"Ask NOD"

Lucky Nexus

From: Posted by NOD
Category: What to do when filing a claim
Date: 09/11/08

Comments

Citation Nr: 0617969 Decision Date: 06/20/06 Archive Date: 06/27/06 DOCKET NO. 04-31 708A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUE Entitlement to service connection for hepatitis C. REPRESENTATION Appellant represented by: Minnesota Department of Veterans Affairs INTRODUCTION The veteran had active service from June 1975 to June 1978. FINDING OF FACT The veteran has hepatitis C that has been related to active service. CONCLUSION OF LAW Hepatitis C was incurred in active service. 38 U.S.C.A. §§ 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2005). The veteran contends that he was exposed to certain risk factors during service that include assisting an accident victim and close contact with a fellow service member who subsequently developed hepatitis. He acknowledges some use of intravenous drugs during service and a tattoo that he obtained prior to service, at age 12. In a December 2002 statement, the veteran claims that he became aware that he had hepatitis C when he wanted to give blood at a blood bank in July 2001, and was told he had hepatitis C. A February 2004 VA pathology report reflects a diagnosis of chronic hepatitis C, grade 2. A VA outpatient record from July 2004 reflects that J. D., a nurse practitioner, noted that the veteran had been evaluated for his chronic hepatitis C. She stated that he was found to have moderate fibrosis on liver biopsy. She also noted that the veteran's risk factors for hepatitis C included intravenous drug use between 1976 and 1978, intranasal drug use in 1976, and tattoos in 1966. She opined that it was difficult to ascertain when the veteran was infected because of multiple risk factors, but that it was more likely than not that he had been infected for at least 28 years. In a medical statement dated in July 2005, J. D. noted her previous statement and that the veteran's most recent potential exposure was in 1978, which was about 27 years ago. Hence, she concluded that the veteran was more likely than not infected with hepatitis C at least 27 years ago. She commented that because of multiple risk factors, it could not be ascertained exactly when the veteran was infected. In his opinion memorandum, dated in October 2005, Dr. E. noted his review of pertinent records, which indicated the placement of tattoos in 1966 and in-service intravenous drug use. Dr. E. did not find any evidence of any injury that involved blood contamination, jaundice, or other symptoms that could be related to acquiring hepatitis C virus. Dr E. believed that the likely causes for the veteran's hepatitis C were illicit drug use, whether intranasal or intravenous, and tattoo placement. He stated that there was no report of any injury that involved any blood or other body fluids exposure, contamination, or any blood exposure during the veteran's military service. Dr. E. concluded that based on the provided medical records, the onset of the veteran's hepatitis C infection could not be determined. II. Analysis The Board has reviewed the record in detail, and first notes that it clearly reflects current diagnoses of hepatitis C. However, as the veteran has been advised on multiple occasions, it is further necessary that the evidence reflect that the disorder was incurred in active service and a link between current disability and service. In this regard, the Board first recognizes there are no contemporaneous records that substantiate the veteran's accounts of assisting an accident victim and/or close contact with a fellow service member who subsequently developed hepatitis. In addition, in his October 2005 report, Dr. E. stated that the likely causes for the veteran's hepatitis C were illicit drug use, whether intranasal or intravenous, and tattoo placement. The Board also notes that service connection for disease based on drug use is precluded as wrongful misconduct, and that the veteran's tattoo was put in place prior to service. However, the Board further observes that while Dr. E. opined that the likely causes for the veteran's hepatitis C were drug use and tattoo placement, he ultimately concluded that based on the provided medical records, the onset of the veteran's hepatitis C infection could not be determined. The Board is also concerned that Dr. E. stated in his October 2005 report that the record did not reflect any report of an incident of blood exposure, and clearly the veteran reported in-service contact with the blood of an accident victim. The Board additionally notes the opinions of the VA nurse practitioner, J. D., who links the onset of the veteran's hepatitis C to multiple risk factors in service, without necessarily limiting those risk factors to drug use. There is also no evidence that directly contradicts the assertions of exposure as expressed by the veteran and/or the opinion of J. D. Consequently, with one medical opinion establishing the onset of hepatitis C during service, and one concluding that onset of the veteran's hepatitis C can not be determined, the Board will give the veteran the benefit of the doubt, and find that the evidence supports the grant of service connection for hepatitis C. ORDER The claim for service connection for hepatitis C is granted. ____________________________________________ John E. Ormond, Jr. Thank you, VLJ Ormond, Jr. This decision is one that clearly demonstrates how justice should be administered-impartially. One of the first things you should look at is that a lowly nurse practitioner, one J.D., seems to know what's going on here and writes it down coherently so no one else can screw it up or twist her meaning. The second thing is that this VET is shooting for 1978 and he has a Stage 2 moderate fibrosis. That 28 long years ago. Everyone's disease progresses differently. Nurse JD talks about his risk factors as being many and varied and some being the wrong kind of bozo no-no. But she ascribes a TIME ASSESSMENT that is essential. Meet Dr. E. No ID tags here but smart money says this guy is the hired gun. He doesn't mince words and pegs it on nose candy, IDVU or (long shot) tattoos. Remember, these risks are always listed in order of likelyhood with the strongest suspect first. It's only speculation on the doc.'s part but they get to opine, not you and me. We VETS just get to sit in the peanut gallery and pick our noses. Now, Dr. E went on to say that he could not determine, given the records provided, the age of the disease. In the next phase of the decision(II. Analysis), The BVA VLJ does what all gov't. employees do- He CYAs. He says : We asked you for evidence , nexus and proof. My ex-VSO called that the Golden Triangle, but only AFTER I figured out I was going to need it to win. You must have it. You will note the Judge weighs the evidence and says there's nothing but the VET's testimony to back up any blood nexus. VA has no dirt on this guy other than his admitted use in service. There is no mention of anything negative that happened after 1978. This VET did not develop a case of Chatty Cathy disease w/ the doctor/pa. So the VLJ decides that the Nurse is smarter than the doc. but still says it's the benefit of the doubt . That's legalspeak for: The guys @ the RO didn't give me enough rope for a Texas Necktie party so you win . An ugly win is still a win . Most VLJs would send this out for a "medical expert" to reopine on. I am much more familiar with that form of VA justice. I wonder if they took this VLJ out behind the barn and had a chat about company policy and to not let it happen again. We can still call this a teaching moment: VET wins because VA forgot to bring nexus . Interesting point: no risks claimed for jet guns, shared razors, tooth brushes, poor hygiene, STDs, alien abduction, Bush's fault. An ugly,sloppy victory like your dog licking your face. Go figure.

Busty Christy Milf

From: braincash
Category: General Info
Date: 08/20/09

Comments

Busty Christy Milf - http://track.braincash.com/track/MTI0ODE5OjM6MjE,5/

Live Voyeur Orgasm

From: livevoyeur
Category: General Info
Date: 08/21/09

Comments

Live Voyeur Orgasm - http://livevoyeur.com/maintour.php/21663/368/A

Last changed: 08/21/09