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You quit when the gorilla is tired." — Robert Straus
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Spine Pain Independent Medical Opinion
James Shields, MD, MBA...A Board Certified Physician
Veteran Spine Pain, Weakness, Stiffness, Neck or Cervical Pain, Fibromyalgia,
Intervertebral Disk Syndrome, Decreased Range of Motion, Degenerative Arthritis
of the Spine, Hip Pain or Weakness, Shoulder Pain or Weakness
Greg served in the Air Force as a C-17 loadmaster in both Operations Enduring
Freedom and Iraqi Freedom. Greg's practice includes VA disability compensation
appeals, Individual Unemployability (TDIU) claims, MST, PTSD and other mental health disability claims and appeals and other veterans disability claims processes. Attorney
Rada offers free telephone case evaluations as well as nationwide representation.
Call today! 844-838-7529
Veterans Psych Evaluations
Brett Valette, Ph.D.
Providing Military Veterans Personalized Psychological and Medical Evaluations. Complete the Contact form, and you'll get a personal phone call from us. We listen, and want to know what you are going through. We provide Independent Medical Evaluations (IME), Independent Medical Opinions (IMO) and nexus letters for ratings reviews, secondary conditions, medical conditions, discharge upgrades, and many types of denied claims. We also provide Social Security Disability claim reports.
Some Wounds Can't Be Seen Contact Us Today
Jim Strickland is a Vietnam era Army veteran and nationally recognized expert on VA
disability benefits. Jim writes extensively about VA and Social Security disability benefits.
Jim's Mailbag is a regular column featured at Stateside Legal where veterans, servicemembers,
and family members can ask Jim their questions about VA and Social Security disability benefits.
Independent Medical Opinion
IMO Nexus Letters Independent Medical Exam
Question: i have ischemic heart disease. i had two stents put in my widowmaker artery 6 years ago and, in july, I had heart attach and they found 80 percent blockage in front of the stents and 90 percent behind the stents or the opposite before and after and they also found 70 percent blockage in the circumflex artery. So now I have 5 stents in my heart. and I also have an aneurysm in my ascending aorta that has grown from 4.1 to 4.4 in 6 months along with mild dilation in the descending aorta.
I have 30 percent disability from VA from 6 years ago due to agent orange exposure. Would the combination of the heart attack, new stents and the aneurysm possibly rate an increase in disability rating? Is the prior blockage and the aneurysm associated? I am a time bomb ticking, in my opinion
Reply: VA has a unique way of rating our heart disease if we are eligible for service connected ischemic heart disease or IHD. The degree of damage to the heart from IHD is a measurement of how efficiently the heart works. Even if you've had a dozen stents and a number of surgical bypasses, if your heart still works efficiently, the final rating will be lower than most would think appropriate. The measurements used are the 'ejection fraction', a measurement of how efficiently the heart pump works and a measurement called cardiac METS, another way to measure the pump of the heart. An aortic aneurysm isn't generally rated service connected as is IHD, since the aneurysm is presumptive to agent orange. If the efficiency of your heart has deteriorated, you may deserve a higher rating...otherwise, probably not.
Question: Good Evening Jim, I am trying to find a definitive answer on whether or not I qualify for a VA home loan. I served in the Navy for roughly 3 1/2 years and got out with an “other than honorable” discharge. Can you help? Thanks!
Reply: Eligibility for a VA loan guarantee requires an honorable discharge thus you are not eligible. You can speak to these folks about helping you with a discharge upgrade https://www.nvlsp.org/
Question: I've had 3 strokes already how do I find an IMO in my area. Thanks.
Jim's Reply: Well...you don't want or need an IMO doctor in your area, you want someone who is competent to review your records. They can be anywhere since you don't need to meet the doctor face to face. You won't need an examination, the doctor will review your medical records you provide and from that he or she will render an opinion about your illnesses.
Question: I was denied direct connection for major depression and anxiety and I don't want to appeal. Can I submit a claim for anxiety secondary to tinnitus based on the fact that tinnitus causes my anxiety to get worse? I live in south Florida and would like to know if you can recommend a doctor.
Jim's Reply: Yes, you may submit any claims you wish. It will help you to obtain an IMO.
Question: I am currently rated at 40 percent, due to arthritis in my knees, neck and back. A few years ago, I was told that the depression I have been suffering from is made worse or could be a result of the chronic pain and reduced mobility of the disability that I have. I filed a claim for that and it was denied. What can I say, I was depressed. I did not file an appeal. Is there any way I can try again to get the depression I have included?
Jim's Reply: Yes, you can file a new claim most any time you'd like. You'll need some new evidence to support your claim that you suffer depression secondary to chronic pain. Your new evidence should be in the form of an Independent Medical Opinion (IMO). You're going to need the IMO from a civilian psychiatrist or psychologist. That person will have to review your medical records and then come up with an expert opinion that supports your claim. You're welcome to try getting an IMO like this from your VA care people, but I'm not confident you'll get that sort of support.Unless you have an expert IMO that clearly states that it is more likely than not that your depression is secondary to your service connected chronic pain condition, I'd predict that the outcome would be another denial.
I am an unashamed enthusiast and won't stop promoting the use of an IMO for claims and appeals. Many years ago I had 2 IMO's done and had to take a loan on my house to pay for them. I won both appeals with no problems. The IMO is unquestionably the very best way to win a claim or appeal when you have a well grounded claim.
An IMO is an Independent Medical Opinion. The opinion is usually a report that describes the experts review of pertinent records that include service and civilian medical records and any other records that may have an impact on the opinion.
A Nexus Letter is similar but that term isn't used as much since the advent of the DBQ and the IMO.
The IMO is based on records provided to the reviewer by the client. There is rarely a face to face meeting as there is no physical exam required. The veteran client must provide adequate documentation for the expert to render an opinion.
All these doctors are specialists in disability medicine and evaluation of your records. Having their favorable opinion
greatly increases the probability that you will prevail with little fuss. Each of these doctors will charge you a
reasonable fee and they are all open to discussing all that with you. There is no good reason to wait...having an IMO helps.
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Nexus and IMO Letters
Veterans Law Attorney Drew Early
Graduate of the US Military Academy West Point
20 years of active Army service, multiple deployments, tours with 2 Infantry
Division, 10th Mountain Division , XVIII Airborne Corps, and Third Army,
Airborne and Master Explosive Ordnance Disposal badges.
Graduate of the Command and General Staff College Master's Degree in
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disability claim
Find out how to file a claim for disability compensation
or increased disability compensation.
When You Hit A Dead End
The Department of Veterans Affairs
White House Hotline
855 - 948 - 2311
< Denis.McDonough@va.gov >
Yes, this really works. No, it doesn't ring in the White House. The email address and phone number are staffed by a seemingly serious group of players, many who are veterans, and if you have a legit issue, telling these folks is like bringing in the artillery. Let's prepare for your call or email. Make some notes before you proceed so you don't forget anything. I prefer email since there's no waiting for someone to answer and I can take my time to prepare the story in just the right detail. Be sure to include your DOB, your last 4, contact info...a couple of numbers, your preferred email and such. Describe the problem as briefly as you can. Less is more. Include the necessary components but don't tell your life story. Don't rant. Be polite...military courtesy will get you places that hollering IN ALL CAPS won't. Respect! Don't waste their time with bogus complaints about your feelings being hurt. If you appropriately utilize this service, I'll vouch that this works like a champ. Tell them you read about this at The VAWatchdog Dot Org...they know who we are.
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Since 2005, We're Keeping An Eye On Your VA
Because Somebody Has To!
Welcome Home! I'm Jim Strickland. I'm an Army vet, I was 91-D20 in USAREUR at the
98th General Hospital near Camp Baumholder 1967 - 1970. I publish the VAWatchdog
Dot Org to help you obtain the benefits you earned by your service to our country.
I'll also share what I'm reading today, the important stuff. An informed veteran
is a successful veteran. Feedback is always welcomed.
Welcome to the KnowVA Knowledge Base
Locate information more quickly and efficiently
Jim Strickland
jim912@gmail.com
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The NPRC
Military Records
Denis McDonough
Secretary of Veterans Affairs
Are You Rated For A Spine Condition?
Mistakes Have Been made!
Accuracy of Claims Decisions Involving
Conditions of the Spine
Independent Medical Opinions Nexus Letters
Thomas Grieder, MD PhD
25 Years Service as a VA Psychiatrist
Lead Psychiatrist East Los Angeles
PTSD Clinical Team
I'm Jim Strickland
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You may file claims on eBenefits or you can mail them in using certified mail or you can even fax them in.
Download VA benefit letters
To receive some benefits, Veterans need a letter proving their status.
C&P Service Clinician’s Guide
When the examiner says, “more likely than not”
or “at least as likely as not”, how
does that affect the outcome of your claim?