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Imo Attached For Opinion

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kate7772

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Sorry, could not copy to original post. Please give opinions on this IMO. These are my thoughts:

This is an appeal for kidney disease my husband suffers from and we are claiming was caused by the contaminated water at Marine Corps Base Camp Lejeune (an uphill battle.)

The report looks good to me but I do have a few questions I wanted to ask here before getting back with him.

**It says he reviewed patient's medical records/testimony,lay statements, personnel records but it does not state he saw the service medical records or C&P file. He did see both and references the C&P opinion elsewhere but does not specifically list it. Should these two things be included in the list of what he saw?

**My husband had two entries in his service medical records where he was treated for urinary issues and pain. These were a year apart and after exposure to the water. I thought maybe these would be important to include as the possible start of the problem but maybe not.

**He referred to a reference which lists harmful chemicals known to cause the kidney disease my husband has but also includes in the list other items, such as: lead paint, cigarette smoke, sewage, whitening creams contaminated cereals, etc. I'm not sure these should all be listed. I'm thinking just pull out the chemicals he was exposed to and not leave it open for VA to say "Hey, these other items could have been a factor." We all know many things in the environment can contribute to medical issues but don't want to give unnecessary ammo.

**The opinion doesn't use the exact wording "at least as likely as not" but does say "to at least the 50% level of probability." Is that acceptable to VA?

**This next may be petty but I have a thing about spelling (not that I don't have issues with it also) and there are some in the report, likely typos. Should I ask that these be corrected or is that not a real issue?

Just want to make sure we cover everything and give VA no reason to say something is not included or done right. We also have a statement in my husband's medical notes from his VA kidney specialist, saying that he feels the condition is at least as likely as not a result of the water.

Any thoughts on this? Anything that I should make sure is included before sending the NOD?

imocopypdf.pdf

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