Greetings fellow Veterans. Jerrel called up asking for a good subject to discuss. Boy howdy was that a wide open invitation to ask what VA litigation subject wasn’t a good one to take a lip whipping to. So, to go out and take a gander at OSA seems like a good candidate as any. Considering they’re going to give that and tinnitus, the two most awarded ratings in the VASRD, a major haircut in the very near future, it behooves Veterans to know what cards they’re holding and which ones they aren’t. VA is well-known for changing the poker rules and trying to convince you it’s to your benefit. Kinda like someone peeing on your leg and telling you it’s raining. 

At any rate, it’ll be a rip snorter. Maybe you’ll learn something. Maybe not. I guess what concerns me the most about the OSA gig is that I got bitchslapped by the rater three times and even had a dyno-mite IMO that cited to VA’s very own peer-reviewed study on the correlation between OSA and PTSD. The VES booth bitch took the IMO cite and reversed it to say the cause of the OSA was upper throat collapse. Only at the VA, folks. Only at the VA could they think you might not read the private IMO and even if you did, you’d know it was bogus because it wasn’t conducted by the VA so the Vet is cheating and attempting fraud. And then drag in obesity. Talk about post hoc rationalizations for prior Agency actions…

redact OSA IMO

redact OSA

Can you imagine being obese in the Marines? I can almost see it now if it were to happen. Think back to the old TV show Gomer Pyle, USMC. So Gomer’s overweight and been told by Sgt. Carter to reduce his BMI RFN. Come Friday afternoon and Gunny shows up and says “Everyone’s confined to barracks this weekend. No town passes, girls. Pyle here is 10 lbs. overweight so you all have a date with your toothbrushes and the latrines until Monday morning. Make ’em, shine for me. You ladies are dismissed.”

Gomer would have  two black eyes, a broken arm and three teeth missing come Monday morning and report to sick call saying he slipped in the shower Saturday night. That and a few piss poor performance reports about disobeying a direct order to shrink. I reckon the VA rater figures if he’s a bit “portly” right now, he must have been so in service. How else could you get OSA, right?

We’ll talk about that tomorrow and the new haircut tinnitus appears destined to get, too.

The call in number is

(515) 605-9764

If you wish to speak to the person to whom you wish to speak, press one (1). Otherwise, keep the squelch turned up so we don’t have to listen to the crunch of potato chips or the better half yelling at you to take the trash out.

If you have a good computer connection, try this one on for size:

The show starts at 1900 HRS in the easterly regions and, of course, 1600 HRS on the more erudite, progressive Left Coast. In fact, we’re so cool out here, we’ve found a way to save 3 hours and repurpose them.

Johnny Walker Black (bottom right kneeling)Don’t leave home without it.


Posted in OSA, Tips and Tricks, VA Medical Mysteries Explained, vA news | Tagged , , , , , , , , , , | Leave a comment


Unless I miss my guess, I reckon summer, or what’s going to pass for summer hereabouts, has arrived. We’ve had two successive days where it actually got near 80°. I’m playing it safe and keeping the pool at 88° until it stays in that vicinity for a week or two. Life is good. Pray for no rain.  And thank the Lord VA started a new fiscal year and turned on the ratings spigot again. I don’t think I’ve ever seen a VA dry spell like this one in my thirty plus years of playing VA poker.

Right off, I have to ask my readership if anyone gets bombarded by idiot commercials on their Goggle™ news feed. You know what I mean. Who are the best attorneys in Gig Harbor? You click on it and it takes you far afield to law dogs in East Bumluck, Egypt. Or you have to click to find out why you need to carry a crayon in your wallet. Shoot. It’d melt in short order or break into small pieces so what’s that all about? How about wrapping your doorknob with tinfoil if you’re staying in a hotel? Or putting a water bottle on top of your tire in a strange parking lot? Or the one that I’m tempted to click on showing how you can always tell when a one-armed bandit is getting ready to shit shekels all over you. Why is it that Rich Dad, Poor Dad is still telling us “I don’t think we’ve seen how high silver can go.” He was saying that in 2008. Why do I need to do something to my iphone before Sunday? I’ve been seeing that one for about six months of Sundays and my iphone still works.

I don’t know about you but I’m a man. I have pockets but I don’t think I have enough to carry all this crap around with me and I’m not about to start carrying a ‘man purse’. Most guys have four pockets like me. One for the phone, one for the car keys and the PPKS, one for the wallet and one for the Kleenex/other. I don’t have cargo pockets in my jeans but it’s an idea if I start packing tinfoil, extra water bottles and crayons.

As for all things VA, on July 1, 2022, VA commenced their new fiscal year for funding. They’re fat and sassy at the beginning before all the VA employees start syphoning off pharmaceuticals and anything else that’s not nailed down. My daddy once pointed out the difference between holding up a gas station and holding up a gas station on a Military base. The difference is about 40 years in Leavenworth versus 2-5 with time off for good behaviour at the state pen. I read the other day some Army O-3 and a couple of his E-8 NCO idiot hierarchy bagged 23 scopes for M4s and then were trying to figure out how to hide what they did when the CID folks showed up. That’s a whole new kind of dum-without a ‘b’.

Yep. We had burn barrels too in Vietnam but we don’t get the presumptive.

With the fresh infusion of Benjamin Franklin coupons comes an equally large number of ratings decisions with actual grants of $. I have a few Vets from the ’91 Iraq/Kuwait who have all the prelim stuff complete, all the c&ps exams done and are patiently waiting for their ratings… since March. Crickets. Obviously there’s some Ethereums involved because a VA denial hits the front page faster than you can say ‘God Bless You’ after a sneeze. It just takes them a month to lick the stamp and take it to the mailbox. Gee. Ain’t automation and computers the cat’s pajamas?

I wanted to tell the story about one of my really old customers who got caught in the Corona Beer virus and its fallout. Back in ’19, they got the bum’s rush on a jetguns= hep c claim. VA wasn’t buying and I get that. You have to have your IMO ticket punched to win these. I dutifully took it up to the BVA on a direct review after I’d tried to take the Regional shortcut with a supplemental 995 and a great IMO. They re-denied using some bogus rationale so it was off to the BVA. After a few years, cirrhosis caught up with him and we got a good Advance to Boardwalk letter from his doctor. The BVA obliged and granted pronto.

Then it was back to the RO Puzzle Palace and the whims of the village idiots there. The latest VA trick on Hep C claims is the Zeros for Heroes® program as most of you know. Man, if you think you can tell when the one-armed bandit is going to spew its largesse, I can predict every one of my Hep c claims is going to get this treatment now- in 2022. You have to start from scratch and get an addendum to the original IMO. This time around you have to point out that DC 7354 starts out its preamble thusly “With serologic evidence of Hepatitis C.” That’s a far cry from being actively infected. Ever hear of antibodies after healing?

You have to write a legal brief for dolts and walk them through their own regulation. No, ma’am. It need not be active. Healed hep c with the following symptoms qualifies. I win these now at the HLR (Higher Level of Review) after a careful DickandJanespeak soliloquy at the informal conference. I can almost picture the light bulbs going on over their pointed little heads when they “get it”. Then we haggle over 10% or 20% instead of TDIU.

This provokes the next line of attack. You begin anew with a fresh filing (only on a 526, mind you) for DC 7312 cirrhosis and sense that same déjà vu coming on. Advancing up the cirrhosis ratings ladder is even more maddening. Examine the regulation.

Generalized weakness, substantial weight loss, and persistent jaundice,


with one of the following refractory to treatment: ascites, hepatic encephalopathy, hemorrhage from varices or portal gastropathy (erosive gastritis).

VA raters have been busy little squirrels during the pandemic. They’ve been given lots of time doing remote ratings and have learned all manner of new bad habits unsupervised. In addition to the purposeful misconstrual of DC 7354’s phrasing, they have applied the same money-saving technique here. Granted, no one is going to qualify for all three of the first-mentioned symptoms of generalized weakness, substantial weight loss, and persistent jaundice but that’s what it says. The ‘and’ is conjunctive so all the ailments are required to get a 100% rating. You don’t get to the Weight Watchers© state or that permanent orange juice pallor until you’re about ten minutes away from punching out. So let’s put that aside and look at the second set of disjunctive symptoms needed to get any baksheesh.

The regulation clearly states you need only one of the next batch of  1)ascites, 2)hepatic encephalopathy, 3)hemorrhage from varices or 4)portal gastropathy (erosive gastritis). Please note the preamble that says you need to eat tons of meds and still keeps suffering this stuff. “Refractory to treatment” means you eat the propranolol (or nadalol) but the esophageal varices never heal. They might quit bleeding (hemorrhaging) but the actual varices persist because of the (wait for it) portal gastropathy-also known as erosive gastritis- keeps getting pushed up your throat. But it gets worse. VA c&p clinicians have been trained to say you have GERD -gastro-esophageal reflux disease. Six of one and half a dozen of another everywhere in the medical lexicon world but  sadly, not at VA, Jose. No sirree, Bob. The failure to use the right term is the death knell to that one. Ditto the hemorrhaging varices. They prescribe the propranolol specifically to thin the blood and relieve the portal hypertension. This keeps the varices from bleeding. Same thing with lactulose. You take that to purge the ammonia out of your blood and reduce ascites (free fluid in the abdomen). VA doctors carefully refrain  from saying ascites calling it instead “free fluid in abdomen near spleen”.  Yep. Missed ascites by thaaaaaaaaaaaat much, 99.

VA will try like the devil to say you need all these ingredients rather than just one. VA will argue your varices need to bleed to get to Bucks Boulevard. That fluid sloshing around in your belly that you have to go in and get tapped for every four months? Negatory on the ascites because your med recs don’t state you’ve been dx’d with ascites. Remember?  That’s just “leakage” from the spleen.

Thus, VA can (and does) deprive you of virtually anything to keep you off Dollar Drive. I can’t count how many decisions I’ve read where the rater says ” You were denied entitlement to PTSD because you did not have a diagnosis of PTSD.” Well, by golly that is 100% correct. VA told the truth. VA’s very own psychologist or a contract clinician made that call and said you didn’t. And until you get your own private psychologist or psychiatrist to rebut that and diagnose you with bent brain, you will remain denied until death does its part.

So, how do you fight these jokers? In this case, we went after the hepatic encephalopathy after beating our fists against the wall for the ascites and varices. That’s just a mouthful of word salad saying your brain is full of ammonia and it gives you brain fog. Brain fog is the non-medical way of saying you can’t remember who the president is, or what day of the week it is. If you cannot recall where you are or when, that’s brain fog. In this case, the c&p clinician quickly “saw” the medrecs prescribing the lactulose and the Vet’s inability to perform the who, what, where, why and when test. It’s one of those rare occurrences where the truth escaped their lips.

The Vet’s spouse was careful to keep pounding that brain fog nail into the clinician’s noggin, too. It finally stuck and  I used it to argue the TDIU under an extraschedular clause (§3.321) and §4.16(b). Because VA had done such a great job of low balling my Vet, he only had 10% for hep c, 30% for cirrhosis and 10% for anemia from all the blood he was losing to the ascites/varices which they insist are not bleeding. It’s downright difficult to put your iPhone 13 on a selfie stick and jam it down your throat to get  video evidence of the bleeding. Maybe a small GoPro? VA isn’t very eager to schedule an endoscopy either.

Most who know me are aware I don’t take a denial as VA’s last word on anything. I’ve been blessed with an acerbic, silver-plated tongue. It works wonders when you’re doing an HLR IC. Call these pukes out. Cite their own regulations to them. Get it in the record for an appeal. Eventually, someone with an ounce of intelligence will “see” the legal flaw and warn the Coach their denial ain’t gonna get airborne. With the new AMA, you can ride this bronco over and over until you get your 8 seconds on board. And I’m always sure to let drop to the HLR booth bitch I’m just dotting the ‘i’s and crossing the ‘t’s to ensure the duty to assist is covered so I can win on appeal without another remand for AOJ errors. That’s guaranteed to make her feel really insecure like she has a piece of black licorice stuck between her front teeth.

Every time some law dog says I’ll never win a claim/appeal, I do. It’s uncanny. How can I still be batting .1000 doing this? I even see the big names getting whacked every once in a while. I promise you I do not cherry pick my claims. I’m obligated to take all my relatives’ claims hereabouts. My daughter married into a huge clan and all the folks my age signed up for the Vietnam War. Some need a&a and the higher SMCs but most are just like all you Johnny Vets -flat feet, bad knees from jumping out of perfectly good 130s at Fort Bragg etc. The usual stuff. My guess is the SMC claims come to me because I’ve written so extensively about the subject.

As I mentioned in my book back in 2012, this process is nothing more than carefully following a recipe. There are no shortcuts. You don’t start before you turn on the oven. You don’t substitute ingredients. You follow the instructions and get what you expected. Failure to follow the game plan results in twice as much work and endless aggravation. Too often I have a Vet call/email me and ask why he lost. He points to his bulletproof IMO for $5000 and doesn’t see the word “probably” or “possibly”. He can’t fathom why reading the claims file makes VA’s $599 QTC Earl Scheib Special™ better than his private doctor’s.

I’ll be writing an article here directly on the new Stover Decision about AO in Thailand. Its thrust appears to be moot now with the imminent passage of the PACT Act. We shall see. Congress speaks and then VA hamburgers their statute into something unrecognizable. I’m guessing you’ll have to be born in an odd month on a Thursday to be considered presumptive. And boy howdy. Think about all my fellow Air America compadres who served in Laos and Cambodia. I see the presumptive only goes back to mid-1969 for those in Laos. WTF, over? I watched AO, AB and AW being liberally applied at 20 Alternate in 1970. By Hmong youngsters. Every month. Go figure.

Posted in Agent Orange, AO, BvA HCV decisions, hepatitis, Higher Level of Review (HLR), IMOs/IMEs, Nexus Information, TDIU, Tips and Tricks, VA Agents, Veterans Law | Tagged , , , , , , , , , , , , , , , , | 1 Comment


Happy birthday, Aaaaamerica. We’ve survived another year in spite of  immense headwinds. I’m sure there are two schools of thought on what has gone amiss or what is going swimmingly across our fruitless plains. In my case, it was a lack of sun and enough rain to float Noah’s rig. It literally drowned the bees or kept them inside waiting for the sun. In any event, I have a Gravenstein with nary an apple. I have two peach trees which look like they were pickpocketed by the deer. Ad nauseum. But what about America? Read on.

Yesterday morning over coffee, Cupcake said she was glad her father was not alive to see what has transpired in just the last twelve years since his passing. I could only concur. Gerald came ashore in the first wave onto Omaha Beach. He went from Corporal to Second Lieutenant in ninety minutes as he watched his platoon decimated before his very eyes. My father became an Ace three times over in eight short months from November 1944 to June 1945. He passed in ’08 and I’m also glad he isn’t here to witness the destruction of  America’s values (not democracy).

  U.S. Marine Carl Spurlin Dekel  celebrated his 100th birthday last week and had a few choice words which seems to vindicate my perception that something is truly amiss in the country Cupcake and I so dearly love. At least I know it isn’t just me. I ascribe wisdom to age and he’s older than me-and a Veteran.

Dekel says Americans don’t realize what they have. “The things we did and the things we fought for and the boys that died for it, it’s all gone down the drain.” Tell me about it Spurlin. Remember when America ran out of toilet paper back in ’20? That’s one reason I’m stocking up on Louisiana Hot Sauce™.

I agree it’s gone down the drain but, being an eternal silver lining optimist, I search for some redeeming evidence it will get better. As all of you know, we (Cupcake) has admonished me numerous times that politics and religion are poor conversation subjects. More wars have been fought over religion than any other subject in history. I won’t violate that taboo. I will simply point to what comes to me via my five senses. This being America, everyone gets to have an opinion.

As of today, gasoline is running close to six bucks a gallon at the local Shell station up the highway. A bottle of Johnny Walker Red is pushing $45 a fifth. A good prime rib eye steak you don’t need a magnifying glass to eat is about $22-$30 -if you cook it at home. I haven’t been to  a restaurant in a few years to say what they get for one there. Police this year have turned into fishermen in a perverted catch-and-release program with felons using handguns. We have a broad chasm of dichotomy on how we should proceed politically. Let states decide their own destiny on abortion or turn America into a nanny state where Mother Government administers everything from cradle to grave? Seems to me the Constitution dang near covered every contingency imaginable but somehow left out the right to an abortion. So, did the 1973 Supreme Court have the right to grant it nationally? Do they have the right to change their minds 49 years later?  Can’t they boot it back to the (wait for it)  United States of America to let their states’ citizens individually decide? Gosh, I’m not a lawyer so I can’t say but there is that little blurb in the 10th Amendment discussing who gets to say what.

Several months ago, I watched a Supreme Court nominee (now a Justice) state she could not define what a woman was because she wasn’t a biologist. This month, every woman in America-birthing person or not- seems to have no trouble defining what that means-biological training or not. Birthing person? We’ve been procreating for aeons and never had any trouble figuring out how the birds and the bees operate. Now, we have to rearrange the English language so as not to marginalize menstruating men who may become birthing persons at some time in the future (maybe even after surgery). Why, they’ve been forced to install tampon machines in boys’ restrooms in Oregon’s schools to ensure “menstrual equity”. I’m gonna take a flying tackle at a rolling donut and venture that if there’s a tampon shortage (which I’ve heard mentioned) this fall when school reconvenes, that cisgender-assigned females will be allowed to use the boy’s room, too.

Somehow, in spite of all the aeons of responsible gun ownership, we now have reached a crossroads of irresponsibility on a national scale. I reckon it’s immaterial arguing about how the cows got out of the barn at this point. Video games? The death of religion? Suffice it to say that it’s broken. I won’t offer repair orders on what needs to be changed. That’s not my job. What I can say is it seems absurd that some folks can look at Sandy Hook, the Buffalo supermarket massacre and Uvalde and see a need to outlaw the ownership of guns but ignore the perennial news of firearms carnage every weekend in Chicago. Why is it acceptable in Chicago?  One life terminated is one too many. Where it occurs in America  seems equally bizarre. Chicago has some of the most stringent gun laws on the books. Ditto other cities where the incessant gunfire is a constant reminder of the new lawlessness. When I read about cops in New York city being lured into an ambush and killed weekly, I scratch my head. Until last week, they, too, had some of the most stringent handgun concealed carry laws in the contiguous United States-let alone possession/registration laws. In comparison, my state of Washington is pretty sketchy. All you need for a CCW permit for your unregistered handgun here is $48.00 for five years and Jesus in your heart. What am I saying?  Shoot, even agnostics can apply. No 16 hours of training and two hours of live fire. No permit to buy and possess ammo. Nothing. So why is it that you need body armor in Chicago or NYC-even if you’re not a cop? Or LA where there simply are no CCW permits except for celebrities? Why don’t we need it (stringent gun laws) in this wild west state where there are no gun laws to mention? Why is Seattle different from Chicago?  I won’t venture a guess. Nope. Call it a fait accompli above my pay grade.

I look around at my once-gorgeous Seattle- formerly known as the Emerald City. It smells a lot like urine with those rich, earthy overtones of feces now. The National Flag of homelessness- the blue tarp- is flown everywhere proudly. The City council allocated $267 million for homelessness services this year. The American flag has been classified as racist. I see the rainbow flag flown frequently… but not Old Glory. Again. I merely observe. I have no desire to preach what you should or should not think. What political camp you belong to should not matter unless you subscribe to the latest woke concept that urine should be considered the new national perfume. How about we call it Eau d’stress and get some celebrity gal to market it. We could donate 1¢ for each sale and solve the homeless problem.  But using the numbers, I logically divided the $267 mil into the 6,000 homeless souls and figured out you could just give each one $44,500 and let them administer their own finances. What? You trust them with free giveaway syringes for their Fentanyl, $600 in cold cash/month for breathing and free run of the food banks. Why be judgmental and say they’re “afflicted” and need supervision? I’m told it’s a lifestyle option for some. I’m not buying but I refuse to be judgmental.

It matters little to me what color you dye your hair or what you believe your sex to be in your own mind. I remember back to a day when we let our hair grow long, smoked pot and some daring souls even ate LSD. We didn’t drive around shooting folks for having short hair. We subscribed to the live and let live mantra. What happened to my beautiful America? Why is everyone so unutterably depressed, morose and a victim?  Like Mr. Dekal above, I signed up to defend what America stands for.  Why is it that in the America of 2022, all we previously held admirable is now racist, sexist and requires a whole new, carefully sanitized and approved vocabulary? Woe betideth any who color outside the lines. Nobody can tell me my ideals as an American have all been clouded by racism. I served with, lived with and ate with all manner of human beings that ran the whole gamut of color, creed and political persuasion. I never held myself to be above a single soul.

I won’t ponder why all this is. What I question is why do I have to go through a re-education camp at the ripe old age of 71 to be indoctrinated on trigger words and instructed on using the correct pronouns? Wouldn’t it be far easier if folks who are conflusticated  about their “identity” wear cute, rainbow-colored descriptive nametags that say Sally (they, their, theirs)  or whatever floats their boat? If you knew upfront Sally wants to be referred to as ‘they’, it sure would go a long way in preventing a shit ton of screaming about how sexually insensitive you are for purposefully butchering Sally’s pronouns. As for appropriating cultural identity, does that mean I have to relinquish my beloved Bavarian lederhosen and foreswear Octoberfest celebrations for life? Am I required to have pronouns. Where do I get them? So many queshuns.

If this keeps up, it’s going to devolve downwards into South LA and folks wearing red or blue kerchiefs to signal not Crips or Bloods affiliation but a profession of Republican or Democratic religious belief. I long for the America I enjoyed as a child. Jump rope and Red Rover. As Mr. Dekal noted in his article, there are so many things our children (and now our grandchildren for us older folks) will never be permitted to know, let alone enjoy-all in the name of political correctness.

Once upon a time, a Confederate flag on the back window of a pickup truck meant nothing more than some good ol’ boy with a juvenile delinquent streak. There was no hint of white supremacy or racism attached. Or, if there was, it was nothing more than the impressionable fringe beliefs of middle-aged idiots on youth. By the time I graduated from high school, the KKK was little more than a mention in history books. Remember all the gomers up in Skokie Illinois who dressed up for some shindig every spring in full Nazi regalia? Did we fence in the Capitol and begin a Macarthyesque witch hunt for any vestige of a resurgence of the Third Reich? Hell, no. So what’s with the Russia! Russia! Russia! diatribe. If there was some truth to it, you can be sure some Cassidy Hutchinson would pop up out of the woodwork and confirm it under oath. Look at what happened to the Supreme Court Justice fight over Kavanaugh. Remember Judge Judy. Hearsay is not admissible. The January 6th Congressional Committee is going to hit that wall soon enough. How do you indict someone based on ” John said that Kathy overheard you say you hate Blacks. You’re under arrest. Please turn around and place your hands behind your back, sir.”

As long as there have been ‘Contrarys’ as envisioned in Thomas Berger’s most excellent novel Little Big Man, so, too, have there been those who desperately seek to be different, dress differently, dye their hair something other than blonde etc. It’s almost a contest to see who can outdo one another and be the most outlandish. Hey, fly at it. Just leave the guns at home. We should settle our differences at the ballot box. Period.

This fall, we are going to have an election conducted by Americans for Americans. Voters must be Americans. In addition, some will discover they need something more than a electric bill or a YMCA membership card to show their bona fides. The whole concept of giving a bye to minorities who purportedly haven’t had a chance to get a photo ID is racist on its face, isn’t it? Are these enlightened folks who claim to speak for you implying that you’re somehow too simpleminded to obtain this ID if you’re a person of color? Are they saying you’re poor, illiterate and somehow disenfranchised by not having transportation to get down to the Department of Motor Vehicles? In a world where you need ID to buy smokes, booze and pot, no one can look you in the eye and say “Shucks. I just never got around to getting photo ID.” I got my learner’s permit (sans photo) in 1966 at 14 ½ in Virginia. I got my permanent one at 15. Yes. It had my picture on it. If the laws haven’t changed, Occam’s Razor posits that the simplest explanation is the correct one. So where are all the folks with no driver’s licenses who drive but cannot vote?

I hate to say it but America is becoming the Land of the Free and the home of the Excuse. Everybody’s freedom is colliding with everyone else’s. Folks with no dog in a fight suddenly have a dog in every fight. What is to be gained by dressing up in your Handmaiden® Halloween costume and parading up and down in front of a Supreme Court Justice’s residence scaring the bejesus out of his/her children? A Supreme Court Justice is beholden to our Constitution-not your political cause d’jour on the subject of immigration or guns. Didn’t anyone explain this to the youngsters in social studies or were they too engrossed in explaining how horrible America used to be in 1609?

I note that neurologists often query my TBI clients as to who the sitting president is. This is to ascertain if they are addled in the head or AO X 3 (alert and oriented in all three planes of who they are, what day it is and where they are in America). By rights, some of these young ones would flunk that test in a New York minute. A humorous newsman has already demonstrated that by going to college campuses and asking educated college students some of the most elementary of questions in that vein. A common rejoinder is “Gosh, I guess I should know who the vice-president is, huh?” But boy howdy can they tell you what Karol Kardashian wore to the Oscars bitchslap.

I’m sorry. I sure don’t mean to insult our youth. I’m old school American. I probably don’t go to church as much as I should (never) and I may have some weird personality habits that offend others. But deep down inside, I’m an American. Not Red or Blue but an American citizen. Not white or black but an American patriot. By its very existence, America has always stood for freedom- freedom to and freedom from. The guardrails around America are just high enough to protect you from falling off the high balcony but no higher. Those same guardrails are not there to fence you out as so many now attempt to portray them. Our differences are artificially created to maximize confusion. Remember that story in the Old Testament about the evil town of Babel? Same game. You are black and only we can help you. Or: You are white and you rely on RINO white supremacists to protect you in Congress. Divide and conquer is the way this works. As my Kindergarden teacher always admonished us in 1955-“Be a do bee, not a don’t bee.”

I suggest we ignore all this discordance and let our common sense of old dictate how we think and act. It’s simple. Act like an American. Love your country. Be old fashioned and be patriotic. It’s how we arrived here where we are now lo these 226 years of our existence. It’s been a bumpy ride accomplished by a lot of bellowing and screaming. I’m fairly confident we can make it another millennium or two if we act like adults. Please vote this November. Show your civic pride. But always remember, we live in a majority rule country. Don’t get hurt feelings and pout. Let’s fix America rather than tear Her down. Our collective will as voters guides our destiny.  Be patient. Be an American. Be a do bee.

And that’s all I’m going to say about that.

Posted in 4th of July, All about Veterans | Tagged , , , , , , , , , , | 6 Comments


It’s not often you get a Vet who comes to you with a great back story. It’s an even finer thing when he hasn’t monkeyed with it and made it a thorough mess with all the wrong filings and denials. Please note I’m using the word ‘monkey’ devoid of racial animus. Let’s get that straight up front. It describes nothing more than an unknowledgeable person, a Veteran in this case, who gomers up his claim before seeking experienced legal help. ‘Gomer’, as used here, is not a contemporaneous epithet for a Viet Cong participant of the SEA Olympics but a synonym for someone who is mentally challenged at VA law. With that in the preface, maybe I can write this blog without offending someone. Seasons change. So, too, descriptive nouns. 

There went any hope of autorotating down.

Stuart came to me via a referral from my Good Humor Man at Tan Son Nhut Air Base in sunny Saigon. I finally got Bob TDIU last summer but when I first got him his Bent Brain rating back in 2018, his girlfriend’s brother- also a Vietnam Vet- called me up and asked me if I’d take his claim. Well, you know me. Being a boots-on-the-ground kind of guy too, I couldn’t say no.


Stu related a history of bent brain that began north of Long Binh back in 69 right before I arrived for the Repo Depot party. Seems he was riding shotgun in a convoy when they hit a buried MK 82 and was injured. To add insult to injury, a few weeks later, he traded places with a fellow trooper who was killed in an ambush. Boy howdy do I know all about that guilt trip shit. The guilt many of us feel about surviving Vietnam is a major component of the PTSD a lot of Vietnam Veterans bear. It also explains why we lose 22 Vets a day to suicide.

My beautiful picture

I began by filing him for PTSD because that seemed to be the index disease. VA promptly denied it. I took a good, long look at his claims file and saw all the evidence he’d amassed back in 1972 when he filed for a ‘nervous disorder’ (and was denied). Stu pointed out he’d never bothered to tell the VA ‘technicians’ about his Purple Heart for the injuries related to driving over the bomb. Weren’t they supposed to know that already? I  filed that with the PTSD just in case but it didn’t catch any air. Strangely, in all the bent brain filings I’d done in the past, a combat medal was almost a gimme for a PTSD rating.

I promptly refiled Stu for TBI and pointed out his STRs supported all this-including the chronic headaches he’d been having for the last 50 years. And Boom! Just like that, we had 40% with the tinnitus. Yep. You guessed it. Zero for the headaches. That denial for the Bent brain continued to bug the bejeus out of me. Having an unbesmirtched record of wins, I wasn’t going to take it lying down. I went out and bought myself an IMO from a PTSD guru and refiled.

Stu is kinda old-fashioned. His phone is a throwback to the old flip phones. It works so why change it? You can’t even take a picture with it let alone do a Face Time™ for a televideo c&p. Being as it was in the Time of Corona, he wasn’t big on going to the library and using Zoom there or wherever you  go to do a Zoom. So he did it via telephone only. I was skittish about this but figured if the VA pukes denied us, I could have him drive up here (from Oregon) to the illustrious LZ Grambo Bed & Breakfast Zoom Club and we’d do it here.

I launched the filing in October last and we waited. Along about February, they had him come in for a video PTSD c&p and it came out positive-in great part due to our private IMO. And then the deferrals began. And the incessant notes about “WTF? Who signed off on this private IMO without a video conference? Find an error and deny pronto.

Our good friends the 60 and 81 mike mike mortars… and the red clay

Sensing this potential defect, they called for a clarification or two on the claim and asked if it wasn’t probably the anxiety rating they’d given him for the TBI. Pyramid that boy to a denial and be quick about it. Next, they wanted to know if maybe it wasn’t a ‘progression’ of the nervous condition caused by the TBI. Then, when that pancaked, a long, pregnant pause deciding on how to lowball him. It’s pathetic to watch but you can almost see the gears turning in their simpleminded brains.

Then, last Friday afternoon, I got a voicemail from Stu in a total panic. Seems some VA rater was catfishing him to see if he could trip him up and get him to blow a hole in the bottom of his claim boat. He told Stu my private IMO was useless and he’d never win with it. How much did he pay for it? He went on and asked him where in Sam Hill he’d gotten the idea that he could provide his own IMO when VA had plenty of independent psychologists he could use for this project. Who was this yayhoo he’d hired who wasn’t even a VSO service officer? I’d given Stu a pretty good briefing on this subject and his instructions were to start crying, melt down and tell them to call me because he was too mentally frangible and might fall apart if pressured. Try as that fellah might, he couldn’t get anything damning out of Stu’s mouth and finally gave up. Probably didn’t even thank him for his service to America.

Well, Saturday morning dawned and I called Stu at 0800 to calm him down. Too late. He’d become so depressed at the thought of all this work going to waste and the added anguish of reliving it in his dreams that he ran down to the ETOH store, grabbed a fifth of __________ and got piss drunk. He was so distraught , he didn’t get a wink all night. I emailed the VA rater who’d tried this stunt and asked him what I might be able to supply to help him out. Crickets.

Along about 1000 Hrs Left Coast (including Portland) I saw the below pop up. We’d managed to catfish them into their own net. By having the VA shrink look at our private IMO and concur with it, they’d inadvertently established service connection for bent brain. Worse, by asking a separate shrink to review it and confirm it was a progression of something that walked like PTSD and quacked like PTSD, they were conceding he had the MDD. This is called a finding of fact. Once you concede, you can only CUE yourself to fix your fustercluck. VA had two shrinks now who had agreed with our shrink. They were stuck to this tarbaby and had to live with it-video or no video.

redact RD 6.25.2022

redact Codes Sheet 6.25.2022

I love catfishing. Lay a good punji pit and let them spot it. Then file for the TBI which was a slam dunk and well documented in the STRs. Get the TBI win and come back with a new, well-constructed PTSD punji pit. Granted, with the Corona, I think I could  have logically argued the circumstances of his dire mental state and trying to comply with a video feed were almost insurmountable barriers and VA should accept the IMO as-is.

Remember that smell of your girlfriend’s perfume?

Considering VA is a nonadversarial, Veteran friendly environment in which to adjudicate our ex parte claims with great deference to the Veteran’s testimony, I am shocked-yes, shocked- to  think these folks would even try to catfish a catfisher. We’re seeing this phenomenon across the VARO plains these days. VA will examine this like a Rubik’s cube® for weeks looking for the weak spot to glom onto. I’m sure some expert there in Portland honestly thought it was ethical to browbeat the poor Veteran into some damning statement with an idea toward getting him to provide the seeds of his own destruction. That, to me, is a new low in an outfit renowned for their reputation of being lower than whaleshit.

One thing I notice about VA raters. They are plumb het up about trying to find a way to defeat us litigators or minimize any remuneration we get. I’m not in it for the dough so when I file a claim with an IMO up front that rebuts their prior denials, they jump on it and grant a lot of times. Here, it was well past a year since the PTSD denial so I wasn’t going to win more than chump change. I think it throws them if they try to figure out my claims game rationale. Gez, if he ain’t doing it for the baksheesh, what’s he up to?


So, the DIY teaching moment here is simple. File the claim. If they deny, set up a new, better ambush. If they call seeking clarification, stand fast and say “You already have it all.” If they persist with their VAF 21-4142s, send in a §5103 acknowledgement saying you don’t have anything more to add and to please proceed to the checkout line at your earliest convenience. Don’t get squeamish or have second thoughts about trying to explain it better. Remember, we’re in the Land of Oz now. If you are adroit, you can keep your claim alive forever. Think of it like dining at the Golden Corral©- endless second helpings. And if they deny?  Then hire me. I’ve walked point on this trail for 30 years now.

The long-overdue heat wave finally got here to Washington state. I’m heading out to the cement pond for a dip. Stay cool.



Posted in All about Veterans, PTSD, TBI, VA Agents, VBMS Tricks, Veterans Law | Tagged , , , , , , , , , , | Leave a comment

Starting a New Business? Consider Hiring Veterans

Starting a new business is exciting and a little scary. The opportunity to be your own boss attracts many people into the world of start-ups, but creating a successful business takes careful planning, attention to detail, and hard work. Obviously, the lifeblood of any business is its employees. You want the best of the best – which is why you should consider hiring veterans. Keep reading to learn more, courtesy of Asknod.

Tips for Starting a Business

Before you can hire any employees, you need to get your company off the ground. Every business, no matter how small, needs a business plan. This is where you determine important things such as who your target customers are, what your mission statement is, and what your start-up costs will be. You also need a plan for financing those costs. You may qualify for a loan from the Small Business Administration.

Anyone starting a small business should give serious consideration to forming a limited liability company. LLCs have several advantages. As the name implies, this formation limits your liability by separating your company and its assets from your personal finances. Another benefit is that you avoid the double taxation that corporations are often subject to. 

Running your payroll is a vital part of keeping your company running smoothly. A good payroll service will ensure that your employees are paid accurately and on time and that your business remains compliant with all applicable laws and regulations. A payroll service can help to streamline your payroll process, making it more efficient and saving you time and money.

Reaping the Benefits of Hiring Veterans

Once you have formed your company, it is time to staff it. There are many benefits to hiring veterans when starting your small business – like increased adaptability, problem-solving, and loyalty. There are also financial benefits. You can take advantage of the Work Opportunity Tax Credit, which is available to employers who hire qualified individuals including veterans.

Simply put, veterans also make for exemplary employees. Military training is fast and efficient, so vets learn and assimilate new skills quickly. They are also excellent at working with and leading a team. They can manage, direct and delegate and will put the success of the company first. When it comes to working under pressure, nobody does it better than a veteran. 

Types of Jobs That Suit Veterans

While veterans can perform any kind of work, there are fields that tend to best suit their unique skills and experience. IT is an excellent fit for vets, as is defense contracting. Healthcare is regarded as one of the best career paths after leaving the military, and many veterans work in public administration or government.

Helping Veterans Succeed

The adjustment to post-military living and working can be challenging, to say the least. By hiring veterans, you give them a chance to earn a living and build a career that can give them a sense of purpose as they continue their lives after service. Vets are used to accomplishing mission goals. Your business can help them keep doing that.

Launching a small business is a big endeavor. Along with start-up capital, a solid business plan, payroll services, and plenty of moxie, you need dependable, hardworking employees. When it comes to the latter, you can’t do much better than filling those roles with veterans. They served their country, and they can serve your business. 


Image via Pexels

Posted in All about Veterans, Guest authors, Public Service Announcements, VA Agents | Tagged , , , , , , , , , , | Leave a comment


The gentlemen who run the Exposed Vet radio show have graciously invited me to attend tomorrow’s show and discuss a recent win I had for SMC T. I’ll be there and will gladly accept any calls with questions regarding the whys, wheres and how-tos of SMC T. 

The Show begins at 1900 Hrs on America’s eastly shores and 1600 Hrs on the westerly side due to global warming. It’s so hot in the mid-west it warps time.

The call in number is

(515) 605-9764

You can connect via your computer here:

If you wish to enter the conversation, please press one (1) on your phone to enable your microphone. Otherwise, please refrain as all the extra noise degrades the quality of the broadcast.

We hope to provide you with a valuable learning experience. Far too little SMC information is out there available to Veterans other than what it’s supposed to be according to VA.

Posted in Exposed Veteran Radio Show | Tagged , , , , , , , , , , , , | Leave a comment


Searching through VA data, it might appall you to discover just how many of you are not totally disabled who should be. I remember seeing some of the early breakdowns of ratings percentages by actual numbers rather than broad statistics back in 2008. I’d just reached 100% P&T and was stupified that VA had caved in so readily. I shouldn’t have been. Having studied it for a few years, I knew what I needed to get there. But how many of you don’t? My most recent battle again impressed on me that Boy Scout mantra of ‘be prepared’-regardless. 

Back in the day, I was a firm believer in hand grenades. Just like an American Express Credit card, I never went anywhere without a couple in my cargo pockets- even the loo. Up north in the land of the elephants that rhymed with mouse, we had a ready supply of those Swedish grenades that must have been designed for the less muscular among the Swedes who only got out for INACDUTRA warfare one weekend a month. You felt like an NFL quarterback and could huck one the length of a football field with little or no effort. Well, almost. An M 26 “lemon” style grenade was slightly less in weight than the old pineapple version of WW II. The reason I know that is the VC repurposed the pineapples with a new prussic acid fuse and there were tons of them you could measure against ours. The Swedish ones were noticeably lighter. The rebuilt pineapples weren’t exactly a big hit with the VC because about one out of five went off instantly when you pulled the bamboo ‘cork’ out of the top. Some went off within several seconds. One out of ten was a complete dud. Hand grenades taught me the value of being prepared for anything. It’s carried over into my VA law games. You don’t have to be an expert legal marksman to hit anything.

SMC T is a narrow  type of SMC rating. If you can qualify to SMC L for aid and attendance and you have a shit ton of ratings for TBI  residuals and PTSD, you qualify for consideration for the leapfrog directly up to SMC T from L. For most of us non-TBI folks, it requires an A&A rating plus a second qualifier like loss of use of your upper or lower extremities or blindness. A certain VSO pushed for this SMC T rating back in 2010 for the huge numbers of Vets who got clobbered by IEDs. I get that. What I never got was that the VA created two classes of Veterans- those who served before 9/11/2001 and those who came after. Trust me when I say we had IEDs in Vietnam. We just called them boobytraps…or mines. Six of one and half a dozen of another. They still can make your neurological existence utter hell for the rest of your life.

One of my clients-Stuart, a ‘transportation expert’,  rode shotgun on convoys from Long Binh up to Quan Loi. He was in a 18-wheeler cab when they hit a command-detonated MK 82 500 pounder buried in Rte. 1 one morning. It blew their tractor upside down 30 feet sideways off the road and cold-cocked both him and the driver. Stu was carrying a Pig and six boxes of 7.62. He said it felt like being in a washing machine with a 351 Cleveland until he lost consciousness. Messed him up it did. Yesssssssssssss. He says he’s never  hit on all eight cylinders ever since. I believe him.  One afternoon, we had a smart fart F 100 driver who was not cleared in hot pickle off a pair of MK 82 500-lb. Snake eyes about 1/4 mile from us. It dang near ripped our wings off and left us deaf as a post for several days. That’s the closest I ever want to come to a TBI.

So when Denise and Carl (not their real names) came to me and asked for help, I couldn’t turn this down. Carl started out Marine Life as an admin weenie at first. Then they ‘promoted’ him to Graves and Registration duty when they needed some new ones. That should have made the hair stand up on the back of his neck. For the uninitiated, G&R is the distasteful job of picking up all the little pieces of people after a fire fight. If you’re really unlucky, they make you map it all out and try to figure out what belongs to who. Boots with feet still in them are very frequent. Parts and pieces of human bodies tend to fly all over the place judging from my own personal experience. Generally, they can blend into dirt and be difficult to see unless they’re either bloody, flesh colored or have a piece of uniform still attached. It must be a traumatic MOS judging by turnover and what it does to the human psyche. Supersize it with a side of TBI from an IED and you have a recipe for permanent mental Hell. Meet Carl.

I think the enduring trauma is when these troops return home. Wives or loved ones are taken aback at the dramatic, permanent change of persona. Granted, being in a  theatre of war changes you. Combat definitely more so. But comorbidity of TBI and PTSD  is almost more than any one soldier was ever designed to bear. It’s a classic example of what  no deposit, no return military philosophy becomes in practice. Carl is a survivor of both and a walking miracle. Survivor inasmuch as each day is a Groundhog Day repeat of pain, headaches and mental turmoil.  Check out his noggin. He probably would not have made it this far without the support of his wife and children after the Marines escorted him to the front gate.  Once you’re damaged, the military can’t 86 you fast enough. I know. I did that perp walk in February 1973 -eight months after I got back to the world. It’s almost as if they fear you’ll contaminate any you come in contact with- like Corona. Carl probably wasn’t a walking, talking inducement to re-up so having him around cast a damper on the oooh-rah morale program. After all he’d gone through, anger management wasn’t his strong suite anymore. It still isn’t.

VA is not overly generous when it comes to handing out SMC just in case any of you hadn’t picked up on that yet. The higher the  award, the more static and recalcitrance they exhibit. You’ll hear every excuse under the sun as to why you missed SMC T by thaaaaaat much. You’ll hear tell that SMC T is reserved for those far more injured than you; that your injuries don’t quite qualify. They’ll aver the regulations are explicit and you need to be more than 100% for bent brain and have a shit ton more TBI than you currently do have. That’s bullshit. Those statistics I mentioned above reveal there are fewer than 3,000 or so rated for SMC T. That’s about the same number as SMC R 2 which is the same dollar value SMC ( $9,850 per month). There’s a reason for that. Think mushrooms and a dark, warm basement full of ignorance manure. I like to point out that since they always get SMC wrong or completely forget about it being applicable, that they should trust me. That one hasn’t worked much yet in spite of my unblemished SMC record.

My beautiful picture

To give you an idea of what you need to qualify for T, take a look at §3.350(j) and then review §3.352(b):

(j) Special aid and attendance benefit for residuals of traumatic brain injury (38 U.S.C. 1114(t)). The special monthly compensation provided by 38 U.S.C. 1114(t) is payable to a veteran who, as the result of service-connected disability, is in need of regular aid and attendance for the residuals of traumatic brain injury, is not eligible for compensation under 38 U.S.C. 1114(r)(2), and in the absence of such regular aid and attendance would require hospitalization, nursing home care, or other residential institutional care. Determination of this need is subject to the criteria of § 3.352.

§3.352(b)(2) gets into the nitty gritty small print of what VA seems to think is really required to attain SMC T. At any rate, it’s my considered opinion (and probably only mine) that you should always be prepared to supply credentials showing you’re certified for medical supervision for Physical Therapy (PT) in home by XYZ PT Co. with Nurse Ratched supervising, swimming at local YMCA times one day/week etc. 38 USC §1114(t) enunciates it clearly but 38 CFR §3.352(b)(2) simply muddies the waters.

(2) A veteran is entitled to the higher level aid and attendance allowance authorized by § 3.350(j) in lieu of the regular aid and attendance allowance when all of the following conditions are met:

(i) As a result of service-connected residuals of traumatic brain injury, the veteran meets the requirements for entitlement to the regular aid and attendance allowance in paragraph (a) of this section.

(ii) As a result of service-connected residuals of traumatic brain injury, the veteran needs a “higher level of care” (as defined in paragraph (b)(3) of this section) than is required to establish entitlement to the regular aid and attendance allowance, and in the absence of the provision of such higher level of care the veteran would require hospitalization, nursing home care, or other residential institutional care.

(3) Need for a higher level of care shall be considered to be need for personal health-care services provided on a daily basis in the veteran‘s home by a person who is licensed to provide such services or who provides such services under the regular supervision of a licensed health-care professional. Personal health-care services include (but are not limited to) such services as physical therapy, administration of injections, placement of indwelling catheters, and the changing of sterile dressings, or like functions which require professional health-care training or the regular supervision of a trained health-care professional to perform. A licensed health-care professional includes (but is not limited to) a doctor of medicine or osteopathy, a registered nurse, a licensed practical nurse, or a physical therapist licensed to practice by a State or political subdivision thereof.

(4) The term “under the regular supervision of a licensed health-care professional”, as used in paragraph (b)(3) of this section, means that an unlicensed person performing personal health-care services is following a regimen of personal health-care services prescribed by a health-care professional, and that the health-care professional consults with the unlicensed person providing the health-care services at least once each month to monitor the prescribed regimen. The consultation need not be in person; a telephone call will suffice.

(5) A person performing personal health-care services who is a relative or other member of the veteran‘s household is not exempted from the requirement that he or she be a licensed health-care professional or be providing such care under the regular supervision of a licensed health-care professional.

(6) The provisions of paragraph (b) of this section are to be strictly construed. The higher level aid-and-attendance allowance is to be granted only when the veteran‘s need is clearly established and the amount of services required by the veteran on a daily basis is substantial.

(c) Attendance by relative. The performance of the necessary aid and attendance service by a relative of the beneficiary or other member of his or her household will not prevent the granting of the additional allowance.

VA makes it sound as if all you need is the a&a of another, and in its absence, you’d need to be institutionalized. Well, not exactly as they say down at Dollar-a-Day Rentacar. If that were the case, there’d be a shit ton more Vets on SMC T.  VA attempts to allege you need  the exact same requirements for a higher level of care required to qualify for SMC R2. In shorthand, that means the wife or parent is going to have to become proficient in a wide array of medical techniques that might even entail removing or replacing indwelling catheters or administering injections. Or, it could be nothing more than learning how to accomplish rudimentary exercises in physical therapy or treating bedsores. At any rate, it will require a lifetime of medical treatment in the home and supervision as described by §3.352(b)(4). VA tossed in that killer qualifier that these regulations be strictly construed such that you generally almost qualify but most often not quite. That clearly explains why there are less than 3,000 who win SMC T or R2. What’s worse, they never tell you what you lack to get the T. That right there is a mega violation of 38 CFR §3.103(f)(5)(6); 38 USC §5104(a)(5).

Denise came to me back in late September. They’d already beat their fists bloody trying to win this and couldn’t get any explanation on how to play SMC poker with VA. All they got was “you’re not that damaged, dude.” She fought them from 2015-2018 just to win the TBI and get a paltry 70% for the bent brain syndrome. In spite of that, VA was adamant about no SMC- not even a&a.  Considering Carl almost went to jail for threatening to beat the shit out of a cop, you’d figure they might grant that much. Denise fought them to a draw and won the a&a to begin the fight in earnest. I admire her for even getting that far. SMC T, however, would remain denied until last Friday morning.

Now, I’ll let you in on a proprietary secret. During the HLR informal conference, I could catch the DRO’s drift that Carl wasn’t going to be SMC T material. She was telegraphing that with all the pleasantries. Surprise, surprise surprise. When they start saying they’ll re-review the claims file and “perhaps” be  able to make a favorable decision, you can almost rest assured they already typed it up and are waiting ready to hit SEND.  Rest assured also that you’ll be reading the denial in 28 minutes. I had already obtained a dynamite IMO from my folks at Mednick so I was acting a bit ambivalent about the whole thing. I told her point blank I fully well expected to get the “we wish that we could award you the T but….” Dear John letter and that the client was completely prepared for that. But I was also equally frank and said we’d just received the IMO in hand from a sme (subject matter expert) board-certified neurodoc that said he would never be able to exist outside a care facility solo without a higher level of care-so fire away as we were all prepared to take this to the BVA. Why, the HLR is just a mere formality I entertain with you VA folks to check all the boxes on the way to appeal. That punji pit always gets them. The reason it works like a charm is VA employees are insecure. If you’re nonchalant in the face of almost certain, 99.999% denial, they wonder what you know that they missed. It works like a charm. Remember, they’re used to dealing with VSOs. We won’t go into that today. Anyway, there was a nice long delayed pregnant pause and then the “Excuse me. Did you say you have a private IMO? From whom?”

I read her the punchline verbatim from the neurodoc and explained that VLJs up at the Puzzle Palace in DC generally ascribe more intelligence to Board-Certified 65-yr. old neurologists than  FNG “family practice” ARNPs with two years of QTC under their belts.  Another pregnant pause before she said she’d certainly give this the de novo hairy eyeball and get back to me. Well, I was right. It was about 28 minutes but it had metamorphosed into a grant. This is the second time the mere threat of a bulletproof IMO has induced them to grant what I wanted.

redact SMC T 6.17.2022

Now, in all fairness, I wouldn’t suggest bullshirting a VA DRO and telling them you have an IMO when you don’t. That’s probably against the law in 48 states even if VA bullshoots us day in and day out. Besides, I’m technically a VA “employee” in a tortured interpretation of the definition and I reckon I could lose my license. But that’s not to say I can’t wave it under their noses and let them know I’m strapping on the shooting irons and preparing for a legal gunfight.  I sure wasn’t bullskirting her on that point. Who ever thought whistling whilst passing the graveyard would become a litigating tool?

Denise and her kids still have a lifetime of challenges before them. $10 K a month will not buy tranquility but it will buy some measure of relief for treating Carl and getting him good professional help. I sure hope they don’t continue to use the VA VAMC for medical because that’s probably half his problem right now. I wouldn’t take my dog to a VA hospital. One look at my belly and you’d agree. That can only be VHA’s handiwork. Considering Denise is now certified for PY and other home care, I’ve advised her to go for the VHA PCAFC caregiver stipend of $2100 a month to help make ends meet.

Happy Juneteenth to you all. There’s no business like Vet business. I might not go to Heaven based on my SEA transgressions but I’m hoping to get a bye if I continue to pull off a few more of  these de novo do overs. Thank you Carl- and especially Denise- for letting me be your sword bearer. It was an honor to be chosen to do this one. What’s best of all is getting it done locally without having to appeal it for 3 years.

Posted in 100% ratings, Aid and Attendance, Gulf War Issues, PTSD, SMC, Tips and Tricks, VA Agents, VA statistics, Veterans Law | Tagged , , , , , , , , , , , , , , , , , | 17 Comments


Well, boy howdy. I honestly thought I’d seen everything but this one is a daisy. I’m not sure how to tell you all the particulars-or if you’d even believe me were I to. It’s so bizarre as to statistically deny it could even come to pass. But then, as I’ve reminded my readership, something very strange is afoot at our Veterans Service Centers across our parched plains these days. Well, parched most everywhere except here in Washington. We’ve had more rainfall in the last 60 days in as long as I can remember. We’re talking Noah shit. I thought it was going to beat down my corn for sure the other day. Good thing them suckers are already 17 inches tall. Eat your hearts out, California. We don’t tan. We rust.

I’ll even tell you that I love you if you want me too   

Imagine this scenario. My client filed for a number of AO claims back in 2018. He’s genuine boots on the ground. No big fight. Prostate cancer, Parkinson’s and DM II- some of the usual Vietnam presents we received for our duty there. Things began to get worse as time goes on. After all, Parkinson’s is progressive. It doesn’t get better. In fact, it gets downright nasty and then it kills your ass. One thing we all know is you don’t get better. Well, you don’t anywhere in our world. This only occurs to Veterans.

David was chasing a SMC S when he came to me. He was already up at the BVA and was wondering what he ought to do. Was he, perhaps, more disabled than SMC S? I took him on and filed him for loss of use of all extremities, R1- the whole shiteree. What the hey? If he wasn’t there already, he soon would be. That was back in July 2021. The new, improved VA bean counters looked in the records and decided to fry his ass for some reason. Why is anybody’s guess. Shoot. Maybe they hate me. Asknod sure stands out like a zit on Denis’ nose, now don’t he?

Don’t forget. Not a word was said about  Diabetes on the 526. The whole idea was the natural, ugly progression of his Parkinson’s alone. VA hired their own Dr. Judas for this project and anointed his hand with the requisite 30 pieces of silver. He became a font of neurocognitive information about Parkinson’s supersized with DM II. Now, if you can believe it, this was a Godsend. Dr. Victor Alpha (not a QTC gomer), in his overt haste to make short work of any Vet who dared go for the R1, did an “ACE” or Acceptable Clinical Evidence review instead of an in-person, face to face review. Thank you Corona Virus pandemic.

But what’s more, he adamantly refused to even look at any neurological lesions ratings percentages for the extremities (DCs 8514, 8520). His objection? In haec verba…

“ Parkinsons [sic] disease is not a condition of the peripheral nerves to include the Veteran’s left and right upper extremity peripheral nerves. Therefore there is no clinical indication to complete a peripheral nerve worksheet”.

But there is that pesky little problem with the Secretary’s regulation which is kinda sorta ya know unequivocal. Attendez-vous!  That little blurb preamble at the start of §4.124a? Ignore it at your peril. Well, of course unless you’re one of them esteemed neurological whiz kid doctor dudes.

[With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves]

Oh yeah. That would be that wad of DCs listed under the above admonition in 38 CFR  Part IV. Thank you Dr. Joubert for being such an officious, overbearing boob.

Now, the silver lining was that Joubert did do the ACE rather than an in-your-face. When you’re gonna reduce someone, your reduction c&p has to be as thorough or more so than the one used to make all those original ratings. If the original one was done in person-and how could you not do it in person- then the new one would have to be also. The icing on this cake, if there is any, is Dr. Dumbshit tried to play VA lawyer and reinterpreted the regulation incorrectly using his superior intellect. I can’t figure out if that was laziness or some narcissistic neurological aberration thing with doctors. Works for me.

Being honest, I sent an email to the raters and warned them that Dr. Dumbshit was screwing up but they blew me off. He even called my Veteran a “combat veteran” which he is not- further  demonstrating he was clueless. Copy and paste, anyone? When I didn’t hear back, I took it up a notch and put in a 526 for an increase in the bent brain rating. Then an increase for the constipation and incontinence. Always keep chipping away. Pile that shit up at their front door.

I’ve never really done this kind of thing before, have you?

The second half of this reduction expedition was done at the Regional Office. It was passed from VSCM to AVSCM to Coach A, Coach B and down the line until handed to the unwitting rater complete with cut-and paste-script. Read it and weep. It’s a hoot.

redact rd

Apparently Parkinson’s and DM II residuals can do the Lazarus gig and evaporate into thin air. Lo, our AO-infested warrior had improved. Not just a little. We’re talking some serious 70% down to 30% shit and another PN down from 40 to 20%.  A 20% and two 10%s reduced to 0% for face stuff. Now what was entertaining was that all these ratings were awarded way back on April 28,  2017. They would be exactly five years old on April 27, 2022 at midnight. The rating decision came out on April 25. Coincidence? Shoooo, doggies. There are no coincidences at the VA. Everything is carefully choreographed-this one included.

But if you scoot down to page 2 at the bottom of the Code Rating Sheet, you’ll see a reduction from 40% to 20% for Left lower extremity based on DM II only. It says nothing about PN due to Parkinson’s. So, somehow, one of the Davemeister’s four extremities is magically devoid of any neurological deficits whatsoever. But wait. There’s more. Go to page 6 at the bottom and note that the same rater is inviting a claim from the Veteran for…wait for it… an increase in ratings for his peripheral neuropathy due solely to DM II that they just reduced. I can’t make this stuff up. Way to go, Team Seattle DROC. You guys and birthing people rock.

redact a&a

But, when you try to fudge this game with another gambler, you better be pretty adept. My daddy would call these jokers “ham-fisted” ribbon clerks. Roger that. Check it out. They keep repeating the lie that the reductions won’t change his rating and incur the §3.105(e) stricture that the reduction be formally arraigned and notification given to object and abate the reduction until a hearing is held. News flash. Akles vs Derwinski (1991) invokes examination for SMC and its ancillary benefits automatically the moment you hit 100% (or TDIU). And boy howdy if they give you SMC L aid and attendance in this rating decision, then they dang for sure-sure gotta give it the hairy eyeball to insure they are not fencing you out of any other extra SMC ratings. VA pukes only think of reductions that cause a monetary reduction as applying to schedular ratings. But what if the “reductions” (which aren’t technically ‘reductions’ in their §3.105(e) lexicon) fenced you out of a bump from L to L 1/2 under §3.350(f)(3)? Ever chew on that one, bubba?

Of even more interest, one of the ways I like to lay a dynamite groundwork for R1 is to feint with the request for SMC L loss of use knowing they’ll step in the pit. Sure enough, they took the bait and went sideways and granted a&a which I conveniently asked for late in the game. But look what they did. They gave him a full blown 100% for the Major depressive disorder to make it the predicate for awarding a&a. It’s a good thing village idiots get merit protection at the VA. The Davester’s combined Parkinson’s also adds up to 100% or at least enough for TDIU. That gives him the ammo for the second a&a… and SMC O… and on to R1. See how that’s done? If you give these clutzes enough rope they’ll clothesline themselves.

 Yes I have but only a time or two

Third rate romance indeed. Can you imagine what would happen if VA DROs had college degrees? They’d be woke. Well, actually I misspoke. They already are-after a fashion. The VBMS Outlook directory now allows you to add your pronouns after you name. I’m beginning to see a few (she, her, hers) appearing. I was going to put (it, they, them) after mine but chickened out.  But seriously, folks. If you let college kids into these jobs, then they’d have to institute equity and give favorable review to you if you were a person of color or… trans or… well, other than straight? But that’s another story for another day. I digress.

Today began with cloudy skies. Almost as an omen, the VA HLR Inquisition forgot the time for the Informal conference. I wonder what they would have done when 1400 Hrs arrived here, in Seattle, and it was 1700 in St. Pete. I specifically warned them I was 3 hrs behind but then look who I was dealing with. I like to do HLRs in the morning after  a lot of coffee. Besides, when it’s 9 here. that means they’re doing the HLR during their lunch hour in Saint Pete. Suffer.

After a email reminder, the DRO called me and got the vapors while apologizing. After a bunch of formalities, I just had to lead off with why these bozos were reducing with the right hand while extending an offer to file for with the left. She never got back on an even keel after that. I let go with the second shot and the ACE review being used for the reduction. The rest was like fishing with hand grenades.  From looking at the computer, it looks like they’re going to rescind most, if not all, of the reductions. I don’t expect them to grant R1. I’m just setting up the Claymores and laying out the wire for the next phase at the Board.

HLR results

So, my corn is almost knee high and we’re a fer piece away from the fourth of July so I got that going for me. Fact is, none of us litigators are having much luck with these HLR reviews since last July. Have you ever been up at a craps table and just be killing them  dead and all of a sudden the dice get colder than a mackerel? Welcome to the new VA game this year. I always thought we got a better shake when the Liberals were in charge of the VA. I don’t see how these folks can dance their way out of this conundrum but then I’ve seen them pull all sorts of shenanigans that take about 3 years to straighten out. It’s worse than herding cats.

Bon chance.

Posted in Agent Orange, Aid and Attendance, AO, Higher Level of Review (HLR), SMC, Tips and Tricks, VA Agents, VBMS Tricks | Tagged , , , , , , , , , , , , | 5 Comments


Winning a VA claim is not impossible. Obviously, it isn’t easy but then there are a lot of things in life that require finesse. After 30 years of throwing darts at VA’s dartboard, I’ve watched them change over time. Old, tried and true recipes for success seem to fall flat and fail. You can never expect anything to remain static forever. Fortunately, there a few of us who just keep plugging away at it and come up with a new repair order. Shoot. Look who you’re dealing with. Government can’t fart their way out of a wet paper bag… or even light one for that matter. Let’s look at the latest techniques that do bear fruit.

I’d like to present what I do as a workaround for this phenomenon. First, we’re in the new AMA (or AMIA) mode now rather than Legacy. Granted, there are still Legacy claims/appeals out there but let’s focus on what most of you will be involved in. I’m going to use a client as an example. Most of you know I cut my teeth on Hepatitis C claims. They were simple and straight forward. You filed. You lost. You came to me. I refiled and took it up to the BVA after obtaining an IMO and you won. If you were severely ill, it was almost a guaranteed 100% schedular and P&T. That was Legacy. Apparently, we were too successful and the financial well began to suck air.

Next, with the advent of the AMA, we found a new brick wall. Even if you had an IMO, VA would still deny by going out and getting another c&p exam to deny you. This forced you to go to the BVA to win. Again, a minor change but one we could negotiate with a slight change of technique. Yeah. I know Medrano forbid this repetitious behaviour of shopping for a good denial IMO. Tell that to the local poobahs.

Then one day, the BVA got fed up with the gomers at the Fort Fumbles across our fruity plains denying virtually everything illegally and shoveling it all up to the BVA. The BVA bozos began shoveling it right back down to the Regional Offices and telling them to quit pawning off their job on the BVA. All that resulted in was a re-denial and another trip to the BVA to try to win it.

So you won. But it wasn’t that simple.  On remand, your local yokels granted your Hep C claim and awarded you 0%. Why? Because you went through the treatment and were cured. You no longer had Hep C so you got SC for it but no VA wampum. The repair order, as usual, was simple. Read §4.114 DC 7354 (Hep c) carefully. VA pukes didn’t…

“With serologic evidence of hepatitis C infection and the following signs and symptoms due to hepatitis C infection:”

I began having to point this out in legal briefs to the BVA. Sure. My client is “healed” but has a lot of residuals. The VLJs concurred with me and sent it back to be rated based on the residuals because 99.9% of us who had Hep C for a gazillion years were mega sick with residuals-not the underlying cured disease. Besides, the regulation says residuals- not proof of continuing disease.

The next wave of stupidity came after a new push. A client is taking lactulose to control his portal hypertension and ascites. He’s also taking propranolol to control his esophageal varices. To get around paying for this, VA demands that you have bleeding varices. Regular old varices, regardless of how many, that are not bleeding are not ratable. I promptly quote Jones v. Shinseki, 26  Vet.App. 56, 63 (2012) and point out that DC 7354 makes no provisions for medication-attenuated symptomatology. Nowhere does it say “rate on residuals after medication”. VA raters look at you with that inimitable 1000-yard stare and say “Who’s Jones?” The end result of this chicanery is you can be 100% on paper for cirrhosis post-hep C and be lucky to get 30% even though the hepatic encephalopathy is so complete you can’t remember your birthday. If you still drive, you pull up to stop signs and wait interminably for them to turn green. Ditto the ascites. It’s controlled by the lactulose to some degree so you won’t be getting any of what’s behind door #2 and Denis the Menace’ cookie jar.

Better yet, try a dumpster dive into your VA VistA records-the ones you dutifully collect from ROI to send in to prove your disability. DC 7312 calls it “erosive gastritis”. Everyone in real medicine calls it GERD. You’re eating omeprazole like candy corn to control it. VA denies a 100% rating because you don’t have erosive gastritis refractive to treatment. Or how about varices refractive to treatment. Or ascites. VA calls ascites ‘trace free fluid in the abdominal cavity’. Six of one or half a dozen of the other everywhere else in the medical universe… except VA. I suppose if you filed for GERD, they’d just turn that argument on its ear and say “Dude, you have erosive gastritis. That’s not the same as GERD. Denied.”

So, it’s back to the IMO factory to get someone to say erosive gastritis = GERD and the trace fluid is ascites. It’s still going to be another trip to the BVA for them to wave their magic wand. These are just a few of the simple tricks VA resorts to in order to defeat you with. But, you can get off this merry-go-round if you’re smart.

Here’s the latest and fastest pathway to SC I can offer. It works right now but that’s not to say they can’t give the rug a tug and jerk it out from underneath you in the future. Start with filing it. VA made that harder, too. If you have filed and lost within a year, you will have to use the new VAF 995 Supplemental. If you filed more than a year ago and lost, you’ll be forced to use a VAF 21-526. At the dawn of time, you only filed one (1) VA claim on a 526. After that you could use a 4138, toilet paper or Standard Form 8.5×11 (white). The operable metric was that it had to be legible. In 2015, that all changed. The NOD 958 came out and no more toilet paper was permitted. No more 4138s as a claim for increase. AMA went even further. Now, it’s a crap shoot. Use a 526 after more than a year and they’re just as liable as not to say “Sorry. Wrong form. Please check your accompanying VA 20-0998 and pick the correct form.  I send in both and it really messes with their heads.

With the advent of the AMA, more forms came out as discussed above. If you do not check off the little box in Block #16 on a 995 that says you’re aware of the §5103 info, everything comes to a screeching halt. They’ll send you a new one (after a month) and ask for it to be signed by you or your sword bearer at VFW. Shoot, even if you do check the box, the odds of getting one of those §5103 requests in next month’s mail are way better than winning the lotto. I see them pop up in VBMS and send in the acknowledgement  lickety spit the same day. Apparently that causes confusion because they postdate them and look into the future a month out for your response-not the same day. Bingo. Thirty day delay minimum. You’d think you could outwit them by just filling out a stock §5103 and sending it in with the 995 or the 526. No way, GI.

How about you get a client’s POA and file a 526 for his ___________. Wrong. You-even though you are now legally driving Fred’s claim boat and have his POA- are forbidden to file the first 526 without his signature. Yep. 30 day delay kicks in for them to send it back and ask Fred for his Fred Handcock in block 33a. I get around that by just having my clients sign one and I put it in the file. If you sign below in block 37A-even though the  client signed it, you go to 526 jail for a month because only the client is allowed to sign it. I usually have to look up the chowderhead employee and send him an email saying the client signed it so no harm-no foul.  You see where I’m going with this? Each form has a punji pit that gains VA another 30-60 days to frustrate your filing. It does nothing to impede your effective date. It merely guarantees delays for any baksheesh you’re due. I could go on and on about these asinine little quirks. VA should coin a new word for this. How about asiten or asitwenty.

So, you file and it’s all plugged in. They promptly send you a VAF 21-4142 or 4142a and ask you for permission to get your private med recs from your doctor. But wait. Asiten kicks in. At the top of the form it says don’t use this if you want it done in the 21st century as it may cause up to a one year delay. Best to go get them yourself. Ever since the advent of Obamacare, everyone charges for sending your records to other physicians… or VA. Especially VA. What the hey? They’re government. They have tons of money right? Wrong. VA refuses to pay for copies of the very same records they asked you for permission to fetch. You foolishly think they got them (because they’ll never tell you they didn’t) and you lose. I could go on and on about that one, too. I found out myself the hard way. I discovered it in my claims file twenty years later. My doctors sent VA the $151.09 bill for the records and they sent a reply back- basically a laughing emoji with tears in its eyes… holding up its middle finger.


So, you lose. You come to me or an attorney. I file you again with the minimal required. I submit the 995 (w/§5103 checked just for shits and grins) and an IMO. VA of course denies because we all know a Board certified MD with 35 years of medical practice has shit for brains. VA’s nurseynurse NP with a two-year practice at QTC knows a shit ton more about all this. No sweat. You file the 10-182 NOD to the Board and remodel the kitchen for a couple of years while you wait. When you do win-and you will- it begins all over again with the 0% program. You have to refile a  995 and ask for a higher rating. You have to obtain evidence that shows you’re entitled to a higher rating. Your own doctor will have to get involved. Even then it’ll be the incremental game of 10%, then 30% and six years later after a real donneybrook-maybe the 100% or TDIU you should have  gotten this year. Welcome to the new, improved AMA, soldier. You can thank the Big Six VSOs for this new denial technique. They’re the ones who dreamed it up.

The teaching moment is how to outwit these jellyheads as quickly as possible. Remember, they will send your efforts up to a DRO for a quick way to reduce you without reducing the underlying combined rating on the first outing. Next, they come back 4 years and eleven months later and say you’re all better. Bye bye TDIU and the fight begins anew. You don’t even know you got screwed.

One technique I use is to flip the selector lever from semi to rock ‘n roll and start spraying the claims at them to let them know this can, and will, only have one ending- P&T. If they deny you saying you don’t have erosive gastritis, file for it. Get you local physician to state it’s the same as GERD. Get it in writing. Get the shit for brains VA doctor to say “ascites” instead of “trace amounts of free fluid near spleen”.

The best bet is to get your IMO doctor to cover any and all symptomatology in one nexus letter. Everything. Each and every symptom associated with the condition should be tied back to the index disease-not just the index disease. If you’re gonna pay $2 K for the magic paper ($10K if your using Hadit’s go-to guru on IMOs), you might as well get them to write it all in there. The cost is the same regardless if you use quality doctors. Well, it is using my IMO outfit. I hear tell it’s on a sliding scale elsewhere- $1000 for the Hep C dx IMO, $1000 for the GERD dx, $1000 for the ascites, $1000 for the varices, $1000 for the hepatic encephalopathy etc.  In fact, one thing I’ve seen in this business is the folks who offer to look under the hood and throw in the IMO for the DM II, the Prostate cancer and the Parkinson’s while they’re doing this. Of course, that’ll be another $1000 each for those too. But why not the hemorrhoids, the flat feet and the tinnitus while you’re there, right?  Wrong. The fact is, if you have all that shit wrong with you, you only need to win a couple to get to the 100%. Everything else is generally a waste of time (and $) after SMC S so why pay $15 K when you can only benefit from $2 K worth. It reminds me of the car salesman asking if you want all the extras like the electric ass scratcher and the autotune for your FM radio.

It used to be I always went to the BVA with my IMO for my win. Now, with the AMA, it’s better to just throw down with your most excellent IMO at the local Puzzle Palace and let them deny it. Nowadays, they are going to deny it even if Jesus supplied you with a buddy letter. Worse, it takes 2-3 years if you use the “hearing” or “evidence” lane at the BVA for your NOD. You know as well as I do that the pathetic attempt at denial below is unsupported and they don’t even bother to go through the motions of citing to peer-reviewed articles anymore. It’s basically ” There is no correlation between the Veteran’s DM II and his peripheral neuropathy in all four quadrants nor the erectile dysfunction because I said so. These problems all began before he was dx’d with DM II so the etiology is due to a different cause. What that might be, we have no clue but VA didn’t pay us to deny based on that theory…yet”

You can benefit by having your IMO already denied at the local shit show and have  the VLJ grant it above using the direct lane far faster than any other path now. When I say now, I mean since July 2021. About that time, the VA seized up. The BVA is so overwhelmed, they can’t see the windows for the filing cabinets. As for HLRs, I’m trying to have a rational discussion on solutions here- not more obfuscating to delay/deny/derail your claims. All my HLRs end with a new rating decision and an interminable delay that begins with a new 0% chase to refile over…and over… and over. That’s what this is all about. You won but you’ll have to file a supplemental to actually get any $.

In sum- file. Get denied. File IMO and get a cheapo depot denial and proceed to the BVA checkout. Win. Lather, rinse, repeat until desired results are obtained. If they give you shit, start throwing a lot of rocks for everything you can dream up until they cave in and you get the P&T.

If IMOs were Bloody Marys, this is what mine look like.

Posted in HCV Epidemiology, hepatitis, Higher Level of Review (HLR), Tips and Tricks, VA Agents, VBMS, VBMS Tricks, Veterans Law | Tagged , , , , , , , , , , | 11 Comments


I’ve been meaning to put this document out there for the seasoned warrior and the naive novitiate alike. Anytime VA  stamps it controlled unclassified info- for internal use only, it’s time to download a copy for your own perusal. This I have done. I’m surprised they didn’t stamp it NOFORN, too.

I’m sure some breathless jellyhead from Hadit will arrive diiirecly and declare it’s a fake or unsubstantiated Russian disinformation to denigrate certain VA MD/JD IMO authors. They still haven’t even acknowledged the validity of the VA IMO shitlist yet. Yeppers. That VBN disease is spreading. If you don’t like what you members write, strike it down with your Jedi might. I assure you. The provenance on this puppy is good to go. There are some interesting tidbits for all diners-professionals and pro se alike. But alas, no sordid tales of witch doctors casting dem chicken bones and adducing your ills. Besides, we’re unwoke around here. We don’t censor you.


NWQ Playbook 1 and 2

Posted in Tips and Tricks, VA Agents, vA news, Veterans Law | Tagged , , , , , , , , , , , , , | 1 Comment