While waiting 16 months for VA to rate me in 08, I read extensively. I was so sick it helped pass the time. My diet consisted of BVA decisions on all the things I had filed for except tinnitus. Porphyria Cutanea Tarda is an Agent Orange disease, but also is a secondary of HCV in about 30% of infections. While waiting, I researched how VA treated this to try to ascertain how they would rate me. PCT is listed under Part 4, 4.118 -skin

http://www.law.cornell.edu/cfr/text/38/4/118

under DC 7815. The ratings are mighty skinny for percentages as you can only imagine. VA is not generous. However one thing I discovered was that for those of us who require phlebotomies (the opposite of a transfusion), there is a higher rating- much higher. DC 7704 concerns Polycythemia Vera and is the only code that contemplates phlebotomies. They give a whopping 40% for it compared to the 10% I got based on scars. I came home from SEA with this but no one had discovered AO and the correlation between the two yet. I found out in 92 and finally had a name for something I’d been afflicted with for 20 years.

When I approached VA with it in 94, the response was predictable-“All well and fine, Mr. Nod, but you weren’t in RVN”. Well excuse me, yes I was.  The argument devolved into the next phase- “Yes, ah, okay that’s all well and good, but you didn’t manifest it within a year of leaving SEA.” Excuse me? Is that Catch 23?

When my Hepatologist doctor finally wrote me a nexus letter that the VSO assured me I didn’t need, he was kind enough to describe the PCT as a secondary of my HCV and not due to the fifth of Johnnie Walker Black VA insisted I guzzled every day.  Thus my PCT rating was upped from 10 to 40% by the DRO review. As for an earlier effective date of 1994, I’m still working on that. It’s before Veterans Law Judge Mark D. Hindman as I write this and will soon be decided.

Dorland’s medical Dictionary has this to say about PCT:

PCT is attributable to only 4 possible medical causes:

1) extreme, prolonged alcohol abuse with resultant hyaline cirrhosis;

2) vertical transmission by genetic predisposition( dominant genes from mother and/or father) ;

3) prior infection with hepatitis viruses A,B, or non-A non-B (hepatitis C); 

4) exposure to 2,3,7,8-tetrachlorodibenzodioxin(TCDD), a byproduct of the manufacture of 2, 4-D and  2,4,5-T, in a 1:1 ratio(phenoxyl herbicides in ester),more commonly known as Agent Orange, White, Pink, Purple and Green.

I hope this helps any of you who were diagnosed with it and given short shrift by VA on it’s etiology. The truth is out there.