A couple of years ago, my colleague wrote a blog post about the difficulties veterans face when trying to obtain service connection for Hepatitis C- https://www.hillandponton.com/hepatitis-c-and-va-benefits/. Because these cases continue to be denied by the VA, an updated blog on this topic is in order.
In the past few years, we’ve seen more and more veterans apply for service connection for Hepatitis C. Oftentimes; the initial claim for benefits is the result of a new Hep C diagnosis, and a veteran realizing that he/she may have contracted this disease during military service. Unfortunately, it is not uncommon for a person to walk around with Hep C for years, and the disease go undetected. According to the Mayo Clinic, this disease is known for producing no signs or symptoms in the earliest stages, and is frequently not diagnosed until liver damage is present. As my colleague discussed in his blog, the biggest hurdle that veterans face is proving the link between the Hep C and military service, especially in cases where the veteran got out of service many years ago.
A common scenario we see in our practice is veterans who allege they contracted Hep C via air gun inoculations prior to heading to Vietnam. Or, allegations that they contracted Hep C in Vietnam via blood contact with wounded/dead bodies or via open sores as a result of jungle rot. The common link in these cases is usually that Hep C wasn’t diagnosed until many years after Vietnam. Despite the delayed diagnosis in these cases, the good news is that the medical literature is on the veteran’s side. The research shows that blood transmission occurs using air guns/jet inoculators, no matter how carefully done. Additionally, the research shows that that any blood transference between patients, no matter how small, represents a transmission opportunity for this disease.
It is not impossible to win a Hep C case; however, an expert medical opinion is almost always needed in order for a veteran to have a chance to prevail. In order to be most effective, the medical expert should review all of the veteran’s records, particularly the records that shed light on any ways a veteran may have been exposed to Hep C. For example, organ transplants or blood transfusions prior to 1992, drug use (either intravenous or nasal), exposure to infected blood, and tattooing are all risk factors for Hep C. The expert will need to consider all of the risk factors and circumstances of the veteran’s individual case, including any relevant epidemiologic research regarding the prevalence of Hepatitis C, before giving an opinion. It is very important that the veteran fully disclose any relevant risk factors, so the medical expert can formulate an unbiased and thorough opinion.
After considering the evidence, the expert will need to opine on the likelihood of the veteran contracting Hep C from service, versus contracting the disease from any other source known to cause this condition. It is important to know that even if there are multiple risk factors, a veteran only has to prove the case to a standard of ‘at least as likely as not.’ Meaning, there is at least a 50 percent chance Hep C was contracted during service. A competent medical opinion is a large part of getting to that 50/50 standard.
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