VA–NOD FORMS OR NOTHING

downloadVA just published their proposed changes to Part three of 38 CFR and will soon only be accepting Form 21-0958 Notice of Disagreement instead of any old piece of paper you have lying around that doesn’t have too many coffee stains on it. The good old days of using the Tickle Me Elmo stationary to voice your imminent desire for appellate review are soon going to be history.

Here’s the article link to the Federal Register discussion. What’s next? Our way or the highway?

VA retiring Tickle me Elmo Form

VA retiring Tickle me Elmo Form

Posted in Uncategorized | Tagged , , , , , , , , | 6 Comments

VA TO CONGRESS– IT WILL JUST CONFUSE VETS

download (2)When you go to any government entity and request their services (which, incidentally, you pay for), are you ever taken aback at the ennui and lack of desire to be helpful? I certainly don’t write this to imply anything about anyone but I am constantly stupefied at the litany of excuses trotted out in response to a genuine “How come you don’t do it this way?” The amount of research time and dollars expended to prove it is infeasible is often more excessive that compliance in most cases.

Once again, the go-to, signature Agency entrusted with  He Who Shall Have Borne The Battle is once again bemoaning the idea of accountability. Let’s delve deeper.

imagesHistorically, the VA, even in all it’s prior iterations, was always a cush, backwater government job with little heavy lifting and a massive medical mission. Every once in a while a war would come along and there would be a lump in the compensation python. With advances in medical science, people started living longer. Surprisingly, Vets eagerly followed suit. With each succeeding war, the odds of survival went up due to new innovations in medicine as well as warfare. Enter the Huey.

Vietnam was the first war where you could be in Tachikawa AB hospital over in Japan  less than 6 hours after losing your legs (and many of your buddies) to a bouncing Betty. The miracle of medicine also guaranteed you could be fitted with a colostomy bag and live to a ripe old age as well. Vets like this didn’t need a lot of evidence to win their claims but life in the service lane is never that simple. Due to sloppy record keeping, the military’s records were pretty spotty until the 80s. Absent medical proof of what you were claiming was anathema to your claim, unless you could wave your Purple Heart or Bronze Star and get a  38 USC 1154(b) Combat “enhancement” that gave your lay testimony the semblance of the truth. Many is the Vet who lost any hope of remuneration due to this brain fart in adjudication logic. Perhaps worse was the July 13th, 1973 records bonfire at the sprinkler-challenged NPRS records warehouse in St. Louis. In some strange Back To The Future scenario, Veterans from the 80’s are discovering that their records, too, were somehow burned up in that fateful 1973 conflagration. VA has yet to reveal how they do this prestidigitation but one day it will come out. Rumor has it they bought a souped up DeLorean with a hyperdrive motivator.

The VA metamorphosed again in 1961 with the inception of the modern Board of Appeals. Even so, the cabal of judges were at the beck and call of the VA Grand Poobah (our future Secretary). This was an arm of the military run out of Fort Fumble until 1988 and the inauguration of the modern day Department of Vet Affairs. All this time, the VA honchos had been pretty much left to their own devices.

Enter Senator Alan Cranston. I suspect the VA had shortchanged some of the Senator’s friends and fellow Veterans back in California. Cranston was an enlisted man in WW2 and was staunchly pro Vet. When debate began on a revised Veterans administration with full cabinet status in 1988 (the inception of the VJRA), Cranston was very critical of the VA. He felt they were finally dragging the VA out of some dark corner and finally getting a good look at a nasty problem. He was right.

images (1)Ever since then the tenor of the argument has remained at this high level of animosity. The VA Secretary feels he is being put upon if they so much as have to adjudicate a Veteran’s claim in less than three years-with a computer no less. Towards meeting that mandate and entering the paperless world, numerous computer programs, .pdfs and electrons have been engaged in the project of putting the VA Humpty Dumpty back together again.

Now the good Congressmen are actually requesting that VA be honest up front on claims and tell Veterans when they can expect to get a decision. Whoa. Hold the phone Congressman Miller!  On top of that injustice, they are asking VA to prognosticate as to what the odds are of the Veteran actually winning this claim based on statistical data that VA currently possesses. As usual, the problem is far more complex than mere mortal, non-VA personnel lower than a GS-95 can absorb. Thus it behooves Congress to butt out. This is VA Rocket Science we’re talking about.

Here’s what the bill (S.1148) entails:

1) would require the VA to post information about the average processing times for disability claims

2) post processing times based on various formats in which a claim can be submitted

3) monitor and keep transparent the backlog of claims,

4) would establish within the VA a commission or task force to evaluate the backlog of veterans’ disability claims,

5) the same VA commission or task force would also evaluate the backlog of veterans’ disability claims, including the current process used to evaluate claims and appeals, the applicable laws and regulations and the appeals process.

6) the task force would also analyze possible improvements to the claims process and submit to the VA remedies and solutions for the backlog.

VA fall guy and designated Apologist-Queen-For-A-Day Robert Jesse rebutted the wish list by bringing the true reality of the problem into focus. His observations were not filled with Rainbows and Unicorns. Here’s his take:

1)  the VA thinks collecting and posting all of that information would be burdensome

2)  the VA thinks collecting and posting all of that information would  actually slow down processing.

3) the requirement that VA provide certain information to each claimant would require VA to revise a number of forms

4) The complexity of the data concerns VA

5) Some of the metrics outlined in the bill are not currently available in VA systems

6) VA generally does not routinely track grant rates for particular types of claims

7) VA generally does not routinely track whether claims are submitted in standard or non-standard paper form

8) the data could confuse claimants

9) Providing this type of information could be seen as directing claimants to file, or not file, certain types of claims

10) Providing this type of information could be seen as directing claimants to elect to use a particular type of representative

11) the data provided may not be the best indicator of the most appropriate course of action for the particular claimant

OIGSo, in a period of less than 90 minutes, Guru and soothsayer/prognosticator emeritus Samuel Jesse has identified eleven excellent reasons why this won’t work and that it will just confuse Vets further. Actually, I didn’t think confusing Vets further was attainable as it has been considered  a done deal for centuries.  It also sounds like a typical government response to a logical “What if?” to me. The major problem I see is in red above. Good Lord. Haven’t we learned anything in over 200 years of government? You never form a commission or task force to investigate a problem from within the organization you hope to repair. That’s Independent Investigation 101. Look at VA’s Hear no Evil, See no Evil, Seek out no Evil, and pretend you didn’t hear any Evil and give a good whitewash to any Evil discovered Office of Inspector General as an example of why that is inadvisable. If you don’t work for the VA and have done something wrong, your ass is grass. On the opposing hand, if you are an offending VHA employee, you will be counseled on how to avoid killing your patients in the future or (VBA) rewarded with a promotion, bonus and transferred to the Manchester RO.

Congress is naive if they think they can pass some high-handed law and effect change at the VA (again). The agency is intractable and staffed with hidebound lifers who refuse to budge even when the Ricster orders it. If you guys and gals think the Obamacare website has a few glitches, you need to view the Veterans Benefits Management System (VBMS) computer first hand. You almost can’t find it hidden behind all the bandaids and gauze. Hell, some of the VAROs have individualized patches in an attempt to keep them from crashing. Rumor has it that it is up and running in 18 VAROs presently on any given day with a slower speed than dial up. In order to maintain a reduction in claims, they are holding off introducing it into the larger VAROs in Oakland, St. Pete’s and Seattle. As for Waco and Winston-Salem? The forecast is still iffy. Very iffy. Like 2016 iffy. Much like the Healthcare.gov site, it wasn’t designed to handle more than 6 VAROs at one time. They’re working on it.

Meanwhile, the VA and the DoD are still in discussions on how to mate the DoD’s shiny new hyperspeed STRs computer to the VA’s pedantic, hopelessly outdated 1995 VISTA system. I’d pass a kidney stone to be a fly on the wall in that office.

veterans-photo1_0

Posted in VA BACKLOG, Veterans Law | Tagged , , , , , , , , | 2 Comments

NEW INFO ON THE ACA (OBAMACARE)

download (4)This just in from member Dave. Trust him to ferret out that which we absolutely have to know about healthcare. To view the new, improved site which has been repaired, go here…

What you need to know but were afraid to ask.

Obamacare subcontractors

Posted in Humor | Tagged , , , , , , , | 5 Comments

NEW VA OVERSIGHT IN CONFERENCE SPENDING

download (2)After it was divulged that VA Human Resources personnel were treated to not one, but two shindigs in Orlando involving millions of dollars, VA has admitted to taking steps that will curb about half the abuses cited. They did admit, however, wasteful spending of $762,000 but not a dime more. Relax. Denial is the first phase of a disease process. Eventually, they will embrace their shortcomings and by 2060 will be willing to incorporate some of the recommendations from an outside review panel. 

What was not negotiable, according to UnderSecretary for VA Bashes Allison “in Wonderland” Hickey, was the idea that anyone-Congress included- was going to tell her how to institute her version of Six Sigma training.

“We owe it to our Veterans to give them the very best. Sometimes this involves teaching our personnel in warm, southern locales with easy access to entertainment facilities. This isn’t an “all work-no play” game. VA employees need mindless entertainment like jello shots and Karaoke in order to unwind after a long day at the cheese and wine tastings. Tasking these employees with mind-numbing concepts that only a VA employee can grasp causes burnout and we can’t afford that. We have too much invested in them. Now that Congress has effectively neutered our bonuses, we have to segue into a new paradigm. We’re more than willing to meet Congress and Veterans halfway but taking Orlando, Bahamas or Jamaica off the table is non-negotiable. Besides, most VA employees make far less than their counterparts in the private sector so we have to offer a competitive wage.” said Hickey.

When queried as to who she was referring to in the private sector, she indicated GEICO Nationwide and other major insurance companies. A quick check revealed most GEICO employees were lucky to see a median wage of $49,000 a year with a no-frills medical policy. VA employees, on the other hand, appear to have a median wage of $94,000 annually with a generous medical/dental plan. VA’s PR flack, Bob, who declined to give his last name, was unable to rebut the reporter’s findings explaining that the work VA does is simply incomparable to the civilian sector.

“What you’re doing is comparing oranges to orangutans.” We’re the VA. We don’t have to answer to anyone. Congress doesn’t get it. They should be worrying about how to fix Obamacare and leave the heavy lifting of Veterans claims to people who know what they’re doing. We are unique in DC. Nobody knows how to do what we do.” said Bob.

Some would say they, too, do not know how to do what it is they are tasked with. Well, allow me to offer a codicil. They are well-versed in the art of denial.

images

download (1)

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FED. CIR.- GEIB v. SHINSEKI–YOU’RE GOOD TO GO, EDDIE

220px-United_States_Court_of_Federal_Claims

Home of the Dead Circus

So many of you come to me and pose questions about Hepatitis C that we often overlook other subjects. I have recently been helping a relative in his final assault on Mt. TDIU. The ascent is always gradual with a few minor ratings squabbles but most assume once a threshold has been passed, a certain age attained or a compendium of percentages assembled, that it is a given. The Dead Circus just gave us all a wakeup call yesterday.

Edward W. Geib is no spring chicken. Assuming he was 18 or thereabouts in 1944, he can’t possibly be a day younger than eighty seven. Under most circumstances, this wouldn’t even be fodder for legal conversation. Octogenarians, especially ones on the far side of the midpoint are not considered prime candidates for employment. Well, “Not exactly.” as the Hertz rental car commercials and VA say. Apparently Eddie is hitting on all eight cylinders and capable of doing the Boston Marathon in VA’s eyes. Seems he’d be better off moving over to the VA pension line if he wants to get 100% of anything. What went wrong?

First, here’s the decision. You can refer back to it as you try to assemble this puzzle. Further, I attach the CAVC single judge decision as well. Judge Hagel is an asshole so you would expect nothing less than what he decided.  GeibEW_11-1501

Ed was an 11B and probably got his trenchfoot in the Ardennes or one of those other wet, nasty places in eastern France, Western Germany or Belgium. He didn’t have the luxury of a nice warm, dry place like Vietnam. On top of that, he got an ear owie when a German artillery round landed near him. This will set you back into yesterday even if it just lands near you. I’ve been a quarter of mile away from a pair of errant Mark 82 500 lb. GPUs and they part your hair even at that distance.

Fast forward to 1946 and a 10% rating for left stinky foot only (not the right one, mind you). If it was anything like the jungle rot I came home with, it was stinky or so my future wife said. If you live with it, it is simply an interesting aroma you smell at night unless you sleep with your shoes on. 57 years later (2003) they caved in and gave him another 10% for the right foot. That’s 20% now and also bilaterally rated so he got another 10% of 20% on top of it (2%) which is good for bragging rights. As with the IRS, 2% rounds down-not up. Eighteen months later in February 2005, he finally got his long overdue rating for hearing loss. One can only wonder how it took that long to ascertain that (1)both feet probably got wet and (2) his damaged hearing deserved compensation. It must be that consarned VA backlog. Too many WW2 Vets crashed the system in 1946 and it took a while to sort it all out. That’s what happens when you give away free money.

As any of you know, getting money out of VA for hearing issues is akin to pulling teeth out of a live alligator that is overly fond of keeping the ones he has. Thus, if you get a hearing rating over 0%,  chances are one of them (the ears) is only useful for hanging your eyeglasses on. It appears VA gave him a combined rating on both ears. Looks like they also threw in the obligatory 10% bone for tinnitus resulting in a combined 70% rating. I can almost see the lightbulb going on over his VSO rep’s head- TDIU, dude!

In 2007, the Edster decided to go for big TDIU. At eighty one, he probably was feeling a little long in the tooth and ready for some well-earned retirement. TDIU from the VA would pad his SSI nicely and he was entitled to apply for it as he qualified ratings wise.

As part of the application, the Edmeister honestly stated he’d been a carpet layer, carpet salesman, carpet consultant but never a carpetbagger. As such he was prepositioned legally to qualify. His employment had ceased in 1989 and he was old. By most standards, he qualified. Most standards, but not all. Age, in and of itself,  is not determinant of TDIU success. Likewise, the nature of his disabilities were not considered so debilitating as to preclude work. What kind of work VA did not say but they insisted he could work if need be to make ends meet. VA is not an employment counselor.

Geib focused his whole argument on one- and only one facet- to his ultimate demise. He was accorded two separate C&P exams that looked at hearing and trenchfoot. The sum of his disabilities was his bone of contention. His argument? Why 38 CFR §4.15…

§ 4.15

Total disability ratings.

The ability to overcome the handicap of disability varies widely among individuals. The rating, however, is based primarily upon the average impairment in earning capacity, that is, upon the economic or industrial handicap which must be overcome and not from individual success in overcoming it. However, full consideration must be given to unusual physical or mental effects in individual cases, to peculiar effects of occupational activities, to defects in physical or mental endowment preventing the usual amount of success in overcoming the handicap of disability and to the effect of combinations of disability. Total disability will be considered to exist when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupationProvided, That permanent total disability shall be taken to exist when the impairment is reasonably certain to continue throughout the life of the disabled person. The following will be considered to be permanent total disability: the permanent loss of the use of both hands, or of both feet, or of one hand and one foot, or of the sight of both eyes, or becoming permanently helpless or permanently bedridden. Other total disability ratings are scheduled in the various bodily systems of this schedule.

VA took a long look at this (in blue above) and figured what the hey? He sat at a desk for the last decade of his employment and was reasonably successful in his endeavours. His hearing, albeit frightful, still did not preclude him from operating a calculator or pencil. In sum, even with the requisite percentages needed to actually qualify for TDIU, the total of his disabilities ran afoul of another part of 38 CFR §4.15-that is, upon the economic or industrial handicap which must be overcome and not from individual success in overcoming it. VA maintained that Eddie could sit and do work and if he got one of those fancy phones for the hearing-impaired or TTY, he’d be right as rain. Somewhere in all this being eighty seven was overlooked. Going down to Abbey Carpets and applying for a job in the showroom -or hell-even in the backroom- was pretty much nigh on to impossible. Employers are munificent people for the most part but few are inclined to hire the age-challenged. Old folks regularly get laid off when they get up in years because they lack the vim and vigor of their younger counterparts. Employers also resent paying the older folks a higher wage based on longevity. Ed was screwed because he waited too long to file. Nowhere was this factored into the Edmeister’s circumstances. Quite simply, his disabilities, rather than his age, did not rise to the level of precluding him from meaningful employment.

The Feds simply took this apart, examined the VA’s rationale of doing two different exams for two  different, dissimilar diseases/injuries and came up with the conclusion that they had not intrinsically done anything untoward. He had a hearing disability-granted. That, in and of itself, was a liability but Mr. Geib had amply demonstrated in the past that he was capable of working around it. Lots of deaf people work. It’s merely a matter of finding a job where that is not prerequisite of employment. VA was not obligated to identify a job he was capable of doing but merely to point out that he was still employable if that was what he chose to do.

Similarly, he complained of the disability of trench foot and how it precluded standing or walking great distances like a mile or more a day. VA Repair order? Why, get a job that entails sitting, Mr. Geib. What could be simpler? Again, VA was under no obligation to supply a list of jobs which neither encompassed walking nor hearing well. They were tasked with deciding if he could work with his disabilities and decided in the affirmative. Next claimant?

I guess I can’t see how he thought he was going to beard the goat on this one. At eighty seven, it’s axiomatic you are not in the prime of your earnings window. Seems he should have armored up for this when he was about 65 or 66. Waiting until it’s bucket list time to go for TDIU is ill-advised. Hanging your whole argument on a turn of the phrase in §4.15 appears to be another poorly conceived legal strategy. And while I admire the law firm of Chisholm Chisholm & Kilpatrick Ltd., of Providence, Rhode Island for being such stand up law dogs for him, I could almost see the writing on the wall long before they got to 717 Madison Place NW in DC.  As I tell my Vets, you have to have a plan for every contingency. This isn’t something you do on the fly. And you certainly start planning it out when you’re young if you’re dealing with the VA if you expect to prevail. On the other hand, maybe Fast Eddie should go down to the VA and apply for a job… If they turned him down, now there would be some fine TDIU evidence.

Posted in Fed. Cir. & Supreme Ct., TDIU | Tagged , , , , , , , , , , , , , , | 1 Comment

HERE WE GO AGAIN ON FIDUCIARIES

downloadIn what looks like a straight up bill to curb bogus bonus awards to VA poohbahs who kill us, Congress is poised to go out and “fix” it. Just as they fixed health care for us, they are preparing to take another gigantic step backwards on VA fiduciaries.

As most know, we finally got a modicum of justice from VA after the Court struck down the practice of the VA summarily appointing any Tom, Dick or Harry with legal credentials as fiduciaries over mentally incompetent Veterans.  See https://asknod.wordpress.com/2011/09/27/cavc-freeman-v-shinseki-2011-assigning-fiduciaries/. The rub was that many of them were crooks and fleeced the poor Vets for years until being unmasked.

The problem with the new bill that is being proposed to curb ungodly bonuses also includes some dangerous language that will allow VA to reintroduce what Freeman took away.

It also gives reservists honorary “veteran” status if they serve for more than 20 years, allows veterans to access information about pending benefits claims, and allows the VA to appoint a fiduciary for veterans who are mentally incompetent to manage their finances.

That one little innocuous phrase is the cause for concern. No one in their right mind has a problem appointing fiduciaries for Vets in need of supervision. Most of us simply feel we should be involved in the process rather than a complete stranger who’s motives may be less than pure.

Posted in All about Veterans, Veterans Law | Tagged , , , , , , , , | 1 Comment

VERTEX ON THE WAY OUT

downloadI spotted this on the wire this morning. It was inevitable and I wondered when the boys at Vertex would pull up the stakes and fold the tent. The only sad facet of this is how many lives were inadvertently affected by using this drug. Incivek by itself is not to blame. The crime was injecting Interferon behind it with the sure knowledge that a new genre of medicine was on the horizon capable of accomplishing the same thing with little or no collateral damage.

I liken it to building Zeppelins and filling them with hydrogen knowing full well that the risk of fire and explosion were far greater than using helium. Few know that Interferon, in it’s first incarnation in 1957, was developed to combat cancer. When it was discovered that an inordinate number of patients were dying from it rather than their cancer, it was pulled off the shelves. In the eighties, it was trotted out once again for the HIV/AIDS epidemic. Having little success again, it was retired until the Hepatitis C virus reared it’s ugly head in 1989.

Thinking they had finally tuned it up, they overdosed thousands of us with it in doses far larger than they should have. When this failed, they began the introduction of Ribavirin. We have continued to watch scientists stumble around in the dark and grab any perceived panacea they come across in a vain attempt to give Interferon credibility. Vertex’ introduction of Incevik was simply more insult heaped on injury for many. Soon, Telepravir and Bocepravir will end up on the same ash heap of medical science. I can’t wait.

With the advent of Sofosbuvir, Simeprevir, Daclatasvir and the new nucleotide protease inhibitors,  patients are finally getting a useful drug that won’t kill them. The inventors of Interferon overlooked the golden rule of physicians-First do no harm.

For those of you out there who don’t get out much or have a newspaper subscription, please refrain from entering any new prophylaxis involving Interferon. It is yesterday’s news.

Posted in HCV Health, research, VA Health Care | Tagged , , , , , , , , , , , , , , , , | 4 Comments

National Veterans Law Moot Court Competition (NVLMCC)

downloadPro se veterans might find this competition interesting.

Hosts:

  • THE U.S. COURT OF APPEALS FOR VETERANS CLAIMS BAR ASSOCIATION
  • THE GEORGE WASHINGTON LAW SCHOOL
  • THE UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

Using cases that look real, and with “dummy” medical records in the joint appendix pdf, teams of law students write briefs covering one side of a case (the Petitioner or Respondents) on a Competition Problem but must be able to give oral arguments–with no visual aids etc–for both sides. Briefs are scored on 100 points (official rules, D.

The 2013 problem and team briefs is about VA physician negligence are here.

When:  Saturday, November 16, 2013, and Sunday, November 17, 2013.  Where: Washington, D. C. Building? All rounds are open to observation to the public and recorded.  I don’t find any previous competitions on Youtube.

Judges’ Criteria (excerpts) 

1. . Command of the Issues. “…how well each team member understands the issues presented in the problem and his or her knowledge of the facts and relevant law, including an ability to identify and finesse fine distinctions.
2.. Organization and Reasoning. ” …to what extent a team member presents a coherent and logical argument that flows smoothly and addresses all necessary points.”

3. Ability to Answer Questions. ” …her ability to interact with the Court. The Judges will evaluate how well each participant answers individual questions, including whether the answers are responsive, comprehensive, and supported by authority, and whether each
participant transitions easily from questions into the planned presentation.
4. Persuasiveness. ” …on the overall persuasiveness of the argument and whether the participant presents his or her position with conviction.
5. Deference and Courtroom Manner.  “…will evaluate the poise and
confidence of each participant, including the ability to maintain eye contact withjudge
panel members and quality of inflection. The Judges will also consider whether
each participant comports with courtroom decorum (e.g., by addressing each
Judge as “Your Honor” and deferring to Judges as they speak).

Update; Thanks to John D for pointing out that the cases and evidence are simulated.  This is backed up by the sentences in the About tab.  Had me worried.   

 

Posted in Guest authors, VA Health Care, Veterans Law | Tagged , , , , , , , , , , , | 3 Comments

SOFOSBUVIR DECLARED LEGAL

downloadToday the FDA approved what I pray is the cure for my illness 15-0 with nary a naysayer among them. Hepatitis C sufferers who failed the Interferon prophylaxis over the years now have one good shot at killing the dragon. 

We’ve waited a long time-some as many as 16 years-for this day. How soon Gilead cranks up the pill machine is the only delay I see. Scientists actually created the first Interferon product in 1957 but didn’t understand how to employ it. They killed a lot of people before they diluted the dose down further and further. After the introduction of Ribavirin in pill form, the two-drug cocktail jumped from 39% success in fifty two weeks to almost 54%. With the latest addition of Telepravir/Bocepravir triple-drug regimen the cure rate has risen to 62% with an average of forty weeks.

In contrast, Sofosbuvir plus Ribavirin in oral form (pills) have a twelve week course for the most intractable genotypes (1A and 1B) with a reputed 97% rate and no relapses. Guess that tells you all you need to know. It won’t kill you and it works.

Genotypes 2 and 3, normally the ones most amenable to treatment with Interferon, are quite the opposite using the nucleotide protease inhibitors. We hope follow-on research will yield better results which are currently in the 69-72% range. Hell, that’s still better than the bug juice.

P.S. The Stock market closed too early to reflect the 3 PM FDA conference review board’s decision. However the stock did rise from 68.68 at 2:30 PM to $69.68 at the closing bell. This one will be interesting to watch. They are pretty much not only the frontrunners in this new race but indeed the only runners with an approved product.

Posted in HCV Health, Medical News, research | Tagged , , , , , , , , , , , , , , , , , | 8 Comments

CAVC–KYHN v. SHINSEKI–NO ADDITIONS TO THE RBA

downloadWe have rules we live by. We have rules for appealing. We cannot modify the rules to “fix” what we forget in a judicial forum. If we appeal to a higher tribunal at the VA, we are allowed to add new and material evidence only up to, and including, the BVA. If we do not prevail there, we appeal to the CAVC but it can only be based on two basic theories-errors of fact or errors of law. We’ll leave prejudicial actions out of this list for now.

Overcoming an error of fact is difficult insofar as the CAVC is not an investigative body. As they are so fond of iterating, they are not a Court of equity nor are they a trier of fact in the first instance. Unless the preponderance of the evidence points to a clearly and unmistakably erroneous conclusion, the Court will affirm the BVA’s decision. On the other hand, an error of law is much easier to propound and indeed, more cases are overturned on this facet.

Similarly, for pro se claimants, there is a modicum of kid gloves treatment accorded us if we do forget something or decide to argue a new concept or perceived error when we arrive at the Court.  Add to that the precept that VSOs are not Leaglebeagle.com and you are considered such automatically. The VA secretary abhors this because he has his game plan carefully constructed around what you are complaining of. If you then take off on a new tack and question the Presumption of Regularity as Mr. Arnold C. Kyhn did, it wrenches the monkeys at the OGC. Conflustication reigns supreme and a new legal noose must be fashioned in short order. Witness the latest Texas necktie party to emanate from 810 Yellow Brick Rd. NW. This was handed down this week. The hamster wheel is in working order and Mr. Kyhn has been aboard for ten long years.

Arnie began this whole deal over a 10% tinnitus rating. He was one of America’s Greatest Generation and answered the call to combat fascism in 1945. His hearing was clobbered and in 1998 (after a protracted appeal) he got what most would say was a generous 50% rating for hearing loss. Unfortunately, he didn’t get the tinnitus ice creme on top. Speaking from a position of knowledge, my tinnitus, in no small measure, is part and parcel of my hearing impairment. When the ringing is at it’s loudest, it often interferes with hearing anything. Hence, the two are part and parcel of one injury and inextricably intertwined much like Harris v. Derwinski. Besides, we’re talking 10%. Remember that.

The Arnold didn’t file for all this until 1998 but VA, in a surprising twist, didn’t hold Maxson v. Gober against him and granted the aforementioned 50% following a BVA remand decision. What they just couldn’t bring themselves to do was give him the piddling 10% for the ear ring. He didn’t appeal it either. In 2004, he decided to come back and revisit that. Mind you, he had an excellent nexus letter (IMO) in 1998 and supplemented it again in 2004 that conclusively tied the two together. VA, as is their wont, decided the audiologist’s 2004 medical conclusions were not new and material and declined to reopen the claim. Arnold was off to the BVA again in short order measured in VA time. In 2006, the ping pong match began in earnest. The VLJ remanded the claim back to the Lincoln, Nebraska RO and  positively insisted they actually do a C&P to ascertain whether his tinnitus was service connected and compensable.

This is where the battle royale began. Arnie maintained he never got the C&P reminder to show up for the hearing test. I’ll buy that. Knowing how sloppy those chuckleheads are, it’s a wonder anything ever succeeds in getting done. As per VA reg 38 CFR §3.655, if you don’t show up for a C&P, you’re screwed.

In February 2006, the Lincoln, Nebraska, RO forwarded an audiological examination request to the VA Nebraska Western Iowa Health Care System. That examination was scheduled for March 7, 2006; however, Mr. Kyhn failed to appear for the examination. On March 31, 2006, the RO issued an SSOC in which it denied service connection for tinnitus based on Mr. Kyhn’s reported failure to appear for his March 7, 2006, examination.
In April 2006, Mr. Kyhn responded to a March 2006 request for information by stating that he had no other information or evidence to give to VA and requested that VA decide his claim
as soon as possible. The matter was returned to the Board and in its May 17, 2007, decision, the Board denied service connection for tinnitus after finding that the record contained no probative evidence that Mr. Kyhn’s tinnitus was incurred in or causally related to service or aggravated by any service-connected disability. As part of its decision, the Board determined that
the Secretary had complied with his duty to assist, pursuant to 38 U.S.C. § 5103A, because a VA audiology examination was scheduled and “notification of the examination was mailed to the veteran at his correct address of record.”

We’ve discussed the much-vaunted presumption of regularity in several other decisions I’ve written up, but the interesting thing about Mr. Kyhn’s predicament was that the C&P exam request is generated, according to VA, in a computer format and a copy of the actual document mailed to Arnie was not in the c-file. Biiiig mistake. It exists somewhere “in the cloud”.  Here’s the 2011 CAVC decision.  At the BVA hanging, the staff attorney merely said they’d mailed it and it was presumed he got it. No document. No date stamp. Nada. Just the word of an honest VA employee reciting the procedure on how this process worked. The BVA bit into it hook, line and sinker.

When Mr. Kyhn arrived at the Court in 2011, he got the bitchslap. Kyhn 2011 CAVC decision. The Court hit the same lure and merely affirmed it. Presumption of Regularity was proven. End of story. Or not. Back the boat back up to the dock, Gilligan. Aye, Skipper. Here’s my first writeup. This was in response to the Federal Circuit reversal and remand to the Court in May of this year (2013).

The CAVC panel has now been appropriately chastised and will have to refamiliarize themselves on their own rules on the admissibility of evidence. When you arrive, hat in hand, at the CAVC, you have a sealed Record on Appeal. How else would you ever be able to decide a claim if you could endlessly add evidence to the file supporting your position? The VA Secretary didn’t feel this applied to him. The Court has always taken a dim view of this and rarely allows anything in after the BVA has spoken. They sometimes “take notice” of generally accepted principles of law or medicine but it happens so rarely that is it is materially inconsequential. Here, however, they welcomed the VASEC’s new evidence in heartily and based their decision on the Presumption of Regularity in large part on the testimony of two VA employees. The Feds weren’t buying and the whole thing came crashing down around Shinseki’s ears. Back to the drawing board.

The OGC maintains that Arnold didn’t raise a stink about the Presumption at the BVA and did not address it until he got to the Court. All well and fine. But the BVA did and that is the problem here. When you file your substantive appeal (Notice of Disagreement) you begin to shape your contentions as to why you feel you got the short straw. When you complete the process by filing your Form 9 (the second step, or what the VA calls your substantive appeal), you further refine your arguments to rebut the Statement of the Case (SOC) that the VA has prepared where they have distilled the essence of their denial. By law, VA is supposed to defend the propriety of their actions and address your contentions. They are not supposed to go far afield and drag in new things to justify their position. Most assuredly, when called on it at the Court, they are not permitted to begin adding to the record with testimonials illustrating how the system works.

The whole purpose of sealing the record before the agency (RBA or R) is to create a static document such that everyone can point to this and that as proof. If you have an electronic transfer of a request for a C&P and it is nowhere to be found in the RBA, it would be hard to say it is a matter of record. Yes, indeed you can aver that you mailed it and the P of R should attach, but absent a concrete document that can be massaged and examined for a date stamp, it is merely one person’s word against another’s. As for supplementing the RBA, that is right out. This was the crux of the argument that caused the Fed. Circus to vacate and remand.  It is also the sole reason the Court was hoist on its own petard.

What will now ensue will be interesting. Will the BVA craft a new decision that somehow tries to artfully skirt this by including Madames Bash and Bunde’s affidavits that order and decorum were observed vis-a-vis the P of R? Will they simply decide too many trees have been slaughtered and this needs to be put to rest before any more P of R cats are let out of the bag? Simply put, this is a tempest in a teapot over 10% that has dragged on interminably for ten long years. It reminds me of the two drunks arguing over who was going to pay the bar bill on the Titanic that fateful evening.

Assume, if you will, that the Ahnold is married and his missus is still making life miserable for him.  That nets them $888.000 a month for the 50% hearing loss. Were he to prevail on this and get his 10%, it would increase his rating to 55% and thus round up to 60. Idiot’s delight. It will mean $1120.00 – a net increase of $232.00 a month. VA has by now squandered untold judicial resources they value so dearly since 2004 in an abortive attempt to deprive an old codger of  chump change. Why, in the scheme of things, they’ve  paid out more in Bonus Bucks to the Veterans Law Judges, Jo Ellen Bash, Margaret Bunde (the Lincoln, Nebraska VSC manager) and a cast of thousands than they’ll ever deliver to Mr. Kyhn in his lifetime. If you throw in hourly wages and salaries on top of it devoted entirely to making life miserable for him, the cost is staggering. Didn’t anyone sit down and do a cost-analysis determination and say “Whoa. Let’s focus our resources on reducing the backlog instead of making life miserable for one Veteran.”? No. Of course not. Can you say myopic? Sure you can. Let’s sound it out, kids. V… A… Backlog…

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