BVA–HBV DUE TO COMBAT BLOOD EXPOSURE

Posted on January 4, 2013 by asknod

I love to read these. VA, in its haste to deny the Vet, sometimes forgets to read it’s own rules and regulations. They publish untold volumes of risk factor questionnaires but when it comes time to apply those assumptions, the VA examiner suddenly becomes non compos mentis  and wanders off the reservation.

Here’s a classic presentation

As per the S[T]R, [the Veteran] had no history for risk factors to contract hepatitis B infection. He also had no documented diagnosis and treatment for hepatitis B in service. As per the C file review, back in October 28, 1988 during blood donation, he was told by American Red Cross society that he had hepatitis. He had test for hepatitis here at Beckley VAMC back in 11/13/2003 and turned out hepatitis B positive and hepatitis C negative. The Veteran reports that he may have been exposed to this infection during transferring the dead body, but unfortunately, as per medical literature, this is not a risk factor for contracting hepatitis B infection. Therefore, as a medical professional[,] I can not tell how, when and where he [was] infected by Hepatitis B virus. Bllood [sic] work up on June 19, 2012 revealed negative for hepatitis B infection.

The Board finds that the July 2012 VA medical opinion is inadequate for rating purposes. The examiner asserts that medical literature does not support “transferring [a] dead body” as a risk factor for contracting hepatitis B infection. Yet, the Veteran has testified to open skin exposure to blood and bodily fluids. VA’s own questionnaire cites “contaminated blood or fluids” as a potential hepatitis risk factor. The Board has also self-researched information published by the Center for Disease Control (CDC) which states that hepatitis B is usually spread when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enters the body of someone who is not infected, which can happen through direct contact with the blood or open sores of an infected person. See http://www.cdc.gov/hepatitis/HBV/PDFs/HepBAtRisk-BW.pdf.

A review of the July 2012 opinion does not reflect that the VA examiner considered whether the Veteran’s transferring of dead bodies involved direct contact with the blood or bodily fluids of deceased service members, as reported by the Veteran. Some literature reports that the hepatitis B infection can live for up to a week outside of the body, which reflects that a dead soldier could still be infectious. See

http://hepatitis.about.com/od/questions/f/Virus_live.htm.

If you plan on blowing smoke rings at the BVA, they better be perfectly round. Here,  a  BVA-requested IMO comes back tainted in spite of its “impartial” nature. Any time VA is involved with the C&P, be prepared for the worst outcome possible.

Posted in BvA HCV decisions | Tagged , , , , , , , , , , , , , | 1 Comment

BVA–WHY WE ALWAYS ADVOCATE APPEALING

Posted on January 4, 2013 by asknod

Here’s a classic that looked like it was heading for the willful misconduct waterfalls. Lo and behold, a true example of a “Benefit of the Doubt ” dance ensued and the Vet wins. I will note that this often happens when a Veterans is given the 1154(b) combat enhancement consideration. Here it proved invaluable in carrying the day.

All the tea in China and an armload of tattoos will not guarantee a win at the RO. These things are very, very rarely decided there. They almost always end up at the BVA. Here, it was because of the innuendos of drug abuse which, you will note, take up all of one sentence and are never mentioned again. This leads us to believe it was one of those fanciful insertions into the VISTA files as in…

VA nurse: ” Sir, are you taking any other prescribed medications or supplements?”

Vet: ” Yes, I take Vicodin as needed for my back pain and Geritol”.

You then read in your records years later: “Vet admits to using prescription-strength pain medications frequently”. You notice they have now dropped the word “prescribed” and it now is a bald admission of drug abuse. Don’t laugh. You have no idea how many Vets have gone down this road. On our Delphi Boards there is a Vet who has returned frequently over the last five years who goes by Codestar 7. He constantly relives yesterday and refuses to reopen his claims for HCV and residuals of IFN treatment. He bemoans a negative reference to drugs in his records as well. My advice is to ignore it and keep moving. One admission in the records erroneously inserted can be corrected. A UCMJ rap sheet that runs on to two pages will be an issue.

More importantly, the Vet kept his story straight and had the combat 38 USC 1154(b) enhancement. Everyone loves a hero. A Purple Heart and a Combat Infantryman’s Badge do not come out of a Cracker Jacks Box. Well, unless your name is John Kerry and you spend a lot of time shooting M-79’s into stumps to “see what it’s got” they don’t.

Learning how to win is not nearly as difficult when someone bothers to explain the rules to you. VA doesn’t, never has and I doubt they ever will get a bad case of remorse and change their ways. DAV’s logo is on this but I suspect the Vet has much to do with the win. Considering its from Houston, I’m surprised the Texas (White Hat) Veterans Commission doesn’t have their fingerprints all over it.

 

Posted in BvA HCV decisions | Tagged , , , , , , , , , , , , , , , , | Leave a comment

19,500 Vets die waiting on VA benefits…By the numbers.

Posted on January 3, 2013 by joeaveragevet

“Delay, Deny, Wait till the Veteran dies” is not just a VA slogan any more.    The number of Veterans who die waiting on VA to process their benefit application has tripled, according to this San Francisco Chronicle article.   It has risen in the past 3 years from 6400 Vets to a whopping 19,500 Veterans who perish in the million man backlog of VA benefits.

Worse, the number is actually higher, according to Bergman and Moore, a law firm which represents Veterans fighting the VA for benefits.

Isn’t it time Congress actually acted, and forced the VA to do what they should have been doing all along, and actually keep Abe Lincoln’s promise to Veterans?

This means that 53 Veterans die EVERY DAY waiting on the VA to processes his benefit claim.

It takes 262 days for the VA to process a Vets claim, according to NBC NEWS.  

In that 262 days,  more than 13,000 MORE Vets will die before their claim is processed by the VA.

You are more likely to die waiting on VA to process your benefit claim, then you are to die in the war in Iraq or Afghanastan.    Just compare the numbers.  It isn’t even close.

Posted in Guest authors, VA BACKLOG | Tagged , , , , , | 2 Comments

THE PERFECT STORM–AGAIN

Posted on January 3, 2013 by asknod

Squidster sent me this disturbing article tonight. It brings back so many memories of friends who decided they couldn’t hack it back in the 70s and punched out. Sadly, we have the perfect storm once again brewing in Iraqistan. Soldiers come home and recieve the “get in line” briefing. After a few months in line they fix it themselves. Voila!. No more problem except for the widow or the bereaved family who thought the VA was supposed to be on this like white on rice.

America reminds me of  our erudite citizens who takes umbrage with another country attacking us. Witness Pearl Harbor. They respond in kind and after the war they minister to the injured. Eventually the fanfare and patriotism wears thin and it’s back to normal. A score of years later another incident flares up, we charge off once again and the injured pile up. This time, due to politically incorrect reasons, the war does not meet the criteria for acceptance. Witness Vietnam and its aftermath.

What we have now is an amalgam of both. Citizen outrage and plenty of political support would argue for a dramatically different outcome but the VA is simply not up to the task. Instead of mortar and bricks (hospitals), they have opted to create endless jobs and tools to measure how the jobs are being accomplished (VAOIG). Fewer and fewer medical personnel can be hired due to the top-heavy nature of administrative bloat. Rest assured that Human Resources counselors will have just the right panacea for underachieving problem workers but no solution for the 2000+ unfilled psychiatric medical workers so desperately needed to stem the PTSD tide at VAMCs. VA assures us this will be solved by 2016. It seems everything will eventually be resolved at some magic moment in the future so we just need to bear with them.

In the military we called this SOSDD (same old shit-different day). VA has elevated it to its present art form-an agency paralyzed from the neck up. Witness that nary a single jetgun decision has been granted at a VARO. Every one we’ve found and published has occurred at the BVA or CAVC. What does this tell you? Veterans Service Center managers are not empowered to grant these. The Extraordinary Awards Program (EAP) that Leroy Macklem ran afoul of is another example. Some actions just cannot be entrusted to the little guys at Fort Fumble.

VA has become so powercentric that virtually all policy questions have to be run by the Vermin Ave. poohbahs to get a political feel for how it will be viewed by the press.

imagesIt is now accomplished at a very high level (BVA and above)

It is only accomplished with a lot of bellowing and screaming (on the vet’s part)

It takes (or used to) 21 months to produce results. Unlike elephant gestation, that number continues to grow rather than remain static.

I felt sorry for all my brothers who couldn’t stand to be alive after Vietnam. I feel even more anger now when I see the same crime being perpetuated yet again and citizens act as though it is a unique event never before seen. VA, of course , is equally mystified and convinced it’s only a minor glitch. Repair Order? Why, hire more PR and HR guys and have  a training week in Vegas.  38 CFR rap Karaoke, dude!

Posted in PTSD | Tagged , , , , , , , , , , , , , | Leave a comment

Where did your VSO come from?

Posted on January 3, 2013 by joeaveragevet

Most VSO’s are chartered by Congress.  (You should know you are in trouble if it has anything to do with congress.  I am still smarting from the fiscal cliff, and not sure we have not fallen off it yet)

According to the DAV’s director in 2008, this is where the DAV “comes from”.    Before I begin, let me remind you there are many, many VSO’s who have helped many a Veteran obtain his benefits and do a fine job.

However, I wonder if your VSO hopes we wont  read Sec. 50302.   Too late, one section follows:

50302. Purposes

The purposes of the corporation (DAV) are-

(1) to uphold and maintain the Constitution and laws of the United States;

(2) to realize the true American ideals and aims for which those eligible to membership fought;

(3) to advance the interests, and work for the betterment, of all wounded, injured, and disabled American veterans;

(4) to cooperate with the Department of Veterans Affairs and all other public and private agencies devoted to the cause of improving and advancing the condition, health, and interests of all wounded, injured, and disabled veterans;

(5) to stimulate a feeling of mutual devotion, helpfulness, and comradeship among all wounded, injured, and disabled veterans;

(6) to serve our comrades, our communities, and our country; and

(7) to encourage in all people that spirit of understanding which will guard against future wars.

This is “troubling”, especially item number 4, above.  The DAV “advances the interests” for disabled Vets but “cooperates with the VA“.    You see, this “makes the assumption” that VA “interests” and disabled Veterans “interests” are one in the same.  (The VA calls themselves a “nonadversarial” system).

Vets, however, rarely suffer such a delusion.   We know well that the 600 or so lawyers who work for the VA do not sit around and think up ways to help us get our benefits, explaining to the judge just how much we deserve them.   Instead, many of us reading this are doing so, in the likelyhood that the VA has already (unjustifiably) denied our benefits.

Thus, the dilemma:    WE ask a “VSO” to help us with our claim, who has promised to “cooperate” with our adversary (the VA).   I’m “not buying” this “nonadversarial” horse puckey one iota.      In short, the DAV is “sleeping with the enemy”…who chooses to call himself our friend…this is the worst kind of enemy!    You need to remember that your VSO “pledged allegiance” to your adversary!

The next time your VSO tells you something like:

“Zero percent is a good rating..this means you get free health care and you can ask for an increase later”

“30% is not a bad rating even tho you can not work…don’t bother appealing it as you will clog up the system…get used to supporting your family on $400 per month“.

“10 years to get your benefits isn’t so bad, after all, you will get retro.  Nevermind you lost your home in the interim and wont be getting any interest, and nevermind that Social Security completes claims in 120 days.  The VA is a more complex system, so it should take the VA longer”

…….Just remember “who” your VSO is cooperating with, and it may not be YOU.

Posted in Guest authors, Introduction-Read these first, VSOs | Tagged , , , , , , , , , , , , | 1 Comment

PROGNOSTICATION AND GROUNDHOGS.

Posted on January 2, 2013 by asknod

No, this doesn’t entail Ouija boards or chicken bones. Nary a tea leaf was harmed in the production of this joke. Member Randy, who now lives in a “Marijuana state” like me, sent this in. That doesn’t mean he was in the “cloud” when he decided to send it nor does it imply that he (or I) imbibe. It’s merely one of those confluence things.  I realize some may consider this joke political in nature but I present it here simply because it was sent to me in the context of an interesting juxtaposition of the universe. The confluence of two disparate but equally compelling annual events on the same day would be considered an auspicious beginning to the Year of the Snake.  Herewith, I present what Randy hath Wrought:

 

2-02-2013

In the coming New Year, 2013, both Groundhog Day and  the State of the Union address will occur on the same day. This is an incredibly ironic juxtaposition of events.

One involves a meaningless ritual in which we look           to an insignificant creature of little intelligence for prognostication. The other involves a groundhog….

images

 

Psychiatrists would think it’s Randy’s way of projecting himself onto others. I know better. His HCV has made him joke-disabled, antisocial with passive aggressive tendencies which makes him act out and incapable of discerning that this will inevitably hurt someone’s feelings. But there is the humor…What the hey? What about Randy’s feelings? Let us not be judgmental. This is a good teaching moment. Perhaps we should all hold hands and have a moment of silence for Randy?

Posted in Humor | Tagged , , , , , | Leave a comment

BVA–GENO 2B & KOREA SERVICE

Posted on January 2, 2013 by asknod

Here’s another classic example of a Vet with service in Korea coming home with HCV genotype 2B. This was very prevalent and one of the signatures of HCV there at that time (pre-1990). Here, it occurred between 1952-54.

A February 2004 private medical record reflects that additional workup included a Hepatitis C genotype showing 2B type Hepatitis.

and this

[In] a December 2008 letter, A. D. Mire, M.D., notes that the Veteran served in Korea and that the Veteran reported no prior history of exposure that could cause his Hepatitis C.

This is geographical sleuthing that is very valuable to your claim. Remember it, Each genotype had a home back then. 3A was prevalent in SEA. 2A&2B in Japan/Korea, 1A in America and 1B in Europe. All that has changed now.

Posted in BvA HCV decisions, Tips and Tricks | Tagged , , , , , , , , , , , , , , , | 2 Comments

BVA–OKAY. I GIVE UP. WHICH HEP WAS/IS IT?

Posted on January 2, 2013 by asknod

FROM THE FILES

OF THE DREW CAREY

MEMORIAL VARO

 

This is one of those priceless “which hep is on first?” decisions that had to end in a remand to keep the room from spinning.  Joebob Vet has a problem here and the VLJ finally consults Dorlands’s Illustrated Anatomy to ascertain what kind of hep they’re talking about.

I really hate to spoil the story but this great stuff.

 The May 2008 VA examiner has expressed the view that the Veteran may have been infected with hepatitis B and hepatitis C concurrently. He expressed the view that it is less likely than not that the Veteran contracted hepatitis C during service, but the reasoning seems limited to the fact that there was no known test for hepatitis C at that time (in approximately 1974).

And this

The Board does not have sufficient medical expertise to understand why the lack of a test for hepatitis C in 1974 renders it unlikely that the Veteran contracted hepatitis C as well as hepatitis B during active service.

And the bottom line?

The May 2008 VA examiner indicated he had no VA records of treatment to review and that he had insufficient medical information to determine whether the Veteran experienced chronic hepatitis B from active service forward.

So, if I have this right, the AOJ VA Examiner decided that no evidence was negative evidence. Claim denied. In the alternative, just because he had HBV in service ( and we’re not admitting he did), it’s almost inconceivable that he was also co-infected with HCV at the same time because we didn’t have a test for it?

There has been much discussion on HAV, HBV and HCV over the years. What did they know and when did they know it? Here’s a brief history.

1972– the HAA Hepatitis Australian Antigens) test comes out commercially. It determines by process of elimination which, of HAV or HBV, you have. If the test is positive you have HBV. If the results do not register, it’s HAV.

Newsflash– There never was a test for “Non A, Non B Hepatitis. This term materialized in the 80s. People were coming down with all the symptoms of hepatitis for a short duration mimicking a HBV (acute) infection that resolved. However, the scientists got no results for the HAA test. They knew they were looking at Hepatitis but it simply didn’t register on the HAA test.

1989– Dr. Southern develops the first test to detect HCV.

1992– Commercial HCV test is made available.

1992– Scientists come out with a sensitive RNA test that determines the presence of antibodies showing prior infection of HAV or HBV.

1999 — the HCV PCR version comes out with 100% accuracy.

There you have it. No testing available equals you never had it in service. I’d give my eye teeth to see where (and how) that’s written in the M21.

What isn’t mentioned here is the spectre of autoimmune hepatitis (AIH) or even Chronic HBV which is rare but not unheard of. I’m sure they’ll send it into the AMC “Black hole” and we’ll hear from it again in a few years. Let this be a lesson to all of you. The VARO Ouija Board raters are lost on this stuff. Groves v. Peake had it sorted out at one point in 2008. VA chooses to profess Alzheimers. If it was hep (NOS or not otherwise specified) in service in 1970 , its assumed to be the same hep in 2006. Groves used PTSD/MDD as a springboard but numerous other VLJ s have used it generously and generically to decide these styles of cases. Just as often,  others have ignored the precedent and meandered down the Maxson v. Gober road and ignored the cryptogenic propensities of HCV to hide itself until 30 or 40 years later.

VLJ Vito A.  Clemente is a past master at this. I’ve read more than one decision where he pulls this rabbit out of his judicial hat. After reading one of these, you often remark “How could he NOT arrive at this same conclusion? Well, pilgrim. Look whom you’re dealing with.

0-1 Chariot of the Gods

 

Taken at Udorn 8/1970. We flew down to get all the red clay out of the gas tank over at the AirAm AOC (codename Waterpump). We were “Laotians” that day according to the Lao Erawan on the side. Most times if we weren’t crossing an international border (such as from Laos to Thailand) we went naked with no logo. They were stick-ons and peeled off  very easily. We also had AirAm and Thai Roundels available. Oddly, we had no AF insignia we could apply. The tail number on this one changed a lot too. Most began with an “O” for Obsolete. This meant they were no longer in the AF inventory.

Posted in BvA HCV decisions, Tips and Tricks | Tagged , , , , , , , , , , , , , , | 1 Comment

BVA–VA SIDES WITH VET’S NEXUS

Posted on January 1, 2013 by asknod

I have often tried to point out that it takes a number of years for hepatitis to manifest to a degree that the individual notices it. Men are notorious for going to the bitter end before keeling over and admitting something is amiss.

Here’s Joe Blow Vet from Oakland. First of all it’s a miracle he won while he’s still alive, but that’s not the point of this story. Everyone knows what kind of problems they’re having doing claims in Oakland.  What is unique is that he arrived with a real nexus and had AmLeg repping him. Somebody has been doing their homework and it wasn’t the VSO unless I miss my guess. I apologize. I’m such a negative Ned when it comes to VSOs. We don’t know he had a lousy VSO. I just assumed that. I could be wrong. I was way off on that December 21 Mayan thing, too.

Check this out. The Vet gets a doctor from the transplant crew ( listen up, Leigh) to write an excellent nexus. Who better to do it? The gal (Dr. Torok) is probably a red hot surgeon in addition to being a gastrodoc from Hell. She knows the etiology of this beast and the four stages equaling 40 years. This puts it smack dab in the Vet’s time of service and cuts off that bogus Maxson v. Gober line of nonsense. Remember how I address this in my book. It’s valuable stuff to know. Here it pays off.

Not only did it pay off having a private nexus, the VA examiner was so cowed by the doctor’s credentials, she went hook, line, and sinker for her take on it. I had the same experience. The VA looked at my nexus and sent out for another one. QTC looked at the rationale for mine and agreed wholeheartedly with my doctor who was a prominent northwest hepatology specialist. Needless to say, I made my service medical records available to him for this.

In a November 2006 statement, Dr. Torok, an assistant professor of medicine in a liver transplant program, noted that from her assessment and her review of his medical history, she did not find any risk factors that would have exposed him to the hepatitis C virus with the exception of the injections he received during basic training in 1966 from the use of jet air guns. That doctor indicated that these guns were used to immunize mass numbers of military personnel in succession with little or no regard to sterilization. That physician stated that she suspected that air-gun injections were the manner in which he contracted hepatitis C. Her basis for her suspicion was the fact that the date of the Veteran’s transplant, May 10, 2002, compared to the date of his enrollment in service, June 2, 1966, coincides with the 30 to 40 years it takes for end-stage liver disease to develop. Dr. Torok concluded by opining that the appellant acquired hepatitis C during active service.

Eighteen months later the VA examiner has an epiphany…

The May 2008 VA examiner opined that it was at least as likely as not that the Veteran’s contraction of hepatitis C occurred in service due to either air-gun injections or sharing of razors and toothbrushes and that it was less likely due to unprotected sexual activity in service with a minimum number of sexual partners prior to his marriage at a young age. The examiner indicated that based on the chronicity of the development of end-stage liver disease, i.e., 40 years, it was at least as likely as not that the appellant contracted hepatitis C during the time frame when he was on active duty. The examiner’s basis for her opinion was various lay statements, including the Veteran’s, and the opinion of a liver expert. In particular, while the Veteran and his brother are not competent to report that he had hepatitis soon after service, they are competent to report that he was hospitalized for appearing to have jaundice.

Roseanne said “It’s always somethin’.” Boy, was she ever right.

images

Posted in BvA HCV decisions, Jetgun BvA Decisions, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , , , , , , | 1 Comment

Happy New Year Everyone

Posted on December 31, 2012 by Laura

I hope you will find inspiration and hope in this Navy photo to bring into the New Year.  I love this one.  Do you?  God bless America!

New Sailors become American citizens

GREAT LAKES, Ill. (Dec. 19, 2012) Recruits take the oath of citizenship during a naturalization ceremony at Recruit Training Command, the Navy’s only boot camp.

U.S. Navy Photo by Lt. Liza Swart
 

 Ed. note: Kiedove has been filling it for me as I have real estate problems that require urgent action. Thank you so much to her for finding all these interesting subjects. As for the secrecy post, remember– we’re all opinionated. Please show respect for others’ belief systems. It’s a big tent here. Plenty of room for everyone.

Have a Happy and Safe New Year

Posted in Food for the soul, Guest authors | Tagged , , , , | Leave a comment