In this thesis (because I don’t like the word blog) I’d like to go over something with Vets that will help them immeasurably  with their filing of a hep. claim. You want to head this particular misconception off at the pass before it starts rolling downhill like a giant, cartoon-sized snowball getting bigger by the minute.  The best way to do it is to address it up front in your filing. Find an article on the internet that tells when (what year) Hep. C was definitively identified and the year they started calling it “Hepatitis C”. This is important. Then, when filling out your Form 21-4138 or on your 8 ½”X 11” Standard white computer paper form (SWF 8.5X11) state the history of the disease and that it most obviously will not be found in your military medical records (SMRs or STRs). Below I will show you just how prevalent this practice is and what a devastating effect it can have on your claim.  Remember that once they get this listed as “non-evidence” the rest of the crap they throw in there will seem natural. If you blow up the bridge, they can’t cross the river.

     Examine this one:  http://www.va.gov/vetapp11/files1/1109040.txt

The Vet in question was in the service from ‘66 to ’68 (he was drafted):

At the time of the March 2003 rating decision, the RO determined that hepatitis C preexisted service and that there was no evidence that the condition permanently worsened as a result of service.

At the time of the March 2003 rating decision, the competent evidence on file included the March 1966 pre-induction examination, which contains findings that the Veteran had a history of hepatitis C in May 1965 with no recurrence.  At the May 1968 separation examination, there is no abnormal evaluation referable to hepatitis C.  At the time of the March 2003 rating decision, there is no competent evidence that any hepatitis C began during service or was the result of service, or that any in service symptoms of the Veteran constituted a permanent worsening of any pre-existing hepatitis C.

Can you believe they handed this down as serious medical evidence? With a straight face, yet? These people are “finders of fact” and dead serious. $5 says they never tested him for HAV or HBV so they couldn’t testify that it could have been one of those. No sir. We wouldn’t want to conflusticate the narrative with all that.

Nexxxxt?    http://www.va.gov/vetapp11/files1/1108537.txt

You are going to love this one:

The Veteran served on active duty from June 1971 to June 1973.Also, as there is no competent evidence during service or since service that hepatitis C, was noted, that is, observed during service, the principles of service connection pertaining to chronicity in service and continuity of symptomatology after service under 38 C.F.R. § 3.303(b) do not apply.  Savage v. Gober, 10 Vet. App. 488, 495-96 (1997)In November 2010, the Board obtained an expert opinion from the Veterans Health Administration (VHA).  The Board had asked the VHA expert, a specialist in infectious diseases, considering accepted medical principles and the medical literature and a review of the Veteran’s file, to express an opinion on the following question: Whether it is more likely than not (probability greater than 50 percent), at least as likely as not (probability of 50 percent), less likely than not (probability less than 50 percent), or an opinion is not possible without resort to speculation that the current hepatitis C was related to the Veteran’s exposure to blood and body fluids as a trainee in mortuary science in service?

In formulating the opinion, the VHA expert was asked to comment on the clinical significance that the ELISA test with western blot in 1987 was negative and whether the ELISA screen would detect hepatitis C.

In November 2010, the VA expert, a board certified infectious disease specialist since 1986 and a physician in the infectious diseases section at a VA Medical Center, after reviewing the Veteran’s medical records and a literature search, expressed the opinion that it was less likely than not that the Veteran’s current hepatitis C infection was related to service including exposure to blood and body fluids as mortuary science trainee in 1973.  The VHA expert explained that the negative result of the ELISA test in 1987, the first-generation screening test for detection of hepatitis C, had a sensitivity rate of 54 to 84 percent, citing three medical references.  And that the negative western blot, also a first generation test, made the sensitivity even greater.  The VHA expert therefore concluded that the likelihood that the Veteran acquired hepatitis C before December 1987 was low.

Houston, we have a problem. An ELISA test (even with western blot) is, and always has been a test for HIV, not HCV. So the “VA expert”, a board certified infectious disease specialist at a VA medical Center, has just demonstrated that he has HIV confused with HCV. We wonder what three medical references he cited. This caused our Vet buddy from Columbia, South Carolina to lose his case. Spookyshit, huh? Conspiracy? No, stupidity. Here’s the ELISA smoking gun. We certainly didn’t have any trouble finding it and about 20 others similar to it and we are not a medical expert in infectious diseases.

http://adam.about.net/encyclopedia/HIV-ELISA-western-blot.htm

Nexxxxxt  claimant, please?http://www.va.gov/vetapp11/files1/1100026.txt

The Veteran served on active duty from April 1972 to May 1973.

The Veteran contends that he is entitled to service connection for hepatitis C because it was incurred during service when the Veteran served as a medical corpsman. A review of the service treatment records shows no complaints or findings with respect to hepatitis C.  The service separation examination is negative for any findings or complaints withrespect to hepatitis C.

    The man was a tramp. He had sex with at least 15 partners whom we will assume were of the opposite sex. Well, there you go.  He couldn’t have possibly picked this up in service around all those bloody, wounded troops. Nope. No flies on him.  Besides, he was only in the service for 13 months so he obviously didn’t have time to get it there.

     So the pattern has been established. First, point out the obvious- no HCV reported in service; second, find a  post-service risk or two that fits in to his history like having sex (even once) and then say that it didn’t materialize for 30 years.  VA has to pole-vault over salient theories in order to get to the alien abduction risk. Once there, they can drag in homelessness, drinking more than one beer a day and smoking left-handed tobacco as risks, too.  This is the snowball we described above.

     I can’t remember whose operations manual its in (Air Force or Army) but to paraphrase the advice, it imparts: If you find yourself in a fair fight, you didn’t plan your mission properly. Do not expect this adventure you are going to enter to be fair. The people you encounter will all smile and treat you like their best friend.  You will think y’all are getting’ along like peas and carrots right up until the denial arrives. It’s a rude awakening- rather like a “Huh?” moment followed about 10 seconds later with a “That’s impossible. There must be a mistake”.  Armor up, bubba. You are in for one hell of a firefight. Following our advice on this just levels the playing field a little bit.  We don’t guarantee you a win-we just guarantee you won’t go into it  with that warm, fuzzy, stupid grin on your face.

     We picked the first three decisions randomly so as to make it impartial. If you think we’re kidding, proceed apace and start reading:

 http://www.index.va.gov/search/va/bva_search.jsp?QT=Hepatitis&SQ=vetapp11&RPP=100&LC=0&ET=&UA=Search

The site is littered with these mangled decisions based on shaky tenets.