Back in those days (1982) each EMG test was accomplished by having the torso poked with 20 long, thin needles attached to an electrode. My google searches found that at that time the needles were not replaced, just sterilized and re-used. It wasn’t until the late 80’s that EMG needles were replaced. Today, it is common pratice to replace the needles with patients who are known to have hep b, c and HIV. I am without a job and poor so all I have for health care is the VA. Trying to figure out what stage my liver disease is in has been a daunting task with the VA.

I finally got a VA – PA (not a doctor) at a small VA clinic to do a cursory exam of my liver and she put it at stage 3 (close to a stage 4). She said since I have 2b that I should be able to start chemo (Interferon riba) since all of my stress tests came back okay. I said that I had a MEB for nerve damage but it was denied. Yet the VA came back with a determination of RA. So since 1986 I have been getting paid at 40% for Rhuematoid arthritis. When they diagnosed me for HCV, they said the tests for RA were negative. The VA-PA said that it was common back then (1986) to get a false positive for RA when a patient actually had HCV. But then she also said that most people who get HCV do so by passing a straw around, go figure!

So I called the NSO rep and he said to give him a copy of the med recs that I found. I mentioned to him that I think I should get a doctor to look over my records to get Nexus? The “more likely than not” nexus! He thought I should, but my financial situation is grim and I can’t afford any other healthcare. The only healthcare I have at this point is the VA. He said I can try to get nexus from a VA doctor but good luck…well lady luck hasn’t given me a smile for quite a while! 🙂

     There is a lot of good news mixed in with your tale. First things first. Go to the DAV VSO and make copies of the medrecs, but guard them with your life. Put them in a safe place. A very safe place.  They are what’re going to win this case. We know how to get you a nexus so put that concern aside, too. There are a lot of dos and don’ts to consider immediately. 

     Start with this. File, if you haven’t already, a Notice of Disagreement. This establishes that you intend to fight your denial. You can always assemble your evidence as you move along, but this is the big moment now.  

     You can add to your NOD with the new records you have discovered now, if you want. What is important is that they be accepted as “original service Dept. records that existed but have never been associated with the file”. This makes them new and material contemporary records that show you were: 

(A)- in Yokosuka when you say you were;

(B)- Were percutaneously pierced by unsanitary needles which had the potential to transmit the HCV virus; and

(C)- It identifies the source of the HCV genetically. There are 11  recognized strains (or Genotypes) with alphabetically lettered subgroups. Hence your HCV is labeled “2” and the subgroup is “B”. Herein lies the reason you are going to win your claim, Mr. Squid.  Hep. 2A and 2B were generally found in Korea and Japan in the 70s and 80s.  1B is more prevalent in Japan and Okinawa now, but at the time you were there, 2A and 2B were.  Oddly 2B as a subgroup is now the most prevalent in Sub-Saharan Africa. Go figure. I guess they migrate like whales. Look at this website to ascertain the prevalence of 2b in Japan:

http://www.wjgnet.com/1007-9327/12/784.asp

     Stage and Grade of your disease is best measured with the Metavir scale. It’s linear and numbered and now become the most accepted. Each stage of liver disease generally runs 10 years and then slows down as it approaches S4. Not always, but in 50% or more of cases. This is why we’re all blooming now. I’m Stage 3.9 and at 40 years. I quit drinking and smoking but will still go S4 eventually. If you add from 1982 that would be 30 years and Stage 3.  Grade deals with how actively the little buggers are munching up your liver. If you did IFN therapy you might end up with S3,G1 or G0. The damage is done, but you can arrest its forward progress towards Hepatocellular Carcinoma(HCC).

     I suspect the VA will send out for an IMO with QTC about the genotype being indigenous to Japan in the 80s. It wouldn’t hurt to submit that( an article about the relationship between the two is attached) with the medical records you found.  At all cost, keep the originals of your records. Do not give them to anyone-not even your NSO.  I personally wouldn’t let them out of my sight.  I’m not a certified Mel Gibson Conspiracy Nut, but that evidence is valuable. I filed my first claim in 1989. The VARO I filed with requested my medrecs. The NPRC sent their ONLY copy to VA. I lucked out and got them back in 09 when I asked for a complete copy of my C-File. If I were you, I would write to the RO in San Diego with a FOIA for your C-File pronto-or a request for just the medrecs. They have them. They just don’t know where they are. VA has that problem. I hear the Cleveland RO has a problem with the paper shredder prowling around after hours on a really long extension cord eating Vet’s files. God, I hate that when that happens.

     CYA is the game here, Squid. Assume the REMFs will do what they did when you were in-Lose things, come to the wrong conclusions, etc. In fact, plan on it. You may have to appeal this, but the prognosis looks really good if you write your response to the SOC properly. That and a nexus will wrap it up nicely. Not all claims have this simple a resolution. Your battle has just begun, but the evidence is enough to rebut their denial.   

     One last admonition. I’m sure your NSO is able and knowledgeable. However, the fact that you told him you should get a nexus rather than him telling you to concerns me. You cannot win it without one. Just so there is no misunderstanding here, this assumes you have no UCMJ violations for drug use or possession and no history of alcohol dependence or abuse.  Those are claim killers, but occasionally have been rebutted depending on the circumstances. Feel free to share this with your NSO. Let him know that you are making a list and checking it twice. My motto in VA claims is like Reagan’s: “Trust, but verify.” You are responsible for this at the end of the day. Depending on anyone to carry your water is a fool’s errand. Do it yourself or make sure the one assigned doesn’t spill it. JOVO

     Here is the gentleman(Dr. Cecil) you should contact for a nexus. Write him and tell him your circumstances and that we sent you. You may need access to a fax machine or, better yet, a scanner, at a Kinko’s or UPS Store if you have none. This way you can transmit a copy of the medrecs to Dr. Cecil.

bdceci01@iglou.com

Godspeed, sir and a warm thank you for your unswerving devotion to America and her Freedom.

I have a scanner and I plan on scanning the medrecs into PDFs for sending and then backing them up twice. You gave me a glimmer of hope. Sometimes it is difficult to discern things from a haze of ambiguity.

I recently met a man who was a marine in Da Nang. He has the bad bug from Vietnam. He got it when a medic plugged some blood into him. He is in good spirits and active but his liver is in bad shape. He said that he had been trying for years to get service connection for his HCV but has given up. His wife has passed on and his daughter became weepy eyed when he talked about his condition. I tried to talk him into reviving his claim but he became quite emotional about it and just doesn’t want to go through with it anymore.

I got with his daughter and gave her a phone number to a VSO in the area. I told her at least you can find out the status of his prior claim and then take it from there. I also pointed her to this website. I said that there are others like us, he is not alone. She hasn’t called me recently so hopefully she is getting some traction. Thank the Lord for people like you Mr. Nod. If there is anything I can share about my experiences along the way to help others, I won’t hesitate to do so.