The meat of the claim:

You have a problem. What’s the repair order? Get your military and medrecs from the NPRC in St. Louis, Mo. if you have never filed for compensation with the VA.

This link will get you started. http://www.hcvets.com/data/va_news/FilingClaims.htm

Otherwise, if you have, request them from your local RO or the RO where you filed your claim if it is different.

Get all of them, charts, labs, x rays, anything medical. Your doctor will need them to create a nexus letter stating your disease (s) were connected to your service.

Start now. It takes time which is something you will find you have lots of as your illness progresses. A wonderful ploy by VA is to wreck your nexus by saying your doc. was not privy to all your military and medrecs so his Dx/nexus is not as valid or valuable as the VA examiner’s nexus. The military records are necessary to ensure the doctor can see you had no drug charges (IVDU or intranasal) against you (UCMJ). VA will remand your file if the doctor does not clearly state that he has reviewed ALL the rec.s-both mil. and med.

Often, you will get into a pissing war as to who’s doctor has the most “board certified”s after his name. Relax. You want private doc nexuses, if possible.

They make $200K a year and are way bigger/better that the $89K VA docs like Dr. Habib Haboob. Besides, they work for you.

Would you ask to be represented by the attorney of the guy who rear ended you? If you have always used private medical care, chances are you’ve been going to the same gastrodoc or hepatologist for years. They are well versed in your medical condition.

If you have been using the VA as your medical provider, all is not lost. Your personal doc is valuable if he is knowledgeable about your disease and its progression. He must, however be able to access all your military/SMRs. That is a prerequisite for the nexus to have medical validity.

Most docs. don’t have a dog in the fight. VA cannot fire your VAMC doc for providing you a nexus. Most feel empathy for you even if you were/are a raging junkie.

If you don’t drink or smoke, you float higher in the sympathy column because you’re not actively engaging in the destruction of your liver. It goes without saying you’d be better received if there was no drug hx at all but we are not all saints. By the same token, anything you tell your doc. is fair game against you.

Again, be honest with the docs. If you tried to bed every babe in Cholon and came down with Syph or the clap in service, that is not willful misconduct. In fact, if its in your medrecs, its evidence in your favor as are tattoos received in service. I never met any vets who engaged in acupunture in service, but that, too would be okay.

A dx of Non-gonococcal urethritis(NGU) can be proof of forgetting to put on the old raincoat. I used most of mine to keep the dirt out of my M-16 barrel. However, if you came home and developed a history of arrests for patronizing  prostitutes for 10 years before finding that significant other, that would constitute evidence against your claim.

Any tattoos received after service are reasons for denial of your claim. There is no reason to have a “Come to Jesus” meeting concerning anything you did after service. If you have been incarcerated (some would prefer to call it being a guest of the state)at the Graybar Hotel for any period of time, the VA will use that against you .They may suspect that you became Jim Bob’s “girlfriend” and that, gentlemen, is a risk factor.

Some RTs are prejudiced. Don’t be surprised. There are just so many $ available to Vets. Any claim that can legally and medically be denied will be. The current success rate is 12 %.

VA is no different than an insurance company. Consider them as such. They are not on your side. You should have a biopsy by now. If not, go get one RFN. Ultrasounds are too speculative and don’t show bridging necrosis.

If you had a love affair with Johnnie Walker Black, and its in the medrecs, you’ll surely need one just to disprove alcoholic hyaline cirrhosis. Your biopsy must show, and I stress MUST, at least a Stage 3, grade 3 liver with 3/4 fibrosis. This is an indication that your liver has been diseased for at least 30 + years.

As you can see, my advice is directed at male Vietnam vets with a window of service from 1962 to 1975. A biopsy for a Gulf war vet would not show this. But for Vietnam vets, sorry, if your biopsy is Stage 1 or 2, it means your hep started in the 80s and means denial.

Your doc., however, will be the final arbiter of this. The more power to you if you can get a later nexus. If you can obtain more than one nexus, it will really improve your chances of winning, especially if your claim is dicey because of a prior risky lifestyle. Remember, no claim is dead in the water  if you can get a nexus. That is the secret to SC.

Remember always- some examiner from the VA is going to “opine” that it is “more likely than not” the hepatitis you’re claiming is not SC. They use anything to reach this end. Everything you did after service is fair game- police records, private medrecs, anything you ever said to a doc, welfare clerk, job applications incarceration records, DUIs, SSA records- anything. If a private dick can find it, they can.

They are going to give you a form (21-4142) to submit to all your health care providers(private) requesting your medrecs. So be honest. It’ll bite you in the ass if you don’t address it. I don’t know how many claims I’ve read that said the Vet said this and the medrecs contradict it.

They will give you a risk factors questionnaire to fill out listing all the VA recognized vectors for contraction of HCV. I am not, repeat not, going to tell you how to fill this out. One observation I will make is I don’t believe some of those factors constitute risk. I am not a doctor. I am not qualified to make that assessment.

The form will become your report card for this disease. Anything you check off will be used in a decision on your claim. Think through it before you fill it out.  You can win. Just remember that you have to prove everything you check off on.

The odds are better than Reno if you can find the supporting evidence. That might be the hardest part.This claim process can and should be buttressed by additional risk factors such as jet guns as we all were subjected to that indignity. It is obvious to everyone except the VA that they posed as great a risk as IVDU .One other risk which is now being recognized by the Court is a duty assignment in Vietnam, Thailand, Cambodia or Laos. This theater had and still continues to have a documented history of high incidences of HBV and now HCV. As such, it is a risk factor in its own right and should be listed.