Reopening back claim after Saunders

[Vync]

For those who want the VA's take on how describes the impact of Saunders v. Wilkie in M21-1:

 https://www.knowva.ebenefits.va.gov/system/templates/selfservice/va_ssnew/help/customer/locale/en-US/portal/554400000001018/content/554400000090796/Saunders-v.-Wilkie,-Apr-3,-2018,-886-F.-3d-1356-(Fed.-Cir.-2018)

 

 

 

[Whodat]

Great info Vync. I have actually tried that in 2018 when I had reopened my Lumbar/Cervical Strain. I actually worded as to Saunder Vs Willie.  Claim was still denied. 

Like we all say, never give up. That's one of my Appeals. Infact I do have a hearing 27th of Apr.

My point is to try to use different avenues of approach. May not get the answer that you aren't looking for but keep fighting. 

[Vync]

@WhodatI know what you mean. The VARO's don't seem to care about recent court precedents until they show up in M21-1. I am in the same boat because of an HLR (due to CUE) that is presently at the BVA because the VA repeatedly fails to follow their own regulations... Nothing like having the DRO agree with me during the telephone call, but the resulting decision acted like it was never mentioned. Fun stuff!

[JKWilliamsSr]

1 hour ago, Vync said:

Similar situation here. The only funds that came out of my pocket which went toward IMO/IME's for a nexus from non-VA doctors was co-pays with my private medical insurance. I did get one great nexus from a VA audiologist. Otherwise, whenever I asked a VA doc for one, they basically either said they are not allowed or said they would, but did not in the end. I do know that at some point, the VA came out with a directive that said a veteran can request the VA provider note the current diagnosis and details, but cannot remember or find a link to it.

I think it depends on the situation on if someone should or should not pay for an outside IMO/IME.   I think for the most part if you are appealing to the BVA it is not needed because they (unlike a lot of raters) know how to apply the law.  That is why more than 75% are either remanded because of a VA error or outright overturned.

If you are going to spend the money I suggest doing your homework.  I don't think people should just get one because they saw an advertisement for a doctor that would do one.  I do however, think an IMO/IME from outside doctors are a necessary evil.  To counteract the clear bias VA examiners have against service connection. I have a lot of secondary conditions that are caused or aggravated by my service connected disabilities.   For lack of a better way to explain it any idiot should be able to see the correlation but it seems VA raters (at least in my case) cannot.  For example my sleep apnea.   I was tying it to weight gain because of my inability to excercise.  However through my attorney I had an IMO done and the doctor mentioned my weight gain but also mentioned how Asthma (I am service connected for that too) could cause or aggravate issues like sleep apnea.  In the end the BVA judge granted my sleep apnea claim based on the IMO's asthma argument.

There are pros and cons for either side.  I will say this.  For me the pros were for the IMO because the doctor that did mine was cited in just about every one of my BVA grants.

[Dustoff1970]

Yes Dr. Anaise's favorable nexus statement saying my OSA Sleep Apnea condition was secondary to my long term PTSD and PTSD medications help me win a recent 50% grant of benefits from the BVA along with my other positive medical evidence that was totally ignored by the VARO as expected.  VARO rater and VA C&P examiner puke used the usual standard excuse that my 30 lbs of overweight for many years was cause of my OSA. 

The BVA cited Anaise's medical opinion as positive evidence in my case and as required Anaise gave a long detailed rationale explanation as to his reason for stating my OSA was due to my PTSD. Also as required by the BVA he reviewed my extensive copies of VA, private and Army medical records from 1970 to 85 and to the present time in arriving at his opinion.

I received Anaise's opinion AFTER the VARO denial and sent his opinion directly to the BVA.  I am sure VARO would have also ignored his opinion with their standard denial statement of "NO EVIDENCE".

This comment is not legal advice as I am not a lawyer, paralegal or VSO.

[deedub75]

7 hours ago, pacmanx1 said:

I personally have never paid for an IMO/IME, I have gotten all my opinions from my VAMC doctors. Instead of getting a letter which some of them did write others wrote a statement in my medical records that my condition was either military related or related to my service-connected disability. I even used a Community Care Provider to fill out one of my DBQs. 

Same here.

I did have my orthopedic surgeon write a nexus letter - well, I wrote it for him and he signed it. He didn't charge me anything. That's how I finally got my knees and back service connected secondary to my plantar fasciitis and right ankle. For my OSA claim, I just had my VAMC doctor put a statement in my medical records saying that my OSA was more than likely caused by my service connected sinusitis. I tried to get a couple of my doctors to fill out DBQs but they wouldn't. Fortunately, I ended up not needing them.