BVA–IT ISN’T THE IVDU, TRUST ME.

2011-02-07_181719_alfred_e_neuman

Alfred “Einstein” Neuman

I love to read about impossible quests and the path ridden to arrive there. Here is one for the ages. I must give Johnny “Einstein” Vet the “What? Me Worry? Award for this one. He has earned it. He takes clueless to a whole new level.

Instead, VA treatment reports provide accounts of the Veteran’s extensive use of heroin since separation from active service. In February 2008, the Veteran indicated that he had been using heroin twice per week, and the most recent time was that very morning. The Board notes that post-service risk factors were previously addressed in the [unappealed]August 2003 rating decision.

One hundred and one ways to successfully lose your claim at the VA. We note in passing that he wisely chose the legal service of the VFW.

ABANDONING VETS SINCE

 

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1899–ONE CLAIM AT A TIME

 

Posted in BvA HCV decisions, HCV Health, HCV Risks (documented), Nexus Information | Tagged , , , , , , , , , , , , , , , , , , | 8 Comments

BVA–CLASSIC HCV JETGUN WINS

GaryJETBasicVeterans would do well to bookmark this decision as a “how to” if they are going to attempt to win a VA jetgun claim. They also might consider looking in the phone book for Veterans attorney Daniel G. Curry’s name, rank, airspeed and last known heading. Relax. I did it for you.

P.S. And another well-presented victory of jetgun science over VA quackery. Note the rainmaker is none other than Virginia Girard-Brady.

 

 

Posted in BvA HCV decisions, HCV Health, HCV Risks (documented), Jetgun BvA Decisions, Jetgun Claims evidence, Nexus Information | Tagged , , , , , , , , , , , , , , , , , , , | 3 Comments

BVA–WRONG GENOTYPE FOR GERMANY

3375662_yjbm_85_2_249_g03I have counseled Vets to use a double-edged sword to prove service connection when filing- i.e. genotype and biopsy. Forty years ago, genotypes had a distinct geographical distribution. A good biopsy-preferably based on the Metavir scale -shows the approximate age of the disease and it’s linear progression. 

Using these two tools and a nexus from a gastroenterologist who succinctly connects the dots for the VA, it’s a virtually bulletproof combination to prove service connection. Using the genotype is very useful as the geographic distribution forty or fifty years ago was a unique, signature footprint.

Here, the Vet is pointing to genotype 2b as being proof of contraction during his service in Germany. Unfortunately, he would most likely have had 1B were it indeed from die Stricherin. On the other hand, if he had service in Japan, Korea or Okinawa he would indeed have been infected with 2b (or 2a)  had he contracted the local, homegrown version.

He does have some self-confessed ‘Imperial Entanglements’ of snorting the white lady and post-service tattoos. These could easily be overcome by a preponderance of the risk factors and evidence (genotype and disease progression)  pointing to service connection as the greatest risk. Having that nexus and a clear, concise rationale that precludes speculation are how these are won.

Johhny Reb was on the right track but went off the reservation with the 2b theory. As I have taught here, it is viable and persuasive evidence when correctly used. I won based on mine being 3a- indigenous almost exclusively at the time to the Indochinese Peninsula and also, of all places, Australia. Since we know it didn’t swim there, I suspect R&R played a great role in its migration.

duel-headerSince he didn’t play the hole card with the biopsy results, and VA noticeably did not volunteer any input in that regard, Johnboy lost. This is a game of inches and Johnny missed by a large margin. I suspect the American Legion was not there to hold his coat during the dual or perform the gentlemanly function of being his second.

Winning VA HCV claims absent any defining “aha” moment like a diagnosis of Hepatitis during service isn’t impossible. Success depends exclusively on risk and exposure to same. Having the correct geographical genotype and a Stage four biopsy simply cements the theory of it’s origin and age. As usual, the third leg of the stool is the nexus but that becomes academic after your evidence proves that the genotype theory and relative age are sound.

Posted in BvA HCV decisions, HCV Health, HCV Risks (documented), IMOs/IMEs | Tagged , , , , , , , , , , , , , , , , , , , | 9 Comments

How long should you wait for a PCP appointment at the VA or non-VA care provider?

30 days

????????  There are about 40 different types of VA appointments based on the purpose of the visit. The over 30-day rule seems to apply to primary care appointments.  Follow-ups are determined differently.

Secretary McDonald said this in a recent speech to the DAV:

We are making good progress in getting Veterans off wait lists and fixing scheduling problems.  We have reached out to over 240,000 Veterans to get them off wait lists and into clinics sooner.  In just the last two months, we have made over 791,000 referrals for Veterans to receive their care in the private sector—that’s up more than 164,000 over the same time last year.     Each one of these referrals, on average, results in 7 visits or appointments.    So, we’re talking about 1.1 million additional appointments in the private sector just from increased referrals over the last two months. 

Can you request a non-VA care referral if the wait is over 30 days?  Looks like a yes. Or you can opt for the wait list–the real one called the Electronic Waiting List (EWL).  

va wait lists

Secret VA  wait lists of the recent past…

But are you eligible for non-VA care?  The VA says it’s “complicated” and vets will be prioritized. If eligible, they’ll get a three-way conference call or if they can’t reach you, they’ll send you a letter, authorization code, appointment time and location. The provider cannot charge vets any co-pays, deductibles or fees–even if the vet is a no-show. 

From a June 2014 Fact Sheet

VA has accelerated care for Veterans currently waiting for health care services. VHA is in the process of contacting in excess of 90,000 Veterans during the first phase of VA’s “Accelerating Access to Care Initiative” VHA will provide Veterans who do not currently have an appointment, or are waiting for additional care or services longer than 30 days the option to be rescheduled sooner if VA capacity exists, keep their scheduled appointment, or be referred to non-VA providers in the community.

I’m hopeful that these changes we’re beginning to learn about will be lifesaving and quality-of-life improving for many.

Posted in Guest authors, Medical News, Medicare for VETS, VA Health Care, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , , , | 4 Comments

FACEPLACING REALITY

10628368_10202542670155487_6048263679916147970_nI found out today is actually “Indigenous People’s Day” now rather than the original celebration of Christopher Columbus getting lost in the Atlantic Ocean and finding Hispaniola. If this is true, then wouldn’t it be appropriate to pack up, leave and return it to the rightful owners? Seems no one is prepared to go that far. I suppose calling it Redskins Day is right out, too.

Enclosed please find for your viewing pleasure the following sent in, collected, and spotted while out and about on our favorite  Social Media Medium. Facepage is becoming droll for the younger generation. My grandkids feel it is no longer viable when their grandparents are active on it.

VA POWs

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And then carefully roll the tp back up several turns where it is still visible.

And then carefully roll the tp back up several turns where it is still visible.

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VA’s new Patient-Centered Community Care program (PCCC)

va waiting roomAre the days of VA secret-appointment lists over with the new private-VA health-care partnerships? Will vets really get access to primary care providers close to home eliminating long wait times? A VA press release (8/13/14) announced contracts with Healthnet and Tri-West Health Care Alliance.  Tri-West is signing up providers so if you like your local hospital/doc, contact them to see if they are joining.

TriWest was awarded a five-year contract by the Department of Veterans Affairs to administer the Veterans Affairs (VA) Patient-Centered Community Care (PC3) program in all or portions of 28 states (AL, AK, AR, AZ, CA, CO, FL, GA, HI, ID, IL, IN, KS, KY, LA, MS, MO, MT, NV, NM, OH, OK, OR, TN, TX, VA, WA, and WV). The PC3 program ensures Veterans will receive timely, convenient, coordinated, high-quality care in their community by allowing VA to make referrals through TriWest to a network of primary and specialty care providers. Under the PC3 program, TriWest will process the referrals, schedule appointments, track medical documentation, and pay claims on behalf of VA and Veterans.

A notice in the Wall Street Journal (6/25/14) adds that Tri-West and Tenet are partnering to provide services in Arizona, California, Missouri, Tennessee and Texas.

As a result, Veterans will gain access to 41 hospitals, 19 urgent care centers, seven freestanding emergency departments, 18 ambulatory surgery centers, 85 diagnostic imaging centers and nearly 600 employed physicians.

The VA stays in control. All appointments start with the VAMC a vet goes to.  The vet calls the VAMC and requests an appointment as usual.  The VAMC will decide where the veteran will be seen and will notify him/her. A three-way conference call will be set up.   Non-VA physicians can write emergency prescriptions for 10-days and the VA pharmacy provides follow-up meds.  The VA supplies durable medical supplies needed. 

It’s horrible that veterans had to die because Congress did not expand non-VA care years ago and there is NO guarantee that they will continue to fund these programs after the VA contracts end.  And “Eligibility for non-VA medical care is complex and varies for non-Service Connected veterans” and  Non-VA Care “feasibility” rules still apply. See: Accelerating Access to Care Initiative Fact Sheet.  Many questions must be asked.  If a vet has cancer, is non-service connected, and facing long waits, can he see a partnership provider fast?  If a vet is depressed or suicidal, is non-service connected, can he see a partnership provider fast? 

Posted in Guest authors, Medical News, VA Medical Mysteries Explained, vA news, VAMC Scheduling Coverup | Tagged , , , , , , , , , , , , , , | 2 Comments

REMODELING THE VIETNAM WAR

June 1966 TSN Vietnam

My father preparing for departure in a F-4 from Tan Son Nhut AB June 1966. Note the centerline 20mm gatling gun McNamara neglected to install internally in 1960

I get a bang out of listening to some of the younger generation of America, civilian and former military alike, who have a discombobulated perception of what happened in the Vietnam War and why. I also fear that what my father told me of Bob McNamara’s shenanigans during that era may soon be repackaged and marginalized- or simply deleted for posterity. We all know from reports of the contemporary fighter pilots’ that by January 1968, just prior to the big Tet offensive, we were down to 250 lb. MK 82s and were buying 1000 and 500 pounders back from Germany for $900/$500 a pop. We sold them to the Krauts for about $10 each in the early fifties as we rearmed them after WW2. Mac had an idea he could run it like Ford. X number of bullets and X bombs needed to kill X number of zipperheads = war over. Simple math.

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French A-1 Sandy circa 1953 prepping for ordnance load out at Da Nang AirPatch

Grand Poohbahs are now celebrating the fifty-year remembrance of Vietnam which will run the entire time from 1964(?)-75 meaning from 2014 to 2025. The memorable Air America Fun Run to the Rooftop was April 29th, 1975 and the final leg occurred over at the US Embassy on Thong Nhut Boulevard a week later on May 7th. Our involvement, however, goes back much further than 1964. The medal I use for my logo and the one struck for us by our allies has the “60-device” on it and even that ignores reality. My father was sent over by Eisenhower and his cronies just before the French bought it at Diên Biên Phú in 1954. They wanted advice on how to deliver better close-in tactical air support for their ground troops. At that point, they had none or little that was effective. Tactical Air Combat Control was simply not in their lexicon then-or now. Army FACs communicated with their HQs and they passed it on to the French AF. In an eerie prelude to May 7th, 1975, one should note the French were overrun and surrendered May 7th, 1954. So much for lucky sevens.

Few also will remember we were down to a two-week supply in country of 5.56X45 mm ammo for our shiny new M-16s in late 1965. We were robbing our Army and our allies over in South Korea and elsewhere to keep our troops supplied. Perhaps that explains why member WGM says he trotted around in Korea with an empty gun for his whole deployment. Hell, even M-26 hand grenades and 40 Mike Mike HE thumper rounds were pretty skinny. The only things in vast supply were antique C-rations and 7.62X51mm ammo for M 60s because we overbought for years to provide for the M-14s we decided not to use. These events, too, are part and parcel of that war but I see no mention.

downloadThe article on the historical perspective needs more work and a George Santayana revision to better enunciate our escapades in Laos and Cambodia during that era. It is one thing to catalogue the thrill of victory and the agony of defeat in RVN proper and quite another to ignore the exploits of our “other” Air Force in the adjacent countries. The lessons we learned fifty years ago there closely echo what is afoot in Iraq today. Seems our little nine-year rescue mission is falling apart less than two years after our departure (again).

Some will never hear of the sapper attacks that occurred in Thailand in the sixties and seventies. It’s not on this timeline. I suppose that wasn’t “war” in the true Vietnam context and most certainly not in the lexicon of the VFW. Their definition is much narrower-or was until recently when their membership numbers began to plummet. Boy Howdy-now it’s “Welcome Home and come on down, The first month’s bar tab ( house beer only) is on us for a paid membership of one year!” My response to their recent conversion is simple. “Tell that to all the parents and wives of the 58,494 who came home in a glad bag. Or worse, the many like Captain Park Bunker who were KIA/BNR in Laos who had an empty coffin Memorial Service. 

Vietnam was a horribly divisive war (or conflict) as many can attest to. It divided families along political lines and changed us forever. Never had we come in third place in a war. It was like coming home from the Olympics empty handed or with a fistful of bronze and no gold. Many said we should never have gone there. That same sentiment reared its ugly head in 2001 and 2003. Hiding your head in the sand and praying it will all blow over doesn’t work. The bad guys get the impression you’re girliemen. Besides, we should be proud of our heritage in helping the downtrodden of the world when their hour of need arises. How else are we going to earn all those fancy medals?

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Ollie-Ollie income free. You can finally come out of the closet and admit you’re a V-Vet, apparently.

 

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Revisiting an ASKNOD post on Fully Developed Claims (FDCs) on another site

carrot

Should I bite?

Every so often, I find posts by NOD on other websites with information and warnings.   I came across NOD’s response to a post–2-years ago– about FDCs on the site DoDLive.   The BVA employee offered cheery advice to vets. (One wonders how many of these “Fully Developed Claims” have been successful and decided within the promised time limits since the program began.)

Today the VA provides a video (1 hour) and some other information about the Fully Developed Claims program.

Here are NOD’s caveats with my emphasis added:

Unfortunately Ms. Trombley overlooks one glaring fact. VA has a habit of failing to go after that which you inform them of. I gave VA the name , location and everything but the GPS coordinates of the civilian hospital I was in during the Vietnam Boundary dispute. Six times. In the 21-526, in my Hearing at the RO, in my SOC, in my SSOC and in evidence submitted to the BVA on appeal. Results? Negative. They said the records they had were adequate. At what point will it occur that VA will not feel sufficiently motivated to even query St. Louis’ NPRC over your STRs?
As for DBQs, I suggest Ms. Trombley, an admitted Veterans Service Representative, look carefully and tell us where the space is for the doctor’s nexus? There is none. Nevertheless, we are admonished to provide a) proof of current disease/injury; proof of same in service and doctor’s nexus letter linking the two aforementioned items. It appears the VA would prefer that they be allowed to supply the nexus. Since 85% of all compensation claims are denied, we can assume that many arrive without this. Can we blame the poor Vet for his ignorance? There are only two venues for compensation claims. Either you DIY or you allow a VSO to represent you. I have had three and none proffered the need for the nexus. I did it myself the fourth time and won everything at the RO without an appeal (100%+40% +10%). I finally wrote a book about it to show other Vets why they lose (asknod.org) Ms. Trombley would do us all a great favor if she more clearly identified why a fast track claim is better. DBQs simply take the VA off the hook for assembling the claim. It does nothing to ensure success and may be more harmful in its present configuration. Stick with the guaranteed requirements of the Caluza triangle above. Lack of nexus sinks more claims than any other factor and Vets are not apprised of it until they get good legal representation.
Considering this is a non adversarial venue in which to present our claims. I would hope Ms. Trombley can explain why the BVA needs a phalanx of 500 lawyers against unrepresented Vets or even VSOs with no juris doctor degree. Veteran friendly? Yes. They smile when they deny. If we’d just give them more evidence, we’d win? No one has explained why there are so many deadbeat Vets filing claims. One can only assume that from the horrific denial statistics.

As for accuracy in claims decisions, by who’s measurement is it 86%? When the fox is in charge of the hen house and egg production, one must look more closely at the purported statistics. Entrusting that measurement to the selfsame fellows who work there is not scientifically or statistically defensible.

I have read the DBQ for HCV and it is defective.  For example,  many extrahepatic conditions aren’t given.  Mental health sequela is left off the form.  The Hepatitis C DBQ needs to be challenged and improved.  As far as trusting VA employees to have your best interests at heart, that is a pipe dream so I guess vets better study up on the Caluza Triangle before going for the FDC carrot.

trust

 

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BVA– LATE 3RD QUARTER DECISIONS ARE OUT

download (3)Third quarter BVA decisions are out and up on the BVA site here. There are now 773 Hepatits C decisions so far this year. I did have a query from one Vet as to how long it takes from the BVA decision to a resolution (i.e. a VARO rating). If you signed a waiver of review with the BVA, you will actually get a decision from the Appeals Management Center  (AMC). I did. It occurs much sooner than a transmittal of your c-file back to the local VARO for the rating. If it does return via snail mail, you can expect a decison to be issued within a month and sometimes two if they are really backed up. Think Seattle, Oakland and Houston, Detroit and Baltimore are way out there.

Posted in BvA Decisions, BvA HCV decisions, vA news | Tagged , , , , , , , , , , , , , , , , , , , , | 2 Comments

HARVONI–IT’S HEEEEEEERE!

10600503_10203626629959910_1414506955141013138_nNeed I say more? Love the name. Love the idea of two Hep C birth control pills in one with no Ribavirin and no Interferon. Smooth sailing and in less time than you can count in Hepatitis C land. Thank you Gilead for persevering. No more hurling chunks and thyroid cancer. No more Ribarage. No more ____________________(insert malady here).

Here’s more:

http://www.hepatitiscentral.com/mt/archives/2014/11/harvoni-is-here-the-once-a-day-single-hep-c-pill.html?eml=hepcen220

Posted in HCV Health, HCV Risks (documented), Medical News, Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , , , , | 7 Comments