Holcombe Medical Consulting

Holcombe Medical Consulting Holcombe Medical Consulting, PLLC provides physician-led occupational medicine and medical-legal consulting services to employers, insurers, and attorneys.

All services are consultative, grounded in current evidence and operational experience. Dr. Thomas Holcombe is an accomplished physician specializing in occupational and environmental medicine. He obtained his Doctor of Medicine from the University of South Alabama College of Medicine and a Master of Public Health from UTHealth Houston School of Public Health where he also completed his residency in occupational and environmental medicine. Before moving to Texas for residency Dr. Holcombe served as a medical officer in the US Navy for six years. He served two tours of duty as a flight surgeon—the first with Carrier Air Wing EIGHT (CVW-8) at NAS Oceana, and the second with Helicopter Sea Combat Squadron TWO-EIGHT (HSC 28) at Naval Station Norfolk. In his role as Medical Director at HV Health & Safety, Dr. Holcombe provides pivotal clinical governance and medical oversight for on-site occupational health practitioners across various projects. His responsibilities extend to managing telemedicine services and overseeing the credentialing of all medical practitioners within the company. His proactive management and strategic leadership in health and safety protocols significantly enhance operational efficiency and workforce welfare in high-risk industries such as construction, mining, and renewable energy sectors. Dr. Holcombe also continues to serve in the US Navy as a Reserve Flight Surgeon. His current assignment is with Marine Wing Support Squadron 473 (MWSS 473) out of MCAS Miramar, where he oversees medical readiness and support for over 800 Marines. His extensive military service has equipped him with unique insights into the demands of emergency medical scenarios and large-scale health operations, making him a valuable asset to any safety-focused organization. His research and presentations at various conferences further reflect his dedication to advancing occupational health standards and his commitment to lifelong learning and service. Dr. Holcombe holds medical licenses in more than 20 states and numerous certifications as Medical Review Officer, FMSCA DOT Medical Examiner, NIOSH Pulmonary Function Testing, and CAOHC Hearing Conservation.

What Is a Disability Evaluation — and Why Does It Matter?When someone has a medical condition affecting their ability to...
03/17/2026

What Is a Disability Evaluation — and Why Does It Matter?

When someone has a medical condition affecting their ability to work, the most important question is often not just what the diagnosis is, but how that condition affects real-world function and job performance.

At Holcombe Medical Consulting, PLLC, we provide physician-led Disability & Impairment Evaluations designed to help insurers, attorneys, employers, and agencies make informed decisions.

These evaluations may address questions such as:
✔ Has the individual reached Maximum Medical Improvement (MMI)?
✔ What functional limitations exist based on clinical findings?
✔ Are work restrictions necessary?
✔ Is there permanent impairment, and how should it be rated?

Each evaluation includes:
• Comprehensive medical record review
• Clinical interview and physician examination
• Functional capacity analysis
• A clear, objective medical report

Our goal is to provide structured, evidence-based medical opinions that help organizations navigate complex disability and occupational health questions.

If your organization needs independent disability or impairment evaluations, feel free to reach out or learn more about our services.
Holcombe Medical Consulting, PLLC

Physician-Led Occupational & Medical-Legal Consulting



https://holcombemedicalconsulting.com/services/disability-impairment-evaluation

Jet Fuel Exposure and Veteran HealthMany military veterans worked around jet fuel every day—fueling aircraft, performing...
03/10/2026

Jet Fuel Exposure and Veteran Health

Many military veterans worked around jet fuel every day—fueling aircraft, performing maintenance, or working in aviation environments. What many people don’t realize is that jet fuel exposure can affect multiple systems in the body, especially with repeated occupational exposure.

Research reviewing military jet fuel exposure has suggested potential links to:

• Respiratory irritation and lung inflammation
• Possible kidney and liver effects
• Immune system changes
• Possible long-term health risks that researchers are still studying

For veterans experiencing chronic health issues years after service, these exposures may be an important part of their medical and service history.

For attorneys representing veterans, these cases often require careful occupational exposure analysis and medical review because military aviation environments can involve multiple toxic exposures at the same time.

With increasing attention on military environmental exposures and legislation like the PACT Act, understanding the science behind these risks is becoming more important for veterans, families, and advocates.

If you’re a veteran who worked in aviation or fuel operations, documenting your occupational exposures during service may be an important step in understanding your health.

https://holcombemedicalconsulting.com/resources/jet-fuel-exposure-health-effects-veterans

Workplace drug testing programs are about more than just laboratory results — they require careful medical review to ens...
03/06/2026

Workplace drug testing programs are about more than just laboratory results — they require careful medical review to ensure accuracy, fairness, and compliance.

That’s where a Medical Review Officer (MRO) plays a critical role.

A Medical Review Officer is a licensed physician responsible for reviewing drug testing results before they are reported to employers. This includes evaluating laboratory findings, reviewing prescription medications that may explain a result, and ensuring the testing process follows federal and industry regulations.

At Holcombe Medical Consulting, PLLC, we provide physician-led Medical Review Officer (MRO) services for DOT and non-DOT drug testing programs nationwide.

Our MRO services support:
✔ Transportation companies and DOT-regulated employers
✔ Businesses with workplace drug testing programs
✔ Third-party administrators (TPAs)
✔ Occupational health networks

An independent physician review helps ensure results are medically accurate, legally defensible, and compliant with federal drug testing regulations.

If your organization needs reliable MRO services or DOT drug test verification, we’re here to help.

Learn more about our Medical Review Officer services:

https://holcombemedicalconsulting.com/services/medical-review-officer

VA Disability Claims Often Turn on One Critical Element: Medical EvidenceMany veterans assume that having a diagnosis is...
03/04/2026

VA Disability Claims Often Turn on One Critical Element: Medical Evidence

Many veterans assume that having a diagnosis is enough for a VA disability claim. In reality, the outcome of a claim often depends on whether the medical evidence clearly explains how the condition is connected to military service.

At Holcombe Medical Consulting, PLLC, I provide independent medical opinions and VA nexus evaluations designed to analyze:

✔ Service connection between military exposures/injuries and current conditions
✔ Secondary conditions caused by existing service-connected disabilities
✔ Functional impairment affecting work and daily life
✔ Medical record documentation supporting VA regulatory standards

As a board-certified physician in Occupational & Environmental Medicine, my approach focuses on causation analysis, exposure evaluation, and medically defensible reasoning—the same framework used in occupational and disability medicine.

In some cases, veterans also benefit from longitudinal medical documentation, which can be built through Direct Primary Care. Continuous clinical records may strengthen the evidentiary foundation for later medical opinions.

⚖️ The goal is not advocacy—it is objective, evidence-based medical analysis aligned with VA standards.

If you are a veteran, attorney, or accredited representative seeking independent medical review of a VA disability case, you can learn more here:

🔗 Link in the comments

Most employers offer mental health benefits.Most employees don’t use them.That gap matters.Across healthcare, aviation, ...
03/02/2026

Most employers offer mental health benefits.

Most employees don’t use them.

That gap matters.

Across healthcare, aviation, manufacturing, and corporate environments, organizations are investing heavily in workforce wellbeing. Yet Employee Assistance Programs (EAPs) often see utilization rates in the single digits.

If support exists but isn’t accessed, risk isn’t truly reduced.

That’s why more employers are beginning to explore corporate chaplaincy — not as a religious program, and not as therapy — but as a voluntary, confidential, relational support presence in the workplace.

When structured properly, corporate chaplaincy:
- Is non-proselytizing and inclusive
- Does not diagnose or provide therapy
- Does not replace mental health professionals
- Serves as a bridge to appropriate care
- Reduces stigma barriers to early engagement

From an occupational medicine perspective, this connects directly to:
- Safety culture
- Burnout prevention
- Retention strategy
- Crisis preparedness
- Total Worker Health principles

Workforce wellbeing is no longer just an HR initiative — it is a risk management issue.

If your organization is evaluating how to better support employees while protecting operational stability, this is a conversation worth having.
—
Thomas Holcombe, MD
Holcombe Medical Consulting, PLLC
Occupational Medicine & Total Worker Health Advisory



Link in the comments.

I’m excited to share something new I’ve been building.Through Holcombe Medical Consulting, I’m officially launching Occu...
02/28/2026

I’m excited to share something new I’ve been building.

Through Holcombe Medical Consulting, I’m officially launching Occupational Medicine Consulting services.

Most people think about workplace injuries after something happens — a claim, a restriction, an OSHA issue, or a dispute.

But occupational health isn’t just about treatment.
It’s about prevention, compliance, safety, and protecting both employees and organizations.

Occupational and Environmental Medicine is a board-certified specialty focused on the relationship between work and health. It involves:

• Fitness-for-duty evaluations
• Return-to-work strategy
• OSHA medical surveillance compliance
• Independent medical evaluations
• Work-relatedness and causation analysis

The goal is simple: help organizations manage workforce health risk proactively — not reactively.

This service line is designed to support employers, safety professionals, HR teams, and attorneys who want clear, objective, evidence-based medical guidance in complex workplace situations.

If you or someone you know works in workforce safety, HR leadership, risk management, or employment law, I’d be glad to connect.

Link in the comments. More to come soon.

— Thomas Holcombe, MD, MPH

Recently in my Medical Review Officer practice, I reviewed a positive amphetamine drug test for a commercial truck drive...
02/27/2026

Recently in my Medical Review Officer practice, I reviewed a positive amphetamine drug test for a commercial truck driver.

At first glance, it seemed straightforward.

The lab confirmed the result.
The driver had a valid prescription.
The pharmacy verified it.

But during the interview, the driver explained the prescription wasn’t for ADHD.

It was for narcolepsy.

That changes the analysis.

Under federal DOT regulations, my role is to determine whether a legitimate medical explanation exists for a positive result. A valid prescription may satisfy that requirement.

But in safety-sensitive occupations like commercial driving, we also have to consider the underlying medical condition.

Narcolepsy is a neurologic disorder that affects wakefulness. Even when treated, some individuals may continue to experience excessive daytime sleepiness. In transportation work, that matters.

The key distinction:

Verifying a prescription is not the same as determining fitness for duty.

Medication presence does not automatically equal safety clearance.

These cases are rarely dramatic — but they are often nuanced. And when safety-sensitive work is involved, nuance matters.

If your organization encounters complex DOT drug testing or fitness-for-duty questions, structured, evidence-based review is essential.

Link in the comments.

Most VA disability claim denials aren’t because the condition isn’t real.They’re often denied because the medical docume...
02/24/2026

Most VA disability claim denials aren’t because the condition isn’t real.

They’re often denied because the medical documentation isn’t structured well enough.

A nexus letter by itself usually isn’t enough.

What matters most is the quality of the medical record behind it:

✔ Consistent documentation over time
✔ Objective findings (range of motion measured in degrees, imaging, validated scales)
✔ Clear diagnostic language
✔ Documentation of how the condition affects function
✔ Medical reasoning — not just conclusions

When a physician has documented a condition across multiple visits, with objective findings and consistent terminology, the resulting medical opinion carries far more evidentiary weight.

VA claims are decided on evidence — not assertion.

The benefit-of-the-doubt standard applies when evidence is balanced. But there has to be credible medical evidence to weigh in the first place.

Documentation drives outcomes.

Clinical integrity is non-negotiable.

Holcombe Medical Consulting, PLLC provides objective, regulatory-aligned medical evaluations and causation analysis.

Link in the comments.

What does a VA disability rating actually measure?It’s not a pain score.It’s not based solely on MRI findings.And it’s n...
02/19/2026

What does a VA disability rating actually measure?

It’s not a pain score.
It’s not based solely on MRI findings.
And it’s not about how serious a diagnosis sounds.

Under federal regulation, VA disability ratings are designed to reflect average impairment in earning capacity in civilian occupations.

In other words:
The VA is asking how a service-connected condition affects your ability to function and work — not just whether it exists.

In my latest article, I explain:
• Why two veterans with the same diagnosis can receive different ratings
• How the VA combined ratings formula really works
• What the new 2026 medication rule means
• When TDIU may apply

If you’re navigating a VA claim — or helping someone who is — understanding this framework changes everything.

Read the full article here: https://holcombemedicalconsulting.com/resources/va-disability-ratings-explained

What makes a medical opinion defensible?In occupational medicine, many of the opinions we provide affect employment, dis...
02/16/2026

What makes a medical opinion defensible?

In occupational medicine, many of the opinions we provide affect employment, disability determinations, workers’ compensation claims, and regulatory compliance.

In those settings, it’s not enough to “feel right” about a decision.

A defensible opinion must be:
• Grounded in published standards
• Consistent with regulatory requirements
• Transparently reasoned
• Clearly documented

For example, when evaluating a commercial driver after a heart attack, the decision isn’t based on sympathy or personal comfort. It’s based on FMCSA cardiovascular standards and risk assessment.

Objectivity isn’t cold detachment — it’s disciplined methodology.

I shared more thoughts on the distinctions between morality, ethics, virtues, and values in occupational and medical-legal work. If you’re in safety-sensitive industries, legal practice, or occupational health, I’d welcome thoughtful discussion.

https://holcombemedicalconsulting.com/resources/professional-ethics-independent-medical-evaluation

Workplace drug positivity is rising — and most employers don’t realize this:A confirmed positive lab result is not the s...
02/13/2026

Workplace drug positivity is rising — and most employers don’t realize this:

A confirmed positive lab result is not the same as a verified positive.

That’s where the Medical Review Officer (MRO) comes in.

The MRO is a physician responsible for reviewing results, verifying legitimate prescriptions, ensuring DOT compliance, and protecting both employer liability and employee rights.

In fact, research shows that a significant percentage of positive drug tests are medically explained after proper physician review.

Drug testing programs are only as strong as the oversight behind them.

If your organization relies on workplace drug testing — especially under DOT regulations — it’s worth asking:

Is your MRO process truly defensible?

Link in the comments.

VA Nexus Letters Explained: How an Independent Medical Opinion Can Strengthen Your Disability ClaimA strong VA disabilit...
02/13/2026

VA Nexus Letters Explained: How an Independent Medical Opinion Can Strengthen Your Disability Claim

A strong VA disability claim requires more than a diagnosis — it requires a clear medical nexus. Learn when an independent medical opinion can strengthen your claim and why the right language matters.

https://holcombemedicalconsulting.com/resources/va-nexus-letters-explained

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Deer Park, TX
77536

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