Hot off the presses for 2013. The very first HCV decision of the new year.

Click here.  Erase the word {query} and then insert  11-3304 in the search bar. Then click on the blue download in the upper left to view.

Keith W. Ketchum, under the able tutelage of Robert V. Chisholm, seeks to associate his depression to the bug juice therapy he took for his HCV. VA would just as much have everyone believe it  happened before , after or maybe is simply a fig newton of Keith’s over-stimulated imagination. It certainly couldn’t have anything to do with Interferon. Why, that’s never been proven, let alone observed as a noted side-effect in more that 68 % of cases and at any rate is not corroborated by any nexus submitted.

They’re not out of the woods on this by a long shot. I suspect there will be a few more C&P exams and some head-butting behind the scenes, but a new nexus would be the icing on this cake. A good brain doctor could inveigh on how it is “more likely than less likely” that ol’ Keith’s trial by bug juice not only kicked his ass but did what it does in a majority of cases-caused unmitigated depression. That would seal the deal unless VA wants to go find one of their proctologists to opine that it “is not at least as likely as not” that this is secondary to HCV drugs. You sure aren’t going to find one in the civilian ranks of gastrodocs willing to look like a boob and say this with a straight face.

I don’t mean to be Captain Obvious and do Mr. Chisholm’s work for him but I will carry the water for Keith. Here’s the VA’s very own website on the subject of Interferon side effects and guess what’s documented as being very prevalent in conjunction with bug juice?

You do not need an astrophysical degree to type in “side effects of Interferon therapy” on  Google. Likewise, a rudimentary high school education in the English language and composition will permit most to absorb some simple numbers and sentences.

Treatment-related side effects are nearly universal

Most common:

fatigue (interferon and ribavirin)

flulike symptoms: fever, headache, muscle ache (interferon and ribavirin)

mild anxiety (interferon)

skin rash (ribavirin)

depression (interferon)

gastrointestinal symptoms: nausea, diarrhea (interferon and ribavirin)

Monitoring for severe side effects (eg, marked anemia) is an important part of treatment follow-up

Management of symptoms due to side effects is critical to completion of therapy

When the VA goes so far as to admit the below, I think we can safely say that they would be contradicting their own research to come up with this lame assertion to deny Keith.

Side effects of treatment, however, are essentially universal.

Well, there you have it from the VA Horse’s mouth. Bug juice causes depression but it   can’t conclusively be said that it caused Keith’s. That would be pure speculation. Welcome to the new VA miracle of a nonadversarial form of denial. Just like members of childhood soccer teams who no longer “keep score”, everyone gets a trophy and a certificate of participation.  Unfortunately, nobody wins first place or gets compensation in this format. To win requires about 10 years or until they realize you’re not going to go away. The addition of a VA attorney will speed things up immeasurably.

Mr. Chisholm understands this and will take his remand back to the BVA for a new bite of the apple. He will also rub this in their noses and remind them that it’s in their words, not his. Sometimes VA must wonder how they get themselves into these predicaments.

#1 Open mouth.

#2 Insert medical treatise.

Depression develops in 20-35% of patients treated with interferon and ribavirin. This can be one of the major morbidities associated with treatment, and practitioner screening for the development of suicidal or other destructive ideation is essential when patients develop symptoms of depression. Comanagement of patients with a prior history of depression or other mental illness by mental health professionals, with appropriate therapy before treatment, is very important.

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About asknod

VA claims blogger
This entry was posted in CAvC HCV Ruling and tagged , , , , , , , , , , , , , , , , , . Bookmark the permalink.


  1. Kiedove says:

    Touché (for using their own words). Better get a screenshot before they take it down.

    (Wordsmiths out there, magna cum laude isn’t capitalized as it is in Atty. Chisholm’s resume.)

  2. RobertG says:

    I have always declared my depression/anxiety is caused by IFN to every doctor at my VAMC. No acknowledgment or agreement just more meds or dosage adjustments. I know I am in the same war with the vA as this vet. The “nonadversarial” type of treatment causes more “depression” to further my cause. More wasted time in this man’s life doesn’t matter to the vA. Hope we all live to prevail…

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