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Getting An Independent
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Berta
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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