Sinuses, Rhinitis, and VA Benefits: What Every Veteran Needs to Know

We dive deep into the respiratory Disability Benefits Questionnaire (DBQ) for veterans, explaining how sinusitis, rhinitis, and other conditions are evaluated for VA disability ratings.

• Sinusitis ratings range from 10% to 50% depending on symptoms like headaches, obstruction, and drainage
• Going to a C&P exam without a prior diagnosis puts veterans at significant disadvantage
• Near-constant sinusitis with headaches and drainage can qualify for 50% rating without requiring surgical history
• Rhinitis ratings depend on nasal obstruction percentages and presence of polyps
• Sinusitis and rhinitis are presumptive conditions for veterans exposed to burn pits and particulate matter
• Environmental exposures like jet fuel can cause respiratory conditions requiring nexus letters
• Examiners often ask open-ended questions rather than specifically addressing rating criteria
• Documenting exact dates and symptoms of sinus episodes strengthens claims substantially
• Medical imaging and specialist reports provide crucial evidence for higher ratings
• Nasal trauma may coincide with TBI symptoms that veterans should also claim

If you're experiencing persistent respiratory symptoms, get proper medical documentation before your C&P exam. Submit all medical records including imaging reports to support your claim.

Tune in live every Thursday at 7 PM EST and join the conversation! Click here to listen and chat with us.

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Episode Transcript

Ray Cobb (00:00):
Love Talk Radio.

J Basser (00:04):
It's time for the Exposed Vet Radio Show.
The Exposed Vet Radio Show, wediscuss issues affecting today's
veteran.
Now here's your host, john MRay.
Welcome, ladies and gentlemen,to the episode of the Exposed
Vet Radio Show on this November7, 2044.
The Faux Red Radio Show on thisNovember 7th 2024.

(00:27):
It's 7 pm Eastern Time.
I hope you pull up by the radioor by the computer stream or by
the telephone and give us agood listen.
Today we've got our number oneguest on.
Her name is Beth Explanenberg.
She is the owner and operatorof Valor for Vet, which is a
company based out of Ohio andthey do comprehensive,

(00:49):
independent medical opinions forveterans in the business and
the cleaning process.
We've got Mr Ray Cobb.
He's riding side subtle.
Today We've got a real bighorse here.
How are you doing, ray?

Ray Cobb (00:58):
I'm doing great, doing great.
Enjoyed the afternoon Good fallday down here, temperature
about 75 degrees and clear skies.
This is great.
Enjoyed the afternoon.
Good fall day down hereTemperature about 75 degrees and
clear skies this is great.

J Basser (01:09):
That's awesome.
It's about 59 here today andcloudy and probably the same up
there with the best thing kindof gloomy today.

Bethanie Spangenberg (01:16):
It sure is .
Every time we do this podcasttogether it's raining.

J Basser (01:23):
Well, we need to get some sunshine and brighten your
day right.
For the past several months,guys bethany's been coming on.
We've been discussing differentareas of interest, from VA
points, discussing DBQ, andtoday we're going to do start
off.
I don't't know how you want tostart, but I think we're going

(01:44):
to just get up a respiratory.

Bethanie Spangenberg (01:49):
Well, I think it's fitting.
The sinus, rhinitis and otherconditions of the nose, throat,
larynx and pharynx.
That's where we're starting forthis DBQ.
And I think it's fittingbecause it is the season for the
winter, bugs and the cold andprobably another few rounds of
COVID coming through and I amalso suffering from a sinus

(02:11):
issue, so it's just fitting forthe season and the weather and
everything else.
So hopefully it won't be, youknow, too long here.
It's a nine-page DBQ but we'reonly hitting on the major spots
so it won't be nothing toooverwhelming as we have seen

(02:34):
some of these DBQs be.

J Basser (02:36):
Drag out, yeah, but it doesn't matter.
You start where you want tostart, all right.

Bethanie Spangenberg (02:47):
Well, I think it's important that we've
talked about these DBQs.
We've done quite a few over thelast several months.
Sinus and rhinitis is a big one.
Once the burn pit and thepresumptives kind of came in for
particulate matter.
We saw an influx of the sinusclaims and the presumptives kind
of came in for particulatematter.
We saw an influx of the sinusclaims and the allergic rhinitis

(03:09):
claims and there's a lot ofsecondary conditions that can
come from that.
But the purpose of talkingabout these DBQs is really to
lay out what the veterans shouldbe expecting for their exam,
helping them to familiarizethemselves with what is in Q and
what kind of questions thatthey should be prepared to
answer when the examiner, youknow, does their part.

(03:31):
The other part of talking aboutthese DBQs is nobody else is
talking about them.
So we're laying them out.
We're talking aboutexpectations from the medical
expert side, what some of thesethings mean and, as I said
before, the sinusitis andrhinitis is a big one, so it's

(03:53):
nine pages and we're just goingto dive right in.
I've got it here in front of me.
This particular DBQ was updatedon September 5th of 2024.
So that is you.
That is just recent.
The first page has an area wherethe medical examiner is to

(04:15):
disclose their relationship tothe VA and to the veteran,
whether they're a VA health careprovider or if they're
regularly seen as a patient intheir clinic.
That's standard for all theseDBQs.
The first page also contains anarea for evidence review and
this is where the examiner talksabout what evidence they have

(04:36):
reviewed, either evidence that'sin the claims file, or whether
they're doing this as what theycall an ACE, which we've talked
about before.
They're doing this as what theycall an ACE, which we've talked
about before, and sometimesthose ACE exams don't require
that records are reviewed oreven that an interview is done.
So providing your records tothe VA before your compensation

(05:02):
and pension exam is important.
Also, on the first page startSection 1, which is the
diagnosis, and we flip to Page 2, and it lays out specific
diagnoses that are in this DBQ.
And, as I always emphasize, youknow, I just said this DBQ was
updated a couple months ago andthe very first box at the top of
Page 2 is the veteran does nothave a current diagnosed any

(05:26):
claim condition.
The reason I point this out isif you're going into your
compensation and pensionexamination without a diagnosis,
you're really hurting yourclaim and putting yourself at a
disadvantage.
That examiner can mark that boxand never has to ask you any
questions as far as the sinusportion, because they can review
it, say well, they don't have adiagnosis, no examination

(05:50):
indicated, they write theirmedical opinion and they can
move on.
That helps them in theirnumbers of turning a case over
and their timeliness for anyincentives that they may be
receiving for their productionnumbers.
So keep that in mind wheneveryou are applying for disability.
You want to make sure that yougo in with the current diagnosis
.

(06:11):
If we go down the list here,there's a few diagnoses on this
list that we're going to talkabout today, specifically
chronic sinusitis, allergicrhinitis, non-allergic rhinitis.
This is also known as vasomotorrhinitis.
We'll talk about chroniclaryngitis and we'll also talk

(06:34):
about deviated nasal septum.
Now these conditions are ratedin the 38 CFR under Section 4.97
.
38 CFR under section 4.97.
And the bottom of page 2 is thesection for section 2 for
medical history, where it's afree text box.
You tell your story and thatmedical examiner types away.

(06:56):
Now, if we go to page 3,section 3, this is where the
meat of all of the questionspertaining to the rating
schedule start.
Before we dive into page 3, arethere any questions?
As far as page 1 and 2 go,those are pretty standard.
Just want to make sure we givea good stopping point before I

(07:17):
jump into the meat of the DBQSOP.
All right, the DBQ.
SOP.
All right.
So for Section 3, it starts offby asking the provider what
sections they're going to befilling out for the exam.
It wants them to designatewhich boxes or which specific

(07:38):
set of questions that they'reasking, based on the veteran's
diagnosis.
So if the veteran is claimingthe chronic sinusitis, then the
examiner can indicate thatthey're filling out the
sinusitis section.
Or if the veteran has allergicrhinitis, the examiner can
indicate that they're fillingout the rhinitis section.
So that really just tells thatrater what specific section they

(08:01):
are filling out.
On the DBQ section.
They are filling out on the GBQ.
So if we look, at part A, thatis, the one that starts with
sinusitis, on page three,sinusitis is more commonly known
today as rhinosinusitis.
Whenever we talk about thesinus cavity, it sits behind the

(08:23):
nose, in your face.
It also has pockets into, likeabove the eyes and deep into the
skull, not quite towards thebrain, but it's right in the
middle of everything and it'sreally a filter, or serves as a
filter, as we breathe throughour nose.

(08:43):
So while old terminology justsaid it was sinusitis, more
recent terminology isrhinosinusitis, really
acknowledging the role that thenose plays in sinus disease.
And you can hear it in me oh,my goodness.
Part A for sinusitis, they'reasking the medical examiner to

(09:05):
indicate the location of thesinus disease.
Now I'm going to list off thesenames only because I want you
to hear the terms.
You're not going to be able tounderstand exactly where these
locations are, but I want you tobe familiar with the different
areas of the sinus cavity tounderstand that there's more

(09:25):
than one okay.
So we have the maxillary sinus,we have the frontal sinus, the
esmoid sinus, the sphenoid sinusand then they use a terminology
called pan sinusitis, meaningthat there is sinus disease in
all the sinus cavities.
So you as a veteran don'tnecessarily need to know where

(09:46):
your sinus disease is located.
That's really for the examinerto understand.
You know, does the veteran'ssymptoms match up with this area
of sinus disease?
Or if it's indicated on a CTscan of the head, the
radiologist will indicate thearea of sinus disease.
So it's really helpful forreally matching up an

(10:07):
individual's symptoms, notnecessarily looking at treatment
for a particular sinus.
Okay, so again, like I said,the questions for this DBQ, they
are not clinical questions,they are directed specifically
to the rating schedule.
We're trying to really narrowdown what exactly the veteran is
experiencing so we can relateit to the rating schedule and

(10:30):
give a disability percentage.
So if we look at question A2,does the veteran currently have
any findings, signs or symptomsattributable to chronic
sinusitis?
And so the first box is chronicsinusitis detected only by
imaging studies.
So I briefly mentioned the CTscans.
You could also capture somesinus disease on x-rays and a

(10:55):
lot of times sinus disease canbe found by accident.
Let's say we're ordering a CTfor the head or the brain and it
will capture some of that sinuscavity and the radiologist may
comment on sinus disease in aparticular sinus cavity.
And it's not necessarilysomething that the veteran may

(11:17):
have symptoms of.
They may have vague symptoms orseasonal symptoms, but the
x-ray or the CT scan may pick itup.
Incidentally, if that's thecase, if a veteran's claiming
the sinusitis disease and it'sonly captured by images and
there's not really any type ofcriteria met for the symptom

(11:38):
portion, the veteran wouldreceive a 10% rating.
If we move on to the nextsymptom capture, a 10% rating.
If we move on to the nextsymptom capture.
The next box is episodes ofsinusitis followed by near
constant sinusitis and the nearconstant sinusitis if it's
paired with headaches, pain ofthe affected sinus, tenderness

(12:02):
of the affected sinus orpurulent drainage or crusting,
that can actually give a veterana 50% rating.
Now if you read the CFR, theway it says is that you also
have to have repeated surgeries.
So you have that near constantsinusitis after repeated

(12:23):
surgeries with headaches, painand tenderness of the affected
sinus and drainage or crusting.
Now the M21 clarifies that no,the veteran can meet the
criteria for the 50% withouthaving repeated surgeries.
They just have to have thesymptom criteria of the
headaches, pain and tendernessof the affected sinus and

(12:45):
drainage or crusting.
So that can be kind ofconfusing.
If you're just looking at the38 CFR, you can get a 50% rating
for just those symptoms thatappears to be, or is consistent
with, a constant sinusitis.
Okay, any questions about thosetwo, the 10% and the 50% rating

(13:05):
.
That's in that first box there.

Ray Cobb (13:08):
No, Okay yeah no it's pretty clear to me.

J Basser (13:15):
Yep.

Bethanie Spangenberg (13:15):
Well, I do want to actually give the
example that is in the N21.
So, and actually you know Ithink I covered it.
So if the veteran, for example,if the veteran has near
constant sinusitis characterizedby headaches, pain of the
affected sinus, tenderness ofthe affected sinus and discharge

(13:37):
or drainage, then they wouldqualify for the 50%.
That's the example that theyhave in the M21.
If we go on down to A3,question A3 tries to narrow down
how many episodes of sinusitisand if they're incapacitating,

(14:09):
they're incapacitating.
So the VA defines anincapacitating episode of
sinusitis is one that requiresbed rest and treatment
prescribed by a physician.
Now, those incapacitatingepisodes.
That requires bed rest is notsomething that you're going to
go into the doctor and we'regoing to prescribe that bed rest
.
It's more that we're going toprescribe an antibiotic and

(14:31):
recommend that you rest yourbody, not necessarily bed rest.
Bed rest is viewed differentlynow than it did 30 years ago and
so we know now that we have tokeep you up and mobile as much
as we can.
So even if you are prescribedan antibiotic for sinus disease,
we may not recommend the bedrest with it.

(14:53):
We're going to say lower youractivity, not necessarily stop
activity.
Does that make sense?

J Basser (15:03):
Okay, the bed rest has changed.

Bethanie Spangenberg (15:05):
Yes big time, especially when we look at
things like back pain or backstrains.
The bed rest idea has reallyreally changed for medicine, so

(15:47):
incapacitating episodes ofsinusitis characterized by
headaches, pain and per orcrusting from the sinuses.
When I say perulant, that meansthat it's chunky, green nasty,
pus-like drainage.
Okay, perulant is a prettierword than pus or green nasty
drained, so prurient is aprettier word to say.

(16:14):
So they want the veteran toreally look at the past 12
months and if the veteran hasexperienced anywhere between
three and six episodes in thelast 12 months, then that is a
10% rating.
If they have experienced sevenepisodes or more in the last 12
months, that is a 30% rating.

(16:36):
Now what I will say that I haveseen is veterans will try to
claim seven or more episodes butthey don't necessarily have the
medical records to match theseven or more episodes.
The VA really wants to seemedical treatment for those
sinus conditions or sinusepisodes.
So if you are able to capturethat, whether it's through a

(16:59):
routine follow-up visit and youjust happen to have a sinus
flare-up causing the headacheand the pain, you need to make
sure that that's documented inthe record so that you can use
that as evidence to get thathigher rating Okay?
The next question talks aboutincapacitating episodes.

(17:20):
So has a veteran hadincapacitating episodes of
sinusitis requiring prolongedtreatment of antibiotics?
And when they say prolongedthey mean four to six weeks of
antibiotics in the past 12months.
So they want to look okay afterthe over the last 12 months.
How many episodes have you hadwhere your doctor has prescribed

(17:44):
four to six weeks ofantibiotics?
That today is absolutelyunheard of.
If you are prescribing anantibiotic for four to six weeks
for a sinus infection as aclinician two, three times a
year that is not caring for yourpatient.
That is actually hurting yourpatient.

(18:05):
That is not the standard ofcare now.
So for you to capture that typeof treatment or that type of
episode, it may be difficult foryou.
If the veteran has experiencedone or two incapacitating
episodes that have requiredprolonged antibiotic treatment,

(18:28):
One to two in the last 12 monthsgets 10%, three or more gets
you 30% disability rating.
So if we move on to A5, brieflygoing to mention it it asks
about sinus surgery.

(18:48):
If there is a particular typeof sinus surgery, then you may
qualify for different criteria.
I'm not going to go really intothat type of surgery because it
is not common that we doradical what they call
quote-unquote radical sinussurgery.
In today's medicine, most ofyour surgeries that involve the

(19:12):
sinus cavity are going to beendoscopic because of the
technology, the cameras, theability that we have in the
surgery the operating room.
Most of your sinus surgeries aregoing to be endoscopic, so that
radical surgery rating criteriadoesn't apply for most veterans
, or I would say 99% of veterans.

(19:33):
It does not apply to so let theholes in the nose.
Exactly and to elaboratespecifically on that, if the
veteran has had radical sinussurgery and has continued
infections in the bone followingthat surgery, they can get a

(19:54):
50% rating.
That is not a good place to be.
You don't want to be there.
You don't want to try to shootfor that rating criteria, so
don't for that rating criteria,so don't.
Now, the last question forsinus is has the veteran had
repeated sinus-related surgicalprocedures performed?

(20:14):
Again, we're just trying to seewhere in that rating schedule
you fit as it relates to theradical surgery or the
endoscopic surgery, Before wemove on to discuss the next
section.
The next section is rhinitis.
They go hand in hand.
One thing I should have donewhen we started talking about

(20:38):
sinusitis is what does it meanreally to have sinusitis?
And I just assumed you knowwhen people say they have sinus
issues, you know, as adults, weprobably understand what they
mean because we've experiencedit at some point.
But by definition, sinusitis isan inflammatory condition of the

(21:00):
sinus cavity.
It can be caused by infectionsor environmental irritants.
The most common cause of sinusinfections are viral infections
like the common cold, like youhear in my voice today.
Now, sinusitis can causebecause of the anatomy.

(21:21):
This can cause because of theanatomy.
If you get sinus inflammation,it can clog up or prevent
appropriate drainage from theear canals.
Okay, excuse me, the ear tubes,ear canals, are what's on the
outside.
Ear tubes are what's on theinside, and we talked a little

(21:41):
bit about this when we talkedabout vestibular disorders.
We're talking, excuse me.
We talked about the eustachiantube in the inner ear and how it
functions.
When the sinus swells it canblock the tube inside the

(22:04):
pressure valve of the ear and itcan cause an inner ear
infection.
Okay, a lot of times when wehave young children that have
runny noses and sinus irritationand they end up with ear
infections, that's the type ofsinus irritation that I'm
talking about can clog thedrainage system and create

(22:26):
bacteria overgrowth in the innerear canal or inner ear tubes.
Sinus disease or chronic sinusinfections can cause headaches.
They can actually cause chronicheadaches With chronic sinus
disease.
It creates an irritation in thesinus cavity and in the

(22:50):
drainage system and it actuallylowers the headache threshold.
Previously we've talked abouthow headaches occur.
We have something that disruptsour regulation system, makes us
a little more irritable andsusceptible to developing
headaches, and sinusitis orchronic sinusitis can be one of

(23:10):
those things that triggerschronic headaches.
Chronic sinusitis can be one ofthose things that triggers
chronic headaches.
Sinusitis can cause oraggravate sleep apnea because it
is your upper airway system.
The purpose of the sinus is tofilter out the air that comes
through our nose and down intoour lungs, so that filtration
system can be obstructed andblocked and either aggravate or

(23:35):
cause sleep apnea.
Sinusitis can also lead tomeningitis because of the
location of where the sinus sits, as it compares or as it
relates to the brain and thecover of the brain what we call

(23:56):
the brain sac or sac around thebrain Because of the close
location.
If you develop bacteriaovergrowth in the sinus cavity
and your body is not able to getthat bacteria under control or
fight off that, that can lead towhat they call translocation,
that bacteria moves into the sacaround the brain and can cause

(24:18):
meningitis.
That is not good.
Unfortunately.
I had firsthand experience withit recently and it's just wild
how bacteria can behave at somepoints.
Wild how bacteria can behave atsome points.
Additionally, uncontrolledsinus disease can actually

(24:40):
aggravate asthma and it canaggravate COPD.
So if you're thinking aboutwhether or not your sinus issue
is, kind of disrupting otherparts of your body.
You know those are some examplesthere that may contribute to
your other conditions or may beaggravating your other
conditions.
Any questions there?

J Basser (25:03):
I had a friend that had that sign.
He had a big sign of infectiondown in Bowling Green, kentucky,
in the rural areas.
Dad was a mayor of a small townand went to the Bowling Green
Medical Center and they testedand he had it had turned into
meningitis and he died.

Bethanie Spangenberg (25:18):
Now, that's very rare and I was
surprised when.
I, like I said I dealt with it acouple of weeks ago, no idea.
The last place I thought thatthat infection would be
affecting the brain was in thesinus cavity.
So you know, for thisparticular individual, he had
fallen and hit his leg likethree or four weeks before this,

(25:38):
and we knew he had an infection, didn't know where it was
coming from.
They did an X-ray of the leg,they worked up the teeth, they
did a scan of the head and hereit was.
It was in the sinus cavity andthat sinus infection actually
created fluid around that, thateustachian tube in the ear, and

(25:59):
so you can see the fluid buildupand it just wasn't, wasn't good
.
I was surprised.
So it's not very common but itcan happen what?

J Basser (26:12):
What controls that valve?
Is that just something you yawnor something like that or do a
dive check?

Bethanie Spangenberg (26:22):
or is that something that controls my
nerves, my understanding and I?
You know that's not reallysomething I've thought a whole
lot about.
That's not my area of expertiseI just the the.

(26:43):
It's a pressure regulationsystem and I would assume that
it's a nerve of some sort.
But if that the sinuses, like Isaid, swell, it prevents the
air from getting out of thatinside ear pressure valve.
So when you go on the plane andthat pressure gets higher, that
pressure valve, the eustachiantube, will try to regulate the

(27:05):
pressure.
So then that way there's not apressure buildup.
If you get pressure buildup inthe ear you can actually start
to develop tinnitus and it canbecome very painful.
So when you have young childrenand they have ear infections
and they can't regulate that earpressure, they can actually
tear the eardrum from that earinfection if the pressure can't

(27:28):
get released.

J Basser (27:30):
That's why I put a lot of tape in kids.

Bethanie Spangenberg (27:32):
Yes we talked about this before.
All right, so for time's sakewe're going to jump into
rhinitis.
Rhinitis is an inflammatorycondition of the nose lining.
It can cause nasal congestion,runny nose, sneezing and itching

(27:53):
.
When we clinically look atrhinitis, we divide it into two
types.
We look at allergic rhinitisbecause allergic rhinitis is so
predominant, and then we alsolook at non-allergic rhinitis.
So allergic rhinitis istriggered by something that the
individual is allergic topollens, dust, mites, pet dander

(28:16):
.
It's an immune response inorder to protect your body from
those irritants.
Non-allergic rhinitis is not anautoimmune process, but it is
triggered by something that canirritate the sinus cavity or the
nasal cavity, such asmedications, hormonal changes,

(28:42):
environmental irritants, likeyou're breathing in smoke and
you bring it in your nose and itirritates the sinuses.
And so what happens is the bodyreleases moisture or mucus in
order to get that irritant offthe sinus cavity or outside of

(29:02):
that nasal cavity.
One other thing that causes alot of what we call the
vasomotor or the non-allergicrunny noses is spicy foods.
If you get a hold of a spicyfood and it's just a little too
hot that your body can'ttolerate it, that whole system
starts to water, you get wateryeyes, your nose starts running.

(29:24):
So a lot of people canappreciate that non-allergic
runny nose when they eat spicyfoods.

Ray Cobb (29:33):
Oh, you mean like jalapenos?

J Basser (29:37):
Yes, Cabernet will not be a little more powerful than
rice.

Ray Cobb (29:43):
Yeah, oh, when I eat spicy foods, that happens to me
all the time.
I can't eat it.
I'm allergic to it.

Bethanie Spangenberg (29:52):
I can't eat it, I'm allergic to it when
we look at the DBQ on page 4,the DBQ questions are again
specific to the rating schedule,not necessarily to the type of

(30:17):
symptoms or the clinicalapplication of the condition.
So for rhinitis, your vasomotoror non-allergic rhinitis does
not typically cause obstructionof the sinus cavity or the nasal
cavity.
But when you look at allergicrhinitis it typically does cause
inflammation, swelling andobstruction.
So when we look at the ratingschedule, sometimes it may not

(30:39):
apply if you have a non-allergicrhinitis.
So the first question that'sasked is there greater than 50%
obstruction of the nasal passageon both sides due to rhinitis?
You are likely to haveinflammation on both sides if
it's an allergic rhinitis.

(30:59):
If it's a vasomotor ornon-allergic rhinitis, you may
not have any swelling of thesinus cavity, okay.
Question B2, is there completeobstruction on the left side due
to rhinitis?
B3, is there completeobstruction on the right side
due to rhinitis?

(31:20):
Now, if you have completeobstruction on the left side or
complete obstruction on theright side, that's a 10% rating.
If you have 50% obstruction onboth sides, that is a 10%
disability rating.
Question B4, is there permanentswelling of the nasal tissue?

(31:42):
And B5, are there nasal, whatwe call polyps?
Now, nasal polyps can developover time due to a chronic
rhinitis disease.
They do not pop up and thendisappear with something that
happens over a short period oftime.

(32:03):
So those who experience achronic allergy type of rhinitis
may develop basically like skintags inside the nose.
You can't see these typicallyon exam.
If they're seen on a physicalexam by the examiner, that means

(32:24):
that they are prominent.
Normally the nasal polyps arevisualized when they get a
camera up their nose to checkout what's going on or it's seen
on a CT scan for imaging.
So typically if an examiner isgoing to look in somebody's nose

(32:45):
to see if there are nasalpolyps, they may not always
capture them.
So if you're a, veteran thatknows they suffer from allergic
rhinitis, chronic sinus diseaseand you have a CT scan.
Sometimes those are incidentalfindings.
They don't pop up as anabnormality, they're in the fine

(33:08):
details of the CT scan.
You can use that and submitthat to the VA to get a higher
percentage.
So if you have nasal polyps,let's see with nasal polyps you
get a 30% disability rating.
So just pay attention to some ofthe imaging that you get for
your sinus cavity.

(33:29):
So then that way you can reallybe aware of what you can
optimize your rating for Now.
The next question talks about adifferent type of rhinitis.
It has to do with abnormalgrowth and abnormal cells, not
very common at all.
Not even going to spend ourtime talking about it.

(33:50):
The one thing, a couple thingsto mention for both rhinitis and
sinusitis.
They are presumptive conditionsif you've been exposed to quote
unquote, fine, particulatematter and you served in
Southwest Asia theater or in thePersian Gulf War on or after

(34:12):
September 19th of 2001.
So I bring this up because whenthe burn pits came out, or when
they talked about the sand, andthe air quality in Southwest
Asia.
Those are fine particulatematter and so if you have a
sinus condition or allergicrhinitis condition, those are

(34:32):
presumptive service connections,so you should be applying for
those, okay.
The one thing I also want tomention about this DBQ is that
the C&P examiner, when you go tothe exam, they may not say hey,

(34:54):
do you experience headachesfrom your sinus condition?
Do you have tenderness aroundyour sinuses?
What they may say is they mayask an open-ended question.
They may say tell me about yoursinus troubles, tell me about

(35:18):
your sinus troubles.
And if you don't hit thesespecific topics or these
specific keywords, they may notask you specifically and they
may not mark that box.
So if you are applying forsinusitis or rhinitis, you need
to look at this DBQ and you needto look at these key words
Headaches, tenderness of thesinuses, drainage crusting.

(35:39):
You need to understand whatkind of terms to use in order to
properly express what you'reexperiencing with your sinus
episodes.
Okay, a lot of times a providerwill just ask open-ended
questions Tell me about this.
They may not ask youspecifically about how many

(36:01):
episodes.
You can put it on a note cardand say well, I experienced a
non-incapacitating episode fromJanuary 12th to February 7th.
You can pull out your notes andtalk specifically about what
you're experiencing in order tocapture what is actually

(36:22):
happening.
Okay, any questions aboutrhinitis?

J Basser (36:30):
No, I'll tell you a quick little.
I'll tell you a quick little.
We had a previous tech guy onthe show.
He did the recording stuffabout two years ago.
He actually passed away here afew years ago.
He went for a CMP exam forrhinitis and renal conditions.
He finally got his chartconnected for it.
But during the process of theCMP exam we said the guy had had

(36:54):
his nose broken on severaloccasions.
The last time he got it brokenhe was in a prison fight while
he was in prison.
The only problem was the poorguy never served a day in jail.

Bethanie Spangenberg (37:08):
So what yeah Sure did?

J Basser (37:13):
They said he got his nose messed up when he was in
prison.
He worked on the aircraftcarrier, decked on a carrier,
got all that grit and stuff youknow, because the planes, the
jet engine would blast off andall that nonstick stuff on the
surface, all that goody sandstuff and the stuff that
exhausts, yeah.
So they said they got it whilehe was in prison because they

(37:33):
kept breaking his nose.
Got him to reserve a day injail?
Yeah, Of course they didn'ttell him he had lung cancer
either, until he had to gooutside and he finally got his
diagnosis.
They told him one day that hehad his lung cancer and the next
day that there was nothing hecould do for him.

Ray Cobb (37:55):
Wow, bethany, we've talked a lot.
Everybody's pretty familiarwith the burn pits.
What about and John justmentioned it what about jet fuel
?
And John just mentioned it whatabout jet fuel?
And some of the Air Force guysthat are at the I forget what

(38:15):
they call them that are at theend of the runway that you know,
pull the pins for bombs andthings and rockets when they're
ready to take off and they getthat big blast of dirt and sand
and jet fuel and exhaustOrdnance.

J Basser (38:35):
Ordnance ma'am.

Ray Cobb (38:37):
Ordnance okay.
Does that cause some of thesesinus problems that we're
talking about?

Bethanie Spangenberg (38:44):
Absolutely .
Now I can say that from workingin occupational health.
Occupational health is on thejob duties.
You know we see patients thatwork in construction.
We see all kinds of placeswhere they breathe in these
respiratory irritants, and jetfuels is absolutely a

(39:04):
respiratory irritant.
There's a lot of chemicals thatwe work with.
There's a lot of fumes that wework with that can cause sinus
issues and go on to developchronic sinus issues.
Now the difference between aveteran fighting a claim and the
presumptive portion is that ifthe veteran doesn't see it as a
presumptive condition, thatwould be something that you may

(39:25):
need to get a nexus letter for.
So in those instances, as amedical expert, I would want to
understand where you were, howlong you were there, for what
type of activities you weredoing, what type of symptoms you
were experiencing when you werearound these fumes or these
chemicals that you can breathein.

(39:46):
And we actually have writtensome nexus letters.
As it relates to jet fuels andthe respiratory component or the
respiratory irritation, thosejet fuels are not good.

J Basser (39:59):
Guys, most of your jet fuels, if you're concerned out
there, most of it's nothing buta different mixture of kerosene.
So that's just.
You know it's the same thing.
You've got a kerosene heater inthe house and you get that
stuff all over you.
That's what it is.
Yep, ap-5 and 4.

Bethanie Spangenberg (40:18):
You know and we I think we've had it beat
in our heads.
I want to talk a little bitabout smoke, just in general,
from smoking.
Okay, we talked previously thatchronic smokers kind of have
their sinus cavity coated and itgives them a little bit of
protection from developingchronic sinus issues.

(40:39):
But smoking not only has itsdirect effect.
Okay, so if you smoke acigarette you're breathing that
stuff in.
But what we don't really talkabout is what they call a
tertiary component, which iswhen those smoke and those
particles get on the clothingand then later on we breathe

(41:02):
those particles in from theclothing.
They can be irritated andbecome particles into the air
and then we breathe them in.
We don't talk about thattertiary component a lot, but
that tertiary component existswith smoking, with chemicals,
with asbestos.
That's why when you get it onyour clothes, those clothes, you

(41:23):
can't rattle those clothesbecause you're going to throw
asbestos into the air.
That's the same with all theseother chemicals.
Throw asbestos into the air,that's the same with all these
other chemicals.
Once they get on your clothingor that toxic substance gets on
your clothing, you ruffle thatclothing, you go, take your
clothes off for the day and youdon't properly wash your
clothing, that chemical stilllives on your clothing and

(41:45):
you're breathing it in.
So that's one thing we don'treally talk about.
When they try to educate you atthe commercial about not
smoking or chemicals, that andyou're breathing it in.
So that's one thing we don'treally talk about.
You know, when they try toeducate you at the commercial
about not smoking or chemicals,so it's just one thing that you
really need to consider.

J Basser (41:57):
You know, in day-to-day life, Well, being a
resident asbestos expert, I tellyou that back in the 50s and
60s, maybe sometimes even the40s, they were mining heavily in
Africa.
They were mining fossil towelAmish side is the best to know
the stuff out of the ground.
The workers would process itand mine it out of the ground

(42:17):
and they would take it andthey'd mill it.
The people would go home fromwork, sit down on the couch and
the kids would come and get intheir lap and the mother would
give them a kiss and the old dadwould sit down and eat dinner.

Bethanie Spangenberg (42:27):
Yep.

J Basser (42:28):
Hundreds of thousands of people died because of that.
The entire factory died, notjust the workers, but the people
that delivered the mail andeverything.
Wow, that's bad stuff, man.
You also get the sinus cavitytoo.

Bethanie Spangenberg (42:50):
And you can develop cancers from those
particles.

J Basser (42:53):
That's true.
I mean it's just like a.
It's just like.
I mean it's got little sharpends on it and it sticks to
anything.
You know.
It sticks to your skin and yourbody will fight it for a while,
but it's indestructible.
And eventually it does turninto cancer.
Yep, oh bad stuff.
So I'm going to move on.

Bethanie Spangenberg (43:16):
oh yeah well, because they didn't have
the, the protection.
You know then, like they do now, the awareness then that they
do now.

J Basser (43:25):
So even when they first started out in the early
80s with protection for the roofrods and things like that, they
couldn't.
They had the full force area,okay, but the mass and stuff
they had for sampling was nogood.
It was one of the early 3Ms andthey still hadn't made it
through it, so of course theywon't tell you that.
All right.

Bethanie Spangenberg (43:48):
So I'm going to go ahead and transition
into the next section, which ispart C.
I'm not going to dive a lotinto it.
It has to do with what theycall the larynx and the pharynx.
So it's the vocal cords, yourvoice box and basically the very
back portion of your throat,basically the very back portion
of your throat.

(44:08):
If you open your mouth and youlook in your mouth, it's behind
your uvula, your little boxingbag that's in the back of your
throat.
There it's behind that.
That's your pharynx.
Okay, there's not a lot reallyto understand as far as anatomy
goes.
The layman phrases that we useis our vocal cords and we know

(44:34):
that when we develop laryngitiswe know that our vocal cords are
irritated.
So just going to briefly talkabout laryngitis as it falls on
the rating schedule.
Laryngitis is inflammation ofthe voice box that can cause
symptoms of hoarseness, loss ofvoice and throat discomfort.
As you hear me now I amexperiencing all those things.

(44:56):
Laryngitis is commonly causedby viral infections, which I
think I got from my children,and irritation of the vocal
cords.
Vocal cords, irritation ofvocal cords can be caused by
mucus, smoke inhalation,chemical inhalation, smokeless
tobacco.
If you're a chronic dippersnuff, it can irritate your

(45:21):
vocal cords and cause laryngitis.
And even if you have heartburnor reflux that's uncontrolled
that stomach acid can irritateyour vocal cords and cause
chronic laryngitis issues.
Now if you getservice-connected for chronic
laryngitis, you get a 10% ratingfor hoarseness and with

(45:44):
inflammation of the vocal cordsor the mucous membranes around
the vocal cords.
In order to visualize the vocalcords, you have to take a scope
down and look, and if anindividual is diagnosed with
chronic laryngitis, you shouldbe seeing specialists for them

(46:07):
to look at your vocal cordsseeing specialists for them to
look at your vocal cords.
The reason I say this andemphasize this is that if you
have hoarseness or laryngitisthat persists more than two
weeks, you need to talk tosomebody about it.
I have firsthand experiencedpatients who've had chronic

(46:28):
laryngitis.
I would refer them to aspecialist and they would find a
tumor or a cancer either on oraround their voice box,
affecting their vocal cords andcausing laryngitis.
So if you're a veteran, you knowyou've been a smoker, you know
you drink alcohol, you haveuncontrolled reflux, that

(46:50):
hoarseness isn't going away youneed to talk to somebody about
it so they can look and makesure that you don't have
something there.
Early detection, your outcomeis better.
Okay, so just keep that in mind.
For chronic laryngitis, a 30%rating means that the veteran is

(47:10):
experiencing hoarseness, withthickening of the vocal cords,
they may have polyps or thepre-malignant or pre-cancerous
changes on the biopsy.
So again, just emphasizing thatif you catch it early, your
outcome is better emphasizingthat if you catch it early, your

(47:34):
outcome is better.

J Basser (47:35):
What's the difference between laryngitis and
pharyngitis?

Bethanie Spangenberg (47:38):
There is, it's just the location.
So the pharyngitis is when youhave that really fire feeling on
the roof of your mouth and itmakes it nearly impossible to
swallow.
So when you go to swallow andthe back of your throat is
really burning, that is theirritation of the pharynx.

(47:59):
It is the like I call them thevoice bubbles, or what I'm
experiencing, that is thelaryngitis.
When you talk, your vocal cordsclap together and they should
be making a fine seal in orderto control the air for your
voice.
With laryngitis, you getirritation of those vocal cords

(48:21):
and so they're not creating theseal for the air movement like
they should, and so you'll getthose the crackles and the pops
when you start to talk, becausethat seal is not being created
like it normally would.
Your pharyngitis is whatprevents you from swallowing.
That's the like.
If you have ever experiencedstrep throat or even mono, you

(48:45):
get this rapid throat pain.
You get this rapid throat painwhen you experience like
post-nasal drip from allergiesor allergic rhinitis or
sinusitis in the back of yourthroat that's more of a slow
progression of a sore throatthat you're experiencing,
besides the pharynx beingirritated.

(49:08):
Does that help?
Of course, the voice box is alittle bit lower than the
pharynx, location-wise, so ifthat also kind of helps
understand where each one'slocated, so, I'm going to jump
to page five.

(49:29):
Page five covers conditions ofthe pharynx and the larynx that
are not common, and so I'm goingto go ahead and jump to page
six.
Really, the biggest one that Iwant to hammer home for the next
one, I guess for this DBQ ispart D and that is the deviated

(49:49):
nasal septum.
We get a lot of veterans thatask about getting
service-connected for a nasalseptum deviation and so we get a
lot.
Like you said earlier, a lot ofthe trauma to the sinus cavity
and the deviated septum is ratedsimilar to the sinus and the

(50:11):
rhinitis conditions.
So question one is is there atleast 50% obstruction of the
nasal passage on both sides dueto traumatic septal deviation?
I will tell you that havingobstruction on both sides is not
common, because normally whenyou get a broken nose, that's
where the deviated nasal septumcomes from.

(50:31):
It's going to be a crooked nose.
It's not going to smash youstraight on, it's not going to
squish you to where you get 50%obstruction on both sides.
You're usually going to havethat nasal septum kind of
crooked.
The nose looks crooked If youlook up in the mirror at the
bottom of where your nose meetsyour lip, that is your septum,

(50:55):
the skin over the septum, so youcan look at it and visualize
that it may be crooked.
Or you can look at the externalpart of the nose and see that
it's crooked, but you're notnormally going to get a smashing
type of trauma whenever youbreak your nose.
A 10% rating is given ifthere's 50% obstruction of the

(51:22):
nasal passage on both sides.
A 10% rating if there iscomplete obstruction on the left
side, a 10% rating if there'scomplete obstruction on the
right side.
Again, your deviated septum isnot normally going to be a 50-50
on each side.
You're just going to have acrooked nose and it creates
either like a 90% obstructionand like a 10% obstruction on

(51:44):
the other side.
Most people who've experiencedbroken nose they're like you
know, I could really breathereally well to my left side, but
my right side I can't reallybreathe out of.
That's typically the historythat we get for nasal trauma.
And when I talk about nasaltrauma, I also want the veteran
to consider okay, if you brokeyour nose in service, somebody

(52:08):
hit you in the face, they kickedyou in the face, they broke
your nose, but did you also loseconsciousness?
Because a lot of timesclinicians will say, oh, you
broke your nose, but they won'task you about TBI type symptoms.
Did you lose consciousness?
Do you remember everything thathappened?
And a lot of your TBIs come fromhits to the face, and so if

(52:31):
you're a UFC fan, you can see alot of TBIs that come from
getting hit in the face, but alot of veterans don't think
about that.
I had a veteran who he wasactually kicked in the jaw and
they broke his jaw, but he wasalso flat on the ground when
that happened, so he had a TBIwhen he was kicked and so he

(52:53):
didn't think about filing forthe TBI.
He just filed for the brokenjaw and it's like well, trauma
to the face, trauma to the head.
You also need to think about aTBI is because if you have a
traumatic broken nose, were youconscious the whole time?
Did you also have a TBI?

(53:14):
Are you experiencing symptomsof a TBI?

J Basser (53:23):
So just think about those when you're filing for
your claims.

Bethanie Spangenberg (53:26):
How much longer do we have.

J Basser (53:31):
I can actually summarize it here in a few
minutes.
Page six We've got a caller.

Bethanie Spangenberg (53:35):
Go ahead.
Okay, I'll be quick.
Page six it talks about tumorsand neoplasms, which they do in
every DBQ, and we'll talk aboutthat in another show.
Page seven what is importanthere is that it prompts the
examiner to conduct any type ofscar exam if it's indicated, and
we've talked about the scarratings and what that means.

(53:58):
The last one that I think isimportant is page 8.
It talks about the diagnostictesting and we talked about the
nasal polyps that give you thatextra rating.
It's likely going to be seen ona CT scan or an endoscope, but
not necessarily on a physicalexamination.

(54:19):
So you need to be looking atyour imaging results and,
additionally, if you've had anendoscope where they take the
camera in, there is a procedurenote that the specialist will
write up.
It'll talk about what the sinuscavity look tissue looked like,
whether they saw nasal polypsor obstruction, and that is

(54:39):
valuable evidence that you canuse to support an increase in
your claim and I highlyencourage you to get that
endoscope procedure test resultsto submit.
And then the last page is thefunctional impact which you
should be putting in yourstatement and supportive claim,

(55:00):
and then, finally, the examinercertification and signature and
that is it.

J Basser (55:06):
Good deal.
Okay, I'll see you guys, yousaid we had a dollar?
Yeah, we do.
It's the guy to what we talkedabout him earlier and he's got
his hand up why it man?

(55:28):
you're like you're going live,hello community, fine, yes,
right, yeah, you mean justexplain the situation.
Or she Hello, can you hear me?
Fine, yes, go ahead.
Yeah, you mean just explain thesituation.
She knows that it's a DIC issueand things like that, and
you're talking about the valveissue versus a supporting artery
disease.
Yeah, I'm considering.

(55:53):
I'm already service-connectedfor artery disease and I put in
for a valve claim about a yearago and was denied, and I'm
thinking about appealing it withan IMO.
And is it something that Ishould do for DIC purposes or am

(56:13):
I covered for any heartdisease-related issue because of
the artery disease, or what'syour opinion on that as far as
DIC and heart conditions?

Bethanie Spangenberg (56:28):
So most people have issues with coronary
artery disease that cause theirdeath or demise.
If your valve disease issignificant enough, a couple
things can happen.
If the coronary artery diseaseor the coronary arteries around
the heart are so severe, it cancause the valves to fail.

(56:52):
Or if the valves are so diseasedit can cause the heart to fail.
Or if the valves are sodiseased it can cause the heart
to fail.
The only way to really know thestatus of the heart function is
to see an ultrasound of theheart.
That ultrasound of the heartwill tell me where the heart

(57:12):
valve disease is and is thereheart failure or decomposition,
meaning the heart is not workingas well in that study.
So if the valve disease is mild,and it's not affecting the
heart function or how itsqueezes, there may not be value
in pursuing it.
I would be happy to look at itand, if you don't mind, maybe on

(57:34):
the next show.
We can kind of talk about whatwe found and maybe open the case
up a little bit more for adiscussion, so there may be
value.
It would be.
I'd have to see what yourultrasound looks like and what
your testing looks like.

Ray Cobb (57:48):
Okay.

J Basser (57:52):
All right.
How would I get thatinformation to you?
Just contact the number orsomething.

Bethanie Spangenberg (58:00):
Yes, I will talk with John at the show
and we'll try to get informationexchanged so we can get that
material over to me.
Okay, Thank you.
Did my explanation make sense?

J Basser (58:20):
Yeah, yes, it sounds like you're saying it depends
how serious the valve disease is.
If it's mild, then it'sprobably not worth pursuing.
Is what I heard.
Is that correct?

Bethanie Spangenberg (58:32):
Right.
Yeah, that's correct.
So we just really got to lookand see where the status of
everything is or see if it'sworthwhile.
I agree with you trying to dowhat you can to capture those
service connections.
In the event, you do pass awayfrom something like that.
I think that's smart and you'rethinking ahead of the game.

J Basser (58:51):
Well, I had the mitral valve issue for years and the
artery disease is just somethingrecently that's come into play.
So the valve issue, I've had itfor years.

Bethanie Spangenberg (59:11):
Okay.

J Basser (59:12):
So the artery disease didn't cause the valve issue?

Bethanie Spangenberg (59:17):
I wouldn't think anyway, we also have to
look at it.
Did the artery issue aggravatethe valve issue?
That echo will tell me a littlebit more about your story, okay
, so what is?

J Basser (59:33):
the individual basis, Individual basis, this.
Everybody is not the same.
So this is the individual basis, Correct.
Once he sees the echo.
Once he sees the echo, he'llknow that can be it.
Do you want the actual echo ordo you need to report, bethany?

Bethanie Spangenberg (59:52):
Just a report.
Just a report, okay, okay.

J Basser (59:53):
Just a report.
Just a report, okay.
Okay, we'll teach him how to dothe portal and how to upload
something to you.
Okay, betsy.
Okay, no problem, no problem, noproblem.

(01:00:16):
It's like you got that out andyou're feeling bad.
It's a bit of a heck of a jobit sounds, you know.
I mean you got a little bit ofyou, got a little bit learned at
the end of there, you know, youtell you have a little draining
stuff going on in your nose,but I'm glad you're doing better

(01:00:40):
.
I'm going to check on Mr Cripps,james, how you doing?
Buddy, I'm doing good.
John, I might have threwanother one.
Buddy, you're lucky man.
Well, I think somebody's ridingon my shoulder too.
I talked to you Friday.
I thought for sure you'd bedoing dial shoulder too.
I talked to you Friday.
I thought for sure you'd bedoing dialysis Monday morning.
I tell you what.
I'm glad you didn't.

(01:01:01):
I was supposed to be ondialysis, I just dodged another
bullet.
You don't get scared like thatman.
But man, I'm happy to be back,I'm good to go.
I'm minus a couple toes andparts of my feet, but heck, I

(01:01:22):
got extra parts anyway.
Why, remember?
Was it Johnny Cash that sangthat song?
He worked at a Cadillac plantand by the time he retired he
had no parts to build a Cadillacplant, and by the time he
retired he had enough parts tobuild himself a Cadillac in his
house.
I'm about 80% aftermarket partsat this point.

Ray Cobb (01:01:47):
He's Troy built.
I think is that what you saidYou're Troy built.

J Basser (01:01:51):
Well, you know, if you've got aftermarket parts,
they're replaceable.
Well, you know, if you've gotaftermarket parts, they're
replaceable.
Well, I don't like saying thisto a lot of Vietnam.
Best get mad at me, you, Heinz57.
Well, you know, I can laughabout it, but for the last two
months I hadn't been laughingabout it.

(01:02:12):
I tell you it's been rough.
Wouldn't want anybody else toexperience that kind of thing.
But let me put the word outthere, man, if you wear AFOs, if
you wear foot braces, wear them.

Ray Cobb (01:02:33):
I left mine off for about two weeks and that's
what's caused all of my trouble.

J Basser (01:02:37):
I was giving my legs a rest when actually I condemned
them.
That's important, yep.
But, anyway, it's really good tobe back.
Well, it's good to hear yourvoice, buddy.
You sound good too.
Last time I talked to you yousounded real weak and now you
sound a lot stronger.
Yeah, I was really getting weak.
I was a whole lot sicker than Ithought I was at the time.

(01:03:01):
If it would have been 20 morefeet to the emergency room door,
I don't think I would have madeit.
Yeah, okay, well, listen, guys.
The only thing.
Thank you for coming on.
I appreciate you very much.
You're always a birth of freshair, and we'll do this again in

(01:03:22):
December, and then we'll do itagain in January and February
Did you want to talk about yourspecial show on Monday.
Yeah, guys, we're going to do aspecial show on Monday.
It's actually already recorded.
We've got a show.
It's in the queue for Mr BillRobinson.
He's the longest-held enlistedprisoner of war in the Vietnam

(01:03:44):
War and a very emotional show,one of the best we've ever done.
Ray did a good job too in theshow and Bill's a good speaker
and just listening to just themtalking to him will open your
eyes up and especially how youknow the VA doesn't treat
everybody the same.
I'm serious, but if it happensfor seven years and they message

(01:04:08):
you like that, that's not good.
You agree, ray?

Ray Cobb (01:04:11):
I agree 100%, he deserves a whole lot more than
what they ended up doing.

J Basser (01:04:17):
And.

Ray Cobb (01:04:18):
I know he's very bitter about the VA, just like a
lot of us are.
And hopefully we can convincehim to take action and let's see
if we can't get him what hedeserves Seven and a half years
in captivity in a three by fivecell a lot of times serving, I

(01:04:42):
would say, more than half of it,or 80% of it in solitary
confinement, and sometimes afterbeing beaten to be tied up.
You just got to hear his story.
You just got to listen to thestory.

J Basser (01:04:57):
Yeah, give a good listen folks.
It's an amazing show.
I'll be there Monday.
Ray will be there Monday.
So the more people listen, thebetter off, the more you'll be.

Ray Cobb (01:05:07):
What's the time, John?

J Basser (01:05:09):
At the same time, jim will be at 7 o'clock.
Okay, ray, if I can help Billin any way, let me know.

Ray Cobb (01:05:17):
We'll do it.
We'll do it.
I know you've met him beforeand actually got to sit down and
visit with him one night whenyou and he both were visiting
here in Winchester.
So he's a big guy.
I mean this isn't a little.
I mean if he was a normal-sizedguy I'm not sure he could have

(01:05:38):
made it, but I think he's about6'3" a big guy and you just got
to hear his story and guys.
You know, I'm glad I never hadto think of the things that he
did.
It's just amazing.

J Basser (01:05:56):
Well, I tell you guys my lifetime I mean, I've been
around the world a few times.
I've met a lot of famous people.
In my lifetime you know Kind oflike Ray's interviewed famous
people, but I've actually beenthere with a lot of famous
actors and things like that.
This guy, ray, is right upthere with them.
As far as you know people,we've met some of the people you
talk to.
It's going to be a really goodshow.

(01:06:19):
Listen, I'm going to go aheadand shut her down.
It's Thursday night and it'scold outside.
I hope it warms you up some andwe'll see you guys Monday and
then again next Thursday.
We're going to have the one andonly John Doley on you guys and
Bethany.
Thank you for coming on, younglady.
We do appreciate you.

Bethanie Spangenberg (01:06:35):
Thank you, I appreciate you.

J Basser (01:06:37):
If you need anything, you can reach out and text me.
I'm only 270 miles or sevendigits away.
All right, Guys, we thank youall for listening.
I'm going to go, just shut herdown.
We don't need to play an extratonight because we're over
anyway.
So thank you all very much.
We appreciate you.

Bethanie Spangenberg (01:06:57):
Thank you, have a good night.

Ray Cobb (01:06:58):
Good night guys.

Bethanie Spangenberg (01:06:59):
Bye, bye.

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