01/23/09

People ask me if having a tattoo will destroy their chances of winning their jetgun claim for Hep. Yes. You read that right. Well, gosh, where should I start? If you have filed your claim, you must have filled out a Risk Factors Questionnaire by now. You may have noticed that they ask you about 10 questions and not one of them mentions jetguns. VA simply doesn’t consider that a risk. Don’t shoot me, I’m the messenger. I think it’s a viable path to infection. Hell, if someone took an air tool covered in blood in a garage setting and jammed it up against my arm and blasted me, I’d say that was pretty unsanitary. I’d say it stood a pretty good chance of pressurizing some blood subcutaneously into my flesh. If he had HCV or AIDS and I didn’t, then I’d be lying if I said I wasn’t worried. VA Examiners don’t see it that way. Now, how does that differ so much from a tattoo? Or shooting up heroin? Or sharing a bloody straw(?) whilst tooting Peru’s main export?

Unprotected sex is another avenue the VA recognizes. However, as with tattoos, the VA considers these vectors of transmission to be a 2 on a scale of 10. If you had unprotected sex with 10 or more partners then you are “at risk” in their parlance. What about the guy that only had 9 partners? Ne problemo? I don’t think so. VA says your chances of getting HCV with one exposure to IVDU a la shared needle are 100%. They say your chances of getting HCV with one Transfusion, which, I might add, involves 800 milliliters of blood, is greater than 60% if it happened before 1989. Do you know if you loaded up syringes of blood, how many it would take to make 800 milliliters? You got me there but it must be more than 200 to 300 syringefuls. Why the disparity in how this disease is transmitted? If you shared razors, toothbrushes, or fingernail clippers they will consider it a risk factor. However , when actually pressed, they will say it is a less that 1 in 10 chance of being infected. It’s actually just “unsanitary” in their book of risks, but they can and do occasionally cave in and hand out a rating for that.

Going back to the IVDU risk, why would you have a 100% chance of catching it the first time out? Or, if snorting coke, why a 100% risk sharing a straw? There is something wrong with the way these risks are assessed. It has a lot to do with morality and public perceptions. VA is not going to suffer bad PR if they turn down a Junkie VET, unless he has an CMOH hanging around his neck. Or a DFC, Bronze Star, Silver Star, CIB or PH. Most decisions involving IVDU that win seem to have a common thread- medics and heroes. If you were in combat, shot up daily, and your buddy managed to inherit the wrong end of a RPG round, you will get SC for picking up all his pieces and carrying them back to the meatwagon or dustoff. You and I know that if he had HCV, it would make sense that you were exposed to his blood, ergo stood a good chance of infection. But that’s a pretty big IF in their book. Fact is, that ugly habit of sticking a not so autoclaved needle in your arm every day was a much higher risk. But the Junkie Combat Vet gets a pass with the CIB. Why? PR and 38 USC 1154(b). Only 15% of us were actually in combat.  85% were thus support troops. John Q. Public is not going to have a problem with VA turning down 12,000 vets each year for HCV just because they were on the wrong end of a dirty jetgun in Basic Training.

The problem is now defined. How shall we HCVets go about convincing the rest of America we have a valid claim to SC? Good Question. I hope you Vets are as good at finding an answer to it as you were defending America. I have faith in you and expect you’ll find the solution. I will continue to find ways to get you SC in the meantime with the risks VA does recognize and new ones you identify. Good Luck, Band of Brothers.

By the way, recognize anyone in this picture? Operating Location Charlie, 1980^th Comm. Sq.  1970.  Two of them had Hep in service within 2 months of this photo being taken. One is service connected (me, bottom right in Camo). I don’t know about the other one (right behind me standing looking right). I pray he didn’t come down with C, too.  Sgt. NOD