Md Statements: Opinions

[Guest jstacy]

I have been reading the board and have come across the following.

You have a MD statement that says it is at least as likely as not, is most likely, was due to.

I received a SC for a least as likely as not ( 50 percent sure)

I have 2 C@P opinion from MD not NP that state most likely. (75 percent)

I have 1 from same doctor that says was due to. (100 percent)

I have no decision because this has been going from the rating team to the development team back and forth. I feel confident I am going to win, But they are really messing with these claims.

Has anyone ever been denied and had a MD statement at the least as likely and and over opinion?

Edited August 30, 2006 by jstacy

[john999]

Yes, based on my Doctor's written report I went from 30% to 70%. I used an independent medical opinion to get TDIU and P&T. The VA fought me on each and every benefit I ever got and IMO's are the only thing that really turned them around so that I got my benefit increased.

[mssoup1]

This may have been a unique case for what ever reason, but my husband had an IMO stating that his eye condition was directly related to his skin condition, which is service connected. The VARO turned it down. We took the denial to my husbands doctor and he was floored. Couldn't believe it. We got it approved when it went to the BVA. Goes to show that nothing is guaranteed and until you get a decision, who knows which way a claim will go. I am not trying to be negative here, but only pointing out a valid point.

We were totally shocked when we turned in the IMO because we thought the claim would have to be approved. Well, what a surprise when we got the denial letter. So, again, even having a good IMO doesn't guarantee you anything, especially at the VARO level.

mssoup1

[vaf]

Same here. Three board certified physician IMO's including one from Dr. Bash. Denied. Without giving reasons and bases, the Board upheld the VA Regional Office's denial. Now, we're waiting in line at the Court of Veterans Appeals. Don't let that stop you, you still need those IMO's, whether its early on at the regional level, or if it unfortunately has to proceed through the Board and on to the Court.

At least at the Court level, you can engage the services of an attorney to point out to the Court the lack of consideration those IMO's were given. We just received a copy of the attorney's brief for my husband's Court hearing, and it's a doozie!

[mssoup1]

Vicki,

I agree with you. Being able to get an IMO, which is in your favor, definitely can help your claim. If not at the VARO level, then maybe up the chain. As I stated before, we had a very good IMO and couldn't get an approval at the VARO level even with the IMO. It had to go all the way to the BVA to get the approval. But, then again, others have gotten an approval with an IMO at the VARO level. I guess you never know what is going to happen while you have your claim in process.

mssoup1

[Ricky]

My treating neuo, 35 year board certified, stated in medical records "due to Ricky's hypertension and DMII (both of which are service connected) and my personal review of his MRI films dated 23 January 2005, his symptoms of 18 January 2005 which included left sided numbness, tingling of the left exterimities, slurred speech, blurred vision were those of a right thalamic infarct (CVA) in the subacute stage (very recent but the thrombosis had completed at the time of the MRI). All of this was comfirmed in a C&P exam.

VA came back on my request for 100 percent for six months for cva as authorized in 38 CFR and stated

"service connection for CVA is awarded at the 10 percent level, however, there is no evidence of recent or active disease or injury to the brain, therefore your request for a rating of 100 percent for CVA is denied.

There was no mention of the Neuro or C&P examiners results any where in the rating decision. Submitted NOD referred back to the above two examinations pluse my neuro provided a seperate IMO about how a stroke evolves. SOC came back and VA stated:

"service connection for CVA is awarded at the 10 percent level, however, there is no evidence of recent or active disease or injury to the brain, therefore your request for a rating of 100 percent for CVA is denied.

So yep I had a denial eventhough I had a "Due to" and a " it really happened guys" from both civilian and VA doctors. Hope BVA will at least read the evidence.

[Vike17]

The VA will discredit an IMO if the doctor doesn't give his/her rational for their desicion. A simple one or two sentance statement from a physician more than likely wil result in a denial.

Vike 17