BVA– Snatching Defeat from the Jaws of Victory

Every once in a while you run across a decision that compels you to read all the way through just to find out why (absent the perennial drug accusations) a Veteran loses something that ultimately is winnable. We here at AskNod have tried to point to all the common and the occasional uncommon reasons why you can lose at this. It amazes me that some Vets have an uncanny ability to keep talking in order to fill in those pregnant pauses medical personnel are so adept at providing. Here it becomes fatal to the claim. There obviously is some grasping at straws as the gentleman slowly realizes he’s going to need more ammo. The claim becomes toxic in spite of the AmLeg’s best efforts (or because of them).

Vets would be advised to take away an important lesson from this. VA has all the records and examines them to determine that your version of events comports with their evidence. If nothing is in sync, they go farther afield and analyze it to death. Here, in desperation, the Vet continues to embellish his lies to somehow buttress his cow feces.

Truth will never get you in trouble. Here, the truth is that the Veteran had no claim(s) that were verifiable and the Vet was well aware of it. He tried to bluff his way through and then, in desperation, started manufacturing evidence simply by  vebalizing it. Being equivocal in a claim is fatal. If you were shot or tagged with a SFW in combat, you would remember every second like it was in slow motion. You would know if you had a transfusion- or didn’t. Va examiners do this for a living, so don’t think you can beard the lion in his own den.

Why this Vet’s SO allowed this to get in is incomprehensible. Once discovered, some form of rebuttal or recusal was in order. Charge or retreat? He chose to charge:

Moreover, the Veteran’s statements as to his history of blood transfusions

are, at best,  inconsistent.  After initially

stating that he did receive a transfusion in connection with
an auto accident, he denied that he had a transfusion, then
stated that he a transfusion; all statements made within a
five-month period.  Specifically, he indicated to a VA
clinician in July 2006 that he did have a transfusion in
1990; he denied any history of blood transfusions to the
September 2006 VA clinician; and he stated in his November
2006 hepatitis C questionnaire that he possibly had a
transfusion.  The Veteran's statements, by themselves,
are not credible evidence that a blood transfusion occurred
in conjunction with his September 1990 accident.  Nor are
they supported by any evidence of record.  See Washington v.
Nicholson, 19 Vet. App. 362, 368  (2005).   

Sharing razors in service is an event which the Veteran is
competent to describe.  See Barr v Nicholson, 21 Vet. App.
303 (2007); Falzone v. Brown, 8 Vet. App. 398, 405 (1995). 
However, competency must be distinguished from weight and
credibility, which are factual determinations, going to
the probative value of the evidence, for the adjudicator. 
Rucker v. Brown, 10 Vet. App. 67, 74 (1997).  Not only has
the Veteran provided inconsistent testimony with respect
to having received a blood transfusion during service, but
he has equivocated on whether he did, in fact, share razors.  
Specifically, he indicated to a VA clinician in 
September 2006 that he may have shared razors with other people, and
he stated in the November 2006 risk factor questionnaire
that he possibly shared razors.  While not a model of
clarity, the Veteran's January 2007 correspondence states
that he received haircuts from foreign nationals, during
which he was nicked on the neck by a razor, and that he
occasionally used razors that were not clean or new. 
Because the Veteran has never made a clear statement that
he did, in fact, share razors, and because, in his last
statement he has, for the first time, indicated he was
nicked by a razor during a haircut, the Board seriously
questions the credibility of the Veteran's statements
regarding razors.  Finally, while the Veteran's report of
jaundice during service is capable of lay observation, it
is contradicted by his assertion in the July 1993 medical
history report that he did not have a history of jaundice. 
The Veteran's assertions are lacking in credibility, and are
of no probative value.

If no one believes a word that comes out of your mouth, you will have a hard time convincing others of what time it is. If you’re going to lie, recite it for a few months or years to make it hold water. Write it down and keep it handy in your wallet if you have brain fog. I, for one, don’t advise it. If VA grants you benefits under false pretenses and then discovers the truth, you will owe a lot of money back and get that unanticipated staycation with free food at the government’s boarding house in Leavenworth, Kansas.

http://www.va.gov/vetapp11/Files2/1112274.txt

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VA Theory of Odds of Getting Hep.

VA has assigned a brand new sliding scale of the odds of getting Hepatitis C and what each ratio is. I had no idea they went into such detailed scientific research to obtain this.  This is utterly mind-boggling.

>Intravenous drug use (odds ratio of 49.6)

>Blood transfusion (10.9)

>Sex with an intravenous drug user (6.3)

>Having been in jail more than three days (2.9)

>Religious scarification (2.8)

>Tattooing (2.12)

>Having been struck or cut by a bloody object (2.1)

>Pierced ears or body parts (2.0)

>Average incidence of seroconversion to HCV (hepatitis C virus) 
after unintentional needle sticks or sharp exposures from an 
HCV-positive source (1.8)

>Immunoglobulin injection (1.6)

Does anyone notice the dichotomy here?  Despite numerous grants of SC with accompanying nexus letters proving the “plausibility”, we can’t even get them to do any comprehensive study on the risk of obtaining it from jetguns. In fact, as one can see above, the odds of this occurring are unknown because VA hasn’t bothered to find out. It’s akin to a gaping black hole next door to Jupiter and not one scientist even remotely interested in examining it to find out the implications for mankind.

Something else is missing from this study and I do not think it is a coincidence either. There is no mention of the risk ratio associated with mass consumption of adult beverages. In fact, where’s the study on the risk of smoking left-handed tobacco and contraction of HCV? VA regularly tars and feathers claimants who admit as much.  Now we see there was no risk- at least on April 7th, 2011.

These findings were divulged in a Board decision attached below. They are not old data, but the latest, cutting edge revelations of a doctor trained in the art of odds.  Its funny how they can be so detailed as to the odds of “Religious Scarification” which I wasn’t even aware was a risk. What about regular, atheistic scarification? In fact, nowhere is alien abduction with resultant percutaneous piercing quantified. No, I’m sorry. This medical finding is lacking numerous untold and unmentioned risks. If you and I presented this as evidence, it would be discounted as not being probative and inherently incredible. This study raises more questions than it answers, I’m afraid.

 

http://www.va.gov/vetapp11/Files2/1112433.txt

Need I mention the Vet lost? No. I suppose not. That would be horribly redundant.

P.S. I just realized why they didn’t discuss the ramifications of alcohol. This emanated from the Louisville, Kentucky VARO. I believe that’s a dry county. No booze ergo no risk.


							
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To Afghan Vets–CYA

In July of 1970, three months after I arrived in SEA, somebody figured out I spoke French. As we were busy ignoring the border between RVN and Cambodia, they needed interpreters to communicate with the Cambodian AF pilots to direct ground strikes. My  orders were cut after I “volunteered” to proceed to Bien Hoa Airpatch,  Right before I deployed, they called me in and I was asked a different question. How would I like to volunteer for something that basically entailed the same job (AFSC 203X0) but slightly different. My first question was “Where?”

The Captain at 7th AF Hq Tactical Air Combat Control (TACC) said “Can’t tell you”.

Me: “What does it involve?”

Capt. “Can’t tell you.”

Me: “Is it dangerous?”

Capt. : “Yep”.

Me: “Does it involve flying?”

Capt.:”Yep.”

Me: “How bad is it?”

Capt.: “The casualty rate is running 30+% but you get Flight and Hostile fire pay.”

In my testosterone-crazed, 19 year old mind, I  readily interpreted this as a guaranteed 70% chance I’d be coming out the other end in one piece. What could be more fun? I’d be meeting good looking women who spoke French in my off hours. Right? Besides, what could possibly go wrong? It was like extra sharp smoked cheese in the mousetrap. It was worse than a moth being attracted to a 30,000 watt light bulb. “Where do I sign up?”, I  asked.

30 years later when I filed my claims for hep. and PCT, I was told a) there were no medical records of my GSW and transfusion and b) I’d never been to RVN, let alone Laos. In addition, there was nothing that said I’d even had hep. in the military.

This is where the conversation turns to you who are coming home from our latest Olympics in Southwest Asia. Gentlemen (and ladies), it behooves you to keep every scrap of paper the military gives you. Most important are things like TDY orders which will never be included in your milrecs. When your health starts to decline and you’re not feeling well about 20 years from now, you will entertain the idea that maybe the VA should make good on President Lincoln’s compact with the defenders of America. That would the one that starts out “For he who shall have borne the battle…”. Having records to back up your contentions is paramount to your claim. If you keep them safe, VA cannot sadly inform you that they had a little warehouse fire  down in St. Louis and everything was lost in 2016. They cannot say there’s nothing to prove your contentions. Military records are powerful evidence to prove your case. I can’t tell you how many Navy Veterans were disenfranchised by virtue of no records of their having touched red clay in Vietnam. VA is intractable on this subject. No tickee, no laundry as they say at the dry cleaners.

Buy a cheap fireproof safe and put all your mil/medrecs in it. Save them until you’re dead and don’t need them. If you die of something you came down with over there, at least your wife can drag them out and use them to get DIC. I know that’s small consolation to both of you, but its good advice.  I kept everything and below is how I proved I was “There”.  One small scrap of paper. A snapshot of a bygone era. A niggling worry in my mind that just maybe they wouldn’t be stand up guys if the shit hit the fan.

One last bit of advice. Do not, under any circumstances, volunteer for anything when they ask you. Some will say it won’t look good in your Personnel jacket. Would you rather face the approbation of 3 at your promotion hearing board or carried by six at your funeral? Yeah, I know. Where do I sign Up?

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Remember DEROS?

Remember that magic moment when suddenly you only had 30 more wakeups? Think back 40 years. All of a sudden 6 actual said”Take him off Point. He’s too short.”  Recall how your buddies would bait you by asking just how short you were?

How about these?

I’m so short I have to climb up on my boots to tie them

…I had to put a rubber on my 16 ’cause I keep getting dirt in the barrel

… my pant don’t fit anymore

… I almost got stepped on 5 times yesterday

…I can’t see over the windshield on the Jeep anymore.

Well, fellow pilgrims, I looked on ebennies Friday night and there it was. My appeals are finally in front of the man for adjudication. It’s almost time for a massive infusion of $ back to 94 or shutdown corner. I’m the eternal optimist. When life deals you lemons, make lemonade. But do not stop there. Seek out the guy who got the potatoes and is making vodka with them.

When VA gets new evidence, they have to address it. Somehow they forgot to do this in 94 and my old claim is still technically open. The DRO said otherwise. That’s why I find myself in D.C. (pro se, of course.) You don’t think I’d trust this to a VSO, do you?

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PCT ratings

While waiting 16 months for VA to rate me in 08, I read extensively. I was so sick it helped pass the time. My diet consisted of BVA decisions on all the things I had filed for except tinnitus. Porphyria Cutanea Tarda is an Agent Orange disease, but also is a secondary of HCV in about 30% of infections. While waiting, I researched how VA treated this to try to ascertain how they would rate me. PCT is listed under Part 4, 4.118 -skin

http://www.law.cornell.edu/cfr/text/38/4/118

under DC 7815. The ratings are mighty skinny for percentages as you can only imagine. VA is not generous. However one thing I discovered was that for those of us who require phlebotomies (the opposite of a transfusion), there is a higher rating- much higher. DC 7704 concerns Polycythemia Vera and is the only code that contemplates phlebotomies. They give a whopping 40% for it compared to the 10% I got based on scars. I came home from SEA with this but no one had discovered AO and the correlation between the two yet. I found out in 92 and finally had a name for something I’d been afflicted with for 20 years.

When I approached VA with it in 94, the response was predictable-“All well and fine, Mr. Nod, but you weren’t in RVN”. Well excuse me, yes I was.  The argument devolved into the next phase- “Yes, ah, okay that’s all well and good, but you didn’t manifest it within a year of leaving SEA.” Excuse me? Is that Catch 23?

When my Hepatologist doctor finally wrote me a nexus letter that the VSO assured me I didn’t need, he was kind enough to describe the PCT as a secondary of my HCV and not due to the fifth of Johnnie Walker Black VA insisted I guzzled every day.  Thus my PCT rating was upped from 10 to 40% by the DRO review. As for an earlier effective date of 1994, I’m still working on that. It’s before Veterans Law Judge Mark D. Hindman as I write this and will soon be decided.

Dorland’s medical Dictionary has this to say about PCT:

PCT is attributable to only 4 possible medical causes:

1) extreme, prolonged alcohol abuse with resultant hyaline cirrhosis;

2) vertical transmission by genetic predisposition( dominant genes from mother and/or father) ;

3) prior infection with hepatitis viruses A,B, or non-A non-B (hepatitis C); 

4) exposure to 2,3,7,8-tetrachlorodibenzodioxin(TCDD), a byproduct of the manufacture of 2, 4-D and  2,4,5-T, in a 1:1 ratio(phenoxyl herbicides in ester),more commonly known as Agent Orange, White, Pink, Purple and Green.

I hope this helps any of you who were diagnosed with it and given short shrift by VA on it’s etiology. The truth is out there.

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Tom Philpott–Military Update.

Every Saturday morning I sit down to read the newspaper and most especially, the column by Tom Philpott -Military Update. It often deals with issues pertinent to our circumstances. His article this week was very touching. It was an article about TSGT. Tom Marcum (AF) and his travails with the military medical community. He is now part of the VA medical circus. We will pray for Tom and his wife April. They have no idea what’s in store for them. While we here confine ourselves to the shortcomings of the VBA and the VHA, the difference is negligible. I recommend you start reading his column if you don’t already. Here’s the skinny:

Tom Philpott can be reached at milupdate@AOL.com or                                                               Military Update                                                                                                                             P.O. Box 231111                                                                                                                     Centreville, Va. 20120-1111

ABOUT TOM PHILPOTT

Tom Philpott has been breaking news for and about military people since 1977. After service in the Coast Guard, and 17 years as a reporter and senior editor with Army Times Publishing Company, Tom launched “Military Update,” his syndicated weekly news column, in 1994. “Military Update” features timely news and analysis on issues affecting active duty members, reservists, retirees and their families. Tom also edits a reader reaction column, “Military Forum.” The online “home” for both features is Military.com.

Tom’s freelance articles have appeared in numerous magazines including The New Yorker,Reader’s Digest and Washingtonian. His critically-acclaimed book, Glory Denied, on the extraordinary ordeal and heroism of Col. Floyd “Jim” Thompson, the longest-held prisoner of war in American history, is available in hardcover and paperback.

The dude’s hot.

Posted in Uncategorized | Tagged | 2 Comments

VA Compensation Rates– In Case Of Success, Click Here.

http://www.vba.va.gov/bln/21/Rates/comp01.htm

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BVA- Hep/Cirrhosis dilemma–DANGER!

Here’s a horror story I’m sure some of you Veterans have encountered by now. Imagine filing for SC for hep and cirrhosis and winning. Your med recs support it and you are most definitely entitled to it. One little problem. You are still healthy enough to soldier on and the cirrhosis hasn’t progressed to a decompensated liver yet with all the attendant side effects so common to the disease. VA rates you at 30% for the cirrhosis (D.C. 7312) and 20% for the Hep (D.C. 7354). So far so good? Not quite. Let’s just say for argument’s purpose that you are slowly going down hill and your health is starting to become an issue. It happens slowly as we all know but it happens. When it does, you usually motor on down to your AMLEG or VFW post and tell the VSO what’s up and they put in a claim for an increase in your rating.

Unfortunately, due to the way 7354 is set up, you are at a strategic disadvantage for rating purposes if your hep is complicated by the cirrhosis factor. At the bottom of the 7354 rating are several notes that basically state you cannot pyramid your claim. That term means you cannot use the rating criteria for cirrhosis issues to up your rating percentage for hep and vice versa.  If you are SC for both then you will be rated on a percentage basis for each individually with extra caution on VA’s part not to duplicate the symptoms of one with the other. It looks good and reasonable until you get to the percentage of disability. VA will do what they did to this Vet with a 20/30 % for hep /cirrhosis even though his true disability picture is higher.  This happens so frequently now that it is really starting to interfere with Vet’s rights to a compensation % commensurate with their true illness.

We at AskNod don’t advocate how Vets should present their claims. We do try to illuminate problem areas you may encounter and this is a big one. We suggest you focus on the real culprit first which is Hepatitis. Get your SC and a rating for this. If your disability picture is extreme, concentrate on a 100% disability rating. If it hasn’t risen to that level yet, then settle for the 60% and never forget that TDIU is now on the table automatically since the Rice v. Shinseki (2009) ruling at the CAVC.  The high Court in AB v. Brown (1995) found that a Vet is automatically seeking the highest compensation he can get when he applies for SC. This just confirmed what we all knew for all these years. Why would a Vet put in a claim for hep and request a 10% rating if he were entitled to a 20 or 40% one?  He wouldn’t and AB v. Brown affirmed that. The Clemons case added the caveat that if TDIU was appropriate then if should be considered automatically without the Vet having to beg for it separately.

Once you have attained the absolute highest rating you are entitled to for the Hep, the matter of cirrhosis should be considered. Trust me, assuming you never attained SVR via Interferon/Ribavirin therapy, Hepatocellular Carcinoma (HCC) is definitely in your future. Your liver will almost always degenerate slowly and eventually become decompensated. When this happens you have reached Stage 4 cirrhosis. Either you get a transplant or you die eventually. That might sound brutal but it is a medical fact. There usually is a period of stability from having a compensated (or functioning) liver and a decompensated (or non-functional) one once you’ve been diagnosed as cirrhotic.

This is the time in our minds for you to file for 7312. Even if you are rated 60% for Hep, you’d need a 90 % rating for cirrhosis to attain a 100% scheduler rating. Let’s imagine they gave you 30% for cirrhosis.  That would simply advance your rating to 70%. A 50% rating would only get you to 80%. Granted, you would probably be granted a TDIU, but you must realize you have to report annually for an exam to ascertain that you are still eligible for it. No, the 100% scheduler rating for the hep is still the advisable course if your symptoms support it.  Or, if you are late to this game and get SC when you have already hit the wall with cirrhosis, a 100% rating for that would be a good choice, too. We will tell you that you have to be pretty sick to get 100% total cirrhosis rating though.

With all this new knowledge, witness the poor Vet below defending himself pro se who has just stumbled across this dilemma. Accordingly, meet the poor Vet from San Juan, Puerto Rico who is preparing to be introduced to VA’s “non-adversarial judicial system” where the benefit of the doubt always accrues to the Vet…

http://www.va.gov/vetapp10/Files1/1002416.txt

The problem is a travesty of justice.-a catch 22. It hinges on §4.16, the pyramiding clause and therein lies the problem. Much like a black hole, the claimant cannot escape once he enters the event horizon (filing for both). Please, if you even reach this point, do not listen to your wife, sig. other or SO. We’ve been there with our own member. You will spend an eternity in D.C. and it will be aeons before you see $.

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BVA–1151 Claim-Contaminated VA Transfussion

9/22/11     

     As we have current member(s) fighting VA over this issue, I include this as the latest BVA word on the subject. Valuable info is always gleaned from these even if there is nothing precedental about them. For those of you from Yorba Linda, that means it won’t set a President.

     Interestingly enough, the Veterans Law Judge who decided this is the one assigned to my case- Mark D. Hindin. I think the man has character and is well-versed in VA law. He’s been there since 1995 in one capacity or another. He seems conversant on VA hep. law as well. Now, If they would give my case to him for adjudication instead of ditzing around with it…


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BVA–Read and heed: 100% ratings

All Vets filing or still appealing for a higher rating on an existing claim should read this decision. It was well done by the Vet. He did slip on the DM2 nexus , but will probably win if he uses his noggin.He just needs his hep. doctor to state as much.

 
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