African American veterans have the highest prevalence of HCV in VHA

In the 2006 article Hepatitis C Infection in African Americans Brian Perlman writes “Although African Americans represent only 12% of the US population, they represent ∼22% of the estimated Americans with chronic HCV infection;” and “The African American population in the United States has a dominant ancestry from sub-Saharan West Africa.”  This map from the Trans-Atlantic Slave Trade Database shows the regions in the America’s where many captive humans from Africa disembarked to slave markets.  The Gulf Coast, the Carolina’s, Georgia, Chesapeake (Tidewater) region were important slaving ports. If HCV originated in Africa (and/or Asia) these ports were probably where HCV was first introduced into North America.

Map 9: Volume and direction of the transatlantic slave trade from all African to all American regions

Introductory Map 9

Epidemiologists who study the genetic diversity of old viruses that have been moving around the globe for hundreds of years (like HCV) also study historical migration routes.   (The Africa-to-Asian slave trade took place over eleven centuries;  The Africa-to- the-Americas slave trade, about four centuries.  (Source-Google Book preview:  A History of Sub-Saharan Africa, page 229, by Collins and Burns)

Interestingly, the VHA has produced a map that shows that the VISN’s (6,7,8, 16) with the greatest burden of HCV are in many of these old slave market areas. hcv visn state map Census Bureau maps show the states with the the largest populations of African Americans are in the South.  The Hepatitis C Index (registration required) provides another tool to explore HCV prevalence in  African Americans with geography.

black map by state 2004

The virus maintained itself inefficiently in the African American community for generations (Ex. vertical mother-to-child transmission, household contact, rags, occupational blood exposures, tattoos, scarification) and spread to slave owners who administered crude health care:

“Masters and mistresses performed a variety of health care needs for their slaves prior to summoning a physician. Southern families often possessed their own medicine chest filled with popular remedies of bleeding, vomiting, and purging.”

Rough sexual assault and bloody punishments can’t be ignored.  The ancient methods of smallpox inoculations called variolation may have played a role.  Plantation owners like Thomas Jefferson made sure that his slaves, employees, and family were inoculated (last paragraph).

Because African Americans (often Genotypes 1) have a harder time clearing the virus, some infected patients have not always been offered treatment or have been excluded from clinical trials.  The VA has recenlty updated their management policies and we hope that previously untreated patients with genotype 1 are now given an equal choice in treatment options.  Any suggestion that the higher prevalence of  HCV in African American veterans is due to misconduct, and not historical and natural events, must be rejected.

We’ll save the topics of blood-letting and variolation for another day.

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

Cushman Manual for Shreddergate Victims

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No, this is not a manual on how to rebuild your Cushman, that you managed to find in your garage.   That manual is here.

This Cushman manual is for Veteran’s who have had evidence shredded and been denied, where the VA continues unabated it is quest to delay and deny until you die.

How do you know if you had shredded evidence?  An IRIS email inquiry is unlikely to result in, “Yes, JAV, we shredded your evidence and we were trying to find you and award your benefits that we so wrongly denied.”

Nooooo….Santa wont be coming until NEXT year.

You have to look for those subtle hints that the VARO shredded your evidence, because they will deny that until THEY die.

Things to look for:

1.  Why did they deny my claim citing a “lack of evidence” when I have it right here?

2.  Why isn’t my C file complete?  Why is it somehow missing that “Veteran friendly” doc’s report that said my malady was “at least as likely as not due to military service”?

3.  Why is my copy of my C file 1400 pages long, but the copy I requested from the VARO only 300 pages?

4.  Why did my copy of my C file have Bob Smith’s medical records in it when my name is JAV?   

5.  “Sniff it”.   If your claim “smells” like evidence has been shredded, it is probably true.  Many thousands of Veterans are victims of shreddergate, and most of these do not know it. Ask Nod readers, however, come armed with knowledge, not just how to detect shredding but what to do about it:

First, try a little “honey”.   Send an IRIS email, innocently asking, “Gee, how come you denied Service connection, when my Doc Friendly Vet, stated it was ” likely due to military service”  on an exam dated 11-21-04?

Next, pull out the 38 …. CFR 3.156 weapon, especially if you have already been awarded benefits and are seeking an earlier effective date.

Lastly, after a BVA denial,  get on your Cushman, and ride to the CAVC in Washington DC.  Get your lawyer on board, and let HIM drive the Cushman.

Posted in Guest authors, SHREDDERGATE, VAOIG Watchdogs | Tagged , , , , , , , , , , , , , | 3 Comments

VICTORIA’S SECRET–WHEN C-FILES ARE COMPROMISED

I got an email from Victoria about her husband’s c-file. First of all, gentlemen, divorce your mind from her name. This is nothing scurrilous. She could just as well have been named Monica. Names are immaterial.

Victoria and her husband have finally received their C-file after waiting almost a year. I’m sure VA will be improving on that lackluster performance nationwide in the future as soon as the VBMS kicks in. Then a simple request for the file  will only require a lowly GS-4 to push {Print} and shazamm! Ten days later you’ll be holding it. But what will you be holding? This is Victoria’s (and Steve’s) problem. His C-file is, how shall we say, “polluted “. They have found another Veteran’s records interspersed with his and are wondering how this will play out come ratings time.

As an aside, Victoria made the first move, as usual. Steve is sick and getting WAY sicker. We all know what this means.  The alpha female roars and St. Louis’ NPRC complies. With the VA, not so much. They are lackadaisical and in no hurry to comply. Considering it was the Fort Harrison VARO in Montana, I think a year to print them was light speed. I hear from others that they have been waiting over a year even with their Congressmen camped out in the lobby at 810 Vermont Ave. NW.

Meanwhile, back at Victoria’s ranch, they are in a quandary. Obviously, contacting the RO will provoke pulling the file from production and entail fieldstripping it to find all these extraneous records. This will cause a major slowdown in their claim if it hasn’t already. You see, they bought my book and went into repair mode. Knowing full well that asking for a copy of the C-file would slow things down, they still opted for it. It’s best to know what the opposition has for hold cards if you seriously want to win.  The fact that Fort Harrison is in the throes of conversion to VBMS and now tasked with adjudicating claims “provisionally” that are over a year old should set off the alarm bells.  You have all the fixin’s  for a long, drawn out clusterclaim. In fact, a lot of them with more coming in every day. Wars are good for business down at the VARO.

Victoria and Steve-first- thank you for permission to talk about this openly. While I would normally give this advice sotto voce and inaudibly to you alone, I think it bears mentioning out loud. You are absolutely right about the extraneous records compromising your c-file. After viewing them, I do not feel they will harm you. As an afterthought, having them in there actually is ammunition later when something goes awry. You can always point to it as a flaw that demands a remand because it is a Cushman violation. No amount of coaxing will put Pandora back in the box and no amount of exorcism will excise that which tainted the decision from the beginning. It demands a complete delousing of the file and a new adjudication sans the offending parts to judicially remain above board.

Which begets the next problem. Here we are in VBMS la-la land, busy as bees uploading C-files at the exponential rate of 10,000 a month across the fruited plain. Again, I ask. What, exactly are they uploading? Or, more appropriately, is anyone checking to see if these new electronic C-files are strictly information and data pertaining to the specific Veteran? Simply copying and refiling them with no quality control leaves Vets in a quandary when they uncover this. A Veterans Service officer from a major VSO would simply march in and demand it be sanitized with absolutely no thought as to how this might delay the Veterans claim(s). Steve, being a man, has dubbed this Victoria’s Secret. Mum’s the word. Full speed ahead with the Claim boat. Onward through the fog. Vote for Oat Willie.  We’re pro se claimants and we’re ignorant. No flies on us.

To put this in perspective, when I received my C-file in 2009, it was voluminous (at three volumes), but devoid of others’ claims work.  Fast forward to 2012 and my loss at the BVA. My attorney requested the RBA which is the Record Before the Agency. That’s VAspeak for the C-file after the Texas Necktie Party. When you go up to the Big House to litigate, everything has a new name. The RBA is what the VA has used to deny you. By now, mine had mushroomed to 3,817 pages. If you hadn’t guessed, I like to write. And this RBA format is the forerunner of what we call the VBMS C-file. News Flash. VA has been doing these for years in .PDF. This wasn’t born in 2010 out of thin air. VA has simply avoided doing it wholesale to every Veteran’s records.

And, like Victoria and Steve, my file had picked up some ticks in the three years since I looked at it last. Included were these  gems during the appeal. Every one of these came from the VARO. None are from the BVA in DC.

2013-05-10 221008

Bogus RBA 22013-05-10 2045062013-05-10 204506_2

The two black dots at the top of each page are where the paper slips over the two old-fashioned spears at the top of the C-file which then fold over to pin it together. Yes, folks this is the technology VA has been employing since the aftermath of World War One and is finally replacing. Call me prescient but I feel there will be a glut of government surplus hole punches with a throw distance of 2 9/16 inches coming on the market soon in all fifty states.

oat willie comic

Onward through the fog.

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FACIAL KNOWLEDGE

From the Social media entertainment capitol of the world… Yosemite Sam posted this one.

374999_10151503741052740_1038197373_nAnd from the twinster in the Appalachians

308565_484429211629942_1345466205_nI know these two. They live down in Las Vegas. The one on the left killed whatzisbutt.

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Meet Ruth and Astra, military working dogs, Bagram Airfield, Afghanistan, April 28-29, 2013

U.S. Air Force photo by Senior Airman Chris Willis

“Staff Sgt. Jonathan Cooper, 455th Expeditionary Security Forces Group Military Working Dog handler, and Military Working Dog Astra take a break from their Vehicle-Borne Improvised Explosive Device patrol….Over the past four months, the MWD team has swept more than 15,000 vehicles, mitigating all VBIED threats to the installation.” 

U.S. Air Force photo by Senior Airman Chris Willis

“Staff Sgt. Jonathan Cooper, 455th Expeditionary Security Forces Group Military Working Dog handler, and Military Working Dog Astra search for Vehicle-Borne Improvised Explosive Devices….Vehicles come from all over Afghanistan and must be searched for VBIED threats before they can enter the installation.”

U.S. Air Force photo by Senior Airman Chris Willis

“Senior Master Sgt. Edward Keenan, 455th Expeditionary Security Forces Group operations superintendent, and Military Working Dog Ruth perform controlled aggression training…. Controlled aggression training creates scenarios in which the MWD team responds to a suspect or unidentified individual.”

We love dogs with attitude.  Woof.

Posted in Future Veterans, Guest authors | Tagged , , , , , , , , , , , , , , , , , , | Leave a comment

Sobering future HCV mortality chart

future hcv mortality

Other slides are worth viewing–just click
on image.

This chart is from a series of lecture slides from the University of Louisville containing information adapted from “Davis et al, Liver Transplant, 2003; 9:331-338.”

The HCV death projections are a lot worse when patients are untreated. Public health officials at all levels of government continue to fail miserably in doing outreach.   This chart is a reminder of why it is important to demand that HCV testing be routine for veterans and all Americans.

The VA has posted a chart about some factors that can affect treatment outcomes–one of which is length of infection.   The sooner it’s discovered, the better the outcomes.  Here’s the link: http://www.hepatitis.va.gov/patient/treat/decisions-treatment-outcome-factors.asp

Like all viruses, HCV lacks locomotion.  HCV is smart however because it kills most victims very slowly thus giving it decades to seize an opportunity to move (float) its offspring into a new host before the current host dies.  And while HCV is replicating like mad, the victim is asymptomatic and completely unaware of the adversary that has made a temporary home within.

Posted in Guest authors, HCV Health, Medical News | Tagged , , , , , , , , , , , , , , , , , , , , | 2 Comments

TIME TO BRING THEM HOME.

I received this from Tom who is a Marine (always). It is hard to look at this objectively although I know some enlightened progressive types will say everyone is entitled to their opinion.

The Marines’ hymn included the refrain “To the shores of Tripoli” which is where this holy ground lies, too. Were this to happen in America, the perps would be carted off and spend 10 years in jail with a “hate crime” ryder attached. Here they are encouraged to deface dead soldiers’ graves. Perhaps it is time to bring these brave, victorious troops home and ensconce them where they belong -on hallowed ground away from raving lunatics.

Who was the rocket scientist who decided to park them here? In light of what transpired recently, who, indeed, was responsible for not immediately rescuing them before this sacrilege was perpetrated? Leaving your comrades behind has it’s drawbacks when political power shifts. I do not care for politics or religion. This is a prime example as it inflames my sensibilities negatively.

Posted in Complaints Department | Tagged , , , , , , , , , , , , | 3 Comments

NEW WEBSITE FOR REAL VA DATA

I’m sure we’ve all read the pablum supplied to us by Under Secretary for Benefits Allison “Wonderland” Hickey and her PR flacks regarding the backlog. Aaron Glantz of the Center for Investigative Reporting has assembled a fancy tool for determining just how bad it really is.  Not that VA is prone to stretching the truth, but it’s always nice to have an independent source with no skin in the game.  Politics aside, I’d be miffed regardless of which political party was the holdup. Ladies and Gentlemen Vets, this is far worse that the VA has been painting it. 

With the advent of the Veterans Benefits Management System, we expected an orderly transition to a paperless system-one that worked. VA can’t even figure out how many servers it will need when all 58 VAROs are up and running by the end of 2013 or… well, when they actually will get finished flushing out the bugs. That’s the ugly truth about design-build concepts. They have wrinkles that beget more wrinkles until the system becomes a patchwork of fixes instead of a well thought out integral creation.

With the new Provisional Ratings program, there will be another bump up in the backlog. VA admits this but seems to think they can still tame the lion before 2015.

Mr. Glantz has created a lovely new misery meter to keep us informed of what isn’t happening at our local ROs. Now you can keep track of where your claim should be using  hard VARO statistical data from prior years-but isn’t.

I’ll put this above in the widgets under the VCM labeled CIR Misery Meter so you can all click on it to consult the 8 ball. This new tool will be more accurate (and honest) than calling 800 Dial a Prayer or an IRIS “What’s going on?” query.  Here are some of the cutting edge subjects you can learn to quote from over dinner with the wife to explain why you may be changing your zip code for something more “variable” (read homeless). It will give you these  new statistics consistently updated to the latest Monday morning reports:

>Veterans waiting on a disability claim: The number of veterans waiting for a response from the VA for compensation for a disease, injury or illness linked to service in the military.

>Average processing time: The average number of days veterans wait for a decision from the VA.

>Average wait for new claims: The average number of days veterans filing a claim for the first time wait for a response from the VA.

>Average time to decide an appeal: The average number of days veterans wait for a response from the VA if they were denied their original claim and had to appeal.

>Completed claims: The number of claims processed by the VA by month.

>Claims received: The number of claims received by the VA by month.

>Claims completed per FTE: The number of claims processed per VA claims employee over the course of a year.

>Employees on duty: Number of claims staff working at the veterans service center at each VA regional office.

>Claims pending at least 125 days: The number of unprocessed claims at least 125 days old, including appeals.

>Claims pending at least one year: The number of unprocessed claims at least a year old, including appeals.

In fact, the only thing Mr. Glantz has neglected here is a good Rand McNally Atlas GPS app that shows the most desirable overpass homeless camping opportunities within walking or hitchhiking distance from the VAROs. I have taken the liberty of doing so.

QR Code for homeless Vets by VARO

QR Code for homeless Vets by VARO

I think a I speak for all Vets when I say that Mr. Glantz has provided us with a valuable tool to decide where to file. This news will allow Vets to vote with their feet and make cogent geographical choices about life until a grant of their claims materializes.

Posted in VA BACKLOG, vA news | Tagged , , , , , , , , , , , , , , , , , | 2 Comments

FACESLAP

Today’s facepage winner has to be Rebeccamarie Beque MignoneSalaiz:

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Most guys only notice the udders (his).

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

MAY 7TH, 1975–VIETNAM BAND OF BROTHERS DAY

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Many of you will remember this seminal date. In fact, I should clarify that and say that the number who will recall the importance of this date is diminishing at an alarming rate. The attrition seems to be attributable to some innocuous weed killer sprayed here and there for a number of years.

The VA recognizes January 9th, 1961 as the official “Opening Ceremonies” Day in Saigon and May 7th, 1975 as the day the last Marine boarded a Huey and struck our colors atop the US Embassy. Nothing like taking third place and bringing home the Bronze, hey? In some confusion, the military disagrees and uses April 30th, 1975 as “Flag Removal Day”. Actually, it was April 29th for the record.

Thirty eight years ago today (by VA’s metric), if you ignore the International Dateline conundrum, we abandoned ship and bailed out. Air America aircraft packed up for shipment at Tan Son Nhut AB were unceremoniously abandoned to the incoming PAVN and NVA regulars who overran the base.

While I certainly cannot find fault with the May 7th date, I strongly disagree with the 9 January, 1961 date. Obviously, VA overlooks the medal struck specifically for us by our loyal allies at the top of this page. It clearly announced 1960 as our official entry into this “boundary dispute”. In reality, I can offer lay testimony that my father was sent over by the Air Force to tactically reconnoiter the situation as early as 1954, prior to the fall of Dien Bien Phu and the French’ ignoble retreat up Route 7 to Vientiane, Laos in a complete, disorganized route.

He “visited” again in 1958 for a fact-finding mission to ascertain the training needs of the fledgling Republic of South Vietnam’s air force. His next visit in 1963 was to cement a stronger relationship between the US and South Vietnam’s nouveax dictator (and former fighter pilot) Nguyen Cao Ky. Ky, like my father, was a devil-may-care risk taker and fighter pilot so they got along like peas and carrots. Dad was instrumental in transferring a lot of old T-6s, P-40s, A-1Ds and other antiques sitting mothballed at Davis Monthan to supplement the mishmash of assorted aircraft the Vietnamese Air Force was flying at the time.

Dad in

Dad in “Down For Double”. (May 1945) Note 16 kills on fuselage.

Dad’s next Southeast Asian adventure began with his assignment as Vice Commander of 7th AF under Gen. William “Spike” Momeyer. This was June 1966 through February 1968. Spike wanted pilots to lead from the cockpit rather than fly a desk back at 7th AF HQ in Tan Son Nhut. This was just my dad’s cup of tea. He was never happy below 20,000 feet ASL. Being a Major General, he was not permitted to engage in actual combat so he relegated his flying to 149 missions in F-4 and RF-4 reconnaissance birds.

1 Oct. 1967 Tan son Nhut AB, RVN

1 Oct. 1967 Tan Son Nhut AB, RVN

 His replacement, Major General Robert “Bob” Worley, took over and was promptly shot down and killed July 23, 1968 north of Da Nang. Thus ended the era of generals flying in combat. As an aside, I went to high school with his son Rob prior to our fathers’ deployment to RVN. Rob went on to an illustrious AF career in his own right and also attained the same rank as his father. He currently works for VA.

66_134_221_117_122167

Maj. Gen. Robert F. Worley (d) circa 1967. Note Parachutist’s jump wings.

Ostensibly, we “exited” the Republic of Vietnam as a fighting force in 1973. This was a good publicity ploy but was not reflected by our actions in the air. We continued to bomb the NVA to keep their feet to the fire long enough to extract a “peace accord” in Paris and retrieve our POWs incarcerated in Hanoi.

Any discussion of when we “left” SEA actually provokes even more arguments as to when we actually arrived. President Eisenhower was farsighted enough to envision a need to contain the expansion of communism. Towards that end, the Berlin airlift and innumerable other “brushfires” little-known to the American public transpired that will probably never see the light of day. As an example, how many of you know that F-100s from the 31 Fighter Wing (Return With Honor) were sitting on the aprons at Elmendorf AFB in Alaska in the winter of 1957 loaded out with tactical nuclear devices awaiting a call to nuke the Kamchatka peninsula back into the stone age?

Rarely have Americans been called to war and suffered such ignoble treatment at the hands of their own military and the American public. For thirty years it was unfashionable to mention you were a Vietnam Vet. Now we are greeted with open arms and lauded with the inane “Welcome home” sobriquet. Excuse me. I came home in 1972. The Hare Krishnas were not the only ones there at San Francisco International who came out to greet us either. So for all of you fellow brethren who broke bread there and survived, I offer this as the thirty eighth celebration of Vietnam Band of Brothers Day. Unfortunately, we are a dying breed that will soon be harder to find than a spotted owl.

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Posted in From the footlocker, Vietnam War history | Tagged , , , , , , , , , , | 2 Comments