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Craig N. Bash M.D., Neuro-Radiologist

7831 Woodmont Avenue, Bethesda, MD 20814

Ph: (301) 767-9525 Fax: (301) 365-2589 E-mail: drbash@doctor.com

INDEPENDENT MEDICAL EVALUATION 2 April 2002

To:

Re:

In 8 May 1952

Out 19 Dec 1952

DOB 4/27/1935

At your request I have reviewed the Medical record of the above named patient for the purpose of making a medical opinion concerning this patient’s pneumonia and bronchiectasis. In order to make this opinion I have carefully reviewed the following information:

Service Medical records;

Post service medical records;

Imaging reports;

Rating decisions;

Chest CT scan dated 29 Feb 1996;

Other physician statements;

Medical literature review.

Impression:

I have reviewed these CT images and it is my opinion that this patient does have Bronchiectasis and he has had it since his multiple in-service antibiotic treated pneumonias, fevers, chills, bronchitis and bronchiectasis all of which occurred in 1952.

It is also my opinion that this patient’s multiple post service lung infections, as documented by Dr. Smith, are all likely secondary lung infections caused by his bronchiectasis.

Facts, Rational, Other medical opinions and references;

8 Feb 1996 “…moderate bullous changes in the right and left apex…mild interstitial fibrosis involving the right and left lung…” DR. Jones;

29 Feb 1996 High resolution CT scan of the chest “…No conclusive evidence of bronchiectasis…” DR. Brown;

3/6/96 examined on 8 Feb 1996 “…occasional episodes of wheezing…soft cough…phlegm is mostly whitish…symptoms for more than ten years…History of multiple episodes of pneumonia in the past and evidence of scarring by CT scan…History of bronchiectasis, however recent CT scan does not show evidence of bronchiectasis…” Dr. Smith;

Dr. Bash usually does not evaluate psychiatric conditions, vaccine reactions or injury, or certain skin disorders related to chemical exposure; however, he can refer the veteran to a specialist who can help.

Dr. Bash works with these Veteran Service Organizations (VSO) among others.