VABACKLOG DEADLINE SAVED BY GOVT. SHUTDOWN

Eeny meeny miny mo Pick a rater -let him go

Eeny meeny miny mo
Pick a rater -let him go

In a rare stroke of luck for the Department of Veterans Affairs, meeting their date of a 0% backlog in 2015 just got a reprieve. This actually couldn’t have happened at a more propitious time for the good general. In an act of celebration, VA Secretary Eric Shinseki sent over 7,000 rank and file VBA employees home while keeping all the gin-swilling higher ups on full salary ahead mode. In addition, not to be outdone, the good general dug deep into the furlough barrel and laid off almost another 3 thousand immersed in converting over Regional Offices to the Veterans Benefits Management Service (VBMS). Fortunately, since it doesn’t work anyway, this actually represents a huge savings for VA because they won’t be lying around scratching their heads and updating their Facebook page on the Veterans’ dime. 

I guess this means we can all expect that it will be several years before things get back to normal and it won’t be VA’s fault. Small consolation for trying to…to… what? Play chicken and see who will blink first? Only in America. The good news is that the Andrews AFB and Camp David golf courses (and their employees) were spared being furloughed so the greens and fairways won’t go to seed or unmowed. Appearances are everything.

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Andrew AFB and the latest negotiations

Of course, we’d much rather being seeing this:

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Two stroke penalty for abandoning
putt and walking off the green

Posted in All about Veterans, VA BACKLOG, vA news | Tagged , , , , , , , , , , | 5 Comments

FED. CIRCUS–COMER v. PEAKE(MD)–VSOS ARE NOT LAW DOGS

download“We also reject the government’s contention that the board had no duty to construe Comer’s appeal sympathetically because he had assistance from an aide from a veterans’ service organization.   Although we have held that the duty to construe a veteran’s filings sympathetically does not necessarily apply when a veteran is represented by an attorney, Andrews, 421 F.3d at 1283, the assistance provided by the DAV aide is not the equivalent of legal representation.   Comer filed his initial claim pro se, appealed the decision denying him benefits pro se, and filed his initial notices of disagreement pro se.   It was not until after he had filed his appeal that a DAV aide, in December 2003, filed a statement on his behalf.   This sort of limited assistance is insufficient to disqualify Comer as a pro se claimant.

I constantly search for that magic decision that enunciates a bouquet of rights all gathered and trimmed nicely that you can point to and say “Here, your honor(s) is the bright line rule that instructs us”. Comer will invoke Groves v. Peake (2008) ( a documented mental disorder in 1952 is the same mental disorder in 1998 and they are one in the same unless you can rebut it. Mr. Groves was asked by VA to diagnose himself, then penalized for being wrong),  Roberson v. Principi (2001) (if you wanted TDIU, you should have asked for it but you didn’t), a brief mention of one of my particular favorites Stanley v. Principi ( We’re not arguing the facts so let’s find out who’s been naughty and who’s been nice in their reading of the statutes), Barrett v. Nicholson (2006) (Whoa, dude. What’s with the hangman’s noose? I thought this was a paternalistic, Veteran friendly environment), Cook v. Brown (1996) (pretty cool-looking law dog you got there, Mister. Too bad he doesn’t have a pedigree.) and others too numerous to mention.

Meet Leroy Comer, Ladies and gentlemen. By the time you finish reading this ,you’ll begin to notice curious similarities in the current case of Malcolm in the Middle. But we’ll talk about that later. Leroy was a ground pounder in the VFW War that wasn’t (Vietnam Misunderstanding). He had the unenviable task of guarding an ammo dump which we all know was the focal point of nightly entertainment for Victor Charlie.  To the VC it was the equivalent of a nudge on Facebook.  I don’t think getting mortared every night for a prolonged period would be conducive to good sleeping habits. At any rate, when old Leroy applied for this in 1988 pro se, VA pointed out he was already rated 30% ( albeit NSC) for PTSD (cause unknown but most certainly not from Vietnam). Thus he got the empty ice cream cone with imaginary ice cream. He didn’t appeal but what he did bring to the table was evidence of unemployability and a long track record of all the hallmarks of PTSD.

Leroy came back in 1999, again pro se, and tried to reopen his claim. Back then we had to have new and material evidence that would allow us inside the RO front door. The RO denied him but he prevailed at the BVA a few years later. Leroy now had 18 years into this game and the hamster wheel was just warming up. On remand in 2003, on his twenty first anniversary of being a pro se claimant, the RO finally buckled and gave him the NSC 30% as SC. Leroy promptly filed his Notice of Disagreement (NOD) and prepared to climb onto the hamsterwheel back to the BVA. By now, 30% PTSD was a masterpiece of understatement and Leroy wanted his 1982 filing date, too. As usual, at the last moment, in an abortive attempt to compromise, the RO pukes relented and offered 50% on the bent brain and no dice on 1982. Leroy probably didn’t know it but he held the aces in this game. His unemployment was still ongoing since 1982. VA wasn’t looking at that. He wasn’t up to 70% so they wouldn’t even consider it. Big mistake. That was the standard of law. VA never even glanced at it.

In 2004, suddenly fully cognizant of their screwups, they quickly scheduled Leroy for his new Dog and Pony show to pretend to “find” that he was really, truly unemployed since his last C&P and therefore 70% and TDIU officially. This was a finding and now VA could point to a day in time that Leroy was officially rated as TDIU. And that day was the day of the Dog and Pony show- May 5th, 2004. So Leroy had a new date to appeal.

His appeal at the BVA thus turned into an argument over his TDIU (as evidenced by the record) being documentable on February 6th 1999-the date of his latest filing.  The BVA just couldn’t give it to him and walk away from it. They also denied the 1982 date saying he hadn’t alleged any Clear and Unmistakable Error (CUE) in that decision. Leroy saw where the railroad tracks led and lawyered up for his trip to the Big House. Finally. But here is an interesting forethought before I proceed. By being pro se up to now, every last thing Leroy said and did was under the highest scrutiny because he didn’t know the law. Under these circumstances, the Vet is to be handled with kid gloves- even if he is represented by idiots on parade from the local Alphabet for Vets VSO.  You cannot know how important that is. It’s even bigger than the Tooth Faery lie about Benefit of the Doubt. Waaaay bigger.

Here’s where the Roberson decision is like a ghostly voice. One would think the VA and the CAVC could correctly add up a few of the precedential cases mentioned at the beginning of this story and realize readjudicating Mr. Comer under the same legal standard they were rebuked for in Roberson wasn’t going to fly. Trying on the fig leaf of calling a DAV leaglezoomdotcom chucklehead serious legal assistance didn’t catch any air either.

Comer first argues that the Veterans Court misconstrued Roberson, 251 F.3d at 1380-84, when it held that it had no jurisdiction to consider the issue of whether he was entitled to an earlier effective date for TDIU benefits because he had not explicitly raised that issue before the board.   In his view, Roberson requires the board to consider whether a TDIU award is warranted whenever a pro se claimant seeks a higher disability rating and submits cogent evidence of unemployability, regardless of whether he states specifically that he is seeking TDIU benefits.   We agree. (Comer v. Peake)

Simply put, under Roberson, a claim to TDIU benefits is not a free-standing claim that must be pled with specificity;  it is implicitly raised whenever a pro se veteran, who presents cogent evidence of unemployability, seeks to obtain a higher disability rating.   See Szemraj v. Principi, 357 F.3d 1370, 1373 (Fed.Cir.2004) (The VA is required, “regardless of the specific labels claims are given in the veteran’s pleadings,” to read pro se submissions sympathetically and “to determine all potential claims raised by the evidence.” 

The government, however, attempts to distinguish Comer’s situation from that presented in Roberson.   In its view, Roberson does not apply:  (a) to appeal submissions to the board following an initial rating determination, or (b) to situations in which a veteran is assisted by a representative from a veterans’ service organization.

The government reads Roberson too narrowly.   This is not the first time that it has advanced an overly restrictive interpretation of Roberson, and this will not be the first time its efforts will be rejected.   See Andrews v. Nicholson, 421 F.3d 1278, 1282 (Fed.Cir.2005) (“Roberson is not limited to its particular facts and instead ․ requires, with respect to all pro se pleadings, that the VA give a sympathetic reading to the veteran’s filings.”

Moody v. Principi, 360 F.3d 1306, 1310 (Fed.Cir.2004) (The VA is required to give a sympathetic reading to a veteran’s filings even where the facts of a particular case do not “coincide” with the facts presented in Roberson).

And last but not least, the cornerstone of pro se law at the VA and something the VA inevitably forget conveniently.

See Hughes v. Rowe, 449 U.S. 5, 15, 101 S.Ct. 173, 66 L.Ed.2d 163 (1980) (Pleadings drafted by pro se litigants should be held to a lesser standard than those drafted by lawyers since “[a]n unrepresented litigant should not be punished for his failure to recognize subtle factual or legal deficiencies in his claims.”);  Forshey, 284 F.3d at 1357 (“[I]n situations where a party appeared pro se before the lower court, a court of appeals may appropriately be less stringent in requiring that the issue have been raised explicitly below.”).

When represented, your law dog is assumed to be the equal of Perry Mason. When pregnant and alone, you the Vet are presumed to be nothing short of Non Compos Mentis and not to be trusted with the TV remote. The CAVC forgot this to their eternal dismay-yet again. For some reason, they become inured to our pain and misfeasance at the hands of the VA. Sometimes decisions like this slip through and are appealed up to the Fed. Circus. This is our only defense. Malcolm in the Middle  went to the  Fed. Circus without a Minder and was finally accorded this consideration. They could see the railroad tracks led straight back to 810 Vermin Avenue NW.

The beauty of arriving pro se pristine at the CAVC with your brand new pedigreed law dog is blatantly obvious. Everything you stumbled through and managed to screw up or forgot to mention at the RO or BVA is forgiven . You mouthpiece can paint a glorious picture that, but for poor Johnny Vet’s ignorance, he still managed to articulate that he got short shrift and the VA squandered twenty seven years of  his life denying him unjustly.  Just because he didn’t articulate it in nunc pro tuncs and slip op’s does not give VA the right to hold him to a standard like Clarence Darrow.

Imagine a guy like Malcolm who went all the way up that mountain by himself and came back to see another legal day. If and when VA ever starts treating us (and our claims) like real human beings, we’ll be in trouble because we won’t get all these special dispensations for being in a nonadversarial, veteran friendly environment where unicorns dance under the rainbows.

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VSC claims adjudication map

Posted in Fed. Cir. & Supreme Ct., TDIU, Tips and Tricks | Tagged , , , , , , , , , | 3 Comments

Not eligible for VA health care?

To get a sense of which “high income” non-service connected vets might be denied VA health care now, we need to get acquainted with Priority 8 GMT income limits for Fiscal Year 2012, (see health benefit chart) and a desired state and county.   For example, comparing these cities using figures for 1 veteran and 1 dependent yields:  Miami =$46,200;  Phoenix =$46,750; Houston =$47,080.

gook

VA gogglygookers

One should also use the VA’s Financial Calculator online tool where zip codes count.  I’ve plugged in a few numbers based on the above.  It appears as if income and assets are treated differently (from free care) to determine eligibility for care with co-pays (I admit that the VA’s gobbledygook copy has me confused.)  I’ve used the VA Health Benefits tool with caution but one must start somewhere.

I’ve imagined a self-employed veteran (F–59 years) and spouse.  The veteran has been in good health until Sept. 2013.  However she’s just learned she has Multiple Sclerosis (MS).  They dropped their health insurance in 2011 because premium increases took too big a bite out of their modest “Mom and Pop” business–a decision she now regrets.  She wants to enroll in VA health care now. Medicare is six years away; ACA has greater out-of-pocket costs.)

I used these parameters: Active Service before 1980? Yes;  VA pension? NO; Purple Heart? NO;  POW? NO;  VA rated Service Connection condition? NO; Military discharge due to disability?  NO;  Eligible for state Medicaid, NO; Within 5 years of discharge?  NO; Vietnam combat vet, SW Asia, WWII radiation exposure, Project 112/SHAD? NO. Allowable deductible Expenses:  Education and Burial, NO.

Now the numbers.  Pretend this couple reported $48,000 income for their 2012 taxes. Their 2012 health expenses were moderate ($1,197.00) giving them a countable net income of $46,803. Pretend they have $50,000 in savings.

I’m using three VA locations with VA Multiple Sclerosis (MS) Specialty Clinics:  Miami VAMC (33125); Houston VAMC (77030); and Phoenix VAMC (85012).

If this vet lived in Miami or Phoenix, the app would report:

Based on the financial information you provided, it appears that VA cannot accept you for enrollment at this time.

If the vet lived in Houston, it would read:

Based on the information you provided, it appears you would be eligible for enrollment in Priority Group 8b or 8d if you agree to make copays for your care…(blah blah).

If this vet had reported just $1,000 less in 2012  income ($47,000 – 1,197.00 allowed medical expenses = $45,803) and even if they had greater savings ($80,000), they could enroll as Group8 b or 8d even if they lived in Miami or Phoenix.

Possible strategies to get into Priority 8b or 8d

fingers

VA to vets; Not to worry.
We’ll let you know.

To reduce income by $1,000 + they (or you) should hunt for more medical expenses (travel to dentists, OTC receipts etc..).  Ask your caring RO for a waiver/financial hardship determination (LOL)? Apply now even if one’s income is higher than published limits.  The VA promises to contact you a letter if you qualify later.  There may be rules against changing residences to qualify but it might be an option in dire circumstances.  Use the calculator to get an estimate. Still apply if marginally over “income and asset” If over assets, pay down your home mortgage, car loan. Take that postponed dream vacation.

croc

VA is so so sad for vets
too rich for care or vets denied SC.
All these difficult decisions. Booohoo….

Here’s the VA’s crocodile tear explanation for enrollment restrictions (the VA):

Enrollment Restriction:
In order to ensure the availability of quality and timely health care to Veterans with service connected conditions, special authority based on military service, low income, and those with special health care needs, in January 2003 VA made the difficult decision to stop enrolling new Priority Group 8 (high income) Veterans whose income exceeded VA Income Thresholds….[new rules]enable the…VA to relax income restrictions on enrollment for health benefits. While this new provision does not remove consideration of income, it does increase income thresholds.

Income is verified (IRS and SSA).  Some fine print:

read-the-riot-act

VA scolding vets

If the IV process confirms the Veteran’s household income exceeds the established VA national income (means test) thresholds, the Veteran may be determined responsible for copays for health care provided since the date of completion of the initial financial assessment. In addition, if the Veteran enrolled on or after January 17, 2003, the Veteran’s enrollment could become denied. As a result, the Veteran would no longer be eligible for VA health care for treatment of their non service-connected conditions.

So there…they’ve read us the riot act in advance of our failure to figure this all out.

This is bad for veterans who are

Enrolled on or after June 15, 2009 whose income exceeds the current VA National Income Thresholds* or VA National Geographic Income Thresholds by 10% or less are not

–eligible for enrollment 

Subpriority e: Noncompensable 0% service-connected
Subpriority g: Nonservice-connected

10%? So is 9.99% the leeway that the VA can add to The Thresholds?  And those 8 b, d, e, g have me officially bleary-eyed and done for now.

Posted in Guest authors, Medical News, VA Medical Mysteries Explained, vA news | Tagged , , , , , , , , , | Leave a comment

MORE POLITICAL CORRECTNESS

20-Outrageous-Examples-That-Show-How-Political-Correctness-Is-Taking-Over-AmericaThis just in from member and neighbor Mark- formerly of Mexifornia as he fondly remembers it.

Due to the climate of political correctness now pervading America,

people who live in or are from northeast Alabama, north Georgia, Kentucky, Tennessee and West Virginia will no longer be referred to as  ‘HILLBILLIES’. You must now refer to them as APPALACHIAN-AMERICANS. And furthermore,

HOW TO SPEAK ABOUT WOMEN AND BE POLITICALLY 

CORRECT:

1. She is not a ‘BABE’ or a ‘CHICK’ – She is a

BREASTED AMERICAN.  ‘

2. She is not ‘EASY’ – She  is

‘HORIZONTALLY  ACCESSIBLE.’

3. She is not a ‘DUMB  BLONDE’ – She is a

‘LIGHT-HAIRED DETOUR OFF  THE INFORMATION

SUPERHIGHWAY.’

4. She has not ‘BEEN  AROUND’ – She is a

‘PREVIOUSLY-ENJOYED  COMPANION.’

5. She does not ‘NAG’ you  – She becomes

‘VERBALLY  REPETITIVE.’

6. She is not a ‘TWO-BIT  HOOKER’ – She is a

‘LOW COST  PROVIDER.’

HOW TO SPEAK ABOUT MEN AND BE POLITICALLY 

CORRECT:

1. He does not have a  ‘BEER GUT’ – He has developed a

‘LIQUID GRAIN STORAGE  FACILITY.’

2. He is not a ‘BAD  DANCER’ – He is

‘OVERLY  CAUCASIAN.’

3.. He does not ‘GET LOST  ALL THE TIME’ – He

‘INVESTIGATES ALTERNATIVE  DESTINATIONS.’

4. He is not ‘BALDING’ –  He is in

‘FOLLICLE  REGRESSION.’

5. He does not act like  a ‘TOTAL  ASS’ –

He develops a case of

RECTAL-CRANIAL  INVERSION.’

6. It’s not his ‘CRACK’ you see hanging out  of his pants –

It’s

‘TROUSER  CLEAVAGE.’

Well, I for one would like to thank Mark for clearing the air on that one.

 

 

 

 

 

Posted in Humor | Tagged , , , , , , , | 2 Comments

DETROIT JOBS

ATT00022Member Bruce (Tip of the Spear) from Georgia sends us this one. Absolutely priceless and probably all too true.

Bob was sitting on a plane waiting to fly to Detroit when a fellow took the seat beside him. The guy was an emotional wreck, pale, hands shaking, moaning in fear.   “What’s the  matter?” Bob asked.

“I’ve been  transferred to Detroit – I’ve heard the people are crazy there. They’ve got lots of shootings,  gangs, race riots, drugs, poor public schools,
and the highest crime rate in the nation.”

Bob replied,  “I’ve lived in Detroit  all my life. It’s not as bad as the media says.
Find a nice home, go to work, mind your own business, and enroll your kids in a
nice private school. It’s as safe a place as anywhere in the world.”

The guy relaxed and stopped shaking and said, “Oh, thank you. I’ve been
worried to death.  But if you live there and say it’s OK, I’ll take your word for it.
What do you do for a living?”

“I’m a tail gunner on a Budweiser truck.”

 

 

 

Posted in Humor | Tagged , , , , , , , | 1 Comment

RAISING THE CEILING

securedownloadJust received this from member Debbie S. I guess it says it all. Drain the swamp or raise the ceiling and continue to swim in shit. My grandson wants to know why the government would pay anyone NOT to grow food. I think we all ask that question eventually. I think they have it ass backwards but I’m not a Senator. 

Posted in General Messages | Tagged , , , , , , | 2 Comments

THE OLD KOREAN WAR VET

thThe  86-year-old Vet went to his doctor for his quarterly check-up…

The doctor asked him how he was feeling, and the old boy says ,’Things are great and I’ve never felt better. I now have a 20 year-old bride who is pregnant with my child.’

“So what do you think about that Doc ?” 

The doctor considered his question for a minute and then began to tell a story. 

“I have an older Vet friend , much like you, who is an avid hunter and never misses a season. One day he was setting off to go hunting. In a bit of a hurry , he accidentally picked up his walking cane instead of his gun. As he neared a lake , he came across a very large male beaver sitting at the water’s edge. He realized he’d left his gun at home and so he couldn’t shoot the magnificent creature. Out of habit he raised his cane , aimed it at the animal as if it were his favorite hunting rifle and went ‘bang, bang’. Miraculously , two shots rang out and the beaver fell over dead. Now, what do you think of that ?” asked the doctor. 

The old Vet said “Logic would strongly suggest that somebody else pumped a couple of rounds into that sucker.”

The doctor replied , “My point exactly.”

Posted in Humor | Tagged , , , , , , , | 3 Comments

SOFOSBUVIR STILL ON TRACK FOR OCT. 25 HEARING

downloadWhooooooooooo, doggies. Gilead is still hot to trot and the show will go on for FDA expedited approval on Oct. 25th. Mark your calendars to come back and find out. This is more exciting than the Affordable Care Act imbroglio. I just hope it will be on the list of “approved ” drugs and not a eugenics cure to eliminate the HCV population of America by withholding it.

Doctors, Doctors give me good news

I’ve got a bad case of Dragon loose

Gilead’s pill’s gonna cure my ills

I need it now-gimme the juice

Posted in HCV Health | Tagged , , , , , , , , | 5 Comments

THIS JUST IN

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Here’s the latest on what is and is not affected by the shutdown at VA. 

 

 

Posted in vA news | Tagged , , , , , , , , | Leave a comment

WALTER REED HOSPITAL SIX YEARS LATER

video-retro-report-walter-reed-videoLargeMember Frank sends us this missive and link to the neverending Walter Reed imbroglio that’s comparable to the erstwhile cockroaches of Hiroshima. It won’t die or go away nor will it resolve any time soon. When you choose to become bellicose and partake of wars, it should come as no great surprise that there will be repercussions. 

As the author, Mr. Winerip, points out, the life expectancy of soldiers from the latest conflagration in Southwest Asia is greatly improved over our last major conflict that generated even near this many casualties. Small comfort to the Sgt. Shannons of America.

As he told Retro Report: “It just missed the bridge of my nose and exited over my left ear. And it took all this bone and everything with it — and, of course, my left eye it took with it.”

He was medevaced out of Iraq, but only nine days after his near-fatal injury, the Walter Reed staff discharged him into outpatient status.

This almost sounds like the miracle of VA medicine I experienced in 2009.

Posted in Future Veterans, Gulf War Issues, Medical News | Tagged , , , , , , , , , , , | 1 Comment