Correct Imo Letter Or Leave It As It Is?

[georgiapapa]

Hi,

I currently have smoldering multiple myeloma. I am a "boots on the ground" Vietnam veteran so I know my multiple myeloma is one of the presumtive diseases caused by agent orange. This message is in regards to a condition which I wish to claim as secondary to multiple myeloma. I also have neuropathy in my lower extremities and my right upper extremity which has increased. As a result, I went to an orthopaedic doctor who conducted MRIs, x-rays, EMG studies, and a CT myelogram of my spine. My EMG study revealed I had "severe , axonal and demyelinating, tibial neuropathy in my right and left lower extremities." The EMG study also revealed I had "moderate, demyelinating, right ulnar neuropathy across the elbow (cubital tunnel syndrome) and moderate, demyelinating, right median neuropathy at the wrist (carpal tunnel syndrome affecting the motor and sensory components."

My orthopaedic doctor at first thought I had spinal stenosis but after reviewing the results of the CT meylogram and the other diagnostic tests stated he could not find an orthopaedic cause for my pain and neuropathy and when I asked what is causing it, he said "it is probably your myeloma but we need for you to see a neurologist to make sure."

I recently went to a neurologist who conducted a neurological evaluation and reviewed all of my tests. After conducting his evaluation and reviewing my tests, the doctor advised me that I have " a symmetrical distal polyneuropathy that is primarily sensory, slight proprioception problems and a positive Romberg which is effecting my gait. He advised me that he believed my myeloma was the cause of my pain and neuropathy. I asked if he would write me an IMO letter and I provided the sample info for him in the letter. He said he believed his report basically followed the same format but with additional info and that should be all I need. He did not act like he wanted to do anything other than his normal report. I reminded him of using the correct terms such as "more likely than not" or " as likely as not" and he indicated he would.

I just received a copy of his report which was thorough but it had what I perceived to be some problems. It was on letterhead but was a copy not an original. It also had the notation "electronically signed" instead of an original signature. In the most important part of the letter where he states the cause of my neuropathy the doctor stated "His neuropathy is most likely secondary to his dysproteinemia/smoldering multiple myeloma." He did not use the language I suggested for the letter.

QUESTION: Should I ask him to change the letter and use the term "more likely than not" or is the term "most likely" an acceptable term for the VA?

QUESTION: Should I ask for an original of the report or would a copy with an original signature suffice? NOTE: I will definitely advise him that it must have an original signature, electronically signed will not work.

Any suggestions would be appreciated. Thanks... Georgiapapa

[docforvets]

I would recommend you ask him to add the phrase "more likely than not" in place of "most likely" and ask him to sign the note in ink. With electronic medical records becoming more prevalent, it is not unusual to see the electronic signature you mention. Should take him about 5 minutes to modify, print and sign the note. He is not changing his opinion, just clarifying it for the VA.

Doc W

docforvets.com

[Pete53]

Thanks Doc that is very important

[Notorious Kelly]

GeorgiaPapa.

Better to get it right from the start instead of second-guessing for months/years.

I wrote an example letter for my PCP and she "refused to sign it" because she didn't write it.

I wasn't asking her to sign it but clearly noted it was an example letter and how important certain wording was to SSDI & the VA.

Good luck!