BVA– BUM’S RUSH

Posted on October 9, 2012 by asknod

How many times are we told we do not have the medical expertise to opine on the etiology of where our disease came from or what particular risk was the culprit? Try this one on for size. Vet partied hearty before service and got Hepatitis (probably A). Lists it at beginning of service. Probably donated blood a gazillion times “voluntarily” while in service with no problem. Vet separates and donates blood about a year after service. HAA test on donated blood reveals HAV or HBV. Vet files for HCV in 2006.

Fast forward to the VA examiner in 2010 who figures it all out. Gifted with prescience, the examiner correctly opines that any Hep the Vet is filing for in 2006 was HCV that predated  service. Whoa, show me the test. Stop. The Vet says he was told he had it before he went into service but there are no private medical records and its basically hearsay. Add to that the Vet isn’t a doctor and is not allowed to comment on things medical in nature such as diagnoses. What if he acquired HAV innocently from the hand-dug well too close to the outhouse when he was a sweet innocent boy (before drugs)?

The logic here is akin to a surgeon armed with a chainsaw doing an amputation.

In this case, the Board finds significant evidence to rebut the presumption of soundness with respect to hepatitis. As indicated above, although the Veteran’s enlistment examination did not diagnose the Veteran with hepatitis, he self-reported at that time that he did not know whether he had a history of jaundice or hepatitis. The report of an April 1977 physical examination, signed by 3 physicians, included the finding “has hepatitis agent, notice 1972, NCNS.” While he was not aware of his hepatitis infection until he tested positive while attempting to donate blood after the military, the physicians at that time determined his hepatitis dated back to 1972, prior to his military service. At the September 2007 RO hearing, he testified that he was aware that he had been diagnosed with hepatitis in 1972, prior to service, and that he did not experience any flares of that condition in service. At the December 2010 VA examination he conceded a history of high-risk behavior prior to his military service, to include intranasal and intravenous drug use.

But wait

The only evidence indicating that the Veteran may not have had hepatitis prior to entering service is his own statement on the enlistment examination that he “did not know” whether he had a history of jaundice or hepatitis. His subsequent statements, both as sworn testimony at the RO hearing and as made to the December 2010 VA examiner, are to the contrary.

Does the reader not find it interesting that if this were an attempt to associate it with service, he would be denigrated as having a poor memory and all his testimony should be viewed skeptically with an eye towards not being credible. Here his testimony is to be believed totally. Interestingly enough, he (and all Vets) always seem to end up on the wrong side of the fence when testifying. Hence, if its positive testimony, its incredible and so remote in history as to be beyond the Vet’s ability to recall it. Similarly if its negative evidence that tends to implicate him/her and imply willful misconduct, it is perfectly believable and should be allowed in unabridged because it is probative and the Vet said it out of his own piehole.

Anything you say can and will be held against you unless it’s favorable.

Anything vA says about you can and will be used against you including hearsay.

Anything you failed to say or disremember can be used against you.

Anything you finally remember cannot be credible because you just now remembered it.

Any hepatitis in 1972 occurred before service because that’s when you partied.

Any hepatitis you might have had in service has been dismissed as incredible. You are not a doctor. You can only testify about drug usage. If you didn’t do drugs in service then it’s not service connected.

Absent a PCR test showing HCV in service, a Hepatitis Australian Antigens (HAA) test in 1976 after service is adequate proof of HCV before service even though it was only good for discerning HAV or HBV.

Is this Tijuana School of Medicine logic? You could bust this wide open and drive a Hummer through it. But will he appeal it to the Court? He had until August 5, 2012.

Posted in BvA HCV decisions, Veterans Law | Tagged , , , , , , , , , , , , , , , | 3 Comments

ILP–SILLY WABBIT. GREENHOUSES ARE FOR HR FOLKS

Posted on October 9, 2012 by asknod

Last Tuesday, in keeping with the standard, paperless VR&E format, my ILP “mentor” came by from the local VARO for a chat. Let’s put that in perspective. He had to drive about 87 miles one way to drop in for a progress report and a chat.  Use of the word mentor here implies someone who teaches you how to accomplish a task. I use the vA meaning of mentor:

 mntôr   n.  one who denies whenever possible.  One who only grants if they must, but only after extensive appeals and with  the smallest amount of compensation possible.          v.     men·tored, men·tor·ing, men·tors Informal

We looked at the Asknod site and he was very impressed. He wanted to know all about the statistics and readership. He wanted to know what kind of content I was posting. In short, he wanted to know if vA was getting its money’s worth out of its “investment” in my computer. Seems like something you could do over the phone or email. VR&E must have a big budget like the HR folks back in D.C. if they can send GS-14s out all day to poke around,  peek in windows and shoot the breeze with disabled Vets for hours on end.

The real problems started to surface immediately. As I mentioned above, my ILP program   has less paperwork than some of the Forward Air Control missions I flew in. Zilch. Zero. We’re talking a 1960s handshake and a “Hail fellow, well met”.  This doesn’t need to be classified or For your Eyes Only. Why the clandestine nature? I literally have nothing anywhere that grants me this computer or denies me the greenhouse. For an agency that drowns you in paperwork (eventually), the complete absence of anything acknowledging receipt of any of my filings is beyond strange. I didn’t even get one of those fancy things that starts out with “You are a Veteran of the Vietnam War. You served in the Air Force from…”

I suspect Kris drew the short straw last year and has to be the waterboy. He speaks often of his boss being the one who makes these important calls. The conversation then took an interesting turn. My mentor suggested that these motions, pleadings and dissertations on the need for a greenhouse were wasted breath. I was encouraged to write as often and as freely as I wished but pissing into the wind was going to have similar results too. The die was cast and the decision had been made.

The next subject addressed was the problem of Imperial Entanglements. This is what happens when you call Senator Patty “NIKE” Murray. She and her minions now descend like a Mongol Horde and make live miserable for the Congressional Interests Desk at the RO. Kris was very unhappy at the prospect of my involving anyone with the honorific of Congressman/woman or Senator. This just created more paperwork, engendered ill will between the Legislative branch and the Veterans Administration and plum made ol’ Krissy and his boss Davey have to work overtime explaining why they can’t do what Congress legislated especially for us in 1980. Certainly I could see the wise thinking here and refrain from that foolishness.  Yep, I nodded, like a country bumpkin. Shure do, feller. Wouldn’t hanker fer that nohow. NosirreeeBob.

The Veterans Administration has, for the last twenty three years, screwed me out of legitimate monies for injuries incurred in war. For my beloved mentor to give me the inside scoop on what the Big Guys were doing was just the opening I’ve prayed for.  By further trying to dissuade me from dragging Senator Sneakers in was the icing. I have attached here the Microsoft Word document with all the salient statutes concerning ILP wrapped up and summarized. It can be adapted by you to file your claim.  This is important because most there in VR&E do not know anything about the IL program. When I applied for it, no one even knew what or where to find the application form. After finally qualifying, my file at the local VR&E was shanghaied back to Seattle where they sat on it. And sat on it. When I finally asked for a progress report, I was called and told it required much development. A week later they called to tell me why I wasn’t getting the computer. After one of my famous letters, they got out the tape measure and fitted me for it.

VR-E Greenhouse 10.8.12 last call

The dance for the greenhouse is more nuanced. I know what I am about and they know I know. Denial now requires very carefully constructed Adobe Acrobat phrases far and above their usual  dangling participle variety. I wager the denial will be crafted by someone with an actual high school diploma. What’s more is that they finally have to deny it in writing which requires more than that high, nasal, whiny voice saying ” Well, ahh, you, ahh, know that to qualify you have to prove that the ahh, greenhouse need is vital, you know, to your ah, independence in daily living. We don’t, ahh,  see that the, you know, greenhouse is vital or necessary. You ahh, have to show that.” No more “Well, this is off the ahh, record but you’re, well,  you know,never going to be approved for this and it will just get messy if we have a lot of legislative ahh, types looking over our shoulder who don’t understand it. Congressional intervention rarely helps and often hinders, you, ahh, you know.”

This is what Senator Murray will be reading the day after tomorrow:

Senator Patty Murray ILP

More recently, last week during his fact-finding expedition, Mr. Kris indicated it would not be in my best interests (and indeed a hindrance) were I to involve you or Congressman Dicks in this conversation. Why he or the Veterans Administration holds that view is confusing. Absent a frank discussion, I will never get any traction on this issue. This is why I write.

And

VA seems to be of a mind that independent living now consists of a cordless phone and a grab bar next to the toilet. Congress did not plan for such an absurd reading of its legislation.

Now for the icing and the little toy greenhouse on top of the cake. I love to save the best for last.

This is the latest 38 USC on ILP-every reference from § 3101 to the real meat in § 3120. Don’t file without it. It alerts them to the fact that you were not raised by wolves and recently disembarked from the USS Mayflower.

Some say I can “turn a phrase”. If indeed I can, this might be an example

As a member of the military forty years ago, I was a stakeholder in America’s freedom. Similarly, as a disabled American with disabilities well over 100%, I find myself today a stakeholder in all that the VA offers. The ILP program was instituted for veterans like me and to fence us out semantically on the turn of a word’s definition is an absurdity that Congress never intended.

I believe I have made my case succinctly and as clearly as possible. In the event my request is still found to be outside the parameters of what Congress envisioned, please send me the paperwork delineating your reasoning and the appropriate forms to facilitate my appeal.

vA has become smitten with the word stakeholder. I asked Mr. Kris what vA’s definition was. A stakeholder is anyone who:

> Has a vested interest in the Agency

> an employee of the Agency

> Veterans who receive medical care from the vHA

> Veterans who receive compensation or pensions from vBA

>Hungry Vets in St. Petersburg looking for people bearing steaks

> Taxpayers who fund the vA

>Congress (both houses)

> The USO

> VSOs

> Little Mikey who likes Life cereal

> The Secretary of the vA

> Contractors who provide services to the vA

> Dead voters in Chicago

> and a cast of thousands more.

vA has a very broad definition for them. Usually it employs the Friday rule and fences everyone out (you had to be born on a Friday, file on a Friday or know somebody who works for vA named Friday). Apparently the reverse is true with stakeholders. Everyone has a voice in it which is very touchy-feely. Stakeholders sing Kumbaya a lot. Stakeholders are interested participants who have a stake in making our lives better. If you are reading this, you, too, are probably a stakeholder. If you’re reading this in St. Pete and you’re hungry, you’re in the wrong line. We’re not holding any steaks.  But what I discussed above might help to set a President.

Mikey. Hey, Mikey. He likes it.

And of course I baited the hook with a USPS 3817 to see if they try the “Huh? We never got it. Now if you’d had a responsible VSO, they would have accomplished this.” News and film in 2016.

Posted in Independent Living Program, VR&E | Tagged , , , , , , | 4 Comments

CAMP LEJEUNE SURPRISE

Posted on October 8, 2012 by asknod

Got disease? Check. Got requisite service? Check. Got nexus? Well…. gee, I think VA supplies that, right? Roger that, Pilgrim. Denied. No nexus included.

Member Shawn sends us this pathetic attempt to resolve all doubt in favor of the Vet. Result? 84% denial rate. In an eerily similar situation, Marines are getting the dry end of the water trough at 84%. Keeping in mind that VA’s denial rate averages 85%, it’s hard to fathom why Lejeune denials are off by 1%. Same VA. Same raters. Same Bat Time and same Bat Channel. What’s different? Ahh, padewan. The new VBMS is finally paying off with 98% accuracy. What else can it be?

 

Camp NoWay, N.C.

Posted in Camp Lejeune poisoning, vA news | Tagged , , , , , , , | 5 Comments

VA MEDICAL MALPRACTICE IN KENTUCKY

Posted on October 8, 2012 by asknod

This will go down in Federal Tort Claims Act(FTCA) lore as one of the most horrendous of VA’s legendary medical malpractice suits. Vets can commiserate with Mike Nash. Around the hallowed halls of the Davy Crockett VAMC, this one will be talked about for years. How it could happen is not anyone’s guess. VA medical personnel are renowned for dumb things. They have worked hard to earn their unenviable reputation. I remember reading about the two-pint transfusion I had late one October night in 2009 while a guest of the Seattle VAMC. Unfortunately, I didn’t read about it until a year later. VA neglected to tell me about it somehow, just as they overlooked that little myocardial/septal infarction shortly thereafter. It seems they had overdosed me on Heparin and needed to “fix” it. Why bother the Vet by waking him up and making him worry needlessly?

I regularly hear from many of you when you finally exercise your right to your medical records. Many come here shortly after saying that they only found out recently they had HCV and VA never told them. I can hear that Jim Nabors echo of Gomer Pyle in the background (Surprise, surprise, surprise, Sgt. Carter). They ought to hang a banner and a picture to that effect over the entrance to every VAMC. Even better, they should name a new VA medical facility in memory of Mr. Nabors.

Here, Mr. Nash has simply tried to improve his quality of life with a circumcision and a penile implant. Murphy’s Law, as usual, has reared its ugly head and Mr. Nash is going to need much more medical attention than he anticipated. This happens so often there ought to be a name for it. Oh yes. I neglected to consider medical malfeasance. vA calls this type of thing a medical misadventure. Mr. Nash knows it by the name of “Doogie Howser does Lexington”.

Looking back on my adventures in VAland, I don’t find it remarkable. I remember my doctor being ecstatic that they had finally (and successfully) managed to glue me back together with no leaks on the fourth try.

Posted in Medical News, vA news | Tagged , , , , , , | 5 Comments

Secret Veterans’ Benefits Academy

Posted on October 7, 2012 by Laura

I really had to hunt for any information about this academy but there is was, in small print, mis-named, on the Baltimore VARO webpage.

The Baltimore Regional Office is co-located with the Eastern Area Human Resource Center (HRC) and the VBA Training Academy.

This appears to be the “centralized location” where VSR/RVSR new hires go to take the Challenge Training Program, new in 2006, but improved in 2012!  Others learn to be instructors.

Recruits travel to MD and live in a hotel.  They study M-F and have weekends off.  The recruits used to spend three weeks at the school.  They now study for eight weeks (page 3).   That pace is still hurried but a little saner.  The previous 3-week residency period was woefully inadequate for the important tasks facing new hires.

The public needs more information about the Veterans’ Benefits Academy, its curriculum and budget. What is taught there?  It’s a secret.  Where is it? The VA would rather you didn’t ask. 

Ed. note: Member Harry and founder of HCVets sends me this morsel.

Posted in Guest authors, Uncategorized, vA news, Veterans Law | Tagged , , , , , , | 6 Comments

BVA–NO TEST FOR HCV IN 72=SPECULATION

Posted on October 6, 2012 by asknod

I couldn’t think how to communicate this decision logic in 30 words or less hence the speculation header. Try this logic on for size. First, the vA examiner reads the file and concluded the Vet never had hep in service. Someone discovered the error and gave the file back to him to save his ass. Instead of coming up with a logical nexus to explain it, off he goes into the deep end of testing protocol which I’m sure he had to read up on before he parsed the denial.

Here, the RO apparently returned the file to the VA examiner mentioned because he had failed to recognize and acknowledge the treatment, including while hospitalized, the Veteran had received for hepatitis during his military service. But even with the benefit of this additional review, this examiner still was unable to comment on this determinative issue of causation and inception without admittedly having to resort to mere speculation, partly because there was no available test when the Veteran was in the military during the early 1970s that would have permitted doctors to determine exactly what type of hepatitis he had. And based on this examiner’s comments and explanation, there seems little to no chance he will be able to provide more definitive comment on this issue, even if given additional opportunity.

The RO desperately tried to rehabilitate the rater’s reputation by giving him a second shot at it but the Board Judge realizes his best years may already be behind him.  Yes, the Vet wins, but this is classic proof of why haste makes waste. Haste,  measured in years at the Oakland VARO, is a subjective vA measurement much like their mathematics.

Posted in BvA HCV decisions | Tagged , , , , , , , , , , , | 2 Comments

BVA– DIRTY JETGUNS = HCV

Posted on October 6, 2012 by asknod

This isn’t a snowball rolling downhill yet but it certainly is a banner year for HCVets claiming jetguns. What’s unique about this is that several VA examiners is saying it. The Vet has just dragged in not one but two good nexus letters. The 2010 VA examiner struggles to turn left-handed tobacco into drug usage and it ends up at the Board. This old boy has it nailed as if he’d been taking a chapter right out of my book. vA cannot just let this go by. They can’t even get their own brethren on board so they just keep kicking it back and forth in house until they find a rater willing to fudge.

What the hell? Seems pretty cut and dried but he didn’t win in Atlantaville. How can you get a positive nexus and still lose. Only at the RO. It took a guy with a juris doctor after his name to sort this one out. It’s Vet-4 vA-1 and they refuse to grant. Where’s that good ol’ benefit of the doubt we keep hearing about?

A March 2008 statement by the Veteran’s private physician (M.M., M.D.) indicated that he had been treating the Veteran for 25 years. He stated that the only blood product the Veteran was exposed to was the air gun in service. His ultimate opinion was that the Veteran’s hepatitis C was probably related to a contaminated multiple medication injector (air gun). 

[That’s one]

The Veteran was afforded a VA examination in June 2008. At this examination he reported that he was diagnosed with hepatitis C in 1989 and told that he had been infected for approximately 12-13 years. He reported several blood transfusions, but none before 1995. The examiner concluded that the likely risk factor for the Veteran’s hepatitis C was the contaminated air gun in service. His rationale was that there were no other risk factors.

[That’s two]

A February 2010 statement from the Veteran’s VA liver transplant doctor, an Associate Professor of Medicine and Pharmacology, Gastroenterology and Hepatology at Vanderbilt University School of Medicine, stated the Veteran was diagnosed with hepatitis C in 1990 and he had no additional risk factors for hepatitis C except for the in-service air gun inoculations. 

[That’s three and look at his credentials]

At a May 2010 VA (QTC) examination the Veteran reported that he had been diagnosed with hepatitis C and his symptoms included tremors, swelling of the legs, fatigue, memory loss, and diarrhea. After examining the Veteran the examiner opined it was at least as likely as not that the air gun inoculations from service caused the Veteran’s hepatitis C. His rationale was that if the air gun was not sterilized then it was at least as likely as not that hepatitis C could be contracted.

[That’s four.]

An October 2010 VA (QTC) medical examiner opined that he could not determine whether the Veteran’s hepatitis C was at least as likely as not related to service. His rationale was that the Veteran had admitted to polysubstance abuse in a previous VA treatment record and the record indicated the Veteran was less than forthcoming with information on this subject. See January 2009 VA treatment record. 

[Ruh-oh Rorge. # 5 says Druuugs! So now we have a lowly ARNP at QTC opining on HCV and upstaging a Vanderbilt Hepatologist.]

The Board observes that at the Veteran’s November 2011 Board hearing the Veteran testified that he had used marijuana a couple of times, but that he did not use cocaine and he was unsure where this evidence came from. 

Where indeed? Piehole diarrhea and honesty destroy more claims. Anything you say can and will be scrutinized for later use against you. Of this you can be certain. Absent this off the cuff statement, the vA would have found something else. They usually don’t fight these this hard with all the favorable nexi. I suspect they just couldn’t let their own raters go down that road. Before long it would become an ugly, ingrained habit and vA is not prepared to go there yet. They can bluff until the rest of us die,

Posted in BvA HCV decisions, Jetgun BvA Decisions | Tagged , , , , , , , , , , , , , , | 2 Comments

Use VA Secure Messaging to your advantage

Posted on October 6, 2012 by Laura

My DH got authenticated at the RO for this VA service a few months ago.  It’s great for checking blood lab results, refilling meds and sending messages to his VA primary doctor.

Since a veteran’s sworn testimony is rejected so often, this service may be useful for evidence in future claims–providing you don’t delete your relevant SENT messages/or replies you receive from your VA health team.  (If you delete a message by mistake, it will go into the Deleted folder.)

Keep it orderly.  An example: 1. Create personal folders under My Folders.  Click Add new folder. In Folder Name type: Refills; click Submit.  From Inbox,  check a RX-related email in tiny box.  From the top drop-down menu, “move selected to”  Refills;  click MOVE button.   Check folder in left sidebar to see if action completed.  You can edit/rename folders later.

Why I like this service:

  • Each email has a unique ID number, is dated and timed (Central Time).
  • In the SENT box, you can see if your email has been read!
  • This is basic and intuitive email app uses larger fonts for easy reading.
  • You can print your emails (which contain email threads). No printer? Use a screen capture tool such as the PC snipping tool and save emails as images on your hard drive.
  • Subject lines are clear and get directed to the right person:  General Inquiry, Appointments, Medications, Test.  You can send now or save as a draft.
  • Application limitations: No forwarding.  No attachments.

Today my DH sent a secure message requesting a new hearing test and hearing aid adjustment.  He reported that his hearing has gotten worse since his last test 3 years ago.

Last week he requested a new pill cutter from the pharmacy and received it promptly via mail.  Meds are refilled promptly.

When his doctor was on vacation, his recent ultra scan results were emailed by a nurse after he made an inquiry.  Less frustration waiting.

This is a vast improvement over telephone communications alone.  Phone calls can’t be  used as evidence, unless you record them (ex. with Google Voice).  With selected VA Secure Messages to your health care team (ID’d, dated and timed) as back-up to your sworn testimony, you’re in better shape.

Caution:

If veterans use the system for frivolous emails, or over-use the system, it could get shut down as the VA is wont to do.

Be careful what you write because your own written words can/will be used against you!  (“Veteran emailed his doctor on Oct 6, 2012 #22675 that he is feeling almost back to new after new medication began. He reports laying a new roof on his house and harvested and split three trees for fire wood.”  Have someone read the email before you hit send. 

Posted in Guest authors, Tips and Tricks, vA news | Tagged , , , , , , , | 8 Comments

BVA– CUE BY ST. PETE”S RO (4th TIME)

Posted on October 6, 2012 by asknod

You get that warm, fuzzy, content feeling about your Regional Office when they keep committing CUE and the Board keeps remanding it via the 59th RO (AMC or Appeals Management Center). Its now 2012 and they’ve been playing pingpong with it since 2003.

If this doesn’t make you want to give the rater and his DRO mentor the Howdy Doody award for best impersonation of a human being, there’s no help for you. Seriously. Once to fix a rating defect is acceptable for a defective download from the M-21 ouija board. Remember that the DRO with the Masters Degree signed off on this, too.  Twice and you begin to wonder what they put in the Tampa municipal water supply. Thrice and you decide to check if the family tree is a straight line that crisscrosses.

Now,  the claim also traversed the AMC so it had to have even more eyes on it (three times). Perhaps you have a mental aberration and are dyslexic.  Why, you might confuse 7345 with 7354 if you were a lay person. But if you were highly trained in the Force and are now a Jedi Master, this should be child’s play.

REMAND

Regrettably, the Board finds that another remand is required in this case to further develop the record and ensure proper application of all applicable rating criteria.

The Board has broken down the issue into three issues and recharacterized the initial assignment of a 40 percent evaluation from July 31, 2000, to July 1, 2001, for simplicity. The Board has remanded this case three times, each time informing the RO that it committed error when it assigned a 40 percent evaluation under Diagnostic Code 7354 prior to this Diagnostic Code’s existence and requested that the RO fix this error. See July 2007 decision on page 13; September 2009 decision on pages 2-4; and October 2010 decision on page 8. As of the date of this current remand, the error has not been fixed, and it cannot be ignored. The Board finds as fact that there is clear and unmistakable error in the July 2003 rating decision, wherein the RO assigned an effective date of July 31, 2000, under a Diagnostic Code that did not exist until July 2, 2001. 38 U.S.C.A. § 5110(g). The Board is remanding for the AMC/RO to issue a rating decision wherein it concedes clear and unmistakable error in the July 2003 rating decision, and corrects the error that was made. 

As to the other portions of the claim, the Board cannot decide the portion addressing the 40 percent evaluation prior to January 31, 2011, because it is possible that the AMC/RO would find that a 60 percent evaluation under Diagnostic Code 7345 (in existence in 2000) would be warranted, and an evaluation cannot be reduced because of a change in the rating criteria, unless genuine improvement has been demonstrated. 38 U.S.C.A. § 1155 (West 2002) (“[I]n no event shall such a readjustment in the rating schedule cause a veteran’s disability rating in effect on the effective date of the readjustment to be reduced unless an improvement in the veteran’s disability is shown to have occurred.”). Thus, the Board must wait for the RO to address the clear and unmistakable error before it can decide the increased-evaluation claim prior to January 31, 2011. 

In the October 2010 remand, the Board in part requested that the RO afford the Veteran a VA examination to determine the current severity of his hepatitis C. The Veteran underwent an examination on January 31, 2011; however, the report is inadequate for rating purposes. In this regard, although the examiner provided the results of liver function tests, the examiner did not comment on the extent of liver damage shown by these results. The examiner also stated that the frequency and duration of incapacitating episodes could not be determined, as the Veteran reported them to be chronic. However, the examiner was advised that an incapacitating episode is a period of acute signs and symptoms severe enough to require bed rest and treatment by a physician. Thus, the examiner should be asked to clarify the duration, if any, of such episodes.

Additionally, the examiner noted that the report of a January 24, 2011, liver biopsy was not yet available and that, “The severity of the [V]eteran’s chronic Hep[atitis] C will be known once liver biopsy comes back. Unemployability will be determined when the biopsy results are know[n] and severity can be determined.” See examination report on page 3. The January 2011 biopsy results were not associated with the claims file, and the examiner never provided an addendum to the examination report after having reviewed the biopsy report prior to the case being returned to the Board. 

Given the above, the AMC/RO should associate with the claims file the January 2011 liver biopsy report and return the claims file to the examiner who provided the January 2011 examination (QLL, M.D.,) to obtain an addendum that properly addresses the Board’s questions as set forth in the October 2010 remand

If we were talking birds dogs, I’d have to conclude that dog don’t hunt. We are talking two signatures here. One must come from a DRO who has 10-15 years of experience doing this.  Using the wrong rating code is Rating 101. You don’t make this error if you know how to read the M-21. And if you can’t read M-21, you shouldn’t even be making the coffee there.

So it is with great pleasure that I award the Alfred E. Neuman award to the St. Pete’s RO for their adroit and timely handling of Johnny Reb’s 2003 rating and indifference to diagnostic code etiquette.

WHAT,

ME CUE?

Here I thought this was an anomaly unmatched in the recent annals of RO rating. I found this later and add it in now. Look at my poor neighbor. I knew Seattle had some M-21 challenged raters, but here’s the evidence. 30% for 7312-yep. 60%? No such animal. The BVA judge is scratching his head and apparently has been for some time since the last remand in 2008 hit the “What is it they’re remanding for?” wall. Sometimes you have to actually read the remand to understand what it is you are being asked to fix.

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

FACEBOOK DETENTION

Posted on October 6, 2012 by asknod

Patricia notified me that someone (Facebook personnel) have placed this in my link to my FB account (Ask Nod). Apparently I have dissed someone somehow or am now considered rude, crude, socially unattractive- not to mention boorish.

Remember the bar scene on Tatooine before they blasted off in the Millennium Falcon  with Harrison and the dog? Think back to the guy who lost his arm to Alec Guinness’ light saber. That’s how I envision this soul. I now bear the mark of Cain. Tricia thinks its the VA’s way of saying “Hi.”  Be daring. Step over the line in the sand. By the way, my publisher put up a nice little blurb on my book that is under asknod run together as one word.

Posted in ASKNOD BOOK | Tagged , , , , , | 4 Comments