How to pay for a much needed IMO to win benefits:

[broncovet]

Here is my plan for Vets to get a favorable nexus: (I suggest you do these in the order listed)

1.  First get your medical file and see if you already have one!  You might and not know it!!  Look for a doc opinion that says your (diagnosis) is "at least as likely as not" due to an event in service.  Dont spend the money on an IMO, if you dont need it.  CAUTION:  YOU NEED AN IN SERVICE EVENT.  The IMO doc can not fix that.  (This does not apply for secondary conditions.   If you need an imo for secondary conditions you need not have an in service event, but you do need a "SC condition" that the doc thinks caused your secondary condition  Example:  PTSD (SC) for Vets seeking sleep apnea.  Many docs feel there is a link between PTSD and OSA.  

2.  Ask your VA doctor if he thinks (your diagnosis) is related to (an event in miliatary service, or aggravation).  If he says, "Yes", then ask him to please document that in your medical records.  If he says "No", then you may need a more "Veteran friendly" VA doc.  You "may" be able to find such a doc by going to your VAMC waiting room, and simply ask (other Vets being treated for your condition) if they like their doc, and, if so, what is the docs name.  Then, try to get that doc by asking for a change of provider.  

3.  If you are unable to get either 1 or 2 to work, then you probably need an IMO/IME.  Here are a few ways I found to get help paying for an IMO/IME:

    a.  Ask the doc.  Tell him you need (these benefits) and ask if he could wait until after you get your retro to pay for the IMO/IME.  Dr. Bash used to do that, and so have others, probably Dr. Anise, who is a Vets attorney and md.  Both of these will probably know what it takes to win your benefits after they read your file.  

    b. If you have been denied (especially a denial at the BVA), then you can seek an attorney who would be willing to "up front" the costs of an IMO.   This attorney would need to "beleive" in you/your case.  It happened for me.  I got a denial at the BVA, hired an attorney who got a remand.  Then, my attorney "up fronted" the cost of an IMO, and, bingo, I won benefits.  You may have discuss this with more than one attorney to find one that believes in you ENOUGH to up front the cost of an IMO/IME.  HINT:  Some IMO providers offer their services "on a delayed payment" to attorney's clients, because the attorney pretty much knows the Vet will eventually win with a great IMO.  

    c.  If all else fails put the IMO on a credit card, or ask a family member for help.  

     These are not "theories".  I have won benefits with these:

1.  My VA doc provided me with a nexus because he was Vet friendly and I asked him.  

2.  For another condtion, my attorney "up fronted" me the cost of the IMO.

3.  Lastly, I put a THIRD IMO cost on my credit card.  Fortunately it was only 600 and he (the IMO provider) let me make "2" credit card payments of 300 each.  This claim is still pending at the BVA, so I wont know if this "actually worked" or not, but many many Vets have won benefits with an IMO, regardless of how its paid for.  

Edited January 8, 2020 by broncovet

[awgv001]

8 hours ago, broncovet said:

Here is my plan for Vets to get a favorable nexus: (I suggest you do these in the order listed)

Here's what I do. Print these two pages I have attached to this message - take it to your VA Doc's, especially any specialists you see. They have a right to refuse in procuring a Nexus, however, if they say "No" or "It's a conflict of interest" or some other jargon/fake reason --- they can't stop you from requesting to see another VA doc with the same or greater credentials to do it instead. The new doc will have to review your records etc etc. of course. I'm going to create a post where this can be easily discovered by the other Hadit members, as this particular form has helped me during my journey from 40% to 60%, to 80% and then currently (as of jan 2020) 90% - with still more to go.

 

NOTE - FOR SECONDARY CONNECTIONS -

You’ll need to submit evidence of:

• The new physical or mental disability from a medical professional or layperson (someone who’s not a trained professional), and
• A link between the new disability and the disability we’ve already determined is service connected. Usually we need medical records or medical opinions from health care providers to support this link.

Edited January 8, 2020 by awgv001
Secondaries!

[broncovet]

I agree with AGWV001, and add his "generic" nexus letters are great, because many private practice docs have no idea how to write a valid "VA" nexus letter.  

Your own family doc, may be willing to do this for your at little or no cost, especially if he has known you and your family a long time.  But, if he writes a statement like:

"The Veterans conditions MAY have been caused by military service".....he wont be helping you.  "May", "Maybe", or "could", or "its possible that service caused the injury" is insufficent for VA.  

The 4 things AGW posted are so important they bear repeating:

1.  CV of the doc establishing medical competence.

2. Doc must state he "reviewed" your medical records.

3.  Doc must have nexus statement in a VA accepted format such as "at least as likely as not". 

4.  Doc must give his medical rationale as to why he offered said opinion.  

[El Train]

Great info.  My VA health care team wanted nothing to do with helping me get service connected.  Down played all my symptoms. Blamed stress, old age, diet; the list went on.  Shaking their head; 'it's all in your head, but don't go to mental health, they'll make thing's worse'.  

Had to go outside the VA and get IMO's from pro's who know the VA lingo.  That was the trick. They're still fighting me on some IMO contentions.  You're damn right I paid for it.  100% now.

 

[Vync]

@awgv001 Yeah, that nexus template is very promising, but it is focused on direct SC, not secondary.

I recently asked a non-VA specialist for a nexus and provided a rough draft based on that letter, but also included the nexus level jargon such as "as likely as not" and pertinent treatment records.

 

[awgv001]

1 hour ago, Vync said:

@awgv001 Yeah, that nexus template is very promising, but it is focused on direct SC, not secondary.

I recently asked a non-VA specialist for a nexus and provided a rough draft based on that letter, but also included the nexus level jargon such as "as likely as not" and pertinent treatment records.

 

I'm going to edit the body to address this as well!

Thank you so much @Vync  for pointing this out!

[Vync]

35 minutes ago, awgv001 said:

I'm going to edit the body to address this as well!

Thank you so much @Vync  for pointing this out!

Glad to help!