I love to read these. VA, in its haste to deny the Vet, sometimes forgets to read it’s own rules and regulations. They publish untold volumes of risk factor questionnaires but when it comes time to apply those assumptions, the VA examiner suddenly becomes non compos mentis  and wanders off the reservation.

Here’s a classic presentation

As per the S[T]R, [the Veteran] had no history for risk factors to contract hepatitis B infection. He also had no documented diagnosis and treatment for hepatitis B in service. As per the C file review, back in October 28, 1988 during blood donation, he was told by American Red Cross society that he had hepatitis. He had test for hepatitis here at Beckley VAMC back in 11/13/2003 and turned out hepatitis B positive and hepatitis C negative. The Veteran reports that he may have been exposed to this infection during transferring the dead body, but unfortunately, as per medical literature, this is not a risk factor for contracting hepatitis B infection. Therefore, as a medical professional[,] I can not tell how, when and where he [was] infected by Hepatitis B virus. Bllood [sic] work up on June 19, 2012 revealed negative for hepatitis B infection.

The Board finds that the July 2012 VA medical opinion is inadequate for rating purposes. The examiner asserts that medical literature does not support “transferring [a] dead body” as a risk factor for contracting hepatitis B infection. Yet, the Veteran has testified to open skin exposure to blood and bodily fluids. VA’s own questionnaire cites “contaminated blood or fluids” as a potential hepatitis risk factor. The Board has also self-researched information published by the Center for Disease Control (CDC) which states that hepatitis B is usually spread when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enters the body of someone who is not infected, which can happen through direct contact with the blood or open sores of an infected person. See http://www.cdc.gov/hepatitis/HBV/PDFs/HepBAtRisk-BW.pdf.

A review of the July 2012 opinion does not reflect that the VA examiner considered whether the Veteran’s transferring of dead bodies involved direct contact with the blood or bodily fluids of deceased service members, as reported by the Veteran. Some literature reports that the hepatitis B infection can live for up to a week outside of the body, which reflects that a dead soldier could still be infectious. See

http://hepatitis.about.com/od/questions/f/Virus_live.htm.

If you plan on blowing smoke rings at the BVA, they better be perfectly round. Here,  a  BVA-requested IMO comes back tainted in spite of its “impartial” nature. Any time VA is involved with the C&P, be prepared for the worst outcome possible.