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From: Posted by NOD
Category: What to do when filing a claim
Date: 09/08/08
You have a problem. What's the repair order? Get your medrecs from the NPRC in
St. Louis, Mo. if you have never filed for compensation with the VA. This link
will get you started. http://www.hcvets.com/data/va_news/FilingClaims.htm
Otherwise, if you have, request them from your local RO or the RO where you
filed your claim if it is different. Get all of them, charts, labs, x rays,
anything medical. Your doctor will need them to create a nexus letter stating
your disease (s) were connected to your service. Start now. It takes time which
is something you will find you have lots of as your illness progresses.. A
wonderful ploy by VA is to wreck your nexus by saying your doc. was not privy to
all your medrecs so his Dx/nexus is not as valid or valuable as the VA
examiner's nexus. Often, you will get into a pissing war as to who's doctor has
the most "board certified"s after his name. Relax. You want private doc nexuses,
if possible. They make $200K a year and are way bigger/better that the $89K VA
docs like Dr. Habib Haboob. Besides, they work for you. Would you ask to be
represented by the attorney of the guy who rear ended you? If you have always
used private medical care, chances are you've been going to the same gastrodoc
or hepatologist for years, They are well versed in your medical condition. If
you have been using the VA as your medical provider, all is not lost. Your
personal doc is valuable if he is knowledgeable about your disease and its
progression. He must, however be able to access all your military/SMRs. That is
a prerequisite for the nexus to have medical validity.. Most docs. don't have a
dog in the fight. VA cannot fire your VAMC doc for providing you a nexus. Most
feel empathy for you even if you were/are a raging junkie. If you don't drink or
smoke, you float higher in the sympathy column because you're not actively
engaging in the destruction of your liver. It goes without saying you'd be
better received if there was no drug hx at all but we are not all saints. By the
same token, anything you tell your doc. is fair game against you. Again, be
honest with the docs. If you tried to bed every babe in Cholon and came down
with Syph or the clap in service, that is not willful misconduct. In fact, if
its in your medrecs, its evidence in your favor as are tattoos received in
service. I never met any vets who engaged in acupunture in service, but that,
too would be okay. A dx of Non-gonococcal urethritis(NGU) can be proof of
forgetting to put on the old raincoat. I used most of mine to keep the dirt out
of my M-16 barrel. However, if you came home and developed a history of arrests
for patronizing prostitutes for 10 years before finding that significant other,
that would constitute evidence against your claim. Any tattoos received after
service are reasons for denial of your claim. There is no reason to have a "Come
to Jesus" meeting concerning anything you did after service. If you have been
incarcerated (some would prefer to call it being a guest of the state)at the
Graybar Hotel for any period of time, the VA will use that against you .They may
suspect that you became Jim Bob's "girlfriend" and that, gentlemen, is a risk
factor. Some RTs are prejudiced. Don't be surprised. There are just so many $
available to Vets. Any claim that can legally and medically be denied will be.
The current success rate is 15 %. VA is no different than an insurance company.
Consider them as such. You should have a biopsy by now. If not, go get one RFN.
Ultrasounds are too speculative and don't show bridging necrosis. If you had a
love affair with Johnnie Walker Black, and its in the medrecs, you'll surely
need one just to disprove alcoholic hyaline cirrhosis. Your biopsy must show,
and I stress MUST, at least a Stage 3, grade 3 liver with 3/4 fibrosis. This is
an indication that your liver has been diseased for at least 30 + years. As you
can see, my advice is directed at male Vietnam vets with a window of service
from 1962 to 1975. A biopsy for a Gulf war vet would not show this. Sorry. If
your biopsy is Stage 1 or 2, it means your hep started in the 80s and will mean
denial. Your doc., however, will be the final arbiter of this. The more power to
you if you can get a later nexus. If you can obtain more than one nexus, it will
really improve your chances of winning, especially if your claim is dicey
because of a prior risky lifestyle. Remember, no claim is dead in the water if
you can get a nexus. That is the secret to SC. Remember always- some examiner
from the VA is going to "opine" that is "more likely than not" the hepatitis
you're claiming is not SC. They use anything to reach this end. Everything you
did after service is fair game- police records, private medrecs, anything you
ever said to a doc, welfare clerk, job applications incarceration records, DUIs,
SSA records- anything. If a private dick can find it, they can. They are going
to give you a form to submit to all your health care providers(private)
requesting your medrecs. So be honest. It'll bite you in the ass if you don't
address it. I don't know how many claims I've read that said the Vet said this
and the medrecs contradict it. They will give you a risk factors questionnaire
to fill out listing all the VA recognized vectors for contraction of HCV. I am
not, repeat not, going to tell you how to fill this out. One observation I will
make is I don't believe some of those factors constitute risk. I am not a
doctor. I am not qualified to make that assessment. The form will become your
report card for this disease. Anything you check off will be used in a decision
on your claim. Think through it before you fill it out. You can win. The odds
are better than Reno if you can find the supporting evidence. That might be the
hardest part.This claim process can and should be buttressed by additional risk
factors such as jet guns as we all were subjected to that indignity. It is
obvious to everyone except the VA that they posed as great a risk as IVDU .
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