Every once and a while we see a really good example of VA bending over backwards using a reverse nexus that flies in the face of anything they have ever held before on HCV. We often get guys Service Connection for HCV based on service medical records showing contraction of a social disease we don’t talk about in polite company.
Hey, life happens when you’re 19 and away from home for the first time in a faraway country with different social constructs. Since it isn’t willful misconduct, it’s a Line Of Duty, or LOD, determination. Humorous yes, but still in the line of duty. I saw patches on hats in-country that said
That’s not necessarily something to brag about but when you’re young, you do strange things you wouldn’t dare do now.
So here we have Army draftee 11 Bravo Johnny Vet- January 69-August 1970 -who got a raging case of bent brain in-country. It took him and VA a looooong time to figure it out but he won in 2014. He would now like to attribute his “polysubstance abuse disorder” to the PTSD which led him to self-medicate. In the process of self-medicationating, he somehow contracted Hepatitis C. Which brings him to our attention.
Seems Johnboy went to DC without that all important nexus letter. Could be that the “free” legal help he hired (DAV) neglected to mention that. The new DBQs VA uses are dandy for the VBMS word search. The only problem is the missing box where your doctor is supposed to insert
36. REASON CLAIMANT HAS HCV
[ ] Wild sex
[ ] Drug abuse
[ ] Combat Dustoff Medic/Crewchief
[ ] Transfusion
[ ] Shared razors/toothbrushes
[ ] Alien abduction
[ ] Other (describe)
That certainly covers everything with the most likely at the top. That’s what Johnny Reb’s Joe Friday rater comes up with. Where a history of drugs is indicated, VA says it is the first and foremost reason every time. Even with any STDs on the record, willful drug misconduct is dragged out as the etiology and whoosh-down the tubes you go. So what do you make of this one?
The Veteran claims that his hepatitis C is related to his active service. His STRs, however, are unremarkable for symptoms, treatment or diagnosis of hepatitis C during service. Instead, current medical treatment records confirm that the Veteran has been diagnosed with hepatitis C.
Okay, hold the phone. Just the fax, ma’m. Just the fax. Why would you find reports of HCV in the 1969 medrecs? It wasn’t “invented” until 1989 by Dr. Henry Southern. I’m gonna go out on the little branches and bet there’s no evidence of a Polymerase Chain Reaction (PCR) RNA sequencing test to determine viral load in his contemporary STRs either. Time to get one of those computer gizmos and google “origin of HCV”, Sherlock. Here’s where it gets hinkey
As already mentioned above, the Board previously remanded this claim for a VA examination to determine if the Veteran’s hepatitis C is indeed related to his active service, including if it was secondarily due to his polysubstance abuse as self-medication for his psychiatric disability. To this end, the Veteran had a VA examination in April 2015. The Veteran reported that he was diagnosed with hepatitis C in 2000. He stated that he was not taking any medication for his condition. He complained of fatigue and nausea. The examiner confirmed a diagnosis of hepatitis C. The examiner indicated that high sexual activity was a risk factor in the Veteran’s development of hepatitis C.
I can’t make this stuff up. It’s priceless reading for everyone but the Johnster here. Most Psychiatrists would unanimously encorse an Axis III dx of drug abuse secondary to PTSD. Most civilian ones, mind you. VA’s shrinks get the 30 pieces of silver bonus for saying otherwise. I’d also wager the “VA examiner” doesn’t have a PhD. after the RN.
He opined that the Veteran’s hepatitis C was less likely attributable to the Veteran’s long history of polysubstance abuse. The examiner commented that based on physical examination of the Veteran, his history and a review of the claims file, there was insufficient evidence to suggest that the Veteran’s hepatitis C was attributed to the Veteran’s long history of polysubstance abuse. He explained that the Veteran had denied a history of intravenous drug use. Therefore, the Veteran’s hepatitis C was not attributable to his long history of polysubstance abuse.
So, let me see if I have this straight. When a Veteran recites his “history” to a doctor, it is considered just that- the Veteran’s idea of how it all went down. If unsubstantiated by cold hard evidence of record, it is merely hearsay and given little, if any, probative value. On the other hand, here, what the Veteran describes as “history” is suddenly given combat presumptive credulity and taken at face value. Gee, when did this all change?
Seems we have a reverse Colvin violation here. The Veteran is now allowed to opine on the cause of his malady and VA will accept his medical acumen. The only thing I find out of place would be the VLJ. She is none other than Kelli Kordich- the one who blew the whistle on Deputy in charge of Rocket Dockets Laura Eskinazi. Seems she would have more of an investigative bent toward getting it right. Such is the state of the art of HCV jurisprudence. One might note it appears that she has been demoted from VLJ to Acting VLJ.