Here’s a good one from the Vacation capital of the south-Saint Pete’s. There must be more Vets per square mile there than you can count in the bars on a rainy day. He’s got AmLeg repping him but you sure can’t see their fingerprints on this one. Or, actually you can but that’s all. No physical representation as in “Yo, Johnny. You need an IMO, dude”.

Check out the excellent craftsmanship of the final IMO. Johnny Vet  was in the right place at the right time.

Risk factors for hepatitis C include shared toothbrushes or razor blades.

In this case, the Veteran has repeatedly contended that he contracted hepatitis C through exposure to one or more of the in-service risk factors identified in the aforementioned VBA Fast Letters. Specifically, he alleges that he was exposed to unsterilized air gun devices used to administer vaccinations, “infected needles” injected by medical professionals, and shaving razors contaminated with the blood of other service members. Conversely, the Veteran emphatically denies exposure to other hepatitis C risk factors, including high-risk sexual activity and intranasal and intravenous drug use.

The Board observes that the Veteran, as a layperson, is competent to report events within the realm of his personal experience. As such, he is competent to state that he was vaccinated with air gun injectors on examination prior to his entry into service. Similarly, he is competent to report having had blood drawn with needles and having shared shaving razors with his fellow airmen. Moreover, the Board finds the credibility of the Veteran’s account is bolstered by its consistency with his service treatment records, which confirm that that he received vaccinations and underwent blood tests to assess his hemoglobin, packed cell volume, and white blood cell levels. Further, the Board considers it significant that the Veteran has expressly stated that his long-term treating VA provider told him that the above risk factors were the likely cause of his hepatitis C. Though a layperson, the Veteran is competent to report what his treating provider has told him in this regard. See 38 U.S.C.A. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence).

So here is a good cite to go to prove your claim using a heapin’ helpin’ of lay testimony. Just make sure you’re not talkin’ through the top of your hat.

He was afforded a VA examination in August 2009. Nevertheless, as this examination was considered inadequate because it did not address all of the aforementioned hepatitis C risk factors.

the June 2011 examiner opined that it was less likely than not that the Veteran’s hepatitis C had resulted from the myalgia he incurred in service

Yeppers. It wasn’t the headache that caused the Hepatitis C. I got that one right.

However, again the examination did not adequately address the Veteran’s reported in-service risk factors. On the contrary, while the June 2011 VA examiner summarily concluded that there “was no history of in-service risk factors such as … inoculation by use of ‘infected needles as well as use of shared razors,’” she made no mention of the Veteran’s lay assertions with respect to those risk factors. As such, it was unclear whether the examiner considered the lay evidence of in-service incurrence.

The examiner again determined that the Veteran’s hepatitis C was less likely than not related to his reported in-service exposure to unsterilized air gun devices, infected needles, and sharing contaminated razors because service treatment records were silent regarding this history. However, this addendum opinion is also insufficient because the examiner again did not address the Veteran’s competent and credible lay statements regarding his in-service risk factors.

I can imagine that happening back in 1974. What I can’t imagine is a squad of guys looking at each other all bloody after a quick dry shave and having one pipe up “Gee, we’re all bloody and have cross-contaminated ourselves with each others’ blood. Quick!. Let us proceed poste haste to sick call to make sure it is annotated in our records for future generations to gaze on.”

This is also where it gets rich. They actually sent it out to someone who knows what he’s talking about. Worse, he was brutally honest in his assessment. Where’s the usual VA Podiatrist or  Proctologist when you’re in a pinch?

Accordingly, the Board determined that another medical opinion was necessary and referred the case for an expert opinion from the VHA in accordance with VHA Directive 1602-01. In July 2013, an opinion was prepared by a medical doctor with the Division of Infectious Disease, Hepatology, Federal Health Care Center. The examiner opined that it was at least as likely as not (50 percent or higher degree of probability) that the Veteran’s hepatitis C was related to service, specifically his reported exposure to unsterilized air gun devices used to administer vaccinations and shaving razors contaminated with blood from other service members.

The examiner observed that the Veteran’s records showed no documented history of IV drug use or blood transfusion while in service and before 1992. The examiner also noted that the Veteran had persistently denied high risk sexual practices. There was also no documented history of occupational exposure, tattoos or piercings, hemodialysis or organ transplantation. However, the Veteran reported sharing bloody shaving with other service members while in service. Based on case reports, the risk of getting infected with hepatitis C was in the range of 3 to 10 percent when mucous membrane or broken skin was exposed to infected body fluid, which was a significant risk from Veteran’s report. It was also true that these devices were used interchangeably amongst service members without sterilization. Thus, based on the Veteran’s reports of exposure and the lack of any other risk factors, the examiner opined that it was at least as likely as not that the Veteran’s hepatitis C was related to these in-service risk factors.

Sometimes they listen. Personally, I like LawBob squarepants’ description of it as VA knitting … Deny, deny, deny, Grant one. Deny, deny, deny, Grant one….

This guy lucked out. He had a handful on nothing- not even a strong suit for a flush to draw to. AmLeg wasn’t exactly a font of information on this and the weakest link was the VA examiner who was consumed by the vapors every time she got to the actual risk factor. It took two years to get her to still screw it up. Meanwhile Johnboy here has to stew in his juices waiting for someone unbiased who would say the VA (emperor) Examiner was naked.

You’ll see a lot of this if you don’t start learning about how to avoid it here.