NEXUS OPINIONS STATEMENTS

[Dustoff1970]

There is a misconception put forth on some veterans benefits forums that a MD doctor's formal nexus opinion is almost always needed for a vet to be granted disability benefit claims from the VARO and BVA.  This is not correct and misleading to the vet in an important way.

I have since 1985, 1998 to present days successfully won almost a dozen claims and BVA, CAVC court appeals without the benefit of a formal doctors nexus statement and representing myself with only one recent exception.  In all these claims and appeals I have used my extensive file copies of active Army, VA, VAHC, and private medical treatment records, hospital discharge summaries, test and lab results, doctors and nurses notes, medical prescriptions, along with other non medical evidence to win these claims and appeals. This evidence has served as the required nexus connection always.

Out of many dozens of VA C&P Exams over many many years did I receive one exam that gave a favorable opinion to my claim.

Here are just a few of many examples where I did not need a nexus statement from an MD or anyone else to win my claim.

1. PTSD and PTSD increases that were based solely on my Army Vietnam and Japan and VA medical treatment records.

2. TDIU based upon only my VA and VA medical treatment records and my submitted statements and forms

3. P&T TDIU rating since 1998 based mostly on my own submitted evidence, forms and one VA C&P favorable exam

4. VN Agent Orange IHD Ischemic Heart Disease claim based only upon my DD214, DD215 and other evidence of VN service and             private treatment records, test results.

5. VA VOCAB Training for both Accounting Degree and additional civilian helicopter pilot license

6. U.S. CAVC Court CUE appeal I won thru a court remand and based upon many years of VA medical and non medical evidence.

7. Loss of Use Disability Claim based upon medical and non medical records only with no doctor's nexus opinion.

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

https://www.facebook.com/Vietnam-Dustoff-Medevac-112614780575067/?ref=pages_you_manage

BA Degree Finance & Tax Accounting, Former SEC CFP, Former Army Guard and Civilian helicopter pilot to Two Texas Governors, 

Advanced FAA and British CAA/Singapore Helicopter Airline Transport Pilot IFR License, FAA and CAA Helicopter Instrument Instructor Pilot License for all Weather Flight, etc. etc. 

Former volunteer Army medevac Pilot Vietnam with Purple Heart, CMB, DFC medal, AMs 1970,

Former volunteer UN civilian solo helicopter rescue pilot 1980 south China Sea (Saved over 1000 VN boat people)

 

Edited March 31, 2022 by Dustoff 11

[pacmanx1]

14 minutes ago, JKWilliamsSr said:

Ok.... You don't need a nexus from outside DOCTORS... is that better.?  Dude you are arguing semantics.    I merely meant to say that if a disability is in an SMR you do not need to get a nexus from any outside source.   The fact that it is in your SMR's should be enough.    Key work "SHOULD" .

Key word is "SHOULD". So, what if the VA C & P examiner's medical opinion states that the veteran's condition is less likely than not caused by or related to the veteran's military service? The veteran is going to need a medical opinion that would put his/her claim in relative equipoise to win his/her claim. Even if the veteran files an appeal the veteran would need a positive medical opinion. There are no slam dunk claims.

Semantics, the VA does this all day all the time and just because your claim worked out does not mean that that strategy/advice will work for everyone else. The fact that the SMRs should be enough is not the point otherwise the VA would not have sent you to a C & P exam. 

To clarify, I did not post that a veteran needed an outside nexus opinion, I posted that a nexus opinion in needed. 

Edited March 30, 2022 by pacmanx1

[broncovet]

Here are a few professional Veterans advocates who advocate for an IMO, when there is conflicting evidence, or when there evidence supporting the claim is absent:

Jim Stickland:

https://cck-law.com/blog/va-tests-automated-va-claim-decision-system/

CCK Chisolm and Chisolm law firm:

https://cck-law.com/video/independent-medical-opinion-va-nexus-letter/

Attig Steele law firm (Veterans law blog):

https://www.veteranslawblog.org/independent-medical-opinion/

   Does an IMO "ALWAYS" work in getting benefits?  NO.  

My cell phone "doesn't ALWAYS" work either.  But it works often enough I carry it around most places I go.  

    NOTE:  There is zero evidence that ANY of the above have ever received a "cut" from referring Veterans to a doctor performing an IMO.  Mostly, Vets ask, "Where can I get (this needed IMO)?  

     And, attorneys sometimes refer Veterans to doctors experienced in writing winning IMO's.  

    In short, the professionals, who depend on winning claims for Vets, often recommend an IMO.  Mine did, and it worked marvelously, and cost very little.  

     Indeed my attorney who recommend the IMO "HAD" reviewed my file and knew that missing key evidence would likely win.   He recommended the IMO AFTER we had won a remand at CAVC, so that the board would have new and relevant evidence to over rule the previous board who had denied me.  

     On an individual basis, you would need to review the file to know whether or not spending the money for an IMO would likely be productive.  

     As always, you dont have to take my advice.  However, please dont blame me when you ignore my advice, and then wonder why you did not get a good result.  

Edited March 30, 2022 by broncovet

[El Train]

I noticed most of the people saying you don't need an outside medical opinion have been fighting their claims for decades.  Stuck in appeals at all levels (won some, lost some, some still in litigation).  The decades of experience makes their opinion valid.  Maybe so, and I respect that.  Then one person says file the claim, if it gets denied, then get an outside IME.  I went this route and got denied 2 out of three claims (both GW presumptive).  That is when I came to this forum and learned about getting outside medical nexus/dbq's.  A year and a half later I got the other 2 claims approved and a hand full of others approved or increased (100% P&T SMC).  I don't enjoy fighting with the VA.  Some people do.  I get it.  There are people who insist on filing more claims after 100% P&T with SMC's.  I even have the itch to file claims I know I can win in appeal.  Not going to wake that sleeping bear up.

There are a lot of things in my SMR's that are vague and lack detail by an E-3 Corpsman.  An MD's IME can clarify this for a VA nurse C&P examiner.  Otherwise probably 'DENIED'!  Going into a C&P exam with an IME already done, keeps the VA a lil more honest.  

 

[Dustoff1970]

Yes GBArmy many vets that meet the required criterial and qualified by medical evidence to receive service connection for a disability or disabilities cannot obtain a nexus medical statement from a doctor/s as the doctor/s are lazy, indifferent or hostile to vets receiving compensation for an illness or injury due to service.  Sometimes this is so when the treating private doctor is even offered proper payment to provide a proper nexus opinion and/or DBQ.

This happened to me on several occasions over many years.  My present VA PCP is lazy as hel and freely admits it and is only good for labs, medicine and referrals and will not give out any nexus statements/opinions for anything so therefore I rely on all my medical treatment records.

My private indifferent heart surgeon would not give a nexus opinion or DBQ but his treatment records, notes, labs, and test results that I submitted with my claim resulted in my receiving VA service connection of 30%  for VN AO IHD Ischemic heart Disease. Also I did not need his opinion due to Presumptive Law regarding vets and AO in Vietnam.

I have always  won my claims and appeals based upon other medical evidence WITHOUT a doctors formal nexus opinion or DBQ with only one time recent exception for OSA Sleep Apnea.

I believe vets should not be discouraged from filing a claim due to lack of nexus statement or DBQ if they meet the criterial and have or can obtain other medical evidence to provide a nexus connection to their disability and service or another possible secondary to another existing service connected disability.  They  still have a chance to win their claim at the VARO or on a BVA appeal.

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

 

[Dustoff1970]

None of my successful self represented claims took over two to three years at the most to receive a favorable grant from VARO or BVA and WITHOUT A DOCTOR'S NEXUS STATEMENT. My one U.S. CAVC court appeal took a little over 4 years as I recall.

Just like the numerous BVA decisions I have read many times the BVA will override an inadequate or defective VA C&P Examiners negative opinion and grant the vet his benefits based upon other medical and non medical evidence and without a favorable nexus statement from another doctor's  opinion on behalf of the vet.

This just happened for me when the BVA noted the defective opinion or reasoning of the VA C&P examiner biased exam statement and DBQ against me and ordered a remand of increase of my IHD Heart disease appeal.  I feel confident of winning this claim with only a 4 years time lapse and NOT decades and based upon the only the VA and private medical evidence submitted by me..

Some folks for stubborn misguided reasons say only another doctor's favorable medical opinion can offset a negative VA C&P examiners opinion or DBQ are just flat wrong.  Just do a research of BVA decisions to see what I say above is true.

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

 

Edited March 30, 2022 by Dustoff 11

[brokensoldier244th]

Or, rather than cherry pick BVA decisions to find the occasional grant to try to use s evidence (which aren’t binding on the VA except in that decision- BVA decisions are not case law and only apply to that veteran), just get a opinion outside the VA and drive on.