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IMO from Dr. Anaise, CKD

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Palma114

Question

On 8/24/2016, VARO made a decision on my Chronic kidney disease claim. They granted me a 60% rating, on CKD stage 3, and Definite decrease in kidney function. I was initially at stage 4 CKD and sick, so they put me on several medications to get my numbers to come down, well after about 45 days it drop from stage 4 failure to moderate stage 3. So I initially filed my claim back in 2004, as all of this was occurring. So I just recently filed a NOD, which states I should have been granted 80%, for stage 4 CKD.

So the C&P Examiner in 2015, never mentioned that I was ever at stage 4. So they only rated me on my now medical status, which is stage 3. So I got an IMO from Dr. Anaise, and he states: A BVA decision in a similar case dated October 26, 2012 states (David Jones, Appellant v. Eric K. Shinseki, Docket No. 11-2704):

The court holds that the Board committed legal error by considering the effects of medication on the appellant's IBS when those effects were not explicitly contemplated by the rating criteria...As this Court has made clear, the Board's consideration of factors which are wholly outside the rating criteria provided by the regulations is error as a matter of law. "Massey v. Brown, 7 Vet. App. 204, 208 (1994); see also Drosky v. Brown, 10 Vet. App. 251, 255 (1997) (finding legal error where the Board, "in essence, impermissibly rewrote" the regulation by considering factors wholly outside the rating criteria); Pemorio v. Derwinski, 2 Vet. App. 625, 628 (1992) ("In using a standard that exceeded that found in the regulation, the Board committed legal error").

Conclusion

After reviewing all of the veteran's medical and military records, it is my expert medical opinion that the veteran's service-connected renal dysfunction warrants an 80% rating. It is abundantly clear from the record that the veteran was diagnosed with stage IV renal failure with a creatinine of 4.5. It is true that the creatinine has improved once medication allowed for some recovery of kidney function. Yet, the rating specifically states that the veteran is entitle to 80% disability when his creatinine rises to 4.5, with no disclaimer to that statement.

A higher evaluation of 80% based on renal function is not warrant unless there is:

* Persistent edema and albuminuria; or, * Creatinine 4 to 8mg%; or, * BUN 40 to 80mg;

Edited by Palma114
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Berta......I heard good things about Dr.Bash's work and considered, but I really liked the MD-Lawyer aspect of Dr. Anaise.  There is apparently only a handful who can generate the kind of IMOs to tip the scales.

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I used Dr. Anaise for my IMO on most of my current claims on appeal.  I'm still awaiting the outcome of a DRO Hearing, but I have to say that Dr. Anaise does an outstanding and in depth report, covering all bases.  It definitely shook up the whole VA's "develop to deny" process, so we'll see.  I also have to say that his office was a joy to work with.  Everything was done on the telephone and via e-mail.  I forwarded PDF's of my medical information, and when they were finished with the IMO, his office sent draft copies of the IMO back to me to review, and happily made any corrections when I noted something, which was only one or two small issues.

I'll let y'all know when I get a "final result" of his IMO.  Have a great week!

 

Mark

 

 

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On 7/21/2017 at 10:08 PM, Wayne TX said:

Berta......I heard good things about Dr.Bash's work and considered, but I really liked the MD-Lawyer aspect of Dr. Anaise.  There is apparently only a handful who can generate the kind of IMOs to tip the scales.

Agreed! 

For those that think we favor one over another is not the case, it is that we are going to these top MDs to win in the game of chess and win "since they can't read."

The only issue I have is I wish "I done it SOONER" with these top of the pyramid experts. As well as discover those coming up or other experts that can be consistently listed with the likes of Dr. Bash, Ellis, and Anaise. 

My "game plan" is exactly General Patton's way of life, which he learned from The Art of War to use the best for each disability I'm claiming.  Recorded service injury >> local board certified MD >>  IMO/IME. Therefore I don't have a favorite, I like all three, which means I will be using all three and one here locally pending (Steingart.)

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When it comes to bigger rating items ( 30% +) I think it's a no-brainer to go with the best IMO Doctors available to us.  Retro will cover those costs relatively quick so throw any spare cash to them.  I don't knock anyone out there helping Vets to win claims/appeals when VA Physicians dodge helping us.   I have learned that some provide more than others.   I am a firm believer that no appeal over 10% should have less than two IMOs involved to at least force VA to counter with two opinions of their own. Ideally, three should normally turn the tide in favor of the Vet with solid rationale evidence by all three. 

Edited by Wayne TX
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I requested to have Dr Anaise write an IMO for me for sleep apnea, and a few other conditions I am filing for, mainly because of the length of time since service. From reading his website, he appears to have experience and success with sleep apnea claims, which is why I had contacted him.

He spoke to me on speaker phone, which made it difficult to understand him. He said that I could not secondary service connect sleep apnea to my already SC conditions, and that it was probably because I was obese (which he then added, "if you are obese"). He also said that it would not be worth the money of the IMO to service connect the cervical condition I have, since I would probably only get 10% at most (which for me, would actually make a big difference). Then he abruptly hung up the phone.  The whole conversation was less then two minutes.  He didn't really listen to me, nor give me a chance to discuss why I was seeking a nexus opinion for sleep apnea, or any of the other conditions I was seeking nexus for (it is only two others, not like a whole shopping list).

This was just my experience of course. From reading this forum, others have had positive experiences. I can't say that I did.

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