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GAO report: High denial rates for Gulf War Illness veterans’ disability claims

One man’s story provides us with an accurate example of what kinds of battles can erupt over veterans’ disability claims, and why working with an experienced attorney—especially during the appeals process—is vital.

A veteran of the 82nd Airborne Division, Ron Mayo, developed plantar fasciitis as a result of his years of service. Doctors at the VA Medical Center he attended decided to treat his condition by giving him a cortisone shot in the affected foot, which then became infected and resulted in him being placed on life support. After another stint at a VA Medical Center, upon returning months later due to continual pain, he was told that the treated leg needed to be amputated below the knee because his infection has spread. One life, forever changed, all because of poor treatment for his disability.

As if losing his leg and having his life forever altered wasn’t bad enough, Mayo also now had to deal with a VA administration that denied any link between his injury/disability and his service as a veteran. The VA twice denied his disability claim for the loss of his leg, claiming that there was no link between his injury and service and also denying that the VA ever caused the infection. This persisted, even though an infectious disease expert at the VA wrote a letter indicating that losing part of his leg was the direct result of the cortisone procedure performed at the VA Medical Center.

Unfortunately for Mayo, even including this letter with his appeal with the VA disability board didn’t work, as the board sent a response indicating that it still needed additional information about his claim first. In their response, they cited needing information about basic issues that they had already been provided extensive information on, such as which leg he was trying to obtain disability for. Still, Mayo has been told that the denied claim and appeal process could take years to resolve.

 

New Report: VA Affairs Denied More Than 80 Percent of Veterans’ Claims

According to a Government Accountability Office (GAO) report released in July, the Department of Veterans Affairs denies more than 80 percent of veterans’ claims for benefits for Gulf War-associated illnesses specifically. This reflects an approval rating which is three times lower than all other types of claims.

According to the VA, more than one million U.S. service members have been deployed to the region since the start of the Persian Gulf War, with many of them experiencing medical issues unique to their service in the Southwest Asia areas. “Gulf War Illness claims” is an umbrella term used by VA Affairs to describe a cluster of chronic symptoms that can include fatigue, headaches, indigestion, joint pain, insomnia, respiratory disorders, memory impairment, and skin problems, for those veterans who served in a Gulf War conflict from 1990 on. The VA believes that these illnesses are linked to toxic exposure, such as exposure to pesticides, uranium, and oil well fires.

In 1994, Congress passed legislation providing Gulf War veterans with undiagnosed illnesses with what’s known as a “presumption,” meaning that they do not have to prove their illnesses to the VA; they simply have to serve on active duty in Southwest Asia any time after August 2, 1990 and suffer from an illness that falls into one of the listed categories.

However, according to the report, the VA approved an all-time low of 17 percent (or 18,000 out of 102,000) for healthcare and disability compensation claims for those suffering from Gulf War illness (compared to VA staff approving 57 percent of all other veterans’ claims for other medical issues which arose during the same time period). In addition, veterans seeking benefits for claims related to their illness also had to wait an average of four months longer than other veterans to hear back from the VA, according to the report.

The report also indicated that there is significant confusion when it comes to these specific claims as well. Specifically, some 90 percent of VA medical examiners appear to lack the training to actually perform exams on Gulf War illness, perhaps because the VA made this type of training optional.

In order for veterans to be better served, first and foremost, VA staff needs better training. In addition, veterans deserve to be provided with more specific information if their claim is being denied; information that will help instruct them in taking the next step to getting their denial reversed and obtaining benefits. Currently (according to the GAO report), the letters are too technical, difficult to understand, and legalistic.

 

Bill to Support Veterans Passes House

One of the bills that just passed the House of Representatives as part of the is designed to cut down on wait times that apply to these claims: The Disabled Veterans Red Tape Reduction Act of 2017 passed the House as part of the National Defense Authorization Act (NDAA), allowing veterans to have their medical examinations done by physicians outside of the VA system in order to help process their disability claims faster.

The NDAA reauthorizes certain national defense programs and spending, while also providing legislators with an opportunity to make some changes, such as passing legislation to help veterans with their disability claims. To this effect, Congress needed to act fast, as the program allowing claims to be processed through physicians outside the VA system is set to expire this year. Similar versions of the bill were also passed in 2013 and 2015.

 

Veterans’ Disability Lawyers Serving New Orleans & Surrounding Areas

Obtaining veterans’ disability benefits can be frustrating and challenging. Too many are in a position of having to appeal denials over and over again and deal with waiting times that are, frankly, deleterious to their health.

Our veterans’ disability attorneys in New Orleans are here to help with denied claims. We’ve helped countless individuals both with the initial application process and in challenging a denial and filing an appeal. Contact us today to obtain more information about how we can help you if you have been denied your claim.

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