FROM THE STAR SPANGLED BANNER

VARO IN BALTIMORE MARYLAND

Through and through GSW to head? Check. (decision here)

Here, service treatment records show that the Veteran was treated by the 95th Evacuation Hospital in Vietnam in July 1972 for a gunshot wound sustained to his head in a confrontation in the local village. Records reflect left occipital entrance and exit wounds, with no palpable cranial defect. There were neither bony nor metallic fragments, nor bone chip nor fracture. The wound was debrided, irrigated copiously, and closed primarily with nylon. Records reflect units of procaine administered, as well as V Cillin K. His stitches were removed later that same month. The small wound had healed nicely; the larger wound was slightly infected, and iodine was applied and the wound was left open to air.

Transfusion? Check.

While there is no documentation of any blood transfusion in active service, the Veteran has credibly testified that he spoke with his sister at the time of the incident; and relayed having received a few pints of blood in the treatment of his combat wound. The Board finds that the Veteran is competent to testify on factual matters of which he has first-hand knowledge and which are corroborated by other evidence in the claims file. Washington v. Nicholson, 19 Vet. App. 362 (2005). The Board further finds no reason to doubt the credibility of the statement, which has been consistent throughout the appeal.

Nexus? Check and check.

In September 2008, the VA physician indicated that, after a careful review of the Veteran’s medical records, no traditional risk factors were identified. The physician noted that the Veteran described a history of receiving multiple injections while serving in Vietnam; and opined that this was the most likely cause of the Veteran’s chronic hepatitis C. In support of the opinion, the physician reasoned that there have been cases described as occurring in this manner.

and

In November 2010, the Medical Director of the Division of Infectious Diseases at the University of Maryland School of Medicine, who was the Veteran’s former VA treating physician, noted that the Veteran had denied ever using intravenous drugs, and that he had no other high-risk behaviors that would indicate the source of his infection. The Veteran reported the gunshot wound to the head, and that he was uncertain whether or not he received a blood transfusion as part of the management of his injuries. The Veteran also received vaccinations via the multiple use nozzle injector during his time in active service. The Medical Director opined that, given the lack of other risk factors and the progression of the Veteran’s disease to decompensated cirrhosis, and the fact that he underwent medical treatment for a gunshot wound and received vaccinations via a multiple use device in active service, it is more likely than not that the Veteran acquired hepatitis C during his active service. The Medical Director also noted that the Veteran’s decompensated cirrhosis suggested a remote infection.

Okay, what’s wrong with this picture? Why is he fighting this at the BVA? He has all the elements needed to win at the RO and yet he’s getting the bum’s rush. Oh. VA’s nexus-probably by a bedpan changer, says uh-uh.

Moreover, the Veteran underwent a VA consultation for chronic hepatitis C in May 2005. At that time he adamantly denied using intravenous drugs. He also reported one occasion of a sexually transmitted disease (gonorrhea) at age 22; and reported having two sex partners in the past ten years, and that protection was used. The Veteran had received a tattoo in 1986, and he claimed that the needle and inks were sterile. He also reportedly shared razors in his household. His past medical history included polycythemia, and the Veteran denied having units of blood removed. He also reported a gunshot wound to his head in Vietnam; and indicated that there was blood present at the time, and that he was transferred to a hospital. The diagnosis in May 2005 was chronic hepatitis C; and a VA nurse practitioner indicated that the origin of infection was vague, and opined that it may have been handling of the wound (sic) in Vietnam.

Well, that all seems mighty vague. If you have the IQ of a goat or work for the VA as a “VA examiner”, that’s pretty much the conclusion you’ll come to. Fortunately for Johnny Vet, he had a VLJ with a modicum of intelligence who didn’t need chicken entrails or tea leaves to figure it out. Too bad it only took 7 years. The poor guy’s liverbox is running on empty and his VARO in Baltimore is minutely parsing the meaning of vague. Notice the 2005 date. This is important. He filed in 2006 and the VA used this as the reason to deny. however, he refiled in 2008 and they are still using outdated info to continue a prior claim denial. That’s a Bozo No-No. Here’s how that one played out:

VA treatment records show that the Veteran screened positive for hepatitis C in April 2005. In February 2006, the Veteran stated that he had never done drugs; and that he may have had a blood transfusion when he was shot in Vietnam. He also indicated that he may have contracted hepatitis C through shots that the Army gave, or through needles used in the hospital.

Based on this evidence, the RO concluded that there was no current diagnosis of hepatitis C; and no evidence that this could have occurred in active service.

Where do they find these “VA examiners”? Is there a special medical school where VA trains them?

This explains why our Silver Queen Leigh is having so much trouble with her claim there. They’ve been fighting for two years just to get the C-file to find out if she, too, is being vague.

Her attorney just filed a Writ Of Mandamus to extricate the C-file from the RO. About time.