Medical Records with claim

drcorp55
Registered: 06/22/10
Posts: 5

	07/12/10	#1

My husband is in the process of submitting claim for Hep C, Vietnam veteran served 1968 – 1969. Discovered in 2005 after blood test for life insurance – he was denied any life insurance. For years his blood tests always showed the liver enzymes as high, but doctor never recommended any further testing. He has no other risk factors, had the jet gun injections and was injured in the field…injury was infected and he required addtl treatment for infection at the time. He is now dealing with the after affects of HepC treatment (glaucoma, fatigue, memory loss, etc).In the process of filing the claim you are asked to attach any medical records…we have his military records, and doctor records from the past 10 years. Is it necessary to send all the records or do we need to sort through them and only send those that are relevant? His primary care physician will provide a letter to help his claim. The whole process is very daunting. Any advice is much appreciated.

NOD

Manager
Registered: 11/22/08
Posts: 652

	07/12/10	#2

Prepare for a long journey, ma’m. You will need to obtain your husband’s medical records from his time in service. In the column on your left is a heading titled “SF180-Med Rec” under Print VA forms. Submitting just your civilian medrecs and military records is not enough. You will need to have these records to prove that your husband was injured in the field. I assume that was in Vietnam. If he sought medical help it will be listed in the medrecs. You will also need a nexus letter from your doctor-preferably the one you see for his hepatitis issues. The letter must conform to certain standards and the doctor must state succinctly why he believes the HCV occurred during your husband’s time in service as opposed to earlier or later. He also must state he has reviewed all the military and medical records from service, and finally must state in percentage terminology the likelihood of the disease being incurred in service. Obviously it occurred 40 years ago so this is going to be a presumptive diagnosis. The proper format that the VA accepts is very concise. It must be phrased just so or it will be rejected. The correct phrases are “more likely than less likely”, ” most likely” or “at least as likely as not”. “Probably”, “might have” or “possibly” all are too ambiguous and will be summarily rejected as too vague. Go to the Forum entitled VA-Tips and tricks and start on Page 2 with the Introduction and work you way through to Holes in the fabric. This will give you much more information that you’ll need to file and will also elaborate on what we’ve already mentioned above. What you must do is present an air tight case to the VA initially to avoid years of denials and appeals. A little preparation now will stand you in good stead further down the road. VA is worse than an insurance company to deal with by a magnitude of 10. They will go to great extremes to find some dirt on your husband. If he even mentioned one time to a doctor that he smoked left handed tobacco, they will turn it into an indictment of his moral character and a possible reason for denial. Their logic runs along the lines of “If he smoked dope then he probably snorted and shot up, too.” I’ve seen cases where a Vet voluntarily sought help for alcoholism with the VA (which they encourage you to do) and they used that as a valid reason for denial based on the theory that if he had a drinking problem then it follows that he had a drug problem as well. VA often invites Vets to attend group counseling for drug and/or PTSD issues. Guess what? Everything you reveal there will make it into your VA medrecs! Think twice before answering any incriminating questions. I’m not suggesting you should lie about it but you’re not legally required to answer. You can always answer that question with another: “I’ve already discussed that and answered it in the HCV Risk Factors Questionnaire. How many times do we have to discuss this subject? You’re beginning to become redundant here, sir, and I don’t appreciate your tone.” That usually puts a fork in it. If, after perusing the site here, you still have questions, feel free to ask more. Take a moment to thank your husband for his service to our Country from all of us here. I am so sorry he contracted this insidious disease. I only hope they find a cure soon before we all die from it. Good luck.

drcorp55
Registered: 06/22/10
Posts: 5

	07/15/10	#3

Good information and thank you! I’ve been working through gathering all the pertinent information (military medrecs and the last 8 years of private medrecs) and my husbands physician, who has been treating him since he was diagnosed with HCV is on board with writing the Nexus in support of his claim. So if I understand correctly, I need to attach all of this information to the claim. I will continue to read through on this site – I have the claim prepared online and only need a few more items before I submit.Thank you again.

NOD

Manager
Registered: 11/22/08
Posts: 652

	07/15/10	#4

Looks good. I assume you are representing yourself in this claim. Smart move. Even if you had a VSO representing you, you would discover that you ended up doing all the paper/leg work yourself. Make sure you get the doctor to write the nexus correctly. This will be the single most important facet of your whole claim. I can’t stress how important this is. Might we suggest you privately email the completed nexus from your doctor to us so we can check it to make sure it will fly with the VA and give you the best chance of winning the first time out? Its purely optional on your part but may save you a lot of time if you have to go to an appeal. Also I might add that if your husband’s genotype is 3a you have a very strong case. Genotype 3a is unique to Southeast Asia (Thailand, Laos. Cambodia and Vietnam) and Australia. That is how I ended up winning my case as I couldn’t find any of my medrecs showing my transfusion. Good Luck.

drcorp55
Registered: 06/22/10
Posts: 5

	07/21/10	#5

That’s interesting about the Genotype. His is 1b. If the cause of the HCV is from the air gun injection would the genotype matter? He was also injured and treated in Vietnam, and ended up with an infection, but the medical people that treated him were americans. It’s all very confusing to me. All I know is that I have the application nearly complete and only need to get the doctor to finalize the letter. I will have you view the letter prior to final submission to the VA. I filed a claim for my mother last year for aid & attendance…my dad was a WWII vet. I found that I did all of the work and only had the VSO put another set of eyes to it, but I did all the follow up and leg work. Seems like a ton of lawyers out there trying to sell the service of helping file VA claims…sounds expensive and duplication of your own work if you ask me. Thank you!

NOD

Manager
Registered: 11/22/08
Posts: 652

07/21/10

I guess I don’t need to tell you that the genotype makes no difference. 3A is an instant winner like a scratch off lotto ticket if you were in SEA. Notwithstanding that, any genotype is unfortunately a winner. Remember. There are 3 essential elements needed to complete the claim. Proof of an illnesss or disease; an event or injury or diagnosis of the same disease in service (via medrecs) and a clear concise nexus from an M.D. that attributes the disease or illness to the Vet’s time in service. One excellent way to prove the age of the disease is to present proof via the Stage and Grade of the disease as measured on the Metavir scale as well as the percentage of fibrosis. I assume by now your husband has had a liver biopsy.

The nexus has to be very concise and rule out any other causes after he left the service. Any hint of immoral behavior or any history of incarceration will be serious grounds for denial. The doctor has to mention that he has reviewed all the milrecs and medrecs in addition to any private doctor’s records. As the nexus diagnosis of HCV is actually speculation, the doctor has to go to great lengths to sound as though it is not speculation, but based on a logical extrapolation of medical evidence. If all the Ts are crossed and all the Is are dotted, then VA will rarely mount a serious offense. However, if you arrive with a lot of Internet articles describing studies done to HCV positive peasants in India and pictures of guys in their skivvies lined up waiting for a jet gun inoculation your claim will fail. If you are basing your whole claim on the idea that this was caused solely by a jetgun then your chances of winning are poor. The injury and infection your husband suffered in Vietnam would be my guess as to a risk factor. Any tattoos while in service or sharing toothbrushes or razors are also vectors for infection which are frequently cited and used to win. I don’t want to rain on the parade ,but after the first jet gun win the VA closed ranks and now routinely denies claims based solely on that defense. There is the occasional judge who doesn’t get the email and rules in favor of the Vet. However, that is becoming increasingly rare. To prove beyond a shadow of a doubt that it was the jetgun you would have to find the Vet who was directly in front of you in basic training and got the shot right before you all those times. It was done alphabetically so its not an impossibility to ascertain. But it does involve a lot of legwork to find the Vet and convince him to share his medical information with you. If he had HCV and if it was the same genotype as you that would be pretty damning evidence in your favor. Two very big ifs.

Should you use a lawyer, be aware that the VA limits them to 20% of all you recover when you initially win. If you take your claim all the way to the Court of Veterans Appeals (CAVC) or the Federal Circuit, they will pay the lawyer directly via the Equal Access to Justice Act (EAJA). That is assuming you are indigent, meet other criteria and have a sound legal argument.

drcorp55
Registered: 06/22/10
Posts: 5

	08/12/10	#7

I have the doctors letter and would like someone to review. How do I send privately for review? Should I attach here?Thank you for all the great advice and direction.I thought of another question as I was reviewing the claim form. It asks you what disability you are filing the claim for. Do we put the HCV as the sole reason or list all the other problems caused by the HCV and treatment. Example being Glaucoma, memory loss, tinnitis (this is not from HCV treatment but over the years has been getting worse and we feel started in the military), etc. Want to get this as right as possible on the first try. Thanks.

NOD

Manager
Registered: 11/22/08
Posts: 652

	08/12/10	#8

I will contact you privately.

AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94

	08/13/10	#9

You are in good hands here…..getting it right from the get-go will make a world of difference in your case. We started with a VSO and ended up on our own….if only I knew then what I know now….ultimately, 7+ years later and my husband is finally sc for HepC….a grant from the Board of Veterans Appeals. If you need any support or another pair of ears to listen, I’ve been through this same procedure with my own husband. It’s tough to be the support person – you are not alone. If there is anything I can do to help you, please let me know.

drcorp55
Registered: 06/22/10
Posts: 5

	08/13/10	#10

Thank you…I wish we knew about this 5 years ago when he was first diagnosed. It takes so long to gather everything and then wonder if you are submitting everything just so. I do know these guys deserve it. Thanks for the offer of support…as I hit the final submit button I may check back with you.

NOD

Manager
Registered: 11/22/08
Posts: 652

	08/15/10	#11

By all means, please contact us before you push “Print” or Send. We sent you a synopsis on your doctor’s preliminary nexus letter several days ago. We hope you received it.