“It is my opinion that this patient died earlier than he would have due to poor VA care. In addition the VA care lent assistance and caused his demise due to carelessness, negligence, error in judgment, and lack of proper skill. In addition his demise was not the usual expected-foreseeable outcome of a thoracentesis (proximate cause). Thus, his demise was not foreseeable. Furthermore, non-timely proper diagnosis/treatment allowed his new and old diseases/disabilities to continue to progress for the following reasons: “
“Dr. Bash then provided a detailed analysis of his conclusion. Dr. Bash felt that assigning a high-risk patient to a first-year resident was a demonstration of poor judgment in itself. “
2)
In this case the VA ordered a remand for the examiner as the claim information” "must be reviewed in its entirety as the VA opinion was inadequate."
In this next case Dr. Bash testified with the veteran at the BVA and had the veteran's compensation restored for recurrent pneumonia.Dr, Bash's opinion also was probative enough regarding the veteran's diverticulitis that BVA remanded for that issue.
“In an August 2006 report, Dr. CRB (Dr. Bash) wrote that he disagreed
with the November 2005 VA examiner because he felt that the
Veteran had diabetes with his reported glucose levels of 133,
132, and 117. Dr. CRB opined that the Veteran's diabetes was
caused by his exposure to Agent Orange because the Veteran
did not have other risk factors for the development of
diabetes. Dr. CRB reiterated his 2004 opinion that the
Veteran's demise was due to cardiovascular disease and
infarcts that were caused by Agent Orange-induced diabetes.”
(To clarify- these glucose readings were done while my husband was on a feeding tube with a paralysed throat and had not eaten real food in weeks.
“In an undated letter, Dr. H.R. wrote that the Veteran's blood
sugars on August 27, 1992 and August 28, 1992 were abnormally
high and should have prompted a glucose tolerance test.”
(this doctor (HR) treated Rod at VA and wanted his glucose checked further but was overruled by the VA cardio doc as within my FTCA case)It took me 8-9 months to find him in private practice.He had written DM in the med recs but someone crossed it out)
3. The weight of the competent evidence is at least in
relative equipoise on the questions of whether the Veteran
had diabetes during his lifetime that was caused by Agent
Orange exposure during his Vietnam service, and whether that
diabetes caused or contributed substantially or materially in
causing the Veteran's death.
CONCLUSION OF LAW
Resolving reasonable doubt in the appellant's favor, the
criteria for service connection for the cause of the
Veteran's death are met. 38 U.S.C.A. §§ 1310, 5107 (West
(note-I had sent significant other solid medical evidence not mentioned in the BVA decision.I even still have more evidence that VA never saw but my point is, BVA read it all but certainly focused on the IMOs.
I was competent enough to prove they malpracticed on my husband without an IMO in 1997 ,dealing with OGC and VA Central and top cardio docs in VACO but the RO found me as incompetent to opine on this newer claim. They ignored every single piece of evidence I sent to them.
A prior BVA remand I got stated:
“The Board notes that, although the appellant has submitted
multiple copies of the November 2004 and August 2006 reports
of Dr. CRB and the undated statement of Dr. HR, none have
been formally discussed by the RO in rendering any decision.”
( an NVLSP lawyer yesterday said to me that multiple errors on my past claims were egregious ones- make sure the RO acknowledges your IMO-and if not, ask them to CUE theselves on any denials that don't consider it)
This case shows how detailed Dr.Bash's IMOs can be regarding multiple complex issues.:
ORDER
Service connection for tinnitus is granted.
Service connection for malaria is granted.
Service connection for cholelithiasis with gallstone
pancreatitis, status post cholectystectomy, hepatitis,
including findings of cystic ducts lymph node with reactive
hypoplasia, is granted.
Service connection for cardiomyopathy of mildly dilated left
ventricle is granted.
The appeal for service connection for liver damage, having
been rendered moot, is denied.
Service connection for peripheral vascular disease (PVD) is
granted.
______________________
In part:
The Board finds the testimony and written opinion by Dr. Bash
to be competent and credible evidence that the Veteran had
Malaria in service that resulted in cholelithiasis with
gallstone pancreatitis, status post cholectystectomy and
hepatitis, cystic ducts lymph node with reactive hypoplasia,
cardiomyopathy, and PVD. See Guerrieri v. Brown, 4 Vet. App.
467, 470-71 (1993) (the probative value of a medical opinion
is based on the medical expert's personal examination of the
patient, knowledge and skill in analyzing the data, and
medical conclusion). The Board notes that Dr. Bash reviewed
the claims file, examined the Veteran prior to rendering his
opinions, and stated the bases for the opinions provided.
Significantly, Dr. Bash's opinions are not contradicted by
any other medical evidence or opinion. The Board notes that
the January 2008 VA examiner could not provide a nexus
opinion regarding these disabilities without resorting to
mere speculation, which the Board finds is of little
probative value. See Hayes v. Brown, 5 Vet. App. 60, 69-70
(1993) (citing Wood v. Derwinski, 1 Vet. App. 190, 192-93
(1992)). Dr. Bash has provided opinion testimony and
statements that are definitive and supported by the evidence
of record.etc”
“ORDER
Service connection for tinnitus is granted.
Service connection for malaria is granted.
Service connection for cholelithiasis with gallstone
pancreatitis, status post cholectystectomy, hepatitis,
including findings of cystic ducts lymph node with reactive
hypoplasia, is granted.
Service connection for cardiomyopathy of mildly dilated left
ventricle is granted.
The appeal for service connection for liver damage, having
been rendered moot, is denied.
Service connection for peripheral vascular disease (PVD) is
granted. “
______________________
A strong IMO is often the best investment a claimant can make, to combat a negative C & P report.
In many cases at the BVA, a good IMO will not award the claim but will trigger a BVA remand, and ,although the remand adds more time , this is far better then a BVA denial , without an IMO, that would have to be appealed to the CAVC.
The CAVC doesnt accept additional evidence so a claimant would have to raise argument and hope for a Joint CAVC remand ,to open the door for an IMO ,at that point.
Question
Berta
I found some good cases at the BVA that included IMOs from Dr. Bash, who will be the SVR guest on March 7th, ( 9 AM CT and 10 AM EST.:
1)Service connection under Sec 1151 for cause of death-granted:
http://www.va.gov/ve...es3/1127261.txt
in part:
“It is my opinion that this patient died earlier than he would have due to poor VA care. In addition the VA care lent assistance and caused his demise due to carelessness, negligence, error in judgment, and lack of proper skill. In addition his demise was not the usual expected-foreseeable outcome of a thoracentesis (proximate cause). Thus, his demise was not foreseeable. Furthermore, non-timely proper diagnosis/treatment allowed his new and old diseases/disabilities to continue to progress for the following reasons: “
“Dr. Bash then provided a detailed analysis of his conclusion. Dr. Bash felt that assigning a high-risk patient to a first-year resident was a demonstration of poor judgment in itself. “
2)
In this case the VA ordered a remand for the examiner as the claim information” "must be reviewed in its entirety as the VA opinion was inadequate."
http://www.va.gov/ve...es2/1117215.txt
“As to hypertension, the Veteran has claimed that this disability has resulted from his service-connected residuals of a transsphenoidal hypophysectomy of a pituitary tumor. In support of his claim, he has furnished an August 2005 opinion from Craig Bash, M.D., indicating such a causal nexus, and this opinion was apparently based upon a review of significant portions of the evidence of record. A March 2009 VA respiratory examination report contains an opinion suggesting the contrary; while this opinion was based upon a claims file review, the examiner did not address the contents of Dr. Bash's opinion. The Board thus finds this examination report to be inadequate and requiring an addendum. 38 C.F.R. § 3.159©(4) (2010). “
----------------------------------------------------------------------------------------------------------------------------
In this next case Dr. Bash testified with the veteran at the BVA and had the veteran's compensation restored for recurrent pneumonia.Dr, Bash's opinion also was probative enough regarding the veteran's diverticulitis that BVA remanded for that issue.
http://www.va.gov/ve...es4/1035711.txt
“ORDER
The 10 percent rating for recurrent pneumonia is restored,
effective the date of the prior reduction, June 1, 2008. The
Appeal is granted.
REMAND in part:
In its May 2009 remand, the Board instructed the RO to provide a
medical opinion as to the etiology of the Veteran's service
connection claim for diverticulitis and irritable bowel syndrome.
The Board specifically indicated that in rendering the requested
opinions the VA examiner "should comment on the February 2009
letter and testimony provided by Dr. Bash regarding the origins
of the Veteran's diverticulitis." In an October 2009
examination report and a November 2009 addendum report, a VA
examiner addressed the likelihood that the Veteran's
diverticulitis and irritable bowel syndrome were related to
service. However, the examiner did not address Dr. Bash's
testimony as requested by the Board Remand. The Court has held
that a remand confers on the veteran, as a matter of law, the
right to compliance with the remand orders. Stegall v. West, 11
Vet. App. 268, 271 (1998). On remand, the October 2009/November
2009 examiner should address Dr. Bash's testimony regarding the
origins of the Veteran's diverticulitis and irritable bowel
syndrome. “
-----------------------------------------------------------------
My BVA case:
http://www.va.gov/ve...es2/0916095.txt
In part:
“In an August 2006 report, Dr. CRB (Dr. Bash) wrote that he disagreed
with the November 2005 VA examiner because he felt that the
Veteran had diabetes with his reported glucose levels of 133,
132, and 117. Dr. CRB opined that the Veteran's diabetes was
caused by his exposure to Agent Orange because the Veteran
did not have other risk factors for the development of
diabetes. Dr. CRB reiterated his 2004 opinion that the
Veteran's demise was due to cardiovascular disease and
infarcts that were caused by Agent Orange-induced diabetes.”
(To clarify- these glucose readings were done while my husband was on a feeding tube with a paralysed throat and had not eaten real food in weeks.
“In an undated letter, Dr. H.R. wrote that the Veteran's blood
sugars on August 27, 1992 and August 28, 1992 were abnormally
high and should have prompted a glucose tolerance test.”
(this doctor (HR) treated Rod at VA and wanted his glucose checked further but was overruled by the VA cardio doc as within my FTCA case)It took me 8-9 months to find him in private practice.He had written DM in the med recs but someone crossed it out)
3. The weight of the competent evidence is at least in
relative equipoise on the questions of whether the Veteran
had diabetes during his lifetime that was caused by Agent
Orange exposure during his Vietnam service, and whether that
diabetes caused or contributed substantially or materially in
causing the Veteran's death.
CONCLUSION OF LAW
Resolving reasonable doubt in the appellant's favor, the
criteria for service connection for the cause of the
Veteran's death are met. 38 U.S.C.A. §§ 1310, 5107 (West
2002); 38 C.F.R. §§ 3.102, 3.303, 3.312 (2008).”
(note-I had sent significant other solid medical evidence not mentioned in the BVA decision.I even still have more evidence that VA never saw but my point is, BVA read it all but certainly focused on the IMOs.
I was competent enough to prove they malpracticed on my husband without an IMO in 1997 ,dealing with OGC and VA Central and top cardio docs in VACO but the RO found me as incompetent to opine on this newer claim. They ignored every single piece of evidence I sent to them.
A prior BVA remand I got stated:
“The Board notes that, although the appellant has submitted
multiple copies of the November 2004 and August 2006 reports
of Dr. CRB and the undated statement of Dr. HR, none have
been formally discussed by the RO in rendering any decision.”
( an NVLSP lawyer yesterday said to me that multiple errors on my past claims were egregious ones- make sure the RO acknowledges your IMO-and if not, ask them to CUE theselves on any denials that don't consider it)
------------------------------------------------------------------------------------------------------
This case shows how detailed Dr.Bash's IMOs can be regarding multiple complex issues.:
ORDER
Service connection for tinnitus is granted.
Service connection for malaria is granted.
Service connection for cholelithiasis with gallstone
pancreatitis, status post cholectystectomy, hepatitis,
including findings of cystic ducts lymph node with reactive
hypoplasia, is granted.
Service connection for cardiomyopathy of mildly dilated left
ventricle is granted.
The appeal for service connection for liver damage, having
been rendered moot, is denied.
Service connection for peripheral vascular disease (PVD) is
granted.
______________________
In part:
The Board finds the testimony and written opinion by Dr. Bash
to be competent and credible evidence that the Veteran had
Malaria in service that resulted in cholelithiasis with
gallstone pancreatitis, status post cholectystectomy and
hepatitis, cystic ducts lymph node with reactive hypoplasia,
cardiomyopathy, and PVD. See Guerrieri v. Brown, 4 Vet. App.
467, 470-71 (1993) (the probative value of a medical opinion
is based on the medical expert's personal examination of the
patient, knowledge and skill in analyzing the data, and
medical conclusion). The Board notes that Dr. Bash reviewed
the claims file, examined the Veteran prior to rendering his
opinions, and stated the bases for the opinions provided.
Significantly, Dr. Bash's opinions are not contradicted by
any other medical evidence or opinion. The Board notes that
the January 2008 VA examiner could not provide a nexus
opinion regarding these disabilities without resorting to
mere speculation, which the Board finds is of little
probative value. See Hayes v. Brown, 5 Vet. App. 60, 69-70
(1993) (citing Wood v. Derwinski, 1 Vet. App. 190, 192-93
(1992)). Dr. Bash has provided opinion testimony and
statements that are definitive and supported by the evidence
of record.etc”
“ORDER
Service connection for tinnitus is granted.
Service connection for malaria is granted.
Service connection for cholelithiasis with gallstone
pancreatitis, status post cholectystectomy, hepatitis,
including findings of cystic ducts lymph node with reactive
hypoplasia, is granted.
Service connection for cardiomyopathy of mildly dilated left
ventricle is granted.
The appeal for service connection for liver damage, having
been rendered moot, is denied.
Service connection for peripheral vascular disease (PVD) is
granted. “
______________________
A strong IMO is often the best investment a claimant can make, to combat a negative C & P report.
In many cases at the BVA, a good IMO will not award the claim but will trigger a BVA remand, and ,although the remand adds more time , this is far better then a BVA denial , without an IMO, that would have to be appealed to the CAVC.
The CAVC doesnt accept additional evidence so a claimant would have to raise argument and hope for a Joint CAVC remand ,to open the door for an IMO ,at that point.
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