Medical Treatises

[68mustang]

Berta on 2-2-09 there was a post on medical treatises being used in support of VA claims. There was a short sample of a treatises. My question is, could we use the internet to look up treatises in support of a particular disability? If not, where else could one look for them? Thanks.

68mustang

[Ricky]

Not Berta, however, the answer to your question is yes. The problem with treatises and some RO's/raters is they view them as mere internet print outs. The reason for this is they are based upon general control groups and do not specifically address your condition.

However, they are dynamite if you can have your doc mention them in an IMO - ie base his opinion off of.

[Rockhound]

Clown Man makes a good point, although treatises do well in supporting a claim, they will carry more weight if a supporting Dr or IMO makes notice of them and as to how that particular treatises supports their opinion. I submitted two supporting treatises with my latest claim that deal directly on point with my condition, but I submitted them even though I didn't have a Dr/IMO to help support their findings and how it supported my claim.

Even if you can not get a Dr/IMO to reference your treatises, submitting them shows the rater that you have done your homework and makes it that much more difficult for them to find fault with your other evidence, so long as the treatises are on point with your claimed condition.

Rockhound Rider B)

[Berta]

When you google the condition- it is best to find an abstract or treatise from a very good medical source- I use Mayo Clinic or John Hopkins, as well as Merck, etc-

sometimes the VA itself has participated in studies that a medical doctor has written a treatise on.

These guys are right however- if the treatise is too general the VA will reject it (and even if it isnt and could fully help your claim- the VA might well ignore it anyhow).

The ADA and the AHA also provide excellent medical information at their web sites.Almost every major disability has a web site these days filled with medical information on the condition.

Any sound medical facts known in the standard medical community -which do not have to be within a detailed medical abstract or treatise -can help support a claim.

The best way to use this type of evidence is to directly associate the information with the clinical record.

For example vet claims heart disease due to his SC diabetes.He sends a medical printout from the ADA that says diabetes can lead to heart disease.He even includes that part of the VA DMII Training letter that associates heart disease to DMII. The info is not specific to this vet's claim.VA denies.

He then rebutts the denial with a copy of his clinical records showing Left ventricular hypertrophy and an ECHO that reveals narrowing arteries and also sends VA print out from Diabetoligica (one of the most extensive medical texts on the net for DMII)that states emphatically the strong association,well known in the medical community, between DMII and Left ventricular hypertrophy.The vet states to VA that there is no other potential documented etiology in his clinical records for his LVH and atherosclerosis revealed in the ECHO-except for the fact that it is secondary to his SC Diabetes.

This is a claim that VA will award if they read his internet print out and cannot find any other cause for his LVH or narrowing arteries.

Another example- my husband with 20/20 vision on his VA employment physical and on his NY driver's license showing no need for corrective glasses, suddenly began to have major visual disturbances a few months after his VA employment began.I took him to the ER at the local VAMC many times that fall with blurred vision, double vision and dizzy spells, all documented by the VA but they sent him to the audiologist (who ultimately provided -at that time-a dynamite statement-used for my present claim-one can never overloook ANYTHING in their med recs).

Long story but I had to prove a SC link from the visual problems and also the audio report to my husband's death.

The VA Eye doc gave him glasses and noted he had floaters in his vision.An EEOC case he had revealed he was unable to read the daily information needed for his job at the VA and made many errors.This was in testimony from his supervisors.He also had documentation of an accomodation request that VA ignored- for help in processing the diet cards as -in his testimony -they picked up a considerable glare- but no one else could see the glare.Also his Voc Rehab records showed he had to have a note taker at college as-even with the VA glasses-he could not see the instruction screens -they had a strong glare-

To sum this up-

all of these documented symptoms-blurred, and double vision, glare sensitivity,floaters, and the documented records of these visual problems were associated to internet printouts from the web that I used to prove the first manifestation of diabetes, from AO,misdiagnosed by VA and that contributed to my husband's death.

In other words- you have to make a case that there is a strong association between your personal med records and known facts in the medical community for a medical print out

to be probative.

I cited the following to VA in my Response to the AMC-

"The US CAVC has referenced the following decisions:

The Court notes that where

medical treatise evidence discusses relationships between conditions with

a "degree of certainty," a claimant may use such evidence to meet the

requirement for a medical nexus. See Wallin v. West, 11 Vet.App. 509,

514 (1998). On the other hand, if the medical treatise discusses the

relationship in more generic terms, the treatise is insufficient to meet

the requirement for a medical nexus. See Sacks v. West, 11 Vet.App. 314,

And

In the past the Court has recognized that sufficiently detailed

the US CAVC within No. 03-1815

Robert W. Brockhouse medical-treatise evidence may be competent to

establish facts in support of an appellant's claim. See Timberlake v.

Gober, 14 Vet.App. 122, 130-31 (2000)

As stated buy, Appellant,

v.

R. James Nicholson

Also the basic tenets of established VA case law and regulations in 38 USCS,38 C.F.R. provide:

and here I reminded them again of basic evidentiary VA case law that says they will fully consider my evidence'''''blah blah ---"

Using medical abstracts and printouts-as these guys said- has much more weight when a doctor uses them.

My IMO doc had access to 2 very expensive medical texts he referenced-and which cannot be found on the net as reference material.

[vmo]

Berta:

Good post, excellent explanation, great job!

[carlie]

Here's another source for Medical treaties.

carlie

http://www.iom.edu/CMS/3726.aspx