Recieved Imo From Doc, Tell Me Your Opinions, Need Help

[krbkwb02]

"(name) is a 45 year old male with end- stage arthrosis of his right hip. I performed a right total hip arthroplasty on him 10/14/2011. He is doing well and has returned to work. He also has mild to moderate degenerative changes on his left side.

I understand he served approximately 8 years of active duty for the United States Army. Pertaining to the question of whether or not his hips are directly related to his service is not possible. However, given his underlying hip morphology,certainly his condition could have been exacerbated by the demands of his military duties. As a result, it is my opinion that his hip condition is as likely as not related to his time of service."

Though not totally a winning ticket, do you think this will help my cause? I also know that it might not be in the correct format for IMO, but it should help somewhat, correct? Should I go ahead and submit as evidence to my claim? Thanks All!

[krbkwb02]

I'm guessing a bit here but now that I have read the letter and more code, heres what I think....I filed this under a secondary condition to my right knee....thinking now its more "aggravated by service" either way I truly believe its connected.

My Doc laughed after surgery and said you have "Women's Hips" other words small for a man.....when the Doc said in him IMO letter " given his underlying hip morphology" he appears to be talking about my small hips, and given the riquors of military service, I think he means that my small hips took a beating and thus wore out more quickly than what they would have.

So then it makes me think aggravated by service...so I looked up the code...

(Authority: 38 U.S.C. 1153)

(b) Wartime service; peacetime service after December 31, 1946. Clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where the preservice disability underwent an increase in severity during service. This includes medical facts and principles which may be considered to determine whether the increase is due to the natural progress of the condition. Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service. I think its evident that the pre exsisting condition aka "abnormally small hips" underwent an "increase" in severity during service without exception

(1) The usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, including postoperative scars, absent or poorly functioning parts or organs, will not be considered service connected unless the disease or injury is otherwise aggravated by service. The IMO states that it is a likely as not

(2) Due regard will be given the places, types, and circumstances of service and particular consideration will be accorded combat duty and other hardships of service. I was an MP The development of symptomatic manifestations of a preexisting disease or injury during or proximately following action with the enemy or following a status as a prisoner of war will establish aggravation of a disability.

Either way like I said, its connected, or so I believe...but yes I know doesn't really matter what I think...lol

[Chuck75]

"Women's Hips" That's a new on on me!

Men's hips have as much variation as women's do. Perhaps the biggest obvious difference is related to child birth and the way wider hips better meet the needs. As to bone mass in general, there can be a great variation from one individual to another, even when they have similar geographic backgrounds.

Most of my ancestors were of German decent, yet tall and skinny, with "light frames", and short and wide, with "heavy frames" are still quite common in my modern relatives and descendants.

[Teac]

Just taking the letter at face value... I don't think it will help with an award. The doctor must state a couple of things in his letter. First he should have indicated if he read you active duty medical records, or not and if there was anything in them that would account for you current hip problems. Secondly, he is stating that you had 8 years in the service but that he could not state the problem was directly related to military service. He then goes on to state but his years of service could have aggravate the hips. Then he states the condition is a likely as not a cause of service.

So what you have is a statement with many contradicting opinions,

1. Can't state the hip condition is a cause of service

2. Service could have aggravated his hips.... ( which is only a guess)

3. Finally he says maybe yes maybe no...

The opinion is one of the worst that I have ever read. Aside from the fact that he doesn't really justify his opinion, he also has no way to connect it to your service since there is nothing in the statement that would leave anyone to think you hurt you hips on active duty...

In my opinion the VA is going to be looking for another medical opinion before any rating is awarded....

[john999]

As an IMO it is weak. There is just no nexus that I see. The doctor is basically saying is your hip condition might have been caused by your service. What kind of work did you do after service?

[Berta]

The IMO criteria is here and Carlie added the specific wording the IMO doc should use, that VA is familiar with, for the nexus statement:

[jbasser]

For an IMO to work one must have the following 3 things;

1. The Provider must state that the History was reviewed. (That is important) Without this the RO will only negate the IMO and counter it with their own opinion.

2. The Provider must provide an opinion in t he form of at minimum (At least as likely as likely as not)

3. The Provide must provide rationale for his opinion.

J