Evidence Alert!: Bloody shared razors from “Barber’s Assistant” Dirty Jobs, Season 6, Episode 5

Modern American barbering demonstration 2011-2012

Discovery Channel, Dirty Jobs (Season 6, Ep. 5, released 2012)

I have queried my spouse about the practices of  village barbers in Vietnam and learned that their methods were unsanitary.  (Village barbers also came to the compound to cut hair and shave soldiers.)  Therefore a show on the Discovery Channel, Dirty Jobs, caught our attention last weekend. We were staying in ND at a hotel watching  Mike Rowe learn how to cut and shave in a barber shop in Mobile.  About 20 minutes into the video, ouch!  The customer’s neck got nicked in numerous places during his shave with a straight razor–by the experienced licensed barber.

I had to buy the video for $1.99 from Amazon so I could share the above screen shot (which has actually tricky to capture at 20:19).  The banter between Rowe, the barber, customers, and camera guys is light-hearted.

Barber:  “Now remember now, this is very sharp.”  

Rowe:  “…you can see the blood pulsing through his jugular.”  Rowe: ” Is it natural for him to be bleeding like that?”  

Barber: “That’s the way it goes…a brand new blade got in my way…”

Then the barber pulled out a dirty styptic pencil!  Can’t sterilize those.  And those blood-STYPTIC_PENCILsoaked nubs are rubbed into face after face. Perfect transmission mode for blood- borne pathogens.

Customer/cameraman, upon seeing the bloody towel used on his face: “Is that MY blood?

Since all the barbering tools are shared between customers the answer might be, on the towel, yes, but that’s the best we can offer.

barber2

Second close-up of bloody scraped neck.

For $2.00 this can be downloaded/copied to a device for personal use such as to support a HCV claim in which a vet has testified that he shared razors and/or used the services of village barbers.  And folks, don’t forget the clippers that trim hair from all facial orifices, necks etc…they nick skin too and are not cleaned between customers.  Barbers don’t run their offices like good dental offices.  If they did, a haircut/shave would cost upwards of $100.00.  Why, because barbering is a very dirty job and I’m glad Rowe included it in his show which was released in 2012.

Posted in Guest authors, HCV Health, HCV Risks (documented), IMOs/IMEs | Tagged , , , , , , , , , , , , , , , , , , , , , | 4 Comments

VA ILP– THE SECRET HANDSHAKE

downloadFor five days I have sat, picked berries, contemplated my navel and wondered how I could apologize to all of you for being so incredibly dense. Cupcake says I’m oblivious to my surroundings yet I see many things she doesn’t. In public, I constantly gauge those around me for aberrant behaviour that might signal mental illness. She finds these types “quirky” and stimulating. If someone is toting a shotgun into Safeway, I notice it because I was trained to see danger once. She might be able to tell me what the color of the lady’s handbag was across the parking lot and whether it accessorized with her blouse . Colors don’t kill you. On that count, I plead guilty.

Here, for over six years, I have been sounding the alarm on the Caluza triangle, aka the Hickson elements, aka the Shedden principles et cetera. Every day I read decisions from the BVA clearly stating the VA claimant, ably represented by the _____________(pick one of the Big Forty Six) arrived all the way up to DC on appeal with no nexus letter. Somehow, everyone who represented the poor fellow had overlooked this important element in their presentation of his claim. The mere fact that it has been enunciated law since Mr. Mario Caluza appealed his migratory left/right  ankle/knee/lower leg injury claims to the Court of Veterans Appeals in 1995, we have known the need for this. VA attorneys who represent us have known VA required it even before that. It was just unwritten until Caluza legally. Therein lay the problem. I call it the secret handshake or the “club password” to get into the treehouse. No tickee-no laundry as they say at the Chinese cleaners in town. Without it we were and are lost.

download (3)When I wrote my book I didn’t enunciate all of the history of VA jurisprudence and the gradual forfeiture of secret handshakes and passwords. Over the years, via the CAVC, the Federal Circuit Court of Appeals and sometimes even the lofty heights  of the Supreme Court, we Veterans have forced the VA to relinquish a wealth of information they hoard regarding adjudication of our claims. Each revelation, each stone overturned-indeed, each case- be it  single judge memorandum or panel ,uncovers a heretofore basic, fundamental right and corrects the path of justice for us. It’s been a long haul since 1989 and the Veterans Judicial Review Act (VJRA). Each day brings new epiphanies to the CAVC judges.

Of note, we were accorded the Veterans Claims Assistance Act (VCAA) in 2000. It compelled the VA to tell us what the defects were in our claims and suggest possible remedies. Few of you will remember the old days. I’ll show you one. In 1989, when you got denied or received a Statement of the Case (SOC), it merely informed you that you weren’t going to get the new Corvette with AM/FM stereo and cassette player. What it failed to discuss was why. Thus began the “reasons and bases” part of our jurisprudence. If you lost, the only way to fight it was to be able to dissect it. VA was not very forthcoming and surprisingly, neither were our National Service Officers (NSOs) who were representing us.  To say we were mushrooms in the basement being fed poop was an economy of words.  By 1994, they were giving us some vague idea but it was written by retards in the typist pool or Adobe 1 for Neanderthals. Dangling participles were the least of our worries. Getting the correct tense on the verbs was often the issue.

1990 VA denial letter

 

By 2000, we had amassed a wealth of Veterans Case law in the legal library but the process still seemed stilted and adversarial. This provoked Congress to lower the bar still further and force VA to suggest remedies for our predicament when we didn’t prevail. That law is still evolving and we see brief glimpses every several years where a new paradox emerges that needs a special band aid. Nevertheless, some precepts like the Caluza triangle are immutable, bedrock principles. How that manages to escape the Big Six twenty -plus years later will remain an enduring mystery.  This is where my obtuse mentality ran aground, too.

download (4)All these years, I always thought the principles of compensation claims adjudication (and by extension, the evidentiary requirements) were parked when we entered into the Vocation, Rehabilitation and  Education (VR&E) Temple. Here, we were to be accorded the “Hail, fellow Veteran. Well met. And how can we be of assistance?” speech. We had passed the test of compensation and were inside the wire. Our bona fides were established and now it was a matter of what services could be rendered, in what quantities and how soon. Sound familiar? Seems I got this speech when I went to the Disabled American Veterans in 1989. They even showed me the compensation rates in $US. Hell, back then they probably could have sold me a Pacific ocean condo time-share in Arizona. I trusted them implicitly.

Recently, as you know, I received my Supplemental Statement of the Case with the latest “What part of ‘No’ don’t you understand? This is the fourth time we told you the greenhouse isn’t in the cards.” After putting it down in disgust, I had to begin research to rebut their latest logic. I had a thirty-day suspense date this time out and time was of the essence.  This was the VCAA moment. All these years, the VR&E crews had been operating in “splendid isolation” as Senator Alan Cranston said it back in 1988 during the discussions that led up to the VJRA.  Similarly, over at VR&E,  the VCAA’s tenets somehow seemed to evaporate or revert to the pre-1992 technique of a simple, polite “No. I’m sorry but it wouldn’t improve your life one bit. Of course, you are free to come back and beat your head against our wall any time you’d like to. We’re open Monday through Friday, 9 to 5 except for Federal holidays.”

The OIG or some enlightened soul suddenly noticed VR&E folks weren’t complying with the Reasons and Bases part of the denial gig. Moreover, they were also violating the VCAA by not suggesting a repair order. While reviewing the SSOC, I began to look in earnest at the requirements they were suddenly iterating for the first time. The denial was still in force but suddenly it wasn’t simply couched in “You have all the greenhouses you’ll ever need. You can buy your veggies like normal folks in the organic section.” Suddenly there was a new, belated explanation for what the actual requirements were that we need to prevail. Granted, they are the new March 31st, 2014 revisions but they are the first glimmering of a “VCAA for ILP claims”. Yup. Prior to this it was simply “No.” Maybe a blithe reference to 38 USC §3120 or 38 CFR §21.160 to make it look official but no substantive paragraph on a 4107 telling you what you might do to prevail. Until now. It’s still not on a 4107 . Hell, I didn’t even get a 4107 as far as that goes which is probably a remandable action in its own right.

However, what finally penetrated my hardwood-encased noggin was this seminal phrase that evoked the echo of “nexus”. When you are trained to examine these denials with a fine-tooth comb looking for the smoking verb as to why you lost, things like:

“The following criteria must be met before providing services designed to promote the pursuit of an avocational interest:

1. The disability condition(s) limits or prevents participation in the avocational interest.
2. The activity must have been previously performed for a significant amount of time, defined as over a twelve-month period.
3. A medical and/or mental health provider must provide documentation that continued support of the activity is not contraindicated.
4. An expert consultation to identify accommodations required to enable continued support of the activity must be completed by a qualified person, such as an occupational therapist.
5. The pursuit of the avocational interest must improve the individual’s independence in daily living in a measurable and verifiable manner.
6. The individual must have the ability and resources to sustain the activity or pursuit after the period of rehabilitation services are completed.

download (1)This is the Rosetta Stone we’ve been looking for. It’s the secret handshake. It’s the guarded password known to everyone at VR&E’s ILP shop that forbade entry. Their problem was that I was bold and laid my cards out on the table from the outset with the gomers up in Seattle. I let them know in no uncertain terms that I was President and Founding member of the Win or Die Club. I made sure they knew this would be appealed as high as necessary and to make sure they had their Is dotted and the Ts crossed. In order to make sure they had complied, they promptly sat on it for six months and changed the regulations to comport with the VCAA. Above, in red, is the crucial element that had eluded me. It was right there in front of me all these years and I should have suspected as much. Roger that. You need a nexus letter for your dream greenhouse. Who woulda thunk it?

VA is as predictable as the snow in winter in the northern climes. They are hidebound and have a one-size fits all to their madness. Thus it should come as no surprise to expect them to copy the M-21 Adjudications Manual chapter and verse and relabel it the M-28. The one thing missing all these years was the above requirements finally committed to paper to make the Texas Necktie Parties perfectly legal. As you can see, the problem is that it’s three years too late. I filed in 2011 so it is inapposite to my claim.  Had they included this in my November 2011 denial, they might have had a quasi-legal leg to stand on. I think they outlawed changing laws in mid-stream after they disenfranchised all the Indians Native Americans out of their land holdings and penned them up on reservations.

VA just showed us the secret handshake, man.

VA just showed us the secret handshake, man.

We at asknod and the eastern consortium of The Tip of the Spear in Georgia (Bruce McCartney) are bound and determined to see this excised from the M21 as it, and other recent additions, are unsupported in ILP law as it is written. The problem is someone will have to carry the flag forward. Since I planned on this anyway, it may come to pass that I’ll be the guinea pig. I feel honored to be tasked with this. I remember the immortal words of old Wavy Gravy the day after I got to Max Yasgur’s farm back in August 1969- “We must be in Heaven, man.” Man, I just love going up to the Court and playing with Willy Gunn. It could be that VA and the VR&E crew will realize they don’t have a pot to piss in or a window to throw it out of and grant me the greenhouse. I know better after all these years. Once VA sets their heels in the dirt, they begin to manufacture reasons and become a prodigious denial machine. They hire even more lawyers to research how this can be sustained. They’ll do this for years if they find a compliant VLJ. If s/he affirms the Fort Fumble decision, the Office of General Counsel will bring their 16-inch guns to bear and spend hundreds of thousands of dollars more with specious arguments defending their defective logic.

Here’s the repair order, Vets. If you’re like me, you go to your personal care provider and ask for a referral to an occupational therapist just as it says in red in #4 above. You have a complete consult with all your evidence at hand. You present the why and the how. You knock down every straw man argument they propose of the six above. You prove by a preponderance of the evidence why you need your tempurpedic bed, your woodworking shop, your riding lawnmower or tractor, your digital photography gear, your metal detector for beachcombing, ad nauseum. The only obstacle is impressing this need for “independence in the activities of everyday living” and all the other horsepucky phases VA VR&E people contrive to prove you are independent of the community etc. I like to throw in “self-actualize” as that’s one of their buzzwords. Here. Let me use it in a sentence. “A greenhouse would allow me to self-actualize my desires while occupying many hours in pursuit of activities which will help other Veterans in my community as well as activities in my own everyday life. It will also help me gain proximity to the outdoors as that avenue is currently not available to me because of my Porphyria Cutanea Tarda”.

I dropped by my provider this morning and asked for a referral because the new Obamacare requirements state I can’t do this without a note from my doctor. It will cost $40 as a co-pay to obtain this home visit/assessment on my Obamacare-approved Medicare Advantage Plan. I  will have a lot of information pre-printed to provide the occupational therapist every thing she or he needs to understand the VA mindset, requirements and restrictions. I also will have everything ready for inspection in the garden.

VA for years played the game and the VSOs were accomplices in it. They still are today. The “game” is allowing VA to provide the nexus fully well knowing what that will say. They’ve gone so far now as to construct the Disability Benefits Questionnaires (DBQs) with no “nexus box”. Thus, when you have you doctor fill it out, there is no place for him to include that all-important, Caluza-required statement that your disease/ injury is service connected. Similarly, applying for an ILP grant requires it as well and getting one in advance should be the opening shot across the bow in the future for all of you who aspire to tap into this rich vein of opportunity.

Fortunately for me, I found out before I got to the CAVC and am still able to add this to my evidence pile. It also occurs at a fortuitous time since this is apparently headed to DC. The new occupational therapist’s assessment will be reviewed in the first instance by a Veterans Law Judge (VLJ) de novo. The Seattle Bozos will be unable to rebut it, though how they would is an interesting thought. Would it boil down to who’s psychology degree was shinier or which institution of higher learning issuing the sheepskin was more august?

Apologies are in order as I said. I cannot believe I could stare at a forest for so long and never see the trees. I do hope this will embolden each and every one of you with “severe disabilities” to throw your hat in the ILP ring, too. There is strength in numbers. VA has been artificially abbreviating this program and desperately trying to put it in mothballs. They are on the verge of it with the bogus “revisions” in M 28R which are unsupported by their own regulations and the pertinent statute. But what the hey? Mission creep is VA’s middle name. Look at the fine job they did in revamping patient scheduling at VAMCs nationwide.

Win or Die VA

Posted in Independent Living Program, Porphyria Cutanea Tarda, VR&E | Tagged , , , , , , , , , , , | 6 Comments

Time for humanitarian medical tourism to get Solvaldi?

Fantasy medivac of HCV vets needed Solvaldi NOW!

Fantasy medivac of HCV vets needed Solvaldi NOW!

Should the VA collaborate with the DoD to medevac the most seriously ill veterans with HCV to another country on Air Force cargo/hospital planes?  Taxpayers would save an enormous amount of money if so.

This would also be a great project for any veteran service organization to sponsor.  If big pharma wants to screw veterans, the VA should just outsource treatment to another country where Solvaldi is much cheaper.  Fly the vets in, spend a few days for exams, fly home, then consult via a virtual service like Skype with foreign docs working in partnership with VA hepatologists.

 

The cost for a 12-week course of Solvaldi differs drastically depending on where you receive the medication.

United States: $84,000; Germany $66,000; France: $50,000; Russia $45,000; United Kingdom: $34,000; Thailand-$5,000; Eqypt-$900.  India, Egypt and Brazil: $840; Burma, Iran, Mozambique, and Kenya: $900.

Indian HCV activists are asking the government not to give Gilead an Indian patent because it’s so cheap to manufacture ($68 -$138) for all twelve weeks of treatment.  I hope they win.

Forbes writes about medical tourism to places like Bumrungrad Hospital but sticks up for the insane US $1,000 per pill cost which has led to a policy of rationing at the VA.  Would one such heavily publicized “Solvaldi for HCV veterans” medevac trip bring costs down?

Do you think veterans would pack a suitcase and board a well-equipped C-17 to another country for immediate treatment?  I do.  Chicago to Sao Paulo is 10 hours and with no jet lag due to being in the same hemisphere.

The VA cannot afford to pay full price for Solvaldi because it’s NOT an insurance company.  We have the planes.  We have medics. Bernie Sanders, what do you say?

 

 

Posted in Guest authors, HCV Health, HCV Risks (documented), Sofosbuvir, VA Health Care | Tagged , , , , , , , , , , , , , | 5 Comments

VASEC FALLS ON HIS SWORD–WE LOSE

downloadUnfortunately, General Eric Shinseki has chosen the least controversial exit of all. Rather than stand and fight the endemic corruption the VA is awash in, he has opted for resignation. We are the losers and I say this with great sadness. In Gen. Shinseki, we had a warrior-citizen who was cognizant of what many of us endured while serving. Having that commonality is a prerequisite for the job in my mind. Former VASEC Jesse Brown was the only other one who could boast of this association. He, too, was an above -average Secretary. I think we all know what is in store for us soon. Can you say “whitewash”?

Just as the GM folks got their neckties in the dirt on the ignition fiasco that caused 12 or more deaths, greedy VA employees has bamboozled Shinseki and given him bogus info. He, to his detriment, took it as gospel and now has to pay the price. Now, here’s why we lose out.

-Gen. Shinseki has five years under his belt and is up to speed on the problems.

-He is now acquainted with who the culprits are and is expertly situated to introduce changes to correct it.

– He is the first VASEC in history to effect changes that have benefited Vets of the Vietnam War (Parkinson’s, B cell hairy leukemia, IHD etc.) in over a decade. The IOM and their ilk have been dragging their heels for years on presumptive issues. Ric cut to the chase and rammed it through. His record on homelessness in Veterans is stellar.

-He has the capability due to his long tenure as a leader/warrior to make bold changes rather than small baby steps. VA needs this desperately.

-He isn’t concerned with stepping on political toes at this point. His focus is solely on us Veterans. He is one so he “feels our pain”. Make no mistake about it. He walks the walk.

– He doesn’t have any “baggage” that drags him down. He’s happily married and has no Monica Lewinskys in the wings. He’s bulletproof on that front. That’s no small feat in this day and age of the roaming eyeball. Witness Gen. Petraeus.

-Given the nod from Congress and the legal authority, he’d go in and sweep out the scalawags who infest the VA hierarchy. He owes no one for his appointment other than the President and Congress. That’s a very tall mandate if the President was willing to stand behind him instead of a golf cart.

-He honestly cares about us as individuals and doesn’t consider us a liability or a lead weight around his neck holding him back from greater things. His focus has always been on a repair order, not a stepping stone to Secretary of State or a Vice Presidency.

-After 38 years in the Army, we can safely say he’s seen it all and knows the repair order for much of what infects VA currently.

– He’s being 86’d for political expediency-quite possibly the worst reason to do away with him. Congress folk are up for reelection this fall and without going into the specifics of which party feels threatened, it is safe to say that the party that flies the blue flag is under considerable approbation from the voting public over a number of fiascos that do not need elaborating here. We all know what they are assuming we read the papers.

-When an agency head with five years under his belt is finally apprised of the shortcomings on his watch, it is asinine to show him the door before he can attempt to correct it. This imbroglio is going to be censured, downplayed and relegated to the back page by the PR wonks both at the White House and the VA. They don’t want the bad press. Everyone knows that. General Shinseki would eviscerate the VA as we know it and an utter massacre would be a given if he was given free rein. I’m sure the thought of that keeps many in the White House up at night wondering just who will be unmasked and convicted.

-Most of the objectionable personnel guilty of these crimes are-yup- political appointees whose careers are in jeopardy. The party in power put a lot of them in there over the last five years and they are not going quietly into the night without a fight. General Shinseki owes them nothing and thus any leverage they feel they possess is nil. Unless he gets the ax. He did-and now they can breathe a sigh of relief.

-After the dust settles in Phoenix, the investigation will uncover a few more minor players and then it’ll be back to lather, rinse and repeat the mistakes. Nothing will ensue other than a lot of new hot air emanating from the usual sources and promises never to let our Veterans down ever again.

-The whole idea of a strong agency head as envisaged by the 1988 VJRA is being tossed out in favor of a congressionally-brokered fix. By that, I mean throwing Gen. Shinseki to the wolves to appease the press and get reelected this fall.

10371483_10203157900141196_7246146644956922799_nMark my words. Nothing positive will come of this. An apt analogy would be to fire the Captain of the Titanic minutes after his ship hit the iceberg. Never mind that White Star senior management ordered him to crank it up to 25 knots. He’s in deep doo-doo because his watchmen were asleep at the wheel or worse. To fire him now before launching the lifeboats and saving lives is pointless and shortsighted. He is perfectly positioned to repair the problems or prevent them in the future now. Why would anyone take the star quarterback out in the 4th quarter in a tie game on 4th and inches-in the red zone? Why, Congress, of course.

I have seen this same scenario far too many times in DC. Politics are Veterans’ worst enemy. Being beholden to them (senators and representatives) for our health and compensation is unworkable. What, exactly, the repair order is does not encompass firing the only one capable of fixing it in the shortest time possible and doing it professionally. I suppose that thought never entered Sen. McCain’s head.  That’s what happens when you’re buzzed on Coors, I suppose.

download (1)We understand the frustration Representative Miller feels over this but it is clearly a case of “Nobody told me” and ”I trusted the bastards”. You don’t just announce the buck stops here and unceremoniously boot him.  Much like a broken automobile, you fix it with the best tools, the best mechanic and newest technology available rather than tow the car to a new shop and hire a new, untried mechanic who is unfamiliar with the vehicle’s problems. Sometimes the shortsightedness of our politicians causes more harm to our Veterans cause than we imagine. Here, it is being perpetrated with anger and effrontery rather than with calm, reasoned logic. Such are the vagaries of politics.  Strangely, we didn’t see Secretary Kathleen Sebelius given this treatment after the Health Care Computer pancaked.  I guess it’s who you know, not what you know. SOP in DC-to our detriment again.

Onward through the fog of stupidity.

Hey kids. Can you say whitewash? Sure. I bet you can. Try it.

Hey kids. Can you say whitewash? Sure. I bet you can. Try it.

 

Posted in VAMC Scheduling Coverup | Tagged , , , , , , , , , | 7 Comments

CAVC– STRONG V. SHINSEKI–WE HAVE ALL BEEN HERE BEFORE

thumb_d10d7a64-04ab-4462-9561-19cb885ef6d9My sincere apologies to Crosby, Stills, Nash and Young for bogarting the Déjà Vu.  It seems no matter how many times we go through this process, the BVA seems inclined to come up with the same tired excuses for their denials. Mr. Michael Strong is now beginning year 13 in a long judicial nightmare trying to prove, at this late stage of the game, that he never used a “glass pipe” to smoke crack cocaine. That’s how asinine the BVA has now become that they would be reduced to putting words in his mouth.

Mike’s history on this was written up in 2011 here. At that time. I pointed out the impossibility of  ever finding in any Veteran’s STRs (or SMRs) a report of sharing razors. Additionally, the chances of reporting minor scratches and cuts incurred playing around concertina wire were also slim to none. The military taught us to be strong- not girlymen. Judge Hagel concurred and saw the improbability of it as well.

Nevertheless, the BVA has once again denied Mike from the RO on up in much the same way they gave him the bum’s rush in 2003. Nothing has changed except the date on the calendar. The rationale for his denial has even become more ludicrous and far-fetched than the 2009 BVA denial. The BVA gomers and the VA examiners have worked overtime trying to pound a square peg into a round hole. Unfortunately it’s a poor fit and so obviously a put-up job that Judge Hagel once again has to wash the OGC’s mouth out with soap.

I include this case for the obvious HCV connection but Veterans pursuing justice would be wise to analyze why this returned like a boomerang. VA is intransigent. They have an agenda of deny until you give up or die. It never dawned on them to read this and try to swallow it hook, line and sinker themselves before asking Judge Hagel to buy in.

imagesIt’s like Chinese instructions on how to assemble a table from Home Depot. The directions simply don’t fit the object they purport to describe. Eventually, VA resorts to manufacturing statements by the Mikemeister that he told them he used a glass pipe to smoke crack. Keep in mind that they have maintained for years that just the mere smoking of crack was the equivalent of snorting it as a risk factor. I also doubt the Mikester got diarrhea of the mouth at this late stage of the game and gave them a blow-by-blow description of how he ingested crack. When that flamed out, they started in on the “He has no history of sharing razors in the service.”  In desperation the short, stubby overheated glass crack pipe materializes like they do in an episode of Cops. To the VA this is called “any port in a storm”.

VA insists that we, as claimants,  have a logical argument for any nexus . It has to be cogent, well-reasoned and easily verifiable. You cannot just up and say “Your Honor, Mr. Strong has a long history of drug abuse and alcoholism. Therefore it ain’t service connected.” You need facts. You need medical studies peer-reviewed and accepted nationally. In sum, you need a bulletproof denial buttressed amply by science- not an alien abduction scenario. Now comes before us Will Gunn of OGC fame with airy theories, illogical, unsupported facts and a blatant attempt to roll Judge Hagel with them. Kind of makes you wonder what Mr. Gunn was smoking.

Here’s a small sample of some of the most priceless illogic you may read this year. You will find ample cites to utilize in your own defense when they start in with the VA examination where you admitted to snorting (or smoking) the entire 1987 production of Peru’s finest export.

In his December 2004 statement, Mr. Strong stated that, in September 1977, a member of his “platoon and company” attempted suicide by slashing his wrists and that he was among the men tasked with cleaning up the soldier’s blood. The Board denied Mr. Strong’s claim, in part, because there was no documentation of this in his “service treatment records.” The Court is dismayed that the Board provided such a patently illogical reason for denying Mr. Strong’s claim.  The notation of another soldier’s attempted suicide is not the kind of information one would expect to find in Mr. Strong’s service records.

Fast forward to 2012 from the 2004 “non-probative” C&P:

In January 2012, Mr. Strong underwent a VA examination. The examiner stated: There is no documentation within the medical record of the patient having shared razors, if this had occurred, this would be considered an inefficient vector at best.

 

VA is cognizant of the risk factor associated with tainted blood. This is why you will find sharing personal items listed as one of the VA -recognized risks of contracting HCV. Yet here, our desperate Examiner is reduced (with no supporting medical logic) to opine that this is not the cause or a slim one at best. Please recognize this technique as VA uses it all the time. You have to read every word to excavate it sometimes. Here it was overt.

He also states that he helped clean up blood products resulting from the attempted
suicide of a fellow soldier. This involved using a mop, towels, and bleach. He was
not exposed to any needle sticks. There is no documentation in the medical record
regarding this event, however from his description of the event (using a mop, towels
and bleach), it is unlikely that he has had any significant exposure to blood products,
given that hepatitis C is not spread through intact skin or mucus membrane.

Well, pilgrim, except for those pesky glass crack pipes, that is. VA blithely glosses over the specifics and focuses myopically on mop, towels and bleach. No discussion of gloves, normal sanitary protocols, viral survival time outside the body or other recognized scientific tomes on the subject. Also note that it is a prerequisite that any nexus or opinion be couched in “at least as likely as not” or something similarly quantifiable. Here, the examiner concluded it was “unlikely” which could just as easily be equivocally stated “likely”.

Patient has a long history of drug and alcohol abuse and multiple admissions for detox in the 1980’s. While he denies IV drug abuse, he freely admits to smoking crack cocaine. Crack smokers use glass pipes to inhale the smoke. The pipes heat up and cause superficial burns on the lip. Sharing pipes carries the risk of transmitting hepatitis C.

Here’s the smoking gun. Nowhere in medical journals has anyone gone out on the little branches and opined that crack pipes cause superficial burns to your lips. It may very well happen but one cannot say categorically that it happens every time, nor can they say it is endemic to crack pipes -or even Mikey for that matter. Jez, what about pot pipes? The Examiner opined that sharing razors was a poor vector for transmission. It may well be the poorest imaginable but nowhere on the VA’s Risk Factor Questionnaire (RFQ)will you find smoking crack a risk for contracting HCV. Here’s the RFQ. Always remember VA is like an ADHD-addled kid. They say whatever pops into their noggin like someone with Tourette’s syndrome. When pushed onto unfamiliar ground, they turn up the bullshit setting. Here, they had to get the VA Examiner to manufacture new risk factors that the National Institutes of Health haven’t even researched-let alone recognized. This is a first for the BVA but then it should come as no surprise. It’s merely an instance that makes one’s eyebrows rise slightly higher on one’s brow. VA desperation knows no limits.

Of course, when you rebut their insinuations, you get an addendum that purports to call you a liar (again).

In July 2012, Mr. Strong submitted a statement in support of his claim. He asserted that the examiner incorrectly stated that he had smoked crack cocaine out of a glass pipe–”I never indicated this and I have never done it.” Mr. Strong subsequently submitted another statement: “I have never used a glass pipe to smoke any type of substance. When I did smoke it was always in a cigarette type paper. To conclude that my condition is the result of using drugs through a glass pipe is totally erroneous.” In August 2012, eight months after the initial examination, the VA examiner submitted an addendum stating, “the evidence used to determine that the veteran used a glass pipe to smoke crack cocaine was the veteran’s own testimony given to this examiner during the course of the [examination].”

I’ve been through this process before. When called on it, the VA C&P exam will not have any such thing written in it or, if it does, it will be penciled in after the fact as “post hoc proof” Sometimes the VA Examiner is queried and recalls very clearly that old Mikey said exactly that but he neglected to enter it in. However, with his eidetic memory and  expert recall, it comes back like yesterday. Of course if you or I tried this stunt, we’d get laughed out of Dodge. The denial would discuss our credibility issues and how no one could remember that far back with such alacrity.

Judge Hagel shouldn’t have to explain this to attorneys schooled in the art of deductive thinking but nevertheless he finds himself doing it not once but twice. Here, he has to carefully explain Evidence Gathering 101 taught to aspiring young policemen with no Juris Doctorate.

[t]he Board found that, although Mr. Strong denied drug abuse intravenously or
intranasally, “he freely admitted to smoking crack cocaine, which the examiner noted involved use of glass pipes to inhale the smoke. The examiner explained that the glass pipes heat up causing superficial burns on the lip and that sharing pipes carries the risk of transmitting hepatitis C.” The Board wholly ignores the fact that there is no evidence that Mr. Strong shared glass pipes with anyone else and instead relies on mere speculation on the part of the medical examiner. It is well recognized that speculative medical opinions are of little probative value and should not be relied upon by the Board. See Hood v. Shinseki, 23 Vet.App. 295, 298-99 (2009).

As you read your denials, you will see this time-worn trick VA employs. They start with a willful misconduct flaw and build upon it like a runaway locomotive. By the time you offer rebuttal, you’re tried and convicted. The trick is so old it doesn’t have a descriptive adjective anymore. It’s built into the M21R.

[t]he Board found that the “[s]ervice treatment records are entirely negative for any
reference to symptoms associated with what is now known as hepatitis C.” However, the Board also acknowledged that Mr. Strong had “a cough and other cold-symptoms” while in service…  Considering that “[i]n the early or acute state, hepatitis mimics a variety of flu-like illnesses and may be difficult to diagnose,” Secretary’s Exhibit at 2, the Board failed to adequately explain its finding that there is no evidence of symptoms in service that may be associated with hepatitis C.

This is another age-old ploy. Describe the evidence and then promptly gloss over it as being immaterial as though it is of no consequence. The technique is necessary so the Board can, in good faith, on appeal to the CAVC, honestly say they mentioned it- ergo- it was part of the Reasons and Bases considered before assembling the inevitable hangman’s noose.

And last, but certainly not least, is our old friend Maxson v. Gober which VA trots out religiously at the drop of the HCV hat. Unfortunately it is apposite to Mr. Strong’s claim for all manner of reason which the OGC is all too aware. They’ve been taken out behind the woodshed numerous times for this on HCV cases and still respond with the same Pavlovian response at the ring of the BVA appeal bell.

Sixth, the Board found:

[Mr. Strong’s] post-service medical records first document his hepatitis C in 2000,
more than 2 decades after his separation from service. So[,] even accepting that
hepatitis C may be dormant or have a latency before the associated symptoms
become evident, the lapse of so many years in this particular instance after his
separation from service and the first documented complaint of this claimed disorder
is also probative evidence to be considered in determining whether his hepatitis C
dates back to his military service. The Federal Circuit Court has held that such a
lengthy lapse of time between the alleged events in service and the initial
manifestation of relevant symptoms and/or diagnosis after service is a factor for
consideration in deciding a service-connection claim. Maxson v. Gober, 230 F.3d
1330, 1333 (Fed. Cir. 2000).

The Board cites to Maxson in support of its finding; however, this case is distinguishable. In Maxson, the medical condition was an aggravated colon, not a disease like hepatitis C which, as noted above, can have a long period of dormancy. Additionally, the holding was specific to “evidence of whether a pre-existing condition was aggravated by military service,” which is also not the case here as Mr. Strong is not seeking benefits based on a theory of aggravation. Maxson, 230 F.3d at 1332. Thus, for the Board to use the length of time between Mr. Strong’s service and his diagnosis of hepatitis C as probative evidence is clearly erroneous, based on the Secretary’s own exhibit. See 38 U.S.C. § 7261(a)(4).

 

And just like moles, Will Gunn and company are industriously trying to undermine the underpinnings of your claim. Mr. Strong’s first “trial” and this do over are classic examples of grabbing any excuse off the shelf without seeing if it fits. Desperate in their attempts to deny at all costs so as to avoid a stampede to the cash trough ( and thus endanger their anticipated bonuses), they grasp at straws to fashion their arguments. The old saw about throwing spaghetti at the wall to see if any sticks is an apt analogy.

So, use this to your advantage. Always rebut the rebuttal as Mikey here did. Don’t allow a lie to go unchallenged. Do not ever, under any circumstances, allow a SOC or SSOC to go by without a vociferous response and a correction of the records.

Mike might not be a saint but neither am I. We all have our Dark side and we also have the ability to right the ship of life. Here, he has done so but is still being tarred and feathered for “drugs”.  VA would blame his predicament on anything but something in service regardless of how far afield they have to go. Prepare to see a revision in the RFQs adding glass crack pipes to the list of risks. On remand, the BVA is going to have to throw some serious money at this to get it to stick. I smell a BVA-ordered IMO at Duke University or the University of Oregon Health Sciences Center (funded by who else- VA) where a noted medical scholar will take his thirty pieces of silver and thrice deny Mr. Strong before dawn based on being Extremely Trashed Or Hammered (ETOH abuse), or any of a panoply of other risks we were unaware of. The Veterans Law Judge will carefully eschew from the mention of glass crack pipes this time and hew to established law. Gone will be any reference to Maxson. Instead, a whole new legal epiphany will emanate from the new VA examiner carefully buttressed by antique CDC handouts. In 2017, it will surface like a bobber after a strike and Judge Hagel will inveigh anew.

I fear Mr. Strong’s legal battle is just beginning. The good news is he and Judge Hagel have demolished 90% of their defensive options.  A refined hanging a la Macklem is what they desire. Or, the OGC will take him aside and fashion a financial modus vivendi and nondisclosure documents will be signed around. For Mikey, a more propitious time could not be asked for, what with the Phoenix brouhaha afoot. I expect Will Gunn is going to be busy this summer up on the hill trying to explain how the VA infrastructure is laid out and how he neglected to prosecute all these Bozos who were cooking the books.

downloadMeet Mikey and his excellent second adventures at the CAVC. This is definitely one of those “Mikey! Hey, Mikey. He likes it.” moments. We commend him for his perseverance and desire to create precedential jurisprudence for those that would follow.

StrongMJ_12-3738

 

 

 

 

Posted in CAvC HCV Ruling, CAVC/COVA Decision, HCV Health, HCV Risks (documented), Tips and Tricks, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , , , , , , , | 4 Comments

ILP–SILVER QUEEN UPDATE

2014-05-27 16.09.54This goes out to Leigh and Paul, long suffering souls of the VA system. Leigh, if you remember was given the bum’s rush on a copy of her c-file for over a year until she went to the CAVC and filed a Write of Mandamus to obtain it. When she did get it, it was incomplete. It makes the Phoenix VAMC snafu look like a wrinkle in the sheet in comparison.

Thus I want to thank them both for the gazillion seeds they sent me this year for the garden. I planted all of them and am donating the balance to the local nursery and to other local Vets desirous of having gardens this year.

 

Additionally, I neglected to mention I planted Marine lettuce this year. Seriously. It’s a strain specifically created on Parris Island I’ve had great success with.

2014-05-27 17.11.20

2014-05-27 17.12.00

USMC Lettuce

 

Posted in Food for the soul, Independent Living Program | Tagged , , , , , , , | 1 Comment

VAMCs–BURNING DOWN THE HOUSE

Breakfast of VAOIG Champions

Breakfast of VAOIG Champions

As predicted, every weekday news cycle brings a new revelation of misfeasance which seems to be metastasizing into malfeasance at VAMCs nationwide. Unlike the commercial, they are not on our side. And much like the commercials for Cheez-It®, the powers that be at the VA Central Office are shouting “I can’t hear you”. 

This was sent in by Member Frank who seems to find all the really damaging VA revelations. He must never sleep. I predicted this was not indigenous to  just Phoenix three weeks ago and it seems I’m fairly well vindicated. Sadly, I have never ever hoped I was wrong so fervently when I made that statement. Alas, we are going to find to our dismay that this is a de facto process known to all but politely not mentioned in mixed company (read Vets).

Hold onto to your brain buckets. This is going to be a wild ride. I will also predict a land office rush to fire up the excuse mill and begin exonerating VAMC hierarchy who were simply trying to “triage” the system to keep it from being overwhelmed. It’ll result in the “little people”- those who do scheduling- being taken out to slaughter so as to protect the big guys. SOS-DD as we used to say.

Read my lips. You’ll hear “Well, yes. We did try to get everyone in to see a doctor or have scheduled exams in a timely manner. Apparently, the front office people misunderstood our intentions and went much further than they were authorized to, resulting in appointment protocol being compromised. We are scheduling retraining to avoid this problem in the future and new regulations are being implemented to prevent this from ever happening henceforth. We apologize if it resulted in some less-than-favorable outcomes for a small number of Veterans. Please bear with us while we correct this inequity and a warm thank you to those who pointed out the deficiency.”

downloadAs predicted, this just came in. VAOIG’s initial response to the Phoenix “scare”.oig

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Posted in VAMC Scheduling Coverup | Tagged , , , , , , , , , | 3 Comments

POGO–THE VA WHISTLEBLOWER WEBSITE

downloadRoger that, folks. Finally a go-to number/website/email to report perfidy. How cool is that? I thought we’d reached the nadir of communications when they came out with 1-800 -Santa Claus. Press 1 for nice and 2 for naughty.  I played hell on Buckwheat Junior with that for years. And now VA employees can finally get even rather than mad. Lord knows, I’ve had my fair share of AFGE guys here with a boatload of bitches and most were spot on. Project on Government Oversight (POGO) now affords them an outlet for all this malfeasance.

We are finally and suddenly seeing the dam break on any number of issues to do with VA. Considering there are basically only three major functions there (VHA,VBA and Graves Registration), it isn’t too disconcerting to find that all three are more sexually congressed up than Hogan’s Goat.

The VA Bodygate fiasco of fingerpointing at the beginning of the weekend was a low blow for all of us still on this side of the grass. We’d all like to think this would not befall us at the end. Fortunately, most of us are north of homelessness and will never lie around a morgue for a year in the popsicle box but this just further illustrates the indifference an agency tasked with our well-being and burial holds us in. Again…

Over the weekend, I perused sites discussing the VA debacle with many comments. I read many and left a few. One acre of anger seems to emanate from a select few who have never served. They consider us trailer trash and feel the entitlements granted to us at signing long ago are superfluous and unearned. Even more, our incessant bitching is the equivalent of whining and asking for a welfare handout. They take umbrage with the idea we would have the temerity to ask for anything after serving. I left a comment that the person voicing his displeasure with Veterans’ complaints would probably be just as disgruntled with the military if he were now forced to speak a) Japanese; b) Russian; or c) Chinese. That provoked another round of Vet-bashing whose bait I refused to strike. Apparently, the cup will forever remain half-empty to some. Equally apparent was the belief that some argue for argument’s sake.

proff_darrelHS

proff_darrelHS replied | Monday, May 26th | View on CBS LA

You already got paid and vets keep their hands out saying “gimme! gimme! gimme!” Disgrace

Few in the civilian world seem to understand that Memorial Day is a day for the dead. It’s their parade, their day of honor and their memories we should embrace.  Call Kingsford Briquets the incense before the altar.We get our day in the sun in November if that is what you can call it. However, right now, every day is Veterans Day because the media finally woke up to the scam we’ve had perpetrated on us for over a century. Unless you just awoke from a Van Winkle snooze, you should be aware of it. In a nutshell, the newsies have stumbled onto the fact VA has been shading the truth. Again…

I’m not going to whine and whimper. I’m not inclined to do that. I saw which way the wind was blowing in 1972 when I came home from my Vietnam vacation. I didn’t wait around for a parade. I didn’t wish for something that was not in the cards. I shut up about what happened, pressed on with my life and sat on it for about 40 years until the VA began a new denial game with me in 2007. Then I started writing about it. I don’t bitch. I offer solutions. There is a difference in the two.

Suddenly, we wake up every morning and it’s Veterans this and VA that. Each dawn reveals a new level of misfeasance and uncaring indifference. Each day, by noon, a new revelation pops up like a bloated corpse rising to the surface in the media pond.  Each new revelation is met by gasps of surprise as if no one could be capable of such lowbrow actions.  As my Aunt Jackie used to say “Sugar, you ain’t seen nothing yet.” Member Randy sent this in and I add it to enunciate my point.

VA has engaged in the same behaviour for eons. Promises made  and subsequently broken are the hallmark of their business model. Apologies for same are as predictable as the platitudes that follow. New promises are ginned up only to be broken anew. New programs abound and trip over old ones in a constant effort to “modernize VA”. Hell, if this continues, we’re going to modernize claims adjudication right into the 22nd Century with little or no resolution.

I saw all this in 1973 when I drove off Edwards AFB for the last time in ignominy. The VFW would have nothing to do with us. We were untermenschen. Dirty, unwashed Vets from the Vietnam debacle. Pseudo-warriors from a pseudo-war. Wannabe Veterans. I walked away from it to keep my sanity.

That many of us who are left from the Vietnam Misunderstanding are now entering the VA medical system is a no brainer. With the new medical paradigm, getting served is somewhat the proverbial crapshoot. Some are less fortunate than others and tend to gravitate back to Mother VA as their protector. They feel a camaraderie among their brethren there. I know. I’ve been an integral part of that brotherhood. My one year vacation at the Seattle VAMC was a wakeup call to just how bad things are there. And yes, in spite of the atrocious care I received, breaking bread with those I served with was an enervating, bonding experience. I will never forget that year.

download (1)I also hear polls conducted by the VA that show a huge groundswell of support for the existing VAMC hospital model and the care received there. When conducting a poll, independence is best advised in order to produce credible results. Tasking the foxes with responsibility for an accurate headcount of egg production in the hen house does not always yield results that can be replicated again and again. Nevertheless, for as long as I can remember, the media has foolishly accepted the pablum fed them by VA on every facet of their programs. It just turned out they were lying about it. I can hear Gomer Pyle somewhere there in the background saying “Surprise, surprise, surprise, Sgt. Carter!”

We have reached a crossroads that has long been avoided. We have finally established that something is amiss- horribly amiss- and is not going to get all better without a meaningful repair order. This owie has been festering for so long it has metastasized into a cancer that infects the VA hierarchy and cannot be excised short of major surgery. Firing one or two gomers up in the airy, top regions of the VHA is not going to cure the patient. The other gomers will just reinfuse the same misogynistic philosophies into their noggins and we’ll be back at square one. We need look no further than the President’s choice of a replacement for the recently fired Dr. Petzel. He’s a clone who used to run the very same VAMC in Phoenix where the whole VA scheduling fiasco was unearthed. You will note I avoid the word “started”. What is afoot in Phoenix is just the proverbial tip of the iceberg.

For decades I’ve watched the Dog and Pony magic performed for the illiterate masses who gravitate towards the Big Six VSOs. They all pray to the same VA god for their largesse and handouts. Woe betideth the VSO who would bite the munificent hand that doles out the free rent and telephones at Regional Offices. This is why you are inclined to hear your service officer handling your claim say ” Hey. Let’s not be greedy here. VA gave you 10% for PTSD and you should be happy. We’ll come back in five years and ask for an increase to 30%. You don’t want them to think you’re greedy or ungrateful, do you? Besides, if you get too rambunctious, they may take your rating away from you.”

We’ve been hornswoggled so long we are content to ride in the back of the bus with Rosa Parks and remain silent. Suddenly, the mainstream media pops up like Ray’s brother -in-law Mark in Field of Dreams and says something inane like “Wow. Are you guys aware that VA is cooking the books on scheduling? Seriously. I’m not bullshitting you.” The problem with this is it has been common knowledge even within the VA for seven long years. I might be tempted to observe “Where’d you park the squad car, Dick Tracy?” if I weren’t down on the floor looking for the ass I just laughed off. Again…

I look forward to a productive newsday today. I have sent my complaints off to the various congressional entities begging them to perform due diligence and not bust out the white paint. I have even gone so far as to point out the inequities of the Independent Living Program and it’s peculiar book-cooking similarity to what is afoot at the VHA. I refer, of course, to the perennial bait and switch; the “we want to make sure Johnny Vet gets everything that’s coming to him”;  the “we’re working on it but we have a new system and some of the personnel haven’t been brought up to speed on it just yet.” Again…

To them, my answer is unequivocal. “When-as in what decade or century in the future-do you anticipate having these legions of bumbling bureaucrats down at 810 Vermin Ave. NW up to speed and the problems solved?” How many more have to die to unearth the mystery of VA medical scheduling and set it aright? Why is scheduling a VA medical appointment so difficult and cloaked in secrecy if we keep shoveling more money down the maw of the VA machine? Mostly, I would ask the most burning question. Why is it that all these folks in charge of the VAMCs were making twenty and thirty thousand dollar bonuses while their Veteran patients were dying needlessly? Who, exactly, is in charge if we have to spend days, weeks and yes, years, in search of the scapegoat- let alone the actual perp who pulled the trigger on us? Again…

It’s one thing to die needlessly after faithful service to your country. It’s another thing entirely to die when the Agency bearing your name and who succors (suckers?) you turns its back and ignores you but assures Congress they are moving Heaven and Earth for just you, the Veteran. I guess I draw the line at the bonus checks.

download (2)At this stage, it’s not politics and I do wish you all would cease and desist with that vein of thinking. In my Memorial Face page post yesterday, a few of you wanted to know why I had not included a nasty, Bush-bashing cartoon as well. If he had done something boneheaded to Veterans, rest assured I would castigate him. However, Bush isn’t the problem. He’s term-limited. What is done is done. Bush might be guilty of innumerable things but he did not order the VA to cook the books. As some say, get over it.  In this conflict, the enemy of my enemy is my friend. Remember that.  If Representative Miller was a Democrat it would have no more bearing on the investigation than finding out Barney the dinosaur was queer. We were promised many things we never received for our service. Let’s stay focused on that.

We, as Veterans, could stoically put paid to the lies and move on but dying needlessly because someone felt it necessary to cook the books to get a bonus is just a little over the top. Similarly, getting into a political donnybrook over whether Bush 43, Clinton, Bush 41 or Reagan screwed us is an exercise in navel-gazing. We allow our differences rather than our affinities to define us at our peril. Senator Sanders may be “independent”, Democrat or an alien from outer space. It’s immaterial to me. I want one thing for us. Whether I drive a Chevy to get there or a Ford is wasted hyperbole. Once the majority of you understand that, we can move forward and correct the deficiencies we encounter at VA.

The iron has never been hotter to strike with than now. Ignore the opportunity to bitch or become vociferous. Write your Congressman or Senator and express your feelings–or do not. And if you work for VA in any capacity and see an egregious situation, I beg you to bring it to light. The number and severity of the violations may be the impetus to ignite the long-overdue firestorm that should have occurred eons ago.

Posted in VAMC Scheduling Coverup | Tagged , , , , , , , , , | 1 Comment

MEMORIAL FACE DAY

10171665_619161021512674_5379154008974011824_nAll the best for the week. I make sure I look at least once every seven days in case something important pops up. So far, it’s valuable for humor.

 

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VA CEMETERY ADMINISTRATION– BODYGATE in LA

downloadIn what has now euphemistically been named VA Bodygate, the last major VA subagency has now been indicted. In what is becoming a ‘he said/she said’, the LA County Coroner’s Office is steadfastly sticking with their side of the story that VA has been repeated informed of the 60-odd corpae undelecti piling up in the meat locker. After a year of protracted negotiations with no headway, the two entities are still at loggerheads. 

With the VA’s faceplant in Phoenix creating a bow wave across America this Memorial Day weekend compounded by the intractable backlog of VBA benefits adjudications, what was seen as the only sub-administration to be operating efficiently has now been exposed.

Seems Veterans “in the way” and should be taken out and shot as one VA supervisor opined. Or, if dead, piled up like cordwood and left to rot as the LA Coroner’s spokeswoman explained.

Happy Memorial Day Weekend.

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