Current work
Today I work through Valor Consulting, PLLC, primarily with attorneys and law firms handling VA disability claims and appeals. The cases that interest me most are the ones where the answer is buried across years of records: competing histories, secondary causal chains, treatment gaps, conflicting examinations, changes in function, and medical questions that cannot be answered by quoting one note.
I approach those files as a physician rather than as an advocate for a predetermined result. If the record supports the proposed relationship, I explain why. If another cause fits better, I say so. If a necessary test or fact is missing, the correct answer may be that the case is not ready yet.
Professional path
How I approach a medical record
I usually start with the timeline. What happened first? What changed? What happened next? Does the diagnosis fit the natural history? What treatment changed the picture? Is there a competing injury, disease, medication effect, occupational exposure, or other explanation that fits the evidence better?
I also pay close attention to function. Diagnoses are important, but disease happens to a person, not a chart. Sleep, mobility, work, medication effects, mood, treatment burden, and day-to-day function often explain the medical story better than a diagnosis code by itself.
Finally, I try to explain the conclusion in plain language. Medical terminology is useful when it adds precision. It is not a substitute for reasoning.
Science outside medicine
I also operate Shamrock Banks Observatory in Clare, Michigan (Minor Planet Center observatory code W24) and have spent years studying physics, mathematics, and astronomy. Observational astronomy rewards the same habit I value in medicine: make the measurement, compare it with the prediction, and change the explanation when the evidence does not cooperate.
That part of my life is covered in more detail in A Little of How I Got Here, a six-chapter personal series about EMS, Army medicine, clinical work, science, and the path back to serving Veterans through medicine.
Selected physician-written resources
- When Is an Independent Medical Opinion Actually Worth Buying?
- What Evidence Would Make Me Change My Medical Opinion?
- The IMO Is Filed. What Happens When VA Pushes Back?
- Direct, Secondary, or Aggravation? Choosing the Strongest Medical Theory
- When a Normal Examination Does Not Tell the Whole Story
- From Medical Impairment to Work Capacity
- VA Presumptive Conditions - Attorney Medical Reference
Robert Townsend, DO
Dr Bob Townsend · Clare, Michigan