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broncovet

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Vets often ask, "Where can I get an IMO to get a nexus?"   

Recall that a Nexus is a key element in the Required Caluza elements of current diagnosis, in service event, and nexus. 

While I have not personally used Dr. Ellis, at least one Veteran has.  However, $500 for an IMO is great.  But, an IME (Independent Medical Exam) would be even better.  

I have heard of at least one doctor who charges up to $10,000 for an IMO.  I think Dr. Bash quoted me $5000.  At that time, Dr. Bash would do the exam without cash up front, then you paid him out of retro.  Im not sure he does that any more.  

Dr. Ellis apparently requires payment up front, but at least its not $5000 up front!

If I had need of a nexus, I would likely hire Dr. Ellis.  I listened to his video and IM convinced he is for the Veteran and knows what he is doing.  

Quote

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

According to his website, you can use Mastercard/Visa/American Express.

For me, being able to put it on a credit card was a great idea.  Why?  Well I was certain an IMO would get me many times that back in retro.  

I actually did the same thing..put my IMO on a credit card, then paid it back when I got the retro.  My IMO was for a voc rehab specialist, and I also paid 500, and it was well worth it.  

If you do not have a nexus, you need an IMO or IME, like Dr. Ellis to win it.  

Source:  Etrain's post on hadit.  Thanks, Etrain.  

NOTE:  Hiring Dr. Ellis would mean you would need to travel to Oklahoma City, as its an Independent EXAM, as opposed to an Independent OPINION.  My opinion is that an EXAM is better.  An IMO is only as good as the current medical records, but an EXAM, the doc can also add his opinions based on him personally examining you.  

Example:  You applied for benefits, but were denied, and you figured out you dont have a nexus.  Well, you didnt get treated for your arthritis, until 2021, but you have been suffering from it, since 2007.  You can Tell Dr. Ellis your symptoms and how it affects your work, since 2007.  Dr. Ellis "could" indicate, in his opinion, your symptoms began in 2007, for example, if he looked at an xray or other medical tests which showed degenerative arthritis.  This could result in retro.  back to 2007.  If you got an IMO, from a doc who has never examined you, then that may not work as well.  

 

Edited by broncovet
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On 12/21/2021 at 6:42 AM, broncovet said:

I actually did the same thing..put my IMO on a credit card, then paid it back when I got the retro.  My IMO was for a voc rehab specialist, and I also paid 500, and it was well worth it.  

I was calling around for qualified range of motion tests and discovered that my local hospital offers a functional capacity exam and an impairment rating together for $700 through their physical therapy department. I noticed my own physical therapy, that functions under another hospital does this too. It may not provide an actual nexus, but could such a thing be used to assist an IMO and potentially help with SC ratings?

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Yes the va use physical therapy note as evidence.

My opinion on imo is the va will order there owe exams.

So I don't feel that those pay medical opinion do much.

If you have been seen at va hospital your doctor can request any exam need for your disability.

If you need a voc rehab opinion why not just sign up for ch31 it a free opinion.

The va use all this to granted 8 years tdiu retro in my case.

 

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You are taking a chance using a physical therapy.  The Board can "pick" among 2 different medical opinions, but they must give an adequate reasons and bases as to "why" they picked that opinion.  

One of the reasons they often cite is "medical exam A" was more thorough, (xrays, mri or other tests) than "medical exam B".  

And, even tho the VA may not give this in a reason and bases, they could select an examiner with "more competence or more experience"...that is, a doctor vs a physical therapist.  

If the VA has a doctor medical opinion that your condition is less likely than not due to military service, you are gonna probably need to rebut that exam with another doctor, not a physical therapist.  

The VA uses NP's all the time to perform c and p exams.  But, the VA c and p examiner has a "presumption of soundness" while you dont get that benefit, when "you" order your own exam, such as an IME or IMO.   For that reason, if you hire an IMO/IME, always include the examiners CV, where he went to medical school, his degree, and experience diagnosis and treating your condition(s).  

You have to demonstrate medical competency, the VA does not.  

Fair?  No.  But, the fact remains, if VA sends you to a c and p exam, your examiner is "presumed" competent and its presumed he or she did a good job "absent" your challenge to the competency of the examiner.  Yes, you can challenge an exam..but I dont recommend going there unless its absolutely necessary.  

   If my 13 year old neighbor, who cuts my grass for a living writes a letter than "your hearing loss is at least as likely as not from exposure to noise in the military service", then the VA wont recognize that examiner, unless you show his or her CV, say, if its Doogie Howsier MD.  

   The answer to your question would therfore depend on the evidence (especially evidence against the claim).  

   Whenever possible you try to throw an "ACE".  (Remember the card game of WAR, where each lays down a card, and the higher card picks up both cards).  

    You may get away with throwing down an 8, but only if you are pretty sure he has a 7 or less.  

     An MD, with years of experiene in your field of medicine is an Ace.  

     A King, could be a NP with years of experience.  

     They go down from there.  

     "If" you have the complete VBMS file, or at least your medical records to include C and P exams, you get to "see" the cards your opponent has, so you can tell which one you need to beat it.  

Edited by broncovet
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10 hours ago, broncovet said:

The VA uses NP's all the time to perform c and p exams.  But, the VA c and p examiner has a "presumption of soundness" while you dont get that benefit, when "you" order your own exam, such as an IME or IMO.   For that reason, if you hire an IMO/IME, always include the examiners CV, where he went to medical school, his degree, and experience diagnosis and treating your condition(s).  

Fantastic advice. I am at this stage now.

10 hours ago, broncovet said:

"If" you have the complete VBMS file, or at least your medical records to include C and P exams, you get to "see" the cards your opponent has, so you can tell which one you need to beat it.  

Yeah and unfortunately my attorney's paralegal assumes a gatekeeper role to whatever I might inquire about in the VBMS. It was like pulling teeth, after several requests. Finally, I mentioned getting a copy of the C-File. "Oh I can do that," she says, "just fill out this electronic request form and I'll submit it."  After a few months I call 1-800-Peggy and no record of request. So, a few days ago I made the request myself in writing and sent it to the appropriate address given to me by 1-800-Peggy.

The paralegal has a lot of experience in SS claims and next to zero in Vets claims. It's hard for her to budge when it comes to wanting C-File info and can't understand why I should want it when the attorney is handling all of that.  Weird huh?  Without that info I can't do anything for myself and my attorney is too busy to micromanage my medical stuff.

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17 hours ago, Mr cue said:

If you need a voc rehab opinion why not just sign up for ch31 it a free opinion.

I'll look into this. Thanks.

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