Another Internet Print Out Question

[carlie]

How about a vet using an Internet Printout to substantiate their claim --

when the print out comes from VHA/DOD Clinical Practice Guidelines,

would this be good ?

carlie

[Guest jangrin]

Carlie,

I would think that anything that the VA/DOD endorses would be very beneficial to a claim. The mere fact that the information is recognized as a clinical practice standard makes it even more appealing because the standard is supposeed to represent the "norm" but can include findings, operations, principles that are found on the fringe of the particular specialty.

Put it in their face with "footnotes" if available. One of the things the SO did when we provided some internet information to substanciate my husbands claim was, she HIGHLIGHTED with a yellow highlighter all the pertinent information. She stated that you want to get their attention so they will read this stuff not just glance at it. We had unit information, and I actually found a picture of my husband that a website had posted. We made comments on the printout and highlighted to draw attention to the point we were trying to make.

Jangrin

[betrayed]

How about a vet using an Internet Printout to substantiate their claim --

when the print out comes from VHA/DOD Clinical Practice Guidelines,

would this be good ?

carlie

Carlie which VHA/DOD Clinical Practice Guidelines are you refering to? would it be

VHA/DOD CLINICAL PRACTICE GUIDELINE

FOR THE MANAGEMENT OF

MAJOR DEPRESSIVE DISORDER IN ADULTS

[nlualum82]

With my successful tinnitus claim, the biggee was probably the 27 year paper trail, which was cited by the rater who disagreed with the hostile C & P examiner, but I also submited some internet info on tinnitus, including an article featuring 2 experts, one of which was something like head of audiology at the Chicago VA. Probably didn't hurt.

[Objee]

I've got good enough relations with my VA treating physicians that they ask me to draft their opinion letters (after we discuss what I need.)

I tail their opinions with a paragraph starting "My opinion is further supported by information in the body of medical knowledge such as" [quotes from PUBMED, NIH, etc.)

This makes the internet info a medical instead of lay submission.

My VSO says this will help internet evidence submision credibility. Sure hope so!

Ralph

[carlie]

Army,

The key word in that post is SHOULD - Should - Should.

carlie

[Berta]

Should is right-

The VBM 2005 Edition has info on submissions of medical treatises or abstracts from the internet.

They reference Hensley V West also.

The information must be very specific as to the claimed disability.I submitted many medical abstracts.

I should have submitted Hensley and also page 99 of the VBM.These were listed under Evidence as "letters" and never addressed in the SOCs.

Dr Bash used 2- or 3- medical references in his IMos.Maybe they will read what he cited-from Braunwald and Harrison-two of the best medical sources around and unavailable on the net(unless you buy the actual medical text)

Although these treatises and abstracts can help a claim-they seem to have more weight in a good IMO.

Also they can be sent in support of the initial IMO request for the IMO doc to consider.

In August I sent Dr. Bash something that supports my claim that was not in his last IMO I got- however he did not use it in the second IMO but we discussed this.

He focused on what aspects of his medical background would give rationale as to the MRIs etc.

But this involves an aspect of untreated diabetes that an Oral Pathologist can certainly support with the specific medical records. The symptoms are well documented in the med recs and also the VA treatment for this symptom. It is in the VA training letter and is a prime symptom of very high glucose.

The medical printouts and med recs etc regarding this were ignored by VA.

I did attach this evidence to my remand request and the BVA sent this back with the appeal.

I have contacted an Oral Pathologist if I need another IMO and have the specific records and the treatises ready for that.There is no other known etiology to the veteran for this symptom-well documented and medicated by the VA-for 2 years- but for untreated severe diabetes.

I certainly would expect the pathologist to use either my treatises or one of many on the net regarding this

unusual facet of untreated diabetes.

Our medical references and printouts often get ignored.

Yet the VA has stated that "Competent medical evidence may also include statements contained in authoritative writings such as medical and scientific articles and research reports and analysis."

38 CFR 3.159(a)(1)(2006) and Hensley V. West

The VBM (NVLSP) also infers that the VCAA hightened the importance of medical treatises -however-VCAA is often ignored as many BVA remands reveal.

I spent a lot time in 2003 explaining to VA how specific treatises were probative to the veteran's disabilities-in my claim- even used two autopsy photos and made a diagram as to the specific medical type of heart and brain trauma that

were caused by Rod's diabetes based on the MRIs and ECHOs etc.They ignored it all. But it helped me realise that I did have a very probative claim and that an eventual IMO would be supportive.

I have spent 4000 bucks on IMOs.

At least all the medical work I did before getting them assured me that money was going to get solid medical opinions that supported the claim. And I do finally know why the veteran died.

Use the best medical references you can-and certainly use Merck too- as this is a VA guideline for numerous disabilties.

Ralph -your VSO is right.

Carlie- you did the right thing too----

If one takes the time they can find considerable VHA statements and info-that can possibly support a claim-via the VA itself.

1968 Army- excellent point:

"I think that citing VA court cases is good when used in NODs and appeals, though. What you're saying at that point is that the VA decision was wrong because court decisions don't coincide with the ruling."

I also usually cite the actual regs, attach a copy of the regs, and attach a copy of M21-1 as to how they are supposed to implement the regs for just about everything.

Edited December 3, 2006 by Berta