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Why Some Imos Are Not Competent Medical Evidence

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Guest Morgan


Thought this might help in our discussions about IMOs that don't seem to be read or considered:


The Board cannot make its own independent medical determination, and it must

have plausible reasons, based upon medical evidence in the record, for favoring one medical opinion over another. Evans; Rucker v. Brown, 10 Vet. App. 67, 74 (1997).

With regard to medical evidence, an assessment or opinion by a health care provider is never conclusive and is not entitled to absolute deference. Indeed, the courts have provided guidance for weighing medical evidence. They have held, for example, that a postservice reference to injuries

sustained in service, without a review of service medical records, is not competent medical evidence. Grover v. West, 12 Vet. App. 109, 112 (1999). Further, a bare conclusion, even one reached by a health care professional, is not probative without a factual predicate in the record. Miller v. West, 11 Vet. App. 345, 348 (1998). In addition, an examination that does not take into account the records of prior medical treatment is neither thorough nor fully informed. Green v. Derwinski, 1 Vet. App. 121, 124 (1991). A bare transcription of lay history, unenhanced by additional comment by the transcriber, is not competent medical evidence

merely because the transcriber is a health care professional. LeShore v. Brown, 8 Vet. App. 406, 409 (1995). A medical opinion based on speculation, without supporting clinical data or other rationale, does not provide the required degree of medical certainty. Bloom v. West, 12 Vet. App. 185, 187 (1999). Also, a medical opinion is inadequate when unsupported by clinical evidence. Black v. Brown, 5 Vet. App. 177, 180 (1995). Finally, a medical opinion based on an inaccurate factual premise is not probative. Reonal v. Brown,

5 Vet. App. 458, 461 (1993). In sum, the weight to be accorded the various items of medical evidence in this case must be determined by the quality of the evidence and not necessarily by its quantity or source.

In this instance the Board finds that the VA examiner's opinion is more probative of the issue here. Unlike the private examiner, who generally offered an opinion without clinical data or other rationale, the VA examiner reviewed the veteran's entire claims file, and recorded a complete examination of the veteran. The VA examiner also offered rationale for the conclusion reached.

The Board notes that in January 2004, the RO sent a letter to the above noted private examiner and asked him to provide records regarding his treatment of the veteran. No response was received. As such, the Board finds that the preponderance of the evidence is against the veteran's claim for SMC for loss of use of both feet.

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Interesting stuff ---

This is what happened to me recently-

My SSOC response clearly made the point that the VA doctor had a mere few chem reports- and based her report on them stating that the veteran showed no Red Flags of diabetes in his files-the Bath VAMC -after telling me , my vet rep, and the director's secretary that all of Rods med recs would be sent back to this VARO-

(they were sent to Bath by "mistake") the VA doctor had a clerk call this local VAMC and said there was pressure to get this done- and they needed at least the chemistry reports-

I actually got the VA itself to verify (in email) that the veterans records remained at Bath for 2 months- although the VA doc does admit to only a few records were used and she couldn't read military time on one of them-

And of course she totally ignored my IMO doctor- who looked at all med recs, the VA OCG reports, past SSOC, the autopsy, and the MRI-

The VARO Manager assured my vet rep that the VA doctor would have all she needed for a proper opinion to include the IMOs I had-

This is the crap that has to stop----

She stated the veteran's medical records (which she did not have) showed no Red Flags of DMII- yet they were resplendent with 6 years of Red Flags-

My response was very strong and I point blank recounted how she was wrong at every medical point she made-

It is wrong that any claimant has to do this-

if we get an IMO (mine was $2,000) it should stave off the continuous arguments they try to pull-

It bothers me that the brief IMO statement I had from a former treating VA doctor-that was ignored too- and it was extremely important-

These VA doctors are paid by the VA- they get under pressure to write anything that will go against the claim-I think they can be censored for this via the AMA-dont know but I will find out-

I have a VACO medical report that states my husband VA care was "substandard" -I ended my response to the SSOC with a copy of that report- stating that even in his death-his medical assessment by VA remains "substandard."

This has got to stop.

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  • HadIt.com Elder

These VA C&P doctors will say anything to help deny a claim. It is bad faith and is a disgrace. You know the government has no real interest is fixing this problem since it will cost them money.

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Guest allanopie

The Board cannot make its own independent medical determination?

So far, I have no evidence from the BVA, that it won't follow the "practice" of the VARO's. But I can tell you this. The VARO's across this country don't give a damn about any rulings, president cases or laws the BVA or the suppreme court hands down. Its the VA people. They dont have to do anything, but what they choose to.

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speaking of va doctors, my first one was terrible. He even fell asleep a few times!!! the next one wouldnt help me and the third one finally did help me and was very nice to me. Shortly after he helped me i learned that he liked helping veterans and had been for many years, and didnt care what they said to him because the patient came first. Unfortunately after he diagnosed me shortly after the Va forced him to retire due to his age. Everyone there said it was because he was helping the Veterans, and yes even he told me it was the reason. What kind of va is this that the doctors will do anything to deny claims to help the patient and then when a good doctor comes along they get rid of them.... I noticed in one of the pamphlets that they give out that they say it doesnt do any good to get mad at the doctors. Gee i wonder where they got this idea from? maybe when one of the patients was tired of getting the shaft from one of them. The first one i had didnt even look at the notes from the other ones and then started to attribute my past experiences with the other ones to a mental condition. I felt like coming over the table and showing him how it felt to where his ass for a hat but, we cant do that or our claim might get pushed by the wayside or worse. The VA has us right where they want us. Im glad that this site is around to steer us in the right direction as to what we can do when they are being all they can be to stop us from receiving our claims.

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Yeah- and as long as the VA signs these C & P docs paychecks-

they will most likely often write up a C & P to go against the vet==

I can't stress this enough-

when you get some C & P crapola in an SOC -you are accepting whatever you do not argue against-

I just broke down my fifth personal VA so called "expert" medical opinion- over the decade of my claims-

I am sorry you have to do this-

In my case the VA ignored my IMos but this VA opinion was awful and easy to knock down-

well no- not easy- but I have a wealth of medical information and knocked it down with that-

We all know medical and nursing students-

or at least could contact them through a local newspaper-

if a vet cannot afford a good IMO- I see nothing wrong with having someone with a medical background-like a med student- for a small fee to go over the SOC opinion and your med recs to attempt to break it down-

In my case the VA doc argued that my interpretation of medical symbols in the veterans file proved my case was wrong.

The VA Doc gave her own "expert" view on one sole piece if evidence from me that she used.(they have over 17 submissions of medical evidence and 2 IMOS)

I point blank stated in the SOC response that this doctor was wrong.

I added that a cryptologist/linquist from the mil had already decifered many of these records long ago (FTCA and 1151 claim award granted in great part due to that decifering)

and that I use MediLexicon and other symbiology and Abbreviation references as used in the standard medical community.

Then this doctor made significant statements proving my claim!

She also stated that wasn't sure how to read the military time on one Chem report-

her rationale was interesting but not medically sound-according to the ADA , the VA itself, and other "expert" literature-although the VA promised my vet rep (he asked fir this opinion) she would have the 2 IMOS and the complete med recs- she didnt have any of that-which I can prove-VA email confirmed that twice.

I just got a vet from one of my vet orgs who has had 4 remands- FOUR remands from the BVA-

He has very good medical evidence but has never attacked the substance of the SSOCs-

as to the medical part-

and it is medical evidence that allows an adjudicator to award the claim-

If a veteran does not attempt to attack a lousy VA med opinion or C & P result (which-in the SOC may be unlike the original report!)

the veteran is accepting this as fact.

I just had a local vet tell me that as he left a C & P exam the doctor asked if what the C & P was for!

He sent them a letter for the results-cant wait to see that.

I feel that these lousy C & Ps are reflecting the overall health care of the VA-

that is scary-

Edited by Berta
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