Hi Jim,
I've never done this before and my VSO is clueless! I am currently being treated by the VA for the Hep C virus with the new drug Harvoni. I am genotype 1 and this drug has 98% success/cure rate.
If after treatment my viral load is undetectable or zero will the VBA reduce my combined rating of 80%?? I am 60 years old but have only been receiving SC benefits since December 2010. I was a Navy Corpsman and thus granted the SC for exposure to blood from 1979-1986. I have read your other posts and the rating decision says "no future exams scheduled". Even if they get rid of this virus with Harvoni I will still have cirrhosis from the effects and deterioration of the Hep C virus over 20 years!
Reply:
You're entering uncharted territory. These new and super expensive drugs are said to cure Hep-C. The word "cure" isn't one that's used a lot when talking about Hepatitis but it appears they're really on to something here.
So...we can't be sure just what they'll do. However, with other "cured" diseases, like a service connected cancer, once the disease is no longer active or detectable, VA rates us on the "residuals" of treatments. For example, the residuals of prostate cancer might be incontinence, the residuals of a lung cancer might be shortness of breath and so on.
If I had to guess, I'd guess that Hep-C will be viewed the same way. If it's no longer detectable, you'll be rated for any residual effects based mostly on how normally your liver functions. That's lab tests of course...there may be other lab values that come in to play...like kidneys.
Always keep in mind that when VA tells you that no future exams are scheduled they don't say they won't ever require an exam. They just say nothing is scheduled. The guys who develop the words VA uses are sneaky bastards. You have to understand their language.
I'd have to say that your first thought must be how lucky you are to have access to a cure. Having the disease in the first place is rough but now you can get fixed. So far as your benefits go, I'd advise that you leave the sleeping dog alone. If you go asking VA what they're going to do, they'll be more likely to open your file and try to modify your rating. As a rule, wait for VA to act before you stir anything up. They may never do anything.
If I were to guess, I'd guess that your benefits are safe over the long run. If VA did propose to reduce the benefit because you're 'cured', there's a lot of room to argue your side of that. It's not been an easy disease for you, I know...and that counts for a lot.
If they do notify you, let me know. I've wondered about this and you're the first guy I know of going through it. I'm interested in hearing the rest of your story as it unfolds and I know a handful of advocates, lawyers and doctors who'll also be interested.