Radio show June 2,

[Berta]

Jerrel I was cut off twice after I tried to discuss Alex's point on IMO/IMEs and then no one answered the phone.

I wanted to explain why I use the terms IMO and IME here.....

And that I had a VA Central office medical review , not an IME.....for my FTCA case.

It is a matter of semantics.

IMO.........the vet sends the IMO doc the stuff , and they do not need a personal one to one exam.

IME- The IMO doctor will want to personally Examine the veteran.The distinction  is that I want vets to know that an IME might cost a lot more than an IMO.

Either the vet or the doctor will have travel expenses. Maybe even an overnight hotel bill.

I guess no one else could call in ....even by hitting # 1 , no one answered the phone. So I left the show  and will continue to use the acronyms IMO and IME here for vets to know the distinction.

There is nothing at all "independent" when the BVA orders  any type of an 'independent  exam,' it will probably be done be a doctor at VA Central or an outside doctor -who VA has paid- like the QTC docs. Luckily those VA doctors at VA Central are some of the best VA has, and they also can read.

[Buck52]

Ms berta

On a case of denied hearing loss because the VA ENT Audologist OPINE this veteran hearing does not meet the VA Requirements of Hearing loss under the CFR's of noise induced hearing loss  but fails to put the test numbers in on the test  and calls his C&P inaugurate for rating purposes.

if a vet calls a  say a Private ENT Specialist and let him know that he has had a bad exam from the VA ENT Clinic  and wants a second medical opinion IMO VS IME and it has to be done to the VA's Guidlines and what they require of the exam.

this private Dr agrees and the vet takes some medical records for the private Dr to read , and this doc has his state license Audoloigist  to do a hearing test ueing the VA guidlines and the VA Maryland CNC Word test....this ENT Writes his impression of the veteran disability and mention that bilatereal hearing loss can be cause as least likey as not cause from loud nosie while in the military.

Would this be considered an IME  and not an IMO?

IMO is when the Dr just gives his opinion? correct?

Now what confueses me

Alex mention that theres a difference in an IMO VS IME

What about the term F.C.E. (FUNCTIONAL CAPACITY EXAMINATION?) We don't hear that term used by the VA to much? at least I never have!

IME is by the VA Standards is Independent Medical ''Evaluation'' 

So when a Dr says I have examined this veteran  or I have ''evaluated''  this veteran  whats the difference?

To me they have to examine you before they can make a correct ''evaluation''...but as Alex stated   the VA Deny's a lot of veteran on an IMO (Independent Medical Opinion..Unless he meant IME Independent Medical Evaluation?

For some reason or another I had always thought the IMO Meant Independent Medical Opinon and the IME Meant referring to an Independent Medical Examination. or the latter?

But hey I'm just a 1st grader here when it comes to the VA And there Interpretation of the Law.  or there own kind of language.

I may not herd everything right I kept going in and out  like a bad connection or maybe some  Bad Radio show connection or tech problems.

..............Buck

Edited June 3, 2016 by Buck52

[Buck52]

Ms Berta

you and Alex were talking about Vietnam and some of the werid things that went on over there...its probably like that in all wars  just my opinion.

From what I hear and read about Vietnam has did a 360% from what it look like back in the conflict...they have tore down all the bombed buildings and rebuilt  them and re -done the land and one can never see the results of  Vietnam what 1965 -1975 was like...I was there in 1968-69  So I was not there to see Saigon fall to the North Vietmense Army in 1975, but they say the country is beautiful now...but for some reason or another I don't desire ever going back.

There are a lot of Vietnamese here in the states that got out in 1975 and have started up business and what knot,  but now They want to go back, my spouse has a Vietnamese girl that does her Nails  and her and her hubby want to go Back, they were young  back in 1975 about 14 or 15...to many bad Memories for me to ever want to go back to that country.

[Berta]

The BVA rarely requests IMOs as explained below. They call them IMOs but maybe some require an additional in person exam with the veteran.

I would think the expense of a VHA in person exam,ordered by the VA  travel wise, is on the veteran.

What Alex discussed is not an additional C & P ordered by BVA on remand, as I understood him.

He was discussing the 901 Rule below I think

 

It doesn’t matter whether they are called IMOs or IMEs …it only  matters if they award the claim.

 

No vet should depend on getting this type of BVA- ordered additional exam.As I stated I don't think Alex was talking about additional C & P s ordered at remand ,done at the RO level.

I think he meant IMOs done under Rule 901 ( 38CFR 20.901)

 

By the time a vet gets a BVA docket # they will have had  time to get their own IMO(IME) to submit one to the BVA.

But

 

Deficient C & P exams should be attacked at the VARO level, with evidence the C & P doc did not consider. The RO could then order an additional C & P but the results might be the sameThe best attack of all is an IMO…..At the VARO level.

 

Unless they want to wait for years to see if the BVA will deny again based on the C & P they got that denied them in the first place. And without their own IMO , the BVA probably will deny again..

 

Rule 901 is only used by the BVA in exceptional circumstances.

 

 

 

38 CFR 20.901 - Rule 901. Medical opinions and opinions of the General Counsel.

• CFR

• eCFR

• Authorities (U.S. Code)

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  § 20.901 Rule 901. Medical opinions and opinions of the General Counsel.

  (a) Opinion from the Veterans Health Administration. The Board may obtain a medical opinion from an appropriate health care professional in the Veterans Health Administration of the Department of Veterans Affairs on medical questions involved in the consideration of an appeal when, in its judgment, such medical expertise is needed for equitable disposition of an appeal.

  (Authority: 38 U.S.C. 5103A(d), 7109)

  (b) Armed Forces Institute of Pathology opinions. The Board may refer pathologic material to the Armed Forces Institute of Pathology and request an opinion based on that material.

  (Authority: 38 U.S.C. 7109(a))

  (c) Opinion of the General Counsel. The Board may obtain an opinion from the General Counsel of the Department of Veterans Affairs on legal questions involved in the consideration of an appeal.

  (Authority: 38 U.S.C. 7104(c))

  (d) Independent medical expert opinions. When, in the judgment of the Board, additional medical opinion is warranted by the medical complexity or controversy involved in an appeal, the Board may obtain an advisory medical opinion from one or more medical experts who are not employees of the Department of Veterans Affairs. Opinions will be secured, as requested by the Chairman of the Board, from recognized medical schools, universities, clinics, or medical institutions with which arrangements for such opinions have been made by the Secretary of Veterans Affairs. An appropriate official of the institution will select the individual expert, or experts, to give an opinion.

  (Authority: 38 U.S.C. 7109)

  (e) For purposes of this section, the term “the Board” includes the Chairman, the Vice Chairman, any Deputy Vice Chairman, and any Member of the Board before whom a case is pending.

  (Authority: 38 U.S.C. 5107(a), 7104(c), 7109)

  [57 FR 4109, Feb. 3, 1992, as amended at 61 FR 20453, May 7, 1996; 66 FR 38159, July 23, 2001; 69 FR 19937, Apr. 15, 2004]

  Beta! The text on the eCFR tab represents the unofficial eCFR text at ecfr.gov.

  § 20.901 Rule 901. Medical opinions and opinions of the General Counsel.

  (a) Opinion from the Veterans Health Administration. The Board may obtain a medical opinion from an appropriate health care professional in the Veterans Health Administration of the Department of Veterans Affairs on medical questions involved in the consideration of an appeal when, in its judgment, such medical expertise is needed for equitable disposition of an appeal.

  (Authority: 38 U.S.C. 5103A(d), 7109)

  (b) Armed Forces Institute of Pathology opinions. The Board may refer pathologic material to the Armed Forces Institute of Pathology and request an opinion based on that material.

  (Authority: 38 U.S.C. 7109(a))

  (c) Opinion of the General Counsel. The Board may obtain an opinion from the General Counsel of the Department of Veterans Affairs on legal questions involved in the consideration of an appeal.

  (Authority: 38 U.S.C. 7104(c))

  (d) Independent medical expert opinions. When, in the judgment of the Board, additional medical opinion is warranted by the medical complexity or controversy involved in an appeal, the Board may obtain an advisory medical opinion from one or more medical experts who are not employees of the Department of Veterans Affairs. Opinions will be secured, as requested by the Chairman of the Board, from recognized medical schools, universities, clinics, or medical institutions with which arrangements for such opinions have been made by the Secretary of Veterans Affairs. An appropriate official of the institution will select the individual expert, or experts, to give an opinion.

  (Authority: 38 U.S.C. 7109)

  (e) For purposes of this section, the term “the Board” includes the Chairman, the Vice Chairman, any Deputy Vice Chairman, and any Member of the Board before whom a case is pending.

  (Authority: 38 U.S.C. 5107(a), 7104(c), 7109)

  [57 FR 4109, Feb. 3, 1992, as amended at 61 FR 20453, May 7, 1996; 66 FR 38159, July 23, 2001; 69 FR 19937, Apr. 15, 2004]

  This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

  This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

  It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.

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  Hide U.S. Code: Title 38 - VETERANS’ BENEFITS

  § 501 - Rules and regulations

   

  https://www.law.cornell.edu/cfr/text/38/20.901

[Berta]

“IME is by the VA Standards is Independent Medical ''Evaluation''  the “E: could mean Examination.

 

“So when a Dr says I have examined this veteran  or I have ''evaluated''  this veteran  whats the difference?

 

To me they have to examine you before they can make a correct ''evaluation''...but as Alex stated   the VA Deny's a lot of veteran on an IMO (Independent Medical Opinion..Unless he meant IME Independent Medical Evaluation? “

 

VA doctors in essense ,’evaluate’ a veteran every time they have a medical appt .

That is what doctor’s do.

I have seen IMOs that do not garner awards because the veteran has been unable to establish an inservice nexus and the IMO doc has little to work with in their SMRs, to try to help establish that nexus.

They cannot perform miracles.

I could not get back with the show when I called in again 2 times. I disagree that VA denies a lot of vets with IMOs, unless the IMOs were prepared without benefit of the proper IMO criteria ( there are many like that at the BVA) or denied because, unless the IMO doctor served in same unit, same time and place, with their own eye witness account of the veteran's inservice nexus given in the IMO (HIGHLY UNLIKELY) ,it is usually a denial due to lack of nexus, which can happen with or without an IMO.

 

I feel that maybe the new idea of having vets prove their claims first (if it is a nexus they will  need to prove) might be a good idea.With their SMRs highlighted as to medical entries and buddy statements if needed, and produced along with the claim,

that would reduce, in time, the BVA backlog and speed up claims at the RO levels.

 

 

 

 

 

[Buck52]

Yes mam I agree

I proved my some of my stressors for my PTSD Claim with my STR's,&DD 214 And I never needed a IMO , the rater used them in my evidence  to my claim.

I was thinking if I was denied I'd need a IMO to nexus the two  but I was lucky the rater did read.

[Berta]

Jerrel just called me.....that part of our show yesterday was very confusing.

The last thing our vets need is more confusion.

The only reason I have been stating  IMO/IME, lately,  is for years I just put IMO here and someone griped and said I should put IME too.

IME is also a acronym for Independent Medical Expert.

I think I might go back to just using IMO. If a vet reads all of the IMO criteria info here at hadit and has an established nexus,

and gives the IMO doc a copy of everything  to include the bogus C & P exam, they have a great chance of succeeding, if the IMO supports their claim and best they get the IMO at the RO level....it could save them YEARS of waiting time at the BVA.