by Jim Fausone

The VA often funds research that is helpful in understanding complex medical conditions.  VA and Stanford University completed a large study that shows that among younger veterans enrolled in VA health care, those with a mental health condition—especially posttraumatic stress disorder (PTSD)—tend to have more physical ailments.  The results, published online Sept. 18 in the Journal of General Internal Medicine, explain the link between emotional stress and physical illness. 

The researchers examined the records of more than 90,000 Iraq and Afghanistan Veterans who used VA outpatient care in fiscal year 2006–2007. The majority had received a diagnosis of at least one mental health condition. About 35 percent of men and 27 percent of women had PTSD. The link between PTSD and medical (non-mental) illness was stronger among women than among men. Women with PTSD had a median of 7 medical conditions, versus 4.5 for women with no mental health diagnosis. The most common physical ailments for women were lower-back problems, headaches and lower-extremity joint disorders. Men with PTSD had a median of 5 medical conditions, versus 4 for men with no mental health diagnosis. The most common complaints for men were similar to those of women—for example, back and knee problems—but also included hearing loss.

As you advance your disability claim and secondary or related claims, this research may be helpful. Read more at  http://www.research.va.gov/currents/oct10/oct10-3.cfm

by Jim Fausone

The rash of suicides this year that involve members of the military has been getting plenty of attention.  Veterans face the same suicide problem brought on by the stress of war.  Military veterans with psychiatric illnesses are at increased risk for suicide, says a new study by the University of Michigan in conjunction with US Department of Veteran Affairs.

The researchers examined the psychiatric records of more than three million veterans who received any type of care at a VA facility in 1999. Over the next seven years, 7,684 of the veterans committed suicide. Slightly half of them had at least one psychiatric diagnosis. All of the psychiatric conditions included in the study — depression, schizophrenia, bipolar disorder, substance abuse disorders, post-traumatic stress syndrome (PTSD) and other anxiety disorders — were associated with increased risk of suicide.

 To read more about the study:

http://www.businessweek.com/lifestyle/content/healthday/645083.html

by Jim Fausone

The story is not that unusual - a service member suffering from psychological problems starts to self medicate, gets kicked out of the service and loses access to VA benefits. Veterans advocates see cynical forces at play in the use of administrative discharges for reasons including misconduct, personality disorder and adjustment disorder — defined as an excessive reaction to a stressful event, with symptoms similar to PTSD. 

The Department of Defense stands to save between $5 billion and $20 billion in lifetime health care and benefits to the estimated 10,000 to 20,000 veterans with so called dubious discharges.  Department of Defense officials have denied they use improper discharges as a cost-saving measure and say discharge policies continue to evolve as they learn more about PTSD and traumatic brain injury.   If you like a conspiracy, this has all the makings needed.  Read more at:

http://www.statesman.com/news/texas-politics/bad-paper-dischares-can-stymie-veterans-health-care-950891.html?srcTrk=RTR_781143

by Jim Fausone

As many VA watchers know, VA adopted a new law “Relaxation of Evidentiary Standard for Establishing In Service Stressors in Claims for PTSD” dated July 13, 2010.                                      

We at Legal Help for Veterans, PLLC have received the first rating decision taking this law into account. The VA conceded the Vietnam Vet’s stressor exposure based on the new rule.  This Army veteran had a Vietnam Service Medal and Campaign Medal.  VA granted a 10% rating and set an effective date of July 13, 2010.  VA did not evaluate the stressors under the old law. If it had, the effective date would have been 9 months earlier.  Is this going to be the way VA handles these PTSD cases? VA concedes the stressor under the new law and does not evaluate or give an effective date back to the filing of the claim.  It seems to me this is improper when the law was changed to make VA’s life easier not to swindle vets on the effective date and retro payments.  

 Yes, we are going to appeal.  I believe the Court will remand and make VA look back to the date of filing the claim using the old law.

by Jim Fausone

We see soldiers discharged for or diagnosed with “personality disorder” all too often in our veteran disability practice. As a result, the veteran is not going to receive VA benefits.   Personality disorder is a “preexisting condition” so there will be no grant of VA disability compensation. After an article in The Nation magazine, the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause rather than a pre-existing condition. The Army had been discharging 1000 vets per year with personality disorder.  However, the annual number of personality disorder cases dropped by 75% after the new policy was implemented. Only 260 soldiers were discharged on those grounds in 2009.

At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD – twice as many as two years before. The Army is now looking at if it misdiagnosed and discharged thousands of veterans in the last few years. The article attached discusses this problem and highlights the need to challenge a VA denial of claims for personality disorder.

http://www.usatoday.com/news/health/2010-08-15-incorrect-ptsd-dismissals_N.htm

by Jim Fausone

The VA is in the process of finalizing new rules that liberalize evidentiary standards for proving stressors in claims for PTSD. The goal is to lessen the burden of proving stressors when the basis of the claim is fear of military action and terrorist’s actions.  The VA has recently issued a Frequently Ask Questions (FAQ) fact sheet. It is worth reading but it will not answer all your questions.   http://www.va.gov/PTSD_QA.pdf

Also this week in a lawsuit brought by a coalition of veterans’ service organizations, the U.S. Court of Appeals for the Federal Circuit instructed VA to issue by Sept. 1 a final regulation authorizing payment of claims for AO exposure for ischemic heart disease, Parkinson’s disease, or B-cell leukemia for any veteran who stepped foot in Vietnam during the war, or their survivors. 

VA has been urging veterans with these diseases to file claims immediately because payments, when they begin, will be retroactive to the filing date. VA lawyers did concede to the court that VA had missed several deadlines set in the Agent Orange Act for reviewing the latest science report and for publishing rules to expand claims eligibility to these diseases.

by Kristina Derro

Cooperative efforts between the VA and several local state courts have allowed for the implementation of a specialty court. These specialty courts around the state of Michigan (with many others in different states as well) give service members from World War II up through the recent Iraq and Afghanistan conflicts rehabilitation from drug addition, alcohol abuse, theft, vagrancy, and other nonviolent crimes that stem from post traumatic stress disorder (PTSD), traumatic brain injury (TBI), or other war-related symptoms.

It is up to the local court, through its judges, staff, and probation department, to adjust their dockets to allow for the program. However, the treatment itself is paid for entirely by the VA. It is a unique way of handling non-violent crimes instead of the usual jail-time or probation. It allows the veteran to be treated for the underlying conditions leading to the commission of these crimes in the first instance.

It has been reported in the New York Times, VAWatchDog.com and NBC, that VA intends to issue new rules loosening the requirements for PTSD. VA is apparently evaluating essentially eliminating the requirement that veterans document specific events like bomb blasts, firefights or mortar attacks that might have caused PTSD. We know this as proving “a service stressor”.  This is particularly difficult for certain types of stressors that are not documented or reported. For example, sexual assault on women is not reported 75% of the time.  Veteran groups assert that the current rules discriminate against tens of thousands of service members — many of them women — who did not serve in combat roles but, nevertheless, suffered traumatic experiences.  The new rules, which we have not seen, reportedly say if a veteran can simply show that they served in a war zone and in a job consistent with the events that they say caused their conditions, that is sufficient.  Sounds too good to be true. We know VA employees will need retraining not to just deny.  How will VA define a “war zone”?  How does that help military sexual trauma (MST) and assault victims? But we will keep you posted if the new rules get issued.  If you have been denied in the past because of lack of stressor, it is time to reapply for benefits.  You can read the New York Times article at the link below.

 http://www.nytimes.com/2010/07/08/us/08vets.html?_r=1&scp=2&sq=va%20ptsd&st=cse

PTSD is one of the toughest disabilities to prove to VA, we deal with veterans every day with this terrible condition. The researchers at the University of Michigan recently issued their findings, which supports a model for PTSD in which exposure to a traumatic event changes gene expression, which in turn, alters immune-system activity, leading to the disorder. So the traumatic event (stressor) causes a change in a veteran’s genes and then alters a normal immune system. Maybe this type of research, from my university, will someday be used by VA to recognize this is a real disability that affects a veteran’s body at the most basic cell level. Read about the research below.

http://michigantoday.umich.edu/2010/05/story.php?id=7739&tr=y&auid=6346997

After a decade of helping veterans, I have to say that we don’t see phonies who are trying to game the VA system. Although the critics of the VA often say there is rampant fraud, we see the legitimate vets who can’t prove service connection because of poor record keeping by the DOD. Sure in a government system as big as VA there are going to be fraudulent claims. But to suggest that PTSD is an easy claim to fraudulently make seems over the top. There is a recent AP article that will cause a new round of hardships for legitimate claimants as people clamor that more must be done to stop the fraud.

http://ap.stripes.com/dynamic/stories/U/US_THE_WAR_WITHIN_FAKE_CLAIMS?SITE=DCSAS&SECTION=HOME&TEMPLATE=DEFAULT