawsuit judge first denied my husband's claim (the original lawsuit was inclusion in the Dow lawsuit for any Vietnam Veteran who had a 100% disability-regardless of nature but they denied plenty of Vietnam vets who fully fell into their own criteria)

we proved he had been exposed to AO in Ashau Valley,with his MOS, his SRB and the actual spraying maps as well as a detailed account he had given of what the AO smelled like, looked like, felt like, and what the effects on the jungles had been.It had been sprayed directly on him and a few other Marines as the planes sprayed it over the Ashau Jungle.

With these specific details Rod gave the Judge and also with a letter I wrote to the judge requesting his signed assurance Rod would never get any AO disease since the judge had determned he was not exposed-the check came in about 3 weeks.

My point is that you m,ust show by your MOS or duties that you were directly exposed to AO or any other toxins and that this caused your disabilities.

There are thousands of veterans - and certainly thousands of Blue Water Navy veterans who cannor prove direct exposure to AO and whose claims are continually denied.

Since the US Army Corp of Engineers certainly used AO on the pipeline and probably other parts of Alaska-have you written directly to them for any information they have that would show they sprayed AO when and where you were in Alaska?

I understand that the Alaksa AO vet who won his AO claim was able to provide VA with info regarding the USA Corps of Engineers usage of AO where he was in Alaska.

If your engineering and heavy equipment MOS can be proven as to time dates perhpas the USA Engineer Corps sprayed where you did this type of work.

Details of what AO was actually like to encounter have caused awards at the BVA to veterans who served outside of Vietnam.

Any other toxins would have to be identify as to what the toxin was and then how and why your MOS exposed you to this toxin.

Have you been able to tell VA exactly what toxins you were exposed to?

This might not be an AO issue but rather a specific other type of toxin that was encountered in your MOS- any fumes from burning off fuels?, any additives to the heavy equipment fuels? ?? I imagine there could be many toxins every veteran has been exposed to during their service.

Edited December 17, 2008 by Berta

[Capt.]

Hello Berta,,,,Thanks for the wonderful information. First I just sent a FOIA to the US Army Installation Management Agency and the DOD Pentagon both FOIA offices and asked for DD1532 Pest Control Summary Reports, DA Form 2785-6 Installation Natural Resources Report Par 1 Land Management and AR 420-74. These are the exact reports necessary to show what , when and where AO was used. I already have posted the valuable 1973 Report on United States Army Material Herbicide Training Conference at Hadit which shows 2 personel , one of which I knew, who were at Fort Greely and attended the Conference. There are over 118 personnel who attended this training. I would suggest that all veterans go over the roster list and read this incredible report from 1973. Once I get the reports above thru FOIA, then I will tie it in. I operated my equipement on the sites that are being remediated and specifically listed with ADEC, US ARMY Corp Engineers , BRAC. Yes I have supplied a list of the other contaminates thru ADEC and they are listed. The buddy statements even state my operating of Hvy Equipement and the right of ways, ranges, roads, burn pits, training areas , dumps and have supplied them with US army Heavy Equipment Operator Certificates and US Army Outstanding Achievment Certificates Heavy Equipment Operator.The VA is not reading these nor are the ADEC, BRAC , Engineer reports , in their words , "not open for discussion". Once I get the reports I have listed then we move forward. I also have sent a copy of my letter to both Senators and my Congressman asking them to make sure I get these reports. The numbered forms above are actually from the Training report I posted at Hadit a while back. I do not know how they will deny me these reports which will show exact dates and such. I am sure they(DOD) do not want this data out but I did list those report forms so we wait to see how they are going to "weasel" out of it. I cannot express the importance to not only myself but to all Veterans about this Training AO report as it will open many doors for others also. Berta, I really am glad to see you feeling better and you have been a huge encouragement to me , and I want to thank you for asking me the questions and supplying me with great suggestions and ideas. Wishing you and your family a Merry Christmas. God Bless, C.C. NEVER GIVE UP.

[Hoppy]

capt.

I am service connected for idiopathic angioedema triggered by light hydrocarbons. Light hydrocarbons include MEK, acetone, butyl, paints, glues, cleaners and by-products from internal combustion engines. I specifically remember that some of these chemicals were know to cause brain damage as far back as when I was in high school.

I had the director of immunology at a VA hospital who had been writing C&P's for the VA for thirty years review my SMR. Angioedema is a vascualar disease. No brain damage as of yet. However, I have read cases where the angioedema caused breathing problems that caused brain damage which was secondary SC'd.

Here are his key points. Diagnosis; Idiopathic Angioedema - Symptoms of angioedema first occurred while serving in the armed forces. The SMR was reviewed and hospital reports from Portsmouth Naval Hospital. There is no known cure. Multiple blood studies have ruled out hereditary forms and other known triggers. Symptoms observed since discharge are clearly angioedema.

He never used the phrase involving the likelihood.

In my case the DRO researched my rate which was a jet mechanic and found all the information on the types of chemicals I worked with. All I did was mention that I was exposed to these chemicals while working on jets and the DRO verified it through his own sources.

Additionally, I submitted studies from the center for disease control in Atlanta Georgia indicating that people who work with chemicals are 12 times more likely than the general population to develop my condition. I thought this was a good argument. Most of the research I found was on latex. The DRO did not mention these studies. However, if there was any question about a statistical link between my condition and the exposure to the light hydrocarbons this research targeted it. If you were not diagnosed in service then I think that statistical linkage would be about the only avenue for establishing service connection. Statistical linkage is medical evidence that is used outside the VA. I have heard of its use in recent years by the VA.

The problem I have seen with other chemical claims is that the symptoms are vague or duplicate known conditions with many causes other than exposure to the specific chemicals used in service. You really need to have a doctor address and eliminate other causes of your symptoms. I think if you were to establish the AO exposure then there might be presumptive diseases to work with. Without it you are back to a new battle for statistical linkage.

I do not feel anybody on this board can give you the complete and comprehensive attack on initial service connection without playing doctor to some degree. After all medical merit wins claims. That is the bottom line.

Edited December 21, 2008 by Hoppy

[Capt.]

Hello Hoppy ,,,,Thank you so much for the post. Actually Hoppy, you are one of the only chemical exposure vets that have expounded on "other" chemicals that can cause these diseases. I really appreciate the sharing of your claim success. ADEC has documented many chemicals including the sites I worked at "keeping open and clean". Benzene, trichloroethylene, DRO, GRO, AO, Nuclear,toluene, PCB, Xylene and possible Chemical , Biological weapons (classified). The asbestos problem has been addressed by the agencies involved and remediated and now gone so as to not pose a threat to humans. There has never been a denial by the DOD or US ARMY. They admit there was some real health issues that resulted in closure of these sites and eventually closure of the post or should I say transfer to the US Army Strategic Missle Defence Command in 1995. I do see what you are saying that it may be left to the doctor to write the correlation and not so much as a broad based , but being specific. However Dr. B said in his nexus (of which I now have 4 Dr. Nexus)that the combination of several of these contaminates of concern worked synergistic and were a result of a phleflora(sp)and caused the diseases. I realize that one chemical exposure is bad enough but if you were multiple exposed this is kinda off the chart. To think that there was that much irresponsibility in a military post is almost unbelievable. I believe that you have really connected those dots and you were fortunate to have someone at the VA that could really read and follow the 38CFR's. If you could post anything that comes to mind to add to your great post , I would appreciate it. Hoppy , Merry Christmas to you and your family.THANK YOU SO MUCH FOR THE HELP. God Bless, C.C. NEVER GIVE UP