How/ Who gets Nexus

Posted on September 29, 2011 by asknod
drdigger
Registered: 10/08/10
Posts: 2
12/24/10 #1
I am a veteran (72-76). I have reopened a case asking for disability compensation for Hep C. After the VA told me that “Sorry, All we can do now is keep you comfortable and in your own home as long as possible”, I found a very well known Dr. that could help me. He has agreed to write the Nexus or be my Nexus. My question is, who gets that statement from him. As he has some experience in this area I asked his Nurse and she said that the VA would send him the paperwork.That also applies to the VA Hematologist that took me through the treatment and my Primary Care Dr. that treated me during the process. Neither is with the VA at the present time (One retired and one left for private practice in a warmer climate).
As I am completely at a loss in this (side effects from the TX) all assistance would be greatly appreciated.
Thanks
Drdigger
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
12/24/10 #2
Dear Sir,VA is full of it. You can file for comp. as long as there is fog on the mirror under your nose. You and only you are responsible for obtaining this all important document. VA will supply one for you in the event you arrive at the rock/paper/ scissors contest without one. However, it will not be in your favor.Writing the nexus letter is part of a three legged stool. You need: 1) Hep currently; 2) Hep in service or, in the alternative, documented risk factors to support a presumptive risk for it while in service; and 3) the all important nexus letter. The requirements for that letter are many and onerous. The doctor(s) writing it must state that he/they have reviewed your military and medical records (contemporary as well as private ones after service), rule out any other intercurrent causes and state with a 51% probability that the hep is “at least as likely as not” related to your service. He has to discount any other risks that may be in your records. A liver biopsy will often show the age of the disease and it is a good yardstick to buttress a nexus. There obviously are other minutiae that are needed but the above is the general gist of what you will need. That will entail your retrieving your medical/military records from the NPRC in St. Louis. Look to the column to the left for instructions on how to accomplish this. Get started pronto. There is a horribly long wait right now due to the large number of Afghan Vets in the VA pipeline. Every time Uncle Sam starts a war, VA has to gear up to do a land office sized business. Unfortunately the funding lags far behind. Let us know if you need more info. That’s our stock in trade to pay forward. Thank you also for your service and we hope you holiday season is bright and cheerful under these unfortunate circumstances
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vso/american legion rep

Posted on September 29, 2011 by asknod
victim88
Registered: 07/27/09
Posts: 14
12/08/10 #1
if american legion has your file on your behalf regarding appeal to bva, would that time also be considered retro pay?  ex. file remanded nov 09, file received bva nov 10, file currently with american legion docket system year 05, possible 12 months delay for review and legal briefs prior to submission to court/judge for final decision?
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
12/08/10 #2
You have lost us with your terminology. You are stating that AMLEG has your POA (Power Of Attorney) and is representing you on an appeal before the Board of Veterans Appeals. That much is clear. We are unfamiliar with the term or concept of “retro pay” where the VA judicial system is concerned. “ex. file” is another term we are not versed in unless it involves David Duchovney. Perhaps you could be more clear in what it is you are asking. If a file is remanded, that means it is sent from one court of appeals to a lower court or back to an Agency of Original Jurisdiction (AOJ) for more development.A file cannot be remanded from the AOJ to the BVA. The BVA remands cases regularly to the AOJ via the Appeals Management Center (AMC). The Court of Appeals for Veterans Claims (CAVC) also remands cases to the BVA for legal insufficiency.

     It would seem you are also saying your claim is with the AMLEG docket system year 05 (2005?). We at AskNOD are really in the dark on this one. We were not aware that AMLEG has a docket system set up or what purpose it would serve as they are not part of the judicial system. If your claim lacks some of the Hickson elements or what is known as the Caluza triangle, then the VSO (AMLEG) may try to obtain the missing info to buttress your claim. If they have been engaged in this pursuit since 2005, as you imply, then something has gone haywire. They would ask for a delay to accomplish this, but not 5 years. Taking even a year to do so would strike us here as gross incompetence. Any info your claim lacks should be able to be assembled in short order (i.e. private medical records, buddy statements, medical examinations, etc.) AMLEG legal beagles, if they really have any, could do this in three months.
     The BVA says they are currently taking 155 days to adjudicate a claim from date of receipt from the AOJ-not counting any time while the files are in the hands of the VSO representing you. If your claim was properly supervised and all pertinent info supporting your claim had been filed prior to certification to the BVA by your service officer assigned to your claim, there should be no need for any last minute “review and legal briefs” as you are implying. However, if your claim arrived in D.C. without any preparation on your service officer’s part, and the evidence is insufficient to prove your claim, then it might take a year to glue it back together again.
     If you could give us a better idea of what it is you need to know, we could respond with a better answer. Try Dick and Jane speak We do speak legalese, but you have to speak it fluently for us to decipher it.

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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94
12/10/10 #3
If your question is:   If you win your claim, what date will  retro compensation be paid back to — ?

The answer to the question is — Any retro compensation due to the Veteran will be payable to the Veteran back to the date the claim was originally filed, unless of course it involves Agent Orange issues — then, it would be 1 year prior to the original date you filed your claim.
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assignment rosters

Posted on September 29, 2011 by asknod
wekan1
Registered: 08/08/10
Posts: 4
10/21/10 #1
I was wondering if anyone knows if there is a way to get a roster of men who were assinged to a unit at the same time I was. I have a pretty goos idia when I was infected. we all recieved a flu shot in the fall of 72 then on new years eve that year I had the worst flu like symptoms that I can ever remember having and I know this is a symptom of the onset of hcv. I would like to find others that recieved that same injection
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
10/22/10 #2
My suggestion is to type in the name of the service you were in on a search bar. There are several organizations that have members that sign up to find old friends. Most are free. If it was a basic training thing, you should try to remember the name (or #) of your training squadron or regiment. The proper branch of the service you were in can point you to the right area to narrow your search. If anyone else has a better approach, please chime in. I’ve never attempted it but with all the assets available on the internet, its axiomatic that the info is somewhere.
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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94
10/23/10 #3
Which branch of the service were you in ?

There are more than a few “associations” – as an example, my husband served onboard a naval ship in the Maine detachment.   There is an association for the ship that he served on that up that meets ever year for a reunion … we went to one and that’s where we found one former ship mate who wrote a “buddy statement” for my husband.
Navy ships can be found on HazeGrey.org I believe, and as NOD mentioned …
As an example if you were in ABC Company, Division XYZ, Battaloion 123, Squad 456 … (please don’t quote or jab me for not knowing the correct “lingo” ) you might just come up with a message board for yours or a starting point to search from.   We recently had a phone call from a former ship mate that knew someone my husband knew onboard, my husband didn’t know the 1st guy but he called and needed some help with a claim for Agent Orange exposure.
The internet has made finding someone a whole lot easier.
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american legion

Posted on September 29, 2011 by asknod
Author Comment
victim88
Registered: 07/27/09
Posts: 14
10/16/10 #1
  if new evidence has been submitted at the ro level, is refusal to review this new evidence a option for the ro? or just send the file to bva?
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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94
10/18/10 #2
Good Morning ….
I left you a response a few days ago to your question in the post you made on the CAVC decision forum.
As per this question, it depends on what process your claim is at whether new evidence is going to be reviewed at the RO level.  Did they state “why” they are refusing to review this new evidence?   A de novo review of your claim has already been done by a Decision Review Officer (DRO) ?  Is AmLg your Service Rep?
Thank you for your service to our Country.
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victim88
Registered: 07/27/09
Posts: 14
10/20/10 #3
thank you for your support,  dro/ro reason for denial, per feb 2007 decision to deny, stating no evidence of hcv in military records, even after acknowleging two separate nexus letter from two different gastros.
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victim88
Registered: 07/27/09
Posts: 14
10/20/10 #4
also yes the amleg is my rep, file in washington, it would appear my file has gone back to the 2007 docket and my amleg rep states they are currently working the 2005 docket.  imagine five years coming this apr 2011, and still with evidence to support my claim, i wait for a favorable decision.
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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94
10/20/10 #5
Thank you for the additional information.  This makes more sense to now.
Regarding “no evidence of hcv in military records” – HepC takes years to manifest itself into a identifiable infection.  A person can be exposed and a blood test would show that, but the virus may not be active and may not become active for years.   Years ago there was no standard of testing for HepC as it wasn’t even a blip on the radar until late ’80 ‘s and it was then known as Hepatitis-non A/non B … until it was graced with the letter C.
What your Nexus needs is 3 distinct parts –
1.)  Known and documented risk factor that occurred while on active duty,
2.)  Current diagnosis of HepC
3.)  The string that ties these 2 together is your doctors statement (Nexus) stating the risk factor is connected to the in-service event and on more likely than not basis is the source of infection …. you can find a sample Nexus to the left underFAQ.  This is also where you can scroll down to Print VA forms where you will find a list of the known risk factors in contracting HepC.
Not sure where you served or during what years but, there is one genotype that is a known risk factor if you served in So. East Asia.  Do you know what Genotype your HepC is ?  If you don’t have a “documented risk factor” in your military records, do you know what the source of infection was from ?   If there is no documented source of infection in your service medical records there are ways to prove risk factor.   Refer to the list to the left under Print VA forms for a complete list of risk factors accepted by the VA.
Now, if you get a solid Nexus in place, medical records pertaining to HepC and all of the ducks are in a row, this would be considered “new evidence” and it can be submitted to the VARO any time prior to the hearing for review.  Anytime you can avoid having to go through the appeals process its a better deal on time for you.  You should not lose your place in line on the docket either.   Not 100% positive on this but will check for you.
If AmLg is your Service Rep., you will need to submit these items to them to submit on your behalf.  I suggest if you continue with them as your Service Rep or change to another Organization or decide to wing it on your own like many of us have here, in any event, always make sure you get a receipt for the documents you are providing, send them Certified Mail/Return Receipt Requested, list what documents you are providing and keep a copy of everything for your own records.  We had a Service Rep who we turned everything over to the Svc. Rep (aka SO) and we continued to submit evidence right up to the SO just prior to the BVA hearing only to find out on the date of the hearing, the Svc. Rep never sent it to the BVA in DC.  Good thing that I brought a copy to the hearing.  The brown stuff the Judge threw on the Svc. Reps face didn’t smell so good.
Five years is a long time.  We have been at this for almost 8 and just received service connection for HepC by way of a BVA decision.  It took 4 years from the date the appeal was filed to have the hearing and another 2 since the hearing to receive the service connection.   Learned alot the hard way, had the ducks been in a row the claim may have never had to go the route of a BVA hearing.
I hope this helps you figure out the schematics of the process and what pieces you may be missing.  If we can be of additional service to you, please let us know.
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Remand Center Decision?

Posted on September 29, 2011 by asknod
ssbov78
Registered: 09/25/10
Posts: 1
09/25/10 #1
I received a BVA decision in 2006 and disagreed immediately. I waited almost 2 years for a decision from the BVA and got the noticed that the claim was sent to my local Remand Center. After a total of almost 5 years I received a letter from the remand center with a decision to deny my claim for a 30% nerve damage due to sever nerve damage as stated by the C&P Dr. and keep me at the 10%. The reason is what got me, they stated that the nerve damage to my 5th cranial nerve due to dental implant was classified as severe but…., when in the C&P exam the Dr. also stated that when touching a tooth 3 teeth away I only had slight pain and for this reason I should be denied, because you can’t have slight pain if the nerve damage is severe. 

I am confused because the tooth that the Dr. was referring to is 3 teeth away and yes it was slight but the implant is the tooth with the severe pain. The remand center also stated that although the Dr. recommended the severe nerve damage they are not obligated to follow his recommendation. WHAT??? Why did I have to wait 5 years for this nerve specialist if they don’t have to listen to him?

 

So now I sent in a rebuttal statement the remand center, but did not send it certified and the BVA is telling me they do not have it… It was sent to the address the remand center gave in there decision packet so I hope that BVA don’t see it because it was included in the package the remand center sent back in to the BVA…

 

My question is: Is there anyway for me to make sure the BVA received my rebuttal statement?

 

Plus I had to call my Congressman after it took 4.5 years and then got my C&P…

 
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NODManager
Registered: 11/22/08
Posts: 654
09/25/10 #2
Dear Sir,

     The normal course of events for a VA claim is the submission of same at the RO (Regional Office) sometimes referred to as the VARO. They now call it the Veterans Service Center (right). It is also referred to in legal documents as the Agency of Original Jurisdiction (AOJ) If you are handed an adverse decision, your option is to file an NOD (Notice Of Disagreement). Often, you will file additional evidence and the VARO will reassess their prior decision. If they continue to deny you, they will mail an SOC (Statement Of the Case) summarizing their reasons for the denial. You have 60 days from the mailing date to file a Form 9 indicating your desire to appeal this denial and have your claim decided by the BVA (Board of Veterans Appeals).Getting a court date now usually takes 2 years. If the BVA Veterans Law Judge (VLJ) finds something legally wrong with the decision, he will remand your claim back to the AOJ via the Appeals Management Center known as the AMC. They, in turn, send it back to the AOJ with instructions from the VLJ to correct the error, schedule a new C&P exam or whatever, and reconsider your claim from scratch. In the event that your claim is denied again, which it appears is the case here, the correct path is for the AOJ to send you a Supplemental Statement of the Case (SSOC), return the claim to the AMC and have the VLJ readjudicate the appeal.

When you are granted a remand and a new decision at the AOJ, you are permitted to introduce any new evidence you have that you feel will have a bearing on the case. This may be submitted directly to the BVA and I strongly suggest you use Certified mail, Return Receipt Requested (CMRRR). This can help immensely when VA says they did not receive it. The courts have come up with what is called the “presumption of regularity” where the U.S.P.S. is concerned. If VA has your correct mailing address, then the assumption is that if they mailed it, then you got it. The reverse is not. You must have proof you mailed it to them. To protect yourself, the CMRRR is bulletproof. I have had Veterans Service Officers tell me this is a waste of time and money on the Vet’s part. We at AskNOD disagree.  If you are mailing important evidence to the VA in the course of your claim, the date of your mailing is an indicator of the nature of the documents mailed; i.e. an NOD following an adverse decision or a Form 9 filing shortly after your receipt of your SOC, etc.

Your mailing without a CMRRR is your word against a monolith like the VA. You have 120 days and nights to object to the adverse decision that will be handed down by the BVA. You have two options: 1) to ask for a reconsideration at the BVA level or; 2) File a Notice of Appeal with the BVA asking for a decision at the Court of Appeals for Veterans Claims (the CAVC or Court). Either way, the magic word is 120 days. If you fail to accomplish this within that period your claim is considered abandoned. It appears your claim is headed back from the AOJ (your local Veterans Service Center) to the AMC for a court date with a VLJ. We are not trying to make excuses for the inexorably slow judicial system the VA runs, but you can see how this archaic system causes interminable delays for the Vet. Watching grass grow is more exciting and the results are visible sooner. Add to this the fact that the VA still uses a paper system rather than record documents and transmit them electronically. This means everything that occurs with respect to your claim travels via snail mail between your RO and the BVA in Washington, D.C.

In order to be sure that the VA has received your rebuttal statement, we would suggest you send it in again to your local RO marked “Attention: Appeals Management Team” and to be safe, send another copy to the Board of Veterans Appeals at the address below:

Board of Veterans’ Appeals

811 Vermont Avenue, North West 

Washington, DC  20420  

Or you can call them at:

1-800-923-VETS (8387) or (202) 565-5436 Monday-Friday 9:00am-4:30pm (Eastern time zone).

Or:

For an Email status report on your claim before the Board of Veterans’ Appeals, please state your name, file number and request, click here BVAOmbudsman@mail.VA.Gov

Or:

For your convenience the Board of Veterans’ Appeals has a FAX line. FAX: 1 202 565 4720

The phone option is superb and will also let you know instantly if you need to resubmit the rebuttal documents so that they can be included in your appeal. Keeping your congressman abreast of the claim is paramount. If they are involved, your claim will move along much faster. Keep in mind, not all Congressmen are so inclined. Consider involving your Senator(s) as well, especially if they sit on the Veterans Affairs Committee in Congress. We wish you the best of luck and a speedy decision and thank you for your unselfish contribution of your time to the service of our Great Nation.
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hep c claim

Posted on September 29, 2011 by asknod
Author Comment
stilwellrick
Registered: 02/17/09
Posts: 8
09/27/09 #1
Hello,I have filed a claim for hep c. once in 1977,again in 1992,and finally in 2002. My clinical records state that I was diag. with hepatitus and isolated for 30 days. Record states was incurred in line of duty, not due to misconduct.Record also states infectious vs serum, awaiting lab results. results never found in records. This last time I filed I filed with my letter of disagreement,my argument was based on the VA insistance that the hep I had in service was not the hep c I now have.My response was that they could not unequivically make that statement,and in my opinion, the records show a non-A,or non-B diag.That I suspect was in fact C,however there were no tests for C in 1972.    Finally to my question. I just recived a letter of a appointment in october for a C&P EXAM. What do you make of that, and if in fact it is a hep C thing, what can I expect. Thanks.  Rick
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
09/28/09 #2
Dear Rick, I am shooting in the dark with the info I currently have from you, but let me give you some knowledge of how these chuckleheads operate. They are going to deny as they already have, but there is one CAVC decision recently decided in your favor. It states that if you had a disease(documented in medrecs) while in service in the line of duty, and it was never specifically identified as infectious vs viral, then it cannot be said with any certainty what kind of hep it was. The ruling wasn’t about hep, but the parallel is there. Legally, you can use this decision(Groves vs. Peake 2008) to butress your case. Look at the NOD page that deals with this on this site. Its the “Important CAVC rulings” and then read the Groves vs. Peake decision. It deals directly with what you are talking about. Remember that you are not allowed to be a doctor or reach medical conclusions. You can only report what your 5 senses bring to you. That is the law(Layno vs. Brown 1994). So simply stating that you don’t believe that the 1972 infection was anything other than HCV is not going to fly. Of course, if you can get a doctor to say that, that’s a different story. I did for my nexus, but Uncle Victor still went out and got several more independent medical opinions to shoot me down.Trouble was they all came back in my favor. That’s the only reason I succeeded.In order for your October C&P to have any weight, you need a biopsy to go with it that shows you have an advanced case of Hep C, such as Stage 3, Grade 3 or so. This proves your infection is almost 40 years old.Each stage equals (roughly) 10 years. As you may know, Stage 4 signals cirrhosis. So if the biopsy reveals your disease to be rather advanced then it means you didn’t get it in the 80’s or the 90’s. Again, you need to get a doctor to provide you with a nexus letter stating as much. Hope this have been of some help to you.
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hcvet
Moderator
Registered: 11/22/08
Posts: 48
09/28/09 #3
Hi Rick, if you have your medical service records, we can help you with the nexus letter. Here’s a link to get the recordshttp://hcvets.com/data/va_news/FilingClaims.htm#How and it’s located to the left of your screen on the sidebar for future needs.Good luck!
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stilwellrick
Registered: 02/17/09
Posts: 8
09/29/09 #4
My thanks to the quick response from manager,moderator. I do have a letter from a private doctor saying that he has been my doctor for the last 25 yrs. and that in his professional opinion the hep I had in service and the hep I have, are more likely than not the same. Once again Thanks for help   PS. I will keep you posted.  Rick
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Bandy1979
Registered: 09/20/10
Posts: 2
09/21/10 #5
I just received my medical records  (less than 3 weeks after request).  At entry it lists the following:
16-18 WBC
0-2 RBC
20-24 Epith cells
+3 Bacteria
2+ mucus
On one page there is a note stamped: THREE COLONY TYPES.  INDICATIVE OF CONTAMINATION.Lab results during separation are not as specific but lists the following in box D:
1-3 WBC’s +3 Epith. rare bacteria.

I have no idea what this indicates.  I was discharged in 1980 and have never passed a physical since.  I was first diagnosed in 1987 as non A, non B.  This was typical back then.  My liver biopsy was in 1988, resulting in Hep C diagnosis.  I receive treatment in 2002.  I’ve shelled out a lot of money since then as well…many health issues related to the damage and treatment side effects.
I also requested a copy of a claim I filed at separation and they included it as well.  I was told when exiting that these forms usually gets ‘lost’.  Well, I received a copy of the ‘Veteran’s Application for Compensation or Pension at Separation from Service’ for leg injuries, but no specific medical records for this injury.
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
09/21/10 #6
<<<<<I also requested a copy of a claim I filed at separation and they included it as well.  I was told when exiting that these forms usually gets ‘lost’.  Well, I received a copy of the ‘Veteran’s Application for Compensation or Pension at Separation from Service’ for leg injuries, but no specific medical records for this injury.>>>>>>

     I cannot comment on the WBC (white blood cells) or the RBC (red blood cells) counts as I am not familiar with that subject. I know that Epith cells stands for epithelial cells. I found this on my search engine if it helps you:
 epithelial cell – one of the closely packed cells forming the epithelium
epithelial tissue, epithelium – membranous tissue covering internal organs and other internal surfaces of the body
If you filed  a claim at separation, was it ever decided by the VA? This is the kind of thing we’re adept at helping you with. Medical science is not our forte, unfortunately.
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Bandy1979
Registered: 09/20/10
Posts: 2
09/22/10 #7
No, I never followed up on the claim.  Always figured there were people in worse shape than me.  I have been limited in what I could do physically, but as time goes by, it becomes in tolerable at times and has moved into my lower back.  I am employed and have insurance.  After recent MRIs I have been referred to an Orthopedic Specialist.  Haven’t went yet as the out of pocket espenses just for the MRIs and the doctors charge to read the MRIs, with insurance cost over $1500 dollars out of pocket!
This compounded with the expenses for my Gastro CT scans and labs are a bit much.  Of course, my liver function tests are still bad and I have increase ammonia levels.
I don’t know how to read the labs in my military records.  Not familiar with the terms, but they seem very vague, plus no mention of the method of injections.  I’m just lost.  All I know to do is try to get my Gastro doctor to take time to read the military records and try to get a Nexus letter.  If successful, will probably just go through an attorney.  Working is quite a challenge and the medical expenses are overwhelming even with insurance.
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AZeeJensMom
Moderator
Registered: 01/05/09
Posts: 94
09/22/10 #8
Brandy,

Can you send me a little more info on your medical issues via private email ?
I would like to help you in any way I can, are these conditions/tests a result of
Hepatitis C …. ?
I’m here to assist you in anyway I can…..
AZeeJensMom
To send a private email to me, click on AZeeJensMom just above the Moderator to the left side of this box and you can send it to me there…and I will respond.
Posted in General Messages | Tagged , , | 3 Comments

Compensation percentages

Posted on September 29, 2011 by asknod
NODManager
Registered: 11/22/08
Posts: 654
09/17/10 #1
     I overheard several Vets talking down at my local VAMC the other day about percentages and how they add up for a total rating. Unfortunately these fellows were under the misguided assumption that the VA is very generous. Not. The only ones who benefit from their largesse are the upper echelon employees who get WAY more than you or I do and get bonuses for all that hard work. Good suits, ties and dress shirts are expensive. So are fine meals at restaurants around the DVA in D.C.  With that said, let us bow our heads for a moment of silence so we can commiserate with the poor souls and feel their pain.Now, let’s get to comp. percentages. Some of you are aware of how this works, but many aren’t. Collecting a lot of 10% disabilities will not get you to 100% disability. That can only be attained by either a total scheduler rating on one disease/injury or by TDIU. Hearing is a classic example. Total hearing loss in one ear will get you 0%. If the other ear declines it will take extensive loss to attain 10-20%.  Hemorrhoids are another classic example. PN is another. DM2 will get you 20% unless your symptoms are really severe and then it starts to go up. Tinnitus? Again, 10% max for both ears. The list of little things like jungle rot, PCT, and ingrown toenails is endless and the percentage of comp. is miniscule.

Take this little example I’ve assembled for examination. Assume Hep C at 20%, DM2 at 20%, PN in all 4 extremities @ 10% each, Tinnitus @10% and PCT @ 10%. At first glance it would appear to be 100% by adding up all the individual percentages. According to 38 CFR 4.25 Combined rating schedule, the Vet will be appalled to discover the “new math” employed. The bilateral factor requires all 4 10%s to be rated first which equals 34%. Next, 10% of 34%= 3.4% which is now added for 37.4%. So, 37.4%+ 20%=50.4%. 50.4% +20%= 60.4%. 60.4%+10%= 64% and lastly 64.4%+10%= 68.4% which rounds up to 70%. Oddly enough this would not entitle a Vet to TDIU because none of the above mentioned ratings, by itself, is greater than 40%. Incidentally, the Vet would need another 90% to reach 100% from the aforementioned 70%. Is that insane or what? Keep in mind that VA’s stated mission is to make sure we get all that we are entitled to. What they give with the right hand, they surreptitiously remove with  with the left- as amply demonstrated here.

This concludes our class on new math today. VA hopes you have found it informative and entertaining.
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remanded

Posted on September 29, 2011 by asknod
victim88
Registered: 07/27/09
Posts: 14
08/25/10 #1
good grief, my claim was remaned last nov, apparently the do failed to advise me of a negative c&p, stating it was not needed due to the negative report?  bva advised differently, now after more evidence has been provided to counter to negative c&p report, this file once again is on its way back to the bva? possible another 12 – 18 months for a decision, should i receive another ssoc for the new evidence status? is this the making for another future remand? what is the all time record for a particular claim being remanded?  should all evidence be address in the soc/ssoc?  if related secondary medical evidence has been included with my claim,
would the rating for hcv & secondary health issues be addressed at the same time? ex, 30% hcv 50% depression, 100% unemply = feet, eyes, etc?keeping hope alive””’
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NODManager
Registered: 11/22/08
Posts: 654
08/25/10 #2
 Dear Sir,

     Answers as you posed them are:
Yes , the BVA VLJ assigned to your case spotted the lack of an exam. Remand for that is automatic. The RO knows this and continually boots them up to D.C. Their undying hope is that you will die or go away. Pi$$ them off and keep your claim alive;
yes you should receive an SOC or SSOC as this (C&P exam) is considered new and material evidence and requires a de novo decision as long as the VLJ has not made a final ruling (38 CFR 3.156(b)). Use the IRIS system of “Contact the VA” and ask them why you have not received a new decision or an SSOC on your claim prior to its being returned to the AMC;
when the claim is finally returned to D.C., it should be reinserted back in its former order unless the remand takes years to accomplish.; The all time record I have seen is one remanded 6 times with partial rulings on the 3rd, 4th and 5th. It was what we call a Fenderson or “staged rating” rating.;
If related  illnesses secondary to the HCV were included and specifically mentioned in the appeal on your Form 9, then they will be addressed by the VLJ IF you claim is granted. They are not automatically SCed because you won the Hep. You have to have a nexus for each ailment relating it back to being secondary to the Hep. The CAVC has decided that if you fail to specifically list all the diseases you are appealing on your Form 9, then any you fail to list are deemed abandoned. Be careful on this. If you did fail to list them all, file a new Revised Form 9 with both the RO and the BVA in D.C. to cover yourself. Do it cert. Mail, return receipt requested. A lot of claims have died on that altar.;
Please check out the medical ratings chart for Hepatitis C ( DC 7354). There is no rating of 30% for hep, just 0,10,20, 40, 60 and 100%.
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victim88
Registered: 07/27/09
Posts: 14
08/26/10 #3
thank you nod, where would we be without your assistance.  upon my discharge 1988 blood work came back RPR: reactive – to syphillis? later founded out to be negative, would a negative rpr test also reveal hcv? back in 1988 they did not known what i had but i had something, therefore they gave shots for syphillis, which myself, nor my wife never had.this topic was never mentioned in the negative c&p exam.  also how is it possible for the va to states pre-existing and use it against the vet?  they documented and accepted damaged goods, meaning the vet and now want to use this as reason to deny my claim.

the entrance exam doc acknowedge “depression with out taking pills”.  i was not treated, years later medical records mentioned “mild depression” no further action,  last enlisted arc- depression/ yet the va states my records are silent for depression?  i was never diagnosed nor treated for depression i was sent to arc for alcohol, point being all signs point towards depression?

would the va deny my hcv & depression claim dated april 06? if my service records reveal long history of head trauma (slipped on ice in booth camp hit head, real hard) medical records start from booth camp to present 33 years /head injury year history, currently under neuro care? i never filed for head injury, had them ( headaches) for so long it is part of my life? in other words make me start my claim all over?  yes you are right there was alcohol during my service, it was sometimes the only thing that stop the headaches, bet you heard that one before, no really this is documented throughout my military service.
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NODManager
Registered: 11/22/08
Posts: 654
08/26/10 #4
Dear 88,So many questions with so many alternate paths based on which decision is made. Couldof, Wouldof and Shouldof ran 4th, 5th and 6th, respectively, at Belmont last year.  Sorry, all humor aside.

<<would a negative rpr test also reveal hcv ? >> The answer is negative. RPR tests are renowned  for false positives.  Most docs. back then would tell the lab to run 3 samples. Rapid Plasma Reagin (RPR) refers to a type of test that looks for non-specific antibodies in the blood of the patient that may indicate that the organism (Treponema pallidum) that causes syphilisis present.

As for VA saying something is preexisting, your entrance medical exam (Form 88) would list any and all preexisting defects. VA cannot claim that your disease/injury is preexisting after you are discharged. Ain’t gonna happen. 38 CFR   3.304 states:

(b) Presumption of soundness. The veteran will be considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted.

VA law says that if any disease, injury, defect, etc. that pre existed service was aggravated and made worse during service (and is documented in medical records) and continues to be a disability then the Vet gets compensated for it- period.Groves v. Peake (2008) 38 CFR 3.303(b).

Does ARC mean Alcohol Rehabilitation Counseling? Am not familiar with the abbreviation.

Lacking a pack of Tarrot cards and precognition, I do not know if VA will deny your 4/06 claim. Is the depression being claimed separately (preexisting and aggravated by service) or as secondary to the Hepatitis ?

<< if my service records reveal long history of head trauma (slipped on ice in booth camp hit head, real hard) medical records start from booth camp to present 33 years /head injury year history, currently under neuro care? i never filed for head injury, had them ( headaches) for so long it is part of my life? in other words make me start my claim all over?>>

Okay. Let’s see if we can sort this sentence out. If you had a documented history of head injury in service and you have an extensive medical history post service for symptoms of this, and it is the same problem you suffered in service, then you are eligible to collect comp for it. If you haven’t pursued a nexus letter for this or haven’t filed a claim for it yet, perhaps you should.  You cannot collect on any injury if you don’t specifically file for it. If you are denied you have to specifically mention it in your Form 9 as being appealed or contested.

I don’t see where alcohol appears in all this, but if you have documented problems with that, the VA will surely say that’s a risk factor for Hep. Why, I have no idea. I guess they figure if you got too lubricated that you might fall in a puddle of someone’s blood and get infected? Naw. My wife wouldn’t even believe me on that one.  That would require a serious stretching of the imagination. Nevertheless, be prepared for some flak about it.
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gpsr3
Registered: 08/26/09
Posts: 3
09/08/10 #5
HI 40% SERVICE CONNECTED FOR HEP-C WITH LIVER CIRRHOSIS, ASK FOR RATING INCREASE DENIED SERVICE CONNECTED CONDITION HASNT CHANGED, I MENTION IN MY LETTER THE SYMPTOMS FORCE EARLY RETIRE, SO FORM 21-8940 WAS IN MY DENIED PACKAGE.SAYING IF YOU FEEL THAT YOU QUALIFY FOR UNEMPLOYABILITY, FILL OUT THE FORM WHAT TO DO NEXT,APPEAL OR FORM 21-8940 OR BOTH ANY RECOMMENDATIONS THANKS FROM GPSR3
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NODManager
Registered: 11/22/08
Posts: 654
09/08/10 #6
What 21-8949 doesn’t say is that you need a rating on one disease/injury of at LEAST 40% (which you have) and additionaldisabilities bringing your total rating to 60% or more; OR, a single disability rated at 70% or more. Failing that, you would have to apply for an extraschedular rating on the hep C to get your TDIU rating of 100%.

Let’s look at your 40% rating. 38 CFR 4.114, Diagnostic Code (DC) 7354, which you are rated under @40% says:
Daily fatigue, malaise, and anorexia, with minor weight loss and hepatomegaly, or; incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least four weeks, but less than six weeks, during the past 12-month period——–40%
The next higher rating, 60%, requires the following:
Daily fatigue, malaise, and anorexia, with substantial weight loss (or other indication of malnutrition), and hepatomegaly, or;incapacitating episodes (with symptoms such as fatigue, malaise, nausea, vomiting, anorexia, arthralgia, and right upper quadrant pain) having a total duration of at least six weeks during the past 12-month period, but not occurring constantly————60%.
From experience, we have discovered that VA tends to rate based on how much time is lost from work- i.e. symptoms lasting at least 4 weeks, but less than 6 will only get 40%. They may make you document it via paychecks or a statement from your supervisor at work. If you claim six weeks or more of symptoms and religiously mention it to your doctor at every visit, you will be rated 60%. You need medical records that substantiate your claim such as AST/ALT (SGOT/SGPT) that is elevated. If your condition is such that near constant debilitating symptoms and prescribed bed rest are diagnosed, then they will grant you 100%- not TDIU. TDIU is not the panacea its made out to be. You are required to submit to a new exam every year to continue your IU rating. If you are rated 100% on the hep via the near constant debilitating symptoms, you will be examined once every two years. If there is no noticible improvement you can petition for Permanent and Total rating. Once you have this there are no more medical exams. After 10 years they can’t even take your  P&T rating away unless you somehow obtained it fraudulently.
     As for advice, in AB v. Brown (1995) the vet was assumed to be appealing for the highest rating possible based on the criteria in the DC. So… it follows that you should appeal for the highest rating possible. If you are 100% with SSI, that is good evidence for TDIU. If you have something from a Dr. saying you are no longer employable due to the disease, this too, would be useful. VA has to assume you are still filing for TDIU even if you do not qualify for it. You can hardly go wrong by filling out the form and sending it in with an NOD or Form 9 appeal. Remember, more options are more chances for success. If you applied for any other claims with this request for increase, make sure you specify in the Form 9 that you are appealing them as well. If you don’t, they won’t. The deck is stacked against you. Be careful if you represent yourself (pro se). Best of Luck @ VA and w/ the Hep.
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gpsr3
Registered: 08/26/09
Posts: 3
09/09/10 #7
    thanks for the help, and recommendations, ok i will do both form 9 appeal an apply for TDIU its seems that i meet most of the symptoms, the way they write up my denial as if iam not sick. i sorry that my liver isnt a big as a water mellon, which seems that their implying so how could i be having all the other symptoms, but iam still sick an suffer from pain fatigue tired, most of the time i been living with the hep-c since the early 1970. i had gall stone bladder surgery in march 2008 at my va hospital. va denied my claim saying not related to hep-c with liver cirrhosis, so i appealed an that pending in the appeal pile, at my local va. whats your take on local law firms in pursuing my claims. i appreciate your time your knowlege an your genuine concern
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NODManager
Registered: 11/22/08
Posts: 654
09/09/10 #8
Local vs. out of state is immaterial. Virtually all the adjudication proceedings occur in a back and forth mode. You won’t have any “Perry Mason” court scenes at the BVA or the CAVC. Everyone files their briefs, then files more rebuttals and pleadings, and finally the Judge(s) says “Enough. I’m going to make a ruling.” There are many attorneys out there and not all of them are top notch. One lady, Virginia Girard-Brady, seems to have some phenomenal success with this venue. She is in Kansas, I believe. I’ll look her up for you.

ABS Legal Advocates, P.A.
3301 Clinton Parkway Court, Suite 1
Lawrence, Kansas 66047
888-511-9675 (central time 8-5, M-F)
Jez, you’ve gotta love Google. I’m not much for people who hyphenate their last names, but I’ll give her a pass. She has had extraordinary luck on Vet’s claims and only takes 20% of the haul.
     As for you parting sentence sir, my time is what I have a lot of now that Hep and AO have eaten me alive; my knowledge is a product of having to do it myself after numerous Vets organizations promised more than they could deliver; and lastly, my genuine concern is born of a desire to help fellow Veterans who find themselves in similar circumstances as me. If the shoe was on the other foot, I’m sure it would be me petitioning you for all the advice I could get to win. And I have no doubt that you would be there for me. That’s what Vets do for one another if they can. May the Lord bless you and keep you if you believe in such things. We have to be politically correct about that subject these days so as not to offend.

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gpsr3
Registered: 08/26/09
Posts: 3
09/13/10 #9
  THANKS FOR THE INFO, I WILL CONTACT THE ATTORNEY, THAT YOU MENTION HOPEFULLY THEY WILL TAKE MY CASE, IF THEY DONT, I WILL APPEAL, THE DENIED, AN APPLY FOR TDIU.ABOUT A YEAR AGO, I WENT TO VOCATIONAL AT THE VA, THE COUNSELLOR, SAID TO ME THAT MY APPLICATION, WILL NOT BE APPROVED, BECAUSE OF THE SYMPTOMS, I HAD, AN THAT THEY WILL DENIED MY APPLICATION. HE SAID WITH ALL THE SYMPTOMS YOU SHOULD BE 100%, HE RECOMMEND I PULL MY APPLICATION,AN THEY COULDNT EVEM GET ME A SECURITY GUARD, AN THE VA WILL HAVE TO GIVE A SPECIAL EVALUATIONS, EVEN WITH THAT YOU MORE THAN LIKELY WILL BE DENIED ANY WAY. SO PULLED THE APP.YES YOU ARE CORRECT I WOULD BE THERE FOR YOU, IN A HEART BEAT,THAT WHAT VETERAN DO, BEING THERE FOR EACH OTHER, BUT FOLKS LIKE YOU, ARE A BLESSING FOR US VETS. GOD HAS GIVEN YOU A PURPOSE, HELPING OTHER VETS, THERE IS NO HIGHER CALLING, I LIKE TO LEAVE WITH THIS QUOTE FROM ROBERT F. KENNEDY,EACH TIME A MAN STANDS UP FOR AN IDEAL, OR ACTS TO IMPROVE THE LOT OF OTHERS, OR STRIKES OUT AGAINST INJUSTICE, HE SENDS FORTH A RIPPLE OF HOPE. THANKS FOR GIVING ME HOPE, SO I CAN CONTINUE THE FIGHT.
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happy to have found this forum

Posted on September 29, 2011 by asknod
squid_with_dragon
Avatar / PictureRegistered: 08/15/10
Posts: 132
08/15/10 #1
I am glad to have found this forum. The VA never informed me that I was high risk for HCV. I carry a bit of resentment over that. To think how many family members and other people I have exposed over the years because I didn’t know I needed to be careful with my blood is, well, to the point of being almost unbearable. And now I am suffering extensive liver damage which could have been avoided had I known the truth about the exposure to Vietnam and Post Vietnam Veterans!brief intro:

I went active into the Navy in 1977 and got out in 1986. I have 2 bronze stars for deployment, a Navy Expeditionary Medal and a Meritorious Unit Citation. I was injured in a typhoon in 1983 with severe neck injury and medi-evac’d to Yokosuka Japan. I continuously had those long slim needles poked in all over my body. I think they were called EMG tests. I had several of those tests done in Yokosuka and several done at the Regional Hospital in Tokyo. I was sent to Balboa hospital and went on limited duty for about 2 years. A medical discharge was denied although my immune system was compromised because of previous nerve damage. I got out and then went to the VA where I was diagnosed with Rheumatoid Arthritis. I have been rated by the VA at 40% for RA since 1986. I have been treated many times for RA over the years when the disease came out of remission. For instance: Cortisone shots and taking prednisone for a year or two.

I believe I have suffered from PTSD for quite a few years but wasn’t treated for it after I got out as a civilian. I have held a high level security clearance as a civilian working for DOD defense contractors for most of my life until recently. I lost my job to lay-offs and have been on unemployment for one year and several months now. Last fall I became very ill and knew something was seriously wrong but I no longer could afford health insurance so I went to a VA Medical Center.

This last November of 2009 I was diagnosed with Hepatitis C type 2b. My viral load is high. I go through days where I feel very ill, including brain fog, fatigue and other physical symptoms. Since I am physically ill, my defense against the PTSD is down and it has come back. Along with the anxiety of my financial situation, I am a wreck. And to add insult to injury the VA has now tested me as negative for Rheumatoid Arthritis!

I did temporary duty as a Master-at-arms and went on drug busts and handled syringes and other paraphernalia quite often. We had a big heroin bust go down when we left a port in France. The dogs came in and when they would hit a locker, I would open it up and reach inside and find syringes, spoons, bags and nose tubes. However I got the job of MAA because our command’s MAA dropped dead from a heart attack and the CO put me in his position until he could req in another one. I can’t find that in my file because it was not my primary job code.

Last Friday I went to DAV and they are filing on my behalf for PTSD and HCV. I already have a 40% rating for RA. I am in the process of getting my medical records and personnel files to them for the claim. I am thinking I should file for SSD as well. My situation has very quickly become quite complicated. I am trying to sort things out and work the priorities but I feel a bit overwhelmed at times.

1) I am out of money and need to pay rent and buy food

The corporate sector no longer considers me to be a “good-bargain” because I am a graduate with 25 years work experience in my field.

My state has no veteran’s preference for State, County or City government jobs.

Federal Civil service is extremely competitive now because of the existing wars.

No retraining programs are available for post-graduates.

That is if I am really physically able to work. That leaves me with VA Compensation and/or SSD as possible income.

2) I need to try and get this bug out of me

The prognosis for having PTSD and an auto-immune disease such as RA is not medically good. However the VA needs to put all of the pieces together for a good sound diagnosis for treatment. I have not been able to get good direction from them so far.

3) I need to deal and live with the liver damage.

All indications are that I have had HCV for at least over 28+ years. I could very well have cirrhosis or liver cancer now. However the VA won’t do a liver biopsy with Type 2 unless treatment fails. As far as I know (which isn’t very much) a biopsy is the only way to tell how much fibrosis there is, which is also a good indicator of how long I have been infected.

Actually the VA has not been very forthcoming about HCV or treatment. I have had to pound out every bit of information so far but then I don’t really know what information to ask. I would rather have some specialists evaluate my condition outside of the VA, but I can’t afford the high risk insurance for a pre-existing condition. I also can’t afford the medical routines or medications that are not covered.

Any suggestions on what I should or could do would be very much appreciated. All of you have had to deal with this and I can share your pain in that regard. I think this forum is good in that we can share our experiences just to be able to deal with this dragon! Thank you for reading this and I will try to read yours too! 🙂
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
08/15/10 #2
Dear Squid w/ C, Welcome aboard. So much info. We’re glad you found us. One thing I want to point out right at the beginning- your hep 2b is from Japan. That is where Hep 2a and 2b are the most prevalent. This is important ammo for your claim seeing’s as you spent some time at the Yokosuka Bar and Grill. Being in the military, even if you were’t in a combat environment, is still a risk factor that most doctors are finally coming to realize.

     We are not a VSO so we can’t do your claim for you, but we can sure as hell tell you what to do and what not to do. Remember, we all had to learn a lot of this by the seat of our pants over a lot of years. Due to the Internet, we can now
disseminate some of this knowledge to Vets and streamline their claims experience. All of us have horror stories and I’m sure you’ll have a passel of them before you’re done. Please don’t hesitate to ask one of the moderators for advice. That’s what we’re here for. VA pays us so well we’re rolling in dough and do this for fun. I wish. Thank you for your service and again, welcome to the site.
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squid_with_dragon
Avatar / PictureRegistered: 08/15/10
Posts: 132
08/15/10 #3
Thank you Sir!I will tell my rep at DAV about the type 2b. I have those medical records for the three months I spent at the hospitals in Japan.

And thank you for the prompt reply! 🙂
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
08/15/10 #4
The information on genotypes versus geographic distribution is available on the internet at various sites. I found that out from my hepatologist in Nov. 06. I have 3a and spent 2 years in various countries it is indigenous to (RVN, Laos and Thailand) in 70-72. 3a is also prevalent in Australia which is where a lot of Vets spent their 3 day R&Rs. VA fought me tooth and nail for 16 months and finally caved in when the doctor they hired for an IMO agreed with my doc on the geographical coincidence.

     Please do not base your whole case on jet guns. VA will 86 it unless you can get a good gaastrodoc to write a bulletproof nexus for it. Better yet, get two or three gastroboys to write one and make sure they all have a F.A.C. after the M.D. I’ve seen a few wins that way , but entirely too few.

     Here’s a site to quote on Type 2. Some sites will claim 2b is indigenous to Scotland and the U.S. and 2a is more prevalent in Japan. That wasn’t so in the late 90’s when they first started analyzing the genotypes.
Or this:
I quote from the latter:
In Japan, subtype 1b is responsible for up to 73% of cases of HCV infection (124). Although HCV subtypes 2a and 2b are relatively common in North America, Europe, and Japan, subtype 2c is found commonly in northern Italy
     The majority of Vets with HCV Genotype 2a and b (where the infection is greater than 30-40 years old) had service in either Japan, Hokaido or Okinawa. I don’t have enough data nor have I seen any on Taiwan, but I suspect it is prevalent there as well. Feel free to research this at your leisure. I just typed in “geographical distribution of HCV genotypes” into my search bar and came up with the above. Keep in mind that HCV is an industrious hitchhiker and can hedgehop from country to country more frequently now. That explains why 1b is becoming dominant in Japan currently, due largely to relaxed sexual mores.
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squid_with_dragon
Avatar / PictureRegistered: 08/15/10
Posts: 132
08/16/10 #5
Thanks for that…alot of great information in there!After all of these years and the VA is still in denial!

I found the pie charts at cmr by region quite useful for geographic dispersion by genotype. France, South Africa and Japan seem to be the top three by capita for 2b. The way I see it, anyone who was injured or wounded during Vietnam and post Vietnam is at an exceptionally high risk of HCV infection. The Genotype is related to the host country where that vet was treated.

I don’t like the way I am being treated here by the VA medical center. For one thing, the VA won’t do a biopsy for 2b unless the treatment fails and the enzyme levels don’t decrease. Well the fact is that I have most likely (not just possibly) been infected during my hospital stay in Japan in 1982. Now this was 28 years ago. The probability that I have advanced liver disease is high and I feel I should not only be compensated for that, but treated for it as well.

The other deal is that VAMCs test every HCV positive patient for HIV. They told me it is because 33% of all HCV + have also been infected with HIV. But is that data based off of just Vets with HCV or the general population of HCV in the USA? I am glad to get a free HIV test anytime, but it appears that they are treating vets with HCV like the other 2% of the total USA population.
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NOD
Avatar / PictureManager
Registered: 11/22/08
Posts: 654
08/17/10 #6
Without betting the farm on it, I would venture to say you’re 100% correct on the etiology of the HCV (Japan). It’s a rare genotype for the U.S. so I think the claim will be more likely to win. However, your battle has just begun. If the VA decides they don’t have enough info to decide the claim they will send you out for an exam and possibly a biopsy. Ultrasound  exams don’t show fatty infiltration or excessive iron deposits so they are relatively useless. Besides, the biopsy will disclose the stage and grade of the disease which will point to how long you’ve had it. Obviously if you are Stage 3, you’ve had it for 30 years or so. This is important ammo for your claim. You may have to take it to appeal and try to get the BVA judge to remand for a biopsy to determine this. 3 months in a hospital is a recipe for viral disaster. Which brings to mind the question we are dying to ask here. We heard you Navy guys have gill slits behind your ears. Is there any truth to that rumor? We Air Force guys had our wings surgically removed when we got out. Did they do that with the gills? Inquiring minds need to know.
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squid_with_dragon
Avatar / PictureRegistered: 08/15/10
Posts: 132
08/17/10 #7
Thanks NOD! :)That is some more great info….

The doctors at the VAMC were the ones who diagnosed me for HCV. I was really sick with relatively some bad symptoms but I didn’t know what was wrong with me. The VA doc did a rather extensive physical and found the liver enzymes to be rather high. She said my bilirubin was not high so I probably wasn’t chirrotic but that didn’t really satisfy my condition. They have a rep there who handles Hep and diabetes who coordinates my treatment. She ain’t a doc but just a liason I guess. I had to pound on her for two months just to get the genotype figured out. Then another three weeks to get the viral load which was high, whatever that means.

She said that since I have 2b that they won’t do a biopsy unless the treatment fails. They did all of the stress tests to see if I can handle the chemo but now I am in a waiting game. Obviously I have some rather nasty daily symptoms, so I didn’t just catch this bug yesterday. Now that I have read the great stuff posted here, it is obvious that they (VAMC) don’t want to give away anything that might make it look like I got this bug during service.

I would like to get a civilian doctor to see what stage I am in. Obviously I am chronic and I would hope that the amount of liver damage along with my age and having RA (autoimmune) needs to be factored in before deciding to get treatment. I should live so long.

I looked at my arms in the mirror and several scars there from the MUNJIs. You are going to Kenya, ok get zapped. You are going to the Persian Gulf, OK get zapped again. You are going to Malaysia and Thailand so take this one too! The guy infront of me was dripping, I was dripping, the guy behind me dripped. It was a walk by shooting! 🙂

The Japanese were some sadistic @#$%. They put in like 50 needles all over the body to check nerve transmission for my neck injury. They would pump electricity through the needles until I was flopping around like a dang fish! All I really remember was that every time I took the test there was a pile of needles laying there and it took more time to put them in then it took to take them out. It really freaking hurt.

Contrary to popular belief, The only squids that have gills are the frogmen (UDT) because they spend more time in the water than they do on land. I was on gators most of my time in hence, the avatar from Little Creek. My shore duty was getting shot at while putting up antennas in the elephant grass, that is when I wasn’t stepping on cobras. We couldn’t hold our booze if we had gills! LOL 🙂
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50% PTSD 20% DMII, what’s next to get to IU?

Posted on September 29, 2011 by asknod
bradlybone
Registered: 08/02/10
Posts: 1
08/02/10 #1
Hi NOD,I just received my initial rating for 50% due to PTSD and had my AO related DMII upped from 10% to 20% where I had been seeking 70% IU for PSTD.

Should I ask for a rating increase for the PTSD as I am unemployable according to my VA shrink?

Should I start a new claim for Hep C as service related? I already admitted to recreational drug use so can I get a Nexus Letter linking the drug use as secondary to the PTSD? And show the link from the service connected exposures plus the recreational use due to PTSD? Is that valid? Is there case law?

I’m about to got to D.C. and visit the Wall. My shrink to me to be prepared to have a partial meltdown. If I do should I go into the Mental Health ER in D.C. to get it into the record?

While in D.C. I will try to get death records that I couldn’t get from the USMC records center in Quantico and hope these will support a rating increase as they were excluded due to no records. I know they got killed but it’s some kind of freedom of information deal. So off I go.

Any tips on re=rateing increase? I want to file withing the year as it looks like I have a year.

Thanks,

Bradlybones

I’ve attached my VA rating letter. (I think I attached it)
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NODManager
Registered: 11/22/08
Posts: 654
08/03/10 #2
Dear Brad.Here’s the long and the short of it. You have a 50% rating for PTSD and  20% for DM2. That equates to a 60% rating for compensation purposes (see 38 CFR Part 4.25). As it stands now you will never qualify for IU unless you ask for an extraschedular rating from the VAOIG.

TDIU was enacted in 1961 to correct a perceived inability of some Vets to ever attain a 100% rating. So the law was sweetened up a bit to read that any Vet with a 40% or higher rating on one disability combined with other, smaller ratings totaling 70% would qualify. Or, in the alternative, a Vet with a single disability rating of 60% would also qualify.

You indicate the 50% for PTSD is brand new (and no, I don’t see the rating attached) which means you can still file a NOD asking for a higher rating of 70%. That is all well and fine but you have to qualify in VA’s eyes for the higher rating. That can only be accomplished by a proper nexus from the psychiatrist and an appropriate GAF score that supports 70%. VA is notoriously stingy with their money (and ratings) unless, of course, it’s bonuses for VA employees and BVA judges. Somehow I don’t see the trickle down theory ever percolating down to our compensation payment level. Several months ago I met a Vet at my VAMC. He told me he was going in for the TDIU rating as he was now 65 and virtually unemployable. He’s been 60% for 40 years due to a Bouncing Betty shearing off his legs at the knees. They told him he was employable all these years and to basically go away. Oh, and he was missing a few fingers, too. Go figure.

As for starting a new claim for HCV, I don’t have enough info to help you on that one. Was the recreational drug hanky panky during or after service? Have you had any tattoos after service but before 1992? Any documented unsafe sexual practices in you post service medrecs? A guest of the State with free room and board (incarcerated for a crime)? Those can sink your claim. However, if you have significant risk factors documented in service like being treated for VD or Clap (or even a case of NGU) you have a pretty good case. It all depends on how you approach this drug thing. Face it. In the eyes of the world we Vets are all drug addicts and junkies and that’s how we got this bug. How you present your claim will determine your success or failure. You are correct in assuming that you could claim drug addiction as secondary to your now SC PTSD, but you would need to show that it was an ongoing affair. From what you say, it sounds like you are past that chapter in your life. VA does not pay compensation or grant ratings for diseases or injuries which you no longer suffer from. Remember the Caluza triangle (also known as the Hickson elements). These were two famous cases heard before the CAVC which enunciated the requirements for SC. To summarize them: 1) a disease or injury in service (or a documented risk factor); 2) a current diagnosis of same; and 3) a proper nexus tying the two together.

If you are going to the Wall, I can only suggest you take lots of Kleenex or a very large hanky. I’ve been there twice. The second time was worse than the first. I discovered in 08 that a pilot I flew with augured in in Feb. 71 the day before I got out of the hospital from Hep. I never could find him and assumed he DEROSed back home. I went to locate him for a buddy statement for my claim. That was a dead end (no pun intended). I guess I had to go see his name cut in stone for finality.  I don’t think you will find closure at the Wall, Brad. It will open up a brand new set of wounds for someone that genuinely suffers from PTSD. Closure is what you experience when you accept reality and move on.

I got a General under Honorable conditions for “antisocial personality with passive aggressive tendencies” after 2 tours back to back. That was Militaryspeak for PTSD in 1972. It was conveniently considered a “personality disorder” rather than a psychiatric disorder and therefore not compensable by VA. I guess I don’t need to tell you what effect a car backfiring on the street had on me for a decade or more.

A visit to St. Elizabeth’s (VAMC in D.C.) will not hurt your claim, nor will it enhance it unless you turn into a mental disaster area. Remember, you are already rated for this. The GAF score, your psychiatrist’s assessment and you employability are what determine your % of rating. If you honestly believe you’re going to need a shrink after the Wall experience, I suggest you forgo the visit. Either that or eat a $hitton of Valium a few hours before you go and get a designated driver.

As for obtaining any records from Quantico, rots of ruck. VA usually depends on the JSRRC to research and discover these records. You are allowed to submit dates, times, names and places and let them do the legwork to substantiate your claim. As your stressors have already been proved, your mission to Quantico is somewhat redundant. Trust me when I say they will give you zilch when you show up there other than the old “Hail fellow well met” speech along with the old saw “ Thank you for your service to our country. “ With that and $5.50 you can get a good cup of Starbucks to go with the depression that the wall is certain to cause.

As for tips for a rating increase, all I can say is don’t contrive it. Don’t pretend you have suicidal ideation or other symptoms that would support a 70% rating. Either you have it or you don’t.  This is not like being a little bit pregnant, Brad. Psychiatrists can usually see right through it and if you are using VA shrinks, they are wise to the ways of Vets trying to attain higher ratings. I’ve heard of Vets seeking SC for HCV resorting to using yellow food dye in their eyes to mimic jaundice. Or the one where you go in for several visits to the gastro doc. They weigh you each time. Pack about 20 rolls of pennies or quarters (if you’re rich) in your pants pockets and then go in the next time without them. Voila !  Instant weight loss.  Or my personal favorite- have your best bud sucker punch you right on the edge of your right rib cage(I advise you to close your eyes when he does it)to make you wince in pain when the Gastrodoc palpates your liver. That’s always a winner. In fact, so is syrup of Ipecac right before you go in. You don’t even have to pretend you’re nauseous. Hurling a few chunks is worth a thousand pictures. A little bit of charcoal artfully applied under the eyes is also useful.

I hope this covers all the bases for you, Brad. I’m glad to see you’ve finally joined the 10%er club (that’s how many claims the VA grants on average). It was probably a very long, lonely quest for justice. Although it sounds trite, We here at HCVets want to thank you for what you did by serving. So many Americans sit back and just assume someone will look after their interests and preserve their freedoms. Unfortunately, that is a very selfish and myopic viewpoint. If it weren’t for Veterans, I shudder to think of where we’d be now.

Sincerely,

Das noodle
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