INTERFERON-FREE TX FOR HCV IN 5 YEARS?

Great. We have to wait five years for an IFN-free therapy for HCV. I don’t have that luxury nor do some of my friends who flunked the PegIntron Olympics. I’m S4 confirmed and it’s a matter of time to when the decompensation kicks in. I think the vA ought to be the lead agency on this and go for it now. I volunteer. Anything beats dying.

Thank you Randy for finding this. The check’s in the mail.

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VIETNAM DICTIONARY

I found this on one of my adventures in reading. It has many fond memories in it as I’m sure you’ll agree. What’s more, you can add to it as you see the need. I did. It is still a work in progress. Enjoy.

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FED. CIR.–GARDIN v. SHINSEKI– WHO’LL BE FIRST?

Very few Vets get to have their names up in lights in perpetuity. Norman Gilbert is one and there are many more over the last twenty three years. Wayne Gardin’s decision here is an example of what sets the stage for the Gilberts in VA jurisprudence.

Wayne’s decision hinged on poor legal reasoning all the way up to the  Fed. Circus. They poked a hole in the balloon and off it went to the cleaners for a do over. It seems that in the rush to disenfranchise poor old Wayne, the Court forgot what they’d held in the Nieves-Rodriquez holding. That was the precept that there is absolutely nothing in any statute that says in order for a nexus to be probative, that the doctor absolutely-positively must have read the SMRs before he opines. I know that I advocate constantly that Vets should have their doctors read and acknowledge that they have done so when writing the letter. I also know now that VA will seize on anything they can to deny, too. Let’s look at WaynesWorld from the vA perspective and see what went wrong. If one believed in Astrology, he would ascribe this to being born under a bad sign. I suspect Wayne was a pragmatist and assumed VA was set up to do that which most of us assume it was- to minister to our needs.

Mr. Gardin served in the Air Force from 59 to 63. He had a few medical problems that indicated he was headed down the road to eventual diabetes, but like most non-medically inclined, he failed to mention this at discharge. So, for lack of medical training, he could not opine as to his incipient disease. When he finally got around to filing for it in 1994 he discovered what we all do when we use a VSO. You need a nexus letter. They fail to tell you this even after denial. It was all a big mystery to them (and us) back then unless you asked about it. Most of us didn’t. We trusted our VSO Bozos.

Fast forward to 2003. Wayne refiled and this time got three nexus letters not to mention statements from friends, family, his postman and the local dog catcher. He was armed and dangerous this time out. Or not. As we all know, vA has a way to demolish even the best laid defense. By artfully cutting and pasting different comments and using “divide and conquer”, they can make your whole sand castle disintegrate. Add the failure to ensure continuity and you have the recipe for the perfect storm of denial. I’m sure Wayne was as dumbfounded as I was when they gave him the 86.

The CAVC gave him an opportunity to go back to the Board in a JMR due to poor English construction in their denial. The Board obliged him by brushing up their pronoun usage and denied once more. The Court this time approved of their new found command of the English language. However, they neglected to read what we call  setting a precedent. For all of you in St. Petersburg, that does sound a lot like setting a president but the two have nothing in common.  Regardless, the Court knows the difference.  Mr. Gardin promptly motored on up to the Federal Circus for a do over.

The Feds carefully disassembled this and spotted the error immediately.

We address first Mr. Gardin’s argument that the Veterans Court created a new rule of law that permits the Board to discount medical evidence solely because the physician providing the medical evidence did not review the veteran’s service medical records. The Veterans Court approvingly noted that the Board discounted Dr. Sexton’s medical report because he did not review the claims file when reaching his determination that Mr. Gardin had had diabetes during service.” Gardin,2009 WL 1006160, at *1. The Veterans Court’s analysis is contrary to law and statute.

Congress expressly permits veterans seeking service-connected disability benefits to submit reports from private physicians:

For purposes of establishing any claim for benefits …, a report of a medical examination administered by a private physician … may be accepted without a requirement for confirmation by an examination by a physician employed by the Veterans Health Administration if the report is sufficiently complete to be adequate for the purpose of adjudicating such claim.

38 U.S.C. § 5125. In addition, the Secretary has defined “competent medical evidence” to mean, among other things, “evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions.” 38 C.F.R. § 3.159(a)(1) (2009). Accordingly, neither the statute nor the regulation requires that a private physician review the veteran’s medical service record before his or her opinion may qualify as competent medical evidence.

This is what sets the stage for the next big brouhaha that I base this post on. Congress, not Sir Eric the Great, is empowered to tell us who can write and provide a nexus letter on our medical conditions, be they diseases of the mind or body. With the arbitrary decision in 2010 to limit all PTSD decisions to doctors from vA, they have abrogated the right that Congress had husbanded to themselves. This cannot stand. Congress, not vA, decides what is permissible.

In the future, one of America’s finest will  arrive with a properly constructed bent brain nexus that vA will denigrate as being substandard. The rationale will be simple . Our doctors at the VBA did not write it and we categorically do not recognize it as being legal. Many trees will be sacrificed to make the pulp for the denials. Many legal hours will be clocked and childrens’ college accounts will be fattened accordingly in the process of determining what we all know. Eventually this new warrior will prevail with his private nexus and the VBA will have to go back to the old archaic, and horribly inefficient, method of letting fraudulent brain doctors opine for their conniving Vet patients who are faking it.

What is perhaps sad is that Shinseki knows this is contrary to the wishes of Congress. Anything that engages in mission creep in this compensation business always is. The Court occasionally will catch it; and if not the Feds do. We shouldn’t have to constantly correct the vA for trying to reinvent the regulations. They know how to read. What they simply couldn’t abide by was the fact that this decision making was out of their hands. That tasked them mightily. So much so that they felt compelled to rewrite the rules and regulations to reflect what “should” have been enacted. This is what happens in the M-21 unofficially. Raters are instructed to revamp what and how its done. Along comes a Wayne Gardin and upsets their carefully laid plans. Now we see a gradual retreat from the Nieves-Rodriguez holding. Either that or the CAVC is getting Alzheimer’s.

The law is written. We are admonished from birth that America is great and a land of laws. If we are dissatisfied with how they are written, there is an orderly method for changing them. I speak, of course, of the vote. Apparently some of the boys up at the vA missed that chapter in history class or they feel they are above the process. Regardless of the reason, the law has been broken. It was knowingly ignored, bent and twisted to comport with what the vA felt was more “functional”. Perhaps their intentions were well-meaning. I, for one, don’t buy that. If this were a rare event I would stand on the ramparts and defend them. Since it is just one in a long litany of disrespect, ignorance, indifference to our plight, and a genuine desire to stand between us and what is rightfully promised us at induction, I see it as a crime.

Our famous new Vet is still anonymous and somewhere on the ladder of denial or will be soon. Who will he be? There are no dearth of candidates for this honor. The military and the vA have ensured that by giving them all “personality” disorders.

Posted in Fed. Cir. & Supreme Ct., Nexus Information, PTSD, Veterans Law | Tagged , , , , , , , , , , , | Leave a comment

Top to Bottom Cleaning

Member Randy sends us his ideas on how to cure the vA problem.

Swab the deck

Square your area away

Whatever terms you care to use there is a heaping pile of BS needing to be cleared out of DC. Specifically the DVA and the minions who control it. If Uncle Shin needs a suggestion for cleaning here is a homemade recipe for him.

Cut the red tape and get the C/P departments down to a manageable number. Say 30-50 people, depending upon historical numbers of adjudicated claims. Out of those employees you would retain the best at following the CFR’s to the letter. Perhaps divide the body into different departments with each department only working on a particular area of the body. These employees would work for a minimum of  four years per department and would then rotate into another section. By the time they have finished the rotation they will have gained the knowledge needed to clean this up and move toward a stronger cohesive group of employees.

Stop looking to add newbies to the program until or unless you want to bring in a few to begin training. Let them cut their teeth on the most tender of morsels such as tinnitus, hernia, burial etc. claims and make sure adequate training is provided to them.

Also, I would advocate stopping the current bonus system based on closed cases. If current employees cannot survive on the current wages then get out because there are others who are more than willing to step it up a notch. A typical GS-15 position is making roughly 85-90,000/year.

It seems rather simplistic and does not have several million dollars behind it but I believe it is a start. We get nowhere without first taking a step.

Randal 7/8/12

Note:

Guest authors are welcome to submit articles for posting here. We do not subscribe to censorship if you are worried some of the thrust of your argument will be modified.

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Each day, 18 more Vets killed on “Highway 1”

In 1999, a group of private companies, such as Kodak, Cisco,  IBM, and  Microsoft got together and developed a system for the VA to use to convert the VA paper claim system to electronic processing called “Highway 1” at no cost to the government.

Today, and every day, about 17,000 Veterans will be so frustrated they will call The VA’s national veterans suicide crisis line (800-273-8255).   And, every day, 18 of these Vets will  (or about 500 per month)  “fall through the cracks” and take their own life  according to the VA’s estimates.  That is, 18 more Vets get killed on the VA’s “Highway One” of benefits claims frustration”.

After more than 13 years of bad contracts, delays, and a million Veterans on a claims waiting list, the VA now promises to have the claims process online by 2015.  Its too late for guys like this, however.

By using “non VA math”, I estimate that another  19,000 Veterans will lose their life to their own hand while the VA takes ANOTHER 3 years to try to fix the broken system.

For those of you who like math, thats 365 days per year, times 3 years, times 18 Veterans per day, which is a little more than 19,000 Veterans to be killed on VA’s “Highway One” of benefit frustration while we are waiting to see if Shinseki’s  contractors, can, indeed, reduce the backlog, and achieve a 2% error rate.

We cant afford to give the VA another 3 years, and 19,000 more Vets lives to fix what should have been done in 1999.  Call your senator and tell him to “fix the VA now”, not in 2015.

Posted in Guest authors, Uncategorized, VA BACKLOG, vA news | Tagged , , , , , , , , | 1 Comment

Why is the VA so broken?

Bob Filner talks to Rachel Maddow on why the VA is so broken, here.

So, why is the VA so “broken”?

There is a “culture of denial”  at the VA that is “anti Veteran”, and often overlooks fellow employees violating regulations, but then nails Veterans.   For example, a blogger who purports to be a retired VA employee rating specialist and trainer for VA employees said this, here  noting that a goniometer is required by regulations:

(Author’s note:  The link, above, appears to be broken, because that website’s moderators apparently have not yet decided whether or not to allow this to be published.    We apologize if this link does not work, however, we have no control over whether or not VBN moderators choose to keep this up or not)

With regard to the use of a goniometer, let me say this about that; I think that many folks make far too big of deal about this. I say this for two reasons. First is the fact that just about any doc who has been doing these exams for any length of time can be quite accurate just using their eyeballs. Granted, they are supposed to use one, but in reality many do not.

Second, my experience with VA C&P exams (and I’ve seen several thousand of them) is that more often than not the C&P examiners are quite liberal in their estimates when they don’t use the goniometer.

Huh?   This senior VA employee suggests that people make too big a deal about employees following regulations?  This same poster, who goes by “Cruiser” at VBN also stated:

As a DRO (Note:  A DRO is an experienced VA claims decision maker who often “reviews” less experienced claims representatives decisions, and, in this case, this DRO claims to train others at the VA! ) I saw this all too often myself. It was extremely disheartening to see veterans come into my hearing room for a personal hearing looking for all the world like a damned invalid after I had already observed them moving about freely in the parking lot or building cafeteria. In other cases after I had my doubts as to what they were telling me I would go to a 3rd story window overlooking the parking lot and watch them walk to their cars after the hearing. I’ve actually seen veterans get out of the wheelchairs that they were in when they appeared in front of me and carry the darned things to their cars after they left the building or tuck their crutches up under their arm as they walked away.

Assuming the trustworthiness of this ex VA supervisory employee, why did he not report this Veteran who was committing fraud, by “faking” an injury?  Maybe there was a reason this employee did not want investigators “sniffing around”?

In response, another poster stated it this way:

You (Cruiser) have categorized Veterans seeking help from the VA as liars and manipulators. That should be a wake up call to all Veterans that is how the majority of VA employees think of us. Veterans or not, when they are manipulating the system, like giving bonuses to those who deny claims AND training them how not to use the instructions they are given, those people are destroying Veterans lives.
Sounds familiar where the VA employees are always spot on when picking out a Veteran faking it, but when the docs or VARO employees do not follow the regulations it is not much ado about nothing, perfectly acceptable behavior. 

Another poster stated:

What a shame there was no disabled veteran taping the shredding of records that has taken place in the past.

Clearly, there is a “war” going on between VA employees and Veterans.  Sadly, the Veterans seem to be getting the short end of the stick.

Asknod notes: Apparently (as JAVet mentions) the link above has been shut down by VBN. The moderators there frequently do this censorship of their readers if the subject becomes too critical of the vA . They also ban members who have the audacity to stand up and be heard from what I’m told. I suppose this “head in the sand” technique has its proponents. It worked well for the likes of Hitler, Mussolini, Qaddafi, and other tin pot dictators. Perhaps the vA could take a page from their playbook?  

Posted in All about Veterans, Guest authors, VA BACKLOG, vA news | Tagged , , , , , | 1 Comment

Shinseki’s backlog reduction by 2015 wont be met.

I hope, for Veterans sake, that I am wrong about  VASEC’s promise .  Maybe he will keep his promise, but the numbers don’t add up.    The VA’s promise to fix the backlog by 2015 is largely based on  the VA’s “fuzzy math”.  

You see, the VA would have to hire 4000 more employees just to “scan in” the billions of pieces of Veterans C files and data.       Even if the VA did have  the budget to hire 4000 MORE employees (and I doubt that, as it was not budgeted in), hiring and training that many people does not happen overnight!

As an example, the VA promised to hire just 1600 mental health workers, and they said it will take until spring 2013 to hire about a third as many.   If it takes a year to hire 1600 workers, then it would follow that it would take about 3 years to hire 4000, and there is certainly no guarantee that they will even start hiring or training  these 4000 employees tomorrow.

Even if they did quickly hire and train these 4000 new workers, it will obviously take months or years for these new workers  to scan in these billions of documents.

The bottom line is that the VA’s “fuzzy math” does not go in the real world, and we can expect 2015 to come and go without the promised backlog reduction…just like 2010 came and went without the fulfillment of the  promise to “break the backlog this year“.

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DEFINITION OF INSANITY

Some noted author or famous person who escapes my brain-fogged memory once said that the definition of insanity was repetitively doing something over and over again in hopes of attaining a different (and better?) result. Ah, Google. >>>author Rita Mae Brown in her book Sudden Death on Pg. 68 from 1983. 

Read more: http://wiki.answers.com/Q/Who_first_said_the_definition_of_insanity_          is_to_do_the_same_thing_over_and_over_and_expect_different_results#ixzz1zxRRdWBB

Gotta love the machine, huh? so, let’s proceed to the subject of today’s diatribe.

IDIOT’S DELIGHT

A PLAY BY ASKNOD

CAST OF CHARACTERS

Will A. Gunn,  General Counsel   DVA

R. Randall Campbell,  Asst. Gen. Counsel  DVA

Richard Mayerick, Leslie C. Rogall, Carolyn F. Washington, David L. Quinn,Joan E. Moriarty, Deputy Asst. General Counsels

After twenty three years in this business of trying to prevent veterans from receiving their benefits as prescibed by law, the DVA, or vA if you will, is no closer to kicking ass and taking names. This is evident by reading many decisions by the Court and the occasional appeal to the higher venues.

vA over the years has had two phenomena. The VJRA with it’s attendant power transfer, and the enucleation of the old boy network of 3-member triumvirate Boards who dispensed what passed for jurisprudence for thirty years.  vA still hasn’t gotten over this. Witness one of the first tête a têtes here with Manio. It was ugly and bloody and the VASEC at the time, Mr. Derwinski, came away with teeth marks all over his ass. While he doesn’t actually dirty his hands, his minions listed above are the ones who do. Will Gunn et al are the men in the trenches. They move and shake. They decide which cases they will fight to the death. They are also the ones who go up to Indiana Ave. NW with a straight face, argue their side of the BVA decision and defend it in the appeal.

Now, we know from testimony at the Supreme Court that the vA admits their RO and BVA decisions (and actions) are substantially unjustified over sixty percent of the time. With that said, why do they continue to perpetuate the same errors decade after decade?

Why no pow wow? What, exactly, is preventing the hierarchy of the VA, the cast of characters above, from sitting down with their “people” and having a production meeting. Were we flies on the wall, what would we hear?

Gunn:  “Okay. Everyone got their Starbucks®? Good. Let’s get to the point here. Ladies and Gentlemen, Mr. Campbell and I seem to be spending an inordinate amount of time relitigating issues I thought were decided a score or more years ago. Why can’t we all get on the same page here? If a Vet has a good case and we have no grounds to deny, why are you guys over at the Board shooting them down? This is not cost effective.  We’re getting our teeth kicked in up at the Court and I don’t mind telling you that I find it embarrassing. Chief Justice Roberts caught that bozo out last fall and he admitted as much. What we need to do is revamp this thing and make it more efficient. Christ! Carolyn and Leslie might as well get hotel rooms closer to 625 Indiana Ave NW if you keep this crap up. It’s cutting into my spare time and my handicap is going up. Questions?

It’s more likely that this will never occur. If any production meetings should occur. I’m sure they will entail crafting new acronyms for reducing the backlog and better excuses for why the new protocols haven’t been given a chance to work.

 From all outward appearances, the vA appears to be in the business of preventing Veterans from attaining benefits. That’s the impression I get. I’m sure the vA doesn’t share my sentiments though. Let us venture further and look at some sobering statistics.

Roughly 85% of claims for compensation are denied the first time out. Ignore compensation for pensions, dependency issues, and the grave marker allowances and you are stuck with 85%. Does that imply 85% of this claimant pool are liars and cheats? Not exactly. It seems we are all maladroit and do not present our claims “in the best light”. According to the vA, we neglect to send in the exculpatory evidence that would go a long way towards remedying the process. Huh? If this were Geico®, wouldn’t they call us back and say “Gee, Mr. Nod. Looks like you failed to give us three estimates for the right front quarter repair. We can’t complete this without it. You know that, right?” vA tells us we inhabit a unique, Veteran friendly environment and then proceeds to give us plenty of rope to clothesline ourselves with. The denial comes as a complete surprise in most cases as we all well know.

Representative Filner D-Ca. has an excellent solution to all this. Trust the Vet. Does anyone believe 85% of us are ne’er do wells? Liars and cheats? Money grubbers? No, of course not. If I were to venture a guess I suspect that five percent might fall into that category. If that’s so, why can’t we do what the IRS did? Grant the claim subject to an audit. Look at how much money they throw away every hour down in Foggy Botttom. Would another billion ever be noticed? According to vA-yes.

If one knew he was subject to a fine and possible prison time, I’m sure this would be a deterrent to the majority of miscreants out in the world. Obviously there are some for whom this will never bother and they will press on regardless. Why should ninety five percent of us have to suffer for the failings of five? In truth, we shouldn’t. Nevertheless we are corralled with them and made to endure an unrealistic wait of years and sometimes decades.

Anecdotal evidence says this:

2011 claims —– 1 million (approx.)

85% denial = 850,000

 # of NODs= 250,000

# of Appeals to BVA = 50,000

# of claims to CAVC = 5,000

Remand rate= 60%

Conclusion? Pursuing your claim has a higher rate of success if you appeal. Duh. I didn’t have to explain that but it is evident that many of these claims are never pursued. My attorney pointed out something I am guilty of too. When someone like the vA calls you a liar and denies you, it can be a personal insult. I took it that way after I realized it wasn’t just some garden variety error. vA counts on this. It’s formulated into the system that way. If every Vet appealed all the way to DC they’d have to come up with a better mousetrap. Instead, they shotgun denials and wait to see who fails to stand up afterward. They repeat the process at the BVA in most cases and wait again to see who falls out of formation.

When the few, the proud, the last Vets standing march up to Indiana Avenue to appeal, vA is there like the attorneys for any large corporation waiting on the steps to strike a last minute accord with you. When they know they are wrong and are exposed in their lies, they beg for the do over. This is what we call a JMR (Joint Motion for Remand). Since few if any of these Vets show back up at the Court again, we can assume that promises were made and gifts were exchanged.

You can now see the enormity of the problem. If you remove the impediment to granting the claim subject to proof of fraud, the system will move forward and the backlog will become a distant memory. Auditing claims with no timetable to adjudicate them takes the inexorable  pressure off the raters to crank these out. We’d all be happy campers. Unfortunately this does not sit well down at 810 Vermont Ave. NW. Until we change the vA mindset that we are all trailer trash and Walmartians, we are doomed to repeat this insanity. They are perfectly fine with that and see no reason to revamp their thinking. Why is that? Roseanne Rosannadanna summed it up in seven words: “It always goes to show it’s somethin’.” Filner sees it. We see it. Hell, everyone sees the forest except the vA.

As some sage once said “They’ll see it only when they believe it themselves and not one moment sooner.” God help us.

Posted in VA BACKLOG | Tagged , , , , | 3 Comments

CAMP LEJEUNE UPDATE 7/2012

This just in from member Shawn who knows where all the bodies are buried back east. It seems Congress is going to finally do something about this horrible mess. I figure they’ll rob Peter to pay Paul in order to get it done. Either that or they’ll rob Peter to pay Paul’s interest on it. Being innovative, I’m sure they’ll find a way to disenfranchise someone or a group so as not to disturb any of their pet bridges to nowhere.

As usual, this closely parallels the Love Canal housing development and the Agent Orange debacle almost to a T. Deny, deny, deny. Then -“Well, we weren’t sure so we didn’t drop the dime on anyone for fear that it would just cause undue stress. Now that we know, well, we’re telling everyone.” That would be fifteen years of not being sure in case anyone’s counting. I’m sure Jerry Ensminger is glad to see some resolution to this. Imagine losing your child to government stupidity. Then multiply it by scores of children.

We children who grew up to be soldiers and ate, inhaled and drank AO in SEA are no different. We went into it just as blindly and were misinformed, lied to and ultimately given the “We didn’t know” treatment, too. The only difference was that Dow and their ilk knew about the deleterious nature of 2,4,5 T for years before they deployed it and sold the military on it.

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VA Employees Meet quotas by denying Vets

According to the New York Times, the employees at the Columbia, South Carolina’s VA Regional Office deny Veterans claims because it is faster and helps them meet quotas.

The Times article says it this way:

They’ve implemented so much stuff, no human can keep up with it all,” said Cindy Indof, a decision review officer who has been with the department for 20 years.

Further, the times said,

The workers (VA Employees) said those quotas encourage processors to take shortcuts that often lead to mistakes, or to focus on easier cases over complex ones. And when in doubt, processors tend to deny claims, the workers said, because denials are generally faster.”

Even more troubling is the VA Workers’ belief  that Shinseki will never be able to reduce the backlog, in spite of his promises to do so:

Mr. Robinson said about 8,300 cases were ready to be processed in the Columbia office, which has about 100 claims raters, many of whom already have more than 140 cases on their desks.

“Do the math,” he said. “There is nothing we can do to catch up.”

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