Dro Job Description

[Guest Berta]

The attached DRO job decription from M21 show you exactly how beneficial these reviews can be.

I have limited time but wanted to post this as I just sent it to the VARO-

for the DRO- because she did not do anything here in regards to my claim.

I figure she never read it.

DRO_Important_job_description.doc

[Berta]

And focus on the "rationale" of the IMO doctor-

I have seen VA knock down excellent opinions from real doctorss only because the IMO doctor failed to completely state their "rationale".

What they mean is what expertise allows this IMO doctor to 'rationally' render an opinion specific to the claim-

If you get a private podiatrist to state you have heart disease due to service -obviously that wont fly-

but the VA can get some VA GP to render an opinion denying you for an obvious SC condition- and they will buy that opinion over a real doc opinion-because they like it better-saves them money-

Dr. Bash, in the IMO he gave me, referenced "thousands" of MRIs of brains of "diabetics" that his professional expertise caused him to study as a radiologist and this was correlated with the clinical records of my husband's MRI brain results. He then added more for the opinion and also a ten page Curriculum Vitae-which many VA doctors can only match with their sole MD diplomas from foreign medical schools and their VA employment experience.

[jlshand]

Berta,

With all due respect. I think "rationale" refers more to the MD's reasoning behind his decision to connect a condition with ,say some symptoms.

For example, if a cardiologist opined that the coronary arteries of a patient were screwed up because of diabetes, might the VA require his "rationale " for making this connection rather than opining the arteries are diseased because of CAD?

Having said this It makes sense that the VA would give more credence toa c ardiologists analysis of herat disease than an analysis of the same condition by say, a radiologist.

BTw, if you go to the BVA decisions and search on Bash, you will come up with a number of monologues from VA people attacking his credibility to opine on so many different avenues of medicine. Makes one think they are really after him

[john999]

I think the more the doctor breaks down the rationale into small interlocking pieces the better it is for the vet. The doctor should explain the condition so that a novice (claims examiner) can understand it as some basic level. Sometimes the doctors may think they are speaking to other doctors when, in fact, they are trying to make the case to a claims examiner who has only a basic knowledge of medical issues.

[Berta]

I agree with the way you have put it- and I think VA's definition of 'rationale' depends on how they can use any of the IMOs reasoning to deny any specific claim-

They questioned the rationale of a known diabetes expert for a vet I helped-

we sent them background info on his expertise (lectures he did, stuff he had published) then they questioned his rationale as to opining on the link to the vets service.

The link in the vets SMRs was quite clear.

The VARO , in my case, is so afraid of Dr. BAsh's IMO I got, that hey didnt read it until I raised hell-

but I still await their decision on that claim-his opinion was medically way above and beyond their expert opinion-their doc used only a few chem reports- Dr. Bash had the whole record, also past SOCs, and info from the OGC and used his ability to rationally opine on the veteran's MRIs in my case.

You are right- I think VA docs worry about Dr. Bash because he reads the entire record and supports his opinons well-he cant perform miracles but certainly has helped many vets who would still be no where without his IMO. I had 2 IMOs. One was from a treating VA doctor who gave me a very brief opinion- but Dr. Bash felt it totally supported his opinion as well as my claim and he referenced this opinion within hs own.

Also the evidence I have reveals that-since the VA could not diagnose my husbands heart disease, strokes, HBP, etc- numerous medical errors were made and admitted to by VA (1151 and FTCA-1997-1998) I made the point -that he also referenced that-

it was more than likely-with past evidence of overwhelming medical errors and negligence that the VA failed to diagnose the ultimate cause of the veteran's problems- DMII due to AO.

John's point is good too- when my vet rep had conference with the VSM and DRO- the DRO said she denied because she could not understand IMOS.

(Say what?) these are the people who control our claims-

a good IMO is clear enough for anyone to understand-

how many claims did this DRO deny with valid IMOS because she couldnt read them-

We have to present a solid medical nexus and valid medical claim- and- as John said-

then deal with people without med background -who have the power to ' interpret 'C & Ps, and symptomology, and then decide the claims, and they themselves have no educational basis for their "rationale".