BVA–SAY, DID I MENTION THE TOENAIL CLIPPERS?

FROM  THE RETIREMENT VARO

IN FT. PETERSBURG

I read literally thousands of decisions a week searching for gotchas, no nexus, and frivolous filings that aggravate all of us. Here is the perfect example of what happens when you deviate from the game plan and speak without the Teleprompter. You realize maybe your claim is a little  skinny or missing that Je ne sais quoi so you fluff it up a little bit and suddenly the vA rater dude perks up and says “Well, hey now. There you go. We have to consider this new risk and factor it into the equation.” That’s just the setup for the SOC (Statement of the Case) letter. If you’re still adding in nail clippers at the Form 9 ceremony then you may want to consider going out and having a chat with somebody who has an MD after his last name. This is just one Veteran’s esteemed opinion, mind you.

Turning to the issue of service connection on a nonpresumptive basis, the Board initially notes that the Veteran is currently diagnosed with chronic hepatitis C. This was first diagnosed in May 2005. He has been treated by VA since that time for his hepatitis C. Thus, the first element of service connection has been met.

The Board also finds that the second element of service connection, an in-service injury or event, has been met. There is competent, credible evidence of in-service risk factors for the disease. In this regard, the Veteran has provided various statements that while in service, he shared razors with other soldiers, received airgun inoculations, and was exposed to other soldier’s blood.

The Board finds, however, that there is no evidence in support of the Veteran’s claim for the third prong of service connection – a nexus between the in-service event or injury, and the current diagnosis. Indeed, there is no competent medical evidence to suggest a nexus between the Veteran’s in-service inoculations and blood exposure, and his current diagnosis. See Hickson, 12 Vet. App. at 253. The only competent medical evidence addressing the etiology of the Veteran’s hepatitis C is the January 2009 examiner’s negative opinion regarding a nexus to service.

Son of a gun. This is  the problem. Like Pinnochio, the nose grows. Each retelling of the story adds and embellishes a little more to tease the reader. In this case it was like a trail of breadcrumbs to  the next one culminating in the Form 9. vA is playing this guy like a professional bass fisherman. Carefully backing the boat up to get the fish out into open water is the first phase. Then allow him to expend all his energy struggling before you scoop him up in the BVA denial net.

During treatment at the VA medical center in February 2006, the Veteran indicated that he was possibly exposed to someone else’s blood while stationed in Korea.

Gee. I wonder if any of those kind, considerate VAMC caregivers might have suggestively proposed that theory?

In a June 2008 statement, the Veteran reported that he was given airgun inoculations during service, and that the inoculation-providers did not change the needles in the airguns. He also asserted that while stationed at Fort Lewis, waiting for his transfer to South Korea, he was forced one time to shave with another soldier’s razor, and that the cooking and kitchen patrol duties at Fort Lewis were done outside in a filthy environment.

Here’s where a careful parsing of  Wikipedia would have been incredibly useful in instructing the concept of hepatitis A and its oral/fecal route of transmission versus HCV’s blood route.

The Veteran was provided a VA examination in January 2009. He informed the examiner that he stopped drinking in January 1992, previously having drank two to five beers every two to three months. He denied having blood transfusions, multiple sexual partners, tattoos, repeated body piercings, hemodialysis, intranasal cocaine use, and intravenous drug use. The Veteran believed he was exposed to hepatitis C while in service by airgun inoculation and by using other soldiers’ razors. He also indicated that he had occupational blood exposure during service. 

This is what sank the battleship. It indicates he’s doing some reading in an effort to add the perfect icing on the cake. Unaware of what he’s done to destroy every ounce of credibility, he continues to the end thinking it will be the magic key to the kingdom.

In his April 2009 notice of disagreement (NOD), the Veteran stated that he had no other risk factors for hepatitis C, but on his November 2009 VA Form 9 formal appeal, he added that he used another soldier’s razor to shave more than once, and shared drinking containers, cigarettes, and fingernail and toenail clippers with soldiers who were intravenous drug users.

Well there you go, pilgrim. Case solved. The fingernail clippers. Who woulda thunk? Now that the cat is out of the bag, you’ll race back to the top to see who was representing this charming storyteller. I’ll save you the trip.

REPRESENTATION

Appellant represented by:  Florida Dept. of Veterans Affairs

Throw in the fact that he’s from Ft. Petersburg and you see the problem. They had this guy on the ropes from the git go. He has scars on his arms from scraping the sides of the cattle chute. This ought to be against the law. You Vets in Florida might oughta boycott these bozos. They couldn’t help little old ladies across a street. They’re so mentally deficient they wear Pollack underwear (yellow in front, brown in back). Homer Simpson’s trained monkey Mojo could run circles around these guys. Or… it’s a vast, right wing conspiracy to deprive us of our legitimate due.

Disregard all after conspiracy. This is nothing more than  vA Standard Operating Procedure on claims adjudication. Use all arms of the Department of veterans Affairs to gather evidence and collate it for later review in the denial.  Better yet, follow the advice I put forth in the book and chronologically assemble the claim. Recall it all. Write it down. There is only one story and one theory. Stay on course.

Or, in the alternative,  utilize Johnboy’s technique here called “Fail To Plan. Plan To Fail.” He has 18 days counting today to get his NOA up to 625 Wagonburner Lane NW.

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BVA–DR. CECIL NEXUS PREVAILS ON JETGUN

You have to hand it to Dr. Cecil. He gets a lot of static for helping and does not always come away with a win. Often, the Vet who seeks him out is less than forthright about his/her medical history and leaves him with egg on his face for supplying a nexus letter based on untruths.

I guess what is equally amazing about this is that it came out of the Oakland RO and didn’t require a decade to accomplish. Someone did receive a bonus for the initial denial.  Jetgun decisions at the RO are nonexistent and are all booted to DC automatically-ergo the bonus.

Here, a Vet with absolutely no risk factors other than service in the eighties comes forward and all vA can summons up is that it can’t be the jetguns. No other etiology is explored or investigated. The clear implication is that he is lying or hiding some seminal event that could explain the etiology.Unfortunately, vA cannot hang any ornaments on this Christmas tree. Additionally, they are trying to pit an ARNP up against a gastroenterologist with a specialty in hepatology-never a good idea in the best of circumstances. Here it backfired and the VLJ rightfully awards service connection to the Vet.

Study this one long and hard. It’s the proof needed to assemble a winning claim for jetguns. I know all of you have heard on other Vet’s help sites that this is Mission Impossible but it really isn’t. That’s why I wrote my book. Jetgun claims are unarguably one of the hardest to win by far but vA has made any claim difficult beyond your wildest dreams anyway. Thus winning this is just marginally harder and requires some specialized finesse. We are happy to supply that here. Additionally, Dr. Cecil is, too.

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BVA–HCV & PRESUMPTION OF REGULARITY

Sweet. Here’s a new avenue of attack I never considered. Gulf War Vet enlists in 2007 and departs 2009. Accepted for service as good to go. Dx’d w/ HCV while in and vA comes up with the grand conclusion it’s from one or more of his three sex partners. This being the same outfit that regularly says its virtually impossible for this to happen (unless you’re out for 10 years). Mark this one down for Technique. Those guys at the Texas Vets Commision are hot. I have seen a lot of success coming out of that outfit. Seems they don’t sleep with the enemy.

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BVA–LET FREEDOM RING

FROM THE ORIGINAL FREEDOM

VARO IN PHILADELPHIA

Here’s a real jetgun win with no baggage attached. Very interesting in light of the tattoo info.

Finally, a January 2012 opinion letter discussed numerous studies that considered the spread of disease through the use of air gun injections. In particular, one study at a VA medical facility included the conclusion that the risk of hepatitis C infection among those who served during the Vietnam era could have been due to jet inoculation. Based on these studies, the physician concluded that it was at least as likely as not that the Veteran because infected with hepatitis C as a result of air gun inoculation during basic training. The Board finds the January 2012 opinion of significant probative value, as it is the sole medical opinion of record that provides a definitive conclusion. Cf. Obert v. Brown, 5 Vet. App. 30, 33 (1993); Beausoleil v. Brown, 8 Vet. App. 459, 462 (1996); Libertine v. Brown, 9 Vet. App. 521, 523 (1996) (holding that any medical link that is speculative, general or inconclusive in nature is of no probative value). The January 2012 opinion letter also provided a rationale and basis for the opinion provided.

Well, there you go. Where do we get a copy of that study? Seems Vets could just include this decision in their filing as evidence to point to. Let the vA excavate it and insert it in your claim. This was decided by a regular, long-term VLJ and not a 90-day wonder  acting like one.

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SIX DAYS LEFT TO VOTE

With six days left, I couldn’t resist. This came to me from brownwater Jimbo. That’s what he calls bourbon. He was also brownwater Navy but we don’t hold that against him.

This is not a political endorsement of any kind. I’m Nod and I approved this message.

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LORRIE AND STEVE

Lorrie and Steve took their six-year-old son to the doctor.
With some hesitation, they explained that although their little angel appeared to be in good health, they were concerned about his rather small  reproductive organ.


After examining the child, the doctor confidently declared, ‘Just feed him pancakes. That should solve the problem.’


The next morning when the boy arrived at breakfast, there was a large stack of warm pancakes in the middle of the table.
‘Gee, Mom,’ he exclaimed. ‘For me?’


‘Just take two,’ 
Lorrie replied. ‘The rest are for your father’.

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MILITARY VEHICLE ORIGINS

I guess you always wondered about these things.

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JOIN THE NAVY

This wasn’t produced in my era. We looked at it with a more simplistic attitude. We knew what the Army would be. We knew what the Navy and Marines would be. That left the Air Force as the only civilized choice to enjoy a four year enlistment and avoid (most) calamity.

With the advent of Be All You Can Be and The Few, The Proud, The Marines and this Youtube Navy entry, I’d say its time the Air Force crank up the PR engines-but then we don’t have to and never did. The Air Force always had women-just none where I was stationed most of the time.

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RECENT MILITARY AND VETERANS’ WEDDINGS

Always Johnny on the spot with a camera, eagle-eyed member Randy sends us these memorable weddings that Veterans and active military personnel recorded for posterity. For lack of anything else to describe some of them, all I can say is a picture bespeaks a thousand words-not all of which are pronounceable in polite society…

 

 

If you have any memorable wedding pictures you like to share with us, feel free to send them in.

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BVA–KNICKKNACK, PADDYWHACK, GIVE THE DOG A BONE

Here’s one of those famous bait and switch decisions repped by none other than the DAV. I wonder who put him up to this division of assets? Divide and conquer is vA’s game, not DAV’s. Unless, of course, everyone is using the same playbook. Ouch.

Yes, our Oakland, California gold rush seeker has struck HBV paydirt. One problem now will ensue. How to prove the liver damage claimed is from B or the C which is on remand? If the odds are what I think they are, it’s two hundred to one they will come back with willful misconduct for the C and leave the B as acute and resolved based on DC 7345. The result will be 0% for DC 7345 (HBV) and no service connection for the HCV until 2022 on his deathbed. The wife will eventually get DIC but a lot of money will be saved in the interim for future Orlando playcations.

Here’s the punchline in the REMAND section. Can you in your wildest dreams envision this getting to DC while all the C&P guys were staring at the ceiling and saying “Yup. HBV, dude”. Considering they regularly test us for HCV and don’t tell us, I wager there’s evidence in his VISTA records somewhere saying HCV POS. Nobody at the RO, even the much-vaunted vA examiners, would let this go to town without some well-reasoned discussion about the pros and cons of HCV. The DAV is stuck on dumb for even discussing HBV unless its the chronic version and I strongly suspect it isn’t. This means someone is flogging the dog over an acute and resolved infection from 40 years ago. Active  HBV viral antibodies are the hallmark of an ongoing disease process but there is no discussion of this. That leads to one and only one result-denial on the C. Its the latest ploy to deny. Here, Johnny. SC for HBV @ 0% but negatory on the C. You never had that in service. Just the B. Oh, and look! The B is miraculously healed and resolved with no ill effects. Of course that C is kicking your ass-not to mention your liver- but it isn’t service-connected. We’d love to pay you for that one but we can’t. Thank you for your service, too.

The Veteran is also seeking service connection for hepatitis C. At the July 2006 VA examination, based on private lab reports, the examiner indicated that the Veteran had no known history of hepatitis C from the records that he reviewed. However, in subsequent July 2009 VA treatment records the Veteran reported a history of hepatitis C. An assessment of hepatitis C was made. However, as there are no contemporaneous lab reports of record, it is unclear whether the basis of this diagnosis was the Veteran’s own history or a positive objective finding of the hepatitis C antibody based on blood work. Importantly, a follow up treatment record shows that the active problem list included hepatitis B, rather than hepatitis C. A November 2011 letter to the Veteran from the VA indicated that his liver tests were still abnormal, but gave no indication as to the underlying cause. Accordingly, the Board finds that further information is needed and that this issue must be returned to afford the Veteran another examination to determine whether the Veteran currently has hepatitis C and, if so, whether it manifested in service.

This stinks. This guy is a combat Vietnam Vet. You didn’t get Shell Fragment Wounds (SFW) from opening up C-rations between 1969 and 1971. They’re measuring this Vet for a necktie and hiding it in a time-consuming remand. He’s toast already but no one will tell him-not even his DAV rep. This fellow needs an HCV nexus-like yesterday.

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