Here’s the absolute latest way to deny a claim. Remember that our good old paternalistic VA is nonadversarial and loves us very, very much. Vet gets hep. Vet files for it. Vet dies from it while waiting to get claim adjudicated. Vet’s wife takes over. Vet’s wife goes to California Department of Veterans Affairs and hires Gomer Pyle to represent her. I smell trouble.

VA examiners know this is too easy- like shooting fish in a barrel. They tell her that hepatitis and gonorrhea are two different animals and you don’t necessarily get both of them together. Kinda like Blue Jays and Cardinals. They don’t much cotton to one another.

From Mrs. Johnny Vet’s decision:

As for hepatitis C, there are several risk factors recognized for contracting hepatitis, including: organ transplants before 1992, transfusions of blood or blood products before 1992, hemodialysis, accidental exposure to blood by health care workers (to include combat medics or corpsman), intravenous drug use or intranasal cocaine use, high risk sexual activity, and other direct percutaneous (through the skin) exposure to blood such as by tattooing.
The service treatment records show that in August 1966, in September 1966, and in October 1966 the Veteran complained of right upper quadrant abdominal pain. On one occasion his temperature was 99 and a gram stain was positive for gonorrhea.

In January 1967 and February 1967, the Veteran was followed for nonspecific urethritis.

In response to a VA Hepatitis Risk Factors Questionnaire he reported that he had engaged in high risk sexual activity and shared toothbrushes and razor blades during service.

In July 2012, the Board obtained an opinion from a VHA physician (expert), who is Board certified in internal medicine and infectious diseases. After reviewing the file, the VHA expert stated that it was less likely that not that hepatitis C or liver cirrhosis was related to any illness, disease, complaint, or event during military service. The VHA expert explained:

The risk of transmission by personal care items is much lower than by the commonly recognized routes of transmission such as injecting drug use, and receiving blood or blood products prior to 1987. Hepatitis C is not transmitted by casual contact or sharing of food or drinks.

Okay, hold the phone. I give. What about high risk sex and jet guns. This old boy doesn’t have a drug history. Here comes the fix.

In an addendum in January 2013, the VHA expert stated that she was not able to find any literature indicating outbreaks of gonorrhea with hepatitis C. The VHA expert explained: That the two diseases have different routes of transmission. Hepatitis C is mainly associated with transmission by contaminated needles or percutaneously by blood. After summarizing various medical studies, the VHA expert stated that: It was less likely than not that there was significantly elevated risk of contracting hepatitis C “due to gonorrhea in 1966.

Hepatitis C and gonorrhea have different routes of transmission? What? Nobody has done a study of outbreaks of Gonorrhea where there was a component of Hepatitis C involved? Well, there you go.  No evidence is definitely negative evidence.

The VHA expert stated that hepatitis C is caused by different micro-organism than gonorrhea with a different usual route of transmission. The risk of incidental sexual transmission of hepatitis C with gonorrhea would only be elevated if it took place among injecting drug users or other high risk individuals.

If  VA paid thirty pieces of silver for this crystal ballgazer then they got ripped off. On the other hand, it was cheap money as an ante to see if Jane Vet’swife take it up to the CAVC. Of course, then they can ask for a Joint Motion for Remand for an equally off the wall IMO from another bubblehead and have her doing the hamster wheel for another ten years. I’m thinking someone is finally going to say “Hey, Jane. What about a nexus letter from your doctor instead of VA’s?

I’ve seen some off the wall VA denials but this one is right up there with alien abduction and black helicopters. If you like fiction, this would be your cup of tea leaves.

VA Specialist in internal medicine
and Infectious diseases