What is the real value of an independent medical opinion (IMO)?

Posted on: Thursday, May 03, 2018
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What is the real value of an independent medical opinion (IMO)?

Question

What is the real value of a (IMO) Independent Medial Opinion when a DRO and his appeal team can ignore or inadvertently reject its conclusions?

I recently was sent a (SOC) Statement of the Case denying all five of the issues I had on appeal at my local (VARO) Veterans Administration Regional Office. The key piece of evident which I paid a lot of money for, which address only 3 of the 5 issues under appeal, ended up not even being considered in layman terms. The IMO never made the evident list on page one of the SOC. And in the decision section of the SOC one reference was made that "No additional medical has been submitted in support of your claim". Let alone no mention of the author of IMO or his views on the issues of TBI, PTSD, sleep apnea. As disturbing and as frustrating as this reality has been for me. I was wondering with my attorney, after a 21 month wait for a decision, just what is the value of such evidence if the decision makers can ignore or reject it without any real accountability of the decisions they make other then to appeal to the next level?

Jim's Reply

I wish I had a really good answer for you, something meaningful that would help to fix your dilemma. The only answer I can come up with is that, yes...you have to appeal the appeal. This is just so ordinary at the VA & BVA that it isn't at all surprising. VA has the opportunity to reject expert testimony...the IME/IMO. Experts don't always agree and if you paid for an IMO and VA disagreed with it, they owe you an explanation why. The well done IMO often, but not always, trumps the VA C & P exam since the IMO doctor is usually better credentialed and does a better job of making the service connection nexus. That happens but not all that often.

That VA overlooks or ignores evidence isn't surprising either. Ten years ago I was often outraged at the amount of evidence that VBA overlooked during DRO appeals and simple claims processing. Today I expect it and I'm actually surprised when VBA gets one right in a timely fashion.  If this was a DRO appeal your attorney may be able to communicate with a coach or other manager and point out the evidence missed. Otherwise, it's back to the appeal of the appeal.

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