Seeking Feedback On Imo - Copy Attached

[free_spirit_etc]

Hi folks! I know it has been awhile! I am now scheduled for a Board Hearing and have the following IMO to support my claim. I am open to feedback to pass on to the doctor. Thanks.

Thanks for the replies. I deleted it. I didn't want to leave it up very long.

Edited August 30, 2013 by free_spirit_etc

[Philip Rogers]

I don't see anything attached.

pr

[free_spirit_etc]

I don't see anything attached.

pr

Thanks for letting me know. I thought I had attached it.

It says I don't have permission to attach that kind of file.

So I just pasted it in.

Edited August 29, 2013 by free_spirit_etc

[stillhere]

Sorry about your hubby! I read the whole thing and would say if the argument was when the cancer started that this IMO covers it very well and you should have no problem if that is what this IMO is meant to do for you.

The dr. is very forceful in his opinion but not overboard. and the back up for his opinion is very well laid out.

Stillhere

[free_spirit_etc]

Sorry about your hubby! I read the whole thing and would say if the argument was when the cancer started that this IMO covers it very well and you should have no problem if that is what this IMO is meant to do for you.

The dr. is very forceful in his opinion but not overboard. and the back up for his opinion is very well laid out.

Stillhere

Thanks stillhere! Yes. That is what the opinion is supposed to be for - to show that it is more likely than not my husband's cancer started in the service. I wanted to run it through here and see if anyone saw any red flags.

§3.303(d) “Postservice initial diagnosis of disease. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection. The presumptive provisions of the statute and Department of Veterans Affairs regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid.

We also claimed the asbestos exposure helped contribute to his lung cancer, bu this issue seems to be an easier issue to establish. I am hoping that if they don't grant it on the in service incurrence that they will remand it on the asbestos issue. They do have a medical opinion that states asbestos didn't contribute to his cancer, but that doctor stated my husband was not exposed to asbestos. I think we have enough evidence that it was more likely than not that he was exposed to asbestos, and so I think that would make the VA examiner's opinion flawed.

I did contact several doctors who promote they can do opinions on toxicology. But getting opinions on that issue would be pretty costly - and an unnecessary expense if I can show his cancer started in service. And on the asbestos issue, I have a feeling that even if I take opinions, the VA would still ask their doctors again, since their doctors had made the assumption he wasn't exposed to asbestos because he wasn't part of any medical surveillance program (that was not even in existence in the 70's)

Edited August 29, 2013 by free_spirit_etc

[free_spirit_etc]

I was also wondering if it is possible to appoint a VSO if your claim is remanded.

I contacted some VSOs from time to time - but for some reason I haven't found many that seemed supportive of my claim. I contacted one of the VET lawyers that also said that if my husband's cancer was not diagnosed in the service, and he wasn't in Vietnam, that I didn't have a claim. But I have read quite a few BVA cases where veteran's were able to prove more likely than not service incurrence with cancer, and widows were able to prove the same.

When I got my letter certifying my claim to the Board I contacted a few VSOs again. One told me that my husband's claim died with him. I know. But I filed for accrued benefits and DIC. I am not sure all the Vet Reps even know about DIC. The one in my area said they would help me - but that I didn't need to appoint them, that I should handle my claim myself.

I just find it hard to go into battle with a Vet rep that is not gung ho about representing me, or not gung ho about my claim.

But one of the doctors I wrote about writing an opinion for the asbestos issue said she works as an advisor for one of the VSOs and can - but I have to appoint them as my Representative. She is very nice and really seems to want to help. But I told her that I don't think I can appoint someone now, as my 60 days to appoint a Representative ended. She had me call the organization. They gave me a number to call at the BVA to ask to appoint a Rep before my hearing. But they haven't returned my call.

Can I ask the Judge at the hearing for permission to appoint a Representative if my claim is not granted? For instance, if it is remanded?

I don't think they can deny the claim because they don't have an opinion that the cancer did NOT start in service. Their doctor just said the symptoms he had from respiratory illnesses were not related to his cancer. I think they know dang well his cancer started in the service, and so they side-step the issue. So if I submit a supportive IMO, it seems like they have to grant the claim or remand it.

Likewise, with the asbestos issue. The VA in the last denial did seem to acknowledge that my husband was exposed to asbestos. But they still used the old medical opinion that stated my husband's cancer wasn't caused (in part) by asbestos exposure to deny the claim. So I don't think the BVA can deny the claim on that issue. If I show he was more likely than not exposed to asbestos, I think they would have to remand it for an opinion where the doctor took into consideration there was asbestos exposure.

So anyway - if they remand the claim, I would probably want to see about appointing a Vet Rep, but I am not sure about the protocol for doing that.

[Berta]

The wording of “mild interstitial fibrosis “could be as compelling as the overall cancer link the doctor made.

“Interstitial lung disease (ILD) can occur without a known cause. This is called idiopathic ILD. Idiopathic pulmonary fibrosis (IPF) is the most common of this type.

There are also dozens of known causes of ILD, including:

“Autoimmune diseases (in which the immune system attacks the body) such as lupus, rheumatoid arthritis, sarcoidosis, and scleroderma

• Medications (such as nitrofurantoin, sulfonamides, bleomycin, amiodarone, methotrexate, gold, infliximab, and etanercept)

• Radiation therapy to the chest

• Working with or around asbestos, coal dust, cotton dust, and silica dust (called occupational lung disease)”

Cigarette smoking may increase the risk of developing some forms of ILD and may cause the disease to be more severe. “

http://www.nlm.nih.gov/medlineplus/ency/article/000128.htm

The wording 'may cause' is not, to me, as prominent as the 'causes' they listed in this link, regarding smoking.

Was the radiation therapy done by the VA?

“And on the asbestos issue, I have a feeling that even if I take opinions, the VA would still ask their doctors again, since their doctors had made the assumption he wasn't exposed to asbestos because he wasn't part of any medical surveillance program (that was not even in existence in the 70's) “

The VA has complied what is called the PIES lists for any MOS that clearly put the veteran into an asbestos exposure situation.

At least they did that for Navy vets and I think USAF vets too,.The Navy list is here at hadit.

Of course if he was Navy, and served onboard ships in the 1970s, it is as likely as not he was exposed to it, even if only by sleeping in the bunks, with asbestos laden pipes above him.

I am glad you have considered two potential causes of his lung disease and claimed them.

I had to do a lot of research for my DMII death DIC claim (this was to render my 1151 DIC as moot, because there is no Honor in a 1151 DIC award

(death by VA)

Even with the extensive medical evidence I had, I ended up getting 3 IMOs too as I knew the VA would do all they could to deny the claim.

BVA did award the claim in 2009 I think.I received an extraordinary amount of additional monetary benefits due to the direct SC award. However ...my stupid former vet reps, to include their Director, didnt think it had a single chance in Hell, and good thing I handled it myself.

I thought I understood one word in my husband's autopsy (fibrosis) and didnt look it up like I did with every single other medical term.

Duh.

One day for some reason last year I looked it up. That single word in the heart slide narrative might have saved me lots of problems because I narrowed that down as solely due to DMII and there was no other etiology at all for this type of cardio fibrosis except for my husbands untreated and undiagnosed DMII from AO in Vietnam,.

Neither his death certificate, nor any VA medical record, nor the autopsy itself stated he had DMII so I had to prove a non existent existence of a diaability from AO and then I learned exactly how the VA caused his death.

I guess my long point here ,free-spirit- is don't overlook anything!

And like you ,I shaped this DMII death claim for the BVA,knowing thr RO would deny it, but the BVA can read.

I do hope you get a DIC award and that it comes from the VARO.It would be great if the lung cancer is SCed and that perhaps any intersital lung disease is not an issue VA gets stuck on, as a way out of the claim because that could have been from asbestos exposure.

: since their doctors had made the assumption he wasn't exposed to asbestos because he wasn't part of any medical surveillance program (that was not even in existence in the 70's) “

If that was stated in a posthumous C & P exam, those doctors made a ridiculous assumption.

That statement could sure be knocked down. It is not only too speculative, it is just plain BS.