VAOIG MANDATES INSTALL OF NEW SHREDDER MACHINES

downloadVAOIG “Acting” Head Honcho Richard Griffin ordered all VA facilities, both VHA as well as VBA Regional Offices, to install  new Binford 5000 Copymatic shredders. These automatically record the documents shredded and keep a facsimile of the destroyed documents in their memory for a week. An additional upgrade to preserve the memory indefinitely was discounted as being unnecessary and cost prohibitive. 

Acting Inspector General Griffin also stated that the Presumption of Regularity attaches to all things VA does and employees would never shred pertinent documents in the middle of an investigation. With the full knowledge that the OIG is en route, a week’s recordings are considered adequate for preservation of evidence. When queried as to the normal time necessary to saddle up the posse and head out to Phoenix, Griffin said the usual turn around is several months. How this squares with a week’s preservation of the documents was not addressed. Mr. Griffin also abruptly changed the subject and ignored entreaties to elaborate.

download (2)With the continuing revelations of impropriety and midnight shredding parties, Griffin was quick to point out that no evidence of secret lists have surfaced in prior visits but acknowledged that if they were hidden -i.e. secreted or electronically inaccessible, that it was possible for VAMC officials to circumvent the hard work of the VAOIG’s investigators. However, in light of VAMC personnel deeply devoted to Veterans Health, this scenario was about as likely as flying pigs in his estimation.

“We try hard to get to the bottom of allegations when they arise but Veterans are a paranoid bunch of folks and see a conspiracy around every corner. Eventually it becomes a classic case of the boy crying “Wolf” and our inspectors become inured to the complaints’. Griffin said.

Griffin went on to say in a prepared press release “Rest assured that if evidence of malfeasance is present on site, we’ll find it. Nothing gets by us. As for Dr. Katherine Mitchell coming forth to substantiate Dr. Foote’s allegation of secret lists, VAOIG is investigating credible reports they were having an ongoing affair at the Phoenix VAMC during business hours. We have substantiated that much so far thus her testimony is not deemed credible. As for Dr. Mitchell’s allegations of personally intervening yesterday to prevent further destruction of  the alleged secret lists, we have been unable to substantiate her presence on site at the VAMC. These are merely rumors and innuendo. We will have a complete report out by 2016 that will carefully debunk anything about secret lists and ask the Senators and Congressmen to hold their water until the fix er, facts are in. Thank you”.

OFFICIAL SEAL OF

download (1)

 

THE VAOIG

Posted in All about Veterans, VA Medical Mysteries Explained, VAOIG Watchdogs | Tagged , , , , , , , | 3 Comments

FACEFRAMES

10269472_10202994743562892_4880076172457322778_nFrom my Face page. I get wonderful ideas from all of you. Thanks.

 

 

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Just like VA backlog.

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CUE–THE QUINTESSENTIAL ELEMENTS

download (1)Clear and Unmistakable Error, or CUE, is one of the most misunderstood, misconstrued, miscombobulated legal concepts for Veterans to absorb. The idea of reaching back into the past to right a wrong is a wonderful thing we enjoy. As long as you understand this is going to be a knife fight in a dark alley and somebody’s feelings are going to get hurt, you jump in thinking justice can be attained. Nothing could be farther from the truth. 

CUE must be blatant. CUE must be visible from across the room. People from all walks of life should be able to look at it and exclaim “Lookey, Bob. Take a good, long gander here. Thet there’s CUE. See thet?” CUE must also pass other tests which I will expound upon but I want to give you a feel for how it gets misconstrued by many and much judicial time is wasted dedicated to fruitless endeavors.

CUE rules are very simple in VA jurisprudence but as we will notice, the VA’s published standard and their actual tape measure, are far different. VA will indulge in the famous “bait and switch” using smoke for camo to deflect the CUE into the wrong legal argument. You’re busy trying to engage them in a discussion about how you got screwed on the rating in 1986 when you should be arguing about the error in the prior denial in 1982 where the real CUE began. VA is not going to point out the legal flaw for you either.

download (3)This is no-holds barred litigation. Nonadversarial  went out the window with Benefit of the Doubt and a Veteran friendly environment in which to present your claim. A CUE claim is Perry Mason calling Hamilton Burger a chowderhead who isn’t familiar with the LA penal code- and probably never will be.

Many have talked of CUE but the essence is never quite captured.  Let me attempt to shine a light that dispels what it isn’t first. Many Vets come to me and show me evidence that clearly refutes what happened in, say, 1986. Okay. Move to the next disqualifier. Was this evidence part of the record in 1986? Good. Was it open to two different, equally compelling theories, either of which could have been correct?  Yep. Then you lose. You can’t come back for a do over and argue how the facts were decided. This is perhaps one of the hardest legal concepts to learn. It has to be a Holy Shit, Batman-epiphany error. Reasonable minds can concur that, but for that one (or more) error(s), a completely different “butterfly” line of history would have happened.

Was it a diagnosis that said acute in 1986? A later diagnosis, not part of the records, saying chronic now refutes it. Yep. You lose. A newer diagnosis that states it was chronic back when you filed was not part of the record in 1986 and cannot be introduced in evidence. The Motion to Revise (CUE) must be based on the 1986 facts in the Evidence of Record (EOR)  or what we call your c-file. You cannot use newer CAVC or Federal Circuit  Court precedence to win with either. Your whole legal argument must rest on established law in effect at the time of your decision.

Did they ignore the rules and regulations? Yes? Was it due to a misinterpretation of the earlier regulations which was subsequently corrected such as Walker v. Shinseki and the correct interpretation of 38 CFR §3.303(b) was finally interpreted the proper way? Yep. You lose. Just because you won in 1986 based on flawed law doesn’t mean VA can’t come back and “fix” it. They “fix” Vet’s ratings all the time based on CUE. Your only defense in these situations relies on a twenty year rating. Once you have that, VA cannot rescind it regardless of the current law unless you obtained it by fraud.

Did they forget to go get your medical records at Mt. Altoona Community Hospital when you filed in 86? You filled out and signed the Form 21-4142 authorizing them to obtain the records but a search of your c-file does not reveal them. Failure to assist. You get a do over, right? Nope. You lose. The duty to assist was taken off the table after Russell v. Derwinski. Read Caffrey v. Brown . Seems what we call a failure in the duty to assist has to be detected and objected to before it’s final. This falls into the category of ‘An incomplete record is not an incorrect record”.

You’re the lucky Vet and you have all the correct stuff to prove CUE and it gets down to the last test. But for the error, had it not been made, would there have manifestly been a major, different outcome? This is the Claymore mine most Vets hit the wire on. Unless it cannot even be proven otherwise that a different outcome would positively have (not might have, could have, possibly, mighty sure or My Uncle Clem won on that) ensued and you would have prevailed, you lose. The outcome must be undebatable. You have to have the photo finish picture to prove it, too.

A classic example of what isn’t CUE is you win a claim and they gave you 20%. You come back five years later and ask for an increase and they give you 60%. You say you should have gotten that at the beginning. Tough luck. You lose. You had an opportunity to pitch a bitch back then but hey-you settled for it. No Indian giver stuff now, hoss.

downloadImagine a Chutes and Ladders game where all the chutes head to the basement and denial. All the rungs of the ladders are broken or missing, too. And the spinner’s loaded. Welcome to CUE jurisprudence.

To prove CUE, you have to have an indisputable fact, buttressed by law current at the time. The indisputable fact must be so overwhelmingly obvious that it would seem almost impossible to not see it. This may be why it’s so hard to win given the relative density of VA’s raters.

VA is extremely loathe to air their dirty laundry. When they make a mistake of epic proportions like CUE, absent any back pressure, don’t expect them to be self-starters and motivated to correct it.

I just finished what may be my final appeal to VA to correct a major error. To make a long story very short, I had a C&P exam July 18th, 2008. The doctor worked for QTC and was a production line type. He reviewed my skin for Porphyria Cutanea Tarda damage, both current and from the past, annotated I got regular phlebotomies once a month to control it and stated (incorrectly) that more than 6 square inches of exposed skin was not involved. However, in the diagnosis and effects on living, he said I was totally disabled. VA proceeded to award me 10% for phlebotomies. When I filed a NOD for DRO review, they upped it to 40% for the phlebotomies but took back the 10%.

Here’s the C&P exam. Click on it to magnify  for reading.

2014-05-02 2250572014-05-02 225443

At first, I only perceived the 10% takeback as the CUE. After rereading the C&P exam, it was clear that I should have been awarded a full 100% from the get go. I had fallen into VA’s trap. They proceeded to make it a strawman argument over the recission of the 10%. The very last thing they wanted to relitigate was 100% versus 40%, or even 10%.  I suspect they never really looked at page two of the C&P exam where the real rating language was. Instead they “top sheeted” it and spotted the phlebotomies and the skin language.

THE PRESUMPTION OF STUPIDITY

Therefore we are back in court as it were. Being pro se, Veterans are accorded the Presumption of Stupidity and allowed to bumble around quite a bit more than if we had legal minders. This is why I can go back and change the particulars of my CUE insinuation. Yes. It’s still CUE but it occurred October 1, 2008, not March 29, 2010. If you were represented by an attorney, VA would forbid this puddle- jumping from theory to theory. Fortunately for us, many chuckleheads have done what I’m doing as it finally dawns on us that VA screws everything up from the get go.  I filed my Motion to Revise based on what I perceived as error. After more investigation, I unraveled it and corrected, or fine-tuned my argument in my NOD. If I find other compelling legal epiphanies on appeal at the BVA, I am entitled to present them as well up until they make their decision. This bugs them no end, I assure you. Pro se Vets are a pill. Fortunately for us, even if we are represented by a mentally challenged service officer from a major VSO, the Courts still view them as legalzoom.com-i.e. a poor substitute for a real attorney with a Juris Doctor after his name.

First, the October 10, 2011  filing which they lost. I refiled it again on August 12th, 2012. This is why you always use the green card on the major filings.

PCT 10% CUE 10-11

Then the denial of the Motion to Revise. I expected to lose. 85% of us do so on the first trip out. Almost 100% do on CUE filings. No anomalies here:

PCT denial sanitized

Then read the enclosed NOD which rebuts their bait and switch refusal to recognize CUE in this claim. Use VA’s laws against them. If they hang you with a regulation, use it to hang them right back with. The Presumption of Regularity is going to be one of our most potent tools in the future in this respect. Every time you turn around, VA is trying to extend this philosophy into decisions. ‘VA examiner is presumed to know his head from his ass, therefore…’  ‘The IME/IMO was probative and the doctor was presumed to be knowledgeable about HCV even though he was a podiatrist…’ Hey, you guys know the drill.

Redacted NOD CUE PCT 4-22-14 pdf

The important thing to keep in perspective is that VA is going to purposefully pretend they were born yesterday (at night) and are clueless. There will be a brief summary of the evidence and then a hard-charging denial that knocks all the underpinnings out of the argument. Unfortunately it’s  often all wasted effort on the wrong legal standard or precept. When they are finally brought to bear on the correct facts, the argument becomes much more amenable to arbitration. I have known them to continue to evade the real premise which is why you want to iterate it over and over to the point of redundancy and painful boredom. LawBob Squarepants taught me that one.

Proving CUE based on a nebulous theory that is built on a lot of “could haves” and “it seemed to me at the time that” will never prevail. When you allege CUE, it’s akin to calling someone a child molester. You had better have the evidence if you want to be believed. Here, the evidence has to be part of the EOR and subject to only one logical explanation. If you need to do a PowerPoint Presentation, chances are your Motion isn’t going get airborne. Read Fugo v. Brown to get a better idea of the legal requirements.

CUE is initially a two- pronged fork where either one of the elements is enough to prevail. Having passed that test, the “manifestly change the outcome” is the third and final pass/fail. Far too many of us make our cases and then fall flat like a souffle when it comes time to prove the outcome would be different. That is why you have to lay the foundation for it back in Phase one of the CUE elements.

Never proceed into a CUE by dividing the elements up into pieces. This legal action requires lego-like precision. Each part must fit together like it grew there. The ankle bone’s connected to the … knee bone and the knee bone’s connected to the …. thigh bone.  When all is said and connected, it’s like a chain link fence perfectly woven together. Each fact is indisputable. Each decision they made is legally indefensible because the preliminary precept was faulty. Identify that first mistake that set all the other dominoes in motion and you have the winning ticket that manifestly changes the outcome.

Old decisions have many errors. VA and especially the BVA, felt they were a law unto themselves before the Veterans Justice Reform Act (VJRA) was instituted by Congress in 1988. Unfortunately, they continued in that vein for years and years. The Court has spent an inordinate amount of time curbing their errant tendencies. To say they are wiser and don’t make mistakes now is hogwash. They are an insurance company. They deny. Legally or any other way- but they deny. This we know.

CUE is just one area where VA feels Veterans don’t belong. It’s messy and time consuming. It opens old defective practices and decision-making that reveals unmitigated bias and indifference to the Vet’s plight. It shows VA for their true colors- colors they would much rather keep out of sight. The brouhaha at the Phoenix VAMC will just be the tip of the iceberg of VA misfeasance, too. You can expect that to metastasize to other VAMCs soon. It’s systemic and not unique to Phoenix. A trick that good would be shared with other VAMCs. You can bet on it.

Hopefully this helps some of you on your decision-making regarding CUE. It is definitely not for FNGs to the claims world. It is something that must be held up to inspection for hours and days to get the perfect perspective and argument. Augment the error with regulations that either forbid or do not support the error. Illustrate all the other possible permutations such as two views of the evidence and discount them to remove it from the argument. Strip the old decision down to it’s bare bones to show why it would have been different if the correct facts were looked at or perhaps to show that they were not looked at in the correct legal light.

download (2)A CUE claim, correctly constructed, could be delivered and argued by Mojo, Homer Simpson’s trained chimp. It’s a complete, stand-alone argument that is indisputable. After reading it, there can be no discussion of merits or faults pro or con. Either it’s wrong or it isn’t. If you make the case airtight, you win.  For some reason, few of us do. Either that or we all are just overly litigious and like to torture VA.

P.S.

The great news is the VA admitted defeat in 2016, I was awarded the 100% for Porphyria all the way back to 1994 with SMC at the “S” Rate. Cool beans. Win or Die.

Posted in CUE, Nexus Information, Porphyria Cutanea Tarda | Tagged , , , , , , , , , , | 53 Comments

The phenomenon of HIV Bug chasers, Gift Givers (Gifters), and the implication for the blood supply

hivThe American Press Association recently dropped the word “homophobia” from its style book for journalists so writers can now address gay-sensitive topics without being accused of hatred or insanity. The FDA is considering whether to allow gay men to donate blood in the future.  The current MSM deferral policy is stated here.  The agency has received pressure from certain Congressmen and the American Medical Association to reverse the gay blood ban, which they consider discriminatory. This might remind some of the shameful days when blood donations were segregated as white or black.  But today the issue is about statistics and the limitations of HIV screening which the FDA states is not 100% accurate.

 Groups like the American Red Cross depend on behavioral self-reporting by donors. Inviting gay men, even monogamous ones, to donate blood is a bad idea for the public blood supply because their partners may cheat.  Unfortunately, the safe sex/movement has been a failure in the gay community according to newsources.  Most MSMs prefer and practice barebacking (BB/unprotected anal sex) whether they are tops or bottoms.  One destructive gay subculture connecting online and meeting up are Bug chasers and Gift Givers/breeders/seeders. Bugchasing is slang for people who seek to become infected with HIV.  Gifters are HIV-positive people who are interested infecting bugchasers.  It’s a mutual decision between these participants.

A 6-year old documentary, The Gift, has been posted on Youtube in 6 parts (116+K views) and in full by TransParanormal.  Another documentary filmed in the UK, I Love Being HIV+, has also been posted on Youtube. A short creative 15-minute film called Chaser has been posted by the producer, Sal Bardo. on Youtube.  The protagonist goes to a bareback party and is told, “No condoms, it’s rude.” Chaser has been viewed online by over 32,000 people. People who engage in risky sexual behavior will donate their blood for altruistic, monetary reasons, or even sick reasons. Because the FDA states that screening is not 100% accurate, a small amount of blood-borne pathogens must be entering the blood supply from many sources. Do we want to add a new source known to practice risky sex?

According the VA, 80% of their patients have not been tested for HIV!  Nationally the VA cared for 26,784 veterans with HIV in 2013.  One should not assume risky behavior since they could have been exposed to the virus via transmission modes such as jet injectors and other unsafe injection practices of the past.  But still, homosexuals actively serving in the military should not donate blood either. Learning about bug chasing on Youtube was an emotional experience for me but it is important to know about.  How could anyone want HIV or disrespect themselves by attending a cult-like HIV sex orgies?  Bacchanals have been a part of human history from the beginning but frenzied parties dedicated to a virus god? I haven’t seen or read any evidence that HIV-positive status is a status symbol in the majority of homosexuals.  However, if you know any young gays that you can talk openly with, let them know that you value them and hope that they’ll stay far away from this destructive subculture and treat themselves with dignity instead.  You could save a life. They all know about this craziness but may be surprised that you do. The FDA’s ban is about viruses and blood only and not a negative judgement about persons per se.  I hope the science will trump political correctness with regard to the FDA’s decision about donors.

hiv chart

CDC graphic

2015 Update:  Further research into the issue of blood safety in the United States has led me be reverse my opinion.  Getting HIV or HCV from a blood transfusion is an extremely rare event.  Any healthy person should be encouraged to donate blood regardless of sexual orientation.  There are numerous safeguards in place so I’d urge all people with healthy blood to donate.  The American Legion is one place that organizes drives at their posts so that is one option.

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Cash for your plasma? No, cash for your time!

downloadHow safe from blood-borne pathogens can our blood supply and blood products really be today?  Grifols, a Spanish company, owns about 147 plasma collection centers in the United States. Articles about Talecris (now owned by Grifol) has many centers near the Mexican border. Poor Mexicans sell their blood/plasma once or twice each week to pay their bills. 

This is happening in non-border states too.  In my clippings folder, I found an ad (2011) from Talecris from the JOBS FLYER of a local MN paper.  It looks like they are targeting students for this exchange and they have three collection sites!  Some job. 

  The company states that donors are being paid for their time only.  Sure.  Wink. Wink. 

http://myappointment.talecrisplasma.com/

 

Does the VA buy these blood products? Are all those burning-the-midnight-oil student donors indeed healthy?  I’ve scanned the FDA website to see if these blood businesses are required to screen for Hepatitis E (HEV) yet however I don’t see any current press releases.  Therefore, baby boomers and pregnant women (HCV/HBV status known or unknown) should be careful because it doesn’t matter if they are transfused with truly volunteer blood or paid-for blood given the current lack of HEV screening.

 

Posted in Guest authors, HCV Health, HCV Risks (documented), VA Health Care | Tagged , , , , , , , | 4 Comments

FACEPLACE-REPURPOSING TO DECREASE GLOBAL CLUTTER

10253995_10152325872843376_926807318203381995_nAh, my cousin Denise. What can I say? She has moved to Idaho and the sights to behold there stagger the imagination. I spotted her ultimate doghouse post this morning. Construction like this could only emanate from the fertile mind of a Veteran. Who else would readily see the possibilities of a defunct dryer and it’s future potential?  Using the national flag of Idaho for the roof was a masterful stroke as well.   

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VAOIG–CAP REVIEW-PHOENIX, AZ

oig

EXECUTIVE SUMMARY

Review Purpose

At the insistence of Rep. Jeff Miller, and prompted by over 1600 complaints of  Veterans waiting over a year and half or longer for primary care followup appointments at the Carl T. Hayden VA Medical Center located in Phoenix, Arizona,  the VA’s Office of Inspector General (OIG)promptly scheduled and performed a CAP Review.  The purpose of the review was also to evaluate selected health care facility operations, focusing on patient care quality and the environment of care, and to provide crime awareness briefings. We conducted the review the same day Representative Miller requested it on April 24, 2014. In fact, we just happened to be there following an earlier phone call from our guy at CNN. Thus we’re able to kill two birds with one stone today.

Review Results

The review covered seven activities. We made no recommendations in the following two activities:

 Coordination of Care

As there is no plan in place to notify patients of the correct date of their appointments, coordination of care was put on hold for a suitable cooling off period to make Veterans forget what it was they were complaining about.

 

 Medication Management
Card-operated machines that dispense medications were installed in the hallway adjacent to the pharmacy’s bulletproof glass windows recently. Veterans with MyHealtheVet or access to Ebenefits can access their medications directly without waiting in line.  OIG’s Quality Control and Assurance Team (QCAT) found a 38 percent error rate with type/dosage of medications machine-dispensed but the VISN director assures us they are on track to reducing it to less than 5 percent by January 1, 2015.

Recommendations

We made recommendations in the following five activities:

 Veterans Dying Waiting for Appointments

We documented forty cases of Veterans dying while waiting for followup care with their Personal Care Physician (PCP)-not the 236 claimed. Due to confusion in scheduling, the deceased Veterans and their spouses were wrongly told to wait until called. This was incorrect advice and resulted in very long wait times that impacted some Veterans permanently. Nurses and frontline stakeholders are scheduled for refresher training in the existing triage protocols to prevent a recurrence of this unfortunate anomaly the week of May 5-9, 2014. Employees were counseled to avoid contact with the media until after training and all the facts are in.

 The Existence of Some “Secret List” for Appointments

In spite of numerous rumors of a secret Bat Cave full of appointments hidden from view, VA’s OIG was unable to substantiate this and found no secret entrances in the basement. A thorough search was conducted, however, and we rounded up the usual suspects.

 Poor Morale Among Medical Staff

VA’s OIG was unable to substantiate that morale was low. They found no one willing to squeal because they didn’t want to lose their jobs. This, too, was third hand hearsay and never substantiated. When interrogated alone individually, all medical employees evoked smiley faces and said they were honored to be employed by the VHA and helping Vets.

 Pressure Ulcer Prevention and Management

A large number of the dead Veterans mentioned above had extensive pressure ulcers (bed sores) indicating poor hygiene and supervision. Supervisors are admonished to continue annotating this information in the records until someone officially declares the Veteran dead.

Accurately document location, stage, risk scale score, and date pressure ulcer acquired for all patients with pressure ulcers. Perform and document daily skin inspections and daily risk scales for patients at risk for or with pressure ulcers. Provide and document pressure ulcer education for patients at risk for and with pressure ulcers and/or their caregivers. Ensure all designated employees receive training on how to administer the pressure ulcer risk scale, how to conduct a complete skin assessment, and how to accurately document findings. Ensure all designated employees receive training on how to identify dead or dying Veterans.

 Allegations of _________________

____________________________________________________________

___________________________________________________(redacted)

Comments

The Interim Veterans Integrated Service Network Director and Facility Director, Sharon Helman,  partially agreed with the Combined Assessment Program review findings and recommendations and provided acceptable answers for improvement plans. She still insists there are no secret records and no Veterans died on her watch. Her feelings were that some Veterans engage in vicarious, risky behaviour to include drug abuse, alcoholism and especially prescription drug abuse. To attribute these deaths to VA’s shortcomings is merely a convenience for survivors to hit the VHA up for money.  She indicated she’ll fight to keep her recent $ 9,345.00 bonus because she was simply following VHA executive orders (See Appendixes C and D, pages 20–26, for the full text of the Directors’ comments.) We will follow up on the planned actions until they are completed.

(signed)

Johnny B. Goode, MD

Assistant Inspector General

for Healthcare Inspections

vaoig

 

Posted in VAOIG Watchdogs | Tagged , , , , , , , , , | 2 Comments

FACE IT–EASTER BUNNY HUMOR

10155422_10152437572269276_3472143893646331807_nIt seems the really good stuff doesn’t surface until the day after Easter. Why not share it sooner? What’s the big deal? Religion? Included here is a rare shot of the Big Guy himself being chased by Chicago’s finest. Seems they thought he had a concealed weapon. My question is where? Between his ears? The basket is in his right hand just outside the photo.

And of course, this was sent in.

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And this:

10269616_10152313944365700_6484779763028729532_n

I’m sure that’s not all our loyal members have in their repertoire. I look forward to more.

 

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VA ILP–THE FARM REPORT

2014-04-18 12.15.18Just in case the VA sleeps with one eye open to make sure my agrarian pursuits are not a flash in the pan, I present the Grahamcracker report. I have been busy prepping for spring as usual. This always takes me away from my VA claims work and I apologize. This year will be a banner one for Veterans on the Key Peninsula. I already held a tomato starts sale and thoughtful folks hereabouts donated $99.00 towards that several Sundays ago. Thank you. 

With all the different flowers and fruit trees blooming, I’ve come to the conclusion a resident, on-site bee presence is going to be needed to ensure early spring pollination. I’ll have to add that to the greenhouse request. Hey! Speaking of which. I called the Prize Redemption Line at 800-827-1000 and complained mightily that VA had been funning me about finishing up my ILP request for the Greenhouse. If you remember, the last fiasco was that they claimed I never sent in the Form 9 within the allotted 60 days-thus voiding the Warranty. Well, we here at Asknod don’t get rolled that easily so we promptly whipped out the green card from our USPS and pointed out Clyde Klopperstad signed for it April 15, 2013. A mad search for it began and it was finally located at the BVA in DC in my decision for the 1994 date of claim. That was back in November 2013. Seems some confused fellow in Seattle “accidentally” thought the Form 9 for a ILP greenhouse appeal had something legally in common with Hepatitis C effective dates appeals and thoughtfully forwarded it to the BVA.

The latest is a compendium of “The dog ate the Form 9” followed by “My dear old dad just passed away and I had to take off for that”. No explanation other than the inadvertent revelation that it had actually been sitting on his desk for months while he wrestled with his conscience and the confangled new M-28 Manual for VR&E claims.  Being born and bred a gfentleman, I decided not to call him on the obvious lie about having “lost” the claim for a protracted time if it had been residing on his desk these last months.

As almost no one other than Independent Living Program junkies would know, VA thoughtfully threw out all the old rules for ILP and instituted means testing, DNA testing, and covert VA Office of the Inspector General  surveillance to make sure you really are as severely disabled as you claim to be. You get photographed laughing when you should be crying like Clinton did at that funeral and your goose is cooked, Jack. No ILP for you. You’re not mentally depressed enough and we have the video.

On a more serious note, I was also told that due to the most excellent points I had brought up in my Form 9, Mr. David Boyd, GS-14 ($110,047.00/ year), head of Seattle VR&E was (or had already) forwarded it to the Central Office in Washington, D.C. to allow more erudite minds to contemplate it and it’s implications to Vetkind. Seems this VR&E file is getting pretty well-traveled between Seattle and DC.

VA is gradually turning the IPL program into a former shadow of itself. Gone are the days of a snowplow attachment to go with your ILP tractor. Riding lawnmower? Shoot, bubba. You need to shag 40 lbs. Get out the push mower. You may even heal up from the DM2 if you loose 80. Reading through the BVA decisions in 2013, hardly anything came up. Vets are getting the message and not even applying. Why bother when the answer is pre-printed, pre-addressed and a foregone conclusion?

The good fellow gave me no idea when it might surface again but after four years, it almost has to be one of the oldest claims on the MMWR.

Enough of that. Look at Spring in the Northwest. Shoot, sounds like an advertisement for Salem cigarettes. Remember, you can click on any of these for a closeup. I pay extra for that.

Strawberries

Strawberries

Strawberries X 10 to the 10,000th power

Strawberries X 10 to the 10,000th power

green pears

green pears

Future Fujis

Future Fujis

Italian Plums

Italian Plums

Soon to Bing Cherries

Soon to Bing Cherries

Red Pears

Red Pears

Gravensteins

Gravensteins

The orchard

The orchard

The not so ILP Greenhouse

The not so ILP Greenhouse

1st Floor- Basil, sugar snaps, kohl rabi

1st Floor- Basil, sugar snaps, kohl rabi

2014 flavors Cupcake chose.

2014 flavors Cupcake chose.

Cuke world

Cuke world

Beets in VA-defined "greenhouse" with latest global warming methane  heating system

2014 Beets in VA-defined “greenhouse” with latest CO global warming methane heating system

 

Posted in Food for the soul, Independent Living Program, VAOIG Watchdogs | Tagged , , , , , , , , , , , , , , | 6 Comments

2014 Hep C Sovaldi sticker shock for insurers

The Kaiser Family Foundation (KKF) has published several articles of interest to Asknod members.  

One April 14 headline reads:  Biggest Insurer Shocked with Hepatitis C Costs.  

Quote: “United Health Group spent $100 million on hepatitis c drugs in the first three months of the year, much more than expected, the company said Thursday.” 

Uh-oh.  High demand and 80K plus per patient in costs have insurers stock costs dropping.   Well, they’ve tried to keep the lid on this disease for decades and now it’s off. 

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If only we could have covered up and ignored HCV a little longer…

KKF links to this VA March 27, 2014 38-page document for providers.  It details a “preferred treatment approach” for HCV by genotyping and other factors for “patient selection.”  It’s clear that VA hepatologists  and experts have been working hard on this strategy to deal with all the newly diagnosed veterans.  They have lots of studies and rationales to back up who gets what and when to manage their HCV crisis.

This article,VA, California panels urge costly drugs for sickest Patients, links to the new WHO 124-page  (April 2014):Guidelines for the screening, care and treatment of persons with hepatitis C infection

Unless the cost of the new drugs are drastically reduced, widespread rationing can be expected.  HCV patients will be stigmatized further as undeserving greedy people who…

  • dare seek a cure at the expense of the innovative drug researchers (who deserve their high-living wages for staying up all night in the lab), and
  • keep our altruistic health insurance CEOs up at night with worry, and
  • who torment the generous House members who fund the VHA’s budget.  By golly, we won’t let HCV-veterans defeat our great nation by breaking the bank! 

This is going to be hard for veterans who suffer from the largest cluster of HCV-infections deniedin America by far, because the VHA does not currently have the funds available to treat everyone, other government programs may not be much better off, and private insurers are beginning to panic.  I suspect that patients, including veterans, co-infected with HIV/HCV, will be more likely to get the new antivirals because of existing public policies. But what about the majority who may find themselves with nowhere to turn?

 

 

Posted in Guest authors, Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , | 8 Comments