ptsd Ptsd Imo Letter

[SFCTRUCKDRIVER]

ok,

hope this is the right way to do this.

for the more knowledgable of you on here, please give your opinion of this letter:

To whom it may concern,

This letter is written at the request of Mr..... who has been under treatment at this clinic since.....

Mr..... is being treated for PTSD and panic disorder with agoraphobia. This has been related to his services and combat experiences. He is currently being prescribed medication as well as pyschotherapy to help with these anxiety and mood issues.

At this point in the treatment, Mr... medications are being adjusted as this severe anxiety is limiting and interferes with his daily functioning.

call em at this number.....

The Dr is a licensed Pyschiatrist and has all those letters besides his name LOL

well,

is this a good or bad letter?

thanks

[SouthernBelle]

I'm going to try to find the IMO that my husband's doc wrote. I'll put it up here.

[SouthernBelle]

Keep in mind that this is not in VA Lingo, and the increase was denied initially, approved on request for reconsideration. I had to get a DRO with at least half a brain to read the entire letter THEN make a decision. This is what the doctor my husband sees wrote:

To Whom It May Concern:

Brian XXXXXXX is an active client at the Savannah Primary Care Clinic VA and is being treated for Post Traumatic Stress Disorder (PTSD), major depressive disorder, and panic disorder. His PTSD is related to combat from from Desert Storm. He is currently endorsing symptoms that include panic attacks several times per week, auditory hallucinations, depressed mood, anhedonia, intrusive recollections, increased startle, hypervigilance (on edge and on guard), poor concentration/focus, avoidance of war material, nightmares two to three times per week, and signifigant unprovoked irritability. His sleep and socialization are poor, and Mr. XXXXXXX often does not leave his bed. He is emotionally numb and detached with signifigant isolation. He has obsessive rituals that include rechecking doors and windows. He always sits by, or faces, doors and windows. His panic and anxiety symptoms have worsened recently. Mr. XXXXXXX suffers from spatial disorientation that requires the use of GPS and cell phone contact with his wife. He often needs directions for places commonly traveled. He also continues to report feelings of being unworthy of having healthy relationships. His insight and judgment are impaired.

Mr. XXXXXXX is unable to adequately function in a college environment. His grades are poor, and he needs tutoring help and special allocations to maintain enrollment in classes. He has had to drop several classes due to amount of time missed and inability to maintain adequate school work. Mr. XXXXXXX demonstrates severe impairment in coping skills and stress management. Social interactions are significantly impaired. Mr. XXXXXXX continues to report inability to work or adequately function in a social environment, and he is currently unemployed. His self-assessment is accurate per his most recent examination at mental health on 9/19/08. His family relations are poor, with isolation and discord. He reports no ability to form relationships outside the family unit.

Mr. XXXXXXX is currently unable to obtain, or maintain employment due to PTSD, panic, and depressive symptoms. He demonstrates severe impairment in his overall mental function, and currently not a candidate for even limited employment. Occupational and social impairment are severe. Prognosis is poor due to the severity of symptoms and the chronic course of the illness. He is appropriate for 70-100% disability related to work function. (He has been compliant with both therapy and medication treatment, and is motivated for continuation of both.)

[Stretch]

Don't get discouraged SFC. I know you are trying hard to get help. There are others that will help. Your letter has the elements needed. Simple, is right that the elements need to consider more detail. There are others that can/will be more specific.

There are also other Post condidering IMO's. Use the Search engine.

I know you have the stressors needed in relationship to combat that you have stated. Another issue that you should explore is 1154 . It is also on this site, and you will have to use the search engine. This will help with stressor.

I got lucky and found it. Some of the links might not work as it is an old post. There is other Hadit infromation on this topic. Use the search engine.

http://www.hadit.com/forums/index.php?show...281&hl=1154

[Berta]

Getting an Independent Medical Opinion:

Independent Medical Opinions can often be the only way a veteran or widow can succeed on a VA claim.

Opinions obtained from private treating doctors are often free yet most independent medical opinions are needed from doctors with full expertise in the field of the disability can be very costly.

However an award can easily absorb this cost with a few comp checks or the increases in comp that the claimant might never obtain without an IMO.

A Valid IMO must contain the following:

The doctor must have all medical records available and refer to them directly in the opinion.

In cases involving an in-service nexus- the doctor needs to read and refer to the SMRs.

Also the doc needs to have all prior SOC decisions from VA particularly those referencing any VA medical opinions or a copy of the actual C & P results.

The doctor should define their medical expertise as to how their background makes their opinion valid.

In other words a psychiatrist cannot really opine on a cardiovascular disease.

An internist cannot really opine on a depression claim.

The doctor must have some valid medical expertise that makes his/her IMO valid.

The doctor should state their opinion in terms of “as least as likely as not”, or “More than likely” as to the present disability and the nexus to the veteran’s service medical records or other SC disabilities, if the medical evidence warrants them to agree with the claim.

They should then refer to specific medical evidence to support their conclusion.

They should rule out any other potential etiology if they can-but for service as causing the disability.

They should briefly quote from and cite any established medical principles or treatises that support their opinion.

They should point out any discrepancies in any VA examiner’s opinion-such as the VA doctor not considering pertinent evidence of record in the veteran’s SMRs or Clinical record.

They should fully provide medical rationale to rebutt anything that is not medically sound nor relevant or appropriate in the VA doctor’s opinion.

They should attach a full Curriculum Vitae if possible or list their expertise within the opinion and tell VA of any special medical background they have that also makes their opinion valid. (For example, how long they have treated patients with the same disability, any articles they have written, or symposiums attended etc,)

It helps considerably to identify pertinent documents in your SMRs and medical records with easily seen labels as well as to list and identify these specific documents in a cover letter that requests the medical opinion.

A good IMO doctor reads everything you send but this makes it a little easier for them to prepare the IMO as to referencing specific records.

Send the VA and your vet rep copies of the signed IMO.

And make sure your rep sends them a 21-4138 in support of it- you also- can send this form (available at the VA web site) as a cover letter highlighting this evidence.

PS- Mental disabilities- make sure the doctor states that you are competent to handle your own funds- otherwise, if a big retro award is due-the VA might attempt to declare you incompetent and it takes times to find and have the VA approve of a payee.

(Unless the CIB,CAR, or PH is on the DD 214-veterans will have to prove their stressor in service for PTSD claims.)

[George Patton]

ok,

hope this is the right way to do this.

for the more knowledgable of you on here, please give your opinion of this letter:

To whom it may concern,

This letter is written at the request of Mr..... who has been under treatment at this clinic since.....

Mr..... is being treated for PTSD and panic disorder with agoraphobia. This has been related to his services and combat experiences. He is currently being prescribed medication as well as pyschotherapy to help with these anxiety and mood issues.

At this point in the treatment, Mr... medications are being adjusted as this severe anxiety is limiting and interferes with his daily functioning.

call em at this number.....

The Dr is a licensed Pyschiatrist and has all those letters besides his name LOL

well,

is this a good or bad letter?

thanks

This letter means nothing to me. If you do not have a confirmed stressor, you will not be service connected. In most cases, the physician is repeating what the patient has said. Has the examiner reviewed your SMR's? What medals do you have? If no medals, does your SMRS show you were exposed to a traumatic event while in the service? What is severe anxiety and in what way does the mental illness limit you socially and occupationally? Are you employed, if so, do you get along with your co=workers? Do you have any friends that you spend time with? Are there any s/i or h/i delusions or hallucinations? How many panic attacks per week / month? The physician can give as many opinions as he or she wants, but we are going to examine the entire c-folder to determine if there was a stressor. It is always best to have a physician examine all the evidence and then write a letter.

George

[Pete53]

I really do not understand how a lay person can even think about writing a Medical Opinion for an MD.

If its an MD he should write their own. Providing the ratings criteria and copies of your Medical Records would help.