CAVC–DIBERNARDO V. SHINSEKI–JETGUN INFO

While this is a Single Judge Decision and useless for precedent, look at the encaptured below for your case. The BVA or the VA has finally released the definitive requirements for successful transmission via jetgun. They can’t put this cat back in the bag.

The appellant first contends that the Board clearly erred when it determined that his hepatitis C was not related to service, despite its acknowledgment that transmission of the virus by airgun was a possibility. Appellant’s Brief (Br.) at 8-10; see R. at 10 (“The biological possibility of transmission of the hepatitis C virus by jet airgun injectors has been acknowledged by VA.”). This argument is unavailing. Establishing service connection generally requires medical evidence or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a
disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376–77 (Fed. Cir. 2007); Hickson v. West, 12 Vet.App. 247, 253 (1999); Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table); 38 C.F.R. § 3.303 (2011).
As noted by Dr. Stevens and relied upon by the Board in its decision, while airgun
transmission of hepatitis C is “biologically possible,” three things must occur:
First, the face of the air gun would have to have blood on the surface[;]

second, there [would have to be] no attempt to remove blood from the device between patients; and[]

third, . . . at least one recruit immunized before [the appellant] would have to
have had an active hepatitis C infection. R. at 31
  Dr. Stevens estimated the current in-service occurrence of hepatitis C at approximately 10%; he further opined that this rate was likely lower at the time of the appellant’s vaccinations. R at 31-32. Based on this, he concluded that it was less likely than not that the appellant contractedhepatitis C while in service. R. at 33. DiBernardo v. Shinseki 2012)

Keep that in mind if you are filing for HCV via the gun.

Dibernardo v Shinseki

 

 

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CAVC–EVANS (ROCKY) v. SHINSEKI–IVDU?

When all is said and done at the BVA, one appeals up to the CAVC-usually with a good reason. We all know (or should be aware) that proving HCV is often one of the hardest legal hills we will climb. Our facts must be cogent, our reasoning impeccable and our SMRs either supportive or neutral for risk. Obvious evidence of negative events will knock one out of the running and very little, if anything, will avail a Vet in these circumstances. Many Vets similarly situated have won, but had enough evidence of combat blood exposure, a medic MOS or similar risk that gave rise to the benefit of the doubt.  In these cases, you can almost arrive without a nexus and still get sympathy from a VLJ on appeal. If the RO screws it up or ignores evidence, you can still pull it off in D.C.

Rarely, we see a Vet come forward and contest the facts as they were written in his SMRs all those years ago. I have yet to see a successful conspiracy defense.  Even more rare is the appearance of a Vet before the Court unrepresented (pro se) with such a difficult row to hoe. Enter Rocky A. Evans, a Vietnam-era Veteran.

Mr. Evans arrived before Judge Davis with no legal counsel. This is not to say he couldn’t find any. There are numerous leagle beagles who will do this for you, and even put up a spirited defense, fully well knowing your chances of success are less than those of a snowball in a warm locale. Granted, Rocky had a piss poor case with no redeeming features, but every dog must have his day. I often ostracize Vets for wasting valuable judicial resources and I would normally continue that here, but I feel compassion for Mr. Evans. He made some poor choices and will suffer the consequences for the rest of his life. Nothing would be gained from telling him what a ditz he is/was. Let us see what we can salvage from this in case we find ourselves similarly situated.

Rocky served from October 1972 to July 1974. That usually indicates a draftee unless he was booted for unsuitability or other infractions. As the record doesn’t indicate a less than honorable discharge, and the law says one is ineligible for benefits in those circumstances, we can assume he emerged unscathed. As a serving member of the Armed Forces in a time of war, he is eligible for benefits. When defending oneself pro se, one must go to great lengths to familiarize oneself with the law. Judging from the tenor of the record, it appears Rocky is no slouch in that respect. He filed a “informal brief” with the Court and they have to do some “kn-str ing” to figure out what his bitch was:

Mr. Evans argues that the Board failed to consider statements from his “civilian doctor” who reported that he “contracted hep[atitis] C in the service.” Appellant’s Informal Brief at 1. The Court will construe this as an argument that the Board provided an inadequate statement of the reasons or bases for treatment of medical evidence from private treatment providers. Evans supra

The backbone of Rocky’s appeal centers on his contention that he was railroaded by some nasty doctors who entered medical information that was untrue into his SMRs.

Mr. Evans also argues that the Board erred in finding that he used IV drugs in service. He states in his informal brief that he did not use IV drugs during or after his service in the Army, and implies that an Army doctor fabricated this information and inserted it into his records. Evans (Rocky) v. Shinseki (2012)

Those are mighty tall assertions that give pause to most legal proceedings. VA and the Court will go to great lengths to disprove allegations of this nature because they call into question the basic fairness of all jurisprudence.

The Board’s determination that Mr. Evans used IV drugs in service is a factual finding, and must be supported by an adequate statement of reasons or bases. The Board is required to include in its decision a written statement of the reasons or bases for its findings and conclusions on all material issues of fact and law; that statement must be adequate to enable an appellant to understand the precise basis for the Board’s decision, as well as to facilitate informed review in this Court. Evans supra

Vets must understand the import of a “finding”. This is different that finding a twenty dollar bill on the floor of the supermarket while you’re waiting to check out. That finding should surreptitiously be stepped on and acquired via the  retying of one’s shoelaces. A finding at the RO or BVA is arrived at because they are “triers of fact”. They are invested with the authority to determine what happened (via their own tortured reasoning) and announce their decision. The fact that they are wrong 60% of the time should not be held against them. This is why the Court exists- to right these inequities. Failing to avail yourself of this invaluable judicial tool is foolish-unless, of course, your case does not have a legal leg to stand on.

The Board noted that the record contained service treatment records in which Mr. Evans admitted to drug use in service, and that the treatment records were created by three different examiners at three different times and places. For example, the record contains a February 1, 1974, service medical record in which the examiner recorded that Mr. Evans “uses needles sporadically, the last time about 10 days ago” and diagnosed hepatitis A and “[h]istory of drug abuse, intravenous.” R. at 49. The record also contains a December 24, 1973, service medical record in which the examiner recorded: “P[atien]t admits to IV use of drugs.” R. at 56. And an April 18, 1974, service medical record notes that Mr. Evans admitted to using various drugs, including heroin and morphine. R. at 57.

The Board also reasoned that, because two of the statements were made by Mr. Evans for the purpose of seeking medical treatment for a condition that was later diagnosed as hepatitis A, and therefore that it was in his best interest to provide accurate information, they would be ascribed greater weight than later testimony by Mr. Evans that he never used IV drugs in service. The Board adequately explained its reasons and bases for assigning relative weight to the evidence of record, and for its factual finding that Mr. Evans used IV drugs in service. Because this factual finding is supported by the evidence of record, the Court concludes that it is not clearly erroneous.  Evans supra

This is the predicate for Mr. Rocky’s predicament. Diarrhea of the piehole 40 years ago  is often a claim killer. There is nothing that can be done to ameliorate this in Rocky’s case. No protestations of alternate risk theories, no argument that his nexus letters are bogus- nothing.

As Mr. Evans was a little skinny on what, exactly, it was that caused him to come down with this disease, the Board has given him due process. Arguing the Army doctor  had it in for him is still not fulfilling the three Hickson elements. Rocky is arguing the case as if he has checked off on all three requirements. This means Rocky didn’t read the rules on nexus letters very carefully. This small inattention to detail  created a problem which might have been avoided.

A strong defense with several well-written nexus letters taking into account the drug risks as well as jetguns etc. might have survived a Court inspection. Arriving pro se with a conspiracy theory and little else does what we all detest- wasted judicial effort. The one universal truth you can take away from this  is Shakespeare’s immortal line  “Whosoever is his own counsel has a fool for his client.”  One must also complement Judge Robert N. Davis for politely overlooking Rocky’s propensity to stretch the truth about the IVDU. I might have let slip a reference to Mel Gibson. My humor is irrepressible as most know.

http://search.uscourts.cavc.gov/isysquery/4fed8b72-36f5-4ba8-9591-ff331bbe1a68/4/doc/

 

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PTSD Fallout Continues

Hot off the email. Thank you for your perseverance for Vets, Bob.

New York Times
March 3, 2012
Pg. 18

Calling For An End To Phony Military Discharges

To the Editor:

“Branding a Soldier With ‘Personality Disorder’ ” (front page, Feb. 25) scratched the surface of an important military scandal.

I have been investigating personality disorder discharges for the last six years. In that time, I’ve interviewed dozens of physically wounded soldiers who were booted from the military with a phony “pre-existing personality disorder,” which prevents the soldiers from receiving disability and medical benefits. They even have to give back a chunk of their signing bonus.

Soldiers severely wounded in combat are finding out on their final day in uniform that they will never get disability benefits — and they now owe the military thousands of dollars.

I have also interviewed military doctors about being pressed by their superiors to misdiagnose wounded soldiers. One doctor told me of a soldier who came back with a chunk missing from his leg. His superior pressured him to diagnose that injury as personality disorder.

The numbers in this scandal are staggering. Since 2001, the military has discharged more than 31,000 soldiers with personality disorder, at a savings to the military of over $17.2 billion in disability and medical benefits.

Barack Obama had been at the forefront of this issue. As a senator, he put forward a bill to halt all personality disorder discharges. But as commander in chief, he has done nothing to halt these fraudulent dismissals.

The American people should confront the president and the Republican presidential candidates with this question: As commander in chief, what actions will you take to keep these phony personality disorder discharges from devastating another military family?

JOSHUA KORS, New York, Feb. 26, 2012

The writer is a freelance reporter.

Editor’s Note: The article referred to by James Dao appeared in the Current News Early Bird, Feb. 25, 2012.

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Slight Delays at CBOCs

I drove by Bremerton, Washington’s VA Community Based Outpatient Clinic on my way to a doctor’s appointment and noticed this. Apparently there are only four doctors now, so some delays are possible. I suggest calling ahead to confirm any appointments made over a month ago. Parking may be extremely limited so walking is recommended. Unfortunately, if you decide to walk or bike, no travel pay will be forthcoming. FYI.

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Everything But The Kitchen Sink

This must be a “women” thing. Do any of you guys suffer this problem?  Over the last six months it’s  become harder and harder to get to the sink and do dishes. Now, with orchids heralding the beginning of spring, everything is on hold near the window. This has always been the sacred area reserved for germinating the year’s new seeds for tomatoes. Apparently I didn’t get the change order. Tomatoes wait for no one. Besides, you cannot eat orchids or any other of the items in my kitchen window. Therein lies the problem. I was summarily informed this morning that what I had mistakenly assumed was “my window” isn’t.

Gentlemen, be careful. It starts with a small orphaned plant. In short order a succession of “temporary” plants crop up and soon the dishes become secondary to the plants. Any attempt to relocate them will be greeted with comments about how insensitive your are to their plight and even the approbation of “barbarian”.

My advice is to stay the course. Rather than retreat, I suggest a tactical advance in a different direction.  I’ve decided to install a bigger, 240VAC panel to the greenhouse and permanently install heat to rectify this. It’s cheaper than a divorce. Obviously, it goes without saying that I’m not putting a sink in there either.

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Dx?–PTSD

Member Paul has decided to let the cat out of the bag. I move his post to the front. This comes as no surprise to me after watching denial get wider than de Mekong.

I was a patient of Ellis-Billingsley back in January – February, 1995, having been hospitalized for a suicide attempt while under “investigation” for a supposed act of misconduct.

I refuse to address her as Doctor in this statement because I know she is something less than an ethical doctor. The first day in Madigan (5-North) she came into my room and grabbed my rank located on my collar and shook it while stating your General is going to bust you in rank. I thought “OMG”, is this the type of care I am going to receive? I was already paranoid enough, not sure who to trust, and just generally scared. I felt terrified by Ellis-Billingsley. Who could I complain to about her conduct? The MEDCOM IG? Who would believe a psychiatric patient in a closed room with a “stellar” doctor assaulting a patient? She put misinformation into my psychiatric records that has never been substantiated by any other doctor or mental health professional.

In the meantime, the DOD-IG was conducting a review of an IG complaint which was later substantiated that a BG and several of his colonel cronies had engaged in ethical misconduct. They were stupid enough to put certain informtion in writing and as an NCO, I felt obligated to report it. Of course, the BG and his cronies were never punished in any way for their ethical misconduct, which in my opinion was pretty serious. I

Now, so many years later to see she has resigned is great news for the military community.

She now has the shoe on the other foot and sees that “all the investigations are a charade as the outcome has been predetermined.” If she had one ounce of personal self-worth, she would have stayed and fought the battle. Instead of continuing to milk the system, thank goodness she ran and cried like a little baby.

Luckily, I finished my military career, but ended up rated as totally and permanently disabled by the VA. Her lack of soldier care, lack of concern for my mental health, and her unbelievable misconduct by physically grabbing my uniform and shaking me remains with me to this day. How she ever reached the rank of LTC is beyond me, although I have my ideas.

It is sad to see so many years later she is (was) impacting the lives of soldiers. I can only wish my fellow soldiers the very best and to let you know the experiences I had under her care. Yes, I think the “system” is definitely flawed and only takes your personal resolve, persistance, and patience to obtain the desired outcome.

Good riddance Ellis-Billingsley for all that you did to me and other mental health soldiers.

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PTSD vs. Personality Disorders

All this talk of PTSD in the news brings back old memories of returning to the World in 72. Since there was no PTSD prior to 1981, we all suffered from a plethora of “issues” when we came home. There were various names given to it by us. That’s where I came up with the term “bent brains” or “bent brain syndrome”. It was also variously referred to as combat stress, combat fatigue, an “inability to reintegrate” (my personal favorite), malingering,  or “faking it.”

Many of us who came home were appalled at the treatment we received from our fellow citizens-not to mention friends. I was never personally called a baby killer. I know others who were. I wasn’t spit upon at San Francisco Airpatch. I stopped short and he missed. I wonder if he would have done that had he known I had my S&W .357 in my shoulder holster under my camo fatigue blouse? That was invisible but the survival knife hanging off my belt wasn’t. I was on TDY when I exited SEA. That meant I didn’t have the luxury of returning to my unit and collecting my belongings. I came home with the clothes I was wearing and a duffel bag of more jungle gear. I took a month’s leave because I’d had a total of two R&Rs of three days each over two years.

On June 15th, 1972 I arrived at Edwards AFB- still in camo jungle fatigues. All my gear was  en route from Thailand. Tough luck.  When I reported to my squadron everyone was nodding in my directions and whispering. A stand to inspection was called suddenly for my section. Everyone fell in and some were leaning over to look down the line at me. The E-8 in charge of our section and the first shirt sedately walked down the line. When they got to me, they stared long and hard-at me then at each other. Comments were made about a) my hair; b) my uniform; c) my unshined jungle boots and my lack of deportment.  I was summarily dismissed to go to the BX and retrieve new attire. I had to squander bucks to buy new stateside fatigues and shiny black boots. I then went to the base Barber shop and got a AFM 35-10 regulation haircut. I was ordered to return for reinspection to see if I had complied. I’ll never forget the monkey first shirt. CMS (E-9) Robert “Jack” Frost (w/ diamond device for First Sargent) walked around me several times. After this, he called in MSGT (E-7) Bartley. Together they discussed me as if I was an inanimate mannequin. Finally the truth came out. I had always striven to keep this discrete, but my father was a Lt. General in the AF. I asked for nothing in the way of special consideration, but Sgt. Frost drew first blood. “I was the first shirt over in 5th AF in Japan, you know. I served under your father and I’ll be damned if I’m going to allow you to sully his reputation, buddy. We’ll be watching you mighty closely. You step out of line and you’ll regret it.”

When I was overseas, what counted was how well you could shoot, how smart you were at making do with what was at hand and that you weren’t a  junkie. Hair just wasn’t on the radar. You got a haircut when you went near civilization. Boots wouldn’t stay black no matter what off the beaten track. Jungle boots were ½ canvas anyway. When I returned, I was reminded of all the reasons why I wished I’d just stayed there for a third year and put paid to it.

It was less than a month later when I was called in for another of those personal inspections by Jack Frost. Apparently my fatigues weren’t up to par because they didn’t have a “crisp crease” and the boots had scuff marks on them. Edwards AFB during the summer, for the uninitiated, is about 95 degrees during the day. Keeping a crease in anything outdoors is virtually impossible if you are working.  I was briefed on my shortcomings again and asked to sign the “finding”. It was all downhill from there. After several more negative findings, I was sent to the shrink to find out what was wrong with me.

By January 1973, it was determined that I was unsuitable for further military service. Prior to my assignment to Edwards, I had glowing Airman Performance Reports (APRs) saying I should be promoted well ahead of my contemporaries. It was said that every effort should be made to retain me in the AF. Suddenly I was anathema. The shrinks determined I was suffering from an anti-social personality and passive aggressive tendencies. My military usefulness was zilch. The problem was how to gracefully dispose of a General’s son discretely. They offered to discharge me promptly the next day if I would just sign the statement admitting I was queer. I couldn’t do it and said I’d try to mend my ways for my remaining eight months. No dice. I was starting to “pollute” the squadron with my antics and I had to be excised. The AF took another month of fiddling around and finally pole-axed me in late February after a Article 15. I got a General Discharge under honorable conditions even though this personality disorder I was afflicted with manifested itself in service. Since it wasn’t a mental illness as the VA or military defines it, I was shit out of luck for compensation purposes. I never got the VA benefits briefing prior to discharge anyway so it really was a moot point.

What the servicemen and women now hitting the exits are discovering is something similar. The military has no great love for you once it has been determined you are damaged-mentally or physically. There is more compassion for those who lose a limb.  That’s a given. There is a lot of nodding and winking when it entails a bent brain. A soldier who gets warped from his/her experiences in a war zone is somehow a wimp in the eyes of his commanders. He’s a liability and useless. He can’t be depended on any longer. Being dead wood, he must be cut loose and replaced with one free of “defects”. His continued presence will spread the “rot” to those who are healthy. This is one of the primary reasons most hate to be classified as such. Even if they are adversely affected, they do not wish to have their manhood besmirched. Face it. Being told or admitting to being half a bubble off is not what you want on your resumé.

The military has made great strides in trying to identify these individuals and offer them help. This makes it easier to cull the herd, too. Swept up in this bent brain round up are the partially incapacitated such as I would have characterized myself. I would have assimilated if the pressure was not so pointed. My father had nothing to do with it. I spent two years over there and part of it involved being actively engaged in bombing the Pathet Lao back into the stone age. If it doesn’t affect you to some degree then it could rightfully be said that you are beyond help.  Most everyone can heal from these experiences. Some take far longer than others. There is no manual or book to turn to for advice or a cure. Some, however, can simply never return to normalcy.

What I see happening now is a carbon copy of what I and many others went through when Vietnam was over. We were diagnosed with “personality disorders” as opposed to “mental disorders”. There is a fine line between the two. One is compensable (PTSD) and one is not (acute stress disorder and anxiety disorder). While the terms of the discussion have changed in the intervening 40 years, the effects of the illness are similar. If I were in the shoes of the troops presently being disenfranchised or having their PTSD diagnoses downgraded to personality disorders, I would ask some pointed questions about who is making these subjective assessments and whether they are considering all the elements.  How many of you have ever been shot at? How many wounded? How many of you have killed another human being? Everyone reacts differently and the longer it happens, the better the chance that one of two outcomes will ensue. Either you get pissed and turn horribly belligerent or you turn to jelly. Some fall in between but most hang on until they reach a place of safety- such as America. Arriving home is a sigh of relief. No stress. No worry of seeing a hand grenade suddenly bounce in front of you.

Unfortunately, what many discover is the thrill is gone. The camaraderie between platoonmates is missing. The “us against them” is absent. The urge is to return to that environment post haste because the thrill of victory and the agony of defeat is lacking. I guess I can’t describe it as artfully as I could in 1972. What I can say is it doesn’t entail shiny boots and crisply starched fatigues. And how regulation haircuts can improve your aim is beyond my comprehension.

My first wife left me due to this “personality disorder’. My second one threatened to until she recognized what it was. You may or may not get over it. It took me more than ten years to come home. I only hope it takes far less for the current crop of returnees. What they do not need is false promises followed by false diagnoses to help America resolve its debt problems. We did this in the waning years of the Vietnam “boundary dispute” and the chickens are still coming home to roost. Asking psychiatrists to couch it in financial terms in 2012 and “relabel” it is equally unproductive.  Much like Wimpy, they are simply put off  until next Tuesday what needs to be addressed today. Our troops deserve better. To see this begin in the military before we even get sandbagged at the VA is the ultimate two-faced bitchslap.

I would gladly pay you for PTSD next

Tuesday for a personality disorder today.

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Miracle On Aisle 2

Phone cameras are neat. They allow you to immortalize things in digital 0s and 1s. Here member Cal stumbles upon a case of Divine Intervention. He tells me he didn’t see a preacher exhorting her to cast sin aside and leave her chair. She did it spontaneously without any bidding. He’s contacting the Catholic Church to check on Beatification possibilities. This is better than a  likeness of Jesus burned onto your toast. Notice she is extending her hands heavenward -or at least to the top shelf.

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Madigan Forensic Shrink Quits

In a delayed announcement, one of the remaining forensic psychiatrists from the Madigan PTSD Clinic imbroglio has decided to throw in the towel.

Dr. Juliana Ellis-Billingsley handed out a press release Feb. 23- “I find that I can no longer work in a system that requires me to sacrifice my professional and moral principles to political expediency. She went on to say her abiding  belief that  “all the investigations are a charade as the outcome has been predetermined.”

We knew heads would roll, but we never suspected that there might be a mass exodus to prevent the stench of  disrepute from attaching to promising careers.  I wonder where Juliana will alight?

Madigan in 2010 diagnosed 1,418 patients with PTSD, acute stress disorder and anxiety disorder – three common behavioral-health conditions that can be related to combat. Of the three, only PTSD is singled out for a guaranteed disability rating and accompanying pension. Over the past two years, the hospital diagnosed 1,699 soldiers with PTSD.                     Uh-oh. 2010 = 1418 soldiers. 2010 +2011= 1699  soldiers. ergo 1699-1418 = 281 2011 soldiers. That’s pretty tricky math. List one year. add two together and move on to the next “fact”.

The reviews at Walter Reed are done with service members face-to-face. It’s not clear if Madigan’s forensic psychiatrists always met soldiers in personal interviews. Gen. Horoho told a House subcommittee that the Madigan team sometimes made decisions “administratively” based on case files.Madigan sources said those cases were rare and tended to happen when clinicians from the Department of Veterans Affairs reached different conclusions from active-duty Army doctors. That can happen because retiring soldiers might begin the process of registering for VA benefits before they leave the service.

Some Madigan doctors apparently were skeptical of the VA diagnoses, which were sometimes conducted by private contractors with less experience working with the military, according to one memo.

In some cases, Madigan psychiatrists found candidates for medical retirements who lied about deployments or who posted information on social media web sites that contradicted what they told clinicians.

Madigan forensic psychiatrists were expected to carry out personality tests to determine whether a patient was misleading a clinician. They were to interview patients and ensure that commanders had verified the soldier’s deployment history, according to a summaries of their standards.
Forensic psychologist Steve Rubenzer in 2006 published a study in which he wrote that front-line clinicians often do not suspect that their patients have financial motives for seeking PTSD diagnoses.   Whoa there, Dick Tracy. They also may be so scrambled they can’t put their underwear on facing forward. Anxiety disorder provokes that.

“Clinicians may not know that a patient has (motivation to mislead a psychiatrist for financial gain), often do not suspect the possibility of malingering, and typically lack the training or tools to assess malingering even if they suspect it. Not surprisingly, they rarely find it.” Rubenzer wrote six years ago in a passage cited by a Madigan doctor.

Read more here. This is absolutely fascinating.

http://www.thenewstribune.com/2012/03/03/2051290/madigan-psychiatrists-who-made.html

Posted in All about Veterans, C&P exams, Gulf War Issues, PTSD, vA news, Veterans Law | Tagged , , , , , , , , , | 5 Comments

Quote for a day

In God we trust.

We trust in Smith and Wesson

when He’s not available.

Amen

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