$180,000.00 LOTTO FOR LIFE

imagesToday was THE DAY. The ARNP popped blue smoke and arms out to line up a landing. Solvaldi time is one month to guns hot. I’ve been waiting for this for seven years so it’s a milestone in my life even bigger than kicking ass with VA. Well, actually I’ve been waiting for this since I got the bug in 1970. I just didn’t know I was dying from it.

ARPN Tobi Ann showed me the magic chart for dummies that illustrates the word Genotype 3 in  bold 48-point followed by the words Sovaldi + Ribavirin X 24 weeks just in case I was out of the loop on this.

I will be SVR within four weeks guaranteed according to Miz Tobi. If I never attain SVR, I will still inhibit the bug so greatly that I’ll probably die of old age. 83% chance of success is the prediction.

download (1)The last admonition was that I was going to consider Miz Tobi as Nurse You-know-who before this was all over. She stated in no uncertain terms that blood tests, when ordered, shall be complied with RFN. Fair trade. My life for six months of inconvenience?

So, let me see if I get this right. $180,000.00 worth of medication, all my blood labs, a new shot at living out my natural life, quite possibly the remission of the majority of the autoimmune issues I currently suffer including the Autoimmune Hepatitis, gradual restoration of part of my liver, improved liver function, pruritis remission-basically my life back- all for six prescriptions times $5.00 per copay for a total of $30.00? What’s the catch?

I must be in heaven, man. I haven’t felt this way since 1969. It was my graduation present. Two tickets to three days of a Music and Arts Festival in upstate New York. 450 yds out @ 5 o’clock.  The idea of living just gives me a shit-eaten grin tonight. Thank you Big Pharma. I finally passed the audition.

8/16/ 1969 Wavy Gravy states "We must be in Heaven, man!"

8/16/ 1969 Wavy Gravy states
“We must be in Heaven, man!”

CLEAR PROP!  

Posted in Medical News, Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , , | 8 Comments

THE FACE PLACE

1922326_10152072086180914_1456280481_nThis is where America gets its humor on short notice. Johnny Carson would have been proud. He could have fired his whole stable of jokesters and harvested the jokes du jour off of FB. Perhaps we could call Governor Christie’s dilemma a “plus size” misunderstanding. Peut- être un mésentente le plus grand, n’est-ce pas?

Posted in FACE HUMOR | Tagged , , , , , , , , , | Leave a comment

WANTED–WILLIAM DEREK CHURCH

doc11Here’s another one of those “Be all you can be” guys. Five-week wonder Sargent. There must be a barcolounger near the fireplace in Hell for these guys. Here’s a .pdf closeup so you don’t have to use a microscope to look at the idiot. My thoughts– What? No Congressional Medal of Honor? Dude, you were ripped off. Church_Poster_PDF. Great little website, too.

Posted in Stolen Valor | Tagged , , , , , , , , | 2 Comments

VA CLAIMS–SUBMITTING PHOTO EVIDENCE

Many Veterans have contacted me about submitting photo evidence and what constitutes an acceptable form by VA.  Our resident dermatologist, Jules, and proud recent member of the 100% P&T club here has clued me in to the requirements.  My attorney extraordinaire, Bob “I make it rain” Walsh even proffered me a form. I hereby share it with all of you. Now follow me on this. 

Photo Form

First, it’s a “live round” Microsoft word doc. It’s ready to modify in it’s current state. I left a static date in the correct format in place to show how it looks ( 01/10/2014). You can change it. Hit “enable editing” in the top yellow bar and you’re live.

Now, this is easy. Here’s a screenshot for all of you. Click on it once to magnify. Place your cursor at the top left like the one in the picture below and then go to the top with the mouse monkey. I call the thing that follows your mouse…nevermind.

screenshotUp in the top left on M/S Word is the action bar for insert next to home. Click on insert and choose “picture” down and to the right below it. This opens another menu of your computer to choose either a picture from your albums or something you have saved and are ready to insert into the Microsoft Photo file.

Next, while poised on the item/picture of your choice, illuminate it by left clicking on it once. Next, return to the bottom of the window and click save.  Fill in the block below and add in the appropriate info as necessary. I’ll screenshoot another finished copy example for you.

doc 3Next, if you are satisfied with the finished product, you want to protect it against tampering by anyone at the VA. Think of it as helping them to keep themselves honest. Move your mouse monkey up to the FILE tab in the upper left where the insert and home tabs are and click it. Choose SAVE AS.

When the next window opens to save it on your computer, I put them on the desktop because I never can find them if I blindly hit okay. It’s like socks to the washing machine. First, name it where it says File name. I like to use  Ask Joe Nod, 004 Right Arm .  Just below it, it asks what file format you would like to save it in. It says Save as type. Click on that bar and a menu drops down. Choose PDF. This pours cement around it and it stays put more or less in this form. It’s a smaller file size than a ,jpg, .tif or .png file and will upload to eBenefits more easily if you should choose to take that risky path. Last, but not least, go to the bottom right and click SAVE.

doc 4Once it’s saved you can open a new file, name it and put all the .PDFs in it. When you need it you can print them up to send in to rebut the denial. But we know you guys and gals are red hot and win them all at the VARO nearest you. This is just one more way to hit one out of the Veterans Service Center when you first come to bat.

Now we’re going to go the extra step that will professionalize the production. Here’s the download to a free ruler you can print. It is accurate. Even though we live in America, dermatologists live in centimeterland- east of the Land of Nod. A Stanley 30-foot metal construction tape is right out. Cut off about 5 cm. of your free new cm. ruler and write your full name, rank and airspeed on it including the date.

Ask Joe Nod    XXX-XX-XXXX  2/11/2014

This is a must have. Every picture must have one and adjacent to what it is you are trying so desperately to draw the rater’s absent-minded attention to. You can see the top edge of the one in the picture above. I cropped it out.

This will help you win your claims. VA will try anything to toss the evidence out or claim they cannot decipher it because it does not conform. What they won’t tell you precisely is what it was that made the picture inadmissible. This format is VA-bulletproof. Of note, this conforms all the way up when they demand stricter protocols for evidence in the Record Before the Agency (RBA) or above (Record of Proceedings or ROP).

Posted in Nexus Information, Tips and Tricks | Tagged , , , , , , , , , , , , , | 5 Comments

GILEAD TO PAIR LEDISPASVIR WITH SOVALDI

downloadThis morning I read with great satisfaction that Gilead Sciences is proceeding with yet even more studies on Ledipasvir combined with Sovaldi (Sofosbuvir), with and without Ribavirin. What is noticeably absent is the mention of the dreaded bug juice- Interferon.

For over a decade we have been subjected to more and more new, improved products that swore to be able to kill the dragon. Each one ratcheted up a few percentage points in success but none even came close to the magic 80% and beyond. In fact, if you go back to the early Interferon days, we were shooting up what would be considered a week’s dose in one shot. People who did this are either no longer with us or are so compromised as to be mushrooms in the basement. Actually, if you were to even contemplate that size a dose today, doctors would tell you it was a death wish. Where the hell were they when our good friend Mark of recent VA win fame was told it was okay to shoot up two doses a week instead of one (of the huge doses) as it would probably hasten his SVR. This brain fart came from-who else- VA doctors.

download (1)

Why, I almost diiiied!

The advent of Ribavirin was heralded as the panacea to knock this bug on its ass. If you consider an increase in SVR (Sustained Virologic Response aka a cure) from 33% to 37% a watershed event, then you were a born optimist. When I took my first shot April 12th, 2007, I was told I had a 66% chance of killing it (genotype 3A) within 26 weeks. Unfortunately, they neglected to read their own baseline testing and spot the autoimmune issues staring them in the face. Much like Roseanna Rosannadanna, I almost died.

The next big invention (that is actually still being promoted) was the triple drug cocktail involving Telepravir/Boceprivir combined with our other two old friends Interferon and Ribavirin. The percentage of SVRs continues to go up but they in no way shape or form got to the magic land above 80-85%.  How about 65% if you could stand the side effects long enough to attain remission? Recently, Vertex pharmaceuticals, the makers of  Teleprevir, sold out their product for $152 million- in effect conceding the future of protease inhibitors is going down the tubes. Smart choice. I suspect it won’t be long before Merck-Victrelis (Schering-Plough etc.)(Boceprevir) and the others follow suit assuming they can find someone interested in buying it.

I think the biggest 800 lb. gorilla infestation that resided on the living room sofa all these decades was  the continued insistence that Interferon caused no more than”flu-like symptoms”. More recently, the Vertex/Victrelis cheerleaders were saying it causes “diarrhea”.  Pardonnez moi. I beg to differ. Everyone, and I do mean everyone I’ve talked to, that has used Interferon has a far different take on it. Since when did downstream issues after the flu entail going blind, thyroid cancer, endless depression, anemia,  malaise and making your teeth rot out of your head? If you were watching TV and the announcer started running off a litany of things (as they currently do) that might be considered adverse effects, like having a stiffy for over 4 hours because you really wanted to be all you could be in bed, you’d nod sagely and say ” Ne problemo.-not me”. But if that same announcer began with “If symptoms continue or you notice your teeth falling out, discontinue use and call your doctor. Has caused thyroid cancer in most lab rats. May cause blindness and major clinical depression to include thoughts of harming oneself. As with all drugs, results may vary.”

I have read extensively about Interferon since its discovery in 1959. The wonder drug, touted as being nothing more than a ” medical leg up” and “something your body manufactures naturally”, was initially produced and proclaimed a cure for cancer. Funny how that story changed in a hurry. I notice cancer is not on the verge of disappering any time soon. Again, in the late eighties it was trotted out as the new panacea for AIDS. That revelation quietly died (along with a lot of AIDS sufferers) and we didn’t see it appear again until the mid-90s when-guess who- arrived. Each succeeding “medical breakthrough” on this drug was accompanied by the “Let’s just give it a chance to work. We know it works. Some just need to do it several times to kill the bugs.” This idiotic mindset that the drug was (and is) safe has festered now for over forty years. The trail of destruction in its wake is amply documented but they still drag it out as some kind of wunderdrug with acute, non-life threatening consequences.

Gilead has been combining it in a new triple drug therapy with Sovaldi and Ribivirin as the go-to combo to kill  recalcitrant Genotype 1A and 1B.  When do you suppose they’ll get around to doing a retrospective study of the folks who were horribly maimed by the “flu-like symptoms” but never cured? Fortunately for us, the days of Interferon vis-a-vis HCV are coming to a close but not soon enough to avoid irreparable damage to yet even more souls. Sure, the new cocktail is 100% effective in 8-12 weeks but they’re still not talking about that 800 lb. Interferon gorilla. What is it about Interferon? Who owns this crap that allows them to keep producing it? It’s more insidious than Agent Orange.

Within a decade HCV will become as rare as Smallpox or Polio. The cure will not entail going blind or require a few blood transfusions to “bulk up’ on your platelet count. You won’t come down with horrible autoimmune disorders secondary to the treatment either. I personally have waited for a shot (pun intended) at this Interferon-free treatment for seven years praying it would show up before I hit stage 4 or hepatocellular carcinoma- the dreaded HCC called liver cancer. With Porphyria Cutanea Tarda, the odds jump 33% higher that I’ll get it (HCC). Sovaldi is merely the cusp of the revolution. When combined with Ledepasvir, it is expected that the SVR will climb into the high 90 percentile for all the genotypes. Eventually, genotype will have no bearing in the success rate. Gilead and the other companies will keep it on the shelf for the occasional outbreak in a third world country and we’ll all breathe a sigh of relief.

Gilead had an opportunity, and indeed did trials, with a combination of Sovaldi and Daclatasvir. The results were off the chart (almost 100% again and again) but Gilead couldn’t reach a modus vivendi with Bristol Myers over combining the two and splitting the profits. Without casting stones, I suspect Gilead, like any big company, wants it’s own sole-source drug and the concomitant profits associated with it. They’re apparently right. When you have the only craps game in town and the only pair of dice, you pretty much control the horizontal and vertical. Johnson and Johnson’s Olysio isn’t going to be a serious competitor. It’s a day late and a dollar short. Besides, it’s also a retread of the Telepravir/Boceppravir protease inhibitor line of products and is yesterday’s news -like Interferon.

Interferon for dummies

Interferon for dummies

The new paradigm is the NS5A inhibitor which is what Sovaldi is. Daclatasvir and Ledipasvir are, too. These are just the tip of the new drug iceberg.  Interferon was like the old Franchi-SPAS 12 gauge street sweeper. The collateral damage was never cataloged because they were too busy trying to prove it  was the miracle cure for Hep. If a majority suffered and fell by the wayside, well, tough shit. It worked for over 34% so get over it.  NS5A drugs do not run around and “shotgun” the HCV virus like Interferon did with its horribly predictable side effects. They work much like that goo you put between the shoulder blades of you dog or cat for fleas. Frontline® and its similar flea juice competitors interrupt the cycle of  flea-breeding. NS5As operate identically and work much like RU-485- the “day after” pill to prevent conception. Anyone with an ounce of sense can see taking a contraceptive is far more logical than opting for a risky 1950s-style, late-term abortion in a back room somewhere with a 34% chance of terminating the pregnancy.

download (2)Having talked with over a hundred of you lucky souls who were cured on the Gilead trials, the worst side effect I’ve heard of is itching and gastrointestinal issues like flatulence. I say that beats the pants off thyroid cancer and  incurable mental depression. Personally, I’ll take farts over blindness any day. Besides, for me it will be the longer 24-week course. For the majority of you, it will only be the eight, twelve or sixteen-week course. I’m stocking up on Febreeze and a back scratcher, dude.

The saddest part of this is that medical researchers were willing to sacrifice us on the altar and tell us we could hack the course and suffer no lasting side effects from the bug juice. In some respects, it mimics Thalidomide in the sixties. Little or no testing resulted in a generation of children disfigured for life. At least they were not killed outright in the pursuit of a cure for morning sickness. Small consolation in retrospect. I’m sure they’ll say the same of Interferon fifty years from now.

Posted in HCV Health, HCV Risks (documented), Medical News, Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , , , , | 1 Comment

Col. (Sen.) Sanders Okay With VA Bonuses

Col. Sanders after some of his hot and spicy.

Col. Sanders after some of
his hot and spicy wings.

Col. Sen. Sanders went on record with Stars and Stripes and had this to say on the subject:

“When people are doing a bad job we don’t want them staying in the job; when they do a good job we want to see them rewarded,” Sanders said. “I’m not going to tell you that’s always the case with the VA.”

When queried on all the recent malpractice, patients dying from hospital-administered overdoses, Legionnaires Disease and HCV infections caused by VA medical personnel,  the Colonel proffered this excuse:

Sen. Bernie Sanders, a Vermont independent who chairs the Senate VA oversight committee and is one of the agency’s biggest allies on Capitol Hill, says most veterans are satisfied with VA care. “If you do an investigation of any given [civilian] hospital on any given day you’re going to see negative things coming out,” The Wall Street Journal reported Sanders as saying.

Yeppers. It’s just that we seem to see and hear about a shitpile more medical misadventures at VAMCs than at other medical centers per 100,000 patients. It’s fairly obvious where this fellow sits if he can speak for me and say “most Veterans are satisfied with VA care.” He doesn’t get out much to VA parking lots.  This morning at the American Lake VAMC in Lakewood, Washington (the other Washington), I witnessed a Veteran holding on to the front of his truck loudly explaining to it just how satisfied he wasn’t with something. Funny how I never see this at regular hospitals. I don’t need to add my two cents in and pile on.

When the political yo-yos in the Senate who hold the financial keys to the VA’s budget are quite satisfied with the status quo of bonuses, it speaks volumes about how entitlement works. Bonuses- be they for low handicaps over at the Andrews course or for accidentally killing off  fewer Veterans than statistically projected within their VISNs- can never be justified in the bright light of the instant, dismal performance. If it were just a momentary glitch and the backlog had begun recently, I’m sure Congressman Miller would not be so quick or vocal to express his displeasure. I’ve personally witnessed the same pathetic system slow down like a computer with 150 viruses to a virtual crawl over four decades. Trying to continue this bonus ruse in the modern, internet-connected universe is a fool’s errand. As Miller stated, the only ones who think they deserve a raise are the ones getting one and the people awarding them. The best line was the one where the employees who stand to get the bonuses opined via their professional mouthpieces that this would cause a mass exodus to the doors by upper management. Jesus Father Christ. What , exactly, did you expect them to say? “It’s time for us sinners to do penance, don sackcloth and forego our bonuses till backlog do us part.”?

This dog chasing his bonus thing is self-perpetuating as in:

Tom:  “Bob, if we give a bonus to Jim for marginalizing all those VR&E Vets, then we’d have to give one to Ralph for cooking the books on the homeless figures-oh- and his secretary Delores ’cause she was in on it, too.”

Bob: “Good point, Tom. I think I’ll put you in for one, too. What’s our tee time?”

We don’t do political so I will end with the thought that it could just as well have been a republicrat. It makes no difference what party but what creed they espouse. It’s a little unsettling to hear him brag about it though.

images

Yeppers. We love the VA. Mo’ bonuses!

But wait.  This just in from the Tip Of The Spear In Georgia (Mac). Eric Shinseki’s list of who’s been nice. I’m guessing there is no “who’s been naughty” one.

Posted in VA BACKLOG, VA Bonuses, VA Health Care, VA Medical Mysteries Explained, vA news | Tagged , , , , , , , , , , , | 4 Comments

CAVC-BARNETT V. SHINSEKI–DENIAL WITHOUT REOPENING A CLAIM

downloadWhat would you do if you tried to reopen a claim for Asbestosis or-what the hey- hammertoe, and they refused to reopen it?  Hell, it happens all the time. But try this one on for size. You file to reopen and VA fights you from one hedgerow to the next all the way to the Court, all the while telling you you have not presented new and material evidence to do so. In a desperate attempt to avoid allowing said reopening, they opt to give you another C&P to prove you do not deserve it. Meet Joseph E. Barnett.

Barnett reversal

Joe Barnett was a squid lifer from 1951 to 1970. Considering how much asbestos they used in ships back then, one wonders how he could not be suffering from it rather than the obverse. When I see these things, I point to VA math and say that anyone who could come up with that convoluted regulation can rationalize anything. And somehow they did-more than once. This is a reopening of a prior, denied claim and means he attempted this at some time in the past with no luck. This often sets the tone of the discussion and creates a “deaf ear” syndrome within the VA.

New and material evidence, for VA purposes, is a low bar to overcome-or should be. We are constantly lulled into complacency with the assurance of nonadversarial justice that will permit even the wildest and woolliest of stories to substantiate our claims. VA is supposed to perform due diligence, even with a smile on their faces, and at least pretend to entertain our requests. With the credibility problems of promising all manner of reform these days, the casualty is the Veteran with a “marginal” claim. Quite simply, a lot of babies are being thrown out with the bathwater and no one is complaining-least of all the babies. This explains why 85% of us lose by the way. We don’t appeal.

Joe arrived at the RO, probably back in 2007 or so, and attempted to reopen with nothing more than a lay statement that a nurse had opined asbestos “could definitely have caused chronic obstructive pulmonary disease (COPD) or at least made it worse”. Most of us who help Vets would probably focus on the word “could” in the prior phrase and cringe at his prospects without a nexus letter tying his COPD to asbestos.

VA has a job to do. Granted. They are inundated with claims and foolishly either refuse to hire enough people or abuse them horribly such that some quit in exasperation. Whatever the case, being behind the eight ball seems to be their lot in life for the last 200 years.  This does not give them the right to revamp the rules on reopening claims or to unceremoniously toss out lay testimony as being speculative simply because it is unsupported by the medical record (in VA’s mind).

downloadAlways remember, fellow Vets, new and material evidence submitted to open and even more importantly, to reopen a claim, is assumed to be credible for purposes of testimony. By serving America, they will at least allow us (on paper) to get our foot in the door to look at this with an eye to approving the reopening. It is a low threshold to get over-or was intended to be by no other than Congress.  Only after your request to reopen the claim is granted should the second facet of the jurisprudence kick in. By that, I mean a genuine weighing of the new and material evidence to determine if it is credible. When you scream that the sky is falling like Chicken Little, VA is at least required to accept that you believe it is falling before telling you you’re full of hooey. Joe didn’t even get close to that polite consideration.

Here, the Board determined that the appellant’s October 2008 lay statement “[e]ven if true, . . . is speculative and does not amount to new and material evidence sufficient to reopen the claim” and that he “was told on multiple occasions that he needed medical evidence showing a current lung disorder is related to service, including asbestos exposure.” R. at 15. The Board also determined that the October 2008 statement did not trigger the duty to assist under Shade and McLendon v. Nicholson, 20 Vet.App. 79 (2006), as the appellant “failed to provide a medical opinion from the nurse or nurse practitioner” and “VA provided [him] with another pulmonary VA examination [in April 2010,] during the course of which the examiner provided a medical opinion expressly rejecting the suggestion that [his] current COPD was related to service or his exposure to asbestos during
service.”  (Barnett v. Shinseki 2014)

download (1)This is where VA stubbed their toe. Veterans Law Judges (VLJs) remind me of little kids who get all dressed up in daddy’s pants and shoes and strap on a tie. We can forego the image of one in robes like Judge Judy because they don’t wear that attire. They’d probably like to but it’s like “all dressed up but nowhere to go” on the Titanic. They don’t hold court and have an audience. VLJs are not ready for prime time justice. They mean well and they look auspicious like judges but the similarity evaporates when they open their judicial pie holes and spout nonsensical gibberish. The unnamed VLJ who authored this abortion went so far as to discuss evidence that was not even a matter of record in the Record Before the Agency or what we call the RBA. When you do that, you are guaranteed to get a rise out of a  CAVC Judge like a small mouth bass going after a #2 Mepps spinner in May. Here’s Judge Lance’s take on it in footnote #1:

1
Secretary’s Br. at 19. The Court is precluded from considering any material that is not contained in the record. 38 U.S.C. § 7252(b); Rogozinski v. Derwinski, 1 Vet.App. 19, 20 (1990) (holding that review in this Court shall be on the record of proceedings before the Secretary and the Board). Nor is the evidence offered by the Secretary the type of information warranting judicial notice. See Monzingo v. Shinseki, 26 Vet.App. 97, 103 (2012) (“The Court may take judicial notice of facts of universal notoriety that are not subject to reasonable dispute.”); Jones v. Shinseki, 26 Vet.App. 56, 64 (2012) (treatise evidence should generally be weighed by the Board in the first instance). Therefore, the Court may not and will not consider any of the Secretary’s arguments premised on extra-record evidence. (Barnett supra)

This is the kind of thing that separates the poker players from the ribbon clerks. It’s also illustrates graphically why 1) we have a CAVC and 2) why this VLJ is never going to be nominated to the CAVC bench. Here’s another major face plant.

In making these determinations, the Board erred as a matter of law in several respects. First, requiring the appellant to submit medical evidence, rather than accepting his lay evidence as credible, violates both this Court’s holding in Justus and the Federal Circuit’s holding in Davidson v. Shinseki, which “explicitly rejected the view . . . that ‘competent medical evidence is required . . . [when] the determinative issue involves either medical etiology or a medical diagnosis,” 581 F.3d 1313, 1316 (Fed. Cir. 2009).

You can see where this VLJ’s judicial notions make his juris doctor’s degree appear to have issued from a box of Crackerjacks. The second half of Judge Lance’s ire falls on due process.

Second, by invoking the April 2010 opinion as a rationale for why the October 2008 decision did not trigger the duty to assist, the Board essentially weighed these new pieces of evidence against
each other without readjudicating the appellant’s claim on the merits. Cf. Justus, 3 Vet.App. at 513.  In essence, the Board determined that reopening was not warranted, as the proper course of action on reopening would be to provide the appellant with a new medical examination, which the RO already did. The flaw in this reasoning, however, and something clearly illustrated by the parties’ briefs, is that the Board precluded the appellant from obtaining meaningful review of its decision.  By relying on the April 2010 examination to find that the appellant’s October 2008 lay statement was not new and material without reopening the appellant’s claim, the Board conducted a weighing of the evidence but precluded the appellant from challenging the adequacy of that evidence as to the merits of his claim.

Let’s parse this in DickandJanespeak. Our VLJ tried to rubber stamp the RO denial with the path of least resistance-merely cutting and pasting in legal precedent with no basis in fact. Joe attempted to reopen his claim. The RO went into denial mode instantly. In their haste to run him off, they even gave him a C&P and convinced the C&P doctor to agree with them. That C&P became the raison d’etre for the refusal to reopen. The attitude was that “You didn’t bring enough evidence to us to reopen and just in case, we proved you didn’t because the C&P doctor said so. This is putting the cart before the horse. You are not permitted to create negative evidence to deny a Veteran anything-least of all a legitimate attempt at reopening an old, denied claim. Yet this is the caliber of justice we are subjected to and VA considers it not only nonadversarial but the best justice in town. I think it’s the best justice money can buy down at 810 Vermin Ave. NW 20420. Remember, The VA Secretary signs the checks there so  justice is what he says it is.

I counsel Vets to examine everything they get from their Regional Office when denied. VA is so inept, they tend to give us the tools with which to rebut their shoddy justice. Likewise, anything issuing out of the BVA is similarly suspect for exactly the same reasoning. Here’s a bright line example. I sent in new and material evidence with my NOD in November 1994. It was date-stamped 7 December 1994 and dutifully entered into my C-file. VA unceremoniously sent me out an SOC a month later and acknowledged they had received the evidence. This was assumed to be credible until they had an opportunity to examine it. They never did. When I reopened and won in 2008, they categorically denied I had sent in anything in spite of it being there large as life. Excuse number two was that they reviewed it but it would not have changed their decision.  Excuse number three was that I had failed to submit a Form 9. Each excuse became more feeble than its predecessor. No one even bothered to accomplish the simple task of thumbing through the c-file to ascertain this error until March 3, 2013. They were still willing to go to Court until my rainmaker started making noises about presenting evidence of AO usage in Laos. That changed their tone. VA is worse than the Keystone Kops. They are more entertaining than Ringling Brothers Circus and about as convincing.

I have often pointed out that I love to read about Fed. Circuit and CAVC reversals because they clearly illustrate just how far you can stretch the rubber band of jurisprudence before it breaks. Judge Lance was on the panel that decided Shade v. Shinseki which is probably why he was handed this one. One can only imagine his glee when he took the whole clerks’ pool under him out to Red Lobster for dinner and announced “Hey. It’s cut and paste time, kids. Let’s take Shade over to Vermin Ave. and TP that chucklehead VLJ’s office with it.”

The crime, as I iterated it in the Shade post was that VA screwed the Vet once at the RO. The BVA simply rubber stamped the denial with flawed legal theory and the Office of General Counsel (OGC) seconded the VLJ and proceeded to prosecute it yet again without even bothering to parse the legal significance of Shade. I take that back. They actually cited to Shade. Dumb and Dumber. This could be superimposed over Shade because it is Shade in everything but name only. How that escaped the OGC will forever remain a mystery.

Kind of like that old rag about those who refuse to remember the past are condemned to revisit it time and time again.

810 Vermin Ave. NW Washington DC 20420

810 Vermin Ave. NW
Washington DC 20420

Of course, the other graphic that comes to my mind is obvious.

45-inch-hole-plus-peripheral-traumaGosh. I hate that when that happens. Well, unless it happens to a VLJ. Then it is somehow fitting and proper comeuppance.

 

Posted in CAVC Knowledge, CAVC ruling, CAVC/COVA Decision | Tagged , , , , , , | 1 Comment

VA-HOLD THE BINOCULARS BACKWARDS, PLEASE

imagesSometimes, they really must take us for dolts, complete boobs or functionally illiterate, double -digit IQ  quirks of society legally licensed to drive automobiles. Children in adult suits if you will. This kind of three card Monte game is the most dangerous when someone fails to point out that we aren’t in Kansas anymore, Toto. Really? All of a sudden, the backlog has decreased, perceived accuracy has increased to a phenomenal 90 % and the average time for a claim is 179 days? Of course, taking a bow, they are amazed they have not yet reduced it to the projected 145 days? In accountantspeak, this is called making the elephant disappear up its own asshole. It’s a physical impossibility everywhere except 810 Yellowbrick Ave. NW, Wash. DC 20420.

VFW Deputy Grand Poohbah Gerald Manar  put it quite succinctly when he said:

“Today there are over 1.7 million compensation, pension and education claims and appeals. Instead of fully fixing the problem, VA leaders have redefined them,” he said. “Since VA couldn’t reduce the entire 1.7 million by 2015, they decided to define the workload as only disability claims requiring rating action.”

Which means, gentle readers, that the VA, not Congress or the public, is in charge of the Miriam Webster Dictionary. Claims are hyphenated like women now. You know. Used to be the simple Miz Arthur. Now it’s Mrs.  Mavi (silent a,accent on second syllable, puleeezze) Arthur-Dreyfus. Much the same, a VA Claim of yore has metamorphosed into a plethora of interesting sublets. Alphabetic ones (DBQ, FDC, PDQ, POW, DIC), presumptive claims for Agent Orange, simple claims, complex clams, dependency claims, burial benefits, education claims, insurance requests and then, of course, Appeals.

But when you partition Claims as a general category into claims with prefixes and suffixes, the landscape becomes blurred and miscommunication at high levels occurs:

longestIn recent months, VA has made significant progress in executing our benefit claims Transformation Plan. We reduced the backlog by approximately 36 percent since March of this year, and we expect these reductions to continue over the next year. More importantly, while increasing our productivity, we have also increased the quality of our work. In June 2011, when I arrived, our average for claims accuracy was approximately 83 percent; as of the end of November 2013, that number was approximately 90 percent. When measuring accuracy at the medical issue level –
which is a more precise measure of VA’s workload – our rating accuracy today stands at 97 percent. My testimony today will focus on how execution of our Transformation Plan has decreased the backlog and increased quality, resulting in better service to the Veteran community and pushing us closer to the Secretary’s goal of all claims completed in 125 days at 98-percent accuracy in 2015.

 You do have to hand it to USB Hickey. She aptly called it a “benefit claims Transformation Plan. She simply transformed the character and number of the claims. If this keeps up, we’ll have claims done to 150% accuracy before we actually file them. We can do away with the CAVC.   Maybe in 2016, VA will be launching what will be touted as the NSA claim.   A program by VA’s finest IT crews, who brought you the DBQ and the VBMS, will have partnered with the NSA who now is monitoring our social constructs and text messaging/phone calls.  Veterans help sites and other watering holes like this will be carefully perused to accomplish this feat. They will be able to decipher any informal claims we may harbor thoughts of filing. This will automatically provoke the filing of the claim and a denial decision will arrive in the mail a short time later. This has a twofold purpose. An inordinately large number of Veterans are employed by the United States Postal Service so this will protect civil service jobs. Secondly, it will help boost the bottom line at the USPS as well. They’ve been running in the red since about 1919 in case nobody noticed.

I really don’t mind getting lied to. I don’t mind having the wool pulled over my eyes. But when a maladroit magician comes on stage and can’t even find his rabbit in the hat and pulls out a picture of one, I become a little peeved. VA has no plan to produce a 125-day decision with 98% accuracy any more than I have a plan for global warming. I’ll make a prediction. If–a big if–VA could keep the VBMS up and running at something over 3 Mbps, they might be lucky to get a 125 day, 38% accuracy out the door by 2018. That assumes we don’t enter the fray on the ground in Syria with all our new-found Muslim friends there. If that happens, all bets are off.

images (1)Having witnessed not one, not two, but about four or more “complete transformations of how we do business” in the last 8 years, I vote for India. At least they answer the phone when you call. And more appropriately, at least they give out a number to call. Ever tried playing knock on the Castle door at your VARO? I know the prefix code at the Seattle RO now. It’s  253-220-XXXX. Hell, you just start inventing the last four and eventually you hit someone and say “Hey. You don’t sound like Christine Cringle. Who is this?” Idiot’s delight. They just give you the right number.  Pick out a name here.  I swear it’s like playing with kids in adult suits.

Posted in VA BACKLOG, vA news | Tagged , , , , , , , , | 4 Comments

FED. CIR.–DIXON V. SHINSEKI–WE AIN’T OBLIGATED TO HELP YOU

downloadEvery once in a while, we get another piece of justice that preserves our sanity and rebuts the idea that we’re pissing into the wind. Veterans law, while touted to be the most lenient, and notably tilted in favor of the Veteran, always seems to have one of those “except when the Vet forgets (fails, neglects etc.) to file a motion in a timely fashion.” clauses. Perhaps we should call it “the Veteran’s clause” as in “Wow. You almost won. You see it? You didn’t manifest the disease to a compensable degree within one year of returning from Vietnam, dude. So that means AO didn’t cause it. Sorry. Thank you for your service, hear?”

Try as we might, we always seem to get fenced out. By all appearances, the rules and regulations are to be construed as to be lenient until a sudden new epiphany arises from the fertile brains of the OGC.  Try as the CAVC and the Fed. Circus might, the VA tortures the wrong meaning of “is” out of it and then pretends to simply be following what it perceived as right and proper. We all know people like this. They take a perverted interpretation and try to make it look mainstream and perfectly plausible to interpretation. They continue the charade until it refuses to fly. This time, the CAVC joined them against us.

In the instant case here, Mr. Donald. A. Dixon has run afoul of time constraints while being under the influence of pro se. Ordinarily, the kid gloves come out and the Donster gets every consideration accorded those who foolishly represent themselves. Don has bent brain issues. He served in the First Gulf War-the one where we politely escorted Saddam’s lost troops back to the border of Iraq from Kuwait. We were polite enough to go along with President Hussein’s  excuse about how GPS devices make lots of errors in that neck of the woods. Don had breathed and eaten a lot of weird chemicals. In addition, they’d hosed the guys with medications to protect against VX nerve gas and a host of others. We’re coming to find out that wasn’t any smarter than spraying AO everywhere in Vietnam. The long and the short of it was Don got horribly sick ten years after he got out with things that you just don’t get until you’re 70. Sarcoidosis of the lungs and transverse myelitis? Not good.

Don filed and lost. No story there. That’s the scenario 85% of the time and especially the first time out. He did appeal it, but with no nexus letter or IMO to link it to service, he went down in flames again at the BVA. Being new at this and suffering the effects of disease and mental defect, he filed his NOA with the Court a few days late. Well, okay. Two months late. I, too, have been so sick I missed filing my Form 9 on time. It  rarely happens but it has been known to happen . VA shows no mercy. Unfortunately, our protectors at the Court take a pretty dim view of this, too. Mr. Henderson went all the way to the Supreme Court for us and came away with a big win on this. Then the arguments began all over again about what sin was permitted to pass muster when you screwed up reading the calendar. That’s when the big takeaway began-or should we call it the “takeback”? Being’s how Indian Giver has become politically incorrect, do we now call it VA’s Native American bargaining technique?

As an aside, let me explain simple justice at the Court level. Court- meaning CAVC. After you lose at both the RO level and the Board of Veteran Appeals, no more evidence can be introduced technically. The VA Secretary loves to think this doesn’t apply to him and gets called on it fairly regularly. If both the Veteran and the Secretary agree to allow a new piece of evidence in mutually, the Court still has the last say but as often as not puts the Kibosh on it. In some instances it is allowed so that a definition or baseline assumption can be established. You can just about count on one hand how many times this has happened. It’s rarer than Extraschedular ratings.

However, when arguing for equitable tolling of your screwup, it follows that you’re going to need a note from Mommy explaining your tardiness or the whole thing falls apart and nobody gets their claim equitably tolled. Mr. Dixon, following suit, explained why he was late and even submitted a cogent note from his treating VA psychiatrist explaining what happened. The Court, in what could only be interpreted as “weird behavior”, denied his tolling motion based on the fact that the shrink had not made the sale that his (Donbo’s) bent brain etc. was “specifically” the reason for the tardy filing. This was a finding of fact that was not called for with a pro se claimant. The Donmeister was no Perry Mason but he was on the right track. In the spirit of equity, they granted the Donster more time to scare up some  good reasons why he should be given a bye.

downloadA few days later, some of the big law dogs jumped in and waved the Pro Bono wand over Mr. Dixon and everyone thought that justice would right itself and prevail.  They got an extension on August 28th, 2012. These new attorneys were the high-price spread and set to work obtaining clarification of the psychiatrist’s nexus letter about what condition Don’s condition was in.  They notified RO Denver on September 5th they’d be needing the C-file and all of a sudden VA sloooowwwweed down to 16 RPM. Sorry, no c-file would be forthcoming. VA flat out refused to do so. Rather than fight tooth and nail and knowing time was of the essence, the rainmakers quickly deployed a paralegal to RO Denver to do a detailed review in-house. VA’s earliest appointment? Why October 1st, senor. The VA minder stood over the poor gal and distracted her as much as possible for the whole viewing. When finished (and frustrated), she selected 30 or 40 documents and asked to have them copied before her departure. No dice. The hearing was four days hence and VA was in full heel-drag mode. The non had now become disconnected from adversarial and the gloves came off. The RO chowderheads refused to copy anything. When asked if they could just make sure to get the copies over to 625 Indiana Ave. NW for the impending extension adjudication four days hence, the RO folks busted out in gales of laughter with “You want it when?” No promises were made nor were any copies copied that day. Or the next. Or the next.

At the same time, Mr. Dixon’s law dogs were busy drawing up a draft with Don’s VA shrink who was simpatico. He polished off a lovely letter and told Don’s attorneys he had to pop out and get VA’s legal beagles to approve his efforts before submittal. Bingo. VA immediately put an end to that and forbid the shrink to do any such thing. Out the window went the IMO. You can hear Tim Allen saying “Arruuu?”

On October 4th, when Mr. Dixon and his shield bearers arrived back to plead at the Court, he got the bitchslap. RO Denver had stiffed him. The OGC had cut him off from his shrink and he was holding an empty bag. The Court did everything but throw a banana peel out in front of him. Using all the wrong legal standards they could erect, they denied his motion for tolling and sent him packing. I’ve been there and it’s an ugly sensation. Your urge is to raise your voice and say “Hey. You can’t do that! I was ill.” But what do you do when the judge and the jury have been bought off? Why, go to the Federal Circus and begin anew.

This is not a nice place. Federal Circuit judges don’t smile a lot. They’re a sour bunch and try to pick apart silly stories-especially ones about the fabled Duty to Assist. This occurred before Judges Dyk, Meyer and Chen.  They probably drink unsweetened lemonade. The CAVC judge who authored this abortion was none other  than the head honcho- Brucey Kasold. He, of all people, should have his little people who read law do this correctly. I could see a novitiate like Coral Wong Pietsch screw it up with less than a year under her robes-but Bruce? No way. There was something else afoot. This reeked of rotten jurisprudence. Kasold had merely done the bobble-head doll imitation and agreed with virtually everything the VA Secretary said and asked for. Somewhere, thirty pieces of silver had traded hands.

As with most cases, the Federal Circuit likes to cut down several fine old growth trees, discuss their authority, confirm they have the right to hear this and pass judgement. They then moved on to the legality of Kasold’s brand of justice. According to them, Bruce needs to go back to law school. When you start throwing roadblocks between Johnny Veteran and access to his records and his doctors, you are waaaay off the reservation. When it is as well documented as it was here, you just know the good judges were going to be more lenient on Dixon. And boy howdy were they ever. This is a reversal. It is not a polite discussion about how Brucey might have come to the wrong conclusion because he got the vapors. It was a DUI/resisting arrest ticket compared to a parking ticket.

Citing to Henderson and Barrett so many times it became supra twenty pages earlier, they demolished both Kasold and the Secretary at every turn. The Secretary went so far as to claim that just because Barrett II held that VA was required to help a Vet on a request for equitable tolling, it said nothing about helping on a Motion for Reconsideration of a request for equitable tolling. Imagine this. It’s a pretty big stretch to squeeze that meaning out of Barrett II. It’s akin to Les Schwab selling and mounting your four tires and then later on saying the warranty doesn’t extend to the front tires because they aren’t mounted on the rear.  

As for refusing to let Don bring the shrink back in to clear the air, that was so egregious it set the Judges’ hair on fire.

We conclude that the Veterans Court erred to the extent that it concluded that Rule 35(e) imposes an absolute prohibition on the submission of clarifying evidence in support of reconsideration of an equitable tolling decision. An attorney from the VA originally informed LeBoeuf that the VA’s Touhy regulations precluded
Kielpikowski from submitting his declaration. Under certain circumstances, the Touhy regulations prevent VA employees from providing expert testimony. 38 C.F.R. § 14.801; see also Parson v. Chet Morrison Contrs., LLC, No. 12-0037, 2013 WL 5961099, at *2 (E.D. La. Nov. 7, 2013). Those regulations, however, are inapplicable where, as here, the VA “is a party” to the proceedings. 38 C.F.R. § 14.801(b)(2)(i).

As I mentioned earlier, it is a given that in order to argue for an equitable tolling issue, it will require the introduction of something (like clear and convincing evidence) to warrant doing so. They don’t just flip a coin like Super Bowl and say “Heads. The VA Secretary has chosen heads so he will make his choice. Mr. Shinseki? What’s your poison? Outright Denial or a Joint Motion for Remand?”

We conclude that the Veterans Court erred to the extent that it concluded that Rule 35(e) imposes an absolute prohibition on the submission of clarifying evidence in support of reconsideration of an equitable tolling decision.

As a final slap in the face, the Fed. Circuit judges gave Mr. Dixon his costs for his attorneys. That’s no small potatoes and expertly conveys the ire of the Court in a not so subtle manner. Kasold should be disbarred or made to wear sackcloth and ashes for a year. I vote for a Scarlet A for Asinine, Abysmal or Anti-Veteran. There’s simply no legal excuse for the CAVC to come down on the wrong side of this. Granted, they’ve been frosted since Henderson took away their right to arbitrarily deny equitable tolling under any circumstances but to cling to each and every subsequent ruling (Barrett I and Barrett II) as being porous as a sieve and open to conjecture is piss poor law. Barrett sealed the portal against this tomfoolery but Kasold still tried to pound in pitons to get a purchase. Thank God someone caught him. This would have disastrous consequences if left as is.

February 4th, 2014 was merely one more case of Vet –1, VA–0. It should never have happened but is indicative of the travails we all endure in this process. So much for nonadversarial conduct and a Veteran friendly environment in which to present our claims. No one can say that Denver (or Kasold) is alone in this kind of behavior. It’s systemic and they got caught doing it. download (1)

Posted in CAVC Knowledge, CAVC ruling, CAVC/COVA Decision, Equitable tolling, Veterans Law | Tagged , , , , , , , , , , , , | 1 Comment

HCV TRANSMISSION VIA SEX

downloadFinally, someone put this to rest with a concise study. Yes it is possible. In many cases it was the only known risk factor. The fact that VA lists it as a risk in the Risk Factors Questionnaire is a dead giveaway. Regardless, VA has been known to say it isn’t or that the risk is so statistically insignificant as to be unmeasurable. This study revokes the myth. As Murphy has been quick to point out over the years, if it can’t happen—it will.

Nodster

Posted in HCV Health, HCV Risks (documented), Medical News, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , , , , , , , | 1 Comment