Questions? 1-888-477-2363

Archive for category: Veterans

You are here: Home / Veterans
Cassandra Crosby, Claims Advocate

Fire Fighting Foam…Deadly in the End

/in /by

Perfluorooctane sulfonate or perfluorooctanoic acid, also known as PFOS and PFOA, are man-made chemicals used to make items heat or water resistant and found in a range of everyday items such as take-out food wrappers, no-stick cookware, and clothing. The military also uses the chemicals in highly concentrated foam to put out petroleum-based fires.

In the 1970s, the Department of Defense started using aqueous film forming foam (AFFF), which contained high concentrations of PFOS to extinguish specific types of fires such as aircraft/jet fuel fires. The problem with PFOS and PFOA is that, unlike other chemicals, they do not degrade over time in the environment. Most are found to accumulate in groundwater and find their way into local drinking water supplies.

In 2000, the only US manufacturer, 3M started phasing out the use of PFOS and PFOAs due to the tendency of the chemicals to build up in human tissue. DuPont was using the compound under the name of C8 and marketing it as Teflon. When 3M stopped production, DuPont built a factory to start producing the chemicals.

Due to several lawsuits against DuPont, several studies were conducted over the years on the impact of PFOS and PFOAs on humans. A study in 2004 by Dr. James Dahlgren, a nationally known toxicologist, identified increased risks of prostate cancer, Hodgkin’s lymphoma, leukemia, and multiple myelomas. In 2012, scientists at Emory University identified similar conditions between individuals who were exposed at the DuPont factories that manufactured C8. Workers showed a three-fold increased risk of mesothelioma or chronic kidney disease and a two-fold increased risk of developing diabetes mellitus Type 2, kidney cancer, and non-cancer kidney diseases. The EPA has also linked the chemicals to low birth weight, accelerated puberty, skeletal variations, liver effects (tissue damage), immune effects (antibody production and immunity), thyroid effects and cholesterol changes.

DuPont itself conducted medical studies on the chemicals as far back as the 1960s that showed liver damage in animals. One study showed the compound bound to the blood’s plasma proteins. In 1981, 3M found the chemicals caused birth defects in rats and informed DuPont. DuPont reviewed births of their employees and found two birth defects of seven recent births and did not inform the EPA of the information or the 3M study. By the 90s, DuPont was aware that C8 caused testicular, pancreatic, and liver tumors in lab animals but again, failed to inform the EPA. In 2006, eight major global manufacturers agreed to stop production of the chemicals.

The EPA studies are specific that exposure is through drinking water and not food ingestion or skin exposure. 3M originally informed DuPont when they began purchasing the chemicals that PFOS and PFOA were never to be disposed into the water, only incinerated. Several lawsuits show that DuPont dumped tons of the chemicals into groundwater sites at their manufacturing facilities.

Most people who come in contact with PFOS and PFOA are exposed to such low levels that there is no expectation of harm. However, because of the high concentrations used in the AFFF, those who lived and worked on particular military installations may be at risk of developing certain conditions. In addition to kidney conditions, the Pentagon has found that PFOS and PFOA are linked to developmental delays in fetuses and infants. In March 2018 report to the House Armed Services Committee, the Pentagon publically listed the full scope of the known contaminant, a first in their history.

The list included over 90 military sites that reported either on-base or off-base drinking water or groundwater contamination where the levels tested above the EPA’s acceptable levels of PFOS or PFOAs. Here is a complete listing of all bases and BRAC bases affected, including those overseas.

Records from a law firm in Philadelphia show that the federal government was aware of the groundwater contamination near several bases caused by PFOS and PFOAs. Despite this knowledge, the military continues to use the firefighting foam AFFF.  While the military is replacing the older version of its foam, the new version still contains PFAS, a shorter chemical chain of the PFOS compound, which exits the body faster but still accumulates in the blood and other tissues. It also does not break down in the environment just as the older chemicals.

But there is a viable alternative…..

3M developed a fluorine-free foam that tested equally as well as the AFFF for putting out jet fuel fires set by the International Civil Aviation Organization. However, after a first failed test (by 9 seconds), the Navy refused to pursue modifications to meet their standards and never adopted the foam. DuPont has lobbied heavily against this product with the Department of Defense.

If you are a military veteran who has experienced one of the conditions below and feel you were exposed to contaminated groundwater at one of the bases listed on the Pentagon’s report, you may be eligible for compensation from the VA or a class action lawsuit.

Rachel Cheek, Attorney

PTSD: Basic Criteria

/in , /by

Post traumatic stress disorder (PTSD) is a recognized psychiatric disorder that a person may develop after exposure to a traumatic event. For many years, PTSD went widely undiagnosed or was not recognized as the serious condition it is. Thanks to advancements in research and the breakdown of social stigmas, we have more information about the condition than ever before. We know that the majority of people who are exposed to traumatic events do not develop PTSD, and we know that veterans of the U.S. military are disproportionately affected by PTSD when compared to American civilians.

This blog post is intended to serve as a brief breakdown of the required criteria for a diagnosis of PTSD as defined by the fifth edition of the Diagnostic and Statistics Manual of Mental Disorders (DSM V), published by the American Psychiatric Association.

Criterion A: Stressor

In the context of PTSD, the stressor is the traumatic event that leads to the development of PTSD. The precise definition of “traumatic event” is contested, but the DSM V requires exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. This exposure must have occurred in one of the following ways: direct exposure; witnessing the trauma; learning that a relative or close friend was exposed to the trauma; or indirect exposure to details of the trauma, often in the course of professional duties (for example, a paramedic treating victims of a serious motor vehicle accident would be indirectly exposed to the traumatic event of the motor vehicle accident even if she did not witness the accident herself).

Criterion B: Intrusive symptoms

Not everyone who is exposed to a traumatic event will develop PTSD. In order for a person to receive a diagnosis of PTSD, the DSM-V requires the person to show at least one intrusive symptom. Intrusive symptoms can manifest in sudden upsetting memories; nightmares or bad dreams; flashbacks to the traumatic event; emotional distress after reminders of the traumatic event; or physical reactivity following reminders of the traumatic event (for example, an increased heart rate after exposure to reminders of the traumatic event).

Criterion C: Avoidance symptoms

The third criterion for a PTSD diagnosis is avoidance of reminders of the trauma. This could be an avoidance of thoughts or feelings about the event or avoidance of trauma-related reminders altogether. A person who suffered sexual assault may display avoidance of thoughts and feelings of the assault and do their best to never think about the event. Someone who witnessed a person drowning may avoid trauma-related reminders and stay away from pools or bodies of water. For a diagnosis of PTSD, the presence of at least one of these symptoms is required.

Criterion D: Negative alterations in cognition and mood

A person who receives a diagnosis of PTSD must display at least two of the following symptoms following the stressor: inability to recall key features of the stressor; overly negative thoughts or assumptions about oneself or the world; exaggerated blaming of self or of others for causing the trauma; negative affect (having a flat or depressed mood); decreased interest in regular activities; feelings of isolation; or difficulty experiencing a positive effect (having a hard time feeling happy).

Criterion E: Alterations in arousal and reactivity

For a diagnosis of PTSD, at least two of the following symptoms that began or worsened after the stressor must be present: Irritability or aggression; risky or destructive behavior (for example, driving recklessly); hypervigilance (for example, not being able to relax for fear that something bad will happen); increased startle reaction; difficulty concentrating; or difficulty sleeping. These alterations in arousal and reactivity are a defense mechanism for preventing further trauma.

Criterion F: Duration of symptoms

Even if a person fulfills all the required criteria, a diagnosis of PTSD requires persistence of the symptoms for more than one month. A person may fulfill all criteria immediately following a traumatic event but two weeks after the event may display fewer or none of the required symptoms. Although the criteria were present for a time, the person would not meet the duration requirement.

Criterion G: Functional significance

The PTSD symptoms experienced by the person with the diagnosis must create distress or functional impairment in a person’s life. For example, a veteran who suffers from PTSD and currently works in an office setting may find that his job performance is impacted by difficulty concentrating or increased irritability with his coworkers. A college student who experienced sexual assault at a party may find that their friendships are affected by their negative affect, hypervigilance, and their avoidance of other social events.

Criterion H: Exclusion

In order to meet the criteria for a PTSD diagnosis, the symptoms must not be caused by medication, substance abuse, or any other illness.

This is an extremely simplified discussion of PTSD intended to provide clarity to a frequently-discussed condition. Follow-up blogs will address specifications of the diagnosis as well as the issue of PTSD as it relates specifically to veterans seeking service connection.

Matthew Hill

Video Blog – Buddy Statements for Service Connection

/in , , /by
Matthew Hill: Hello, I’m Matthew Hill here with Carol Ponton, on the Hill & Ponton VA Video Blog. It’s a day we’re talking to you about buddy statements.
Carol Ponton: Buddy statements.
Matthew Hill: It’s a third in a four-part series on buddy statements and their importance in your claim. The first one was just the overall importance of buddy statements, and then we talked about how to create one.
Now we want to jump into specifics. Here we’re going to talk about service connection claims, proving that your disability is related to service and using buddy statements to do it. We see this right now where we seem to see this a bunch is with Thailand and veterans trying to prove they’re exposed to agent orange, herbicides, while they were in Thailand and using other veterans to help for that.
Carol, what do you see?
Carol Ponton: It’s crucial to proving these cases. Unfortunately, the VA seems to take the position that nobody worked on the perimeter, although the perimeters are so close to everybody. What we have-
Matthew Hill: It’s like since everybody worked on the perimeter, nobody worked on the perimeter.
Carol Ponton: Right, and so we found that we’re able to get benefits for veterans with buddy statements. We try to get someone that we can show that was in his unit, someone replaced him in his unit, someone worked with him on the flight line, and says, “I saw them spraying,” or one of the things we have is Thailand’s a jungle.
There was no jungle around our base. You could see the jungle off in the distance, but all you saw coming up close was dead foliage. Periodically, somebody would come around and spray it. There was never a lawnmower there. There was always spraying. For that reason, I know that this was herbicide that was used there, and it killed all of the foliage. These are ways to get people benefits.
Matthew Hill: Right, and so going back to what she was saying, having somebody there, and again, laying out the predicate, laying out the foundation of, “My name’s Jimmy Smith. I served in this unit in the Army. We were stationed at this base in Thailand,” and just going down the ladder of all those things and then saying, “While I was there, I was in a hooch, and we were 15 meters from the actual perimeter. I worked on the flight line, which might have been 50 meters from the perimeter. Bob Jones was in my unit, and we worked together. We were there for 10 months,” so just laying out what the person knows, how they are connected to either the veteran or the place and time. Then that just gives further evidence of what was going on with the veteran.
With Thailand, it’s just the VA stance is just nonsensical. They’re making each and every veteran fight this as if they grant benefits for one of our veterans saying, “Okay, you were close to the flight line. Therefore, you were close to the perimeter, and we’ll give you benefits.” But when it comes to the next veteran-
Carol Ponton: You’ve got to start all over again.
Matthew Hill: It’s like they have amnesia.
Carol Ponton: One of the things that we use for a buddy statement is maps, photos. It’s really important to take a photo of the base and show where were you living, where were you working. When you went off base, did you go across the perimeter? Then I have veterans that have the hooches that maybe they lived in that had no windows. They would talk about the fact that there would be storms blowing dust through there, or that they would have … one of them had a garden and said the people who went around spraying for herbicides and killed their entire garden.
What you want to do is draw a picture. The clearer you can make it for the VA, the better chance you have of winning. The more people that can verify this is what was going on, the better chance.
Matthew Hill: Right. It’s your story, and you’ve got to tell your story. The VA doesn’t believe your story, so you need to have supporting characters. You need to have others verify what they can of your story. Again, this is one of the most important pieces of evidence you get, because you can create this. You are in control of this to the extent that you know people who are there with you. You know people who served where you served, and you can get their statements to help you win your case.
Carol Ponton: Exactly. If you’re not in touch with someone, you don’t know how to get a hold of them, go online. There are a lot of people now that are going online searching for other people or people that have put statements online, because they’ve been so frustrated about what happened to them. There are pictures of Udorn or all the other bases in Thailand. You can bring that picture, make a map yourself of what happened, and then give it to your friend for them to identify.
Matthew Hill: Just, yeah, say where they were.
Thank you again for tuning in. This is a third part in a four part series on buddy statements. Again, we talked today about service connection and how you can get your case connected to service through the help of buddy statements. The next one we’re going to do is going to be on increased rating and buddy statements. Thanks.

 

Amanda Dejesus

Understanding Individual Unemployability Benefits

/in , /by

Often times, when a veteran is applying for VA disability benefits, they are unable to sustain a substantial gainful employment. This can be very frustrating combined with the fact the VA appeals process can be quite challenging. Individual Unemployability (IU) benefits or Total Disability based on Individual Unemployability (TDIU), is a benefit offered through the VA that allows them to pay select veterans at the 100% disability rate even through their service-connected disabilities are not rated as 100% disabling.

Eligibility and Required Evidence

It is important to note that there is a certain eligibility criterion that needs to be met before a veteran can be considered for IU. The eligibility criterion is as follows:

  • You must be a veteran
  • You must have at least one service-connected disability rated at 60% or higher
  • Or have two or more service-connected disabilities with one being at least one disability rated at 40% or more with a combines rating of 70% or more
  • You must be unable to maintain substantially gainful employment as a result of service-connected disabilities

Evidence:

A veteran must not only meet the eligibility requirements for IU to receive this benefit but they must also show certain evidence. The veteran must show evidence of at least one service-connected disability and the service-connected disability or disabilities have to prevent the veteran from performing any mental and/or physical tasks that are required to obtain or maintain substantially gainful employment. It is very important to note that marginal employment such as odd or side jobs are not considered gainful employment for VA purposes.

Substantially Gainful Employment and Sheltered Work

What is substantially gainful employment? It is employment that proves a wage greater than the poverty level. For a single person, as of 2016, the poverty threshold is close to $12,500. This comes from the U.S. Census Bureau. Simply put, if the veteran’s earnings are less then the threshold, then they are not considered to be gainfully employed.

It is possible to work and obtain IU benefits. The VA does recognize that some jobs are considered to be “sheltered work”. This is a protected employment or a “sheltered” work environment that would provide special accommodations to the veteran that would not be provided to any other employee. If you are a veteran wondering if you work in a sheltered environment, you can ask yourself if you were to leave your current position, would your employer replace your current position? Is your current position created just for you and your disabilities?

For veterans who are still working and do not work in a sheltered work environment, but still need to work for financial purposes, or for those veterans who do not want their employer to know about their disabilities, it may still be a good idea to apply for IU. Once the veteran is no longer able to work due to their service-connected disabilities, and they meet the other eligibility requirements, then that veteran would be covered so to speak and continue in the VA appeals process.

Something to keep in mind would be that this benefit is not for veterans who are going to temporarily out of work.

Applying for Individual Unemployability Benefits

The first step is to complete the VA Form 21-8940: Application for Increased Compensation Based on Unemployability. This form can be found here. Along with this form, evidence to help prove this claim should be submitted. This can be a letter or an opinion from the veteran’s doctor or an expert stating that the veteran is unable to maintain substantially gainful employment because of their service-connected disabilities.

Nicholas Wright, Attorney

Service Connection by Aggravation

/in /by

There are many different ways to get service connection for your disability from the VA.  While direct service connection is the more traditional route:  a veteran receives a disability while in service and the VA awards service connection.  There is also a secondary service connection, which provides compensation for conditions due to service-connected disabilities.  But what happens if the condition you want compensation for existed prior to your service?  The answer is service connection by aggravation.

38 U.S.C. § 1153 provides that “A preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service unless there is a specific finding that the increase in disability is due to the natural progress of the disease.”  A veteran claiming his or her disability was aggravated in service usually is granted service through the Presumption of Aggravation.

There are a few requirements to trigger the Presumption of Aggravation:

 

First, the condition must have existed prior to military service. 

This is usually shown through a veteran’s entrance examination that will make note of a specific disability. If a veteran’s disability is not noted on an entrance examination, the veteran is entitled to the Presumption of Soundness and does not have to prove aggravation unless the VA rebuts this presumption by clear and convincing evidence. Click to read more on the Presumption of Soundness.

Second, the disability must have worsened during service.

The burden of proof here is on the veteran to show—usually through medical records or expert opinions—that the condition worsened in service.  Documentation of treatment for a disability during service is one way to show worsening. Another way is to have a medical expert compare the veteran’s disability before service to its state just after service.

Third, the worsening of the disability must be above and beyond the natural progression of the disability.  

Certain disabilities naturally get worse over time.  The VA will only compensate veterans if the disability was worsened past the extent it would have worsened had there been no service at all.  Again, a medical expert is usually required to give his or her opinion on whether the worsening in the veteran’s condition was above and beyond the natural progression of the disability.

Finally, the worsening must be permanent. 

A temporary worsening in the veteran’s condition, only for it to improve back to the level it was before service is not compensable.  This can be shown through records of continued treatment of the condition, or by a medical expert’s opinion that the condition has remained permanently aggravated.

A few final thoughts on the Presumption of Aggravation—one, the condition must have been worsened during active duty service. Two, the veteran does not have to prove a specific in-service event aggravated the condition—it is only required to show that the disability worsened during service. And three, the worsening in the veteran’s condition does not have to be dramatic enough to warrant a higher rating under the VA’s disability rating schedule.

Hill & Ponton P.A.

5 Things You Should Know in Supporting an Addicted Loved One

/in /by

Watching a person you love struggle with addiction is challenging, frustrating and often painful. It may leave you feeling underappreciated, taken for granted and helpless. You might also be unsure about how to help your loved one or support her in a healthy way.

The hard truth is, unfortunately, you can’t force someone to get help. And until your loved one is ready to admit she has a problem, it may be very difficult to watch.

A person struggling with addiction may not be ready to seek help and is often in denial about her substance abuse. While you can’t make the decision for her, you can still be supportive as she reaches for recovery.

Here’s what you should know in supporting an addicted loved one:

Educate Yourself About Addiction

One of the best things you can do is to learn about addiction. Many people think of addiction as a moral failing, but it’s actually a disease of the brain. Once someone becomes dependent, the chemical makeup in the brain changes and addiction takes over.

Addiction is often a co-occurring disorder, too. That means your loved one may also be struggling with mental health issues, such as anxiety, depression or obsessive-compulsive disorder. Understanding the nature of the beast can help you realize your loved one is not necessarily choosing his addiction.

View Infographic

Just remember, it’s important to support your loved one without enabling his addiction. Refrain from enabling behaviors, like helping your loved one get drugs, loaning him money or paying his bills.

Know How to Speak With Someone in Active Addiction

Knowing the right conversations to have — including what to say and what not to say — can be pivotal. Obviously, addiction is a hard thing to talk about. Here are few pointers on how to dialogue with your loved one:

  • Remain calm and collected.
  • Honestly express your love, concern, and care for her life.
  • Be authentic and open, while also conveying that you’re serious about getting her help.
  • Share your desire to be supportive, and demonstrate you’ve educated yourself.
  • Don’t be forceful or shame/guilt your loved one about her habits.
  • Be prepared for denial or negative responses.
  • Avoid threatening or demoralizing your loved one.

Understand That Addiction Is a Family Affair

Living or interacting with someone who’s dealing with an addiction is no easy feat. Everyone around an addicted loved one suffers in their own way. Educating yourself and being patient, compassionate and as loving as possible can go a long way in helping you navigate tough moments.

Full Infographic

When your loved one is ready for help, knowing what treatment options are available, how insurance works and what detox or withdrawal symptoms are like will come in handy. Keep in mind that intervention is always a viable option if the circumstances become life-threatening.

Maintain Boundaries and Have Your Own Support System

Dealing with someone who’s addicted to drugs or alcohol can be emotionally and mentally taxing. That’s why it’s important for you to have people you can lean on, too, and know what healthy boundaries you can put in place to stay grounded.

Joining a support group such as Al-Anon or a 12-Step program for family members affected by addiction is a great way to help you feel supported on your own path.

Learn How to Support Your Loved One After Treatment

Ideally, the goal in supporting an addicted loved one is to get him into treatment. However, addiction recovery goes way beyond detox or treatment.

Helping your loved one integrate back into his life after treatment is crucial to sustaining his recovery. Be willing to attend meetings with him, and provide a supportive environment free of triggers, stress or substances as he learns how to return to his life.

If someone you love is struggling with addiction, help is available. Contact us today to learn more about how to help your loved one get on the road to recovery.

 

Carly Benson, a writer for Skywood Recovery
As an avid traveler, yogi & confessed self-help junkie, Carly writes about her adventures in life & sobriety on www.MiraclesAreBrewing.com where she offers inspirational concepts & coaching for recovery, faith & living an intentional life.

Robin Rosenblad, Claims Advocate

What if the VA Sends Me a Notice Proposing to Reduce My Disability Rating?

/in /by

There are times when the VA might review a disability rating you have had in order to determine if your condition has improved.   If the VA is considering lowering your rating in this situation, try not to panic as there are some procedures the VA must follow and things you can do to assist your case.

First of all, you must realize that simply receiving the letter proposing the reduction does not mean that your benefits have been taken away.   You will continue to receive your benefits until such time as the VA makes a decision about the proposed reduction.  The VA is required to provide a claimant with written notice prior to enacting the reduction so it should not occur without notice to you.   The VA must also allow a period of at least sixty (60) days to allow the claimant to provide additional evidence of how the service-connected condition has not improved.

Request a Hearing

First and foremost, it would be wise to request a hearing with the VA regarding the proposed reduction.  You must request the hearing within thirty (30) days of the date of the VA letter proposing the reduction.  The VA then cannot reduce your rating without having the hearing (which typically takes some time) and will allow you more time to provide that additional evidence.

After requesting a hearing, there are other things you can do.

To assess your current condition, the VA might require that you undergo another disability C&P exam.  If one is set for you, DO attend it!   Be forthright and let the examiner know all the symptoms you are still having and how often they occur.  (If you do not attend the exam, the VA will have the right to reduce your rating.)

Obtain “buddy statements” from family, friends, co-workers, etc. regarding how your condition still affects you.  They can describe details of instances they recall where you were unable to participate in certain activities or events due to your medical condition or how they and others have had to assist you in order for you to manage your home life or work life because of your disability.  If someone has known you quite a while, they can possibly attest to how your condition has actually worsened over the past year(s), months, etc.

You can obtain copies of your medical records where you have told your doctors about your ongoing symptoms and you have continued to receive treatment for them.  Then, you can prepare a statement yourself talking about the conditions you still have and point out entries in your medical records that confirm this and attach those pages to your statement.

The VA is not supposed to reduce your rating simply because you may have had a short period of improvement.   It is only supposed to reduce a rating if a veteran’s condition shows “sustained, continual improvement.”

If the VA reduces your rating anyway, you can still appeal it so long as you do so within one year of the rating decision.

Matthew Hill

Video Blog – How to Make Buddy Statements

/in , , /by
Matthew Hill: Hello and welcome to the Hill & Ponton VA Video Blog. My name’s Matthew Hill. I’m here with Carol Ponton.
Carol Ponton: I’m Carol Ponton.
Matthew Hill: This is the second part in our four-part series on buddy statements. We talked about the importance of buddy statements in the prior one and how they can affect your claim and how crucial evidence they are.
  Today we want to talk about how to make a buddy statement. The critical things that need to be in the statement that your buddy, friend, family member, service member puts in there so that it is a competent statement.
Carol Ponton: And we see this because when we get veterans, they often have buddy statements from people who are no longer alive or no longer available. And that’s why we want to make sure you know it’s very important … When you think about a buddy statement, you need to start out with, “Why did I pick this person? How is it that he has anything to add?”
  So if it’s a person who was in the military with you, it’s very important to give his or her full name, what service they were in, if possible their service records, so that the VA, because they tend not to believe people, can verify that this person was where he said he was and had the opportunity to observe you, and therefore his statement is very credible.
Matthew Hill: Right. You want them to be able to observe you, or they happen to be in the same place or the same year. Something to where it puts them there. Their name, their unit, where they were stationed, their MOS, what they were doing, so that you give them … It’s the foundation. Those might not be directly related to your case, but those are the foundation for why they are able to make a statement.
Carol Ponton: And why should the VA believe this person? For instance, if it’s Thailand and they’re talking about the herbicides that were sprayed there, this person would have to show that … How can the government find out that he actually was in Thailand during a relevant time period, and therefore what he says is very important, okay?
Matthew Hill: Right. And to that, it’s also speaking to competence. And competence basically means that that person has the ability to talk about some issue. And they have the ability to do so because they have the background. They have the knowledge or understanding. And so in Thailand, there would be various degrees of that. You’d have someone who was there and eyewitnessed the actual spraying, understood how close he was or his unit was to the actual perimeter.
  And then you could have a different, more sophisticated level of competence. You could have somebody who was actually doing the spraying, and you could say, “This is what the barrel said on the stuff I was spraying.” So various levels of competence, but they need to establish that. Why can they say what they say? Were they there? Did they see it? Did they hear it? Did they talk to somebody about it?
Carol Ponton: Exactly. And what is their connection to you? Were they stationed with you? Did they come and replace you? Were they in the same unit that you were in? You need to let them know everything you can possibly think of to build up your case. This is the time to do it.
  And it’s so sad, because sometimes when we get the case, that person’s not there anymore and we can’t elaborate. We can’t make it better. So think about all the questions that you think somebody would ask if they’re trying to prove something.
Matthew Hill: And who was it that said, “Just the facts, ma’am.”
Carol Ponton: Nothing but the facts.
Matthew Hill: Nothing but the facts. Well that’s what you want here. You don’t want somebody making an argument saying, “Please give this guy benefits. He’s a really nice man. He deserves what he’s getting.” That doesn’t get you anywhere, and frankly it distracts from the value of that person’s statement. So you want that person to give the facts. “I was here. I knew him in service.”
Carol Ponton: “I actually saw this.”
Matthew Hill: Yeah.
Carol Ponton: “We lived in the same hooch. We worked in the same flight line.” Anything that’s very significant to prove your case.
Matthew Hill: And the value of this is tremendous. We spoke about this in the prior one, but if you get a competent statement from someone else that is critical to your case, the VA might dismiss it. If you’re in the regional office, this happens. But if you keep appealing, you get up to the BVA, they understand the legal implications of a competent statement. And they understand that they have to take it seriously. And if they don’t, then they can get appealed to the Veterans Court.
Carol Ponton: And for that reason, we see a lot of cases are won at the Board that are not won at the regional office because the Board gives this a lot of credibility. And they look at the VA and they said, “Why didn’t you pay any attention to it? Because this proves the case and we’re gonna award benefits.” So don’t stop at the regional office. Take those buddy statements all the way up.
Matthew Hill: Well thanks for watching. This is, as I said, the second part in a four-part series on buddy statements. The first was about the importance. This was about how to write one. And then next two will be how a buddy statement is important both in the service connection case and a rating case. Thank you.
Cassandra Crosby, Claims Advocate

Eye Conditions and the VA

/in /by

Over 250,000 veterans are receiving disability compensation for eye or vision conditions; over 80,000 alone from the Gulf War. Also, 75% of veterans with traumatic brain injuries (TBI) have vision problems, often without even realizing the problems are related to their TBI or getting compensation for the vision condition as secondary to the TBI. Eye conditions range from injuries, damage from exposures and illnesses or diseases contracted while in service. There are also eye conditions that are secondary to other medical conditions that are eligible for VA disability. The VA Healthcare system also provides eligible veterans with eyeglasses or eye care if they meet certain requirements. In this blog, we will explore some of the eye conditions that are eligible for disability benefits, how they are rated by the VA, and what requirements a veteran must meet to get eye care through the VA Health Care system.

Eye Conditions Ratable by the VA

The most common eye conditions rated by the VA include impaired vision, blindness in one or both eyes, conjunctivitis, and unhealed injuries. But, there are several others and some are direct service connection disabilities while others are secondary. Whether the condition was caused by an injury, exposure, or illness, the following eye conditions are ratable by the VA:

  1. Loss of the eye or both eyes
  2. Loss of the eyelids, eyelashes, or eyebrows
  3. Lacrimal gland and lid disorders
  4. Ptosis of either or both eyes
  5. Conjunctivitis related conditions
  6. Corneal conditions
  7. Inflammatory eye conditions or injuries
  8. Glaucoma
  9. Cataracts and lens conditions
  10. Retinal conditions
  11. Neurologic conditions
  12. Tumors and neoplasms
  13. Other eye conditions

An injury to the eye that occurs in service and causes damage to the eye is compensable provided it causes permanent or chronic damage, even if it is only a scar. Acute injuries that are treated and resolved are usually not compensable unless they return or are considered in remission such as cancer. Any illnesses to the eye that manifest during active duty service are also compensable, even if they are not the result of or caused directly by military service. For example, if a veteran is diagnosed with glaucoma while on active duty, or within one year of discharge, it is service connected.

Secondary Eye Conditions

Secondary eye conditions are those that are caused by another medical condition or medications used to treat another medical condition but are not directly related to military service or did not actually manifest during active duty. These conditions, as long as they are related to a service-connected condition, are still service connectable as a secondary condition. An example is if a veteran is service connected for diabetes mellitus and develops diabetic retinopathy, the retinopathy is secondary and is eligible for VA compensation. Some medical conditions that can cause secondary vision problems include:

  1. Diabetes – retinopathy, glaucoma, and cataracts
  2. Sarcoidosis – optical neuropathy
  3. Lyme Disease – retinal vasculitis and optic disc edema
  4. Cerebrovascular events (stroke) – blind spots
  5. Thyroid problems – double or blurred vision, protruding eyes
  6. Multiple Sclerosis – changes in vision, optic neuritis, gradual loss of vision
  7. Rheumatoid Arthritis – thinning of the cornea

Another example would be if a veteran took a medication and the medication caused eye problems. Some examples are:

  1. Hydroxychloroquine used as an anti-malaria medication as well as to treat lupus and rheumatoid arthritis can cause ocular toxicity and cause problems with the corneas
  2. Medications for depression, Parkinson’s disease, seizures, ulcers, asthma, arrhythmia, and hemorrhoids are also linked to glaucoma
  3. Bisphosphonates (for bone loss) are linked to orbital inflammation, uveitis and scleritis
  4. Topiramate (Topomax) used for migraine headaches and epilepsy can cause angle-closure glaucoma, usually seen soon after starting treatment
  5. Tamsulosin (Flomax) can lead to intraoperative floppy iris syndrome
  6. Erectile dysfunction drugs are linked to ischemic optic neuropathy
  7. Blood pressure medications, specifically diuretics, can sometimes be linked to worsening glaucoma
  8. Corticosteroids can lead to cataracts and glaucoma with long-term use
  9. Drugs for organ and bone marrow transplants such as cyclosporine and tacrolimus can cause posterior reversible encephalopathy syndrome with bilateral vision loss
  10. Minocycline used to treat acne can cause increased intracranial pressure and papilledema, leading to permanent vision loss

If a veteran is taking any of the above medications, or has in the past, and has the linked eye condition, they need to speak to their optometrist about whether there is a link to the medication and file a claim. There are certain signs that link the medications to the conditions, and a trained optometrist will be able to distinguish the signs.

How Eye Conditions are Rated

Eye conditions are rated by the VA based on three main measurements; central visual acuity, visual field, and muscle function.

  1. Central Visual Acuity: this is how focused or blurry images are at specific distances. This is often tested with the eye chart we are all so familiar with. The central visual acuity measurements go from 20/20 to 5/200 and the VA rates based on corrected vision, if it can be corrected.  Anything worse than 5/200 is considered blind. The VA rates both eyes together, so if a veteran is blind in one eye and has 20/20 in the other, they would probably only receive a 40% rating.
  2. Visual Field: This is a measurement of the area that the eye sees. Often eye exams have a chart included with 16 meridians for each eye moving outward from the center. This measures the field of vision and, while complicated to measure, when it is not as to the right, it can be compensable. This will show if there is vision loss in the peripheral vision, upper or lower vision, central vision, etc.
  3. Muscle dysfunction: This measures how well the muscles of the eye move and is measured on the same type of chart as the visual field. The example to the right shows the measurement field of an eye whose muscle function limits upward and downward vision but is able to move side to side.

Once an optometrist has gathered all of these measurements, they are able to rate the eye condition using scales that combine all three measurements for both eyes. Each eye is not rated separately, so if a veteran was blind in one eye and had good vision in the other, they would not be rated 100% in one eye and 0% in the other, it would be a combination of both eyes. Only an optometrist is able to measure eye conditions, and there is a disability benefits questionnaire a veteran can take to his or her optometrist to fill out if filing a claim. While not a perfect claim, it can give the optometrist an idea of what the VA is looking for and how they rate eye conditions.  If filing a claim, the VA will also schedule a C&P exam at the nearest VA center for the veteran.

Other Eye Benefits

Those with accessibility issues may also be eligible for Special Monthly Compensation for their vision loss. These include additional compensations for such things as housebound, loss of an organ (eyes), aid and attendance (home help), and even home health care. Another assistance is such things as alterations to a veteran’s home for accessibility, mobility aids, service animals, and unemployability compensation.

The VA Healthcare system also offers routine eye care to all veterans. Veterans with a service-connected disability, former POWs, Purple Heart recipients, those with an increased pension based on A&A, significant functional or cognitive impairments, or whose vision impairment is so severe it interferes with their ability to participate in their own medical care are eligible for eyeglasses. Check here for eligibility requirements.

Your vision is important to your independence, make sure you take care of it and get compensated properly if it is impaired.

Rachel Cheek, Attorney

Traumatic Brain Injuries and Recent Veterans: An Overview

/in /by

Traumatic brain injuries (abbreviated as TBI) are physical injuries with psychological effects. TBI occurs when trauma to the head results in the brain shifting inside the skull. Motor vehicle accidents, bomb blasts, blows to the head, gunshot wounds or other penetrating head injuries, and slip and falls are examples of the type of injuries that may cause TBI. The condition can be difficult to diagnose because symptoms can mirror other conditions such as PTSD or dementia. Many people may simply attribute a change in personality to the psychological aftereffects of the traumatic event itself and do not realizing that symptoms such as sudden mood shifts, hallucinations, difficulty communicating, confusion, and poor memory are typical of an injury to the brain.

Unfortunately, blast injuries to the brain are becoming a characteristic of veterans who served in Iraq and Afghanistan. According to Department of Defense statistics compiled in 2017, an estimated 22 percent of combat casualties from Iraq and Afghanistan are brain injuries. For comparison, it is estimated that 12 percent of all Vietnam veterans suffered some form of TBI. Veterans who are diagnosed with TBI also present symptoms for longer than civilians who are diagnosed with the same condition.

Widespread Use of IEDs

The widespread use of IEDs in Iraq and Afghanistan is likely responsible for the rising numbers of veterans struggling with this condition. When the force of a blast from an IED or other explosive hits a person, their head is forced in the direction of the blast. When the blast wave passes, the person’s head will stabilize. This motion may sound familiar to anyone who has ever experienced whiplash in a car accident. When a blast (or any other force) is strong enough, a person’s head can be forced to move so quickly that the brain inside their skull continues to move after the skull has ceased motion. The resulting impact of the soft brain against the hard inside of the skull can cause physical trauma such as contusion and lesions to the organ of the brain. This trauma can cause the “death” of the neurons that are responsible for transmitting messages to and from different areas of the brain and which control the body’s functions.

Different parts of the brain control different functions, so symptoms of TBI depend on the area of the brain that was affected. Symptoms of TBI vary widely and may include effects such as increased anger or impulsivity, problems reading, writing, or otherwise understanding language, sensory difficulties such as tinnitus or blurred vision, seizures, memory loss, headaches, and behavioral changes. The severity of TBI can range from a mild concussion to total loss of consciousness and a vegetative state or even death. Although most TBIs are classified as mild, long-term symptoms may be observed.

Symptoms of TBI

It can be difficult to separate symptoms of TBI from other conditions.  For example, it is not uncommon for a veteran who has experienced an IED explosion in combat to suffer from both TBI and PTSD. Both conditions can cause symptoms such as insomnia, depression, irritability, and anxiety. It is important that a qualified professional assess all possible conditions to ensure that you are being properly treated. Treatments for TBI may include a combination of cognitive, speech, physical, and occupational therapy as well as medication to control some particular symptoms.

Though diagnoses of TBI are becoming more frequent, American veterans have struggled with the condition for over a century, since the use of bombs became a common war tactic in World War I. TBI can be an extremely serious condition, and its effects on veterans are only just now being fully researched. If you believe you may have experienced TBI, you should contact your doctor or neurologist. If the TBI and its resulting effects can be connected to your military service, you may be entitled to VA benefits.