MILESTONES–RIC MICHAELSON

Rick MichaelsonRic chieu hoi’d in his sleep yesterday morning early. It was unexpected and sudden with no warning. He will be sorely missed by all of us. He was my son-in-law’s father and I had just helped him win the big 100% banana with SMC S less than three months ago. I expect his wife Marcia will have to fight for her DIC.

I told her and I will tell all of you spouses. Make sure to get an autopsy when this occurs. When you have less than ten years under your belt on 100% permanent and total, you run the risk of VA telling you to buzz off. The only exception is if you pass from a service connected disease. The autopsy will provide the evidence VA requires.

Ric did a year with the 15th Aerial Port Squadron at An Khe in 1967-1968 and was there when they attacked in December and took out the C-130 on the ramp. He served faithfully and suffered a lot of the usual Agent Orange diseases we all do. It’s going to leave a big hollow spot around here for a long, long time.

Ric’s world in 1968:

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Posted in Inspirational Veterans, KP Veterans, Milestones, Vietnam War history | Tagged , , , , , | 3 Comments

Poor VHA business practices hurt all veterans

In 2012, OIG determined that the VHA had mismanaged its Medical Care Collections Fund (MCCF) program.  They write: 

VHA is authorized to bill third-party health insurance for covered health care provided to veterans at VA and non-VA medical facilities. The MCCF program recovers costs of medical care that VA provides to patients who have coverage under a private health insurance policy. A veteran may have coverage under a personal or spouse’s insurance policy. VA considers a
veteran’s health care billable if the treatment is non-service-connected and the third-party health insurance policy covers the treatment.

This revenue is not a trivial amount of money when collected.  VHA reported MCCF third-party insurance collections for FY 2010 was 1.9 billion and for FY 2011, 1.8 billion.  I almost hate to link to this study because it’s so frustrating.  The VHA needs these funds to provide state-of-the-art care, hire and retain the brightest physicians, and keep the ERs running smoothly 24/7.  Other VHA medical budget priorities include traumatic brain injury care, spinal cord injury care, prosthetics , mental health,  telehealth, and more.

When we see private providers, they follow this basic process, the same one the VHA is supposed to follow:

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If administrators can plan Orlando parties (conventions) why can’t get their act together and obtain private insurance information, apply proper coding and bill Aetna, Humana and other private insurance carriers?  (The VHA cannot generally bill Medicare but it can bill Medigap Supplemental plans.)  The bad news from this audit:

The OIG audited eight sites and found The 8 facilities had almost
2 million unbilled patient encounters on the FY 2010 RNB report which totaled nearly $1.7 billion in unbilled medical services. The majority of this unbilled amount on the RNB report was attributable to a small number of high-value patient encounters.

High-value claims are over $400,000, medium-value claims are $5,000 to $400,000, and low-value claims are less than $5,000.  Can you imagine any regional hospital not billing Blue Cross for care worth $300,000 +/-?  But back at the VHA ranch, medical committees find time and energy to deny disabled veterans structural alterations, and deny care through their fiscal and ethical mismanagement.  And then there is the little matter of co-pays and co-insurance which veterans in some priority groups must pay for VA care and prescriptions.  According to the SRC report (page two):

The VA has the authority to bill most health care insurers for nonservice-connected care; any insurer’s payment received by the VA is used to offset ‘‘dollar for dollar’’ a veteran’s VA copayment responsibility.

If the VHA isn’t billing a veteran’s insurance company, then he’s getting screwed out of this dollar-for-dollar offset. (Anyone ever had a co-pay offset by the VA?) 

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Fantasy Priority 8 vet “Hmmm. Should I buy a private jet or yacht next?”

Well, gee, aren’t Priority 8 veterans rich?  Living high on the hog?  Why can’t they pay $50 a pop to see a VA specialist? And med co-pays? The answer is below.

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Why doesn’t our veteran (if under 65) just buy a marketplace private plan?  Well, it might be too expensive and Congress won’t allow our veteran to be enrolled in VA care AND buy a ACA plan.  Why? Who knows.  That would make too much fiscal sense so let’s discriminate against our veterans instead.  If you want to buy a ACA plan for the family (that we could then bill), you can’t take advantage of your earned VA health benefit.  Oh, and Thank You for your service!

Posted in Guest authors, VA Health Care, VA Medical Mysteries Explained, vA news | Tagged , , , , , , , , , , , , , , | 1 Comment

PRESUMPTION JUNCTION, WHAT’S YOUR FUNCTION?

CaptureShades of Sesame Street. Now you’re going to have that antique ditty running through your brain for a week. Presumptions. This seems to be the new lightning rod of Veterans Law. VA has always held a royal flush in this game to our paltry three of a kind. We just didn’t know the rules of this Indian Poker. We’re learning.

I keep getting emails about presumptions. Member Del asked if there wasn’t a presumption for everything. The short answer? Yes. Most especially in VA’s favor, of course. I’ll take the Veteran’s presumptions first. We get the first big one the day we sign up. Never in your life were you ever so minutely examined as you were that day. They knew more about you than the doctor who delivered you. Every mole, smallpox scar, everything you personally endorsed (checked yes) on  a Standard Form 88 or 92 at entry and separation is a permanent part of a record that will be scoured for some small speck of proof that you a) had it before service; or b) if you had it before you enlisted, then it did not get worse (wasn’t aggravated) by your service. It could have gotten worse after you got out but that was probably due to __  ______ _______(use M 21 1MR + Adobe 2 CAPRI 21-ULUZ denial form letter). This Presumption of Soundness is the foundation of most Veterans claims. It is the bedrock you build on. Make sure it’s firm ground before you call the cement wagon to pour.

If your SF-88 says you had a trick knee as a kid but it’s all better now. Okay. If it goes south in Basic, you sure can’t say it happened on that ten mile hike a week after you got there. You might argue it’s a torn meniscus this time and has nothing to do with hokey knee syndrome but you will probably lose.

The next presumption, while less known, is the most Holy Presumption of Stupidity. Since we are not accorded the right to have a real law dog at our side, we are forced to do it ourselves (pro se) or go to the VSO of our choice.  It makes you feel like Sgt. Tahmooressi down in a Mexican jail. You don’t get one phone call. You don’t get a shout out. Even if you hire that VSO chucklehead, you still are the blind being led by the blind in the eyes of the Court of Vet Appeals. This is your ticket to success if used correctly. You have to iterate every possible permutation of a claim so it is never misconstrued by VA. You are not a doctor so don’t start acting like one and using internet terms like radiculopathy. Maintain that stupid act. It protects you until you get to a real lawyer and a doctor you get to choose.

Another presumption is the Presumption Credibility that all Veterans who served their country honorably and are competent to testify honestly in their own behalf without shading the truth for financial gain. This presumption holds water until VA finds out you are lying, have presented false anything, or your testimony is incredible. Again, this is one of those presumptions that is not accorded mere mortals. It is a right accorded us for service. VA will do anything in their power to find some inconsistency, some small, inconsequential fact, some piece of evidence that conflicts with your recollection and use that as the springboard to destroy your testimony. This a baby with a tub load of bathwater. You don’t want them to throw this out. You tell the truth, the whole truth and nothing but. When it comes time to do the Benefit of the Doubt Ouija reading, this weighs far more than you think. If you are proven to have stretched the truth on any one facet, everything you say will be deemed a whopper.

Brown v. Gardner   The reason VASEC’s name is first is it’s one of those things where VASEC Jesse Brown, a former Marine, had his BVA decision reversed at the CAVC. He then decided to fight it up at the Fed. Circus and got his ass whupped again. Unfazed, he squandered yet even more scarce judicial resources and got certiorari at the Supreme Court where he got the final smackdown. How’s that for nonadversarial? What gets me is he was a disabled Veteran himself and he fought this to the bitter end. Keep that in mind. That’s who we’ve been dealing with all these years. The VA professes constantly to be pro-Vet 24/7. It’s not a presumption however. It’s merely their impression of themselves they see in the mirror. Running contrary and parallel to this pseudo-nonadversarial posture is the nature of Federal Statutes and regulations. We know these as 38 USC (Congress’ intent) and 38 CFR (VA Secretary’s translation of Congress’ intent).  The second one with all the small print is the problem.

When we allow the VA Secretary to opine as to what Congress intended in 38 USC, we are giving his translation deference. This concept is boilerplate law in Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (1984). What it does is give the cachet of respectability to how VA reads their own regulations. The problem as Vet attorneys see it is that in this nonadversarial system where every benefit of the doubt is accorded the Vet, somehow good ol’ Johnny Vet almost always loses at VA three-card Monte. Like about 85% of the time. You get better odds in Las Vegas casinos and they buy your drinks. How can deference to an adversarial opponent’s (VA) decision that you were X% disabled on Y date not be nonadversarial in the first instance? More importantly, how do you overcome this finding of law. If we live in a sheltered legal cave with all these friendly VA folks in charge of us, why do we always roll a seven on the second throw? As always, it depends on whose dice you are using.

The Veterans Law Library widget up above in the header is a valuable tool for spotting new Fed. Circus and CAVC precedence in VA law. An article there on this Gardner/Chevron dichotomy is very piercing. We have watched VA law evolve from the COVA era of being yes-men for the VA and the BVA. The chutzpah of Brown may have engendered that. Nothing like a little conflict to raise the hackles and poison the well.

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Now let’s look at the VA’s Presumptions. We don’t have to. It’s a blanket presumption that they do everything right. In order to refute that presumption on any given facet-be it a bogus C&P exam for your bad back by a ophthalmologist or proctologist, or an incorrect rating from a braindead rater- you have to prove it was clearly and unmistakably erroneous. This is not a true CUE test. You do not have to prove that the error manifestly changed the outcome. You merely have to prove that what looks irregular is irregular. If VA sends every Vet to QTC for C&P and they send you to the VAMC for a “special” C&P exam by VA’s “impartial” hired gun, that’s not regular. If it turns out they’re using a Certified Nurse’s assistant to say your bad back is fine and the range of motion was five by but fail to mention you had to stand up out of the wheel chair, that’s not regular.

nursery-rhyme7If you do not contest the fact that the VA doctor/nurse is not a specialist in their field, then you have not overcome the presumption and it turns into a pumpkin and six mice at midnight after sixty days.  You have to use VA’s presumptions to your advantage rather than sit in the back seat and accept them. Presumptions are just that- they are presumed correct unless questioned. If questioned and proven false, the earth opens up and swallows them whole. In their place is whatever you presented as your evidence. No do overs in this game.

downloadThe presumption of validity can come crashing down around their ears as well. When VA declares a finding, it is like a survey pin. No one is allowed to move it even if it’s in the wrong place short of another survey that indisputably (clear and unmistakable evidence) proves it’s in the wrong place. If VA pounds the pin in the wrong place to your advantage and gives you too much, it falls to them to prove they made the mistake. Only then does CUE enter in. If they wish to take it all back, they have to prove the CUE. But that’s not all. They also have to prove it with the existing evidence and further show that, but for the error, the outcome would have been manifestly different. They suffer the same sixty day presumption that if they felt the C&P examiner had shit for brains, they could get a new C&P. They can do this to their heart’s delight in a nonadversarial system until they get the results they want. Once they let a C&P stand, they are, in essence, agreeing with it the same as they hold us to. This is where you can turn their own decisions into your favor.

Member WGM did this in Texas. VA said he got his HCV, not from a jetgun but from STDs. Forget the three nexus letters from real doctors with real MDs after their names. Forget that the VA examiner has a CrackerJacks© degree from Mt. Altoona Jr. College. She opined and declared under penalty of perjury that the STDs were the guilty party and there was nothing more to talk about. Unfortunately, she didn’t close her piehole there. Instead of looking it up, she foolishly relied on the Presumption of VA Intelligence and declared getting the clap was willful misconduct. After sixty days the concrete had set up pretty good on that STD finding. Once the examiner was apprised of the fact that it was perhaps not very wise to acquire these diseases but certainly not against the UCMJ, they had to revise their decision. Without batting an eyelash, they merely erased the word “not” and were left with STD=HCV. All the evidence pointed to jetguns. The whole case was carefully constructed around it. VA thought they had out-presumptioned old WGM right up until their presumption bit them on the ass.

download (1)The Presumption of the Regularity of the mail is another new hotspot of attorney activity. VA has been caught cooking the books at VAMCs all over the nation. I’ve lost count but it’s well over two hundred and going up like a progressive Las Vegas Slot. This calls into question their ability to maintain credibility in appointment scheduling. If you had a C&P scheduled that you never heard about, they used to trot out the “We sent him a letter.” story. Vet attorneys nowadays are asking for a copy of the letter and VA is unable to produce them. VA maintained for years they were merely “electronically generated and then erased”. Form letters- but with your name on it. If VA sends you a denial, an SOC, an SSOC or anything like it, they place a copy in the c-file. Remember the litany. If it appears regular, it is regular. So if they send you a “be there or be square” letter it should rightfully be somewhere in the VBA system or over in VISTA. If it isn’t, it’s irregular. Having a huge paper or electronic c-file comes with a new set of responsibilities. VA hasn’t absorbed that legal concept of electronic constructive possession yet.

Presumptions are a vital part of every one of our  decisions. They’re like those boxcars in the cartoon above. If you assemble them correctly, preserve them properly and employ them to your advantage at the right time, you paint VA into a corner they can’t escape from. In the event they play dense and ignore you, you still have them preserved for that  VA rainmaker that can and will use them to win for you. The only enemy is your piehole.

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Another strategy for getting veteran-related questions answered clearly

stampI’ve often been impressed with the clarity of reports written by the Congressional Research Service (CRS) at the Library of Congress (LOC).  I had a few questions about Health Care for Veterans: Answers to Frequently Asked Questions  (2/24/14) and sent an email to the author.  A staffer quickly replied with a formula email:

This is in response to your recent e-mail to the Congressional Research Service (CRS). CRS provides research and analysis exclusively to the U.S. Congress. Because we work only for Congress, we are unable to respond to other inquiries. More information about CRS is available athttp://www.loc.gov/crsinfo/.

Shucks. I then asked:

Thank you for your response.  Then should I send my questions to my senator’s or representative’s staff and see if they will contact you?

A fast answer:

That’s correct, you should place a request through your senator or representative’s office.

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Yay! I just emailed this vet’s request to CRS!

So here is my strategy for getting information from these organized government minds. I will send select questions to a MN senator, but with a header, something to the effect: “I am requesting that a CRS Specialist in Veterans Policy, NAME on report, and a CRS Analyst in Health Policy NAME on report, answer my questions…” and reference the report by title, date and number.  The staffer who handles constituent veteran matters will probably be elated to know exactly what I want and where to get it. Additionally, they will learn facts absent in the VA’s often deceptively written gibberish–and who could expect much given recent evidence of the VA’s total lack of respect for information and record-keeping?  In sharp contrast,

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Fort Meade Delivers, or Finding a Needle in this Haystack Couldn’t be Easier

librarians are organizational wizards of the highest order!  This excerpt from a blog post by LOC law librarian Kurt Carroll may sound a bit smug but if you click on the image, they have a right to brag about their management skills and professionalism.

 

 

The other day I visited the Library of Congress’ High Density Storage Facility at Fort Meade, Maryland.  Yes, that’s right; we are shelving books in Maryland.  With 2.65 million volumes in the Law Library, you don’t really believe we shelve them all in the sub-basement of the Madison building, do you? …retrieval from Ft. Meade is accurate and reliable.  Books at Ft. Meade are listed in the catalog the same as books in our reading room and closed stacks – and they are requested in the same manner.  Delivery will take longer, however.  Deliveries from Ft. Meade are made twice daily.  Books requested by 8:00 a.m. are usually delivered the same day.  Books requested after 8:00 a.m. are generally delivered the following morning.  It’s a longer wait, but a 100% retrieval rate.

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VBA Overflow storage? And regular storage?

Now, view (again) the “record keeping mayhem” by the dysfunctional minds at the VBA, review the 2012 OIG report on Winston-Salem or the 2009 Audit of Veterans Benefits Administration’s Control of Veterans’ Claims Folders.  The latter estimated how many claims folders were lost, misplaced and mismanaged.

folders lostVA-produced documents are opposite of  those of the CRS which rightly crows, “… the CRS is well-known for analysis that is authoritative, confidential, objective and nonpartisan. Its highest priority is to ensure that Congress has 24/7 access to the nation’s best thinking.” Our taxes pay for the research services of the CRS, we might as well use them via Congressional constituent services. If you want to try this, remember that only elected representatives from the state of your residence will help you.

Posted in Guest authors, VA Health Care, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , | 1 Comment

VETERANS DAY–DESSERT

CaptureThis is a very powerful commentary by Vietnam Veteran Donald Singleton. I think it’s worth watching in its entirety for many reasons. One thing you will not hear, and I cannot thank him enough for foregoing it, is that insane blurb the Veterans Administration came out with in 2008… 

Welcome Home!

Donald captures that eerie feeling we all had when we got off a C-5 or a World Airways 727 at Travis and discover we were suddenly back in Kansas and it felt wrong. All wrong. Six ways to Sunday all wrong.  For him, to have to go up to DC and start fighting with his own countrymen and women-indeed- his own brothers and sisters less than three months later, it must have been… what? I can’t imagine.

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Lima Site 108 Muong Soui, Laos September, 1970

I don’t think I will ever be able to capture the two emotions in words (or worlds)-going and coming back two years later- first to a land where you trusted no one but round eyes and back to a country that was oblivious at best; angry and judgemental at worst and bordering on a narcissistic fascination with itself. To a land where electricity was unheard of in most parts to a land where total darkness was equally alien. From Banana leaf bungalows to concrete high rises. The dichotomy was uncanny.

I don’t know if I have the stamina to go find an old Bug and fix it up. All I can say is Donald, Brother, from one SEA Vet to another – We made it. We’re alive. We came home with a few chips and dents. We’re missing some paint but the body is still there. You’re an amazing man. Thanks to Brother Bruce for sharing this with us.

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Posted in Inspirational Veterans, Veterans Day, Vietnam War history | Tagged , , , , , , , | 2 Comments

MARINES 5-BAD GUYS 0

downloadI love these stories. Either the same crooks came back to get all the goodies they spotted the first time (greed) or they had the ungodly bad luck to pick the same house that had recently been burglarized. Either way, breaking into a Veteran’s house, and, God forbid, a Marine’s house of all the houses you could choose, is a dicey undertaking under the best of circumstances. Grand theft auto? Much safer. For everything else there’s Mossberg. 

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Posted in All about Veterans | Tagged , , , , , , , | 3 Comments

VETERANS DAY 2014

downloadI was beseiged this afternoon with emails asking if my joke posting for today was all I planned on putting up. Well, not exactly. That space was supposed to be occupied by a long story with photos of Butch Long getting his long-overdue medals and most especially, his Combat Infantryman’s Badge. This time the Army Board of Corrections of Military Records (ABCMR) was the grinch who stole the show.

The ABCMR is  still our same old Army but with a more laid back “the day after” Army mentality. A cattle prod couldn’t spark them up any more than a U.S Congressman. We tried. This began in June of this year along about the time the corn went in.

The Real Story

I told you of my neighbor Butch Long who was short sheeted by the Army at the time of his discharge in 1970.  I was asked to help after Butch had been promised this about five or six times over 40 years and no one ever followed through. We’re talking VSOs stepping on their neckties here. Perhaps I was just the right guy in the right place with enough brains to figure it out. Please – no X files music. Unfortunately, once apprised of the mistake, the Army again took their sweet time and made us present evidence that Butch wasn’t just some PX Ranger looking for a good deal on military insignia. Hey. Guys do that. It’s embarrassing to be a man when you see it happen. If you’re a combat Vet, it pisses you off. Being gentlemen and bred better, most refrain from bodily harm or summarily “repossessing the illicit paraphernalia”. I’m sure it happens but I am equally sure you gentle readers would never partake. Emasculating the hoser with verbal acrimony is far more satisfying. You and I could never become masters of it like women in a vicious, ferally-worded catfight, but you get the idea.

THE CORDUROY FIASCO

IMG_6792Butch was to receive his regalia (to which, by now, he has been entitled to for forty five years, nine months and 21 days) this afternoon by our distinguished Congressman Derek Kilmer (26th District). Derek’s a real cut up. When he was trying to pin my medals on me through that corduroy sports jacket, we discovered why you never, never, never want to wear corduroy anything at an awards ceremony.  His paraphrased comment was along the lines of:

“Man. I haven’t had this much trouble since Prom night.”

Derek didn’t expand on that cryptic comment nor did I venture to ask for clarification. Fortunately he was far enough away from the microphone.  He is always available and is a Veteran’s friend. He ramrodded this through as soon as I began the quest with his VA interface Nicolas Carr. The Army was more than willing to throw in a Purple Heart based on the telegram notifying his parents that his face, right eye and upper body had been remodeled with a 60 mm mortar several nights previous. How this managed to escape the Army medal clerks then bears remarking on. Commanders and the REMF Paper Faeries around them never lose their own myriad commendations and medals requests. How could this have gone AWOL for half a century? One thing became apparent though. No CIBs were going to be awarded without documentation.

imagesTo add insult to Butch’s injuries, the ABCMR, knowing full well we were up against the clock for Veterans Day, let this sit in the out-basket for a week after the 24th of October before mailing. Considering they are located at Fort Meyer in Arlington Virginia, they had far more faith in the USPS than I do. Sure enough, when Nick Carr called them to politely ask if we could still expect to plan our presentation on Veterans Day, he discovered that someone forgot to put it in the mail. But, with any luck and a tailwind, it (might, could, could oughtta, quite possibly, with a high degree of probability, conceivably) [pick one] be there by Monday. As of yesterday’s mail we were still skinny on paperwork or any colored ribbons bearing the likeness of George Washington.

Which was okay. I was prepared to either run down to Fort Lewis and play PX Ranger myself  or have to temporarily requisition my Uncle Jay’s medal box for his CIB and Purple Heart. As for the rest, I had all the RVN “I was there” stuff from Derek’s presentation to me. Hell. They were still New In Box. Bruce “Mac” McCartney (no relation to Paul) from our Eastern outpost in Midway Georgia provided a period 1969 Army Commendation Medal. Bruce, for all of you who do not know him, is super in his own right. I’d have said he was an idiot for doing four tours as a combat Dustoff medic back then (1968-1972)  but now I’m merely in awe. He’s living proof of how you can dodge almost all the BBs. He has also come out of retirement to show us all ILP and how to obtain greenhouses.

Fate was just not on our side. The house of cards finally fell down because Butch’s daughter Carol, who was born while he was in-country, had to work on Veterans Day. I mean they were not going to budge on this. That’s worse than blowing a red light right in front of a cop on your way to your own wedding and you’re already ten minutes late… And you have a warrant out for, like, a gazillion parking tickets. I’m familiar with that scenario.

Carol, if you remember, is the one who told Christine about Butch’s plight. Christine’s light bulb went off at the KP Vets monthly meeting when the President announced the Air Force Board of Corrections of Military Records (AFBCMR), after sixteen long months of Ouija work, had finally acknowledged my medals. There’s method to this madness.

NEW DATE FOR PRESENTATION

Congressman KIlmer has graciously agreed to set family time aside and come out on Saturday, the 6th of December around the middle of the day to present Butch with a small tribute of what our Country owes him. Fortunately we didn’t have to water the Tree of Democracy with his blood on January 18th, 1969. We will celebrate that miracle and certainly remember the other two who did. Their testimony from the grave is the only reason why Butch will get his CIB. Pretty cool, huh? It’s like Buddy Letters from Heaven.

Personally, I think it’s one hell of a story. You can’t make this shit up. Well… unless you’re a PX Ranger.

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Posted in Inspirational Veterans, KP Veterans, Veterans Day, Vietnam War history | Tagged , , , , , , , , , , , , , , , , | 4 Comments

Veterans’ Day Greetings

My hubby’s late brother served in Vietnam in the Army Corps of Engineers. After the war, he worked in construction operating heavy equipment–hard work.  He ALWAYS took Veterans’ Day off.  To celebrate, he went to his favorite bar and enjoyed himself among his buddies.  He felt it was his due. (Then back to work the next day to support his family.)  Hope all vets are enjoying something pleasant today!

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A yeoman (F) on Submarine K-5 gazes through her binoculars. (80-G-1025873)

The VA has an overview of the history of the observation; the impetus was World War I.  Women played a broader role in this war.  Interestingly, the Naval Act of 1916 let women in.  Its”vague language relating to the reserve forces did not prohibit women.” So women, who were prohibited from joining the armed services, were able to enlist as yeomen.  For more information, this article makes for good reading.  The Nineteenth Amendment to the United States Constitution, giving women the right to vote, wasn’t passed until 1920 (August).

The BBC has a wonderful site about WWI from the British perspective. How did WW1 change the way we treat war injuries today? is just one interesting guide.

Blood transfusions were a big change but the science of them was very new:

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Top: First World War blood transfusion apparatus. Below: the Thomas splint introduced in 1916. Pictures BBC/ Getty and Wellcome Images.

The British Army began the routine use of blood transfusion in treating wounded soldiers. Blood was transferred directly from one person to another. But it was a US Army doctor, Captain Oswald Robertson, who realised the need to stockpile blood before casualties arrived. He established the first blood bank on the Western Front in 1917, using sodium citrate to prevent the blood from coagulating and becoming unusable. Blood was kept on ice for up to 28 days and then transported to casualty clearing stations for use in life-saving surgery where it was needed most.

The history of military blood transfusions, those life-saving procedures with unintended and sometimes tragic consequences years later, is an ongoing area of interest at ASKNOD. Apparently WWI is where the learning began for military doctors.

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PRESIDENT ANNOUNCES NEW DATE FOR VETERANS DAY

CaptureIn a bold move certain to upset the major Veterans Service Organizations across the fruited plain, President Obama today asserted his authority under his Executive prerogative to change the immutable date of Veterans Day. Numerous United States Postal Service workers, which encompasses the majority of Veterans,  have for years advocated a “fluid date” that comprehends three-day weekends, permits more quality time with your buds down at the VFW Bar getting sudsed and reminiscing about all those German babes of the evening you “conquered” in hand-to-hand combat between the sheets. 

In his Executive order, the President announced summarily that, predicated on his interpretation of what Congress really meant back in 1938, three-day weekends are paramount to the health of the current government workforce (excluding the standing military). He also cited to former President Gerald Ford’s misguided efforts in 1971 to move it to October 25-thereby carving out a niche of respectability for  his executive proclamation.

Veterans Day is now slated to be combined with December 7th and form a new, combined three-day weekend geared toward a much-needed break between Thanksgiving and Christmas. Again, due to the inviolate nature of having these holidays misguidedly relegated to specific dates rather than days, the newly combined Veterans Day/Pearl Harbor day, tentatively to be called Vet Dudes day (VD Day for short), has been chosen as the first Monday in December.

As you can imagine, this will cause consternation among many who served America, most especially in the Navy but certainly including the other services. The President explained his logic thusly:

obama-vpn“In order to keep America strong, we need more shopping days between Thanksgiving and Christmas where you- my fellow Americans- can exert your God-given right to go out and rescue our beleaguered economy. President Bush screwed this up horribly and we have striven to repair the poor choices of his administration. While the economy is coming back like an express train,  nothing will cement these gains unless I act unilaterally.  I have recently heard the desire in your collective voice and I feel this is the solution. Knowing the intractable nature of Congress and their inability to engage in bicameral, bipartisan legislation, it behooves me to act to enforce Americans’ wishes forthwith. In time, the wisdom of my choices will become self-evident. It always does.

In order to avoid confusion, I have instructed the Attorney General to make this effective next year although I feel we should just go ahead and, you know, like, do it maybe twice this year and bust out this new Vet Dudes Gig on the first Monday next month. However, I feel it would be inadvisable until we get all the Veterans and their advocates on board with it. That will entail time to acclimate them. Being responsible and transparent, and having America’s interests uppermost in my administration’s agenda, I feel we can sacrifice this year and give the negative Nancys time to get acclimated to the change.  Make no mistake. Three-day weekends are the wave of the future. America’s government workforce, excluding the active military, of course, demands this special dispensation. They are overworked and underpaid.

 Having an extensive background in these matters, I discussed this with the Joint Chiefs of Staff of America’s military forces and they concur that we simply cannot have everyone off that weekend. What the hey? Somebody’s got to protect us against this Ebonics-ah-Ebola thing. Besides, technically speaking, active military forces are not yet Veterans in the truest sense of the word and I know they will understand.  I also wish to thank all of you for your most recent mandate for my policies at polling places across America last Tuesday. Your trust in me is well-placed.  I feel this is one small step in repaying that trust. Happy VD Day and thank you for your service to America.

downloadLastly, I have instructed our new VA Secretary to drop what he is doing to restructure the VA and promptly promulgate new rules to effectuate my decision today. There will be ample time to fix those pesky waiting periods that are allegedly killing you Veterans. America’s economy is far more important that a bunch a whiny, malingering mentally deranged Veterans hanging around Veterans Affairs Medical Centers seeking sympathy and free medical services. Besides, that’s why I invented the Affordable Care Act. Hey, if you like VA medical care, you get to keep VA medical care. I’m not trying to take it away from you if you can get it. In fact, I modeled the ACA after the VA model. I’d like to think I am boldly going where no President has ever gone before. Thank you again. I wish I could be there today but this China gig came up suddenly and -well-what can I say? My tailor is in Hong Kong.”

Posted in Humor, Veterans Day | Tagged , , , , , , , , , , , | 3 Comments

BVA–REMAND TO”READ THE C-FILE”

download (2)This is a proof-positive illustration why you and I, and indeed, everyone who enters this convoluted system is condemned to purgatory for years until someone tasked with making the decision actually cracks the books and reads the c-file. It borders on malfeasance. It also make one wonder why the VFW was AWOL on this.

 

REMAND

In its July 2011 remand, Board directed that the Veteran be afforded a VA examination, which was subsequently conducted in September 2011. The VA examiner opined that it is less likely than not that hepatitis C was incurred in or caused by in-service injury, event, or illness. The rationale was that a blood transfusion in 1976 (prior to service) was the Veteran’s only risk factor for hepatitis C.

In response to the Board’s remand directive to consider the Veteran’s in-service history of circumcision, vasectomy, and cyst excision, the VA examiner noted that the Veteran does not have any history of circumcision, vasectomy, or cyst excision. Service treatment records clearly show that the Veteran had a circumcision in November 1984; a cyst removed in 1989; and a vasectomy in 1999. As the September 2011 medical opinion is predicated on a grossly inaccurate medical history, the claim must be remanded.

And just to keep them on the reservation, the VLJ suggests:

The examiner must accept as fact that, after service the Veteran did not undergo any surgeries, did not have promiscuous sex, did not drink a lot, and did not get any tattoos.

And we wonder why it takes a lifetime to win these things.

 

Posted in BvA HCV decisions, HCV Risks (documented), Remanded claims, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , , , , , , | 5 Comments