BVA– NO DIC FOR WIDOW

FROM THE HORSE-TRADING

RO CAPITOL OF THE WORLD

I don’t know which is more painful – the idea of the BVA VLJ having to sign this decision or the widow conned into chasing this chimera with no hope of winning.

 I take no pleasure in bashing the VA. I find it unavailing and I’d be out of a blog if they ever started performing up to their own ideals. I commiserate with this poor widow that she will never attain DIC, but it simply wasn’t possible given the medical evidence that Mr. Bourbon was the guilty party. When you live that close to a man, I think you’d be able to discern a pattern of ETOH abuse over 30 or 40 years. To ignore it and mount a legal assault on VA for benefits is either the height of hypocracy or… the product of some extremely poor legal advice.

Were you or I to have consulted with a VA-approved attorney, he would have  asked VA  for the same file (the C-file) that contained all this nefarious information about our Resurrected Brother’s alcoholic liver. He would then have ascertained the futility of the endeavour and communicated as much to the widow. She, with this valuable knowledge, would apply for a pension if it paid more that SSI.

What happened is best described as tragic. Somehow, or some way, this poor widow woman was induced into filing a rainbow chase claim. The American Legion SO, were he properly trained, could have avoided this too. Somewhere along the line someone had to convince her this was the correct and lucrative path and perfectly legitimate. Assuming her age to be 78-82, she didn’t hatch this on her own. Perhaps she had a greedy daughter or son in law. It still should have stopped at the VSO for a long discussion of how they were going to win it.

Springing all this evidence into court and embarrassing his spouse is unprofessional. Nevertheless, this is what we see day in and day out. Blame it on the Vet if you must but don’t compound it with interest by dragging the widow through the mud. Due diligence would have revealed the predicate for the denial and the futility of an appeal.

http://www.va.gov/vetapp11/Files4/1133916.txt

From the footlocker:

Posted in BvA Decisions, BvA HCV decisions, From the footlocker | Tagged , , , , , , | Leave a comment

BVA–40 YEARS TO SC

FROM THE MAPLE SYRUP

RO IN VERMONT

Imagine filing shortly after service for Hep because you came down with it a week after you got out. You know the dentist is responsible but VA treats you like a dolt and denies. Being young, dumb and underrepresented (by VSO), you are induced not to appeal.

Insert thirty years and then discover it has gotten worse and changed flavors. That’s what our Vet has discovered. To add insult to injury he went through two, count them, two DRO reviews with no luck. Finally the BVA adds it all up and comes to the right conclusion. Gee, the Vet wasn’t lying and there may be some substance to his contentions. VA calls them contentions because that’s how they view them. The theory can also be called “Guilty until proven innocent”.

The Vet has finally prevailed by amassing so much evidence that even  reasonable minds could only come to the conclusion it occurred in service. What  is disturbing is that the DRO couldn’t do this. After all, they are the best of the best at the RO and the senior raters. The refusal to grant in 2009 just proves the futility of trying to get anything out of these bozos once they throw the gauntlet down. Moving the claim to D.C. is prudent in the long run. Your decision will occur a year sooner and most with any legs will win.

The Veteran wisely collected “buddy letters” from all his friends and relatives to document this. His filing in 1972 although unappealed, was  more ammunition in his favor. He presented this well and was lucky the VA’s “nexus” was in his favor. It’s risky business to allow them to do this, but here it paid off.

http://www.va.gov/vetapp11/Files4/1134287.txt

Note the tail number starts with an “O”. That’s not a zero. The O designation (Obsolete) was the AF and the government’s way of taking the aircraft “off the books and transferring it to places it wasn’t supposed to be or to organizations who were not governmental. Even the military has rules. This one still has it’s AF insignia on it before transfer to the RLAF in 1968. These brand new Cessna 170Es  (O-1 E) were declared obsolete as soon as they were “born” and accepted by the AF.

Posted in BvA Decisions, BvA HCV decisions, Tips and Tricks | Tagged , , , , , , , , | 1 Comment

BVA–DM2= HCV

Here is something Vets can take to the bank. Peel off the studies on HCV and DM2 and insert them into your claims. Then proceed to get it in nexus format. This is proof positive that HCV equal DM2. VA has denied this for years but this puts paid to the story. Read it closely and look up the studies to print and include in your claims. This is an instance where the evidence is overwhelmingly in your favor. The Vet wins on his hypertension claim as well even though it was far more tenuous.

In contrast, the file contains positive nexus opinion 
of September 2011, offered by a practicing hepatologist.  
The doctor cited numerous medical studies and provided 
additional medical information, but determined that he 
could not conclusively say that HCV was the proximate 
cause of the Veteran's diabetes.  He further observed that
 based on the preponderance of (specifically cited) evidence 
linking both HCV and cirrhosis with diabetes, it was his 
expert opinion that it was more likely than not that HCV 
and cirrhosis were either causally related to or chronically 
aggravated the Veteran's diabetes.


The Court has held that a medical article or treatise "can  
provide important support when combined with an opinion of 
a medical professional" if the medical article or treatise 
evidence discusses generic relationships with a degree of 
certainty such that, under the facts of a specific case, 
there is at least "plausible causality" based upon 
objective facts rather than on an unsubstantiated lay 
medical opinion.  Mattern v. West, 12 Vet. App. 222, 228 
(1999); see also Sacks v. West, 11 Vet. App. 314 (1998) 
and Wallin v. West, 11 Vet. App. 509 (1998).  Here, the 
studies cited by the hepatologist assisted him in 
providing a positive and adequately supported medical 
opinion in 2011.

The BVA has been good to us this year and even more so in this last quarter. Realization that something is amiss should be evident by now. If we have appealed 20,000+ denials of HCV at the ROs, how many were filed, lost and unappealed? Frightening to think. Using the 28% figure, I would assume somewhere in excess of 100,000 of us filed in 2010-2011.

We are rapidly becoming dinosaurs in this fight, so it behooves us to fight all the harder to win. With the BVA more inclined to actually read the appeal and use elementary logic, chances of a win go up daily.

http://www.va.gov/vetapp11/Files4/1138429.txt

Posted in BvA Decisions, BvA HCV decisions, HCV Health, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , , , | 1 Comment

BVA–ABSENT RISK FACTORS= JETGUNS

Its nice to see these decisions as they are entirely too rare. Here, there simply isn’t any other risk. Try as they might, VA cannot hang this guy out to dry. I wonder if they are finally coming to rue the day they said it was biologically plausible…

http://www.va.gov/vetapp11/Files4/1140321.txt

I’m sure the AMLEG guys got this fellow’s photo on the wall in the trophy room. It’s probably the first HCV one, too.

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

BVA– Internet Articles = No Service connection

Here is a classic example of what not to do. Even though this widow has a law dog, the approach is all wrong. You can submit evidence until the dump truck breaks down from the excessive load to the front door of 810 Vermont Ave. NW and it will get you no  closer to SC. You can submit like cases of BVA and Single Judge decisions from the CAVC and the same will ensue. Absent a true and  coherent nexus letter , your efforts will not avail you. Here, the widow is doubly disenfranchised as her husband, a combat Veteran, cannot speak from the grave to describe the blood exposure he undoubtedly experienced.

Take this to the bank when filing your claim regardless the circumstances. Amassing large quantities of articles about HCV clinics in India and contamination of jetguns  in a Pakistani weight loss clinic in 1998 will not get you there.

http://www.va.gov/vetapp11/Files4/1132480.txt

Posted in BvA Decisions, BvA HCV decisions, HCV Health, Tips and Tricks | Tagged , , , , , , , | Leave a comment

BVA–TRANSPLANT= SC FROM JETGUNS

Here’s a classic jet gun win with nexus letters to go with it. What is notable is that the doctor writing the nexus is also the transplant surgeon and uses the trnasplant as prima facie evidence that the infection is 30-40 + years old. This places it squarely in the time frame when the Vet got his jetgun innoculations. This, Veterans, is the ticket to a good letter in my book. Metavir scoring , Childs-Pugh or any other that shows the disease is extremely advanced is an indicator no one argues with any more. One simply cannot “hurry up” the infection by drinking or doing drugs post service.. Once you get it, it is a linear progression of approximately 10 years per stage from 0-4. Thus, 40 years (2002) is smack dab at the start of this fellow’s induction in 1966. Okay, to be terribly anal, its thirty six years.  This is excellent evidence for any of you who are post transplant.

http://www.va.gov/vetapp11/Files5/1142926.txt

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

NEW VA HEPATITIS DISABILITY QUESTIONNAIRE

VA just released this and a bunch more the other day. This is the one for Hepatitis.

http://www.vba.va.gov/pubs/forms/VBA-21-0960G-5-ARE.pdf

This is the list for all the questionnaires:

http://benefits.va.gov/TRANSFORMATION/dbqs/ListByCondition.asp

 

Posted in General Messages, HCV Health, vARO Decisions | Tagged , , , , | 4 Comments

BVA– More Magical Disappearances

This morning, I decided to write down all the numbers and amounts of Hepatitis claims to hang on the bulletin board in front of me. This would allow me to watch the quantities change or jump around. I started with 2011, because that is what pops up first. You can see this when you click on BVA decisions above.

I wrote them all down. Yesterday or late Friday night, the BVA uploaded the last of 2012 or the majority. The number was 20, 537  of 668,105 claims appealed. This morning the number was  16,356. That’s odd. So I clicked back to 2010 and there were only 1,508.  2009 was 1417 and so on. So I gather there is a major epidemic afoot and I’m planning on letting the CDC in Atlanta know it. Even if the figure is 16K+, that’s a major uptick from 1508 in case anyone is math-challenged. And the kicker is that apparently there wasn’t one single claim appealed for Hep in 2003. Numbers are our friend.  I’ll keep you posted (get it?) Posted? Never mind.

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

BVA–BUILDING A CLAIM? HIRE THE CARPENTER

Before I begin, I wish to inform Miss Manners, who excoriated me for my incorrect capitalization of “Veterans” in the middle of a sentence, that it is my habit to do so. For your edification, I do this because we are the only ones (8%) who seem to feel it is their duty to keep people free-not just ours.  Most volunteered for the privilege. I gather you didn’t. Veterans, with a capital V, are the idiots who get blamed when the bombs don’t fall where they were intended to, when there is “collateral damage” (civilians), or on the off chance, when someone is “terminated with prejudice” as we used to say. Veterans, with a capital V, are the ones who occasionally get maimed or killed engaged in playing cowboys and indians.  However, veterans with a small v-perchance are those who have worked at GM for ten or more years. They are all honorable veterans of whatever endeavor they set themselves to, and are often quite adept at it. What they will never do is rise to the level of Veterans, and so I shall continue to commit this grammatical error. That’s all I have to say about that.

As much as I exhort  fellow members to engage the enemy in hand-to-hand combat, when circumstances find you needing a leagle beagle,  there are few with more legal acumen than the gentleman defending this Vet.  Mr. Carpenter needs no introduction as I have written several times of his finesse.

As BVA decisions are woefully incomplete, the names of these claimants are not available. We only discover their gender in the rare place where they divulge it via a pronoun.  I take literary license to substitute one where it entertains. Here, I won’t.

This gentleman, a Vet, stands tall in his shoes. If he enlisted in 1971 and still saw service in Vietnam, you have to know it was an unsafe, unsettled time.  We were busy retreating  (advancing in a different direction) from the dear old RVN. The fact that the Vet became homesick and went back into battle almost 17 years later (and was burned) tells us much more.  He may have been a weekend warrior. I can hear that one coming.  If he was 18 when he enlisted in 1971, that made him a 37 year old in the Nasty Guard-hardly a couch potato.

He arrived in DC on appeal asking for a ratings increase on three items and SC for the Hep. He’ll take home what’s behind door number 3-  Uncle Victor’s cookie jar. SC for hep will be the moneymaker here for this gentleman. Scars are like Tinnitus and hemorrhoids. You don’t die from them and VA ratings top out at low percentages.

Our Veteran friend also has some “imperial entanglements” here in the form of drug abuse issues. I suspect if it were  sniffing glue, some parallel argument would be substituted that was equally damning. What is of interest to me is how this is evolving. Obviously, due to VA law, Mr. Carpenter didn’t stroll in off the street at the RO and offer his services. The Veteran had to lose first, which is asinine, but that is a subject for another day.

What happened is the Vet probably did a little homework and knew that the Indochinese peninsula was crawling with every kind of Hep on earth-and thriving, too. He offered as much in testimony. As a combat Veteran (the burns, I would assume), his testimony is gold. Therefore, the after-service negative history has to be couched in polite terms. The VA examiner wants to accord this guy proper respect. The Certified Bedpan-Changing Nurse CBCN)  providing the VA’s nexus very carefully  segues into the drug hanky panky, but immediately seeks sanctuary in…

the issue of etiology of hepatitis C could not 
be resolved without resort to speculation.

Enter the cabinet maker/builder. This Vet would be toast without him. He convinces the Judge to remand this for a real opinion. As luck would have it, they got an assistant  professor of gastroenterology. This guy works over at the VAMC in a sharing arrangement from Duke University’s medical program. VA likes to do this. They don’t hire the doc full time per se. He is paid by Duke but his practice is probably exclusive to the VAMC. He cannot be suborned. VA doesn’t own him. Being knowledgeable about all things Hepatitis, he writes the truth on the magic paper…

The VHA physician stated that the Veteran was part 
of the group of Veterans who carried the highest 
risk for infection with hepatitis C.  The Veteran, 
via shared razors, was noted to have "blood 
exposure" in Vietnam.  The physician opined that 
while intravenous drug abuse, which had been noted 
in earlier parts of the medical history, would be 
a greater risk for hepatitis C than the Vietnam 
blood exposure of Gulf War burns, he conceded that 
there was conflict in the record.  Accordingly, 
in full understanding of both the in-service 
history and the later drug abuse, the physician 
stated that the record was sufficient to show 
that it was at least as likely as not that 
current hepatitis C was caused as a result of 
military service. 

I certainly won’t ask why no one obtained a liver biopsy to show a Stage 3, Grade 3 liver. That would have sealed the deal as to whether it was pre or post service . Had this Vet attained it post 1991, the Stage would be 1 or early 2. Fortunately, you only need one fact to win, so its immaterial here. Since he’s  a Veteran of two wars, I would trust the guy to tell the truth. He apparently self-reported the other negative evidence.

Thus, although this Vet’s post-service risks are great, he gets the benefit of the doubt-something that wouldn’t have happened if the Kenster hadn’t been there to make sure he didn’t get screwed. Having a law dog there with you tells Uncle Victor one thing and one thing only. There is no doubt that you are headed to 625 Indiana Ave. NW if the decision is adverse.

If you knew you were preparing to engage in a legal skirmish with Ken, you’d look at the cards more closely- and perhaps choose to fold.  A good nexus from a VA source that couldn’t be compromised certainly wasn’t what VA expected, either.

I have pointed out the new legal epiphany which VA has used for years off and on. They have started employing it more and more on the Hep claims recently because they’re running out of ammo to defend this. Remember, before Groves v. Peake (2008) VA examiners could “opine” and say “the hep in service appears to have been acute (infectious) whereas the hep he has now is C”? PCR testing put a fork in that. If it wasn’t tested and it was called “hep” in 1970, then it’s still hep today and BOTD says its HCV. However, in the new denial process (post PCR), trying to figure all this out causes consternation and a fear they may get it wrong. Rather than deny the Vet, they leave it purposefully vague and unattainable as in the phrase above. I think it’s on Page 1069 in the M-21-A1.

When all else fails, claim speculation. The phrase to be
employed should closely resemble this: "It's simply too 
speculative for the examiner and it gives him a migraine"

Mr. Vet loses on three 10%ers and wins the big one. Mr. Carpenter catches the next flight back to Topeka and they all go to Heaven in a little row boat. Cool or what?

http://www.va.gov/vetapp11/Files4/1136090.txt

The teaching moment here is when you’re standing at the mailbox looking at your shiny new decision and you see the word “speculative”, it’s time to lawyer up unless you have some powerful evidence you haven’t sent in yet.

Posted in BvA Decisions, BvA HCV decisions, Nexus Information, Tips and Tricks | Tagged , , , , , , , , , | 1 Comment

BVA– WHEN CUE ISN’T

From the Biggest little RO in the World (Reno) comes this little gem. Yes, it comes down from DC, granted, but it originated in the fertile minds of those funny guys in the back Room in Reno.

Johnny Law was a cop in the Army and had some imperial entanglements afterwards  of the drug kind. The boy came down with a dose of the Dragon and filed for SC. Reno sleuths took the story hook, line and sinker. They did the etch-a-sketch nexus and presto! SC for Hep with blood exposure and other cop risks. This was 2003. They granted in 2004.

The rater must have had a nagging suspicion he stepped on his necktie or a superior finally and belatedly got around to reading the thing he signed several years earlier. The defecation contacted the rotary oscillator and the rater was called in for a “pep talk”.

The Chinese Fire Drill was announced and VA  inveigled Johnny back in for a new Dog and Pony show. Nothing had changed medically speaking. He still had the bug and the risks were what they were. Well, this just couldn’t stand. The same VA rater redid the prior rating over and came to the new, revised and VA-directed nexus of willful misconduct and drug risks. Repair order? Take his rating away and declare it was CUE from the get go. Since the same rater was just rearranging the same guy’s rating to comport with the new reality, it really wasn’t all that wrong-perhaps more of a ” reality readjustment” . Johnny and the AMLEGs took this up to Judge Parker and he took a gander at it.

CUE is very unique. In order make Johnny walk the plank, they had to show that the result-a “holding” they had adjudicated- was undebatably wrong and would have manifestly have come out different but for the error. It didn’t.  All they had was two equally subjective and opposite decisions. One had been made 8 years ago and a new one that VA wanted to use as the right one was still wet ink on the paper. Parker rightfully reasoned that VA hadn’t made their case by showing a different outcome would have ensued. At best, it was in equipoise, but we don’t do benefit of the doubt at the CUE party. Result ? Christians 5, Lions 0.

When the last signature is on the paper, its too late to change your mind. VA would like to believe their rules are for us.Parker turned the tables and simply held VA to the same standard. Wow. Totally new concept.

http://www.va.gov/vetapp11/Files5/1143804.txt

Posted in BvA and VARO CUE DECISIONS, BvA HCV decisions, CUE | Tagged , , , , , , | 1 Comment