BVA – Gastrodoc vs. ARNP

Posted on October 1, 2011 by asknod

Just when you think you have all the answers and the best or safest way to tackle a hep. claim, along comes a BVA decision that makes you sit up and take notice. Granted this has no precedence and cannot be cited by other Vets, but the information about the inner workings and the thought processes of VA examiners  is  extremely revealing.

Witness this gentleman from sunny, western Florida. He’s being repped by the Florida Dept. of Vet affairs. They are a reputable, no-nonsense bunch of state employees who help Vets obtain SC. Makes sense. It keeps them off the State’s welfare roles. Definitely a win-win for the Vet and the state.

He had some other baggage that put a wrinkle in this story. He smoked hash and drank booze and got caught while in the service.. Well, there you go. Risk factor and willful misconduct. How you can get Hep from the business end of a hash pipe or the mouth of a beer bottle is obvious to the VA. Because he arrived without his own nexus, VA felt sorry for him and decided to provide him one courtesy of their  very own VA medical personnel. The ARNP, in January of 2006 opined that it was simply impossible to speculate on whether it was from being a medic (big risk), smoking hash and swilling beer (medium risk) or his post service drug addiction( major risk). That was January. In March she had a change of heart and opined that the etiology was less likely than not the 1 ½ years of being a medic or the UCMJ  beer bong infraction, No, the smart money was now on the fact that he had a twenty year history of IVDU after service and that was more likely than less likely the cause. Now, stay with her on this. Here’s the unvarnished rationale:

She explained that the Veteran’s in-service diagnosis of infectious hepatitis was mostly

likely hepatitis A as evidenced by symptoms of abdominal pain, jaundice, and an inability

to digest food.  Supporting documentation consisted of an April 1973 treatment note, inwhich the Veteran denied drug use, thus making it more likely that he contracted hepatitis A, not hepatitis C while in service.

VA examiners are real Dick Tracys. Sherlock Holmes would feel like a mental midget next to these sleuths. He denied using drugs which automatically ruled out Hep C! Which begs the question of what exactly she was smoking to arrive at that conclusion. Keep an eye on these April, 1973 treatment notes. We haven’t heard the last of them.

In November 09 on appeal, the Board remanded for another VA exam- this time for any possibility of secondary service connection. Oddly enough, they asked the same ARNP to do this…

On this occasion she noted the Veteran’s risk factors of a tattoo prior to service, blood exposure and shared razors during service, and IV drug use after service. Consequently, the examiner was unable to resolve the issue of whether hepatitis C was due to or a result of infectious hepatitis without resorting to mere speculation.  Her only rationale was that the etiology of hepatitis C could not be isolated to one specific cause as the Veteran had multiple risk factors for the disease.

The Board was beginning to feel confused now. Here the RO had three shots at coming up with an etiology for the HCV and they couldn’t commit on two out of three. In addition, VA’s highly-trained ARNP “examiner” is somehow trying to graft the HCV onto the HAV. So the Board called in the Hexpert…

For further medical comment on this issue, the Board requested a VHA medical expert opinion in April 2010 from a hepatologist. The Board received the expert medical opinion in September 2010. After reviewing the claims folder, the hepatologist concluded hat it was at least as likely as not that the Veteran’s service-connected infectious hepatitis was associated with an acute hepatitis C infection and caused his current chronic hepatitis C infection.

In discussing the rationale of the opinion, the hepatologist noted that the infectious hepatitis of April 1973 became chronic, i.e. there was evidence of persistent abnormality in his liver enzymes (“abnormal laboratory exam, an elevated SGOT of 148″) a year later in August 1974.  He also noted that the Hepatitis A virusdoes not cause a chronic hepatitis infection.  In addition, the Veteran was diagnosed with drug abuse in September 1973, admitting to smoking hash and drinking alcohol. The hepatologist went on to explain that, regardless of the Veteran’s report of lack of exposure to needlesticks or intravenous drug abuse, it was his opinion that the acutehepatitis infection in April 1973 was at least as likely as not acute hepatitis C and that the subsequent natural history would be the development of a chronic hepatitis C infection in most affected individuals.

Now, the Board summed up the positive and the negative to do the benefit of the doubt dance. Yes, they do that at the Board. You may never see it at the RO, but that doesn’t mean anything. Their mission is to bag ’em and tag ’em and let the Board sort it out.

The positive evidence of record consists primarily of the VHA medical opinion, from a board-certified hepatologist, which reflects a full review of all medical evidence of record, including the prior VA opinions, and bases his opinion on professional and personal experience, as well as the traditional risk factors for hepatitis C.

On the other hand, the negative evidence of record consists of a January 2006 addendum in which a VA nurse practitioner was unable to provide a definitiveopinion.  However, in a March 2006 opinion, the same VA medical professional determined that the Veteran’s service-connected infectious hepatitis did not play a significant role in the development of the current hepatitis C.  She articulated a credible opinion regarding etiology, and supported that opinion with clinical rationale and citation to the Veteran’smedical history.

What no one (besides the Hexpert) is admitting here is the glaring fact that this Vet had a AST (SGOT) of 148 a year after his “ acute, resolved HAV infection”. If the AST was cooking at 148 you can bet the ALT was about 170+. The Board does mention it in passing, but it is not addressed in the positive-negative powwow. This is the smoking gun. How is it the ARNP, assigned this job not once, no, not twice, but three times, managed to overlook this little tidbit. It was right there in his SMRs. VA examiners are paid very handsomely for their expertise. That’s all they do. They didn’t run down to the VAMC and grab her out of the gastroenterology clinic. She was on staff at the RO.  This is the St. Petersburg VARO. The smart money says she still works there and is currently denying HCVets on a fairly regular basis.

Finally, in the last paragraph, we find the real reason the Vet won. It turns out a Board certified hepatologist  is a full house whereas an ARNP is two pair.

In this regard, the Board acknowledges that neither the negative March 2006 VA opinion nor the September 2010 positive VHA opinion referenced medical literature to support the medical conclusions contained therein or to reject any opposing conclusion but that both opinions were based upon a complete and thorough review of the claims folder.  However, the March 2006 negative VA opinion was rendered by an advanced registered nurse practitioner, and the September 2010 positive VHA opinion was rendered by a doctor who specializes in gastroenterology and hepatology (indeed the Chief of the Gastroenterology and Hepatology Department at a medical facility).

 

     This further illustrates the “white wall”. The gastrodoc didn’t say the ARNP twit was all wrong.  He didn’t ask how she could come to the horribly misguided conclusion that the HAV was acute. An AST of 148 a year later is not just a smoking gun- its a smoking 155mm Howitzer.. He made his own case without  disparaging hers.  They should revoke  her  license to opine, but they won’t. She works for VA and does what she’s told, even if it conflicts with the truth.

We at AskNod do not subscribe to conspiracy theories about how VA seems intent on denying our claims with the flimsiest of evidence. We do not produce complicated plots that require hours to explain. We don’t have to when evidence like this surfaces.  We do not believe this constitutes a coincidence.  VA personnel are employed to do this for a living, not a side job. This is all they do. We, as Vets, would like to hear the VA’s tortured explanation for why they suffer this 70% error rate in ratings.

Here’s the link to the BVA decision. It really wasn’t even close in spite of how the VLJ characterized it.

http://www.va.gov/vetapp10/files5/1040154.txt

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BVA–38 CFR § 3.156(c) for EED

Posted on October 1, 2011 by asknod

     From that Religiously Challenged city in Texas where they burn down churches  (Waco) comes this quintessential case. Vet applies for chronic Hep. B in 2002. Vet gets the bum’s rush.Vet fails to file NOD and appeal. Vet applies for Tinnitus in 2005. Claim denied. Vet fails to appeal. In 2007, The DAV represented him with more success. He obtained his medical records from the NPRC in St. Louis and submitted some showing hep. in service. Since these are new and material evidence, the RO had to reopen his claim. Now, the interesting part is that these are no run of the mill medical records. These are contemporary “Official Service Department” records. As such, they permit the 2002 decision to be vacated as if it were CUE. This lucky Vet may win his hep. claim with effective date of the original 2002 date. Stinky, dude. Nine years of back pay if he wins and gets a Fenderson rating. We certainly hope he wins this one. 


 

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BVA–DYING BEFORE YOUR CLAIM IS DONE

Posted on October 1, 2011 by asknod

 

We are attaching a series of decisions that deal with the “What if” of passing before one’s claim is accomplished. This situation leaves the battle for DIC in the widow’s lap. The first decision here is what we call a negative objective in FAC parlance. The widow loses because the Vet was not service connected for the hepatocellular carcinoma (HCC).  These are included to illustrate what occurs after the Vet sets off to the Happy Hunting Grounds. Unlike trying to shop for a favorable nexus, the VA is bound by autopsy results in rendering its decision. Period.  If this Vet had had a claim pending for Hep. or was already rated for it and the cause of death was Hep. or one of its ancillary disease processes, the widow would have prevailed.

http://www4.va.gov/vetapp10/files4/1038652.txt

This next decision highlights what happens if you wait too long and marry shortly before your spouse’s death. You must have been married for a year or more prior or have had children with the spouse at any time prior to death.

http://www4.va.gov/vetapp10/files3/1026355.txt

The decision below is an example of what will occur should the Vet pass away during the pendancy of the appeal or before the the BVA has an opportunity to remand the case to the AOJ for a rating.

http://www4.va.gov/vetapp10/files3/1022414.txt

We include the following to foster understanding of substitution:

38 U.S.C. § 5121A has this to say on the subject:

§ 5121A. Substitution in case of death of claimant

(a) Substitution.—

(1) If a claimant dies while a claim for any benefit under a law administered by the Secretary, or an appeal of a decision with respect to such a claim, is pending, a living person who would be eligible to receive accrued benefits due to the claimant under section 5121 (a) of this title may, not later than one year after the date of the death of such claimant, file a request to be substituted as the claimant for the purposes of processing the claim to completion.

(2) Any person seeking to be substituted for the claimant shall present evidence of the right to claim such status within such time as prescribed by the Secretary in regulations.

(3) Substitution under this subsection shall be in accordance with such regulations as the Secretary may prescribe.

(b) Limitation.— Those who are eligible to make a claim under this section shall be determined in accordance with section 5121 of this title.

We probably should have posted information of this nature sooner. We apologize for our tardiness in doing so and hope it has not caused any undue stress on anyone seeking the information.

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BVA- Oops! He died.

Posted on October 1, 2011 by asknod

This is an example, in our minds, of what the VA wishes it could do with all our claims. We know there are a few caring souls in the system and they work hard to see justice done. Unfortunately, justice is as uneven as an unpaved road. The decision below is a classic example of a Vet fighting for his claim for years and years, only to die towards the pendancy of  it. His battle began in 03. He was finally granted SC @ 0% in 05. The battle continued for 5 more years with a rating that certainly didn’t match his medical situation. Finally, in 08, the RO begrudgingly assigned him 40% for the HCV and 70% for cirrhosis. At the top of the decision, under “THE ISSUES”, the reader will note the appeal is for “an initial rating” of a higher percentage. This is an important distinction. It indicates the Vet had been appealing the original 05 decision as well as the newer one. Had it been an appeal of a denial for an increased rating request, it would have been phrased differently.

 

Judging by the fact that he punched out in the middle of the claim before he could get 100%, the reader is left with the distinct impression that he must have been pretty ill. This illustrates what is wrong with the system. Taking years to adjudicate a Vet’s claim deprives him/her of financial security (or what VA would have us believe is adequate remuneration) until the time of their choosing. In this case it had quite an impact on his bottom line. It likewise stands to reason that the stress associated with this didn’t help his medical condition. Our hearts go out to his family.

The Veterans Benefits Improvement Act of 2008 fortunately will allow his spouse to pick this claim up where he left off and hopefully she will get her DIC . It would seem that there is a better way to run this railroad. Perhaps these injustices will soon become a thing of the past. We here at AskNod certainly hope so.

 

 

 

http://www4.va.gov/vetapp10/files4/1035595.txt

 

 

 

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HCV Genotypes and Jetguns

Posted on September 30, 2011 by asknod

 

Having now read somewhere in excess of 30 to 40 thousand BVA decisions, something very apparent is starting to emerge. Veteran’s claims for HCV where the genotype is mentioned are predominantly Genotype 1A.

 

While that might not seem to be important or earth shattering, it contravenes the theory ofVietnam and SEA service being a breeding ground for HCV and, hence a risk factor for the same. The predominant genotype of HCV on the SEA continent (Cambodia, Laos, Thailand and Vietnam) at the time of the Vietnamese War was 3A. 3B was present but not nearly as prevalent. Service inOkinawa, Japan and Korea reflects that 2A and 2B were the predominant strains in those theaters. Moving toEurope, we find that servicemen were infected in larger numbers with the 1B variant.

 

 

 

So how do we account for the inordinately high numbers of  our troops being infected with Genotype 1A? We at ASKNOD, being unschooled in the arts of medicine, have come to the unscientific conclusion that the high incidence of this disease in only one strain would require a disease vector that is common to all servicemen. Et voila! Enter the jet gun.

 

 

 

It is established medical theory that communicable disease paths are readily discernible after years of study. This is based on numerous studies and vast quantities of medical dissertations which unfortunately consume vast quantities of paper and deplete our forests of trees. One scientific theory, known as Occam’s razor, puts forth the proposition that  the simplest explanation for an otherwise inexplicable event is usually the correct one.

 

 

 

Armed with this information, what should we make of VA’s stubborn refusal, above and beyond the FAST letter and the “plausible” argument, to admit to the obvious? It’s like the family in the 50’s who kept the retarded – mentally challenged aunt in the upstairs bedroom when visitors dropped by and insisted she just wasn’t up to seeing guests that day. VA similarly has their collective head in the sand on this important issue. Despite continued denials of the correlation between jetguns and a high prevalence of HCV among Veterans, no definitive studies have ever been launched by the VA to explore the possibilities of this theory. Given that these chowderheads squander money left and right to find a better computer system or streamlined claims procedure, ostensibly for the health and well being of us Vets, doesn’t it seem odd that there is a tremendous black hole where a medical study should be?

 

 

 

Meanwhile, Vet’s claims are regularly shot down based on arcane theories that are medically outdated. We have seen tens of thousands of claims denied based on the idea that the HCV was not present in service in 1970 and the Vet was not diagnosed with it until, say, 1998-ergo it was contracted after service due to a”risky” lifestyle. Of course, when pressed to define the term, the VA examiner is often vague and shrugs his shoulders. Keep in mind, also, that there was no definitive test for HCV until 1989. Worse yet, the VA is fond of falling back on  Maxson v. Gober (Fed. Cir. 2000) noting that the amount of time that lapses after service without complaint is a legitimate consideration for denial of service connection. While this argument might have some weight where hemorrhoids or impaired hearing are concerned, it certainly has no applicability to hepatitis C claims. HCV, by its very nature, is a stealth disease with no outward manifestations for decades. This is common medical knowledge to everyone but the VA and much to our detriment.

 

 

 

One of these days, long after the majority of HCV infected Veterans have passed away, there will be a revelation on VA’s part that, lo and behold, there was a link to the pedojets. There will be much sorrow and consternation with speeches claiming that if only VA had known the truth, then remuneration would have been forthcoming to all those disenfranchised Vets, their widows and the orphaned children. Witness the Agent Orange debacle if you doubt the scenario described above. Two of the AO diseases, Porphyria Cutanea Tarda and Chloracne, will not be remunerated by VA unless a Vet exhibited symptoms of them within one year of leaving Nam. Assuming you were one of the Few, the Proud, the Marines (the last servicemen to depart) playing “Up on the Rooftop” on May 5th, 1975 at the U.S. Embassy, that means you had to have DOCUMENTED symptoms by May 5th, 1976 or you were shitoutofluck on your claim. How’s that for a Catch 22? The Government, via the VA, is not going to offer service connection for another 20 years for anything having to do with AO, yet the Vet was required to start collating his evidence (and preserving it for his future claim) as soon as he departed sunny Southeast Asia. Hello? McFly? What’s wrong with this picture? In a court of law, this is known as “post hoc rationalization” and is definitely a Bozo no-no. According to the VA, Veterans of all stripes should have been aware of this eventuality and, like Boy Scouts, prepared for it.

 

 

 

Perhaps the general American public, should they read this screed, can understand the frustration, despair and depression Vets experience when they file a claim with the VA. The process is not for the weak of heart and only rarely rewarded. We won’t even discuss the interminable  delays Vets suffer from the inception of their claim to final adjudication. Suffice it to say  your  toddler child could very well be in college before a meaningful resolution is in sight.

 

 

 

One last note. We at AskNOD are not language challenged and capitalize the word “Veteran” for a very good reason. As we are accorded such atrocious treatment by the government, we attempt to recover some of our dignity by emphasizing our contribution toAmerica. A “veteran” could be someone who worked for GM for 20 years or a perennial politician firmly ensconced in D.C. A “Veteran” in our lexicon is one who selflessly offered his/her services in defense of  their Country. There are damn few of these.  Please pass it on, as hackneyed as that phrase sounds in emails..

 

 

 

 

 

 

 

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Hepatitis 3A Genotype

Posted on September 30, 2011 by asknod

Fellow Veterans- 


     The Hepatitis Genotype identified as 3A was only found in two geographic locations in the 60s and 70s. These are identified in numerous Genotype charts that show infection rates for the different types of HCV. 2A and 2B were indigenous to Japan, Okinawa and Korea as an example. 3A, however was relegated strictly to the mainland of Indochina which includes both Vietnams, Cambodia, Malaysia, Laos and Thailand. It also was predominant in Australia. Without digressing into how many military personnel took their R&Rs there, I suspect that the prevalence of 3A on that continent shows that it didn’t swim over from Indochina. Many Veterans overlook this important factor when filing a claim and it can be crucial in whether you are successful or not.

Subsequent distribution has changed in the intervening forty years. With air travel, the genotypes have migrated around and disersed but most models still show a high prevalence of 3a and 3b distribution in Southeast Asia. Perhaps not so odd is the high incidence now of 1A in the Vietnams.

 Keep in mind that I already had a nexus from my own private doctor attributing the HCV to service  and a QTC doctor which stated the same thing. This simply wasn’t good enough for the VA. I believe they were bound and determined, in spite of the fact that I had Hepatitis (unidentified as A,B, or C) while in service, to deny my claim. Fortunately, my private Doctor had mentioned that the 3A genotype was generally found only in SEA. I included this fact in my claim on the Form 21-4138. 15 months later, the IMO doctor, after basically denying my risk factor (transfusion), came up with the lame info that, yes indeed, 3A  was only found in SEA and therefore it was “at least as likely as not that” that because I was in SEA for 2 years while serving in the military , that it was certainly “plausible” that I contracted it there. Never mind that I had a transfusion for a GSW in September 1970 or that I had a documented hospital stay of seven weeks (for the Hep.)3 months after the transfusion.


If your HCV was denied by VA in the past, I strongly urge all Vets to find out what Genotype they are infected with, as this (3A) can be the difference between success and failure. Most Doctors automatically check these days for the Genotype because some are easier to treat and have a higher rate of remission. 3A is one of these. 1A (found predominantly in the U.S.) is the hardest to defeat. I hope this information will assist some of you in winning what sometimes feels like an impossibility. It is true that VA erects what appear to be insurmountable roadblocks to prevent Vets from being granted service connection for HCV. Having the correct ammo for the caliber of your gun is imperative. Close only counts with hand grenades and Claymores. Genotype 3A is the 5.56 X 45mm you need to make this fly if you served in SEA.Now, with that said, I see no reason to go into your extracurricular activities when you were off duty. Always remember that any admission of drug usage is a claim killer. If you honestly believe that left handed tobacco and Schlitz had no bearing on your HCV, why mention it? VA “examiners” will latch on to pot or booze as precursors to drug usage and say that if you smoked dope you probably were a junkie too. Just for your info, if any of you think you were snorting coke in SEA, you are sadly mistaken. Due to the fact that toot is a hydrochloride based product(water soluble), it sucks up moisture as soon as it’s exposed to the air. If you had a quantity of it in SEA, it would turn to liquid goo in several days unless it was vacupacked. Chances are that anything you inhaled nasally was Junk or White Horse(ground up tablets of methamphetamine). I personally don’t think that leads to HCV, but that’s just my opinion. VA uses any info they can unearth to deny you- even if the info is not medically sound. Blood is bright red if you hadn’t noticed. If any of you were sharing a straw with a fellow Vet, don’t you think one of you would say: ” Gee, Bob. You’ve got a bodacious nosebleed and you contaminated my straw. Yechhh!” This thought obviously never occurs to medical personnel in their rush to judgement. So keep this in mind before you blithely spill the beans in your Group Therapy session. Trust me- they write it all down and it will come back to haunt you. I don’t advocate lying. I simply would ask you to decide personally if the risk they list is truly a risk in your own mind. My risks didn’t include drugs  in my mind so I never listed any. Good Luck and I hope this will help some of you with your claim(s).

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New Address- Military Medical Records

Posted on September 30, 2011 by asknod
hcvet
Moderator
Registered: 11/22/08
Posts: 48 
09/27/11 #1
Hi folks, Please direct new members that need medrecs to include this address

National Personnel Records Center
1 Archives Drive
St Louis, MO 63138-1002
… USA

For Pre2001 veterans should send a request to all 4 addresses… click here to view http://hcvets.com/data/va_news/FilingClaims.htm#How

From Dan Sickman

This is an FYI from NARA; NARA asked for the widest possible distribution to
everyone who interfaces with veterans,, so here is their announcement:

Please pass this information on to those members of your organization that
interface with veterans. Your assistance with this initiative will allow
us, and you, to better serve the needs of our veterans. If you publish a
newsletter, we would appreciate it if you include this preferred channel for
submitting requests in an upcoming issue. You can also post this
information to any web site that you have.

The new address for the National Personnel Records Center is:

National Personnel Records Center
1 Archives Drive
St Louis, MO 63138-1002
USA

The majority of personnel have moved to the new location and the military
personnel records are in the process of moving. The entire move should be
completed by the end of the Summer of 2012.
Edit | Delete
hcvet
Moderator
Registered: 11/22/08
Posts: 48 
09/27/11 #2
As a reminder, ALL retirees and Honorably Discharged veterans should ensure
that their family knows the location of their military Separation Document
(DD Form 214 from 1950 to present and WD (War Department) Form 53-
55 and other variations prior to 1950).

Note that registering a copy at the county court house may make that document a public record. Separation Documents issued after 1969 may contain a Social Security Number which could be used for identity theft. Storing the Separation Document in a safe deposit box may make it difficult to retrieve immediately upon the death of the retiree or honorably discharged veteran. The better storage locations are:

1-Fire safe in a secure location of the house (not in the bedroom, as this
is where most thieves search first). Be sure spouse/NOK knows the location
and has key/combination.

2-In a watertight fo od container (Glad, Tupperware. etc.) in the
refrigerator. Most refrigerators are fire resistant. Additionally, a
refrigerator is heavy enough to fall through the floor of a building into
the cooler part of the fire in the basement and better survive. Finally, a
refrigerator is large enough to be easily located in the ash and ruble of a
fire or other serious incident. (As a bonus, everyone has a refrigerator,
not everyone has a fire resistant storage box). Be sure to inform your
spouse and relatives where to locate your Separation Document – and any
other important papers.

As a reminder, the preferred method of submitting a request to the National
Personnel Records Center (NPRC) is via the Internet. Please note that in
some cases using a browser other than Internet Explorer may create problems
with data entry. As you know, the NPRC provides copies of documents from
military personnel records to authorized requesters. Our web-based
application will provide better service on these requests by eliminating our
mailroom processing time. Also, since the requester will be prompted to
supply all information essential for us to process the request, delays that
occur when we must go back for more information will be minimized. You may
access this application at:

http://www.archives.gov/veterans/military-service-records/

This improved on-line request process should be used INSTEAD OF
Standard Form 180 for requests from the veteran or the veteran’s next of
kin, if possible. Your assistance with this initiative will allow us, and
you, to better serve the needs of our veterans. If you do not wish to use
the Internet, you should use Standard Form 180. You should pr int Standard
Form 180 as you need it, not in advance because the form is periodically
revised and updated. It should not be available on your web site. You can
have a link to the NPRC web page.

The link is:

http://www.archives.gov/veterans/military-service-records/standard-form-
180.html

Since the Standard Form 180 is updated periodically, it is NOT recommended
that large quantities be printed/photocopied and stocked.

The form will be updated with the new address within six months. The US
Postal Service will forward mail if requests are mailed to the old location
until February 2012.

 

Dan Sickman Sr.
Non-Attorney Veteran Advocate
pointmanlawgroup@gmail.com
267 603 2567
Posted in BvA HCV decisions | Leave a comment

Independent Living Program

Posted on September 30, 2011 by asknod

Dang. I just got turned down by VA for a new computer, a greenhouse and a sewing machine. This is available to those of us who are never going to work again. It’s called the Independent Living Program or ILP for short. It’s administered by the Voc Rehab component of the VA Gestapo. Okay, I didn’t expect they’d pop for the Singer, but I figured I could get the greenhouse based on all the chow I take down to the food bank. As for the computer, well, this site is important. I mentioned it, too. Apparently the VA doesn’t care about poor hungry people (including Vets). As for the computer, they don’t feel it will contribute to my well-being. I suppose Drew Carey and The Price is Right is more their idea of mental pablum. As I am in a rural setting and my neighbors are almost out of .22 range, I figured I had a pretty good shot at it. Seems I was mistaken. I had to pester them to even tell me I lost. They did rock, paper and scissors and Kris rocked to paper, so he called. He says “you know” too much. As in, ” Well, Mr. Noodle, we, ah, you know, looked at this long and hard, you know, and the feeling was like, you know, will it ah, improve the independent aspect you know, of the ah, ability for you to be like, you know, independent.” 

    Another NOD to file. I asked him if he was going to mail a denial so I could file a disagreement. He said yeah, but that I would have to supply new and material evidence if I was going to file the NOD. I asked what part of 38 CFR ILP was located in. It took Khristopher Columbus about 3 or 4 minutes to come up with the correct regulation. This is all he does for VA and he doesn’t even know where his authority emanates from?  I thought this kind of stupidity was a thing of the past. What happened to a Grateful Nation providing for the Vet’s creature comforts?. Jez, I’m at 150% now and if I win my back claim, that’ll put me over top for the SMC-S rate. I’m low risk for all the other stuff. I have my wheelchair and walker. I ADA’d my house when I built it and the hallways are all 4 feet wide. The fact that I am housebound and chained to a water closet seems to be immaterial to these guys. 
     I use my wife’s computer when she’s out showing houses to do all this. For some insane reason, I thought I might get a sympathetic ear from the VA bozos at Voc Rehab. Maybe they read this site and decided a denial might end AskNod as well. I doubt that. VA has its moments but I severely doubt they could be bothered by us. We haven’t put a hole in their bottom line like Leroy Macklem did to Uncle Eric last year. He smoked them for a judgement all the way back to 1950. Sweet, Leroy. Shinseki’s still seeing red over that one.
     Some Vets try to shoot the moon with an ILP request. We’re talking John Deere tractors with all the attachments. Hell, all I wanted was a new laptop and some new software. I guess I’ll have to ask Santaseki for it in my NOD. Onwards through  the fog. Vote for Oat Willie. And yes. I have the forms to apply for the ILP gig if everyone wants to inundate them before Christmas.

Posted in All about Veterans, Independent Living Program, Tips and Tricks, Uncategorized, VR&E | Tagged | 3 Comments

AO Exposure on Naval Ships

Posted on September 30, 2011 by asknod

 If you have been denied SC for any AO diseases because the VA said you weren’t in country or because of the Haas ruling on blue water Navy, see this site to see if you ship was designated as an exception to the rule. The list is very extensive and you may hit the jackpot. Besides, nobody is going to convince me every squid sailed over on the SS Minnow. I’m betting a bunch flew over and landed at the busiest airpatch in the world at that time and took surface transportation to the nearest port city after a short stay down in Cholon.

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Risky Business–The Mirror Test

Posted on September 30, 2011 by asknod
Sorry. No Tom Cruise and no U-boat commanders in this.  

     When you file a claim for benefits, you will be asked to supply any and all pertinent evidence you have, know of, and any personal evidence you can testify to (if you so wish) that would aid in your decision. There is no implied requirement that you supply the VA with negative, or harmful evidence. This would be in keeping with the holdings of the Fifth Amendement ensconced in the Bill of Rights. Should they come across proof that you have acted fraudulently later, you can be prosecuted for it and go to jail. Be aware of that.  

      Some Vets read this very broadly and assume the VA is their good buddy. They may go so far as to feel compelled to get diarrhea of the mouth. An inattentive Service Officer can often let damaging information get by him and enter the claims process. Like a bullet, once this happens you cannot call it back. 
      Members have approached us over the last several years and asked that burning question. Just how much information about myself should I, or am I required to supply to the VA? Like any Texas necktie party, the more rope you give them, the better the chance of your neck getting longer. With that said, think about this. I’m certainly not suggesting lying about it. That would fall into the category of supplying knowingly false or fraudulent information to illicitly receive compensation. You don’t want to go there.
     The VA utilizes what we here consider to be almost Gestapo tactics in their pursuit of denial. It sounds so natural to hear a VA official say “We grant all claims that are presented that can be proven. This is a non-adversarial process where the Veteran is accorded the benefit of the doubt and his lay testimony is given full faith.”So we propose viewing it like the VA.
     When you look at the Risk Factors Questionnaire, consider modifying it. I refer to the risk of jetguns (unlisted) and haircuts (same). Remember all the times the barber used the straight razor to trim off the hair where it met your neck? What makes you think he had a corner on the sterilization market? I never noticed any autoclaves back near the mirror. The razors always sat on the counter and the combs always soaked in that vase of blue water that looks like the liquid they use in portable toilets. Sterilization consisted of rinsing it in 116 degree water and  wiping it back and forth on the leather strop. 
     The main thing, though, is how to view the different risks they list as being suspect. If you were in the habit of injecting drugs with all your buddies using the same syringe and needle, you probably shouldn’t be here reading this and trying to figure out a way to win. Nevertheless, we have a big tent and there’s room for everyone. If you did it once or twice to “experience” it, chances are it isn’t the culprit that VA would automatically assume it to be. Similarly, snorting junk was not the kind of thing that provoked nosebleeds. Snorting or shooting up a lot of anything is different though. Doing it with shared instruments is suicidal behavior. You certainly don’t need us to tell you that. Apparently, using a Pedojet air inoculation system with poor sanitary hygienic practices is different and only a plausible, unproven risk factor. 
     We don’t believe that you are any more obligated to provide VA with evidence you personally feel is irrelevant than they are to render a decision on your claim that is going to be fair and balanced. If you smoke or ever smoked pot and admit it, you will be seated at the back of the bus with Rosa Parks. Likewise, admitting to having consumed vast quantities of adult beverages for aeons and/or continuing to do so while pursuing the claim will generally cause problems. VA may insinuate that you are a perennial abuser of multiple drugs based on your history or what fell out of your pie hole when you were at the VAMC on a detox staycation getaway. 
     If you have information about yourself you alone possess that would be prejudicial to your claim, I ask you to look in the mirror and be honest. Is the action or info you are contemplating withholding the most probable reason for your disease? If it falls into the category of willful misconduct, please be considerate of other Vets and don’t clog up the system with it.  If you have multiple risk factors that are all potentially suspect, would the admission of the negative evidence you alone possess be a deciding factor in a denial of your claim? Consider that 60%+ of Vietnam Veterans have this disease. I mean Veterans who were in-country, not Vietnam-era Vets. Yet when collated, we see that many Vets who weren’t in-country also are infected. We see a predominance of 1A genotype which is American grown, not the 3a seen in SEA.  The odds of your getting it from the jetgun are not quantifiable according to the VA. So, if they won’t consider the jetguns to be a risk, why should you consider a minor indiscretion or two to be one? Most Veterans fail to see the big VA picture. Any admission of impropriety will become the self-admitted risk factor in spite of your lack of medical training to describe it in context or rule it out as the reason. 
     My lips are sealed as to what my proclivities were during my two-year vacation in sunny Southeast Asia. The fact that my tin canteen rotted out from carrying Tanquery gin is merely a coincidence. I suspected metal fatigue or shoddy workmanship at the time. No one else’s did. It was bad enough that we were forced to crush up quinine pills and mix them with water to impersonate tonic water. War can be pure hell and the deprivations we were forced to endure are too numerous to list here. As for illicit substances, I suppose I could have claimed the Slick Willie plaint- I didn’t inhale. I could have used the novel defense that I was never innoculated with jetguns so that was right out, but that would have been lying and my claim would have been thrown out. For years VA wanted us to prove we were zapped by the jetguns. They went so far as to say there was no evidence of it in our SMRs or inoculation records! They now begrudgingly acknowledge we were, but fall back on their immutable “plausibility” argument. 
     In summary, I would have to admonish anyone who files or considers doing so, to view it in a different light. Knowing full well that the prosecution is going to use everything in their legal quiver to shoot down your claim, do you honestly feel like giving them the arrows to do so when you have no medical training to make such a determination as to the cause? Put another way, the fact that they will knowingly use such arcane theories as the fact that it (HCV) wasn’t mentioned anywhere in your medical records during your enlistment as reason for denial, do you feel obligated to say “Oh, yeah. I did snort some toot with my buddy Raybob once in 88, about 20 years after I got out.” Your testimony that neither you nor Raybob subsequently suffered bloody noses while engaged in this will be deemed irrelevant. You have no medical training to be able to see red stuff and determine that it was catsup from the french fries present on the living room table. VA, on the other hand, has a large stable of medical professionals available on a moment’s notice for a professional opinion on not only catsup, but which brand it was. Do you really want to go there? 
     The VA has gradually come around to the system whereby you provide a doctor’s letter which says “It is my opinion that thus and so…, therefore I believe it is at least as likely as not etc.” VA will supply one of these in the event you don’t. Due to Appeals precedents, the VA can no longer arbitrarily say “denied” without some explanations. This is where the rubber meets the road. VA’s reasons and logic assume the worst-unless it’s material to their case to be otherwise. This leads to incongruous decisions such as having unprotected sex with multiple partners in service is much less of a risk factor than engaging in it after service where the risk is astronomically high. I got a lot of laughs from the BVA decision wherein they reasoned that a self-administered tattoo at home with India ink prior to service was undoubtedly the cause of the Vet’s hep. That kind of decision is rare these days. In its stead, VA carefully examines each and every risk factor known and assigns a value of probability to it. IVDU tops the list followed by transfusion, hemodialysis, risky sexual behavior, tattoos and so on down the line. Any admission of drug abuse of any kind, as you well know, is the death knell for your claim. I think the whole process is highly subjective. By that, I mean letting one doctor decide which particular risk factor your disease is caused by is rather tilted. The doctor is merely engaging in conjecture. Given enough time and resources, you could assemble a book of possible nexi both pro and con. VA has simply streamlined this process in their favor. Giving them more ammunition to help you lose is the antithesis of fair and balanced. 
     After all these words, I can only come back to the mirror test. I find it underhanded that we, as plaintiffs, are guilty until exonerated. If a court of law is so obviously biased and justice is tainted 70% of the time, where do you draw the line on what’s permissible? Is it cheating to “disremember” like politicians in an attempt to get away with it? I’m glad I didn’t have to personally cross that bridge. It’s risky business fraught with pitfalls. Each of you must make those decisions to be forthright or less than equivocal. Or…screw the moral compass. It doesn’t function well in the VA Triangle anyway
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