It appears that the VA is being more critical of IMO/Nexus letters. In the past it use to be, "More Likely than Not" was enough to get an approval of your claim. Do you know what the VA is looking for? Can you provide an example of an accepted Nexus letter that the VA will accept? I'm in the process of obtaining an IMO/Nexus and would like to avoid any pitfall. Are you in a position to call the VA and actually ask them for guidance on what they will accept now? About 3 years ago I submitted what I thought was a very good Nexus. The VA threw that out in the blink of an eye. That claim is sitting with the BVA. I just want to be in a better position to provide the VA with the evidence they require. Thank you.
Plugging in a phrase like, "More likely than not" isn't nearly enough. The statement would have to be supported by science and made by a qualified individual. For example, a podiatrist shouldn't opine about heart disease for your IMO. I haven't seen any particular shift in what VA accepts as an IMO.
Call the VA and ask them for advice? That's a new one on me. But no, the VA doesn't help you to win your claim by offering personalized advice.
Since I don't know where you're getting your support from, the best I can offer is that experience counts. The doctor should have a deep understanding of what VA needs to hear and must have to support your claim. Asking your family doctor to provide an IMO is usually a waste of time.
The 2002 edition of The Clinicians Guide is the tool I use most often to develop what I think VA must have in the record for you to prevail. If you'll study that guide and tie those principles to your claimed conditions in The Schedule, you should have a winner.
I'll remind you that sometimes we don't win because we don't have a well grounded claim no matter how much we believe in our cause. There's only so much that wordsmithing can do to help and legit IMO doctors won't fudge anything to help you.
In the end, if you want a great IMO these are the folks who can help https://www.vawatchdog.org/imo-ime-medical-opinions-exams.html Good luck.