Champva Qualification Question

[JAB]

I understand that I'm required to be permanent & totally disabled for my wife to be eligible for CHAMPVA, and after several phone calls, I'm still confused about this.

I was originally granted 100% compensation in the 1990s under 38 USC 1151 which was non-service connected. Several years later, as my health declined, I received a new rating which continued the original rating and added an additional illness which was also evaluated at 100%. At that time, I started receiving a special monthly compensation for being above 160%.

I don't see P&T on any of my papers, but I did receive a letter from the VARO in 2007 stating that I'm not scheduled for a future exam since improvement of my disabilities is not expected. Then in 2012 I received a VARO letter saying that information used to establish my benefits had recently changed, and that I was enrolled in priority group 1 and that I was now rated 100% "Service connected".

Should I send champva an application and let them figure all this out, or should I ask my VARO to readdress my case. My wife and I are a little apprehensive about stirring up any trouble with the VARO, and we wonder if we should just let sleeping dogs lie. :) Any help would be greatly appreciated.

[JAB]

Berta, I did a poor job of explaining things and I'm not sure how to clear it all up. The 160% I referred to, was actually 2 conditions rated at 100% each. Their letter stated that my smc was due to having a total of 160%. In fact, it is 200% but like you say, the pay chart only goes up to 100%.

"Question....in 2012 did the VA pay you separate additional compensation,as retro, for the SC they deemed as 100%?"

No. I received the 2nd rating around 2002 and that only added the smc to the original 100% 1151.

Berta the first condition was chronic hepC and the VRO decided it was more than likely that I caught it from non sc surgery at the VA hospital. I have since learned how the virus was transmitted by that jet gun injector they used to immunize us while in BT. Everyone had blood running down their arm and we all became so-called blood brothers. That would mean that I should be sc instead of 1151 but since I was at 100% anyway, I've never mentioned this to the VRO.

Below is the letter I mentioned receiving in 2012, and I don't know what "change" they're referring to.

[Berta]

That statement in the thumbnail is very odd.and I have never seen VA refer to a disability status as "unique."

ASKNOD, our member here, is an EXPERT on Hep C.

What does concern me here is that ,in your case, a direct SC award for the Hep C ( Vietnam Vets of America had the first air gun award for Hep C and Monte Wilson ( the NSO who helped the vet) told me all they used was a printout of an article from a newspaper published in England to raise the case to 'as likely as not".....

a direct SC award,in your case , would trump the 1151 because the new etiology would indicate that VA was NOT at fault on the 1151 issue.

In my case, my AO DMII death award (and my more recent AO IHD award) trumped the 1151 death award but did Not render it Moot.

In your case I think it would---meaning the 1151 would be changed to SC on paper but no monetary gain for that possible decision by the VA ....Except for this......

I believe they would have to rate you as P & T 100% SC for the Hep C due to air gun.

That would give your dependents CHAMPVA and Chapter 35 bennies.

Also, in the event of your death, VA would grant (if the Hep C is a contributing factor to your death)

DIC with no problem ,to your spouse.

VA probably would grant DIC under the 1151 too ( only one check but 2 potentials for DIC-(I have 3 separate DIC awards) but .if the VA does SC you for the Hep as a direct SC due to air gun, even if you didnt have P & T status in your lifetime, the VA would grant that at your death, for the DIC award...garnering the dependents those additional benefits at that point.

When a vet dies with any 100% SC, at death, they are automatically deemed Permanent and Total.Because the disability has lasted their lifetime.

I hope you stay with us for a LONG time....I just wanted to clarify this stuff.

Was there anything you had raised in the record that might have indicated you could have gotten the Hep from the air gun?????

"I have since learned how the virus was transmitted by that jet gun injector they used to immunize us while in BT."

Some of the air gun immunizations were found to have caused Hep C..They were checked by batch numbers but I dont recall where I got that info. Do you have proof positive of that, even if it is an internet printout?

You are in a "unique" situation..... but I think VA should have followed up on what they sent to you and advised you to claim the Hep C as directly due to service.

Geez...my daughter said blood poured out of her arm when immunized at Lackland AFB. And they went from airman to airman, how did they sterlize the needles?????

I think it would be very advantageous to you if VA trumps the 1151 with a direct SC award.

There wont be any retro.....however they would be the assurance of benefits for the family.

I hope others chime in here.

'There wont be any retro" or maybe there would be......maybe a 3.156 claim??????

Did you ever get denied for the Hep before getting the 1151 award?

This is mind boggling....I think the Vietnamese barber in Danang gave Hep C to many incountry vets when he shaved them

[JAB]

Was there anything you had raised in the record that might have indicated you could have gotten the Hep from the air gun?????

No, I'd never connected the blood sharing air gun with hepC, until years after I was awarded the 1151 claim.

Some of the air gun immunizations were found to have caused Hep C..They were checked by batch numbers but I dont recall where I got that info. Do you have proof positive of that, even if it is an internet printout?

No proof but the air gun was red with blood splatter AND with blood from touching other arms before mine. I don't remember seeing any attempt to clean the head of the gun.

I think it would be very advantageous to you if VA trumps the 1151 with a direct SC award.

True........ but Berta, I'm hesitant to start a fight with the VARO again, can you understand? Maybe if ASKNOD or another member has air gun info, they could chime in here. If proof about this has been established out there somewhere, maybe I can find it, then I'd be more inclined to give it a try.

[john999]

I certainly remember the blood with the air guns at Ft. Benning in 1969. I remember seeing other guys with awful infections days later. I would want to get to the bottom of my being eligible for Chapter 35. In this day and age ChampVA can be very valuable since combined with medicare it usually pays the whole freight for medical treatments. The only problem with ChampVA is reluctance of doctors to bill them as secondary. Many doctors just refuse to bill them and send you the bill with threat of collection agency.

[Berta]

I mentioned the VVA win for Hep C and air guns. It hit hyperspace vet advocates right away.

So I called the VVA NSO ,Monte Wilson, who handled the claim and also had limited emails exchanged with him …..2 or 3 PCs ago.....to find out how the vet did it.

This was a VARO decision. There is no BVA decision we can access and read. And I also had in my older PCS the article from England that the vet used to succeed.It might be still on the internet.

I just found this statement from VA via google. I know it isregarding the same Hep C award I talked to Monte about.

I had no idea ,until today, that VA had issued a Fast Letter on this award due to what VA thought to be erroneous info in the HVC web site named in the Fast Letter.

Possibly a Hep C vet had sent the VA printouts from the web site in support of their claim. So VA checked it.

This 2003 Fast letter concludes with this statement:

“The large majority of HCV infections can be accounted for by known modes of

transmission, primarily transfusion of blood products before 1992, and injection drug use. Despite the lack of any scientific evidence to document transmission of HCV with airgun injectors, it is biologically plausible. It is essential that the report upon which the determination of service connection is made includes a full

discussion of all modes of transmission, and a rationale as to why the examiner

believes the airgun was the source of the veteran’s hepatitis C”

http://www.hepatitis.va.gov/pdf/jet-injectors.pdf

I was on the above HepC site above many times after the VVA Hep C win and now I wonder if there had been other misleading info there regarding air guns.

However, the VA letter says exactly what a vet needs to succeed on a Hep C Air gun claim.:

“It is essential that the report upon which the determination of service connection is made includes a full

discussion of all modes of transmission, and a rationale as to why the examiner

believes the airgun was the source of the veteran’s hepatitis C”

An independent Medical opinion could rule out any other etiology but for the use of the Air Gun.

It isnt easy to do that. The VVA vet had tattoos but VA didn't deny on that basis. VA would deny claims like this if the vet had a history of intravenous drug use.

It might be very difficult for any vet who had post service occupations, such as being an EMT, nurse or doctor, to be able to convince the VA their Hep C came from an air gun.

Still absolutely nothing is impossible.And a good IMO doctor with expertise in blood problems

would have the most updated medical info available to bolster their opinion with.

A gastroenterologist or hepatologist would have the background this type of claim would need and surely that background specialty could overcome some negative C & P done maybe by a nurse or PA with no expertise in the field of blood disease.

The VA weighs heavily (that is they SHOULD ) on the expertise and CV of IMO doctors,as well as the full medical rationale they give in their IMOs, when they(VA) considers IMOs against their own medical opinions.

One strong IMO for the claim

and one lousy quackola VA opinion against

means the veteran should succeed under Relative Equipoise ( the Benefit of Doubt)

"true........ but Berta, I'm hesitant to start a fight with the VARO again, can you understand?"

Absolutely. and that is why I almost didn't appeal my last award letter.

But when I figured how much they still owed me due to a CUE they made in the 1151 CUE award as part of in their 2012 AO IHD decision, I appealed that mother in a heartbeat

They want us to be afraid we will lose what we got ,if we stand up for our rights.

I dont see how your established 1151 award could be miraculously altered and revoked by the VA but I too hope ASKNOD will chime in here as soon as he can....

[harleyman]

post deleted by Harleyman.

Edited September 29, 2013 by harleyman