BVA–LAST NEXUS STANDING

Here’s a little trick we have noted over the years of reading decision after decision. On a vast majority of the claims for jet guns, most Vets, due to their unfamiliarity with the Caluza triangle (Hickson elements), submitted claims without nexus letters. When and if they got lucky enough, they ran out and got one to CYA. Some even got good ones that stood up to the rigors of vA’s requirements.

In almost all cases up on appeal at the BvA , when these were presented with a waiver of review by the claimant, and were the only nexus of record on file in the claim, the VLJ was inadvertently forced to grant the claim.There’s a simple reason for this. It backfired on the VARO because they  were too lazy to mount an offense that investigated the medical evidence. Instead, relying on that old, tired saw “There is no evidence in the SMR’s that the claimant had HCV in 1969”. and “The veteran claims he got the dragon from jetguns, but he has no medical training (Espiritu v. Derwinski 1992)  therefore anything the poor misguided soul says is bogus and pure speculation.”

What they fail to do is where the error begins. If the vA Examiner doesn’t perform the magic “It is less likely than more likely that this ever happened the way he says it did,”, then there technically is no “finding” being being pronounced by the VARO. Ergo, no vA nexus. Where you do see the Examiner opine is after a C&P. No C&P = no nexus.

When you submit a really good one that passes all the requirements, and attach a waiver of review in the first instance with the BVA, you create the only nexus of record. If the VLJ isn’t playing fair, he could remand it back to the RO and allow them to craft a denial that fits the original but buttressed by a C&P exam. Yep. You’d have to report for a Dog and Pony show that would reveal what? A tattoo or two? BFD. You can claim they arrived after 1992 and sanitary protocols because you know vA is going to assume they are antiques from the seventies AFTER service. Always remember- you are the date stamp of your tattoos. Whatever you say on the subject is true unless rebutted. We do know that not all tattoos were recorded at exit exams. You are medically competent enough to remember when you woke up with these new acquaintances (Layno v. Brown 1994) If you don’t report for this bogus D&P, you lose anyway. Let’s not go there.

Vets who have won like this (with only one nexus in the C-file) originally arrived with nothing but a 21-526 and perhaps a note from the American Red Cross donation station saying “Thanks, but we were unable to use your gift of life”.  They have no risks other than the jetguns and file with their VSO or pro se. As you can see  from the prior post, many arrive this way. Some, but not a lot, manage to obtain one and for those smart enough to fence off the VARO, they can prevail. The waiver of review, in essence, precludes the VLJ from doing anything other than ruling on it. You have all three requirements for the claim present. The RO (and the BVA) don’t. Check and Mate (checkmate), as they say in Chess. Once painted into this corner, unless the VLJ and  his merry band can find a loophole, there is and can only be, one legal outcome. You may have to go up to the Court to prove that but it is immutable law.

An interesting case would be if a Vet were denied in spite of all the evidence being pro and little con. If the VLJ remanded it back down to the RO searching desperately for a denial, I wonder why the Vet couldn’t file an appeal staying the remand and make the bastards rule on what they have in hand. vA screws us fairly regularly with or without the evidence. Why should the RO be given numerous opportunities that will produce a denial that finally sticks? That was the priceless argument put forth in Shinseki v. Macklem recently.  Anyway, that’s J1VO.

Posted in BvA Decisions, Jetgun BvA Decisions, Nexus Information, Tips and Tricks | Tagged , , , , , , , | Leave a comment

PENSION FLIM-FLAMMING

Giving credit where credit is due, member Shawn sends us this morsel. It’s a sore point with me and others where our Veterans assets are disbursed. This really hit home for me in 2010 when my wife’s father passed away. The estate planner showed up and started telling us to move what assets Grandma had left into a trust or transfer them to us so she’d qualify for a VA widower’s pension and quite possibly A&A now that she’s in a nursing home. Grandma doesn’t need it. She and Grandpa did quite well for themselves while they were in their earning years. The SSI was chump change that paid for the gas and groceries.

This is forbidden where Medicaid is concerned and rightfully so. More and more people with obvious financial assets are moving them adroitly into shell trusts or other’s bank accounts in order to qualify for funds that rightfully should be disbursed by SSA. To add insult to injury, the vA makes no effort to determine if you’re scamming the system.  We only see that level of investigation when someone like Keith Roberts pulls their string one time too many and aggravates the vAOIG. The true measure of  vA’s wrath descends then- whether deserved or not.

Surely there are those of us out there who were profligate or worked under the table for wages only to discover they shortchanged their Social Security check to their own detriment later when they needed the income. I know of one who gets about $862, maybe $900 tops because he did this. He’s broke and sick and didn’t foresee HCV. A viable recourse would be to apply to the vA for that pension at the 100% rate of $2769/mo. after he turns 65. I would. What I wouldn’t do is transfer my millions or however much I’d amassed over the years into secret accounts in order to take advantage of that paltry sum. Especially when it robs the food out other Vets’ mouths (figuratively speaking). Sadly the “I,me,me, mine” generation as envisaged by the Beatles song and practiced by the Congressional vultures has come home to roost.

Rarely do I advocate against Veterans except for those who clog up the judicial system with meritless claims. This is one time I agree that the system is  broken  and in need of transformation. With government on the verge of breaking under the financial strain, it seems criminal for the rich to game the system and even more egregious for the feather merchants who aid them in this scheme to benefit as well. Pitch a bitch. It’s your money they’re absconding with.

Here’s the article and thank you to Shawn for bringing it to our attention. This is your site. Use it when you see a problem because these things metastasize when they are ignored. Look no further than those crazy programs where farmers were paid NOT to grow things. Next thing we see is millionaire movie star “farmers” investing in farms they don’t operate and have no plans of growing foodstuffs on. Hell, they often don’t even have harvesters or tractors with which to NOT grow the crops they’re getting paid NOT to plant. America has a flat tire. This November would be a good time to fix it.

It’s Joe Veteran’s Administration

but the  Benefits Department ain’t his.

Posted in All about Veterans, Complaints Department, vA news | Tagged , , , , , , | Leave a comment

BVA– TEXAS VETERANS COMMISION

FROM THE DAVID KORESH

MEMORIAL VARO IN WACO

Here’s an interesting decision. We don’t know if the chicken or the egg came first. We do know that WGM used this outfit  out of Houston, but that is no guarantee of success up in David Koresh’s neighborhood.  We’ve heard all manner of strange occurrences at the Wacko RO so another one with no nexus letter shouldn’t come as any surprise. At least they managed to fill out the Form 8 correctly and certify the appeal.Maybe WGM arrived at the Texas Veterans Commission (TVC) office with the nexus in hand and didn’t need an admonition to supply one.

One thing’s for sure. The TVC isn’t going to supply one and if you’re headed to a Texas Necktie party it’s a good idea to have one. Nevertheless, the gentleman from the TVC in Waco didn’t see fit to inform our Veteran friend. Therefore he becomes the odd man out when the music stops. This is sad. Perhaps criminal is a better word.

We all know what the program is and can preach about it all night. The VSO/TVC groups all know this isn’t going to get past V2 and take off without the nexus so what gives? Here we are in Washington D.C. with 2 or 3 years into an appeal and someone (VLJ George Senyk) has to be the bearer of bad tidings? Why even bother with a VSO if this is the case? Hell, why bother to appeal at all?

This is one of those classic examples of why you should either educate yourself on the process  if you intend to DIY or get a real legal beagle. They may soak you for 20% but at least they know the ingredients for this recipe. Texas Tim is now up broken paddle creek with very few options. He can’t appeal to the Court because that would be futile. What could he possibly hang his Stetson on? The only viable option is Square 1-refile to reopen with a corresponding loss of his earlier claim date of 2008. Four years invested in this and nothing to show for it. I reckon down in Texas they have some cute phrase for when that happens and it’s probably more strongly worded that “Don’t that just take the cake?”  or “Dang!” In South Carolina, we’d use the longest word ever invented for that purpose: “Shiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii-i-i-t!”

Posted in BvA HCV decisions, Nexus Information | Tagged , , , , , , , , , , | 10 Comments

HCV & PALEO FOODS

HCV requires a special diet that takes the load off the liver much like a jackstand takes the pressure off a wheel supporting a vehicle. One good way to do this is to eat good, empty, high fiber foods that have vitamins and minerals but lack the cholesterol baggage. Meet Mr. Coconut.

The coconut is what my son refers to as Paleo food as in Paleolithic in that it is a staple of many who lack access to Safeway grocery stores and their ilk. He’s a half-owner in a Crossfit  Exercise Gym and strongly recommends it. It does have saturated fats but no  transfats or the aforementioned dreaded cholesterol. It has no additives, is low in iron and has lots of neat things in it like potassium in case you get tired of pounding down bananas. My parrot loves it. The coconut milk  is very nutritional, too. Were I still a drinker, I would consider a marriage with Vodka.

I swear by these things for several different reasons. They’re about $1.50 each and last longer than a bag of potato chips.  Sitting  here typing is hard work and my brain needs manganese and saturated fat. Many will say its too difficult to access the cocomeat. Nonsense. If you wish to forego the milk you can crack it open without draining it. In that event, put on a raincoat or w/p apron.

Check it out for the visually inclined. Three tools are needed. A drill or sharp punch to go through two of the three holes at the north pole, a hammer or like device and a very dull butter knife . Unless you want to get on a first-name basis with the ER nurses, this is an important consideration (the knife).

Phase 1–drill the puppy out. Here’s the tools I use, too.

Next, drain out the milk. Two holes are needed for this unless you have lots of time.

Coconuts always crack on the equator, never on the vertical.

Next, crack the two halves by laying them flat and reduce to quarters or eighths.

Take your dull table knife and insert it between the hard shell and the meat and work it around the perimeter until the meat breaks free. Throw the shell away.  My goat won’ t even eat it.

Rinse off the final product and enjoy. For some anally retentive types, removal of the brown skin with a carrot peeler is considered a must. I look at it much like the skin on a potato.

This concludes Sunday’s Betty Crocker adventure in fine dining. If you are having problems, there’s a coconut helpline available M-F from 0800-1730 EDT at 800-827-1000.

Posted in HCV Health, Medical News | Tagged , , , , , , | 2 Comments

Veteran Homelessness: VA execs..can you spare 400 million?

According to military.com, the VA paid out $400 million dollars in bonuses last year.  What would happen if that money went to homeless Vets instead?

While the VA reports that they have reduced homelessness by 12%, I remain skeptical because the VA has a tendency to manipulate the numbers, like this.

But, let’s assume for a moment, that the VA is correct that 75,000 Veterans are homeless on a given night.

Let’s make a further assumption.  Let’s assume the VA has a change of heart, and decides to award benefits to these 75,000 homeless Vets, instead of paying that money out to VA executives for great performance, and also used the other $ 100 million they committed to help homeless Vets.

Instead of paying out $400 million in bonuses, and another $100 million to “communities that help Vets” The VA could award each of 74,400 homeless Veterans a  40% disability rating, and still have money left over from the 500 million.  This would not cost taxpayers a cent, but instead VA executives would not get a bonus and “communities that help Vets” would not get any money to help Vets.    Maybe these communities would not need money to help Vets  if 99.2 percent of homeless Vets  had an income to help themselves.

For those of you who like math, thats 74,400 Veterans times $ 560 per month for a 40% disabled Veteran,  times 12 months in a year equals   499.9 million dollars.

Professor Linda Bilmes suggested something very similar in her 2007 testimony to congress.   That is, she pretty much suggested simply immediately paying Veterans their disability and then auditing some to ensure accuracy, rather than have the Veterans wait in a million man long line for benefits.

Posted in Complaints Department, Guest authors, vA news | Tagged , , , , , , | 6 Comments

VIETNAM MILESTONES

The latest on Leon, too

22-year-old Army Sgt. Steve Flaherty  made it home 43 years before his mail did. The fact that Secretary of Defense (and Library of Congress thief) Leon “sticky fingers” Panetta has now started trading “artifacts” with the DRV makes me want to puke. They are no better than Jane “better Red than dead” Fonda. The treatment and murder of our pilots should never be forgotten. We still have untold numbers who were captured in Laos who have never been accounted for.  Do we have to buy them back, too?

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FOOTLOCKER–DEWAT

DEWAT— (DEactivated WAr Trophy) –def.  A weapon or munition, which, by being rendered inert or by damage, is no longer functional. Permission to keep and possess same is at the discretion of the Commanding officer (MACV directive 1966).

And if you were up-country on the other side of the fence, you could send these out in the diplomatic pouch from the U.S. Embassy at APO Seattle 96243 (96546). I tried it just to see if I could. This arrived at Mom’s house in Alexandria, Va. two weeks later. Notice the impact damage from the 5.56X45 mm NATO round. #1 apparently transited through the upper chest of the bearer and still exited with enough energy to almost penetrate the  firing mechanism-even at 160 yards. Round #2 fired from about 40 yards penetrated the handle and unfortunately damaged the grip-not to mention the hand of the gentleman holding it.

My son used to tote this around when he and his friends played war in the early 90’s.  It certainly raised a few eyebrows and had concerned mothers calling Cupcake to ask if she knew her eight year old son was running around unattended with an RPG  2 and a fistfull of bottle rockets.

Notice the rich mahogany furniture on the barrel and what’s left of the handgrip.

All that damage by a  .22 calibre-sized bullet one and a half football fields away.

Posted in From the footlocker | Tagged , , , , , | 4 Comments

53% ERROR RATE IN PERSPECTIVE

Re  Joe Average Vet’s post on a 53% error rate just at the SDRO. I have had vast volumes of private mail on that subject and 40+ hits every day since it was posted. Let us put this in perspective. A noted Veterans attorney (mine) emailed me last night and posited the “what if?” question that sits on our lips unspoken. Trust a rainmaker to see it in true perspective.

What if …

GEICO’s gecko stood up and said in that inimitable bogus Aussie accent that they were extremely proud of the fact that they were able to resolve claims for the most part in 585 days with an average error rate that rarely exceeded 53%-at least at their San Diego office, but that they were unwilling to extend that claims resolution time to their Oakland and Seattle regional offices?

United Airlines proudly announced that its aircraft safely took off and landed at their destinations 47% of the time and they were actually striving to improve that a bit due to passenger dissatisfaction with the exceedingly high number of aircraft accidents resulting in fatalities?

Premera Blue Cross made a TV commercial wherein they touted their doctors and medical staff were generally successful in resolving 47% of all emergency room visits to the satisfaction of the patients and apologized profusely for the others who had untimely outcomes that resulted in permanent disabilities including death?

Ford Motor Company came forth and said they stood behind their solid record of 47% of cars and trucks sold actually being road worthy and explained that Pintos were an unfortunate aberration that they were actively working on to reduce?

The New York Solid Waste Refuse Utility put up billboards that pointed out they invariably picked up at least 47% of all garbage weekly, admitted occasionally missing some but were analyzing their practices and hoped at some time in the future to improve sanitation practices to avoid further incidents of the Plague?

Your vet attorney, who agreed to take your case, bragged that his win/loss record was 47%/53% but not to worry because virtually all his peers had similar statistics and that he was taking remedial law classes to improve that average?

Your wife, who you adore, said she was faithful to you for the most part 47% of the time,  had minor transgressions which she  couldn’t  explain but was making a concerted effort to eliminate them and apologized for the large number of STDs she inflicted on you?

Your general contractor building your $799,950 custom dream home announced after breaking ground that his price estimates were generally spot on 47% of the time and that he had the ultimate confidence the foundation subcontractor, who similarly had a win/win record of getting  houses plumb and level 47% of the time, would succeed in doing so on yours sometime in 2013 ?

I could go on but the gist of this comparison is fairly obvious as my attorney friend pointed out. How is it that a Government agency tasked with the important job of ensuring its citizen soldiers are properly remunerated, cannot accomplish it in a timely manner and get the decision correct more frequently than 47% of the time? We live in America where anything is possible… except timely , correct compensation for injuries and diseases more often than not documented in the medical records of those individuals.

vA would have you believe that it is a very complicated process fraught with complications, the likes of which we have no idea. That each claim is so unique it requires endless rounds of prognostications and reexaminations to ascertain the Veteran is not simply trying to scam the system?  Keeping in mind Veterans are constrained by a finite life span, endless examinations of chicken entrails and tea leaves  are slowing the process down. I might also point out that there appears to be a finite number of chickens available for these Ouija board exercises in the vA’s budget. With a one million plus backlog, Tyson ought to be making money hand over fist down in Arkansas with shovel ready jobs for chicken manure  technicians. This would also have a nice rebound effect on unemployment and reinforce the concept of  the Trickle Down Theory of  Economics. Properly instituted, tea futures will go through the roof. The prospect of increased Ouija® board and Magic 8 Ball® sales is a given with 57 VAROs.

We know many things now. vA opted to stay in the dark, paper-file ages for decades past when their peers came forth from their hovels and built digital file records in new, improved buildings. These peers even had the foresight to equip themselves in the process with operable smoke alarms and sprinkler systems where they store those records. The vA system of claims decisions is archaic and unworkable based on the fact that they have been taking aeons to decide simple claims for as long as I can remember.  Granted, my experiences are more recent-only going back as far as 1989 so this can hardly be considered aeons from a geological perspective.

The constant drumbeat of excuses, mea culpas and promises to do better if given the resources and funds falls on the deaf ears of Veterans. Having been granted these requested assets, the problem stubbornly persists. Illuminating a government problem obviously does not solve it. Unless, of course, you throw more money and personnel at it. Again… and again and again and again…. Gosh, does this sound redundant?

I submit that the vA is a perfect candidate for shovel-ready jobs. The need is there and it doesn’t require years-long EPA reviews and endless lawsuits from the Sierra Club. According to the vAOIG, the feasbility studies are complete. Press “Print”.

Posted in Complaints Department, VA BACKLOG | Tagged , , , , | 2 Comments

FOOTLOCKER–HOME SWEET HOME

Ah. The M-4 Poncho-a veritable me casa tu casa for six months of the year twice. I went through two monsoons because I stayed an extra year. This device caused me to lose untold pounds like those plastic sweatpants and matching tops As Seen On TV©. Remember them? Sweat those pounds off. Being inside this during a torrential downpour was no panacea for staying dry when it was 88 degrees out.

This was a reissue of a used one but was perfectly functional. I got it May 21st, 1970. It’s born on date was 19 April 1966  as stamped on the front side. It must have been in the bottom of my duffel bag when I returned. I’ve taken it up to 8.500 feet hunting in Wyoming and it kept me dry there, too. In the freezing cold, you can light a propane torch between your feet and make a miniature hot house. Combine three and make a tent with a floor.

They doubled as a stretcher in a pinch.

Posted in From the footlocker | Tagged , , , , | Leave a comment

VETS SEEM TO HAVE MORE HCV

Here are some high-falutin’ government studies that confirm what we were beginning to suspect.

PubMed Results

Item 1 of 1    (Display the citation in PubMed)

1. Am J Gastroenterol. 2002 Jul;97(7):1813-20.

Spectrum of disease in U.S. veteran patients with hepatitis C.

Nguyen HAMiller AIDieperink EWillenbring MLTetrick LLDurfee JMEwing SLHo SB.

Source

Department of Medicine, Veterans Affairs Medical Center, University of Minnesota, Minneapolis 55417, USA.

Abstract

OBJECTIVE:

Hepatitis C virus (HCV) infection is more prevalent in U.S. veterans attending Veterans Affairs Medical Centers than in the general population. The purpose of this study was to examine the risk factors, psychiatric and substance abuse conditions, and severity of liver disease in veterans with HCV.

METHODS:

The medical records and liver biopsies of 206 consecutive patients with HCV attending a multidisciplinary medical/psychiatric chronic hepatitis clinic and who met eligibility criteria for interferon alpha-2b therapy were reviewed.

RESULTS:

The mean age was 46.5+/-6.8 yr and 77% were Vietnam-era veterans. Risk factors included i.v. drug use (64%), blood transfusion (15%), and cocaine use (9%), and were unknown in 12%. The average estimated duration of disease was 24+/-7.6 yr. A history of alcohol abuse or dependence was identified in 80% of patients. Psychiatric illnesses were present in 60%, the most common being depression and posttraumatic stress disorder. Overall, 89% of patients had documented psychiatric and/or substance abuse diagnoses. Severe fibrosis (stages 3-4) was present in 32% and severe inflammation (grades 2-3) was present in 71% of biopsies. Psychiatric and substance abuse diagnoses did not correlate with severity of liver disease. A total of 145 patients (71%) were prescribed interferon-based treatment. The overall virological sustained response rates were 16% after interferon monotherapy and 28% after interferon/ribavirin therapy. Reasons for not receiving interferon therapy included minimal fibrosis on liver biopsy (37 patients [18%]), worsening medical conditions (nine [4%]), and worsening psychiatric and substance abuse problems (14 [7%]).

CONCLUSIONS:

Advanced fibrosis is common in this cohort of veteran patients with chronic hepatitis C, and the overwhelming majority of these patients have psychiatric and/or substance abuse diagnoses. Despite these comorbidities, the majority received interferon therapies in the context of a multidisciplinary clinic. These data emphasize the importance of hepatitis C care that includes linkage of medical care and psychiatric services.

PMID: 12135041 [PubMed – indexed for MEDLINE]

and this as well:

PubMed Results

Item 1 of 1    (Display the citation in PubMed)

1. J Clin Gastroenterol. 2008 Jan;42(1):97-106.

Outcomes of a Hepatitis C screening program at a large urban VA medical center.

Groom HDieperink ENelson DBGarrard JJohnson JREwing SLStockley HDurfee JJonk YWillenbring MLHo SB.

Source

Department of Medicine, University of Minnesota, Minneapolis, MN, USA.

Abstract

GOALS:

To determine the outcomes of implementing clinical care guidelines for Hepatitis C screening, evaluation, and treatment in a large urban Veterans Affairs Medical Center.

BACKGROUND:

Little information exists regarding the actual outcomes of institutional screening programs for Hepatitis C.

STUDY:

Retrospective review of all patients tested for Hepatitis C at the Minneapolis Veterans Affairs Medical Center from January 1, 2000 to December 31, 2001. Logistic regression was used to determine factors related to successful referral and treatment.

RESULTS:

During this period 36,422 unique patients were screened for Hepatitis C virus (HCV) risk factors, resulting in 12,485 HCV enzyme-linked immunoassay antibody tests. HCV antibodies were positive in 681 (5.4%) patients and 520 (4.2%) were HCV-RNA-positive. Of HCV-RNA-positive patients, 430 (83%) were referred, 382 (73%) attended the Hepatitis clinic, and 232 (44.6%) received liver biopsies. Patients referred had significantly fewer comorbidities, known marital status, and greater prior clinic attendance than those not referred. Overall, 124 patients with established fibrosis received antiviral therapy (32% of patients attending clinic or 24% of viremic cohort). White race, fewer major medical problems, and age less than 60 years predicted antiviral treatment. Sustained virologic response occurred in 46 (37%) of treated patients (9% of the viremic cohort). Patients with a sustained virologic response include 17 patients with stage 3 to 4 fibrosis.

CONCLUSIONS:

This screening and referral program resulted in 73% of HCV-RNA-positive patients attending a specialty Hepatitis C clinic and 24% of those most likely to benefit received antiviral therapy. Measures to increase referral, engagement in care, and antiviral treatment are needed.

PMID: 18097298 [PubMed – indexed for MEDLINE]

How much did it cost to discover this is what concerns me. I’d rather see the money spent on the Vets. Multitasking demands I visit my Facebook page once a month and mine it for nuggets as below.

Posted in HCV Health, Medical News, vA news | Tagged , , , , , , , , | 2 Comments