This decision, decided in 1999, is something we have been searching for at AskNOD for quite some time. To wit, a decision on Hepatitis (and by extension, Hepatocellular Carcinoma) that set precedent. As you are aware, to set a precedent (or to sit a president for all of you from Chicago) requires a panel or en banc decision of the CAVC. A panel decision consists of 3 judges. An en banc decision is one decided by the whole Court- i.e. all seven judges.

While this decision is 11 years old, it in no way is out of date for judicial purposes. The meat of this decision is that the mere presence of the Vet in Southeast Asia was conducive to his contracting liver cancer (from Hepatitis). He had no seminal moment of infection, no medical records pointing to hospitalization, and nothing untoward that would set off alarms with his doctors. He simply fell ill about 40 or so years after service and subsequently died.  His wife filed for DIC and appealed all the way to the Court. She also did a very credible job of backing up her claims not only with nexus opinions from the Vet’s treating physicians, but with coherent, well posited theses on the prevalence of Hepatitis infections and HCC in indigenous SEA populations. This avenue of attack has never been used by Vets since except in unsubstantiated claims to that effect. This lady did her homework or else her attorney did. I suspect the former.

In any case, I feel it behooves the reader or any Vet considering filing to investigate this disease vector. Obviously, if the Court is willing to recognize it as a viable risk factor, then Vets should be utilizing it in their defense and citing the decision as established precedent. Any evidence you can submit in favor of your claim has to be rebutted or addressed by the RO and the BVA. If they consider this information and still deny you, you have even more ammunition with which to build your case. VA is not permitted to ignore CAVC precedent-setting cases such as this. Of further note, remember that the CAVC is NOT a division of the VA. They are a completely separate entity and often at odds with the VA Secretary and his minions. Witness this case and the ensuing favorable decision:

http://search.uscourts.cavc.gov/isysquery/3574ef27-1230-470c-bd11-19ff6e2dffbb/8/doc/