retiredat44

Thank you Carlie, for the insight.. now I just have to stay alive.. btw, I gave my wife the names and addresses of people in case I die.. so she wil be able to continue where I left off.. (I am not being a drama queen, I am always a fever away from the end..) They told me if I get one more fever from the pancreas, they will remove it.. everyday I wake up sick and hope this is not the day..

I think my VSO said I might get a date in about 3 months for a video hearing.. 9and thent he actual hearing date could be a year after that.. I am a bit worried that my condition might not be as evident by video, as I am a mess and shake and look bad in person... up close,, in video they will not see me clearly upclose.. Judges are not doctors and have no clue how being sick feels, they only thing they have ever had was the flu or a toothache, I am light years beyond that.. I would like ot know who else will be in the hearing room.. besides me my rep from American Legion, the Judge, and who there knows anything about medical? I know they have a recorder, the person running the recorder... I went though and SSDI hearing, and they made me feel like I was a criminal and had done horrific crimes to be there... If I knew more information before I go, I can be a little more prepared... I suppose I will need to bring all my medical records.. I am just to sick to handle flipping through pages and talking.. I shake and fumble.. I go to website forums looking to read about other Vets experiences about the hearings....

mY father was in the navy in the early 1950's He had asthma and smoked 2 packs a day.. he never ever went to a doctor, but was always gagging and coughing, and had problems with food,, after 30 years went by he went to the VA and they gave him 100% after one c&p exam.. I have been sick and in and out of hospitals and the VA only gives me the runaround..... not sure what the hell the VA is doing.. it's al upside and crazy..

I wish I could chat with some people who have had BVA hearings, and also people that have had the American Legion as their legal rep.. Just to hear experiences..

Yes, I remember she was talking about some form 9.. of which she pulled one out and I signed.. I believe that form has the options of all the different types of hearings to choose from? She had to write in the remarks section about the video hearing.. and there are options to check off on the form.. I have told people I am very sick and told them I am very sick, and tried to show them, it is in my claim too.. but I really don't think they have a clue.. I suspect they just don't understand,, unless they had the disease.. I tried to get the point across and even asked if they had some system in place for people that are sick,, I can't get a decent answer.. I will ask again.. I have complications due to necrotizing pancreatitis (with pseudocyst.) http://medical-dictionary.thefreedictionary.com/necrotizing+pancreatitis

Question whether the BVA hearing ( http://www.ohamvets.org/claim.htm ) in person or live video, I would expect being there in person would be best: drawbacks: -might take a couple years longer -I am too sick to travel far any opinions on BVA hearings, travel vs live video ? Thanx.. ==========

My Disability claims process proceeds, slowly.. The American Legion is representing me and my claims in my Veterans Disability claims process to increase my rating. They have decided to take my case to the Bureau of Veterans Affairs. Thye will hold a hearing. They are trying to get it live video feed, or else it will have to be in washington D.C. where the hearings are held, in which case I would need to travel. If I travel it might take another 2 years to get a hearing. My legal representative is pleased with all my evidence. The struggle has pretty much destroyed me personally. This win would be a huge win for my family and I. One more big problem, I am way too sick to travel. Also, not to be a drama queen, but people with necrotizing pancreatitis, and that also have complications (all of which I have) usually die of muti-organ failure after only a few short years. If this drags on pass my death, my family may never see the benefits.

I think I maybe confusing som epeople regarding my VSO (Veterans Serice Officer). First of all.. a couple years ago, after getting out of the hospital after a 6 month stay, I spent a another 6 months learning to walk, and eat again... I then went to a Vet Serice office, like I did in the 1990's when I first got 50% rating. I got a new VSO and started filing new claims.. then after a couple denails, and starting NOD's, I got another denial. I went calling on him at m local VA clinic, clse to my home about 15 minutes away. I found out he had been promoted, and was told the soonest I could see anyone was next January. 4 months away. I said screw that and went to the VA regional office where American Legion, my claim sponsor had office is located. It is about 50 miles from my home. But, a smal price to pay for having representation. I walked in and told them I needed to write an NOD for a negative decision I just got 2 days ago. he didn't have the time that day to do much he said. I called and told them I needed to go over a VSO with al my documents and medical records. I got a new VSO, and she also does VA Disability hearings. So, I got an appointment to go over everything, and is setting up hearings for me, via live taped video conference with their Washignton D.C. office. So, After talking to a couple VSO's in that office, I am working with the one that actually goes to the hearings and represents Vets. She is the VSO that says my documents and medical records, and IMO looks very good to her. I still need to work hard and get more organization on al my paperwork, but I still have to pul my weight and continue getting more diagnosis, etc... They are treating me well, and appear to know what they are doing. If I don't make things clear when I post onthese forums, I am sorry, but soem things are a mess and I am learning.. It appears that some of my ideads about putting in some claims are just wrong at this time and must be done at the correct times.. The people here are invluable, and I am defintely listening and taking notes. I wil let anyone know when important things happen, but for now I need to simmer down, and try not to die and get what I need done. Thanx All.. S!

I have currently suffered from extreme edema, and this morning my VSO has helped me with the claim stuff,, I am taking medicine for edema.. I take diareutics because my limbs and stomach fill with fluid.. the decision was a frakekd up and the VSO is fixing everything. I wil have a BVA hearing in the coming months she says.. I have been taking floresemide for edema. I had an extra 30 lbs of water in my in 2008. My leggs were the size of elephants legs. The damned exams by the claims and their reports are all lies.. my records have all the proof.. She is confident of my claim being approved.

I was pumped full of heparin for several month and almost lost my eyesight, and they rushed me up to the eye clinic from m y hospital bed.. I found out there is a class action against the makers of Heparin, and I signed up.

I just spent one hour with my VSO, and she will also go through the appeals process with me,, she is asking for a BVA video conference.. She likes my IMO and is completely satisfied with it.. so, in a few months there maybe some progress regarding a hearing date.. I have to many irons int he fire, and she says that everything looks god, and not to put any more irons in the fire for now.. I will give her any more medical records I get as I continue going to more doctor appointments.. I have more appointments for neurology, and also the pancreas and liver..

Sorry if it looks like I ignored something,,, I am really ina ness right now with the rest of my claims and life problems, and whent he time artises I wil look into other things... between illness, and the thopughts of just ending it all,,, or my health killing me first,, and the VA disability cclaims process, and a messed up life... I can't do all this stuff! If/when the time comes where I can work on more stuff like the 1151, I will, but I can't do a damned thing for now.. if/when my claim is settled permanatnely and I win, I can apply for the ful 100% for my hospitalization, and if any injuries can be filed on on top[ of that I will, but for now, I am trying to stay alive.. every freaking day I question if it is worth trying to live, or if I am going down for the count, again,, it's happned a few times..

Here is is again, copied from the thread I posted it in.. (not sure what you are looking for, I am getting ready to go, so I hope this is what you would like to see: First the copy of the denial.. (note I also have a seperate NOD claim not yet addressed_, more on that later.. ======= c: -------DEPARTMENT OF VETERANS AFFAIRS Regional Office 　 (1-800-xxx-xxxx) 8810 Rio San Diego Drive San Diego CA 92108 　 SEP,l () 2.0\0 In Reply Refer To: xxxxxx/xx CSS xxx xx xxxx xxxxxxxxxxxxx xxxxxxxxxxxxx xxxxxx Dear Mr. xxxxxxx: We made a decision on your claim for service connected compensation received on October 30,2009. This letter tells you what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision. We have also included information about what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided .' We determined that the following conditions were not related to your military service, so service connection remains denied: Medical Description tremors gastritis) to chemical rashes secondary secondarysecondary to JP-4 jet fuel Chronic pancreatitis (previously claimed as 　 Allergies,intestinalJP-4 jet fuelDistal polyneuropathydisorder, irritable bowel syndrome,bilateral hands swell, and skinand benign essentialexposure to Your monthly compensation payment of$845.00 will continue unchanged. We have enclosed a copy of your Rating Decision for your review. It provides a detailed explanation of our .decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on your claim received on October 30,2009. It represents all claims we understood to be specifically made, implied, or inferred in that claim. 1I11111111III11111111111111111I11III11111I1111111111111I111II111111111111111111111111 　 　 c: -------DEPARTMENT OF VETERANS AFFAIRS Regional Office 　 (1-800-xxx-xxxx) 8810 Rio San Diego Drive San Diego CA 92108 　 SEP,l () 2.0\0 In Reply Refer To: xxxxxxx/xx CSS xxx xx xxxx xxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxx Dear Mr. xxxxxxx: We made a decision on your claim for service connected compensation received on October 30,2009. This letter tells you what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision. We have also included information about what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided .' We determined that the following conditions were not related to your military service, so service connection remains denied: Medical Description tremors gastritis) to chemical rashes secondary secondarysecondary to JP-4 jet fuel Chronic pancreatitis (previously claimed as 　 Allergies,intestinalJP-4 jet fuelDistal polyneuropathydisorder, irritable bowel syndrome,bilateral hands swell, and skinand benign essentialexposure to Your monthly compensation payment of$845.00 will continue unchanged. We have enclosed a copy of your Rating Decision for your review. It provides a detailed explanation of our .decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on your claim received on October 30,2009. It represents all claims we understood to be specifically made, implied, or inferred in that claim. 1I11111111III11111111111111111I11III11111I1111111111111I111II111111111111111111111111 　 　 2 CSS xxx xx xxxx xxxxxxx, xxxxxxxxxxx What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you should write and tell us why. You have one year from the date of this letter to appeal the decision. The enclosed VA Form 4107, "Your Rights to Appeal Our Decision," explains your right to appeal. If You Have Questions or Need Assistance If you have any questions, you may contact us by telephone, e-mail, or letter. Here is what to do. If you Call us at 1-800-xxx-xxxx. Send electronic If you use a at Please Put your full name and VA file number on the letter. Telephone Telecommunicationshttps://iris.va.gov. to the address at the top of this inquiries through the Internet Write number is 1-800-829-4833. Use the Internet letter. send all correspondence Device for the Deaf (TDD), the In all cases, be sure to refer to your VA file number xxx xx xxxx. If you are looking for general information about benefits and eligibility, you should visit our website at https://www.va.gov. or search the Frequently Asked Questions (FAQs) at https://iris.va.gov. We sent a copy of this letter to your representative, American Legion, whom you can also contact if you have questions or need assistance. Sincerely yours, P.~ xxxxxxx Veterans Service Center Manager Email usat:https:/liris.va.gov/ Enclo~ure(s): Rating Decision VA Form 4107 cc: American Legion 215/xxxx/9-10-10 　 　 DEPARTMENT OF VETERANS AFFAIRS San Diego Regional Office 8810 Rio San Diego Drive San Diego, CA 92108 　 xxxxxxxxxxxxxxxxxx 　 VA File Number xxx xx xxxx 　 Represented by: AMERICAN LEGION 　 Rating Decision September 8, 2010 　 INTRODUCTION 　 The records reflect that you are a veteran of the Peacetime. You served in the Air Force from xxxxxxxx to xxxxxxxxxx. We received a request to reopen a previous claim on October 30, 2009. Based on a review of the evidence listed below, we have made the following decisions on your claim. DECISION 1 . The previous denial of service connection for chronic pancreatitis (previously claimed as intestinal disorder, irritable bowel syndrome, gastritis) secondary to chemical exposure to lP-4 jet fuel is confirmed and continued. 2 . The previous denial of service connection for distal polyneuropathy and benign essential tremors is confirmed and continued. 3 . The previous denial of service connection for allergies, bilateral hands swell, and skin rashes secondary to lP-4 jet fuel is confirmed and continued. 　 xxxxxxxxxxxxxxx xxx xx xxxx Page 2 EVIDENCE • VA Form 21-4138 "Statement In Support Of Claim" received October 30, 2009 and November 5, 2009. • VA "Duty to Assist" (VCAA) letter dated February 18,2010. • VCAA Notice Response received February 24,2010. • Rating Decision dated July 30, 1999 and evidence enclosed. • Service Treatment Records, (STRs) from 1979 through 1982 (partial copies). • OCCMED study from xxxxxxxxxxxx M.D. with a history of medical retreatment dated September 2, 2009. • VA examination dated July 14 and 23, 2010, VA Medical Center (VAMC); San Diego. REASONS FOR DECISION 1. Service connection for chronic pancreatitis (previouslv claimed as intestinal disorder. irritable bowel syndrome. 2astritis) secondary to chemical exposure to JP4 iet fuel. Service connection was denied for chronic pancreatitis. (previously claimed as intestinal disorder, irritable bowel syndrome, gastritis) secondary to chemical exposure to JP-4 jet fuel in the Rating Decision dated July 30, 1999 because service treatment records show a couple episodes of acute viral gastroenteritis. These records do not show a diagnosis of chronic pancreatitis. Also, private treatment records showed complaints of an intestinal disorder in 1993, 10 years after active duty service. This decision became final on August 13,2000 because you did not file a timely appeal. In order to reopen a claim,. new and material evidence must be presented: New evidence means existing evidence not previously submitted to agency decisionmakers and can be neither cumulative nor redundant of the evidence of record. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. Additionally, this evidence must raise a reasonable possibility of substantiating the claim. We have received new and material evidence in the form ofOCCMED study from Maria Nellie Betancourt M.D. with a history of medical retreatment dated September 2,2009. Therefore, your claim is considered reopened. The VA examination shows a diagnosis of status post necrotizing pancreatitis secondary to endoscopic retrograde cholangiopancreatography with residual chronic pancreatitis. After review of your service treatment records and claims file, the examiner provided the opinion that there were no human studies, which have connected chronic pancreatitis 　 　 xxxxxxxxxxxx xxx xx xxxx Page3 . with exposure to toxic fuels such as JP-4. The animal studies cannot be extrapolated to your chronic pancreatitis condition. Your condition followed your bile peritonitis and ERCP procedure in 2008. Your 1990s Kaiser and VAMC treatment records never diagnosed chronic pancreatitis. The diagnosis of irritable bowel syndrome because of lack of other diagnosis began in the early 1990s or 9 years after discharge from service. There were no medical records between the time you were discharged and the 1990s. The examiner stated that it would be mere speculation to attribute your chronic pancreatitis due to exposure to aviation fuel (JP-4). Therefore, the previous denial of chronic pancreatitis (previously claimed as intestinal disorder, irritable bowel syndrome, gastritis) is confirmed and continued because the evidence continues to show this condition was not incurred in or aggravated by military service. 2. Service connection for distal polyneuropathy and benign essential tremors. Service connection was denied for distal polyneuropathy and benign essential tremors secondary to chemical exposure to JP-4 jet fuel in the Rating Decision dated July 30, 1999 because service treatment records noted tremors of hands in two occasion during service, however, neurological treatment report of January 1999 showed no evidence of any neurological disorder. This decision became final on August 13,2000 because you did not file atimely appeal. In order to reopen a claim~ new and material evidencemust be presented. New evidence means existing evidence not previously submitted to agency decisionmakers and can be neither cumulative nor redundant of the evidence of record. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. Additionally, this evidence must raise a reasonable possibility of substantiating the claim. We have received new and material evidence in the form ofOCCMED study from Maria Nellie Betancourt M.D. with a history of medical retreatment dated September 2,2009. Therefore, your claim is considered reopened. The VA examination shows no clinical evidence of a distal polyneuropathy 'either by history or on clinical neurologic examination and benign essential tremor, familial, by history, pre-dating entrance on active military duty. After review of your service treatment records and claims file, the examiner provided the opinion that your tremor represents a benign familial tremor, and was unrelated or result of exposure to aviation fuel. There was no evidence of distal polyneuropathy; and, therefore, there would be no evidence of exposure to aviation fuel causing or resulting in such a polyneuropathy. Therefore, the previous denial of distal polyneuropathy and benign essential tremors is confirmed and continued because the evidence continues to show this condition was not incurred in or aggravated by military service. 　 　 xxxxxxxxxxxxxx xxx xx xxxx Page 4 3. Service connection for allergies, bilateral hands swell, and skin rashes secondary to JP-4 iet fuel. Service connection was denied for allergies, hands swell, and skin rash secondary to chemical exposure to JP-4 jet fuel in the Rating Decision dated July 30, 1999 because the condition was acute and transitory. Service treatment records show complaints on dermatitis while you were working with fuel and chemicals, however, this condition did not continue after the exposure stopped and in 1998 the VA examination showed no residuals. This decision became final on August 13,2000 because you did not file a timely appeal. In order to reopen a claim, new and material evidence must be presented. New evidence means existing evidence not previously submitted to agency decisionmakers and can be neither cumulative nor redundant of the evidence of record. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. Additionally, this evidence must raise a reasonable possibility of substantiating the claim. We have received new and material evidence in the form ofOCCMED study from Maria Nellie Betancourt M.D. with a history of medical retreatment dated September 2, 2009. Therefore, your claim is considered reopened. The VA examination shows a history of contact dermatitis secondary to exposure to het fuels and recurrent on exposure to chemicals used in the printing process but without recurrence. After review of your service treatment records and claim file, the examiner provided the opinion that you're your allergies, hands swell, and skin rash occurred while in service and were secondary to exposure to fuel, but there was no current skin condition that is secondary to that exposure. Therefore, the previous denial of allergies, hands swell, and skin rash is confirmed and continued because the evidence continues to show this condition was not incurred in or aggravated by military service. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our web site, www.va.gov. -., 　 　 xxxxxxxxxxxxx ~ Department of Veterans Affairs YOUR RIGHTS TO·APPEAL OUR DECISION After careful and compassionate consid.eration, a decision has been reached on your claim. Ifwe were not able to grant some or all ofthe VA benefits you asked for, this form will explain what you can do if you disagree with our decision. If you do not agree with our decision, you may: • appeal to the Board of Veterans' Appeals (the Board) by telling us you disagree with our decision • give us evidence we do not already have that may lead us to change our decision This form will tell you how to appeal to the Board and how to send us more evidence. You can do either one or both ofthese things.

I am going to see the VSO office this morning to go over my case.. I called and said since my orignal VSO is no longer on my case they need to know my case very well... so I am going to bring them up to date on everything.. I am worried they have no clue... so, this morning I wil find out if they know wtf is going on.. and what they are doing..

I have more neurologist appointments coming. My primary care doctor is sending me a consult for tremors, shaking, and pain. I am not real happy with my Dystrophy diagnosis and feel I have MS. When the Neuro doctor saw my last time ( a couple years ago), I had just spent 6 months in a hospital bed and had lost most of my muscles.. I got some of them back now.. and feel it was a misdiagnosis.. I am hoping they wil consider MS is more likely is one of my nervous system ailments, along with all my other health problems.. Is there soemthing I should ask the neuro doctor? I want to bring a list for him to go over and ask for tests.. thanx.. btw, it might be a few weeks before I get the appointment..

I also haver been through this IBS diagnosis,, which actually means you have an undiagnosed disease.. whenit comes to getitng benefits and help, getting a diagnosis of IBS is just like saying you are not sick.. it is is limbo.. you are screwed unless you get a diagnosis of UC, Crohns, cancer, etc.. as IBS is not taken seriously, and SSDI, and the GI clinic, and al doctors wil just say you have pain and gas, and diareahha, etc.. which leaves you just very sick but not able to qalify for beneits,, because whoever wrote the disease and benefits books and regs, decided to leave IBS sufferers screwed.. unless this has changed recently...

I posted the 'Decison' in the Denied thread a few days ago..

I pondered your queation about migraines, and can honestly I say suffer and have suffered form them sinch my USAF days.. I have 50% from headaches.. but I never found a cure.. I only do what most people do, scream and cry for a couple days, sometimes on my head, upside down, in a dark room, if there is a dug that helps, I have never had it, nor been offered it.. I try to take excedrin for migraines.. soemtimes it helps..

Received a negative decision, filed an NOD. My VSO (Veteran service officer), told me that I could not files any statements with the NOD (he typed it up), only the NOD. MY question that I want to ask is why did they only rule on one out of 4 chemicals I got sick from and are clearly in my claim and IMO. They totally left out three chemicals I got sick from on active duty. he said I have to wait until they send the forms asking if I have more information to add to my claim. That may take 6 weeks. I know I alreayd posted this in my claims denied thread, but I am not sure if I am going ot get any responses buried in that thread. So, I guess we cannot get any questions answer on any aspects of the denied claim until there is a hearing? I believe the people who did the claim purposely left out the information, or they lost part of my claim, or?? This is very serious, as if they just don't pay atttention and wite anything they want, how can they get away with that? The VSO seems to think I need to bring in new proof, yet I say they purposely ignored proof.. so if they never used it, isn't it new, it should be re-applied and it can easily be shown the core of the case was fraudulently and not investigated. Just ignored. To remind everyone , I worked and got sick from: Jet Fuel, Deisel, Leaded gasoline, Trichloroethylene They only denied the whole claim on Jet Fuel, with no mention of the rest of the chemicals in the DENIED. That was a huge ommitance. I want the Response in my hearing request to show the other chemicals were completely un addressed. Also, how and why were they left out? on purpose, stupidity? Please, any ideas? There is no question of whether or not I had contact, or questons of if I got sick.. the questions are health effects. Everything else was agreed when my records are reviewed showg illness contact, and my 50% current rating. Thanx..

Has anyone here ever used a real lawyer to fight the VA? Was it successful? Did you try the VA service organizations too? etc.. etc.. Thanx..

Retiredat44's: IMO VA with name redactions: part of the summary, only a very smal part of the total IMO, not included full letter, and the research and references.. (I scanned thiese documents and in the process of cut and paste some letters may have been chopped off,, I may need to repair more..) ============ DIAGNOSTIC IMPRESSION: Page 13 of I: 1. Exposure to a variety of fuels, organic hydrocarbons, JP-4, leaded gasoline, anc solvents in printing. Exposure to carcinogens. 2. Hypertension. 3. Chronic Pancreatitis, with pseudocyst. 4. Edentulous. loss of tooth enamel. 5. Loss of hearing by history. 6. Tremor SUMMARY and DISCUSSION: Mr. xxxxxxx joined the U.S. Air Force when he was 22 years old. I have reviewed his entrance physical examination and it was unremarkable. The examinee did not have any tremors, and although congenital cataracts were noted, he did not have any other abnormal findings. Soon after he was assigned to a fuel specialist job. As a result, he worked with a variety of fuels, including leaded gasoline (utilized in Europe at the time; the examinee was stationed in Germany), aviation gas, diesel and a variety of jet fuels, most commonly JP4. His job entailed not only fueling a variety of aircraft and automobiles, but also defueling, dealing with controls, valves and connecting/disconnecting loading hoses and other fuel-related equipment. I am sure the examinee was exposed to JP-4 fuel and a variety of other fuels containing combustible hydrocarbons, plus a substantial number of additives. FU11hermore, the examinee was exposed to combustion fumes from a variety of engines, gasoline fumes from vehicles and was probably exposed to fumes not only outdoors, but also within confined spaces. The examinee initially developed upper respiratory tract symptoms as evidence by the medical records I have reviewed. Although these were labeled as "upper respiratory tract infection", the examinee had a number of these episodes and was even diagnosed with a right middle lobe and right lower lobe pneumonia. He also developed skin rashes, which most probably were secondary to handling a variety of fuels, solvents that usually act as defatting agents, leading to acute and chronic irritant dermatitis. Around this time the examinee also developed tremors. These are documented in the medical records I have reviewed, and were initially labeled as "essential tremors". A contrast-enhanced brain CT scan showed brain lesions, which were not discussed in any of the notes I have reviewed. Although the examinee had a history of headaches, the headaches and that he experienced seemed to be more severe, lasted for lon.ger periods of Comprehensive AOE/COE Consultation xxxxxxxxxxxxxx. MD. MPH Page 14 of I time and appeared to be associated to visual phenomena. None of these features wen present in his previous headaches. Due to the possibility of JP-4 related headaches, the neurologists decided to remove th( examinee from having any further fuel contact. His symptoms appeared to improve afteJ he was removed from his fuel assignment. However, the examinee was in fact transferrec to work in a printing press, and assignment that led him to common in contact with yel more solvents, these were used to clean the ink from the printing press rollers. Mr. xxxxxxx has been recently diagnosed with myotonic dystrophy. This condition i~ hereditary, autosomal dominant and usually characterized by anticipation, that is the disease is usually manifested at an earlier age with each degeneration. It is a chronic, slowly progressive multi-systemic disease which clinically presents with muscle wasting, iridescent cataracts resulting in lens opacities, heart conduction defects and occasionally, with endocrine changes. I am concerned over the fact that this examinee's father, who was the only apparent with a tremor, did not appear to have Mr. xxxxxxx's clinical presentation. I am also concerned that ITom the review of medical records, it does not seem to me that his exposure to JP-4 fuel and other types of leaded and unleaded fuels were properly evaluated at that time this examinee had these symptoms. Although I have not seen electrodiagnostic studies among the medical records I reviewed, Dr. Delaney, who recently evaluated this examinee mentions the presence of distal polyneuropathy. This can also be caused by solvent exposure, and it is worth mentioning that hexane, an alkane hydrocarbon contained by JP-4, is well known for its neurologic effects, with peripheral neuropathy being one of the most notable. In fact, the clinical presentation, which is due to one of its metabolites, also involves atrophy of skeletal muscles resulting in loss of coordination. In June 1995, the U.S. Department of Health and Human Services through its Agency for Toxic Substances and Disease Registry issued a document by the name of Toxicological Profile for Jet Fuels JP-4 and JP-7. Consistent with toxicological principles, the degree of risk of adverse health effects from exposure to hazardous chemicals such as JP-4 or JP-7 is commensurate with the dose of exposure, its duration, the route of exposure, nutritional status, family traits, lifestyle, sex, age and state of health. The exposure may also be mitigated or enhanced by other chemicals to which the subject was exposed at the same time. It is important to recognize that the exposure to fuels does not only occur by inhalation, but some of these fuels are readily absorbed through the skin. The exposure can be extremely complex because these fuels are a mix of hydrocarbons of varying weights and composition (what is called "wide-cut fuel) with different physical and chemical properties that are altered under a variety of circumstances. Exposure to the environment can change the composition of the fuel; the same can be said about the results of combustion or what happens with the chemicals are exposed to moisture. The Comprehensive AOE/COE Consultation xxxxxxxxxxxxxx, MD. MPH Page 15 of 15 more complex the mixture, such as in lP-4 or lP-7, the more difficult it is to ascertain the potential for toxicity. In general, because of the environment in which exposure to lP-4 and similar fuels takes place, very little is known about its human health effects, especially chronic effects that may manifest itself years and sometimes decades after the exposure took place, Although OSHA has developed regulations and guidelines for lP-4 exposure, it is not possible to determine accurately if Mr. xxxxxxx's exposure was in compliance with the currently accepted 500 ppm exposure during an eight-hour workday (TWA) within a work room air type of environment, Since very little is known about the adverse health effects from chronic exposure to lP-4, the best we can do is to extrapolate the results from exposure in animals. Exposure to jet fuels was associated to decreases in white blood cell count, red blood cell fragility, weight loss, long-term liver inflammatory changes, changes in urine osmolality and a dose-responds relationship between chronic exposure to lP-4 and progressive kidney medullary mineral deposits resulting in nephropathy which lasted after the exposure was removed, Chronic intermittent exposure resulted in cystic degeneration of the prostate in rats and slight body weight reductions at higher dose. Chronic exposure over 12 months was associated to testicular atrophy after the end of the exposure period. Dermal administration of lP-4 to the skin of mice was associated to any increased rate of squamous cell carcinoma in the exposed minus, When one lists the most common component of jet fuels, especially lP-4, the potential for serious expo sue effects become more obvious. Jet fuels containing a number of carcinogens. Polycyclic aromatic hydrocarbons (PAHs) and benzene feature prominently, PAH are contained in cigarette smoke, and are known to undergo bioactivation, resulting in carcinogenic intermediates that ready penetrate the human cells. Benzene is well known for causing hematological injury, with exposure resulting in aplastic anemia, acute myelocytic leukemia and myelofibrosis. Additionally, jet fuel contains toluene, which is a very common solvent utilized in the printing business. Overexposure to this chemical is associated to visual deterioration, cognitive disorders and a variety of other findings, which are commonly seen in patients with chronic, significant exposure (these are studies of chronic "huffing", or sniffers). Although toluene is not associated to hematological problems as is its cousin benzene, toluene causes much more neurologic sequelae. Toluene also produces reproductive and dermatological defects. Jet fuel also has a variety of trim ethylbenzenes resulting in neurological and behavioral effects in exposed rats. They also contains xylenes, which are usually substituted benzenes or benzenes with an alkane attached. Xylene exposure it is associated to irritation of the eyes and upper airways, leading to lung congestion. It is also associated to neurologic effects, which include memory problems, impaired equilibrium and Comprehensive AOE/COE Consultation xxxxxxxxxxxxxx. MD. MPH Page 16 of I, sometimes acute exposures are associated to cardiac sensitization resulting II arrhythmias. Exposure to xylene, toluene and other solvents has been associated with hearing loss. jP-4 also contains n-hexane, which is the most toxic of the alkanes. Accurately, it cause: nausea, vertigo, bronchial and intestinal irritation. It is highly neurotoxic, leading t( peripheral neuropathy. It also causes significant lung damage, characterized b) emphysema and chronic obstructive pulmonary disease. It is also carcinogen. These are only a few of the many components of JP-4. The list of components, naturally does not include a variety of additives, corrosion and icing inhibitors and other ad-or chemicals to stabilize the hydrocarbon mix, avoid/lower its propensity to explode, and t( avoid the growth of bacteria. Additionally, we also have the components of the combustion exhaust, which typicall) consist of volatile organic compounds (a variety of hydrocarbons of all types 01 compositions), inorganic gases such as carbon monoxide, carbon dioxide, suIfoxides ane nitrogen oxides, plus the surplus of raw fuel that escaped combustion. In addition. methanol and alcohol as well as oxygenated organic compounds, polycyclic aromatic hydrocarbons, on zone and a variety of particulate matter is produced. All of these components are inhaled in the setting of Mr. xxxxxxx's work as a fuel specialist. In an article entitled Biological and Health Effects of Exposure to Kerosene-based Gel Fuels in Peiformance Additives by Glenn 0 Ritchie and others in connection with USAF bases (Journal of Toxicology and Environmental Health, Part B, 6: 357-451, 2003), a large number of exposed personnel complained of "dizziness, imbalance, walking difficulties, general weakness/fatigue, difficulty gripping objects, and numbness/tingling of limbs; itching skin, blisters, skin rashes on hands/arms, chemical allergy, difficulty breathing, chest tightness, excessive sweating, trouble concentrating, forgetfulness" and a perception that work was impacting health. They also complained of headaches, blurry vision, tremors, teary eyes, chronic pain, heart palpitations and skin problems. These authors documented carcinogenic potential and exposure leading to a variety of skin disorders. The article also presented evidence of extensive neurologic problems associated to exposure. Exposed individuals reported dizziness and difficulty maintaining posture balance and were clinically tested with the results consistent with deficits in postural equilibrium seen in workers with some chronic or chronic exposure to jet fuel. Long-term exposure was reported to produce nonspecific central nervous system symptoms such as loss of appetite and nervousness. Chronic pancreatitis secondary to exposure to medications has been recognized, and more recently we are starting to recognize that solvents may have endocrinological toxicity. Comprehensive AOE/COE Consultation xxxxxxxxxxxxxx. MD. MPH Page ]7 of]' This includes, of course, not only the adrenals and the thyroid gland but also tht pancreas. Absent significant alcohol exposure, and given the multiple adverse effect~ known to occur in the liver and the kidneys secondary to lP-4 jet fuel exposure, : contribution to Mr. xxxxxxx's chronic pancreatitis is reasonably probable. I was also surprised that none of the medical records entertained the possibility of lea( exposure and its adverse effects. Mr. xxxxxxx tells me that in Europe, where he spent most of his Fuel Specialist assignment, vehicular fuels were still leaded at the time he wa: working. If this is correct, then, the potential to exposure to lead should have beel addressed and monitored according to well established guidelines by OSHA and NIOSH I did not see any evidence of such in the medical records. In my professional opinion, and within reasonable medical probability, Mr. xxxxxxx': tremors, his cognitive difficulties, and his pancreatic problems have had a substantia contribution which is attributable to lP-4 exposure, exposure to jet fuel, gasoline ant fumes resulting from combustion of the above. There is clear evidence of substantia exposure over a prolonged period oftime with cumulative symptomatology that led to his removal from exposure, only to be exposed to some of the same chemicals in the form 0f solvents for another year in the printing business. In my professional opinion, and within reasonable medical probability, his curren disability does not accurately reflect his current clinical problems and the totality of th, impairment and disease attributable to the

I can admit that I don't care about having sex,, I am to sick... too much pain.. of course seeing a good looking girl does ignite my flames.. but too sick to ever do anything again... the pain is frakkin unbearable.. but... I remember an older guy saying this: I used to go on trips and on a tour the woman tour guide would make the guy horny and want to jump her bones, but now with age, that sex drive burden no longer exists, and now he can have fun instead of that constant drive always taking over..

I suspect either: 1-they lost some of my IMO 2- they are trying to BS me.. I would post my IMO (the summary is only 18 pages.., though..) I have been really busy going through paperwork and getting everything ready for the fight.. Monday I go to my congressman.. I have been going through bad depression because of the way they are treating me.. it's was hard getting out of bed last night after beingin bed for a day and a half.. I wish I could post it so everyone could see how good of an IMO it is.. it does go through al the chmicals and is in my favor.. and it is really professionally done, I had a freind who does medical investigations for accidents, and he is happy with it too.. thanx all!

I just wrote (typed, as my hands shake so bad I have to use the computer... to type everything..) a letter to my Congressman using regular postal mail. I downloaded the form (form his website) for for people living in his district. He is Darell Issa. I filled out most the form, like my name, but then attached copies a a letter. of course I did not include medical records and stuff, that would be stupid, but I did attach necessay info.. and some copies of documents that will help. I can only hope he can get a reasonable answer why they ignored three out of four chemicals that are a must to use on the job... and was soaking in them daily (literally soaked clothing..) wet hands... lungs full of vapor.. my wife was crying when she found out what they are doing to me.. =========