SPAMBOT GOT IN

Sorry for all of you not being able to comment or use the site. I inadvertently uploaded a spam bug on the Mars v. Venus thinking post and it caused the site to seize up. It took 24 hours to get the WordPress police on it. Problem solved. Even though I take full responsibility for it, in the future if you send me something to post, try to ascertain if it’s clean beforehand. Your help with this would be appreciated in advance.

The Hired Help.

Posted in General Messages | Tagged , , , , , , , | 1 Comment

New medical coding: Out with the old: Amputation; in with new: Detachment

Here is a change veterans should be aware of:  The VHA, like all health care stakeholders, is implementing the Tenth Revision of the International Classification of Diseases (ICD-10).  The government-wide conversion deadline is 10/14.

The ICD-10 is far larger and detailed.

ICD-10  Clinical Modification (ICD-10-CM) will go from about 13,000 codes to about 68,000 available codes.  ICD-10 Procedure Coding System (ICD-10-PCS) will go from about 3,000 codes to 87,000 available codes.

This change will impact veterans’ claims in the future.  A 21st Century System for Evaluating Veterans for Disability Benefits (2007), by the Board on Military and Veteran Health, provides an overview of the ICD and VA schedules.  For example, “Raters must match conditions in the medical records to the proper diagnostic code in the Rating Schedule.(p. 263);…VA provides flexibility by allowing the rater to use an analogous condition as a guide for determining the rating percentage.”

The Rater’s schedules only have about 800 codes, many of which are outdated. Veterans lucky enough to have a rating may want to learn about the new diagnostic codes.  Errors are sure to multiply.

Click the image below for a brief discussion of PTSD diagnoses comparing the ICD-10 and the DSM-IV.

PTSD Diagnostic Criteria

Click image to go to VA.

The terminology in the new ICD can be bizarre.  Living babies delivered by all means are now objectified with the term “products of conception” in the ICD-10-PCS.  This bothers me.  Will people with terminal illnesses be referred to as “products of terminal illnesses” in the future? 

New terms, new world?
“Ahhhh, it’s a female product of conception.”

Well, coding is another huge topic.  The resource quoted above is a free download or it can be read or skimmed online.  Scroll down to see the Table of Contents.  Sample chapters:

4 The Rating Schedule

5 The Medical Examination and Disability Rating Process

6 Medical Criteria for Ancillary Benefits

Another good resource:

Private search engine: http://www.icd10data.com/

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VA GUN SCARE– IT’S A CONSPIRACY

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Every time I get one of these in the mail, I immediately digest the entire website to make sure I’m not being inveigled into promoting some goofball “Holes in the Poles” theory about where the aliens park all their spaceships and do the  5 million light year/50,000 hour maintenance under the hood.  Come on. I don’t want to belong to the E Pluribus Unum Club with the “one eye on the pyramid” logo.  Read some of the stories to get a feel for it. I’ve been sucked in by a few. They’re like black holes-plausible at first but then you feel like you’re in Oz, Kansas.

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So if they have stories like “Use this single loophole to avoid paying taxes (HD video-$9.95), see if the guy’s last name is Madoff. If it  has articles like “Bill O’Reilly finds who killed Jesus”, move your wallet to your front pocket and leave.

I only have enough time to fight for Veterans and try to stay alive. Add in farming and it gets crowded. If I had to join the tinfoil hat club, I might have to give up one of the others. So what should the emailbox regurgitate but 8 tiny reindeer attached to a bunch of cc’s informing me that VA now requires you to give up your guns. Not. I don’t care if everyone you know is digging an underground bomb shelter/gun storage for the Last Days. It’s coming but not for a while.

Let’s read this like good ol’ boy Jeff Foxworthy.  You may be incompetent :

if you are unable to find your way to the supermarket.

if you are unable to find the trail of breadcrumbs you left to help you get home from the supermarket.

if you are unable to remember which jacket you left the Glock .40  in.

if you can’t remember if you ever wear jackets.

if you have someone else do your finances.

if you can no longer spell finances.

if you wear adult diapers and drool a lot.

if you are not actively involved in the changing of the above diaper.

if you can’t remember your wife’s name.

These are clues to warn you about being incompetent. If you fit this category, VA is instructed to get you a fiduciary or see if one of your family members can do it. Family is probably better if you are worried about theft. VA has a pretty spotty record on that fiduciary-appointing business. Best someone in your own family takes you for a ride than a total stranger. That way the clan benefits as a whole.

So, you get the idea. You’re no longer a candidate for Mensa. Chances are, you probably shouldn’t be toting anything more lethal than a butter knife. VA knows this. You know this. Chances are your wife/daughter/ fiduciary knows this. They may have already taken precautions and removed the lead lollipops.

Much ado about nothing. The sky is not falling. Chicken Little is a bit premature. The VA is not going to suddenly turn you in to the FBI. What will happen is that your name will be entered into the Honorary Adam Lanza Memorial database as one who should not be allowed to own or possess firearms. It does not encompass Vets with PTSD-yet. The operable word is “yet”. Gun control is a gradual process like moss growing on your roof. One day you look up and it’s green instead of grey. I can see them getting their fair share of the hairy eyeball soon but not today.

This isn’t a conspiracy to take your rights away. It’s a concerted effort keep guns out of the hands of crazies. You have to start somewhere. VA is simply helping to compile their portion of a database for national consumption. If it ended there, it would be okay. A conspiracy consists of silent, dark night hand offs and subterfuge. VA isn’t hiding what they are up to. It’s what they will start doing openly to the large cadre of bent brain Vets some day that is of concern. Will they or can they adjudge this group as mentally unbalanced to the point where their 2nd Amendment rights may be abridged? That’s an interesting discussion for another day.

I guess I don’t have to mention how this will cause a lot of servicemen to think twice about claiming PTSD with the inevitable outcome of deprivation of their constitutional right to keep and bear. Pretty tricky, huh? Chances are the VA just found a cure for the disease and doesn’t even know it.

VA IS THE FOX NEWS

OF CLAIMS ADJUDICATIONS

YOU REPORT

scWE DENY

Posted in vA news, Veterans Law | Tagged , , , , , , , , , , , , , , , , | 3 Comments

VETS DYING WAITING FOR BENEFITS MORE FREQUENTLY

Yowsers. From Membress Shawn who is Law Bob’s girl Friday, we are showered with these two sad articles.

VA promised us something when they set up shop two hundred years ago. They aren’t performing for anyone but themselves. You notice the Orlando Learn and Play Vacations go off without a hitch unless VAOIG catches wind of them. Same for all those bonuses at the Central Office. With that much efficiency, we should be able to accomplish claims in two shakes of a lamb’s tail.

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C-123s AND AGENT ORANGE PHASE II

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I received this in the pipeline from the $1,23 crowd.  I refer to the second generation of Air Force Nasty Guard and Irregulars who were handed the old RANCH HAND C-123 Providers after the war. The list doesn’t stop there. Some were converted into air drop tankers for forest fires and the gift of AO just kept on giving. Dioxin and Picloram are very heavy metal solutions. They never lose their strength until diluted  innumerable times by the elements. Even then they only percolate to a certain depth. Their legacy lives on for many future generations when they percolate into the water table. This is science-not conjecture. Monsanto has been examining this phenomenon since 1957.

Read this and weep. VA, in their unending battle to absolve the government of any culpability, refuses to acknowledge that the above is true. When accosted with unassailable proof that C-123s were awash in it, they opted to hire their proctologists and foot doctors to opine on matters chemical. Independent IMOs are all well and fine but VA always seems to go to the same closet for theirs. Oddly, they all seem to support the VA’s theories every time. Rarely does the Vet or Vets as a  presumptive group win this war of words. Why is that? Read on.

From Steven Avery (Vets atty):

In a stunning rejection of American science and medicine, on January 10, 2013 VA officials trashed the input of expert scientists and physicians who’d earlier challenged the VA’s rejection of C-123 veterans Agent Orange claims. The VA flatly (but graciously!) dismissed or simply ignored vital concerns raised by the outside experts, and continued to defend VA’s initial, unchanging, knee-jerk, automatic and characteristic refusal to permit C-123 veterans to receive medical care. Please – we need both an attorney and a scientist to articulate a response to this recent VA letter…ideals on where to find such talent?

None of the independent experts were paid for their review of the situation and development of opinions. All of the VA personnel were paid to reject the outside experts’ opinions. The VA response is amazingly flawed, both in the science and the law, and a more detailed rebuttal of it will follow soon. The key errors we’ll point out now are as follows:

1. We do not contest the VA’s perspective that we are not a presumptive eligibility population, but rather are individually eligible to submit justified Agent Orange and military herbicide exposure claims. However, the Secretary has the authority to designate these veterans as a presumptive eligibility population, and the Secretary of the Department of Defense has the authority to designate, even retroactively (because all the airplanes have been destroyed) the fleet as “an Agent Orange exposure site.” Still, the simpler and more precisely-focused definition of this population is to permit individuals to be recognized for exposure by acknowledging the contamination of the aircraft and the fact of exposure, to be established by the individual’s proof of service such as flight orders, Form5s or other official documents associating the individual veteran with the airplane within the 1972-1982 timeframe, thus avoiding creation of a presumptive eligibility population

2. VA rejects wipe-based sampling, yet this was (and is) simply the gold standard scientific method for such testing, and it determined the C-123 to be “heavily contaminated.” In such testing, surfaces were not “rubbed” as the VA letter states, but to prevent surface agitation the wipe method requires simple gentle wipes, as the word implies – only VA challenges this procedure which has been accepted by the EPA, NIH, CDC and appropriate regarding the C-123 contamination studies

3. The wipe samples consistently proved presence of dioxin and military herbicides, and the VA’s characterization of the amount or degree of contamination as “residual” or “trace” is word-smithing meant to minimize or totally dismiss the scientific results of the Air Force’s own testing over several decades

4. The VA references to testing which establishes contamination many decades later is similar word-smithing to dismiss actual results: In truth, tests were conducted (but ignored by the VA) in 1979, fourteen years after that particular airplane’s last Agent Orange spray mission, and the tests confirmed military herbicides and dioxin contamination. VA ignores the fact that the veterans began flying these airplanes in 1972, thus the contamination was more concentrated when considering the half-life of dioxin on surfaces

5. VA tries to redefine both science and law in this letter. Science states that “exposure is the contact between a chemical or biological agent and the outer barrier of an organism.” Thus the veterans are exposed if their skin touches a contaminant, even if it is the VA’s hypothetical “dried dioxin.”

6. The pertinent laws and Code of Federal Regulations state that veterans outside the “boots on the ground” presumptive connection, such as the C-123 veterans, will be similarily protected.  When VA promulgated its herbicide presumption in 2001, the issue of herbicide exposure outside Vietnam was also addressed.  66 Fed. Reg. 23166 (May 8, 2001).  VA explained if a veteran did not serve in Vietnam but was exposed to an herbicide agent defined in 38 C.F.R. § 3.307(a)(6) during active military service and has a disease on the list of presumptive service connection (which includes diabetes mellitus type II and ischemic heart disease), VA will presume that the disease is due to the exposure of herbicides.  See 66 Fed. Reg. 23166; 38 C.F.R. § 3.309(e).

7. The VA dismisses the scientists’ insistence that the C-123 crews warrant VA benefits for exposure to military herbicides, yet that phrase is the one used in the law and the C.F.R.s. Nonetheless, the multitude of Air Force tests establishes the dioxin contamination of the C-123 fleet

8. VA mentions dismissively that “some” of the C-123 fleet was contaminated; in fact, 42% of the C-123s flown were former Agent Orange spray aircraft; in fact, only two of the eighteen remaining airplanes at Davis-Monthan were free of dioxin contamination at the tine of the fleet’s destruction as toxic waste in 2010

9. VA continues to ignore the vital facts that the veterans duty on the C-123 was for a full decade, and scientific tests show long-term, low-dose exposure to dioxin is extremely harmful

10. VA continues to ignore the fact that crews flew these contaminated airplanes the year (1972) after the last Agent Orange spray missions (1971)

11. Here, as ever since the veterans’ concerns were raised, the VA ignores the confirming opinions regarding exposure submitted by the CDC/Agency for Toxic Substances, the EPA, and the NIH. VA references their scientists and medical doctors (who only completed a literature review, in which publications which confirmed veterans’ exposure were ignored) and altogether ignores those of other federal agencies, universities and institutions. VA even makes reference to literature in their denial argument, some of which was authored by scientists who have concluded the veterans were, in fact, exposed

in their literature review meant to deny veterans exposure

12. The VA response completely dismisses all post-application exposure claims, which are actually well-founded in law, C.F.R.s, BVA, Court of Veterans Appeals citations…and science

13. Despite the fact that C-123 veterans’ exposure claims have been vetted by the American Legion and the Vietnam Veterans of America, VA insists there isn’t even enough “benefit of the doubt” to permit claims

14. Despite the fact that C-123 veteran’ exposure claims have been vetted by numerous physicians and scientists, to include members of the National Academy of Sciences, VA insists there isn’t even enough” benefit of the doubt” to permit claims

15. Despite the fact that the federal agencies responsible for making determinations regarding contamination and exposure have vetted those issues regarding the C-123 veterans, VA insists there isn’t even enough “benefit of the doubt” to permit claims

16. Despite the fact that the VA’s Board of Veterans Appeals has eventually recognized USAF Reserve C-123 veterans’ claims from the same units, and same bases, and same time frame and awarded service connection, VA insists there isn’t even enough “benefit of the doubt” to permit claims

he VA is dedicated to preventing C-123 veterans’ claims. It is our just and proper role to energetically advance our claims, but we are amazed that the VA is equally dedicated to preventing these claims rather than finding the proper channel to allow them to proceed. The VA is dedicated to preventing C-123 veterans’ claims…they should be dedicated to doing what is right and proper under the law.

—-VA’s response to the fifteen scientists and physicians joint letter to Under Secretary Allison  “Chipmunk” Hickey—-

Dear Dr. Stellman:

I am responding on behalf of Allison A. Hickey, the Department of Veterans Affairs (VA) Undersecretary for Benefits. Thank you for the letter expressing your views, and those of your colleagues, on the important matter of Agent Orange herbicide exposure and its relationship to Veterans who served stateside aboard C-123 aircraft previously used for aerial spraying of Agent Orange over Vietnam.
It appears you question the scientific analysis on this issue provided by the VA Office of Public Health and believe disability compensation should be based on evidence of dried dioxin residuals present on the interior surface of a C-123 aircraft. We appreciate your interest in this group of Veterans and the information you have provided. It will be considered as a source of evidence when adjudicating claims from this group of Veterans. However, we must also consider the evidence described below and must follow the laws that govern disability claims based on Agent Orange exposure. All claims are evaluated on a case-by-case basis.
Disability compensation provided by VA must be based on establishing service connection. This requires evidence of a current disability, evidence of an injury, disease, or event in service, and evidence of a medical nexus or link between the two. When Agent Orange exposure is claimed as the basis for the current disability, there are two routes to service connection. If the Veteran’s service falls under the Agent Orange Act of1991, which establishes a presumption of herbicide exposure for service in Vietnam, then the Veteran is eligible for service connection of diseases associated with such exposure by VA without the need for a medical nexus. Service aboard post-Vietnam C-123 aircraft does not meet the requirement for Vietnam service and so there is no presumption of exposure for these Veterans. Therefore, the alternative route to service connection is required which involves evidence of direct exposure on a facts-found basis.

The evidence associated with service on post-Vietnam C-I23 aircraft shows that some of these aircraft contained dried residual traces of the Agent Orange herbicide contaminant dioxin, which could only be obtained and measured by rubbing the interior metal surface with the solvent hexane, You have stated that the dioxin obtained by this process is sufficient to establish that the crewmembers were “exposed.” However, the scientists and medical doctors of the VA Office of Public Health have documented with scientific literature that residual trace amounts of dioxin on metal surfaces is not biologically available for skin absorption or inhalation because it is not water or sweat soluble and does not give off airborne particles. As a result, they have concluded that the likelihood of dioxin exposure was minimal, Your view of potential exposure must be weighed against their view when VA evaluates a disability claim.
In addition to the issue of potential exposure, there is the issue of establishing a medical nexus or link between the in-service event of flying on a post-Vietnam C -123 aircraft and development of a current Agent Orange exposure-related disease. VA laws and policies related to Agent Orange exposure, whether presumptive or based on facts-found evidence, address exposure contact that occurs during the actual spraying or handling of the dioxin-containing liquid herbicide. There are no provisions for secondary or remote exposure, as is the case with dried dioxin residuals on metal surfaces found many years after the liquid state. The scientific evidence available to establish a medical nexus in these cases is limited and the VA Office of Public Health has provided a medical opinion that it is insufficient to establish the required nexus. While your letter focuses on the issue of potential dioxin exposure, it does not offer an opinion on the medical nexus issue nor does it address the potential for long-term health effects or disabilities resulting from service on the post-Vietnam C-123 aircraft.
Another issue you raised is the wording of the Agent Orange Act of 1991, which establishes a presumption of exposure to “herbicide agents” used in Vietnam that includes chemicals other than dioxin. You state that consideration should be given to these other chemicals when considering disability compensation based on exposure because they may have been present in the post-Vietnam C-I23 aircraft, However, since there is no presumption of exposure to any herbicide agents without Vietnam service, this legislation is not applicable. Additionally, the National Academy of Sciences’ Institute of Medicine, which is named in this legislation as a major source of scientific information related to herbicide agent exposure and its adverse health effects, has determined that dioxin is the primary “chemical of interest” associated with adverse health effects. If a disability claim were based on exposure to other herbicide agents, the same evidence of direct facts-found exposure and a medical nexus would be required for service connection.

We appreciate your input and the evidence you have provided on the issue of disability compensation for Veterans who served aboard post-Vietnam C-123 aircraft. When VA receives claims from Veterans based on this service, they will be evaluated based on the totality of the evidence, as described above, and determinations will be made on a case-by-case basis.

Sincerely,
Thomas Murphy
Director, Compensation Service

Oh well. Back to the drawing board. This shouldn’t come as any big surprise  Just when VA was looking to put the AO monkey back in the cage, out pops his offspring- SON of AO. What few realize is that all that AO in the bottom pan under the floors is not just AO. There’s undoubtedly an accumulation from earlier years of all the other flavors like Pink, Green, Purple, Blue and White. Disturbing, huh?

Posted in AO, Medical News, Nexus Information | Tagged , , , , , , , , , , , , | 2 Comments

THE CIGARETTE POLICE

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Once upon a time in sunny southern Orlando (1994), the Nod Family made their second pilgrimage to Disneyland. Unaware at that point of the growing dragon within me, I still drank and smoked.

One of my enduring joys was to savor the early morning and enjoy coffee and newspaper then perform my ablutions.  Sometimes, not having finished the paper, it was not uncommon to take it to the library. In those unholy days, we still smoked virtually everywhere. “Politically correct” was not in Miriam Webster yet.

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One morning several days into our vacation, I had occasion to visit Disney’s finest restrooms prior to launching into the Paris theme. We were all gathered outside said rooms and preparing for the onslaught. I opted to use the facilities one last time and Cupcake happened to point to the sign that said “No smoking in restrooms”. Note that it didn’t say “strictly enforced” nor did it mention anything about it being a major infraction  comparable to burglary or Grand Theft Auto. Nowhere in there was a discussion of just  what the meaning of “no” really is. I say it’s rather ambiguous. I told Cupcake jeeringly     ” Oh, yeah.What’s going to happen? I suppose the cigarette police are going to arrest me?”

I proceeded to settle in and lit up. I was rather engrossed in reading when the smoke alarms started going off. I quickly doused my cigarette and prepared to retreat. As I exited the stall,  several of Disney’s finest approached and asked if they could have a word with me outside. The alarms were absolutely earsplitting and made conversation all but impossible. I exited with one on each side and we had a discussion outside about how I had inadvertently missed the sign. I pointed out that I was reading the newspaper when I walked in. We moved back to better view the sign and clarify the meaning. About that time I noticed the flashing red light on the roof of the structure. As with all buildings at Disneyland, the loo was built to look like a French bakery or the entrance to the stables.  I’m virtually positive that the light blended in beautifully with the architecture-when it wasn’t ablaze.

After profuse apologies and promises to be more aware of my surroundings,  a careful check of my ID, and confirmation that I was a legitimate paying visitor, I was allowed to rejoin Cupcake and the children. They were in quite a lather. Actually lather doesn’t adequately describe what was going on. Perhaps ROFLOAO (plural?). They had front row seats on the park bench  directly across from the entrance/exit and watched the whole Keystone Kops Komedy unfold. For the rest of the vacation- indeed often in the months and years afterward, Cupcake would look at me with a quizzical pursing of the lips and whisper “cigarette police?” followed by gales of laughter. Worse, my children did it too. In fact, they did it in front of their friends who also seemed to know who the Disney cigarette police were. It is only now, with the passage of almost 20 years, that it is a rare occasion when this comes up in polite conversation-if ever.

After several years of counseling, I was able to hold my head up and meet others’ eyes. Men hate to admit they’re wrong. What’s more, many often don’t believe the rules were written for them specifically. I belonged to the latter class.

Yesterday, Cupcake and I went to see the liverbox gurus to beg for my life. I refer to the Sofosbuvir Phase II testing protocols. While searching for a place to park, I found a really nice spot and prepared to scoot in. Cupcake pointed to the sign that said “Big Bozo No-No” and I prepared to elaborate on why that fortunately didn’t apply in our case. Suddenly, the pursed lips appeared out of nowhere  followed close behind by uncontrollable mirth. Yes, the dreaded cigarette police had been invoked. I promptly put the car back in gear and moved. I saw no reason to follow Custer to the top of the ridge and die on that hill.

No bozos

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WIRELESS TECHNOLOGY

A bird’s view of wireless tech via Law Bob:

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Posted in Humor, Uncategorized | Tagged , , | 4 Comments

CAN’T WE ALL JUST GET ALONG?

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Remember poor old Rodney King down in LA? That started a riot of epic proportions that Los Angelites will long remember. The plaint was to quell the populace and coax Pandora back into her box if at all possible.

In this context, I ask it of Gilead Sciences Inc.  and  Bristol-Myers Squibb. The two drug giants have both come close to kicking ass and taking names on HCV. It won’t help some of us but there may be many who will heal. The problem is that Gilead’s kids and the B-MS youngsters can’t seem to all play in the same sandbox.  B-MS is willing but Gilead will not be rolled. I think there’s too much testosterone in the room and Gilead is convinced theirs is the better product. Collaboration is not for discussion. There’s simply too much money on the table and greed is more important than lives.

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Perhaps this ad came out  in anticipation of the problem about how to divvy up the pot. So, as usual, the little guys get the short straw. By the time they agree on collusion, another 100,000 of us will go down the tubes. Smokin’!

Ed. note: This is the one. This is the koolaid without Interferon. Used in conjugation with Ribavirin, it is an oral pill rather than injection. 12 and 16 week course to SVR.  No more going blind, coming down with thyroid problems, DM2 and fibromyalgia. Pending FDA approval, Gilead’s will be out in 2014. It would be nice to get them together, but in the interim, I’ll take the next bus and it happens to be Gilead solo.

Posted in HCV Health, Medical News, research | Tagged , , , , , , , , , , , , | 8 Comments

VA PTSD SUICIDE STATISTICS FOR 2012

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Hot off the press. Find out who, where and when. The why is pretty much a foregone conclusion.  A big thank you to Bob for this one. Perhaps this will also help in spotting trends that develop geographically or by age group. Or maybe it’s merely the Book of the Dead. One thing is a given. If the VA is the author, it’s going to read like Grimm’s Faery Tales or have some colorful pigs in the story.

Mr. Brock's claim

And they all lived happily ever after.

Posted in Gulf War Issues, PTSD, vA news | Tagged , , , , , , , , , , , , , , , , | 3 Comments

IHOP IS RUNNING A SPECIAL ON SENIORS

From whom else but the Tomster

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So is the Big Bear car wash

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Get an additional 5% off by showing your VA card.

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