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Getting An Independent

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Berta

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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.

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Thanks so much I am at this point in my claim my IMO is a Neuro surgeon who had avised me that my back could not be fixed adn not to waste the money. We tried Physical theraphy but now I have the very bottom disc L5 S1 is completley gone and the other 3 aboe it are bulging also. A bad back is a house of cards.

I did want to ask is it good to also bring the last C/P exam from the VA on my back? I saw myself where the artheritis is thrown out as a result of my SC back I hope to get that and the nerve dammage caused by the bulging disc. I do want to know do I get him to see how the rating scale is used in the VA Rental put up the most complete back infromation I could use but I will e-mail him also have a good day and thanks for your work on behalf of us vets...... I just went back and read the C/P stuff I will need thanks...

Edited by oldman273
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Question on getting an IMO before I have retired from active duty.

I will be retiring from active duty in one year. I have already attended a briefing by the VA on how to accomplish all the paperwork.

My original plan is to go to a VSO (such as DAV, AMVETS etc) to have them review my medical records and assist me in completing the VA forms AND the form I will take in for my final Service Retirement Physical Exam. The items the VSO will identify will go into my final physical for additional support and documentation. Then, after this exam is completed and the paperwork is done, I plan to file (through the VSO) all the VA paperwork.

Here in the DC area, we now have the Benefit Delivery at Discharge (BDD) process whereby, if I file my 21-526 with VA 6 months before retirement, I will have my rating upon retirement (actually get get a good "estimate" within a few weeks of filing of it if I also file for VA Disability Assistance Transition Program (DTAP) rather than waiting several months after retirement

MY QUESTION IS: Should I use just the VSO to have them review my records and prepare the "disabilities" I take into my final Service Retirement Physical???...

-OR-

Should I go out and get an independent IMO to take to my retirement physical which might more adequately "connect the dots" that are throughout my career medical records?

My hope is to have everything substantiated so it can also be documented in my retirement physical paperwork. My biggest concerns are "connecting the dots" since that is often NOT done and substantiated before one retires, so I can show they are all during my period of active service.

Thanks for any advice. Happy to answer any questions.

Trying to live up to my boyscout motto of "Being Prepared!"

Cheers

Raybob

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Sorry no one had answered you yet-

I hope my post is still here as to exactly what an IMO needs to contain.

I sure admire anyone who gets their ducks in a row like you are doing-

You obviously have some documented disabilities and maybe some secondary conditions-

if this stuff is well covered in your SMRs you might not need even need an IMO.

Are you comfortable telling us what you intend to claim for comp?

You have already gone through a MEB? And do you have the results?

Or no MEB but retirement-do you mean you are a lifer or becoming a veteran after many years of service but not 15-20 years?

Edited by Berta
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What I find sickening is that Veterans have to spend "Out of Pocket", to prevail in a claim.

My record is riddled with bogus opinions, by less than competent doctors at the VA.

Some of us cannot always afford to see private doctors. Additionally, I'm having a hard time trying to find a reputable Ortho-Neuro doctor who will take the time to render a bona fide opinion (on my old hip injury, and how it contributed to a spinal condition), which dates back to the mid seventies.

I also have issues about this doctor Bash, who rapes Veterans for a IMO. You really have to wonder if he's not taking advantage of people who clearly don't have the advantage to a fair and just medical exam by a gov't. employee.

So, when you look at the big picture, we are shafted either way. If you're on your death bed, you'll prevail; until you drop dead, THEN the scumbags deny your claim. Either way, you're F*cked!

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Be sure to get a COPY of your discharge physical!!! If you file a VA claim upon retirement - the VA becomes the "keeper of your records." My husband's discharge physical has disappeared. Of course, the VA keeps telling me to check with the Records Center - and the Records Center tells me the VA has it.

The VA had it at one time, because earlier decisions refer to it. But they don't have it now.

Also - make sure you get copies of any DOCTOR's notes. When my husband asked the Base for his Medical Records, he was given a bunch of very brief computerized pages.

He went back to find out why his records were so brief. They said he hadn't asked for the Doctors Records (which are somehow different than the Medical Records)Of course, these were Post-Service Records, so it might be different.

As far as getting an IMO - you might want to consider it. This would mostly concern the severity of the disability. But it might also concern the occurance.

Or you might consider waiting and see what they come up with first - and then you will know more of what you will need in the way of an IMO.

Also make sure you keep getting treatment for Service Connected Conditions - and you might want to consider getting a non-military non-Tri-Care provider for this, if the military or Tri-care provider balks at writing any opinions for the VA.

Actually, my husband's military provider was going to write my husband an opinion letter, but then told us the base attorney told him that he couldn't.

Good luck,

Free

Question on getting an IMO before I have retired from active duty.

I will be retiring from active duty in one year. I have already attended a briefing by the VA on how to accomplish all the paperwork.

My original plan is to go to a VSO (such as DAV, AMVETS etc) to have them review my medical records and assist me in completing the VA forms AND the form I will take in for my final Service Retirement Physical Exam. The items the VSO will identify will go into my final physical for additional support and documentation. Then, after this exam is completed and the paperwork is done, I plan to file (through the VSO) all the VA paperwork.

Here in the DC area, we now have the Benefit Delivery at Discharge (BDD) process whereby, if I file my 21-526 with VA 6 months before retirement, I will have my rating upon retirement (actually get get a good "estimate" within a few weeks of filing of it if I also file for VA Disability Assistance Transition Program (DTAP) rather than waiting several months after retirement

MY QUESTION IS: Should I use just the VSO to have them review my records and prepare the "disabilities" I take into my final Service Retirement Physical???...

-OR-

Should I go out and get an independent IMO to take to my retirement physical which might more adequately "connect the dots" that are throughout my career medical records?

My hope is to have everything substantiated so it can also be documented in my retirement physical paperwork. My biggest concerns are "connecting the dots" since that is often NOT done and substantiated before one retires, so I can show they are all during my period of active service.

Thanks for any advice. Happy to answer any questions.

Trying to live up to my boyscout motto of "Being Prepared!"

Cheers

Raybob

Edited by free_spirit_etc
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Raybob

I retired just over a year ago and filed using the BDD program as well. I brought a typed list of issues for SC to my seperation "physical"--in the AF it's now just a review & dr visit. I tried to think of everything that is/was in my SMR, but missed a few. Ever had "shin splints"? Crazy, but they are a rateable condition as are flat feet and tinnitus. Who knew. Fortunately for me, the intial C&P exams caught the flat feet & tinnitus.

My point is, a list can't hurt and is a good reminder for you; if they add it to your SMR (mine was attached to the clinical notes printout for the appt) so much the better.

Do go to see a VSO before your seperation physical and get them to help you 1) prepare your claim, and 2) prepare your list of medical issues for your visit with the doctor--it's not like he's going to read your entire SMR before the appt, and the list helps him/her find the relevant entries in your SMR. Actually, your claim should contain every condition you are submitting, so making the list for the retirement physical should be easy.

Read CFR 38 pertaining to disability ratings...read the Clinicians Guide prior to the C&P exams (wish I'd had that last year).

Get your SMR before you depart on terminal leave. The the records section will release it to you to handcarry to the VA. Make a copy of everything--scan if you can--before passing to VA. Ever hospitalized? Ask for the inpatient treatment records--they may not be in the SMR.

IMO is key for service connection--but if you file for VA benefits while still on active duty under BDD it pretty much makes the case for SC. That's the big hassle...getting service connected for something that crops up 2, 10, 20 years later. The other hassle is for something chronic, but that you "sucked up" (shin splints come to mind) or blew off going back to the doctor because it was too much trouble--so, feel free to visit the doctor during the next year to get chronic conditions documented.

Good luck!

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