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From my understanding when getting an IMO they need to state that they have reviewed your case.

Does this mean printing off all the VA Notes from the Blue Button or that I have to track down the C File?  I reread the denial letter and I was denied the claim for the earliest diagnoses of psoriasis in 8 months after I got out.  And am trying to get his opinion through lay statements and pictures.  How much does he need to review?

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The IMO doc needs to review your medical records, not so much your entire case file.  The medical records are usually easier and faster to obtain than your whole cfile.  The doc may accept your lay statements on service, such as "I worked on jet engines", or "I carried a 60 pound backpack for 4 miles a day".  The cavc has ruled that a veteran is competent to testify about stuff that a layperson can observe, just like the above.  The lay person can not testify, "I had diabetes", because he does not know how to interpret blood work to make such a diagnosis.  However, if a current doc is prescribing you insulin, then your testimony that you had diabetes, would likely be accepted as it was confirmed by a doc.  

No, lay statements and pictures wont suffice.  The doctor can rely upon other doc's diagnosis, opinions, notes, etc., but not lay persons.  For example, do you know how to read an xray?  Do you know what high or low blood sugar is?  

A successfull IMO has:

1.  The doc has expertise in the area.  If you are getting a sleep apnea IMO, then the doc needs training and experience in sleep medicine.  The IMO is considered an "expert" witness.  

2.  The doc must review the medical records and so state.  

3.  The doc needs to opine that your (diagnosis) is "at least as likely as not" due to (an event in service or aggravation".  

4.  He needs to give a medical rationale as to why he made statement 3, called the nexus.  

     If your IMO does not have all 4 of these things, you are probably wasting your money.  

     An IME is better, which includes a medical exam by the doctor rendering an opinion.  IMO is based solely on doc's interpretations of what other docs stated previously, since he did not examine you personally.  

Edited by broncovet
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