Made An Imo Format - May I Have Your Thoughts?

[hedgey]

I figured that when going to see the Dr, it might help if I had a 'form' partly filled in and ready for them to just add a line or two and a signature. I used one I saw here or somewhere online, and adjusted it a little. I'd really like to know what anyone thinks about it:

Veteran's Name: ________________________________________________________

Veteran's File Number _______________________

Diagnosis/Condition_______________________________________________________

Practitioner's Name ______________________________________________________

Practitioner's Address ____________________________________________________

_____________________________________________________

Practitioner's Phone _____________________________________________________

In my medical opinion, the currently existing medical condition is (please check one)

__________ Related to

__________Likely related to

__________At least as likely as not related to

an injury, disease, or event occurring during the veteran's military service.

Related injury or illness occurring during service (as described by veteran or as found in records provided by veteran):

_______________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Signature and Title of Practitioner Date

Signature of Veteran Date

I don't know what's up with the spacey formatting it looks much neater in Word....

[carlie]

hedgey,

I would also suggest putting a check-box or line for,

I have reviewed the veterans Service Medical/Treatment Records.

carlie

[jerrbilly]

Hedgey, you're doing the right thing and I see that you're taking a pro-active approach to your claim. Kudos to that. Keep up with the "no quit" attitude and you will eventually win.

[kw34]

Not trying to discourge you but I think someone produced something similar but it did not go over well.

[jerrbilly]

I agree that the best nexus letters do not involve "check boxes"

[carlie]

Not trying to discourge you but I think someone produced something similar but it did not go over well.

kw,

I remember that as well.

I believe that the results will depend on the doctor.

Doctor A might feel, this is great, I can just check things off,

sign it and I have satisfied my patients request.

Doctor B might feel, who does this yahoo think they are, putting

words in my mouth, what a scammer.

Also, I feel a limited form as such does not provide an

appropriate section to show full medical rationale for their opinion.

jmho,

carlie

[ArmyTexas]

It could be very usefull if you also have treatment records from the same doctor. The records of treatment could be used to put things together. Ex: if you went to the doc for a consult. Typically in their letter to you primary care doc, they said that they reviewed all tests, X-ray, MRI's and examined the patient. Now if you can get them to look at your records from the military that will complete the Nexus.

I used a similar form like for my pending Cervical claim.

The neurosurgeon wrote his report up in non-VA language, but had everything needed to connect secondary thing. I just used the form to bridge his report with what the Va wants to hear.