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Getting An Independent

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Berta

Question

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 to all!! This is GREAT for preparing for my medical reviews and paperwork. I attended a brief by the VA which was excellent and they went over how best to complete the paperwork... I think I may go a couple more times to make sure I get it all accurate. Also, I will be at a briefing where the DC DAV Field Service Superisor will come speak to us about how they support the process as a VSO - they office right in the VA office in downtown DC. I've already copied my medical records thru last Jan... and just need to review them to get the latest and also the stuff they have online. Also, I requested and received DVDs of my x-rays and MRIs from the hospitals I used back in San Antonio the last 3 years. Trying to do my homework, and all of your suggestions are very helpful! Thans for all you do! Cheers, Ray

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Thanks, Berta. I am still active duty and will retire with 34 years next Spring. I have not had any MED or my retirement physical yet. I plan to get all my SMRs together (to date), go see the local DAV VSO and have them review my SMRs, take what they write down in with me to my retirement physical, then get the results from that and update/prepare my VA 21-526 forms.

Cheers

Ray

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?

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I paid for mine and so so glad I went that route. I had two VA shrinks write up opinions but they didn't know what the VA needed and the wording wasn't right. I was even going to write up the damn letter myself and just get her to sign off but thought otherwise. An IMO from an independent entity is valuable and that's why there's a fee. They know the what's needed and specialize in IMO's. Consider it an investment that will pay off 50,000% for you in the future. You got to do the dirty to sometimes get the shine.

Frank

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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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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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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I have a doc visit this Thursday for my lower back. I called about a dozen doctors regarding an IMO. Only one in my area said they could do it for $800, but I will have to save up for that because my insurance says IMOs are not covered. I agree that having to save up a lot of cash to get an IMO is just crazy.

Also, my entrance physical says nothing of back problems. However, my exit physical indicates explicitly that I have a history of back problems. Somehow, the VA could not connect the dots there...

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