How’s this for the most defective diagnosis in the history of Hep. Keep in mind that Wonder Woman had to go back to college to get this right.  Exactly which college is not specified.

The examiner provided an addendum report in September

2011. She stated that further research of the literature

regarding hepatitis C had yielded information that resolved

earlier concerns and led her to revise her former

conclusions with supporting evidence. The examiner first

noted that it could be stated with “reasonable certainty”

that it was not at least likely as not that the Veteran’s

chronic hepatitis C was caused by [gosh, nobody said it

was] his acute episode of hepatitis in 1969. She reasoned

that while an acute case of hepatitis could not be classified

with certainty at the time of illness without testing for

specific viruses, the tests of which were not available back

in 1969, there were many epidemiologic factors that

make it more likely that the 1969 infection was hepatitis

A and not related to the Veteran’s subsequent hepatitis

C. As to the epidemiologic factors, the examiner detailed

that hepatitis A was endemic in Southeast Asian (sic) and

very commonly encountered. It was easily spread by

fecal-oral contact and commonly by food or water,

making it likely that sexual contact even with the use

of condoms could result in transmission. The Veteran

indicated that he had no risk factors for hepatitis C, which

was transmitted by blood, with the only risk factor being

sharing razors and having multiple sexual partners with

use of condoms. The examiner noted that hepatitis C was

not usually spread by sexual contact and the casual

sharing of razors would not likely result in transmission.

She further found that the Veteran’s statement that

several buddies may have developed hepatitis around

the same time strongly demonstrated that he did indeed

have hepatitis A. The examiner also indicated that due

to the Veteran’s history of hepatitis B (he has antibodies

to hepatitis B showing that he had a resolved hepatitis B

infection) raised a possibility of hepatitis B at the time

of his acute illness. [but not C].

So a quick recap. Hep A is oral-fecal but somehow gets in the semen? Hep C does not. Razor blade sharing is not a risk factor even though vA maintains it is. Last but not least, Hepatitis A has been known to penetrate condoms. Oh and one last one- HAV does not cause HCV. Boy am I glad we pay this medical whizbang big bucks to keep up with current medical dictum.

But wait. Capt. Obvious has more to impart:

The examiner further noted that another factor

strongly against the Veteran’s initial illness being

due to hepatitis C was that the acute infection with

hepatitis C is usually clinically asymptomatic with

only 40 percent or less of patients have jaundice

at that time. She commented that studies have shown

that those with symptomatic illness with jaundice

initially are much less likely to develop chronic

hepatitis C than those who have clinically silent disease.

The Veteran had an acute illness characterized by jaundice

and fatigue lasting for six months, which was not unusual

for any type of hepatitis. The examiner found the

Veteran’s account of taking six months to recover

from fatigue from the initial episode was not

significant. [???????]

Yes sir, this babe should be a judge. She could merely look at the claimant and ascertain all she needs to know to make an insightful ruling (which would be 98% correct and occur in 125 days or less.) I don’t make this stuff up. It’s positively insane. What hurts is Tommy Havatampa here was repped by the famous American Legion. Now, who allowed him get to the BVA with this bogus vARO nexus in his C-file? This isn’t justice. It’s copy and paste nexus and not even believable. I smell bonus in the vA examiner’s Christmas paycheck. That or she went to Orlando to teach others this new technique.

Next week– Hepatitis A transmission by alien abduction after service (shared straws with the aliens) and how to write it up properly to avoid remand.