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Posted (edited)

§ 3.328 lndependent medical opinions.

(a) General. When warranted by the medical complexity or controversy involved in a pending claim, an advisory medical opinion may be obtained from one or more medical experts who are not employees of VA. Opinions shall be obtained from recognized medical schools, universities, clinics or medical institutions with which arrangements for such opinions have been made, and an appropriate official of the institution shall select the individual expert(s) to render an opinion.

(b) Requests. A request for an independent medical opinion in conjunction with a claim pending at the regional office level may be initiated by the office having jurisdiction over the claim, by the claimant, or by his or her duly appointed representative. The request must be submitted in writing and must set forth in detail the reasons why the opinion is necessary. All such requests shall be submitted through the Veterans Service Center Manager of the office having jurisdiction over the claim, and those requests which in the judgment of the Veterans Service Center Manager merit consideration shall be referred to the Compensation and Pension Service for approval.

© Approval. Approval shall be granted only upon a determination by the Compensation and Pension Service that the issue under consideration poses a medical problem of such obscurity or complexity, or has generated such controversy in the medical community at large, as to justify solicitation of an independent medical opinion. When approval has been granted, the Compensation and Pension Service shall obtain the opinion. A determination that an independent medical opinion is not warranted may be contested only as part of an appeal on the merits of the decision rendered on the primary issue by the agency of original jurisdiction.

(d) Notification. The Compensation and Pension Service shall notify the claimant when the request for an independent medical opinion has been approved with regard to his or her claim and shall furnish the claimant with a copy of the opinion when it is received. If, in the judgment of the Secretary, disclosure of the independent medical opinion would be harmful to the physical or mental health of the claimant, disclosure shall be subject to the special procedures set forth in §1.577 of this chapter.

(Authority: 38 U.S.C. 5109, 5701(b)(1); 5 U.S.C. 552a(f)(3))

[55 FR 18602, May 3, 1990]

Edited by carlie

Carlie passed away in November 2015 she is missed.

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Posted

VA rarely goes outside of the VA for this type of IMO-

I did see a BVA case where the BVA went outside the VA for an environmental specialist's opinion that went against the claim but the BVA still granted the claim -as the other evidence was supportive of the claim.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

  • HadIt.com Elder
Posted

The VA has their herd of aged and wet-behind-the-ears doctors to do 10 minute C&P exams and this is what they rely on mostly. I ask my regular VA doctor to do medical evaluations for me for establishing service connection and she does it. It is in the regs and they are required to give opinions on these requests. If you want a outside the VA opinion you would have to raise a stink but it could be done as with everything else in the VA.

Guest jangrin
Posted

Carlie,

I interpret this to be either the veteran (claimant) or the office that has jurisdiction (RO) to be able to get an IMO for complex or unusual cases. So to me it seems that it is for both/either.

Jangrin

  • HadIt.com Elder
Posted

Carlie,

This actually pertains to the VA. If a claimant want to go and get an IMO as medical evidence, they can do so at anytime and have it entered into their C-file as evidence without VA approval.

Now if a veteran wants to get a IMO for their claim and have the VA pay for it, I would imagine then they would have to go through the VA to get it approved. However, if the veteran is paying for it themselves, there's nothing stopping them from doing so from VA.

Vike 17

Posted

So, then if the vet is paying the fee for a legit IMO doc -- the VA doesn't have to approve

the doc in order to accept this as qualified medical information. Right ? ?

carlie

Carlie passed away in November 2015 she is missed.

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