Medical Opinion

[steve&pat]

I found this on C&Ps & doctor statements--- Thought it might help someone--

On medical opinions--CP doesnt always top doctors opinion

For "Olsarge", "Auditory" and others, the law re what constitutes an

adequate exam by either a VA examiner at a C&P exam or a private physician's

medical opinion has changed significantly in the last few years. One main

change is that the VA can no longer reject a private doctor's opinion on the

basis that the doctor did not review (or have access to) the vet's entire VA

claims file folder. Similarly, a VA doctor's opinion will no longer be

weighted as having more probative value simply bc he/she did review the

vet's C file folder. The precedent Court case that lays it all out is:

Nieves-Rodriguez v. Peake, 22 Vet.App 295 (2008) – key holdings:

1. A medical opinion, whether VA or private, is not entitled to any weight

if it contains only data and conclusions.

2. The Board may not prefer a VA medical opinion over a private medical

opinion solely because the VA examiner reviewed the claims file.

3. It is the factually accurate, fully articulated, sound reasoning for the

conclusion, not the mere fact that the claims file was reviewed, that

contributes probative value to a medical opinion.

Just thought this info might help,

Katrina J. Eagle

Attorney at Law

The Veterans Law Office of Eagle & Wildhaber, LLP

Representing America's Veterans and Their Families

858 272 1560 (San Diego, CA) / 877 787 7207 (toll free)

www.veteranslawoffice.net

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Maybe this might help a VET---

STEVE & PAT

[carlie]

Good Post - thanks.

carlie

[retiredat44]

I wish someone could boil this down so I could understand it better... I am espeically interested as I have just recently submitted an IMO with an appeal.. it was very thorough and included tons of medical research with the exam, research, and opinion.

[carlie]

I have just recently submitted an IMO with an appeal.. it was very thorough and included tons of medical research with the exam, research, and opinion.

retired,

I hope the IMO relates everything to you and the military directly

and not just general research on the condition, in the population as a whole.

jmho,

carlie

[Berta]

I agree

.

"It is the factually accurate, fully articulated, sound reasoning for the

conclusion, not the mere fact that the claims file was reviewed, that

contributes probative value to a medical opinion. "

This means that it is the medical rationale that gives any opinion weight.

I have the criteria for getting an IMO here under that topic.

I developed this criteria from the 2 IMos I got from a neuroradiologist who also had worked for the VA (Dr. Craig C Bash).

He knew exactly what wording he needed in the IMO.

For the medical rationale part he referred directly to evidence (MRI, blood chem readings, etc, etc) and other established documents and medical records, and opined why the C & P examiner was wrong.

He used 2 top notch medical treatises to support his conclusion and enclosed a 12 page Curriculum vitae of his expertise.

My claim was to prove diabetes caused my husband's death.Diabetes never appeared once in my husband's medical; records as I claimed it had been misdiagnosed and caused the CAD and CVAs that caused his death.

One key point of his initial IMO was his statement that- as a neuro-radiologist he had read thousands of MRIs of diabetics and his opinion as to the extent and type of my husbands severe brain trauma and lesions were based on what his experience had found-brain ischemia had been caused by high glucose (ie diabetes).

They didnt reject his first IMO-they never read it- so after getting a VA opinion I asked him for additional opinion to knock that one down.

I also had a free brief statement in email from a former VA doctor-it tooks many months to locate him and Dr. Bash contacted him to put his statement on his letterhead and it was incorporated into the final IMO.

The BVA awarded my claim, and gave great weight to the IMOs from Dr. Bash because of his meticulous medical rationale and also they gave great weight to the brief statement from the other doctor-the former VA Neuro-It was only 2 sentences but it was dynamite.It was considered a probative IMO because of the circumstances of the claim.

[halos2]

So nice of you berta to break the contents of messages down for those not as familiar with the VA lingo, processes and make it readible for new one's here. Very generous of your time. Thank you.

[free_spirit_etc]

Ah... This is good news. B)

I may go ahead and see about getting an IMO without getting the rest of the C-file. Ironically, what I have not been able to get from the VA is a copy of my husband's discharge physical (They say it doesn't exist) and a complete copy of the VA medical opinion that was used to deny my claim.

Neither one is probably actually necessary for an IMO. But I have been worried that the VA would not want to give an IMO any weight unless the doctor could state he reviewed the entire C-file.

Free

I found this on C&Ps & doctor statements--- Thought it might help someone--

On medical opinions--CP doesnt always top doctors opinion

For "Olsarge", "Auditory" and others, the law re what constitutes an

adequate exam by either a VA examiner at a C&P exam or a private physician's

medical opinion has changed significantly in the last few years. One main

change is that the VA can no longer reject a private doctor's opinion on the

basis that the doctor did not review (or have access to) the vet's entire VA

claims file folder. Similarly, a VA doctor's opinion will no longer be

weighted as having more probative value simply bc he/she did review the

vet's C file folder. The precedent Court case that lays it all out is:

Nieves-Rodriguez v. Peake, 22 Vet.App 295 (2008) – key holdings:

1. A medical opinion, whether VA or private, is not entitled to any weight

if it contains only data and conclusions.

2. The Board may not prefer a VA medical opinion over a private medical

opinion solely because the VA examiner reviewed the claims file.

3. It is the factually accurate, fully articulated, sound reasoning for the

conclusion, not the mere fact that the claims file was reviewed, that

contributes probative value to a medical opinion.

Just thought this info might help,

Katrina J. Eagle

Attorney at Law

The Veterans Law Office of Eagle & Wildhaber, LLP

Representing America's Veterans and Their Families

858 272 1560 (San Diego, CA) / 877 787 7207 (toll free)

www.veteranslawoffice.net

- Hide quoted text -- Show quoted text

Maybe this might help a VET---

STEVE & PAT