RE Has any one used the following Doc's for IMO's and nexus letters

[Rattler767]

I am looking at Doc's for IMO's and nexus letters. I know Berta likes Dr. Bush and he has a good Rep but he is a little expensive. I need to know if anyone has used the following two.

 

Dr. Thomas J Seiter MD 

Dr. David Anaise

 

[El Train]

You should throw in Dr. Ellis at the Ellis clinic (OKC).  Very affordable.  Worth a trip.  Got me to 100% P&T.

https://ellisclinic.com/va.html

[pacmanx1]

Don’t take this the wrong way but I have never paid for an IMO/IME. I am not sure if I am that lucky, or I am that screwed up. I had a senior VAMC Psychiatrist for my C & P examiner, and I had a senior Rheumatologist write in my treatment notes that my disabilities are military related. The first claims I filed were all denied and then the VA ordered a new mental health exam and the examiner stated that my disabilities could not be determine without both a mental and physical medical exam and that was it. Bingo, my claims were granted. I even used a Community Care Provider to do a DBQ and the VA granted my claim. Lucky or just broken down. I say if you can afford it go for it, but I could not, it is an investment in yourself and that is always a winner.

[pwrslm]

Start at your local VA Primary Care Team. Talk to your PCP, see if s/he will help you document the current condition. Ask if they will enter an opinion into your medical record as to the etiology of the condition. Etiology in medical records is an assignment of a cause, an origin, or reason for the medical condition. If they are willing to help, and you can show them how an in service condition is linked to your current condition, then you are over a big hump. 

This is the cheapest route. You can also ask your own non-VA caretaker to do the same if you do not use the VAMC.

Alternatively, if they refuse like mine did...get on the phone. Call non-VA medical offices and ask them if they will do an independent medical opinion and/or exam for you, and what would they charge. I spent 2 days and found a orthopedic spine surgeon who wrote an IMO for me for $250. It was well worth it and landed my first claim. First time out the door it landed me with 60%. Your motivation is the key to it all.

 

 

to correct this, the $250 I paid included an exam, so the IMO was an IME as well.

Edited December 22, 2021 by pwrslm (see edit history)

[Slick]

Dr Bash has a good success rec ord, however he is expensive.  He'll interview you, take notes and do the write up.

Impression is he just pulls similar reports from his file (boiler plate) changes the name and some other things to fit your case.

I'd just weigh out the cost of his services and what you'd gain in back pay/future $.

Even with his cost, I was happy with the outcome.

[JKWilliamsSr]

19 hours ago, pacmanx1 said:

Don’t take this the wrong way but I have never paid for an IMO/IME. I am not sure if I am that lucky, or I am that screwed up. I had a senior VAMC Psychiatrist for my C & P examiner, and I had a senior Rheumatologist write in my treatment notes that my disabilities are military related. The first claims I filed were all denied and then the VA ordered a new mental health exam and the examiner stated that my disabilities could not be determine without both a mental and physical medical exam and that was it. Bingo, my claims were granted. I even used a Community Care Provider to do a DBQ and the VA granted my claim. Lucky or just broken down. I say if you can afford it go for it, but I could not, it is an investment in yourself and that is always a winner.

You may both be lucky and screwed up    but in all fairness I think we all are to some degree. 

I think needing an IME/IMO depends on who is doing your claim.  My claims have been done out of Houston and I personally believe they have some of the worst/laziest VARO's in the nation.  Now keep in mind this is from personal experience and there may be people that have had instant success.  I have not. 

I have had both an IME (Dr. Ellis) and IMO (through attorney) and I personally believe they were worth every penny.  A judge recently made a decision on my appeal and I was granted service connection on on 7 of 11 disabilities.  The other 4 were remanded.  I am waiting on the letter to see what the remand was for but I am sure it was because of inept VA practices.   The IME/IMO I am sure played a part in those decisions because the VA has repeatedly denied for bullS*%& reasons.   I probably could have succeeded without them but giving history I did not want to take any chances. 

[pwrslm]

Dr Bash and Ellis are not so special. Lawyers have Doctors like them on retainer for accidents where they take the Insurance Companies to court to sue for clients injuries. That industry is huge! The specialists like Bash and Ellis literally show up in court and give testimony if it is necessary. The boiler plate reports are basic formats that cover specific terms and cover a legal necessity most of the time. They complete the opinion portions with acceptable medical treatise and specifics about your condition in these opinions. They probably have assistants that they pay to do research as well so they can provide a solid foundation for their opinions.

If it ain't broke, don't fix it.  Bash and Ellis specialize in VA Claims. 

Edited December 22, 2021 by pwrslm (see edit history)

[El Train]

4 hours ago, pwrslm said:

Dr Bash and Ellis are not so special. Lawyers have Doctors like them on retainer for accidents where they take the Insurance Companies to court to sue for clients injuries. That industry is huge! The specialists like Bash and Ellis literally show up in court and give testimony if it is necessary. The boiler plate reports are basic formats that cover specific terms and cover a legal necessity most of the time. They complete the opinion portions with acceptable medical treatise and specifics about your condition in these opinions. They probably have assistants that they pay to do research as well so they can provide a solid foundation for their opinions.

If it ain't broke, don't fix it.  Bash and Ellis specialize in VA Claims. 

Maybe true.  I know Dr. Ellis has trained C&P examiners to do C&P exams (which use a boiler plate dbq form and give an opinion).   His IME's blew away any of the VA/QTC examiners IME's.  In fact one VA examiners said his IME's were impressive.  But you best have the medical evidence and treatment records to back up you claims or he isn't taking your case.  Instead of hiring a lawyer to drag it out, then collect 20 to 30%, I did it on my behalf.  Got to 100% P&T, SMC-s in less than two years.  

I got low balled and denied on a few issues due to lack of medical treatment records, natural progression, or no in service complaints.  All which are VA lingo to deny.  He specifically points out where and when the claimed incidents happened, what treatment was administered, then writes the all important VA lingo to help the VA out (they need help sometimes).  I wish he didn't include what percentage the claim deserved.  I had three claims get approved for way higher than his assessment (couldn't believe it).

After a few denials, I knew I needed a MD's opinion to help prove where the VA got it wrong.  Some claims were new, like TBI.  A very difficult claim since the VA doesn't really know as much as they should (at least at my clinic).  Got 70% for that (they combined it with ptsd for 100%).

Last but not least; there is another forum out there that will tell you these DR's are on a blacklist of some sort.  Fair enough, they probably are, but the VA has to take their assessments into consideration regardless.  It is medical evidence.  And if they did an in person exam, read all the evidence and state their curriculum vitae, they have to consider it. Hell, I hired one DR. to do a nexus and DBQ that had over 20,000 C&P's under their belt.  

[Rattler767]

I thanks everyone for the answers. I will post this soon in other places in the form when I can get the docs scanned in. An auto accident kind of slowed me down. As of 11-19-21 I am rated 70% PTSD using the VA Doctors and there C & P Exams. I had the VA Cue themselves on UI and they gave me UI too. Its an interesting one to learn from. 

The one I am having problems with is a knees and hips that the VA C & P Exam that was crap. and then went and got a laughable IMO. He basically said that there was no way my right knee injury could cause hip problems and my left knee problems. He is a foreign Doc so I guess he has never heard the rime. "The knee bone is connected to the lag bone. The leg bone is connected to the hip bone."

I am looking for an IMO to dispute the Bad one.

[pwrslm]

You can also include any medical treatise you can find. Google scholar, NIH and Medscape (to name a few) are good places to start. College libraries have access to national journals as well as medical teachings on many subjects. If you look for etiologies of knee and hip problems, you probably will find what you need.

Mayo Clinic has a good run down on causes, which is essential to document the link between active duty and current conditions.

Risk factors A number of factors can increase your risk of having knee problems, including:

Excess weight. Being overweight or obese increases stress on your knee joints, even during ordinary activities such as walking or going up and down stairs. It also puts you at increased risk of osteoarthritis by accelerating the breakdown of joint cartilage.

• Lack of muscle flexibility or strength. A lack of strength and flexibility can increase the risk of knee injuries. Strong muscles help stabilize and protect your joints, and muscle flexibility can help you achieve full range of motion.
• Certain sports or occupations. Some sports put greater stress on your knees than do others. Alpine skiing with its rigid ski boots and potential for falls, basketball's jumps and pivots, and the repeated pounding your knees take when you run or jog all increase your risk of knee injury. Jobs that require repetitive stress on the knees such as construction or farming also can increase your risk.
• Previous injury. Having a previous knee injury makes it more likely that you'll injure your knee again.
• Complications

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you'll have similar injuries in the future.

[Mr cue]

I never understood the imo thing.

I pay for one years ago and it didn't help 

First the va will order it owe medical opinion.

If you were seen in service for the injury it is in your record.

Then there is this.

The presumption of soundness essentially states that, except when there is clear and unmistakable evidence to the contrary, or a condition is noted on a veteran's entrance exam, a veteran is presumed to be healthy upon entering service.

so I really never understood the whole thing

[pwrslm]

The part about "clear and unmistakable evidence" is a high hurdle for the VA to overcome. They literally have to have proof that a condition pre-existed to do so. I had an injury in Basic. The Dr that saw me said that "I" said it was an old football injury. (Funny though, I never played football!!!). I had to go to the High School where I dropped out (9th grade) and got the records showing the lack of any sports activity. If I had not done that, the VA likely would have denied my claim.

The Presumption of Soundness is US Code, which is the Law, unlike 38 CFR, which is regulation that the VA uses to interpret and enforce the law.

 

[Mr cue]

As with me va stated because I broke my elbow when I was 10 years old it not was service connected.

Enlistment stated I broke elbow when 10 year old even got my record forgot they send me to doctor to make sure I was fit.

I didn't get a imo I used this and it was granted.

 

[jbasser]

In addition, if you have to go to the BVA Dr Bash will go with you. Not many other docs would do that, but you have options, If you are on a tight Budget, other entities are available. Valor4Vet is one.  Here is a link to her interview with Exposed Vet Radio. It is a good listen. 

https://www.blogtalkradio.com/jbasser/2021/04/01/haditcom-exposed-vet-podcast-with-valor4vets-bethanie-spangenberg