VAMC– SOVALDI RECON

downloadKnowing it’s no fun to be blindsided by medical unavailability, I decided to be the point man, take the 77E and move out ahead. What I found at my VA Medical Center is cause for immense concern. VAMCs  have been instructed to triage Hepatitis C Veterans and allow only the sickest inside the wire. The ARPN explained that this was necessary due to the high cost of the drug and it’s “unavailability” as yet. 

So let’s investigate the findings. First off, to my intense concern, I was asked why I kept referring to it as Sovaldi. My “hepatologist” Eileen Hansen, corrected my mistake and told me it is called Sofosbuvir. Sofosbuvir went out in December when it went to market but I guess this email didn’t hit Eileen’s desk. Calling it Sofosbuvir now is like calling Valium Diazepam. Huh? Using the VARO-Who’s Who function at the top of the page, I “googled Eileen to make sure she wasn’t a chowderhead FNG. Nope. She’s a top of line ARNP and professes to be a designated specialist in this field. What is truly odd is that I have never met the shadow doctor behind her. She’s a ARNP and not permitted to operate without supervision. It’s a damn good thing, too. As for unavailability, I suppose q-tips were in the same category when they first came out.

ehPut your cursor on it and left click to enlarge the above. No need for a magnifying glass. Yessiree, Bob. She’s not a bedpan changer at $102 K. After having dealt with her on and off for over six years, I always find it amazing that every time we meet, she has no recollection of dealing with me-ever. After my Interferon misadventure in 2007, she tried to put me on the triple-drug Vertex (Victrelis) cocktail in 2011 even though the records clearly stated I was allergic to it. That’s why they call it “practicing medicine” rather than “performing”.

When we last talked in 2012, she informed me that if any new technology/treatment came up, I’d be the first to know of it. VA treats their 100% disabled with great care. I heard nothing all this time other than pleas to let them run the butt tractor (colonoscopy) up my derriere and take a peak. Next, it was a desire to run one down my throat and take pictures of my esophagus. They have two biopsies of the liver box already but still want another one. Why they feel the need to be paparazzi and photograph my insides to death is a mystery. The last time I let them go into my abdomen, they screwed it up and used it as an excuse to keep me a year and let the Doogie Howsers practice on me..

When we met yesterday, she was excited to tell me if I was lucky and didn’t get bumped like someone on standby for a flight, I would be in the running for one of the prized Sovaldi Sofosbuvir slots next spring in 2015. She also asked if I’d be interested in a drug trial of Olysio and Interferon at Virginia Mason Hospital in the meantime. I had to break the bad news yet again and explain for the third time that Interferon wasn’t in the cards. Five minutes later in the same conversation, Eileen made sure I knew that I should always be careful and let other doctors know I had a bad experience with Interferon and it was not an option for me. Perhaps a medical ID bracelet?

This is what we are dealing with at the VHA. Sovaldi will not be available to the masses for quite some time. If it is, it will be predicated on your being Stage 4 with at least a confirmation of fibrosis by ultrasound or core biopsy. If you ain’t dying, they ain’t buying in Seattle.

Because we are so trusted and considered salt of the earth, the VA has elected to entrust us with a maximum of a one-week supply of Sovaldi at any given time. This will then entail four trips a month at 33 miles one-way to pick up the medication. They absolutely will not mail it as they do morphine and all the other Schedule II narcotics  I used to get. Since it is not a doctor’s appointment, no travel pay will be forthcoming. After the first month, if you have not been caught selling this valuable medication on the open market, VA will allow you to pick up a two-week supply and cut your trips down to two a month.

I have genotype 3A which requires the longest to cure at 24 weeks. Nurse Hansen was quick to point out that VA was being mighty generous to even consider doing this for me when you realize it costs $1000.00 a pill. Oh, yes. That was reiterated five times. If, on the off chance the ultrasound did reveal any nastiness, why, I might be able to get into the next cohort of ten lucky lotto winners. Due to the immense costs to the VHA, there was absolutely no way to accommodate all the infected souls. Seattle is running them through at 10 souls every 16 weeks. I was going to point out there were 52 weeks a year and at 16 -week intervals that would add up to —well, never mind. It’s probably VA math. Considering there are over a gazillion Vets with HCV, using the triage method, those of you at Stage 2 should be able to get Sovaldi before you need a transplant 20 years from now.

So, in summary, if your are deathly ill, you get to move to the front of the line– in ten-person/sixteen week intervals. Except for those of us on 24-week intervals. If you are eligible, there are trials available but you have to ask regularly to find out.  VA is not mailing out reminders. The waiting list is out the door and around the block. The VHA’s purse is being sorely tried over this high-priced drug so we have to understand that they cannot serve everyone. We should be grateful that we are even being allowed access to it considering the VA is low on bucks. So much for cutting-edge Veterans care. For he who shall have borne the battle–unless it costs a shitpile.

I was going to ask her how they can afford to give out those humongous bonuses to the VISN heads of $25,000.00 each year if they are so strapped financially. I decided against it. You notice Eileen’s employment info above shows she didn’t get a bonus last year so there’s no use rubbing salt in that wound. She should be pissed she got the shaft.

If you have access to Medicare, I think the smart money is to go there. They trust you not to sell the pills but how in Sam Hill could you (or would you) put that on Craigslist?

images

12-week Supply of Sovaldi (Sofosbuvir-Gilead Sciences Corp.) Regular price- $1000.00/pill. $500.00 each OBO. See “Bob” at Wright Park in Tacoma on Tuesdays at noon at the NW corner. Codeword is “Swordfish”. No dealer inquiries. Cash only. Volume deals available on request depending on availability.

I guess you folks realize no one would ever go out on the little branches and tell this to you if you called up to inquire about the availability. This is why I went in and played dumb. You have no idea how difficult that charade is for a former Mensa member.

PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS__PS

Please tell us if you have been accepted by VA and are currently being treated by them with Sovaldi or Sofosbuvir (same drug according to everyone but VA). It has come to our attention that the VHA may be offering lollipops with no “lolli” on the stick. I was told Monday during my indoctrination that I would have to eat five (5) ribivirin pills per day if, and when, I began txment next year. Furthermore, if my weight increased above 165 lbs, it would have to increase to six.  I am currently 154. Since most I have talked to took only two (once in the morning and evening) in prior txments, I suspect we are getting the anal smoke therapy.

Obviously, if no one is getting the Sovaldi, then VA is once again saying one thing and offering nothing. Please set us straight. Have you or anyone you know received any of this medication or are you slated to get it in the near-term of the next month or two? VA and the VHA are not in the habit of “rationing” treatment for any disease so this would be an anomaly of the highest magnitude. Having dealt with VA for a number of years, I strongly suspect this is a public relations ploy. The details are too sketchy, the Ribivirin dosage is exorbitant and only ten souls per 12 weeks are slotted in. This dog doesn’t hunt.

Posted in Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , | 4 Comments

IRRITATED SERVICE OFFICER COMPLAINS

downloadI found this comment on my How Low is Low? post and felt we should all analyze each and every point Mr. Kenneth Aune brings up. So, forewith, I transplant his complaint and query here and my rejoinder.

Mr. Aune opines:

I’d like to know WHO has compiled this article and what credentials he or she has. I am a retired Accredited Service Officer, and I question much of and [sic] the precedence of your article. The Organization I worked for and the names you named, they represent veterans at the VA’s Central Office and the Board of Veterans Appeals and also on Capitol Hill addressing both houses for veteran rights. They go up against the legal minds of the VA. The couple [sic] names I recognized, they are highly knowledgeable in VA law, and some are retired from the VA (30 years plus) BVA. Lawyers? I would put my knowledge of VA law up against them any day. The difference being, these VSO Service Officers deal with VA only, the lawyers have other interest to generate income. They review claims and reject those that are not slam dunk claims. They do not want to do much investigating. You claim the VSO’s dislike [sic] the lawyers make too much money. The amount they receive is determined by the VA, and there is a cap on there [sic] reward. We have a problem with the veteran paying someone when it’s un-necessary. VSO do it at no cost to the veteran.

And my rejoinder to Mr. Aune:

Dear Mr. Aune,
I’m the author of the article.  My name is Alex Graham. I’ve been actively engaged doing claims since 1989. I have been through the process-each and every one of them- numerous times. I have won every one of my claims when the VSOs who swore to help me either couldn’t or wouldn’t.

download (1)All the wages paid via dues to the VSOs’ officers mentioned in the article are taken directly from what is called an IRS Form 990. IRS stand for Internal Revenue Service, Mr. Aune. They are not prone to lying or publishing lies of others. Unless these folks are lying, I assume the grossly inflated stated wages are correct. I did make an apology to another service officer from Virginia who pointed out that only the actual member’s dues support these highly overpaid guys in funny hats. Local donations to the Service organizations go directly to Vets fortunately. Apparently the local organizations are wise to the Nationals and keep their donations to help physically disabled Vets rather than give it to the financially challenged ones who get $350 K a year for going up to Congress to get drunk and bitch. Personally, in all the HVAC hearings I’ve watched, I have yet to see Art Wilson, Larry Maher or Danny Wheeler show up.
As for being “highly knowledgeable in VA law”, why is it the VSOs have such a miserable track record versus attorneys? Or, if you will permit me to observe, why is it I haven’t seen any of these whizbang VSO legal beagles you swear by up at the CAVC ? It’s because they are not lawyers, Mr. Aune. They are not permitted to represent Vets because they have no legal training recognized by judges. Why do you think VA employs 500 lawyers at the BVA to process our appeals? If they were nonadversarial, the natural path would be to hire folks who have the same legal training as you-albeit hopefully with a better command of the English language. As for putting your own legal acumen up against the likes of Kenneth Carpenter or Bob Chislholm, I fear it would be a slaughter like something right out of the Roman coliseum days- Lions -5, Christians-0.

imagesVSOs on average, win 20% of the 50,000 or so cases they take to the BVA. Attorneys win 28%. At the Court of Veterans Appeals, where you actually do have to have a law degree that didn’t come out of a Crackerjacks box, 65% of the lawyers prevail against the VA.  This means a lot of VSOs lost a lot of cases that they should have won if they ever had the legal talent to do so in the first place. Either that or they have incredibly bad luck at this business.

Perhaps you do not get outside and visit the real legal world much, but during your watch, while you were busy looking out for Veterans’ rights all these years, your VSOs have allowed VA to amass a huge backlog that is off the charts. Where, exactly, were all the VSOs who were being paid vast quantities of cash to defend our rights? Out on the golf courses around DC “bonding” with their VA counterparts? Your arguments are hollow,sir. Try as I might, none of what you say agrees with anything I see in the real world.

Mr. Wilson of DAV complained recently that attorneys should be 86’d out of the arena or reduced to a $200 pittance for repping a Vet. By that metric, why does Art Wilson need a $353 K salary? We’re here to help Vets. Remember?

Let’s put legal binoculars on and see what we see. If a Veterans Attorney sees a claim that is defective, unwinnable, or in some way fraudulent, as an officer of the Court, he is precluded from accepting it. Frivolous lawsuits by attorneys are forbidden. Fortunately for you VSOs, your ignorance legally protects you from the wrath of the Court when you arrive with a bogus claim for Hepatitis C due to Agent Orange. That’s one of DAV’s specialties. Think about this further. Why does DAV hire a legal firm (CCK) to handle all their appeals to the CAVC?

In sum, Mr. Aune, what you do not know about the process is appalling. Since you are not required to read law and pass the bar, you are allowed to act like a pro se Vet. In fact, the Court of Appeals has granted Vets that dispensation such that if they are under the wing of a VSO, they are permitted the Presumption of Stupidity and given even more leeway to account for the frightful legal advice given them. (See Comer v. Peake) A lawyer is held to a much higher standard and fined for his stupidity. We never read about law dogs filing appeals for a 10% rating for tinnitus for each ear.

Lastly, I would point out a glaring inequity. Why would any attorney worth his salt take on VA claims? The return is 20% on the venture versus an easy 40% were he to choose chasing  ambulances. Additionally, he would have a much faster path to riches if he steered clear of the VA arena altogether. Real  Courts pay the attorneys promptly without grousing. Can it be some are attracted to this because they see a disservice to Vets being perpetrated by unschooled VSOs? You have admitted their altruism is AWOL.

Judge Meg Bartley

Judge Meg Bartley repped thousands of Vets for free

And one final observation. VA lawyers usually are asked to intercede only after a VSO has hopelessly hamburgered a Vet’s chances of winning. This is why we have the phalanx of pro bono lawyers (Pro bono, Mr. Aune, is Lawyerspeak for “free representation” versus paid) such as the NOVA group or the NVLSP. If you are familiar at all with your Veterans Benefits Manual put out by Lexis Nexis, you would know that one our most esteemed new judges in years at the CAVC is Meg Bartley. She wrote the book you supposedly used to help Vets-that is- assuming you called what you did “helping”. Do tell, Mr. Aune. What is your win/loss ratio?

I neither champion lawyers or badmouth them. Universally, they have been proven an advantage at the VA. I am open-minded enough to counsel Vets to do as they so choose. We call that free will in America.  VSOs do not have the same cachet. They are hat in hand with the VA’s employees and the symbiosis is far too congenial for my tastes. Anyone who gets paid (by VA) for each POA he turns in cannot be an objective force in helping a Vet to win. That’s like putting a $250.00 bounty on every Veteran’s head.

VSOs represent the largest majority of Veterans claims help yet they only have a 15% win rate at the Regional Offices. Do you see the problem? No, I suppose you don’t. Vets don’t need lawyers. They need someone like you, right? God help us.

I note you have studiously omitted the name of the outfit you work for yet you imply you are on a first name basis or recognize many names mentioned here. Can it be you are too embarrassed to mention your own VSO ? Is it one of the highly-paid outfits I mentioned in my article? It’s okay. I understand.

Posted in VSOs | Tagged , , , , , , , , , , | 18 Comments

MAKING AO PRESUMPTIVE FOR THAILAND

 

The-Gordian-Knot

Alexander the Great cutting the Gordian Knot

Trust another Zoomie to come up with a better way to skin a cat. Meet Member Karen- formerly of the Zoomer profession herself- and married to a Thailand  groundpounder with all kinds of Orange Fertilizer problems. Karen has cut the Gordian Knot many of us encountered when we arrived to fight the war in Krong Thai, which is how we said it there. In fact Thai means “free” and that is, in essence, what Karen has done.

Being on the other side of some magical fence, we were never accorded the presumption of exposure to the stuff. In fact, in order not to ruffle the feathers of the King, our ambassador advised the military not to spray the stuff anywhere in Thailand unless it was an absolute necessity to insure base security. In that event, the military was instructed to refer to it as a “tactical herbicide” akin to Tordon 101 (Agent White) or some of the other “benign” flavors of what we call Roundup nowadays.  Calling it a tactical herbicide preserved the fig leaf of respectability but all parties knew full well it was the magic fertilizer. I also saw a lot of barrels of A Blue. They were marked Cacodylic Acid and a few other ingredients I can’t remember now.

Most do not know but Agent Orange doesn’t “kill” vegetation. It’s a massive dose of amphetamine and the plant feels impelled to grow like Jack’s famous beanstalk-immediately. The cell structure quickly breaks down under the overload and the plant dies thinking it has just begun to be all it can be.

The Gordian Knot that Alexander the Great solved by cutting is the enigma of how we all arrived in Thailand. VA would have us believe we materialized like the doomooflotchie on Star Trek. ” Aye, Cap’n. Beaming down landing party of nine to Don Muang Airpatch. On their way.” We all remember something different if we were Army, Air Force and sometimes the odd Marine. Our memory began a day and a half earlier in San Francisco. Most of us reported to Military Air Transport Service (MATS) at Travis Air Force Base. There we boarded a spartan, stripped down 707 leased from World Airways. This would also be the last time a lot of us saw a roundeye for a year.

World Airways had intermediary stops as needed for fuel. As was customary, refueling requires deplaning. From Travis, my flight landed in Honolulu. Next stop was Guam. A short hop to Yakota AB in Japan, on to Clark AB in Manila and then the final leg down to Saigon. Again, deplaning was required for refueling. Up until about the time of the Parrot’s Beak intrusion into Cambodia (March 1970), World Airways usually flew on to Bangkok and landed at Don Muang Air Base to the north of the city.

Saigon to Bangkok

Saigon to Bangkok. left click with your cursor on it  to magnify

Looking at the map. one can see the problem of flying over the battle. With the 707’s abysmal climb capability, it had a hard time making it up to 20,000 feet before crossing over the thick of the battle. The border was barely 130 klics away and Phnom Penh was only another 50. In order to avoid any problems with SAMs, a C-130 Klong Flight was introduced and made the trip twice daily.

Essentially, everyone had boots on the ground in the most real sense.  Yep. Boots on the PSP or concrete at Tan Son Nhut Air Patch. This satisfies the codicil of who was or was not “boots on the ground”. It makes no difference you were there for an hour of two once when you arrived and again when you left. The point was that you “touched” the land mass of the Republic of South Vietnam and thus were presumptively exposed.

Karen did what I never had to. She excavated that link by several different avenues and then found the decisions at the Board of Veterans Appeals Website and downloaded them as well. I was sent TDY back to Saigon in July 1970  after sailing through in May and had kept my orders showing proof of boots on land then. Before I found the TDY orders, I had been contemplating what Karen did but that was back in 1994. Internet access to that kind of thing would have been a real stroke of luck if I even had had a clue how to.

imagesWhat this means for John Q. Thailand Vet is glaringly obvious. We’ve been playing their simple-minded game for about a decade while mincing what the meaning of “tactical herbicide” is. All this time, VA has known full well what we knew. Everyone, with the exception of squids who sailed over on their boats, had to have landed at Tan Son Nhut and thus fulfilled the requirement that s/he touch red clay to join the Nehmer class. Of course, none of us could produce a boarding pass for this airplane flight so we were shit out of luck to prove that we did take a smoke break in a war zone. As an aside, legally speaking, I think we should all be accorded a bye on lay testimony to that effect based on Layno v. Brown ( anything that comes to you via your five senses is admissible). The sign (above) was right there in front of our eyes. The civilian terminal even had huge, red neon letters you could see from two miles out-at night.

Here’s the link to the BVA win based on the World Airways theory. This decision relied on the Pan Am flights but the technique is identical.

Here’s the .jpgs  for all the pilots and attendants who flew us.

WAirways Pilot

WA 2

testimony (pilot)testimony 2And here is another one I found. http://veteransvoteyourcause.com/files/HHegetheimerletter.pdf

Here is the link to AO being sprayed around Sattahip and U-Tapao via the CHECO reports.

Karen is wisely doubling down on her husband’s claim. In addition to the World Airways path, she is also going for residual perimeter duty exposure. She has three buddy letters of confirmation of duties on perimeter. She also has the complete, unredacted CHECO report and if she doesn’t, it’s above underneath the VCM medal.

This finally solves the conundrum of how we all arrived in Thailand absent alien abduction. VA is not going to like the floodgates to open on this and let another million or so Vets through the door. They really shouldn’t worry as they are getting off lightly. Think how many already died without getting this presumption.

Thailand Veterans, start your keyboards. And a warm thank you to Karen for her hard work that others might win as well. I’m telling you guys. These women are carrying the water more and more nowadays and making you look lazy.

Posted in AO, Medical News, Nexus Information, Thailand AO presumptive path, Tips and Tricks | Tagged , , , , , , , , , , , , , , , , , | 19 Comments

KPVETERANS.NET

Key PenisnsulaWhat could be better than falling into cow poop and coming out happy and sweet-smelling as a clam at high tide? I decided to affiliate with the local Veterans outfit here in my neighborhood. Imagine a peninsula fashioned identically like Florida where it only take 45 minutes to travel from the Georgia Border to the Keys at the bottom.  Likewise , imagine the width at about 3-4 miles and you have a good idea of the parameters of our rural world. According to the VA’s Disabled Veterans tables by zip code, we have 341 Vets on the VA’s disability roles out of our 16,037 residents. The gravy is my Veterans Organisation is independent and fiercely protective of its own individuality. Yessir. No affiliation whatsoever.

While the Puget Sound is far more congested than, say, the Gulf of Mexico, it is nevertheless much in keeping with the Southeast Corner of  the United States geographically. It has bred a hardy, independent type of settler and homesteader from the late 1880s to the early period of the 1900s. The Google Earth picture shows the remarkable similarity.

My daughter married into the homesteaded community so I find myself related to every Anker, Michaelson, Loy, Niemer and Lutz on the peninsula. What it also means is rugged individualism and a unique, local take on government’s role in our life. Some of the folks hereabouts tend to carry openly. If you understand the 2nd Amendment, you don’t need a Thesaurus to decipher the statement. Even more have one legally concealed. Washington State is one of those amalgams of recently arrived progressives of the Sandy Hook persuasion contrasted by a staid, conservative element whose country ways are deeply ingrained. I live on five acres and can still legally shoot off my back deck. If it’s raining, I have an indoor pistol range.

The good news is it carried over into the Veterans organization. They didn’t cotton to the idea of having any one of the Big Six  (or one of the other 39) step in and assert control of their endeavour. Good deal. The VFW is now making overtures and the membership was very vocal in their feelings about this at my first meeting last Monday. Just my kind of people. After what we’ve discovered about the lot, I think I might have pulled up the tent stakes and marched out if I knew I was going to be affiliated with them.

My history with the VFW goes back to Lancaster California and 1973. Seems the Vietnam Boundary Dispute didn’t qualify as a genuine “war” and that I was not going to be admitted as a dues-paying member. Rather than head over to the American Legion with my tail between my legs, I decided to forego the whole Veterans experience for 40 years.

I’m back. I hope to sell lots of tomato starts to eager people desirous of helping Vets. This is also an opportunity to sell bricks with inscriptions to be laid around the flagpole at the local Veterans Cemetery. KPVeterans use their donations locally as they should. Somehow, the Honchos at KPVets do all this donation work without any fuss and bother.

I look forward to a long and fruitful relationship with them. What might be the icing on the cake would be if they had Imperial Connections to allow me to legally help Veterans on their VA claims without risking the VAOIG Police  or the Office of General Counsel breathing down my collar for “informing” Vets on how to prosecute their claims.

I’ll keep you posted on how this unfolds.

 

Posted in VSOs | Tagged , , , , , , , , , , , , | 1 Comment

THE FACE PLACE

ATT00548Member Mark of the 100% Alumni Club sends us this one. Been there, done that. Fixed the problem. Twice. The second one was free and I got a son out of it to boot. 

P.S.

ATT00530

Posted in FACE HUMOR | Tagged , , , , , , , , | 2 Comments

GENTLEMEN, START YOUR TOMATOES

Tomatoes 2014It’s that magic time of the year again. Flowers are poppin’ and spring is springin’. Cupcake said I may have planted a few too many tomatoes. I’m sure my three neighbors want some. Funny thing  is when you get them suckers up to about two feet in a gallon  potter, you’ve got more friends than Jennifer Aniston.

I went light this year with only ten flavors and 135 plants. Like Karen Carpenter said; You can never be too rich or too thin!” Tomatoes to me are like money. I donate them to Vets causes so I’ll be sure to qualify for my INDEPENDENT LIVING PROGRAM GREENHOUSE. Because it’s necessary and vital to my endeavor and I aspire to self-actualize and integrate with my community. All that from tomatoes.

2014 tomato farm2014 dining room We had a long freeze in late February that wiped out the lettuce. Don’t laugh, Bruce. I lost 75% near the outside walls.

2014 lettuce after freeze2014 lettuce 2Notice what happens when they move Daylight Savings time to an earlier date? It’s like New Hampshire insisting on being the first to hold their Presidential primary. If you move your date back, we flowers will just pop up and bloom sooner.

2014 spring2014 spring 22014 spring 3

And a fond farewell to my old friend Molly, this morning. A faithful wingman for over a decade.

molly-with-trophy

Posted in Food for the soul, Milestones | Tagged , , , , , , , , , , | 8 Comments

WILL VA ATTAIN 125 DAY/98% ACCURACY BY 2015?

Open voting. No cookies. No sign in. No track back. Please be honest. It will let you vote more than once because I don’t want it to be a “in order to vote you will have to register or sign in.” One click polling. No gimmicks.

Posted in polls, VA BACKLOG | Tagged , , , , , , , , , , , , , | 2 Comments

VAOIG–WEINER BUSTED SEXTING AT NEW JOB

oig-sealVAOIG officials have redacted the investigation but it appears former Rep. Anthony Weiner, New York’s last, best hope for Governor (Mayor? Dog Catcher?), is out of the VA for now. In what appears to be a case of leading a double life, Weiner tried to ride two horses-or maybe three simultaneously. We have no confirmation he was the fellow busted on this but inside sources at the VA’s Central Office at 810 Yellowbrick Ave. NW in D.C. have confirmed it. What the hey. The sexting thing gave it away anyway. Sexting at work is sooooooooooo yesterday.

weiner1I haven’t seen anything this heavily redacted since I got the Air America Files back from my FOIA request in 2011. This looks like a zebra. Seems there were a lot of shenanigans afoot and VA is now busy sweeping up the broken glass. I always get a bang out of who gets the ax. Usually it’s the one least guilty like the secretary for not asking appropriate questions or filing out the proper forms documenting the illegitimate travel or booze buying.  In this case, they simply gave him his own travel card and carte blanche to travel whither he would. That included horse shows near Dulles which made some of those trips appear legitimate. Free access to the hotel room mini bar wasn’t the smartest idea though.

All in all, it only cost you and me, the taxpayers, about $30 K for the goodies. That doesn’t include base pay and frills. I’d think they should make him give that back by assigning him to the Fort Leavenworth Regional Office for several years as a Human Resources interface with some of the more intractable inmates.  They could have off-the-record, back-door meetings and face-to-face counseling.

download

It must have been some other body.

I guess it could have been worse. He didn’t have any security breaches of Veterans information so we have that going for us.

1981790_818736681474264_1728488752_n

Posted in VAOIG Watchdogs | Tagged , , , , , , , , , , , | 4 Comments

CAVC–PEOPLES V. SHINSEKI–“DEXEDRINE? SORRY, WE DON’T SEE IT”

thumb_d10d7a64-04ab-4462-9561-19cb885ef6d9Once again we venture into reversal land at the CAVC. This is my pet subject. It allows us to minutely examine BVA jurisprudence and see where they saddled up the horse called Illogical and rode out onto the fruited plain in search of a satisfying rationale.

Walter M. Peoples was a Veteran of that interim period between Korea and Vietnam. This in no way should marginalize him for compensation purposes. Nevertheless the VA’s Office of General Counsel seemed Hell-bent on just that. Walter had filed for this in the past and been denied. Just when he did is unclear from the record but he had reopened the claim and had his teeth rearranged a second time. Being older and wiser, he opted to take it to it’s logical conclusion and find out if he had been screwed illegally. Well, duh. Where did you park the squad car, Dick Tracy? We’re talking VA here.

Meet Walter M. Peoples… CAVC Walter M. Peoples

The VA says this all turns on a subjective reading of a Service Treatment Record (STR or SMR) in October 1957 regarding a prescription for dexedrine. That’s the trade name for dexamphetamine or good old-fashioned speed. It was widely prescribed in that era for narcolepsy which Mr. Peoples suffered from. VA took the position that the notes were illegible to their highly trained VA Examiner who perused it. The BVA went further and had a forensic podiatrist schooled in adducing chicken (foot) bones do an “Independent Medical Opinion” wherein he could find absolutely nothing that resembled the word “dexedrine”.  Other doctors, however, seemed to have no problem deciphering it. Mr. Peoples’ decision is also germane and important because it clearly redefines the term “benefit of the doubt” on the off chance VA misplaced their copy of 38 CFR.

VA has long held (narrowly) that all the evidence and testimony must be assessed, weighed, measured, and minutely examined in an effort to determine whether it is a plus or a minus. Only after this weighing on the VA scales of justice can a benefit of the doubt decision be arrived at. Quite simply, if the pluses outweigh the negatives, then you win. If they are equally balanced for and against, the benefit of the doubt is awarded the Vet. It rarely works that way-if ever. I’ve read thousands of decisions and the one commonality in all that were unarguably indisputable was the decision by VA to say the benefit of the doubt was for application. Ten of your buddies could testify they watched you step on a mine and lose your legs. Each one of them could say the reason your legs evaporated was due to the Betty. You would not win until a doctor opined and said the reason the legs were no longer present was due to trauma while in the service. At that point the benefit of the doubt would kick in and you’d win. But not before. Ever.

In Mr. Peoples’ case, a doctor prescribed him some speed for narcolepsy. It’s in the record. VA swore up and down that it wasn’t, or, if it was, that it had nothing to do with narcolepsy. What they forgot to do was read 38 CFR §3.102 to its conclusion as well as 38 USC §5107. Had they done so, Walt wouldn’t have wasted 20 years of his life on this project.

“The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary” and, “when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant.” 38 U.S.C. § 5107(b) (emphasis added); see Douglas v. Shinseki, 23 Vet.App. 19, 23 (2009) (holding that the benefit-of-the-doubt rule applies after careful consideration of all procurable data); 38 C.F.R. § 3.102 (2013) (stating that when, “after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant”) (emphasis added).

Here, the Board did not merely decide whether the October 1957 SMR is favorable, but rather evaluated multiple other pieces of evidence to make a determination as to what the October 1957
evidence actually shows. As reflected by the Secretary’s concession that this case “largely turn[s]” on the determination of whether the appellant was prescribed Dexedrine in October 1957, this is exactly the kind of “issue material to the determination of a matter” or “any other point” that is contemplated by the benefit-of-the-doubt doctrine articulated in section 5107(b) and § 3.102

downloadSomehow, the RO, the BVA and all the King’s men could not see the word dexedrine. Remember when you were a kid and some cookie monster entered the kitchen and ate up all the cookies? You probably testified that you had no idea how or who was involved but then got diarrhea of the piehole and allowed as you had personally witnessed a one-eyed, one armed flying purple cookie eater circling the house that morning. Mommy would intercede and point out that you couldn’t say you knew nothing but were aware of unidentified, ocularly-challenged flying objects in the immediate vicinity of the cookie jar. Judge Lance sadly had to explain this dichotomy to the OGC folks. Lying is an art form. Ambiguity is your best friend. Someone needs to explain that to the VA on a fairly regular basis, apparently. I’ve seen more situations where they just kept coming back in succeeding denials with new rationale for the decision which was not part of the original denial. Like any whopper fish tale, eventually something doesn’t fit.

The Board’s analysis of the October 1957 SMR is simply untenable. Initially, the Board is inconsistent in its own findings of fact. Although it first found that “the exact names of . . . [the medications prescribed] are not immediately clear to the Board’s review,” and “the October 1957 treatment notation’s list of medications is illegible,” it went on to determine that “nothing written there otherwise appears like ‘Dexedrine’ either,” The Board cannot have it both ways: either it can decipher the notation or it cannot. Moreover, to the extent that the Board believes it is competent to determine in the first instance what the notation says, it does not explain why it found the appellant not competent to do so or otherwise not credible in his report of what he was prescribed or what treatment he received.

The reader or law scholar should note right here that the BVA judge was skating out onto mighty thin ice and a Colvin violation as well. VA is prone to be disingenuous. In their effort to prove they are overwhelmingly correct and the evidence can only be interpreted as being in their favor, they tend to spread the butter too thickly. Here, they simply went so far overboard that they appeared amateurish in their attempts to pull the wool over the judge’s eyes. This will often cause the judge to increase his scrutiny-exactly opposite the desired effect. And rather than assuaging his curiosity, this brought it roaring back.

Likewise, the other medical opinions that the Board found “constit[uted] the decisive and determinative medical evidence in this case” did not actually comment on the October 1957 notation.

I suspect this is what put the fork in the reversal.

In contrast, four separate medical professionals reviewed the SMR from October 2, 1957, and concluded that the appellant was prescribed Dexedrine.

> A July 1990 opinion from Dr. Mary Hamilton states “I have read his military records” and “[h]e was given Dexedrine [in October 1957].”

> In a May 1996 report, Dr. Jimmie McAdams indicates that “I cannot decipher the [doctor’s] handwriting in regards to his impressions, but it appears one of his prescriptions was Dexidrine  (#2).”

> Additionally, a June 2002 report form Dr. Wayne Mosier states that, “[a]ccording to the medical records available to me, Mr. Peoples was prescribed Dexidrine on October 2, 1957.”

>Finally, Dr. D.L. Trent, in a June 2002 report, states, “[b]y careful examination of the medical records that we have available, both of the V.A. and the private physicians that [the appellant] has seen over the years, it is noted that on the dates of October 02, 1957, at which time he was in active service, he was prescribed Dexidrine (an amphetamine) which was a common treatment modality of the time for narcolepsy” and “[d]ue to the poor manuscript of the prescribing physician it was unclear as to his impressions and reasoning for the use of this medication.”

It strikes me that the fire in St. Louis on Friday, July 13th, 1973 was woefully incomplete. These records, by rights, should have been declared forgeries and never been a part of the Record Before the Agency (RBA). Most disturbing is that this is all a matter of record and anyone with an ounce of sense could have simply read through the file and seen it. My case was identical in that respect. The Bozo RVSR clearly stated “We received your new evidence and we’ll get back to you after we make a new decision.” It took them six years, a DRO, a complete re-review before certification and the Form 8, a BVA denial  and last but not least-six months of motions at the CAVC before the OGC flunky said “uh-oh.”

As I like to point out, reversals are much like Clear and Unmistakable Error (CUE). They rarely occur and Judges are loathe to use the reversal option to express their dismay with how the BVA conducted it’s fact-finding expedition. Unfortunately, when you leave this much evidence on the table, the Veteran or his law dog is prone to find it. When the sum is this damning, reversal is the only option. In VA jurisprudence, if you lie, cheat and are unmasked, they reverse. No ifs ands or buts.

Posted in C-Files and RBAs, CAVC ruling, Important CAVC/COVA Ruling, Veterans Law | Tagged , , , , , , , , , , , , , , | Leave a comment

CAVC–MAUGHAN V. SHINSEKI–ANY OLD DOC THAT YOU THINK WILL DO

download (1)The following case illustrates what a lot of you who file for HCV are encountering. It also exhibits a large amount of chutzpah on the VA’s and the BVA’s part about what they think constitutes justice.

Many of us wait years for an appeal to reach the docket and then are subjected to a remand for what would, on paper, appear to be a shot at some kind of impartiality. Many is the Vet who has has written me and said “Gez. I got it remanded for a gastrodoc to take a gander and they sent it out to a proctologist (or substitute who you got here). One even got a specialist in OB/Gyn. He lucked out. His law dog spotted it within 60 days of the bait and switch and they blew an ass gasket. VA suddenly decided another specialist in the affected field might be more appropriate and he won.

Here’s the .pdf  MaughanSA_12-2832

Quack Doctor

Dr. Speculative

Steve Maughan wasn’t so lucky. Initially, the Board sent it out for another Dog and Pony exam but the VA examiner did the 4th and long and punted based on having the vapors and feeling the whole thing was too speculative to even consider. The CAVC considers that the same as no decision at all. This has conflusticated the VA in the past. To remedy it when it happens, they withdraw 30 pieces of silver from the bank and go shopping for a negative medical opinion. Since they have a gazillion doctors working for them, they “doctor-shop” it until they find a willing subject. The reason this is evident is a Vet at the Winston Salem, N.C.  VARO lost. He appealed and the BVA sent it out to a “impartial gastroenterologist” at the Portland, Oregon VAMC. I reckon they were fresh out of gastrodocs in Pennsylvania, Delaware, Maryland, Virginia or any other VAMC within 2500 miles based on this. I’m guessing our reknowned Dr. Ben Cecil would have done it for free and he’s in Louisville.

Steve’s nemesis turned out to be a urologist. VA reasoned that was close enough. The problem was that the Appeals Management Center (AMC), that 57th Regional Office on 1722 Eye Street NW 20421-1111 around the corner from 810 Yellowbrick Road, specifically asked for a hepatologist or gastrodoc to take a gander at this complicated liver problem.

If you can believe it, VA was unable to find a single one that wasn’t booked out six months or up to his ass in livers. Hence the downgrade to a urologist. God, I hate that when that happens. Judge Coral is having none of this. While I have no love for the AMC, they did specify on the remand the second time that it specifically be a liver doc. The BVA’s answer to Coral was the usual bitchslap.

A specialist, albeit not the specific specialist the Board had in mind, performed the examination. Further, the Board left open the possibility for this scenario as well as for the scenario of a general physician rather than a specialist performing the examination. Use of the phrase “if at all possible” indeed conveys acknowledgment by the Board that a hepatologist or gastroenterologist might not be able to perform the examination.

Whoo, doggies. That doesn’t cut it at Indiana Ave. NW these days unless you get Judge Bruce “I affirm” Kasold. With the advent of the new bevvy of  judges recently, they are performing due diligence in Court. That does not permit vacuous rationale on the BVA judge’s part. Here’s the rules according to Carol:

The Board’s reasoning is problematic for a few reasons. First, the Board insinuated that so long as the Secretary obtained an opinion from a specialist, any specialist at all, then he substantially complied with its instructions. By requesting an opinion from a hepatologist or gastroenterologist, the Board indicated that it believed the controversy in this case could not be resolved without placing it before a medical examiner with specialized knowledge about the liver. Applying the Board’s present logic, an opinion from a podiatrist, or an ophthalmologist, or a dermatologist would have been acceptable because those examiners are specialists in something, even though their knowledge of liver disease might be restricted to what they learned years ago in their general medical school courses.

This is the stuff we dream of. For years, we’ve been saddled with the old saw that “if you were unhappy or had some misgivings about the IME the BVA sent out for, you had ample time (sixty days) to voice your concerns. Coming to the Court with your dissatisfaction at this late date is unavailing.” Here. Judge Carol politely points out that isn’t according to Hoyle.

Chances are we’re not going to see Steve back at 625 Native American Ave. NW again. Unfortunately, this isn’t the end of VA podiatrists and dermatologists opining on your L5-S1 DDD.

Posted in CAVC ruling, IMOs/IMEs | Tagged , , , , , , , , , , , , | 2 Comments