Skin Deep: Navigating DBQs and VA Disability Ratings for Veterans

Veterans navigating the VA disability system for skin conditions need to understand the intricacies of how these conditions are rated and documented to maximize their benefits.

• DBQ Discussion

• Eight key characteristics of skin disfigurement determine rating levels including length, width, contour, texture, and inflexibility

• VA considers only face, neck, and hands as "exposed skin" regardless of what clothing you wear

• Understanding the distinction between systemic therapy (oral medications, injections) versus topical therapy (creams) is critical for proper ratings

• Skin conditions are rated based on percentage of body affected and treatment requirements, ranging from 0% to 60% compensation

• Document flare-ups with dated photographs since conditions may not be visible during C&P exams

• Skin conditions can be secondary to other service-connected issues like diabetes, braces, or orthotics

• Common service-connected skin conditions include dermatitis, fungal infections from deployment, and chloracne from Agent Orange exposure

• Veterans can decline physical examination of sensitive areas if medical documentation already supports their claim

• The PACT Act now makes melanoma presumptive for veterans with qualifying burn pit exposure

Contact Valor 4 Vet at 888-448-1011 or visit www.valor4vet.com for assistance with nexus letters for your VA claim.

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

Visit J Basser's Exposed Vet Productions (Formerly Exposed Vet Radioshow) YouTube page by clicking here.

Episode Transcript

Ad (00:00):
Blog Talk Radio.

J Basser (00:04):
It's time for the Exposed Vet Radio Show.
The Exposed Vet Radio Show.
We discuss issues affectingtoday's veteran.
Now here's your host, john andRay.
Welcome, ladies and gentlemen,to the episode of the Exposed
Vet Radio Show on this June 6,2024.
Today is the anniversary of thefinal battle of Midway, the

(00:28):
final day.
We all think back about thatday that turned World War II
into favor of the United Statesat the time.
Today we've got BethySpangenberg on.
She is a volunteer vet.
She's the chief of the bosswe're going to do another series

(00:49):
of discussions.
We're going to do the DBQ.
We're going to go over thosepainful, dreaded skin diseases.
She's got a lot of informationto pass out.
Our co-host today is Mr RayCobb.
He's traveling a little bit,but he's on the air.
How are you doing, ray?

Ray Cobb (01:05):
I'm doing great.
Yeah, it's a little warm outhere where I'm traveling, but
the scenery is gorgeous and Iwent to a place today called
Fiery Valley and it was not onlyhot but all the rocks are
beautiful, deep red.

J Basser (01:24):
Copper in them there.
That's good Awesome.

Ray Cobb (01:26):
Yeah, a lot of copper.

J Basser (01:28):
Good.
Well, Bethany, how are youdoing tonight?

Bethanie Spangenberg (01:33):
I'm doing well.
I've been busy this week withthe kids and basketball camp and
volleyball camp, and so, as ofright now, we're enjoying the
weekend.

J Basser (01:45):
So you got your weekend to the family itself
with no extra activities, orwhat?

Bethanie Spangenberg (01:50):
Yes, and that's why I'm happy to be where
we're at right now.
It's been a long week.

J Basser (01:55):
Shut the doors, lock everything and just close it,
turn the phones off andeverything.
Just do family time.
Maybe get you some hamburgersand hot dogs and cookout or
something you know I like thatyou know that would be good I
like that there you go.
But yeah, we're going todiscuss the old, dreaded skin
diseases, you know.
But you go right ahead and takeoff or turn it over to you.

Bethanie Spangenberg (02:17):
Well, before we get too deep into it,
Ray, are you going to visit thesequoia trees or the Sequoia
Forest?

Ray Cobb (02:27):
No, we did that the last time we were out here.
They're absolutely gorgeous.
I think our next trip, though,we will go up there.
We'll also hit a couple of thenational parks over there in the
California northern side of ityeah.
They're actually beautiful.
Northern side of it they'reactually beautiful.
They have one there known asthe Robert E Lee, which is the

(02:48):
largest and oldest in the forest.
It's amazing.

Bethanie Spangenberg (02:54):
Yeah.
I think that's something thatyou have to see in your lifetime
.
It's definitely something toadd to the bucket list.
We went out there probably 10years ago now and I'm going to
take the kids back, but it isunbelievable to see those trees
Awesome.
So I wanted to ask.

J Basser (03:13):
I think that's probably back in the 80s.
I should go back to San Diegoone week in a while.
It's all that.
It's a long trip.
Yeah, yeah, we'll be from San.
It's a long trip, yeah.

Ray Cobb (03:26):
Yeah, we'll be from San Diego, mm-hmm.

J Basser (03:30):
That's cool.
No, it's beautiful.

Bethanie Spangenberg (03:35):
All right.
Well, I just had to ask, sinceyou mentioned you were in the
area, but let's transition intothe skin stuff again.
So, last month, I think it was,we talked about the scarring and
burn scars and disfigurement.
This week or this month is skindiseases and specifically the

(03:58):
rest of the skin rating schedule.
And before I I'm going to do itbackwards this time Instead of
doing the DBQ first, I want totalk about the rating schedule
because I think for the skin youreally need to understand a
little bit about the ratingschedule.
It's like foundational forunderstanding what is in the DBQ

(04:20):
, because what's in the DBQdirectly reflects what's in the
rating schedule.
I think it's important to startthere with a little bit of
foundation.
So when we talked about burnsand scars, we talked about eight
characteristics of skindisfigurement and those eight
characteristics carry over intothe rest of the rating schedule

(04:45):
for skin disorders.
And then we also need tounderstand in the rating
schedule how exposed skin versusnon-exposed skin is defined.
We need to understand what theVA views as systemic therapy
versus topical therapy, the VAviews as systemic therapy versus

(05:08):
topical therapy.
And then we also need tounderstand how they look at
pyramiding for the skincondition.
So we're going to cover each ofthose little areas before we
dive into the DBQ.
So those eight characteristicsof disfigurement that we talked
about when we discussed scarringand we're just going to briefly
go over those but those carryinto the reading schedule for
other skin diseases.

(05:31):
And the eight characteristicsare that if a scar or skin
condition is five or more inchesin length.
If a scar or skin condition isa quarter inch wide or greater.
If the skin contour is elevatedor depressed.
If the skin sticks to theunderlying tissue and it's fixed

(05:53):
so it doesn't move.
If the skin texture is abnormaland a surface area of greater
than six square inches.
If the underlying skin tissueis missing, the fat, tissue or
vascular area under the skin andit's greater than six square

(06:14):
inches, and if the skin is hardor inflexible in an area greater
than six square inches.
And so those differentcharacteristics will give
different ratings further downin the rating schedule.
So just a reminder of whatthose are.
When we look at exposed skinversus non-exposed skin, it's a

(06:40):
little bit different than whatwe would think.
Well, I'm wearing a t-shirt, myelbows are exposed.
Well, the VA doesn't look at itthat way.
The VA considers the exposedskin to be the face, the neck
and the hands.
So even if it's on your elbows,they don't consider it exposed
skin.
If it's on your knees, theydon't consider it exposed

(07:03):
exposed skin.
If it's on your knees, theydon't consider it exposed.
So, outside of the face, theneck and the hands, all of the
other areas are considered to benon-exposed.
Does that make sense I mean doyou?

J Basser (07:17):
understand, not that it quite makes sense, but Well,
I think you wear clothes, longsleeves and things like that too
.
That's what they do, livingthat Amish life.
Yeah, this is a bit of somegood furniture, right.

Bethanie Spangenberg (07:43):
So when it comes to understanding systemic
therapy versus topical therapy,so systemic therapy, from a
clinical standpoint, issomething that is in the body
and runs through the body, andthe way the VA also recognizes
it is whether the medication istaken orally, by injection, if
it's used by either like asuppository, which is either

(08:04):
vaginally or rectally, or ifyou're using it intranasally.
So steroids, light therapy,immunosuppression, those are all
considered to be systemictherapies and so, based off of
the rating schedule, if you havesystemic therapy, that might
fall into a different criteriafor your disability rating

(08:27):
percentage.
And then they look at topicaltherapy being any type of
treatment that is administeredthrough the skin and it's
specifically meaning liketopical cream, or sometimes even
testosterone is topical whereyou put it on the skin.
So they consider I mean, whenwe look at testosterone

(08:47):
specifically, if you put it onthe skin, that's topical.
But testosterone also isavailable in injection and that
injection is systemic therapyand a lot of medications can be
given both ways and, dependingon what treatment you're
choosing for your skin condition, it may affect what you receive
on your disability rating.

(09:09):
The last thing I think isimportant to understand is how
pyramiding is viewed for skinconditions.
So if you have multiple skinconditions affecting one area,
then you get the higher of theratings.
So, for example, if you have aburn scar affecting the chest

(09:33):
and the back but you also have askin fungus that affects the
chest and the back, they're onlygoing to give you one rating
and it's going to be the higherof whatever condition.
Now let's say you have acne onyour face, you have a skin
fungus on your chest and yourback and you also have scarring

(09:55):
on your left leg.
You can receive separateratings because it's affecting
different areas of the skin.
You guys follow me on that one,yeah.
So that can be kind ofconfusing because you know when
we start to really look at whatthese skin conditions are
affecting, sometimes the mathcan be difficult to calculate.

(10:20):
You know how much of the skincondition is covering certain
parts of the body and we'll talkabout that as we go through the
DBQ.
So now that we kind ofunderstand those basic things
that apply, those basicdefinitions that apply to the
rating schedule, I want to diveinto what they call the general

(10:44):
rating formula for skin.
So they have this generalrating formula that most of the
skin conditions fall under andif there's a skin condition that
isn't specifically mentioned inthe rating schedule, then it
falls into this category.

(11:04):
So they have, like, specificdiagnoses that have specific
ratings, and one example is acne.
Acne has its own rating andthen chloracne has its own
rating.
But other conditions that maynot fall into the rating
schedule as it's defined will belumped into the general rating

(11:28):
formula for the skin.
So dermatitis or eczema fallsunder the general rating formula
for the skin.
Dermatitis and eczema are oneof those that I was going to
briefly talk about today as wego through the DBQ.
That's diagnostic code 7806.

(11:52):
And then dermatophytosis, orthose are your fungal infections
.
So if you have atinia corporis,atinia cruis, there's your nail
fungus, your athlete's foot,there's tinia versicolor.
Those are all fungal infectionsand they fall under the general

(12:16):
rating formula for the skin.
So if you're listening and youmay not have dermatitis, maybe
you don't have a skin fungus,but you have any of the skin
conditions that I'm about totalk about.
I'm going to list all of themthat fall underneath that

(12:39):
general rating formula.
You'll want to listen to seehow it's rated.
So the other conditions thatare rated under the general
rating formula is lupus,erythematosis and Ebola, skin
disorders or skin disorders thatblister, psoriasis, infections

(12:59):
of the skin, including bacterialinfections, viral infections,
skin conditions that areassociated with the collagen or
vascular, like scleroderma, anytype of disorders that create
skin plaques, and any diseasesinvolving how the skin sheds.

(13:21):
There are some disorders thatthe body doesn't like to shed
the skin, and so the skin willactually flake up or start to
build up, and that is alsocovered under the general rating
formula.
So it's pretty broad.
There's a lot there.
There's several diagnosticcodes that are covered, and so

(13:42):
it's important to kind ofunderstand how these are looked
at.
Any questions so far.

Ray Cobb (13:51):
These skin conditions that you've named.
I've heard of several folksthat have something like that.
That wasn't even in themilitary.
Are these basically fromexposure of some type of a
chemical that caused this, orhow do you define that and
identify it?

Bethanie Spangenberg (14:11):
So that's actually a great question.
So I'm going to kind of breakdown a few of the diagnoses that
I talked about.
So if we look at dermatitis andeczema, those can be secondary
to like a knee brace or anorthotic.
If you wear like even some theycall them AFOs from.

(14:31):
We had somebody call inpreviously saying they wore AFOs
to help with their foot drop.
If that causes some skinirritation around the lower leg,
that's a dermatitis.
That may be service-connected.
The eczema Eczema can developfrom other autoimmune disorders

(15:06):
the tinea or the fungus that wetalked about.
I've seen a lot of those comeback from our more recent
veterans where they're out inthe desert and they're wearing
all their equipment and they'veactually they may have never
brought it to anybody'sattention.
I remember doing a DPQ for aveteran that had just gotten out
.
I think it was actually a yearafter he'd gotten out and he was
talking to me and I looked atthe bridge of his nose and he

(15:27):
had this flaky skin across thebridge of his nose and I asked
him about it.
I said, well, you know how longhas that been there?
What is that?
He goes.
You know, I don't know.
I get a couple patches on myface and then he goes.
It's actually all over my back,he goes.
It started when I was deployedand so I looked at his back and
I'm like, oh, I said that iswhat we call tinea versicolor.

(15:50):
So it's a type of fungus thatmakes little patches of the skin
, kind of crust around like theedges, but the inside is a
little bit pale, a little bitwider.
We call it tinea versicolor.
The inside is a little bit pale, a little bit wider.
We call it tinea versicolor.
And here it was, from all thesweat and all the moisture and
wearing his body armor and hisface mask while he was in the

(16:12):
desert.
He's like, yeah, I had no idea,they didn't tell me anything
and he wasn't there forconditioned DBQ, he was there
for something completelydifferent.
And I was like, yeah, you needto go have your primary care
doctor, either give you anantifungal for it or see a
dermatologist if they don't giveyou an antifungal, but you

(16:34):
should also apply for a serviceconnection because that's
consistent, your timeline isconsistent and that's a known
trigger for developing that typeof fungus.
So that's one example.
We get a lot of foot fungus.

(16:54):
We get a lot of the nail funguswithin the nails.
The foot fungus I'm talkingabout is from having wet feet
and in your boots, so we got alot of those.
And then the nail fungus, wherethe nail actually gets really
thick and it turns yellow andit's really hard.
That's a foot fungus or afungus within the nail, in the

(17:17):
nail bed.
A lot of times in order totreat that, you actually have to
remove the entire nail and takean oral medication to get the
nail to return to its normalappearance.
And we see those with vasculardiseases if there's not good
circulation in the toes, whetherit's from peripheral arterial

(17:41):
disease, whether it's fromvascular disease, which we've
talked about in the past, and iteven could be from diabetes.

Ray Cobb (17:52):
Question.
With that.
You just explained somethingthat happened to me three years
ago.
I go in.
The toenail is exactly what yousaid.
It was thick, it was a darkyellow and my podiatrist removed
it and then started me on a Iguess it was an antibiotic and

(18:16):
it returned to normal.
Now how does that fit into aclaim?
I mean, if it's something thatcan be rectified, I guess is
what term I would want to use.
Then it's improved or gone away, correct?

Bethanie Spangenberg (18:36):
Yes, so it would just depend, like if you
filed for it while it was active, then you would get some type
of compensation during thatperiod.
It was active because you werebeing orally treated with
medication.

Ray Cobb (19:01):
Now, once you're not on an intermittent medication or
need the oral medication, thenyou drop to a zero.

Bethanie Spangenberg (19:03):
So if it reoccurs which with diabetes,
you're going to most likely haveit recur again.
If you don't stay on top of themedication, or if it starts to
recur, your doctor may put youback on that medication.
Once you're on that systemicmedication, then you become
compensable depending on theduration then you become

(19:26):
compensable depending on theduration.

J Basser (19:28):
Keep an eye on that nail next to your cuticle and
your toe Ray, and if you feelit's got a ridge or raises up
like a bunch or whatever of thenail, then that means it's not
fully healed.
It's not fully healed.

Bethanie Spangenberg (19:40):
Yeah, okay , any other questions?

Ray Cobb (19:46):
No, you just told me something I got that I didn't
know I had.

Ad (19:52):
So, let's actually dive into it.

Bethanie Spangenberg (19:56):
It really does.
You know, I actually I do.
I do a lot of medical readingand medical research, with me
being in the medical field andthen doing the medical opinions,
but then I also have type 1diabetes.
I'm constantly trying to learnand understand this disease and

(20:17):
I'm trying to prevent thetypical comorbidities so that I
can be present for my children.
That's probably what I live foris to be present for my kids,
and so I'm constantly listeningabout how to prevent the
complications.

Ad (20:35):
And.

Bethanie Spangenberg (20:35):
I heard something this past week about
diabetes, and when you look atwhat they call the mitochondria,
the mitochondria is the energy,the workhorse of our cells and
how our bodies function, and soif you don't have healthy
mitochondria, your body's nothealthy.
And so they looked at themitochondria of individuals with

(21:01):
diabetes and individuals withcancer and they could not tell a
difference.
That is how bad diabetesaffects the body and the energy
system of the body is that itcould not tell the difference
between somebody who had cancerand somebody who had diabetes.
So I thought that was prettyshocking.

Ray Cobb (21:24):
Yeah, yeah so.

Bethanie Spangenberg (21:29):
So if we look into the general rating
formula for this again, this iswhat I've been preaching about
since we started and we're goingto break down the actual
ratings.
And we talked a little bit withray, with your condition, we
talked a little bit about it, solet's look at it specifically.
So if you're only using atopical therapy for the last 12

(21:50):
months and there is onecharacteristic that we mentioned
, one of the eightcharacteristics involving less
than five percent of the wholebody, you get a zero percent.
So let's say, for that footfungus, let's say your provider
didn't know what it was, or theywanted to try to use a topical

(22:10):
treatment first, and it's lessthan 5% of the whole body and it
only has the thickening of thenail, so the texture of the nail
is abnormal.
So you would qualify for a 0%.
If there is characteristiclesions involving less than 5%

(22:31):
of the exposed body.
So in the face, neck or hands,you get 0%.
Okay, so less than 5% affectingyour body or the exposed area,
you get a 0%.
So, moving into the 10%categories, if there is

(22:51):
characteristic the skin, ifthere's one of the eight
characteristics I'm going to saycharacteristics a thousand
times.
I need a different word.
If the skin condition has oneof the characteristics and it's
anywhere from 5% to 20% of thewhole body, so it's covering,

(23:16):
you know, 5% of your left legand it's less than 20%, it's 5%
up to 20%, that's 10%compensation.
So if there's a characteristiclesion from 5% up to 20% of the
exposed body, that's 10%.

(23:36):
So if you look at the face, theneck and the hands and there is
are you guys following me whenI'm talking about the?
There's a lot of percent,there's a lot of characteristics
.
So if they, have any yes, it is,and it's hard to try to

(24:00):
reiterate and be understood.
So they're trying to find awindow of how much coverage of
your body there is of this skincondition, so, and they're
looking at the whole body andthen they're also looking at the
exposed body and then they'realso looking at the type of
treatment.
So each percentage kind ofbreaks that down.

(24:20):
So if there's intermittentsystemic therapy for less than
six weeks per year, that wouldbe 10%.
And that may be something whereyou're on the oral antifungal
medication for your toenails.
If that's an intermittent oralmedication for less than six
weeks, that's going to buy you a10% rating.

(24:43):
Okay, in the same pattern,looking at the percentages of
coverage 20 to 40% of the wholebody is 30%.
Disability rating 20 to 40% ofthe exposed body is 30%.

(25:06):
If you're on systemic therapyfor more than six weeks but it's
not constant over the last 12months, then that's 30%.
And then the top tier is if theskin condition is more than 40%
of the whole body, that's a 60%compensation.

(25:26):
More than 40% of the face, neckand hand, that's 60 percent
compensation.
And if you are on constant ornear constant systemic therapy
over the last year, that is a 60percent compensation and I have
seen some of those conditionsfor dermatitis or for eczema

(25:48):
where they have to be on aregular immunosuppression to
kind of tame that condition.
So that's a lot.
That's a lot of numbers to kindof spit out and try to explain

(26:16):
for your dermatitis, eczema,your fungal infections and then
anything that doesn't fall inthe rating schedule specifically
.
Any questions about that?

J Basser (26:25):
What is like, for example?
Right, we're talking aboutdiabetes and you know where does
it come into play, say, ifyou've got vascular disease or
venous insufficiency.
One of the characteristics ofit is trophic changes in the
skin, and it's where your skingets real shiny, real dry and

(26:47):
the hair just disappears.
Does that cover that, or isthat part of a separate process?

Bethanie Spangenberg (26:53):
So that does cover the characteristics
portion that we talked about andit may qualify for the
dermatitis under the generalrating schedule they would have
to consider.
Are they looking at the skinchanges as a part of a nerve
disease or are they looking atit as part of the diabetes,

(27:17):
because you can have where theneuropathy gets so severe that
the skin becomes shiny and theskin loses its hair, and so they
.
I think, in my opinion, they'dhave to look to see which would
give you the higher rating.

J Basser (27:36):
Yeah, basically I think it's diabetic small fiber
neuropathy and it's part of theautonomic process.

Bethanie Spangenberg (27:43):
Yes, that would be interesting because I
think you'd almost, because youwould technically get like what?
30% for a left leg neuropathy,a severe neuropathy with the
autonomic changes or the skinchanges.

(28:05):
But I don't think you're legwould consume 40% of the whole
body.
So I think you're still betteroff going the neuropathy route.
Or you may look at it and say,well, they're saying I have a

(28:30):
mild neuropathy.
Or you may look at it and saywell they're saying I have a
mild neuropathy but the skinchanges cover more than 40% of
my body, and so you may want toargue that it's a skin condition
and you could probably get ahigher rating with the skin
condition.

J Basser (28:47):
It's not just legs, it's all the way from the wrist
to the elbows too.

Bethanie Spangenberg (28:53):
Yeah, that's a great question.
I've never, you know, I don'tthink I've ever seen it it filed
either way.
I don't think I've everactually seen specific um like
an application or a dbq requestor exam request that
specifically talks about theskin changes associated with

(29:14):
diabetes.
Now I've seen, you know, a lotof funguses come, requests come
through from diabetics Even,like if you're diabetic and you
have your skin fold where yourbelly sits on your legs and that
creates a great place forfungal infections.

(29:36):
I've seen veterans apply forthose fungal infections and be
compensated for that.

J Basser (29:44):
I hope those nipples will take care of that belly
when he's down.

Ray Cobb (29:52):
It's working on mine pretty good.

J Basser (29:55):
Oh gosh, I mean, there's so many things, there's
so many things.
With diabetes it's unsanitable,especially with that kind of
stuff going on.
That makes it hard.

Ray Cobb (30:09):
Well, and what also is .
I mean, for example, I'm 60% inboth legs for diabetic
neuropathy and then I've got afoot drop in both feet wearing
an AFO, so I have two Ls andthen those two 60 percenters.

(30:29):
It would not benefit mewhatsoever to turn a claim in
then for the skin disease if thetop is a 40 percenter, correct.

J Basser (30:47):
The top for skin is 60 .
Yeah.

Bethanie Spangenberg (30:50):
You're our team.

J Basser (30:55):
Until they invent an R3.
No.

Ray Cobb (30:57):
That's how they go right.

J Basser (31:03):
I mean, you don't want to overthink it.

Ray Cobb (31:05):
as far as you can go Until like that nurse
practitioner told Pam and I acouple of months ago now you got
one foot in the grave and theother's on a banana peeling, and
hold on when that bananapeeling slips.
That's when I can go to R3, huh, oh gosh.

Bethanie Spangenberg (31:28):
So now that I've explained, or I've
tried to explain, how thatrating schedule works, that
really guides how the DBQ looks.
So I've got eight pages of DBQin front of me.
The first page starts out sameas every DBQ they're asking for
the veteran's information andwhat role the medical examiner

(31:48):
plays to that veteran and whatrole the medical examiner plays
to that veteran.
And then the second section onthe first page talks about
evidence what evidence wasreviewed.
I always like to take a minuteto talk about what evidence
should be provided.
Evidence specifically for thisis you want to show what

(32:10):
medications have been used inthe last year for treatment of
your claimed condition.
So if you have a fungalcondition and I really lean on
fungal conditions because it'sprobably one of the most common
that I've seen as secondary toother things so the skin, the
fungal condition, whatevertreatment that you're getting

(32:32):
for that, you want to show thatin your medical records.
You want to make sure that thathas been outlined, whether it's
a prescription history from thepharmacy, whether it's your
treatment records directly.
You definitely want to havethat in the file.

(32:55):
You also want to talk about.

J Basser (32:56):
You also want to talk about.

Bethanie Spangenberg (33:01):
Want to try that again.

J Basser (33:05):
Focor Menazal Beta Metastone Cream.

Bethanie Spangenberg (33:22):
Oh shoot to say that word.
You also want to submit your ownpictures because who knows when
you're going to get called forthis DBQ and you might be having
a great day.
The day you show up to your DBQand your skin condition is
perfectly controlled, it is whenyou have those flare-ups and

(33:44):
when those flare-ups are at itsworst you need, you must take
pictures to document, date thosepictures, submit those pictures
.
I have used those picturesduring a DBQ because and I put
like free text sticks there'sactually not a spot to really
talk about that in thequestionnaire, but I say you

(34:06):
know the veterans submittedpictures from this date
demonstrating lesions or areasof the skin and like describe
the skin and how much of it iscut, like percentage of the body
is covered.
Because those pictures tell astory and you want to make sure
that the VA has that informationand even you can even bring

(34:29):
them with you to your GBQ, tothat exam, so that way that's
part of your story and you cantell the examiner.
You know, look, I've alreadysubmitted these pictures.
I just wanted to bring them toyou because you know, of course
today I would be having a, anokay day, but I want you to see
what this condition does on aregular basis.
So that's part of the evidencethat I think that you should

(34:51):
have in there.
Page two it talks about thediagnosis and the very first
question.
I always emphasize howimportant it is to have a
current diagnosis.
The first question is does aveteran have a current skin
condition?
And you can say the medicalexaminer can say yes or they can

(35:12):
say no, so you want to makesure that that diagnosis is in
your file.
What's also interesting issometimes you know, I'm not a
dermatologist, dermatology isnot my area of expertise.
Sometimes, when a skincondition presents to the
primary care clinic, sometimes Ican look at and say, well, I

(35:35):
think this is what it might be,so we're going to try this.
And then I'm going to refer youto the dermatologist.
Well, a lot of these generalexaminers that they're sending
the veterans to it's the samething.
That's not our area expertise.
So we can look at the veteranand say I don't know what that
is and I have no way of knowing.

(35:56):
You need to go to thedermatologist.
Now, sometimes when you go tothe dermatologist, they have to
get a biopsy of that skincondition to really understand
what is going on.
I've had patients where theythought it was psoriasis and
they go to the dermatologist.
They get a biopsy done and it'ssome other crazy skin condition

(36:18):
and it's not psoriasis.
You talk about it with yourprimary care doctor.
But if they're not sure youknow, ask to see the dermat path
and the effectiveness oftreatment, because if I put

(36:59):
hydrocortisone cream on a fungalinfection it will never go away
.
I have to put an antifungalcream on a fungus infection to
make it go away, so that'simportant.

(37:22):
In the diagnosis section wetalked briefly about the
dermatitis, the eczema and thefungal infections, which are
covered under the general ratingformula.
The other two conditions Iwanted to touch base on, because
they are so common, are acneand chloracne, and those are
outlined in the diagnosissection on page two.
Further down in page two is themedical history.
The medical examiner is just totell your story in that area.

(37:44):
One of the questions in therespecifically asks about any
resolved skin condition.
Did the veteran previously havea skin condition that is now
completely resolved and nolonger requires treatment of any
type?
And we could say this aboutRay's toenails Ray, you had your
toenails removed.
You no longer have the nailinfection.

(38:05):
We can say that it is currentlyresolved.
It is completely resolved andno longer requires treatment of
any type.
But you have a history of it,you have pictures of it, you
wrote it in your statement andwe're going to document that for
possible compensation and thatfungal infection is likely to

(38:25):
recur again because you'rediabetic.
So you want to make sure that'salso, you know, discussed.
If we look at page three, all ofpage three and most of page
four is asking specifically thetype of treatment, the route of
treatment and the duration oftreatment, because we talked

(38:49):
about how the rating schedulebases all of that stuff to give
you disability percentage.
The provider goes down eachcategory of treatment and
addresses each question relatedto the rating schedule.
If we go to page four, at thebottom of page four, that's

(39:09):
where the medical examiner doestheir exam and this is where the
provider has to do aninspection and document the
condition and indicate whatpercentage, approximately how
much of the body or the exposedarea, has been affected by the

(39:30):
skin condition.
Now I want to take a minute tooto also talk about the physical
exam, because, let's say,you're a veteran and you're
service connected for genitalherpes and you're trying to get
a disability percentage becauseyou're on daily antiviral

(39:51):
medication for control of yourgenital herpes condition and you
have a DBQ coming up.
You have a comp and pen comingup and you're getting really
anxious about going.
You can go and you can declinethe physical exam Because, based
off your history, you'realready demonstrating that

(40:13):
you're on antiviral medicationevery day.
They already have enough to rateyou based off your medical
history.
That medical exam is not evergoing to be 40% or more of the
whole body, ever going to be 40%or more of the whole body.
That medical condition willnever be 40% of the exposed body

(40:36):
.
But you show up.
So then that way they don'tdeny you because you failed to
report, but you show up and youdecline the exam if you're not
comfortable because the evidenceis in the file.
I've had cases like that and Iwant the veteran to know that if

(40:57):
you decline the exam, thatmedical examiner should
professionally accept youranswer, document the answer and
move on.
Understood answer and move on.

Ray Cobb (41:13):
Understood, yeah, so that puts it back on him.
Now, does that go back?
Does the medical examiner thenlook at?

Bethanie Spangenberg (41:24):
your medical records, or does that go
back to the adjudicator?
The medical examiner shouldalways look at the records
because they have to report ordocument the history and
treatment, but that's somethingthat the rater should also be
looking at as well.
You still want to show up, butyou don't have to participate as
far as showing an area thatyou're not comfortable with,

(41:49):
especially when the evidence isalready in the file, to give you
a rating.

J Basser (41:54):
Right.
They should understand thatalready and not even put you in
that situation.

Bethanie Spangenberg (42:02):
You would be surprised.

Ad (42:05):
When.

Bethanie Spangenberg (42:05):
I was in there as a C&P examiner.
They required us to do forerectile dysfunction for a
period of time.
They required us to doexaminations and I'm like why
there's there's truly no examfor erectile dysfunction?
Why am I doing this exam?
This is completelyunprofessional.

(42:25):
Why might it?
well, you have to, well, youhave to, and they got so much
pushback on it that they decidedthey created a box in the DBQ
where it says individualdeclined or examination not
pertinent to the condition.
So they changed it because ofall that pushback that they got.

J Basser (42:46):
Well, it's not history , it's a little part one.

Bethanie Spangenberg (42:53):
And that's similar to this.
Now, let's say somebody does Imean herpes anywhere, even on
the face or any other body part.
The timing has to beappropriate to even appreciate a
sore associated with thatcondition.
A sore associated with thatcondition.
So just because they schedule aDBQ, you know, let's say, I

(43:16):
show up tomorrow for a DBQ, I'mnot going to have a cold sore on
my mouth tomorrow, so you haveto take I mean, for that
instance, you take a picture todemonstrate, if you're not on
regular medication, but most ofthe time, what I find, both
clinically and when it comes toVA disability, that if a veteran

(43:37):
does have any type of stressorat home, then they elect to use
antiviral medication on aregular basis to prevent any
type of viral outbreak, preventany type of viral outbreak.

J Basser (43:53):
So part of One of the major players is, I'm sorry, ray
.

Bethanie Spangenberg (43:58):
No, go ahead, I was going to move on.

J Basser (44:00):
We've got a lot of vest-taking guardians and we
have a lot of veterans gettingsome fungal infections down
south and one of our buddies hadabout killed him and they
slayed him like a fish becauseof that.
I guess it's a what was thatcondition called Ray?
Was that foreigners gangrene,what it was?

Ray Cobb (44:20):
Right, right.
And I mean they actuallyclaimed and told him that if
they waited 10 more minutesbefore they did the surgery,
that they wouldn't have beenable to save him.
It was that close, yeah.

J Basser (44:37):
So that and you younger guys out there, if you
ever go and your wife talks youinto going to see the doc and
getting a skip treatment for avasectomy, make sure that you
walk out of there with aprescription for some type of
medication, because that'sanother issue that brings on
those infections.
You know that.

Bethanie Spangenberg (44:58):
Yes, any type of stress, whether it's
physical, emotional, I mean evenunperceived stress.
If you change your diet, if yougo from a regular diet to a
keto diet, that's still stresson the body and people can get
outbreaks or viral infectionsfrom that.
So part of the physical exam,at the very last section it says

(45:23):
does the veteran have a skincondition currently without any
visible characteristic lesions?
At the time of the exam andthey can mark that they do have
a skin condition without anyvisible characteristic lesions
and that would put you at a zeroif you don't take medications.

(45:43):
So you want to make sure againthat you're providing your own
picture.
So I just want to reemphasizethat Section five is for
specific skin conditions.
I had talked about the ratingschedule defining specific
ratings for certain skinconditions such as acne and

(46:04):
chloracne, and the rest of page5, all of page 6, and even into
page 7, is specific questionsabout each specific kind of
condition.
So if we run through the firstexample, we're looking at acne
and the medical examiner issupposed to document if the acne

(46:26):
is superficial and if it'ssuperficial, that's a 0%
disability rating.
If the acne is deep acne but itaffects less than 40% of the
face and neck, that is 10%.
If it affects 40% or more ofthe face and neck, that's 30%.

(46:49):
And if it affects body areasother than the face and neck,
that's 10%.
So if you have acne on the back, that is going to be a 10%
disability rating.
If you have acne on the back.

J Basser (47:01):
that is going to be a 10% disability rating If you
have an acne cyst moved inservice.

Bethanie Spangenberg (47:06):
You have it cut out, then that would be
service-connectable.

J Basser (47:11):
Say that again If you had an acne cyst cut out in
service, then that would beservice-connectable if they
operated on you in the service.
What kind of cyst.
It was acne.
Basically, it was on the temple.

Bethanie Spangenberg (47:25):
They cut it out.
So that would be.
It'd be more probablycompensable for a facial scar,
mm-hmm.
So Wow.
Now when we look at chloracne,we know that.
So we understand acne becausetypically we see it when we're
in our younger years.

(47:46):
We've seen acne flare up withhelmets or face straps or other
skin irritation.
Chloracne is a little bitdifferent.
So chloracne is a little bitdifferent, predominantly in its
appearance.
When we look at chloracne, whatis predominant is the
blackheads, or the comedones iswhat we call them.

(48:08):
So it looks a little bitdifferent in appearance and it's
specifically related to dioxinexposures and that's how we've
connected it to Agent Orange andother dioxins.
Is that predominance of thechloracne?
Those two go hand in hand.
When we look at the rating,it's actually very similar to

(48:30):
acne.
If the chloracne is superficial, it's 0%.
If it affects less than 40% ofthe face, it's 10%.
If it affects 40% or more ofthe face and neck, it's 30%.
Now what changes is?
If there is core acne in theskin folds, such as the armpit,

(48:54):
the groin under the breasts orbetween the fingers, that is a
20% disability rating, and ifit's anywhere else on the body,
it's a 10% rating.
So, continuing through five andsix.
Again, it's specific to thedifferent skin conditions, even

(49:15):
the top of seven.
The next section, which is inevery DBQ, is the tumors and
neoplasms.
I'm not going to run throughthose.
It talks about specificallyskin cancers.
The one thing I do want tomention is that the PACT Act
made melanoma presumptive.
So I think that's important,that if you're a veteran and you

(49:37):
have the burn pit exposure andyou qualify for that PAC-DEC
presumption definitely need tokeep that in mind.
And then page eight, the lastpage, is scarring and
disfigurement, which we talkedabout last month.
It's just a reminder to thatmedical examiner that hey, if
any of these skin conditionsfall into the scar and

(49:58):
disfigurement category, you alsoneed to complete that DBQ to
appropriately give the veteranthat rating.
A section for other pertinentphysical findings, a section for
functional impact and then anopen section for remarks and
that gets you through the DBQ.
Then an open section forremarks and that gets you

(50:19):
through the DBQ.
Now, depending on how many skinconditions a veteran has, a
face-to-face examination isneeded for the skin condition
DBQ and the time that theveteran is actually in the

(50:40):
office can range from 20 to 40minutes to complete this DBQ.

J Basser (50:43):
And that's the skin, dbq.
Okay, now step back and take adeep breath and breathe a little
bit.
There you go.

Bethanie Spangenberg (50:52):
You've got to get ahead of yourself.
That's a lot of information andI knew it was going to be tight
because it's 7.51.

J Basser (50:59):
You got it, didn't you ?
You smoked it, girl.
You got it, didn't you?
You smoked it, girl, you got it.

Bethanie Spangenberg (51:05):
Lots of info but, I think even just the
conversations about talkingabout what you guys have seen
and experienced.
I think that's very valuable.
And then, ray, you've got thechloracne, correct?

Ray Cobb (51:21):
No, you've got the chloracne, correct?

J Basser (51:23):
No.

Bethanie Spangenberg (51:23):
No, I do not have it.

J Basser (51:24):
No, so is that James?
James has it.
James has it.

Ray Cobb (51:26):
Yes.
So he would have been theperfect person to have.

J Basser (51:32):
Yeah, very, very.
I mean he's heavy exposed.
He's probably one of theheaviest people that has ever
been exposed to it, because heactually sprayed it, didn't know
what it was.

Ray Cobb (51:44):
I love his story that he tells.
Well, he used to be Fort Gordon.
He would go back into a little.
He was a game warden.
He'd go back into the gamewarden's hut, his little office,
and if anybody's ever been insouthern Georgia you know that
mosquitoes are very bad there inthe summer and especially.

(52:07):
And he had his little hand pumpbug sprayer and he'd sit there.
The mosquito would come by andhe'd spray it and watch it fall
down.
Little did he know what he wasdoing was spraying it on himself
as well.

J Basser (52:23):
Wow.

Ray Cobb (52:25):
He said they'd fall down like a dive bomber, you
know.

J Basser (52:36):
Skin conditions.
There's so many conditions ofskin and the body that it's kind
of unbelievable what happens toa vet, especially in service.
You don't have to be combatrelated.
It could be anything.
The military is like a big massindustrial complex.

Ray Cobb (52:55):
People do get hurt and injured and exposed and
everything I guess I thinkBethany made an excellent point
tonight that we need to educateourselves.
For example, you know I'm up toan R2, and even though my toe
was treated, the nail has beenremoved at least twice, maybe

(53:18):
three times, cream's been put onit.
I've taken an oral pill for it,but little did I know that that
might have been a claim yearsago that I could have used.
I haven't had a problem in thelast five years but prior to
that.
You know I hate to say this,but the VA doctors are not going

(53:43):
to tell you that this is acondition that you can file a
claim on.
I have never had a doctor totell me that of any of my
conditions, it's either anotherveteran's told me I've listened
to a show like this or you knowthat's the way that I read
something, heard something.

(54:03):
So you know, guys and gals outthere, you know you've got to.
It's your responsibility tolook at what your conditions and
what your medical situationsare and determines whether or
not you may have a claim for it.
If you do, then proceed with it.
I think your education iseconomic to me.

J Basser (54:26):
I was with Michael Palmer at the headbark back in
2020, when COVID was going on.
They checked my feet out and Isaid to a young lady I had a.
My right big toe was bad.
I had a bad fungal infection.
She checked me out.
She said you're pretty good.
I need to go see podiatry.
She said podiatry won't see you.

(54:47):
They're not servicing for yourfeet.
I said, okay, I come home, madea phone call Over here across
town.
I went into the Lexingtonpodiatry and modeling center.
All the doctors looked likenumber 10 models.
I went back and sat down andshe said that's got to come off.

(55:08):
She took it off and then theydid laser treatments on it.
You ever seen that Lasertherapy on it?
After all the soaking and that,yeah, after soaking and that's
the salt and all that crap andthings like that, it grew back
after almost what.
Eight, nine months Went back tocheck it out again.
She said, oh, it's got to comeoff again.

(55:29):
The thing's been off threetimes.

Bethanie Spangenberg (55:33):
Wow.
Another thing I'd like tomention, since we're on the
topic, is even especially withbeing diabetic, like anything
that involves your feet, youneed to heavily document and be
mindful of, because even thosetoenail removals, if you get an
infection from that toenailremoval, you can lose your toe,

(56:00):
lose your toe.
So you just have to be, bothmedically and even on the claim
side, just be mindful, checkyour feet every day and ask
questions when you go to thedoctor, like is this somehow
related to my diabetes?
And from a primary carestandpoint.
We are programmed to consider,you know, to look at the
differences in our feet, butmost because of the time crunch,

(56:24):
most examiners, primary careproviders, don't look at their
feet of their patients.

Ray Cobb (56:34):
You're right, they don't so right, they don't.

J Basser (56:43):
No, you know at that point you're a person you know.
Back in early days, right, vadoctors had somebody with them
and they would go in and theywould dictate what they were
going to do and they wouldexamine you.
Now you're going to sit infront of the computer just
typing away, you know, and theymight take 30 seconds and look
at you.

Ray Cobb (57:01):
Yeah, or don't even look at you, you just talk and
they write it all down, yeah.

J Basser (57:06):
Yeah.

Ray Cobb (57:08):
You know Bethany pointed out another thing about
the AFOs that will also qualifyyou for caregiver one.
What's that?
I went to the AFOs.
Well, I had AFOs.
If you don't get those thingson correctly, they cause
blisters and I ended up havingto have the skin graft, and so
that's what got me the R1 underthe caregiver one, because the

(57:33):
caregiver one program is aboutif you have to have braces,
assistive putting them on andadjusting.
That is one of the criteriathat qualifies you for level one
.
So you know, keep that in mind.
And once again, we're talkingabout the diabetes of the feet.

J Basser (57:56):
If you do that, you're going to breakfast at IHOP,
right?
What's your closest IHOP at?

Bethanie Spangenberg (58:00):
Oh gosh, If you do that, you're going to
breakfast at IHOP, right?
What's your closest IHOP?

Ray Cobb (58:05):
at Gosh.
I've been to a few IHOPs, yeah.

J Basser (58:16):
All right, folks.
We've got a minute and a halfleft.
Betsy, why don't you go aheadand give the information about
Valor for Vet and the phonenumber to contact information,
if you would?

Bethanie Spangenberg (58:28):
Our website is wwwvalor4vetcom.
Our phone number is888-448-1011.
Give us a call.
We have veterans waiting totalk with you about any
questions you may have about ourservices.

J Basser (58:50):
Good job, guys, good job.

Bethanie Spangenberg (58:54):
Thank you for having me.
I appreciate you allowing me tospeak about all this medical
nonsense.

J Basser (59:02):
It's not nonsense.

Ad (59:03):
I mean I'm sorry to say.

J Basser (59:06):
No, no, it's actually a comparative of people learn it
.
What's wrong with you?
So no, as a matter of fact,you're a good start to Taylor
Chase.
This is the last time I saw allof you.
How many hundred DBQs.
Anyhow, y'all, I'm going to goput a plug on it To the next

(59:27):
week, guys, we'll have anotherguest on, we'll do another show.
Well, thanks, bethany, forcoming on and giving us some
good information.
Thanks, ray, for coming in whilehe's on his vacation and we'll
be signing off.
For now.
You have been listening to theExposed Vet Podcast.
Any opinions expressed on theshow are the opinions of the
guest speakers and notnecessarily the opinions of

(59:48):
Exposed Vet, exposedvetcom orBlog Talk Radio.
Tune in next week for anotherepisode of the Exposed Vet
Podcast.
Thanks for listening.
Hey guys, we'll all be here.

Ray Cobb (01:00:03):
Okay, All right, that's good, Anthony.
I told a gentleman fromChattanooga to reach out to you.
I don't know if he has yet.
I told him to refer my name toyou.
He needs a little bit of workand some verification.
But I also told him that beforehe did anything he needed to

(01:00:23):
try to find his medical recordsfrom being in the service.
But if a gentleman fromChattanooga, Tennessee, reaches
out and gives you my name, thenhe's legit.
I did talk with him.

Bethanie Spangenberg (01:00:37):
Do you have a name?

Ray Cobb (01:00:39):
I don't with me now.
I do at home.
I have it written down at homebut I'll get it to you.
I'm hoping he's taking the timenow because his right hand is a
10% disability.
He was in the Navy in asbestosexposure but he hasn't gotten
anyone to say that, so hedoesn't have anyone to say that

(01:01:03):
so he doesn't have the diagnosisfor it yet.
Oh, he's going to have to.
Is that the guy I talked to,though?

J Basser (01:01:11):
I'm not for sure.
I told him he needed to get ahigh-resolution CAT scan, HRCT.
Yeah, yeah, yeah.
That was probably him, becauseI told him the same thing.
Everything else would be abiopsy.

Ray Cobb (01:01:28):
Well yeah, or a watch, yeah.

J Basser (01:01:35):
And without that he hadn't got a chance to win an
acclaim.
Well, he had to wait for it.
He had a lot of problems withit.
He had a lot of problems withit you know Right, this is like.

Ray Cobb (01:01:43):
He's trying to say he was exposed while in the Navy.

Ad (01:01:47):
But as I questioned him, I had a little bit.

Ray Cobb (01:01:49):
I said well, did you work?
You know, did you have to helpremove asbestos from any ship?
No, but it was all around me.
Well, okay, that's when I gotinterviewed by the Packback
people.

J Basser (01:02:04):
They're like tell me how you were exposed to asbestos
.
I said, well, I ripped it outon more ships of submarine.

Ad (01:02:11):
Okay.

J Basser (01:02:11):
Now, how were you exposed to radiation?
I said, well, I was removingasbestos on more submarines
inside the reactor compartments,yep.

Bethanie Spangenberg (01:02:18):
Hey, john, that necklace.
I tried to look it up and Icouldn't find that radiation
necklace that you were tellingme about.
Can you send me the name ofthat again?
The?

J Basser (01:02:33):
other one.

Bethanie Spangenberg (01:02:35):
Well, you were saying about the genie
bottle right.

J Basser (01:02:36):
Yeah, the genie bottle yeah.

Bethanie Spangenberg (01:02:37):
TLD.
Okay, you were saying about.

J Basser (01:02:40):
You're talking about the TLD, the genie bottle, right
, yeah, the genie bottle.
Tld, yeah, tld, yeah.
Okay, let me look it up and seewhere they're at, okay.

Ray Cobb (01:02:47):
I tried to find one.

J Basser (01:02:50):
Well, I looked and I couldn't find so Okay.

Ad (01:02:55):
Well, I know they're all in the vintage.

J Basser (01:02:58):
Okay, the vintage.
I think they're still in use.
They were the cat's meow.
Back in the 80s Everybody hadthem.
A dual crystal, I couldn't findanything.
Let me dig, I can't findsomething.

Ad (01:03:19):
Okay.

J Basser (01:03:20):
They've got to be around somewhere.

Bethanie Spangenberg (01:03:24):
See, everything I find is a device,
but he's restricted on what hecan have.
So if they have the necklacething you were talking about,
that would be cool.

J Basser (01:03:35):
All right, well, I'll look it up, we'll find it.
I'll send you some informationon it anyways.

Ad (01:03:41):
Okay.

J Basser (01:03:42):
Or you can get it, because I'm pretty sure they
still got them.
They got to have.
Matter of fact, my wife wasworking in government.
She was temporary over to thereading place.
They read them here in Kentuckyand that's all she did was plug
them in.
You know they did the readingswith both crystals and a's.
All she did was plug them intothe.
You know they did the readingswith both crystals and a couple

(01:04:03):
times she read the bottomcrystal and that's pretty
serious.
People died.
They don't advertise that stuff, do they?

Bethanie Spangenberg (01:04:09):
They don't .
And there's actually, they'redoing a lunch and learn.
There's an attorney firm here.
Well, I said locally, it'sprobably somewhere in like
Tri-State area here, locally.
Well, I said locally, it'sprobably somewhere in like
tri-state area that's doing alunch and learn on the uranium
enrichment plant here.
And so I was going to sit anddo it, because I did not realize
until about two weeks ago thatthere is specific reference to

(01:04:36):
this Portsmouth plant or Piketonplant here in Ohio in the 38
CFR.

J Basser (01:04:43):
Right.

Bethanie Spangenberg (01:04:45):
I had no idea Also.

J Basser (01:04:47):
the gaseous diffusion plant for Dukes of Kentucky is
also listed.
Oak Ridge, tennessee.
Yeah.

Bethanie Spangenberg (01:04:56):
Yeah, Oak Ridge.

J Basser (01:04:58):
Yeah, All right.
Well, I will find that for you.
I know it exists, so I mean,matter of fact, I've got an old
one in my drawer that I kept youknow.
Still, I'll find it for you.

Bethanie Spangenberg (01:05:11):
Let me know like what it looks like or
what words I need to look forSomething.

J Basser (01:05:16):
TLD.
Basically it's a TLD T as in.

Bethanie Spangenberg (01:05:21):
I don't know.

J Basser (01:05:25):
Tango Leroy David.

Bethanie Spangenberg (01:05:28):
Okay, yeah , tld.

J Basser (01:05:36):
Dosimeter, some old luminescent December.
That's the changing a littlebit.
It's not the GE bottle, but thesame thing that changed the
design a little bit.
Calcium fluoride it's got aclip on it hanging around your

(01:05:59):
neck.

Bethanie Spangenberg (01:06:08):
I'll do some digging now that I know
specifically what I'm lookingfor I'll send you the link to it
, okay okay, sounds good okay,let's see here Sounds good.

J Basser (01:06:25):
Okay, this is the newer version.
There's more.

Ray Cobb (01:06:38):
Hmm, it's a little technology, hey guys, we'll
catch up with you later.
I've got to go and win a littlemoney tonight.
I need some spending money.

J Basser (01:06:47):
Yeah, you're on vacation, don't be falling over
here, I am on vacation, don't befalling off the tunnel.
Hear me.

Ray Cobb (01:06:54):
Don't be falling off the tunnel.
My fingers soar from pushingthat button that says spin, spin
, spin.

J Basser (01:07:03):
Good luck, buddy.

Bethanie Spangenberg (01:07:05):
Have fun.

Ray Cobb (01:07:06):
We will.
We'll catch up with you guyslater.
Enjoyed it, bye.

J Basser (01:07:13):
Let me dig this thing up, beth.
I'll give you several things.
That's you guys too.
Okay, sounds good, all right,and that's you guys too.
Okay, sounds good.
All right, we'll catch youlater.
Give me a holler or shout ormessage or call or whatever.

Bethanie Spangenberg (01:07:27):
All right, sounds good.

J Basser (01:07:29):
Have fun with the kids All right, bye, yes, bye, bye.

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