Jump to content
VA Disability Claims Community Forums - HadIt.com Veterans


  • veterans-crisis-line.jpg
    The Veterans Crisis Line can help even if you’re not enrolled in VA benefits or health care.

    CHAT NOW

  • question-001.jpeg

    Have Questions? Get Answers.

    Tips on posting on the forums.

    1. Post a clear title like ‘Need help preparing PTSD claim’ or “VA med center won’t schedule my surgery instead of ‘I have a question.
       
    2. Knowledgeable people who don’t have time to read all posts may skip yours if your need isn’t clear in the title.
      I don’t read all posts every login and will gravitate towards those I have more info on.
       
    3. Use paragraphs instead of one massive, rambling introduction or story.
       
      Again – You want to make it easy for others to help. If your question is buried in a monster paragraph, there are fewer who will investigate to dig it out.
     
    Leading too:

    exclamation-point.pngPost straightforward questions and then post background information.
     
     
    Examples:
     
    • Question A. I was previously denied for apnea – Should I refile a claim?
      • Adding Background information in your post will help members understand what information you are looking for so they can assist you in finding it.
    Rephrase the question: I was diagnosed with apnea in service and received a CPAP machine, but the claim was denied in 2008. Should I refile?
     
    • Question B. I may have PTSD- how can I be sure?
      • See how the details below give us a better understanding of what you’re claiming.
    Rephrase the question: I was involved in a traumatic incident on base in 1974 and have had nightmares ever since, but I did not go to mental health while enlisted. How can I get help?
     
    This gives members a starting point to ask clarifying questions like “Can you post the Reasons for Denial of your claim?”
     
    Note:
     
    • Your first posts on the board may be delayed before they appear as they are reviewed. This process does not take long.
    • Your first posts on the board may be delayed before they appear as they are reviewed. The review requirement will usually be removed by the 6th post. However, we reserve the right to keep anyone on moderator preview.
    • This process allows us to remove spam and other junk posts before hitting the board. We want to keep the focus on VA Claims, and this helps us do that.
  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • VA Watchdog

  • Can a 100 percent Disabled Veteran Work and Earn an Income?

    employment 2.jpeg

    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

  • 0

you don't need a private doctor imo to win a appeal or a claim


Mr cue

Question

It is really get to me that the only advice I see give is a veteran need a private imo.

To win there claim or appeal.

When did hadit stop stating law cfr VA manual to help veterans.

If you file a claim nine time out of ten the VA is going to order exams with it without a imo.

I just don't see how this is helping.

My opinion is that it is discourage veterans.

We all understand that it hard to get your VA doctor to do a report and most don't have 1000s to pay for One.

An 9 time out of ten the VA is going to not even address the private imo away.

They have want to address your record

So give this advice to me is sending veterans down a rabbit hole.

This is my opinion.

Other believe this is the only way.

I have Never had a private imo done or use in any of my grant's

The VA half the time doesn't even want to address there own comp exam.

If there favorable.

 

 

 

Link to comment

Recommended Posts

  • 0
  • Community Admin

It’s not a hadit thing it’s what the membership is saying , but I agree with you I never needed an IMO for any of my decisions and most of the vets I know didn’t either.

in past years on occasion an IMO might be suggested but it wasn’t common. 
 

Knowledge Is Power! That means digging in on the law, the manuals, court decisions and so forth.

 

  • Like 2
Link to comment
  • 0
  • Content Curator/HadIt.com Elder

I agree with @Tbird. The Intent to file process is a strong way to protect an effective date for new/supplemental claims. For increases, you just need medical evidence. I used non-VA medical nexus/IMOs a couple of times.

Trust the VA to get it right is an option, but I personally found they tend to get things wrong often.

You can can also go in armed with knowledge and evidence if you choose. I did this many times and spoon-fed the VA exactly what they needed. All they had to to was confirm and verify, but quite often they didn't even do that right. That explains why two-thirds or more cases are overturned or remained by the BVA. 

Link to comment
  • 0

I'd say on about 90% of my claims that were granted did not need an IMO from a private doctor and these were a combination of claims that were granted on the first try and some on appeals. 

I did a few claims that I never would have won without a nexus letter from my doctor. These claims were initially denied and went through the appeals process all the way to BVA and remanded. I kept running into the same NP examiner at the VAMC who denied me and doubled and tripled down on her incorrect opinions. The only way I was finally able to get my claims away from this examiner was to file a supplemental claim with a nexus letter from my doctor. Once I did they, exams were order with a contractor instead of the NP at the VAMC who kept denying. All claims were finally granted. Some of those claims went back 10 years. 

If you records are strong and you meet all of the Caluza elements then you shouldn't need an IMO from a private doctor. 

Link to comment
  • 0

  Out of all my successful claims and appeals since at least 1998 representing myself before VARO, CAVC, and BVA there is only one time I payed for a private doctors medical opinion to support my claim/appeal in a recent winning grant from the BVA for OSA Sleep Apnea. The other times I won my claims or appeals based on the medical records and other evidence I submitted on my own.

I am glad I did because the VARO denied all my extensive favorable medical and other evidence to deny my OSA claim with the stupid "NO EVIDENCE" statement and no real explanation for their decision.  They made the same statement in recently denying my IHD Heart Disease increase claim that I also appealed to the BVA and received a remand so this appeal is still pending.  The BVA OSA grant also resulted in my automatically receiving SMC-S and 5 years back pay.

Dr. David Anaise only charged me $1500.00 dollars for issuing me TWO SEPARATE medical opinions on the above claims/appeals.  That is a good deal to me in this present day and age and NO he did not charge me thousands of dollars.

There comes a time when even experienced old hands like me may need a PAYED LAWYER OR DOCTOR to assist them against a stubborn deny til you die VARO.  A former VA nurse and now LHI C&P examiner confirmed this to me recently that to save VA money the VAROs practice deny til you die doctrine against vets all the time.  I of course knew this all along for past 35 - 40 years.  With just a little bit of research and after talking to other doctors I decided on Anaise as I was not about to pay "THOUSANDS" of dollars to any other doctor.  That would have been really stupid of me.  

I have been P&T TDIU since 1998 thanks to my own abilities and no one else.  DAVID against GOLAITH. Can you hear me now.

Others carry on about another doctor asking $10,000.00 for an opinion but when I talked to him on the phone he also quoted me a much lower price than $10,000.00.  I have never had to wait more than 2 to 4 years for a favorable cliam or appeal.  I also like to brag about my own successes. I suspect some vets are j

 

Edited by Dustoff 11 (see edit history)
Link to comment
  • 0
  • HadIt.com Elder

I would say that if you have a mental health claim getting a friendly shrink to write you a letter is going to go a long way.  I went from 30% to 70% TDIU thanks to an IMO.  The VA was just determined not to grant a decent rating or TDIU even though I was on SSDI for the same thing.  I was in treatment for years with private doctors so that helped as well.  Now recently I got some major claims done without an IMO, but these were all Agent Orange related.  I have used VA records for years now and VA has a hard time denying their own treatment records.  I got IMO's and never paid a dime.  My insurance paid.
 

Link to comment
  • 0

Yes you are one smart cookie and this issue of paid medical opinions is a poor dead horse that has been discussed to death on the forum.  I do not understand the animosity against paid for medical opinions at another location social media.  I suspect it is due to jealously. As I recall all veterans like me are legal adults from time we entered active service and later as veterans so we should know better than to be ripped off by anyone.  Trust but verify and RESEARCH has worked for me for many many years now. 

Representing myself since 1998 has been free of charge to me as I paid no one else except one time and did not charge myself for the other claims and appeals. See you at the rodeo. Burp

 

Edited by Dustoff 11 (see edit history)
Link to comment
  • 0
  • Lead Moderator

It is great you never needed to get an IMO.  

I agree it is not always needed as most of mine were done without it.

There are times where it sadly is needed.  I have a rare condition and the VA had no idea how to rate it.  I had to take it to the CAVC and yes, I needed a lawyer as I did not have time to fight this and take care of my family.  I did need one, IMO for this condition.

For all the other 9 conditions I did not need any help doing these.  I got all the help from here.  

So, for the most part I agree you should not, but there are times it is needed.  

Edited by shrekthetank1 (see edit history)
Link to comment
  • 0

I could be wrong but the only advice I see posted for every veteran is that you need a imo.

Like I said that wasn't the case on hadit.

We use to give law cfr and bva cases that may help the veteran.

That is how many if us became verse in the law and cfr. Well that how I got started.

The law and cfr and VA manual are the rules the VA must follow.

This is how you win claims.

 

The veteran affairs has give a billion dollars contract for comp exam.

Believe me you will be send for a comp exam. With or without a private imo

If the case go to the court it is about not about a imo it's about the law.

I just feel we are doing a dis service to the veterans who post on hadit.

With the only advice give is you need a imo. This is my opinion

 

 

Link to comment
  • 0
  • Community Admin

@Mr cue I agree with you. It seems that there has been a trend for for some members to push IMO's, I don't agree with that. Perhaps some folks  forgot what hadit.com is all about and others never understood. 

When you run a forum such as this the membership drives the conversation. Sometimes I need to step in and redirect the conversation but as a rule the membership is the driving force on discussions.

 

  • Like 1
Link to comment
  • 0
  • Community Admin
8 hours ago, shrekthetank1 said:

It is great you never needed to get an IMO.  

I agree it is not always needed as most of mine were done without it.

There are times where it sadly is needed.  I have a rare condition and the VA had no idea how to rate it.  I had to take it to the CAVC and yes, I needed a lawyer as I did not have time to fight this and take care of my family.  I did need one, IMO for this condition.

For all the other 9 conditions I did not need any help doing these.  I got all the help from here.  

So, for the most part I agree you should not, but there are times it is needed.  

@shrekthetank1I agree. It is more the exception, not the rule. `

 

  • Like 1
Link to comment
  • 0
  • Moderator

Here is how you can "really" find out if you need an IMO/IME:

1.  Review your cfile.  Does each issue claimed have a valid nexus?  If you dont have a valid nexus, or you have nexus statements that conflict (one doc says you do, another says you dont), move to next step.  

2.  Ask your regular doctors to provide a nexus.  If a VA doc will not, move to step 3.  

3.  Review your decision.  What is the reasons and bases for denial?  If the decision says something close to "there is no evidence that your current disability was due to an in service event.  NOTE::  VA often disguises the real reason.  "If" you have a current diagnosis, AND you have an IN Service Event, with a valid nexus, you should be service connected.   Since you cant count on VA to tell you the real reasons for denial, lowball or bad effective date, you may need to consider a professional representative, such as a lawyer, to help you decide.  

4.  "Other than a valid nexus", you may still need an IMO/IME "if" you were lowballed, and your medical records dont show "all" your symptoms documented.  

5.   Are you seeking TDIU?  Did your doc state you are unable to maintain SGE, but you got denied anyway?  This is a trick.  You see, you have to show you cant do ANY job, not just your present job.   Your doc can state you are unable to maintain SGE on your present job, but the doc can not say, whether or not you could be retrained for a "sedentary" position or another type of position where your disabiilites could be accomodated and you could still work.  

    Example:  You are SC for 2 bad knees.  You work in a warehouse moving boxes.  Your doc has opined you are unable to move boxes anymore, because it inflames your knees.  However, could you be retrained as, oh maybe a computer programmer, where you dont need to be on your feet for extended periods and lift objects over the doc's weight limit.  

This is a great example of when you need an IMO from a voc rehab specialist to get tdiu, if you have already been denied.  

6.  Lastly, you may still need an IMO/IME to document earlier symptoms that were not documented previously in your records, to get an EED.  

     Example:  Your family doctor, of many years was there and he assisted with your birth.  

He is aware of your medical history since birth.  You join the military as a parachutist, and develop knee problems out of the service.  But, you live with the pain of bad knees for years, even tho, you had applied and were given an unsatisfactory effective date.  

Your doctor may be able to document previously undocumented symptoms, "especially if" you visited that doctor (perhaps for another issue), and he saw you limping.  

       No, an IMO is not needed all the time.  Its a tool.  It takes some effort to really determine if you need one, or you can just spend the money anyway.  I recommend you follow the above steps to decide if you need one..not just guess at what is in your medical records.  

      I did not spend the money to buy an IMO, until I had exhausted all other avenues.  

Edited by broncovet (see edit history)
  • Like 2
Link to comment
  • 0
  • Moderator

 I disagree with a blanket statement, "you dont need an IMO to win your claim", when, in order to make a good choice (whether or not to get an IMO), you need INFORMATION, 

like I posted above.  The CFR's wont tell you if you need an IMO..that can only be determined with a thorough review of your cfile, as I explained above.  

  • Like 1
Link to comment
  • 0

As I explained you don't need a imo to win a claim or appeal.

This post isn't to debate it this my opinion.

Many have won claim and big retro without a imo.

8 year retro tdiu for me.

Based on the law and cfr.

To tell veterans that they need a imo to win there appeal it claims is doing a dis service.

Tell them the law or regs show them case that are like there so they can get a ideal of how the VA should be handling there claim.

Tell them to go pay 1000s of dollars is not advice.

My opinion

Link to comment
  • 0
  • Moderator

Many Veterans have won claims WITH an IMO.  Maybe you dont need one...I havent reviewed your file.  

If you have all the evidence present, nexus, and what I described above, you can get by without one.  

To advise All Veterans NOT to get an IMO is a bad idea, when you have not reviewed their file and dont know what evidence they have or dont have.  

You wont be winning a claim WITHOUT a valid nexus, and that may or may not be in your file.  

Its like saying "you dont need a car", when you have no idea whether or not they need a car.  Some people need one, others dont.  It depends on circumstances.  

But, telling all Vets , "they dont need an IMO" is a bad idea, and bad advice, since some will never win their claims without one.  

Evidence wins claims, CFR's not so much.  When you have the evidence, you should win, when you dont have the evidence, you need to get it to win.  

I explained, in detail, above, how to tell if you need an IMO.  Not everyone needs one, but, without one, many claims will fail over and over again.  Neither the board nor the CAVC will award benefits if you lack the applicable documented Caluza elements.  And, to get them documented, if you dont already have them documented, you will need your own doctor (IMO/IME). 

People "in the know" KNOW that it often takes an IMO to win.  

That is why some law firms "up front" the cost of an IMO needed to win.  In other words the law firm "risks their own money", because they know the Veteran should win, but cant win without medical evidence which is not in the cfile. 

Edited by broncovet (see edit history)
  • Like 1
Link to comment
  • 0
34 minutes ago, broncovet said:

That is why some law firms "up front" the cost of an IMO needed to win.  In other words the law firm "risks their own money", because they know the Veteran should win, but cant win without medical evidence which is not in the cfile.

Are you getting a cut because ever post is about a imo if anyone dispute it you jump out the wood work to make sure that ever veteran understand they can pay for a imo.

We all understand your opinion on imo.

It is on ever veteran that post thread.

There is no need to try and explain your opinion on imo to me or on my post.

An like I said it is doing a veteran dis service looking for help with all you got is imo.

There are law reg cfr VA manual bva cases court cases.

But all I see u and many others tell veterans is that they need a imo.

So then? Is are U getting a cut.

Because this is crazy to me

 

 

Link to comment
  • 0
2 hours ago, broncovet said:

 I disagree with a blanket statement, "you dont need an IMO to win your claim", when, in order to make a good choice (whether or not to get an IMO), you need INFORMATION, 

like I posted above.  The CFR's wont tell you if you need an IMO..that can only be determined with a thorough review of your cfile, as I explained above.  

I agree with you on this.  The truth is there comes a time where the best advice you can receive is to get an IMO.  The majority of people reaching out to forums such as Hadit have had to deal with multiple denials from the VA.  They believe they have all the necessary information and yet keep failing.  They are trying to figure out what the problem is.  For the most part you only get one shot at an appeal and you want to make sure you have it right. 

Getting IMO's was the best decision I could have made.  It took me 20 years to get to 100% P&T  and the disabilities I am rated for now are all the same (except 1) when I first filed in 2002.  The hurdle I kept having to jump was the VA examiners inept opinion stating my disabilities were not service connected.  Once a VA examiner gives a negative opinion the best way to refute that is by getting a positive opinion from another medical professional.  In my experience most VA examiners are Nurse Practitioners or Physician Assistants.   I don't think they are qualified to give the opinions they are making.   That is just one mans opinion.  

When people come here they are likely at the appeal level and this is where it can be daunting.  When you take an appeal before the BVA you are dealing with attorneys.  The VA is going to have an attorney argue against your claim.  We will need evidence to the contrary.  If you go before the BVA and they have a negative opinion you have to argue that opinion was wrong.  There is plenty of case law on how claims are supposed to be adjudicated how many of us point out errors and get the VA to acknowledge and accept it.  I know I can't because on 3 HLR's I cited regulations and case law and still had my claims denied. 

I will give an example on how that while we may have information our application could be incorrect.   This is directly from my own argument that I made during and HLR and it led me to hiring an attorney and getting an IMO.   For Diabetes I argued that because of my service connected disabilities I was unable to exercise.  This led to weight gain which caused my Type II diabetes.  The VA had 2 negative opinions.  One from an MD who stated that paraplegics can exercise and maintain a proper BMI.   Another from a NP that stated that she did not see where I was placed on waivers from exercising while on active duty and thus could not relate my weight gain to Diabetes.  Both of those opinion are flat stupid but they worked against me.  It was those opinions that led to my throwing my hands in the air and getting an attorney. Through my attorney I got an IMO and this was the difference maker. 

If I was to argue this on my own at the BVA I would have used the obesity as an intermediate step leading to Diabetes.   Would that have worked on my own I don't know.  However my IMO used that and other theories to service connect my diabetes.  It was one of the other theories that the BVA judge granted my service connection on. 

In my BVA decision the judges stats and I quote: "In his august 2020 report, Dr R.L. opined that the veterns DM was aggravated by OSA.  He reasoned that OSA can impair glucose control, citing a study showing a clear inverse relationship between OSA severity and glucose control in patients with DM. Dr. R.L also cited another physician who reported that OSA can also increase blood sugar levels because of the stress associated with Chronic Cleep deprivation and abrupt awakenings in the night."

Although there is a negative nexus opinion of record, that the opinion address the relationship between the veterans orthopedic disabilities and his DM; The veterans OSA was not considered"

Given Dr. R.L's positive opinion, the evidence is at least in equipoise that the veterans DMII was aggravated by his service connected OSA.  Accordingly service connection is warranted"

This is how an IMO can make a difference. Suggesting a veteran should get an IMO is reasonable. 

Edited by JKWilliamsSr (see edit history)
  • Like 1
Link to comment
  • 0
2 minutes ago, Mr cue said:

Are you getting a cut because ever post is about a imo if anyone dispute it you jump out the wood work to make sure that ever veteran understand they can pay for a imo.

We all understand your opinion on imo.

It is on ever veteran that post thread.

There is no need to try and explain your opinion on imo to me or on my post.

An like I said it is doing a veteran dis service looking for help with all you got is imo.

There are law reg cfr VA manual bva cases court cases.

But all I see u and many others tell veterans is that they need a imo.

So then? Is are U getting a cut.

Because this is crazy to me

 

 

I am sorry dude but you are posting an opinion saying IMO's are not necessary and I think that is bad advice.  An issue I have here is that someone disagreed with your opinion and your response to him is " are you getting a cut".  It is clear you have a negative opinion of those that say get an IMO and your responses to them show it. 

I will say this from the personal experience of a 20 year battle with the VA.  I will tell anyone that is going to the BVA with an appeal to get an IMO if they do not have a positive medical opinion in their file.  It was the IMO that got me over the top.  I failed at every turn without one. 

  • Like 2
Link to comment
  • 0

When I got out service 1993 and old veteran told me that you have to build up your jacket to get higher rating.

Which mean treatment records.

For the condition that you injury in service.

The VA will order there own medical opinion with or without a private imo or with treatment records.

I have won many case with this been the process.

And with the law and reg the veterans affairs is to use.

Now if ppl want to make it more than that that is fine.

This post wasn't to debate imo I was trying to inform veterans that you can win case with out a imo.

And study the law and reg and bva cases which are the same as your condition.

So u can get a ideal of how the VA should be handling your claim and issue.

Its alot bigger than paying for a imo

Link to comment
  • 0
  • Community Admin

This to[ic has been talked to death. This is not a website about one topic. Some say it’s worth it, some say it’s not. Beating a dead horse here and I can see no real value to further discussion.

  • Like 2
Link to comment
  • 0

You are right u can close the post I made the point I just wanted veterans to understand there are ways to win a claim or appeal without a imo.

Find the law that address your issue and look up bva decision that are like your condition.

Follow the blue print if the bva decision.

Look up the law the bva use in the decision.

This is the other way you win claims and appeals

I am done with it.

Link to comment
×
×
  • Create New...

Important Information

{terms] and Guidelines