Articles Posted in Public Benefits

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A.M. received a human papillomavirus vaccine in 2007. Shortly thereafter, she developed autoimmune limbic encephalitis and an intractable seizure disorder, resulting in cognitive impairment. Her mother (McCulloch) sought compensation under the Vaccine Act, 42 U.S.C. 300aa. A special master awarded compensation for A.M.’s injury and accepted the parties' agreement on the amounts and mechanisms of compensation. Neither party sought review. Months later McCulloch sought an award of attorneys’ fees and costs under section 300aa15(e)(1). A special master awarded fees and costs and included amounts to cover the expenses, under Florida guardianship law, of maintaining the guardianship for A.M,-- a required condition for receiving the full payments under the merits judgment. The Claims Court upheld inclusion of those amounts, but cited section 300aa-15(a), the provision governing merits awards of compensation, instead of 300aa-15(e), the fees/costs provision on which the special master relied. The Federal Circuit affirmed while acknowledging that the Claims Court improperly reopened a final merits judgment by awarding money under section 300aa-15(a). Nonetheless, it was appropriate for the special master to award guardianship-maintenance expenses under that section because McCulloch incurred a continuing liability to pay such expenses as a condition of receiving, for her daughter, the compensation awarded on the merits in this proceeding. View "McCulloch v. Secretary of Health and Human Services" on Justia Law

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Sucic served on active duty 1973-1979 and 1982-1984. In 2007, he was granted service connection for post-traumatic stress disorder (PTSD), effective January 2003. In 2008, Sucic requested an effective date of June 1992. After remand by the Federal Circuit, the Veterans Court entered judgment in June 2016 and issued its mandate in August 2016. Sucic died five days after the Federal Circuit’s mandate issued but before the Veterans Court vacated the Board’s decision. Sucic’s counsel did not notify the Veterans Court of his death until after the Veterans Court issued its mandate. Sucic’s counsel filed an unopposed motion to recall the Veterans Court’s judgment and remand decision and a motion to substitute Sucic’s three adult children as claimants. The Veterans Court concluded, and the Federal Circuit affirmed, that the non-dependent adult children were not eligible accrued benefits beneficiaries under 38 U.S.C. 5121(a), qualified for substitution. View "Sucic v. Wilkie" on Justia Law

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While serving in the Navy, Scott developed a bilateral foot disability caused by prolonged standing. In 1973, the VA Regional Office (RO) awarded Scott service connection for bilateral pes planus (flatfoot) and granted him a 0% disability rating under DC (diagnostic code) 5276. In 1990, the RO added to Scott’s service connection hallux valgus deformity (angulation of the big toe toward the other toes) without altering his rating. In 2007, a VA medical examiner diagnosed Scott with plantar fibromas (masses of fibrous tissue in the arch of the foot) in addition to his prior diagnosis. The RO continued Scott’s 0% disability rating. In 2014, the RO increased Scott’s disability rating to 30%; the decision did not mention Scott’s plantar fibromas. In 2016, the Board of Veterans’ Appeals increased Scott’s disability rating to 50%, but did not address the effect of Scott’s plantar fibromas on his rating, finding that Scott was entitled to the rating “under DC 5276 . . . for [his] bilateral pes planus” under the benefit of the doubt rule, 38 U.S.C. 5107(b). The Board concluded that DC 5284, which broadly covers “Foot injuries, other,” without identifying any specific condition, was inapplicable because the service-connected condition, pes planus, is specifically listed. The Veterans Court affirmed. The Federal Circuit vacated. The Veterans Court improperly affirmed based on rationales the Board never provided; the Board erred by failing to consider DC 5284. Foot conditions not specifically listed in the rating schedule may be rated by analogy under DC 5284. View "Scott v. Wilkie" on Justia Law

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Ruel served in the Marine Corps, 1966-1969, including two tours in Vietnam; he was exposed to Agent Orange. He died in 1984. His wife, Teresa, sought benefits. In July 1984, the VA received her Form 21-534, which the VA treats as an application for Dependency and Indemnity Compensation (DIC) a benefit paid to eligible survivors of veterans whose death resulted from a service-related injury or disease, and for a Death Pension, a benefit payable to a low-income, un-remarried surviving spouse of a deceased veteran with wartime service, 38 U.S.C. 5101(b)(1). The claim for pension benefits was denied based on her income; the denial did not mention a DIC claim. In response to Teresa's “Application for Burial Benefits,” the VA authorized payment of $150.00, stating: The evidence does not show that the veteran’s death was due to a service-connected condition. Teresa did not appeal. In 2009, ischemic heart disease was added to the presumptive list of diseases related to herbicide exposure while serving in Vietnam. Teresa submitted a new Form 21-534. Her claim was granted with an effective date of October 2009. Teresa sought an effective date of July 1984 arguing that the VA never adjudicated her 1984 DIC claim, which remained “pending.” The Federal Circuit reversed the Board and Veterans Court; proper notice of an explicit denial of a claim under 38 C.F.R. 3.103 requires an actual statement or otherwise clear indication of the claim being denied. View "Ruel v. Wilkie" on Justia Law

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Jones served in the Marine Corps, 1968-1970. A VA psychiatrist treated him and diagnosed him with PTSD in 2000. Jones formally applied for disability benefits for PTSD in 2011. In 2012, the VA Regional Office awarded him a 100% disability rating, effective April 2011, the date it received his formal application. Jones filed a notice of disagreement arguing that he should receive an earlier effective date that reflects VA medical treatment beginning in 2000. Jones asserted that he “did not file until 11 years later because the doctors did not explain to [him] what PTSD really was.” In 2015, the Board denied the claim, acknowledging the existence of “VA medical records showing treatment for mental health symptoms” in 2000, but finding that the records before it “[did] not indicate an intent to file a claim for benefits and are not considered an ‘informal claim’'.” The Veterans Court affirmed, finding no informal claim under 38 C.F.R. 3.155(a). Jones died in 2016; his wife substituted into the case, arguing that the Veterans Court applied a heightened standard to determine whether the VA was required to assist Jones in obtaining his treatment records, which might contain an earlier, informal claim. The Federal Circuit vacated the denial. The Veterans Court erred in ruling that the duty to assist only “includes obtaining records of treatment at VA facilities that are relevant to the claim.” View "Jones v. Wilkie" on Justia Law

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James served on active duty during the Vietnam War. He sought service-connected disability compensation for “a lumbar spine disability and cervical spine disability, as well as an increased rating claim for pseudofolliculitis barbae.” On January 28, 2016, the Board of Veterans’ Appeals denied his claims.. On Friday, May 27, James placed his notice of appeal (NOA) in a stamped envelope addressed to the Veterans Court in the mailbox at his residence and put the flag up for collection. James left town and did not return until late on Monday, May 30. James discovered the NOA still in his mailbox and deposited it that night at the post office. The next day, the Veterans Court received and docketed James’s NOA, which bore a postmark of May 31, more than 120 days after the Board mailed its decision. The court ordered James to “show cause why his appeal should not be dismissed.” James argued that the 120-day appeal window should be equitably tolled because an errantly lowered mailbox flag constituted an extraordinary circumstance beyond his control. The Veterans Court dismissed James’s appeal as untimely. The Federal Circuit vacated. The Veterans Court erred in creating a categorical ban by holding that equitable tolling can never apply to an entire category of cases involving a fallen mailbox flag. The extraordinary circumstance element necessarily requires a case-by-case analysis and not a categorical determination. View "James v. Wilkie" on Justia Law

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Procopio served aboard the U.S.S. Intrepid in 1964-1967. In July 1966, the Intrepid was deployed in the waters offshore the landmass of the Republic of Vietnam, including its territorial sea. Procopio sought entitlement to service connection for diabetes mellitus in 2006 and for prostate cancer in 2007 but was denied service connection for both in 2009. The Federal Circuit reversed, holding that the unambiguous language of the Agent Orange Act, 38 U.S.C. 1116, entitles Procopio to a presumption of service connection for his prostate cancer and diabetes mellitus. The term “in the Republic of Vietnam,” unambiguously includes the territorial sea under all available international law. Congress indicated those who served in the 12 nautical mile territorial sea of the “Republic of Vietnam” are entitled to section 1116’s presumption if they meet the section’s other requirements. View "Procopio v. Wilkie" on Justia Law

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Hansen served in the Army National Guard for six years, which included, at the start of his service in 1959, 182 days of active duty for training. Hansen died from amyotrophic lateral sclerosis (ALS) in 1998. In 2009, his widow applied to the VA for benefits under 38 U.S.C. 1310(a), which provides that “[w]hen any veteran dies after December 31, 1956, from a service-connected or compensable disability, the Secretary shall pay dependency and indemnity compensation to such veteran’s surviving spouse, children, and parents.” A 2008 regulation declares that “the development of [ALS] manifested at any time after discharge or release from active military, naval, or air service is sufficient to establish service connection for that disease.” 38 C.F.R. 3.318(a) (ALS Rule). The Board of Veterans’ Appeals and the Veterans Court held that Hansen’s “active duty for training” service does not qualify as active duty, and denied the benefits claim. The Federal Circuit affirmed. The 38 U.S.C.101(24) definition of “active military, naval, or air service” has been interpreted as excluding training in these circumstances. View "Hansen-Sorensen v. Wilkie" on Justia Law

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Cook served on active duty in the Navy, 1972-1973. Cook’s service records indicate that he experienced back pain. In 2000, Cook sought service connection for back problems and later filed a claim for total disability based on individual unemployability (TDIU), also back-related. The regional office (RO) denied both claims. Cook appealed and testified at a Board hearing in 2012. The Board remanded; the RO again denied both claims. Cook again appealed and requested an additional hearing to present further evidence. The Board denied Cook that additional hearing and denied both of his claims. The Veterans Court, upon joint motion, vacated and remanded because the Board did not adequately explain its decision. On remand, Cook again requested another Board hearing. The Board denied a hearing and denied Cook’s claims for service connection and TDIU. The Veterans Court vacated and ordered a hearing. The Federal Circuit affirmed. The Veterans’ Judicial Review Act codified a veteran’s longstanding right to a Board of Veterans’ Appeals hearing, 38 U.S.C. 7107(b). The courts concluded that the statute entitles an appellant to an opportunity for a hearing whenever the Board decides an appeal, including on remand. View "Cook v. Wilkie" on Justia Law

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Garcia served in the Army from 1952-1954. The military’s records of his medical treatment during service were among those destroyed in a fire in 1973 at the National Personnel Records Center in St. Louis. The record of his medical examination upon leaving the service was not destroyed and reveals a normal psychiatric state and no severe illnesses or injuries. Garcia saw Dr. Smoker, in 1965 for a burn from a welding accident. In 1969, Dr. Smoker diagnosed Garcia with, and prescribed medication for, paranoid schizophrenia. In 2002, Garcia sought disability benefit, alleging service connection of disability-causing paranoid schizophrenia. The regional office denied the claim. The Board of Veterans’ Appeals remanded for a VA psychiatric examination. Although García claimed to have been seen twice for his condition while in service, a VA examiner found it “impossible to say, without resorting to mere speculation, as to whether this veteran’s schizophrenia, paranoid type actually started in Service, without more documentation and records.” The previous denial was “confirmed.” Garcia collaterally challenged the 2006 Board decision, alleging clear and unmistakable error (CUE). The Board and Veterans Court rejected Garcia’s CUE arguments. The Federal Circuit affirmed, upholding the Veterans Court’s application of 38 C.F.R. 20.1409(c) to bar a due process allegation of CUE. View "García v. WIlkie" on Justia Law