As expected (see article below), there will be no adjustment of VA disability benefits based on inflation in 2016. All current disability benefit amounts will remain at 2015 levels on December 1 when new rates ordinarily go into effect. The government reasoning behind not increasing benefits next year is based on the decline of gasoline prices and how that decline affected the economy as a whole. However, as has been pointed out by several commentators, elderly individuals are much less likely to operate automobiles or at least not operate them as much as other groups in the population; therefore, they are not affected as much by gasoline price reductions. The elderly are more concerned about the increased costs for food, shelter, utilities and healthcare so while the cost for fuel remained low or decreased slightly, the prices for items that have a greater impact on the budgets of elderly Americans increased.
Based on preliminary government reports, it is increasingly likely that there will not be a cost of living adjustment (COLA) for veterans or social security benefits in 2016. The lack of inflationary trends indicates no growth in the adjusted cost of living index through the third-quarter of 2015.
While no official information has been yet released, based on current information, a COLA adjustment seems very unlikely.
For those of you affected, it may be of interest to note that VA disability benefits have never been increased since their inception. It is inaccurate to speak of an "increase" in benefits based on the annual COLA adjustment. In reality, there is no increase per se, the initial rates are only being adjusted to keep pace with inflation. So, veterans (among others) only see a theoretical status quo in the benefits, never an increase.
Once the VA has determined that the veteran's psychological profile (diagnoses) and the evidence of stressors (events) that occurred during active duty military service are present, it will make a determination that a diagnosis of PTSD is warranted. VA will then review the most current clinical evidence of record to determine how the severity of your symptoms impairs your social and industrial (ability to work) capacity. The VA has a schedule of rating disabilities, located in title 38 C.F.R., Part 4. The VA has established “Diagnostic Codes” (DC) for various medical and psychiatric disorders, which include a description of the severity of related symptoms and a corresponding disability percentage (called a “rating” or “evaluation”). Although there are different DCs for covered psychiatric disorders, the VA evaluates the level of disability due to psychiatric disorders under the same criteria, regardless of the actual diagnosis. 38 C.F.R. §4.130, DC 9411, governs PTSD ratings. This regulation provides graduated ratings of 0%, 10%, 30%, 50%, 70% or 100%. A 0% rating is noncompensable, This means that you have service-connected PTSD, however, there is little or no impairment as a result. VA compensation payments begin at 10% and increase at each rating level.
The VA has adopted the criteria established in the DSM-5 as the basis for its psychiatric ratings, including PTSD. Although it is being slowly phased out in favor of more robust tests, there is a diagnostic matrix called the Global Assessment of Functioning Scale (GAF) that may be used to determine your level of disability. The lower the GAF score, the higher the level of social and industrial impairment. Section 4.130 is reproduced below. You can share this with your psychiatric provider of care, who can prepare a report or opinion letter for submission to the VA that describes your level of impairment.
Bear in mind that even if the severity of your symptoms do not satisfy the diagnostic criteria for a 100% (or total) evaluation under the rating schedule, if your rating is high enough, another VA regulation (38 C.F.R. § 4.16) allows the VA to pay you at the 100% level if medical evidence demonstrates that your are unable to obtain or maintain substantially gainful employment as the result of your service-connected PTSD. The technical term for this is a total rating on the basis of individual unemployability due to service-connected disability (TDIU or IU).
38 C.F.R. § 4.130, DC 9411
GENERAL RATING FORMULA FOR MENTAL DISORDERS:
Material courtesy of Vietnam Veterans of America
The Veterans Affairs Department must learn to favor veterans when deciding whether to approve claims for illnesses related to environmental exposures and contaminants, senators said during a Tuesday hearing on Capitol Hill.
From the South China Sea to the Arabian Desert, from Iraq to Camp Lejeune, North Carolina, and elsewhere, service members have been exposed to pollutants that have harmed their health, yet the VA continues to engage in “passive-aggressive rebuttal of scientific findings” to deny them health care and compensation, charged Sen. Richard Burr, R-N.C.
Speaking to the Senate Veterans' Affairs Committee, Burr implored its members to increase their oversight of the VA's handling of toxic exposure claims, adding that while he is encouraged by VA Secretary Bob McDonald's recent efforts to improve the department's understanding of exposure-related illnesses, more needs to be done.
"To this day I remain appalled at the way the United States government has treated these families," Burr said, speaking of the more than 1 million residents of Camp Lejeune who consumed contaminated drinking water at the installation from the mid-1950s through 1987. "Our government rewarded them for their service by negligently poisoning them.”
Sen. Kirsten Gillibrand, D-N.Y., and Sen. Steve Daines, R-Mont., have sponsored a bill, the Blue Water Navy Vietnam Veterans Act, which would grant benefits to hundreds of thousands of sailors who served on aircraft carriers, destroyers and other large Navy ships in the waters off Vietnam and have illnesses associated with exposure to the toxic defoliant Agent Orange.
The VA provides compensation and care for veterans who served in the "brown water" Navy — small boats and crafts that patrolled rivers and inland waterways — but does not acknowledge exposure among many veterans who served on the larger vessels at sea.
The VA argues that those sailors were not directly exposed and therefore, their illnesses are not service-connected.
The Institute of Medicine released a study in 2011 saying there is not enough information to determine whether these "blue water" veterans were exposed to Agent Orange.
But Gillibrand cited an Australian Veterans Affairs Department study that found its vets were exposed to Agent Orange when its ships distilled seawater contaminated with the herbicide for onboard use.
She said blue water veterans are suffering needlessly as a result of "arbitrary bureaucracy."
"Instead of treating every Vietnam veteran who suffers from disease caused by Agent Orange, the VA is only treating those who stepped on Vietnam's soil or served on boats on inland waters," Gillibrand said. "This is arbitrary and capricious."
Sen. Richard Blumenthal, D-Conn., and Sen. Jerry Moran, R-Kan., have co-sponsored a bill that would require VA to establish a center for researching the health conditions of descendants of troops who may have been exposed to toxic chemicals.
Blumenthal urged the VA to speed up the process for recognizing the health consequences of exposure to toxic chemicals.
"Here's what we know about the modern battlefield: There are all sorts of toxic substances, many more than the lay person can imagine. [It's] dangerous even for those who didn't serve in combat," Blumenthal said.
Several birth defects in children of Vietnam veterans are considered by the VA to be service-connected, including spina bifida for children of male vets and 18 health conditions for children of mothers who served in that combat zone.
But the Blumenthal-Moran bill would require VA to look at the health of military offspring beyond the Vietnam era, to include the Persian Gulf War and the conflicts in Iraq and Afghanistan.
David McLenachen, VA acting deputy secretary for disability assistance, said the Veterans Benefits Administration is taking steps to improve its determinations for claims related to environmental exposures, to include contracting with the Institute of Medicine and other scientific bodies to study the issues.
He said the VA uses the research to change its policies as needed and cited recent examples including the recognition of Air Force reservists who flew in C-123 aircraft that had been used to spray Agent Orange during the Vietnam War; veterans exposed to mustard gas who have been granted presumptive service-connection for respiratory illnesses; and a recent announcement that rules will be amended to establish presumptive service connection for conditions related to the contaminated drinking water at Camp Lejeune.
But those changes likely would not have come about if not for small groups or individual veterans who fought for recognition — a process that often takes years.
Gillibrand pointed out that the Australian study was undertaken after Australian officials noticed higher rates of cancers and illnesses among its blue water Vietnam veterans, then noted that the VA rarely initiates efforts to resolve such mysteries.
Retired Marine Master Sgt. Jerry Ensminger testified Tuesday for the seventh time about the Camp Lejeune water problem, an environmental disaster that claimed the life of his 9-year old daughter Janey in 1985.
"Agents with VA have expended more effort, time and money devising methods to deny Camp Lejeune victims their rightful benefits rather than providing them," Ensminger said.
McLenachen acknowledged that the process is slow.
"As the science develops so must our policy," he said. "We need to learn how to streamline this process."
VA Adds 22 Ships to List of "Brown Water Navy" Presumed to Have Been Exposed to Agent Orange Contaimination
"A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. The last date on which such a veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he or she served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975. “Service in the Republic of Vietnam” includes service in the waters offshore and service in other locations if the conditions of service involved duty or visitation in the Republic of Vietnam." 38 C.F.R. 3.a.6.iii
VA has defined "the waters offshore" in the above regulation as duty in the river estuaries, internal waterways, and immediate waters off shore. Viet Nam This definition precludes "blue-water navy" ships that operated well off-shore such as aircraft carriers, etc. To be eligible for Service-Connected Compensation benefits based on AO exposure for ships operating in coastal waters, a claimant has to prove that he or she actually was assigned to a particular ship known to have operated in the coastal water areas.
The VA provides a list of these ships here: http://www.publichealth.va.gov/exposures/agentorange/shiplist/list.asp
The VA has just added twenty-two (22) ships to the official list of those presumed exposed to AO. To check for your ship, access the list at the link above and look for your ship. If you served on that ship during the periods shown, you are presumed to have been exposed to AO and any of the fourteen (14) AO-related medical conditions that may have manifested are considered Service-Connected.
If you have more questions about "brown water navy) service, just give us a call.
Reversing a long-held position, the Department of Veterans Affairs now says Air Force reservists who became ill after being exposed to Agent Orange residue while working on planes after the Vietnam War should be eligible for disability benefits.
The VA said it has been working to finalize a rule that could cover more than 2,000 military personnel who flew or worked on Fairchild C-123 aircraft in the U.S. from 1972 to 1982. Many of the Vietnam-era planes, used by the reservists for medical and cargo transport, had sprayed millions of gallons of herbicide during the 1955-1975 military conflict in Southeast Asia.
If the White House Office of Management and Budget approves the change, it would be the first time the VA had established a special category of Agent Orange exposure for military personnel without "boots on the ground" or inland waterways service in Vietnam. That could open the VA to renewed claims by thousands of other veterans who say they were exposed to Agent Orange in less direct circumstances, such as on the open sea.
The announcement is expected as early as this week.
"It's certainly taken long enough," said Jeanne Stellman, a public health professor who has done extensive research on Agent Orange at Columbia University. She described the VA's move as welcome but little to celebrate over. "These veterans have paid the price of mistreatment and neglect."
An Institute of Medicine report in January concluded that many C-123 reservists had been exposed to chemical residues on the aircraft's interior surfaces and suffered higher risks of health problems as a result. The institute is part of the National Academy of Sciences, a private organization chartered by Congress to advise the government on scientific matters.
Using that report, the department "determined that potentially exposed veterans would be eligible for Agent Orange-related benefits," the VA said in a statement. It also is reviewing whether certain active-duty troops may have been exposed. "Our goal is to ensure all affected C-123 crewmembers receive disability benefits and medical care."
Before requesting the report, the VA had generally denied claims submitted since 2011 by C-123 reservists, saying it was unlikely they could have been exposed to Agent Orange from the residue.
About 653,000 Vietnam-era veterans have received Agent Orange-related disability benefits since 2002, when the VA officially began tracking the cases.
The proposed rule would expand coverage under the 1991 Agent Orange Act to reservists who were stationed at Rickenbacker Air National Guard Base in Columbus, Ohio, Pittsburgh Air National Guard Base and Westover Air Reserve Base in Chicopee, Massachusetts.
Many were pilots, mechanics or medical personnel and simply followed orders when it came to working on C-123s, according to the C-123 Veterans Association. It was formed four years ago by retired Air Force Maj. Wesley T. Carter after he and other reservists noticed a pattern in the various ailments they suffered.
The reservists under the rule would be entitled to VA disability benefits if they developed health problems such as prostate cancer, diabetes and leukemia that were determined by the VA to be connected to Agent Orange.
"There wasn't that much talk of Agent Orange," said retired Tech. Sgt. Ed Kienle, 73, of Wilmington, Ohio, who worked on C-123 aircraft as a pilot and mechanic from 1972 to 1980. He said reservists generally knew the planes had once sprayed Agent Orange, but he didn't think twice about it when he was asked to clear away parts coated with residue.
After retiring from the military in 1997, Kienle said he developed skin cancer and respiratory problems and is being treated for indications of prostate cancer. He has joined with other reservists in the "Buckeye Wing" stationed at Rickenbacker in pushing for C-123 benefits.
In April, VA Secretary Bob McDonald expressed dismay in an email to department officials that multiple delays have "stretched our already thin credibility." At the time, officials were looking to Congress for legislation to provide benefits for the C-123 reservists.
But veterans groups and lawmakers including Sen. Sherrod Brown, D-Ohio, said the VA had legal authority to bypass Congress and act on its own. Brown and two other senators said last week they would block a Senate vote on President Barack Obama's nominee for VA's top health post until the department made clear whether or when a new rule would take effect.
The upcoming rule would not include roughly 200,000 "Blue Water" veterans who say they were exposed to Agent Orange while serving aboard deep-water naval vessels off Vietnam's coast, according to two VA officials who spoke on condition of anonymity because they were not authorized to discuss the matter publicly.
"If they do cover the C-123 guys and not us, we would feel very slighted," said John Paul Rossie, executive director of the Blue Water Navy Vietnam Veterans Association, pledging a renewed push for benefits.
Veterans' organizations and several members of Congress have been calling for expanded VA benefits in a broader range of environmental toxic exposure cases, including those involving Gulf War neurotoxins and burn pits in Iraq and Afghanistan.
Article originated by Associated Press 6/15/2015
President Barack Obama on Friday visited Phoenix’s Veterans Affairs hospital, the epicenter of a health care crisis that shook up the agency, to assess the pace of progress in meeting former service members’ needs and to discuss new efforts to spur additional improvements.
The president and Veterans Affairs Secretary Robert McDonald sat down with veterans, VA employees, representatives from veterans’ groups and elected officials to learn more about what went wrong in Phoenix and what more needs to be done to overhaul the troubled VA medical center there. The Friday stop in Arizona was aimed at highlighting the steps that have been taken to address what a White House review last year described as a “corrosive culture” at the agency and a lack of transparency and accountability.
Mr. Obama said new VA leadership has been “chipping away at those problems,” improving wait times and access to providers. But there is more work to do, he said.
“We all know that there have been significant problems at this facility, that the kind of cooking the books and the unwillingness to face up to the fact…went on too long,” the president said.
The visit was Mr. Obama’s first to the veterans’ medical center in Phoenix since allegations began to surface last April of wrongdoing among schedulers there. The VA has endured months of turmoil after revelations of widespread mismanagement and secret wait lists led to the resignation of a number of top officials, including then-Secretary Eric Shinseki.
VA employees across the country were falsifying records to make it look as if veterans were being seen for medical care within defined time frames. In reality, veterans often were waiting weeks or months longer than official records reflected. Officials in the VA’s Office of the Inspector General, its internal watchdog, testified in Congress that the long wait times contributed to patient deaths.
Administration officials recently have trumpeted an array of metrics showing that access to care has accelerated, both in Phoenix and across the VA system. Still, officials have acknowledged that the depths of the problems in the agency were daunting and that much more work remains.
A senior administration official said significant progress has been made, but the problems at the VA never were going to be fixed in a year. Mr. Obama has made upgrading the VA health-care system a priority, and he remains committed to that goal, officials said. He has also pushed for a focus on ending veteran homelessness and has implemented changes aimed at smoothing troops’ transition from activity duty to veteran life.
Mr. McDonald, a former Procter & Gamble Co. chief executive, has been making changes since taking over as VA secretary in July, including launching efforts to bring to the department a private-sector mentality of prioritizing customer service and implementing quality-control measures.
Mr. McDonald has had the support of most veterans groups, lawmakers and the administration since taking the helm, buoyed by the widely held idea that fixing the problems at the VA will take time.
“He sees things firsthand for himself, and it’s even more encouraging that the president’s joining him on this trip,” said Garry Augustine, executive director of Disabled American Veterans, an advocacy group. “I think it’s appropriate that they both pay a visit to the hospital.”
Despite Mr. McDonald’s outreach efforts, the VA still suffers from problems that he has said might take months or years to fix, even with a recent injection of some $16 billion in emergency funding approved by Congress in 2014 in part to help reduce a substantial backlog of patients waiting for appointments.
This week’s announcement that Messrs. Obama and McDonald would visit the Phoenix VA hospital brought renewed calls from Republican lawmakers urging the administration to make better use of the funds allocated and speed up the firing of negligent and underperforming executives.
“The vast majority of this money remains unspent, and the expanded accountability authority has rarely been used,” Rep. Jeff Miller (R., Fla.), chairman of the House Committee on Veterans’ Affairs, said in a statement. “It’s time for the administration to step up and use the tools Congress gave it to reform the department into an organization truly worthy of the veterans it is charged with serving.”
The emergency funding measure also has been criticized recently by some veterans’ groups. A survey of veterans conducted by the Veterans of Foreign Wars organization suggested that large numbers of veterans don’t understand how to take advantage of the program to get appointments with doctors outside of the VA system or said they weren’t give then option.
Mr. Obama said Friday he is committed to implementing the legislation promptly, adding that he would work to ensure veterans are aware of the private-sector care options available to them.
(article from Wall Street Journal)
On Thursday, the Department of Veterans Affairs proposed new rules substantially overhauling the financial eligibility aspect for Non-Service Connected Pension benefits. Since the "Improved Pension" went into effect on January 1, 1979, the applicable law (38 C.F.R. 3.274) simply stated that a claimant needed to demonstrate "limited net worth." "Net worth" is defined as the total amount of net household income (gross income minus allowable household medical expenses) plus net assets. However, the law never defined a set amount that constituted "too much" in net worth. The VA was always straightforward in stating that their decision would be subjective based on whether or not (in their sole opinion) it was "reasonable" that a portion of the claimant's estate should be consumed for their maintenance. Or in plain English, should the claimant spend some of their funds before receiving financial assistance from the VA. Obviously, this approach could (and did) lead to many attempts to hide otherwise countable assets to create artificial eligibility.
The newly proposed rules amend existing 38 C.F.R. 3.271 through 3.276 and add new section 3.277 through 3.279. These new rules make numerous detailed changes but the main ones are:
At this point, the VA has 60-days to receive comments on the proposed changes. The VA must respond to these proposals and, when complete, will publish the final rules in the Federal Register. At this point the laws will take effect.
Congress Authorizes COLA for Disabled Veterans
Congress has passed legislation that would provide a cost of living adjustment for disabled veterans receiving disability compensation from the Department of Veterans Affairs and other compensation for survivors of veterans who have died as a result of their service to the country.
Known as the Veterans’ Compensation Cost-of-Living Adjustment Act of 2014 (S. 2258), the bill would increase the disability benefits for veterans using the same cost of living adjustment as Social Security.
The bill now heads to the president for signature. If and when it is signed into law, the bill would increase compensation in the following areas beginning December 1, 2014: wartime disability compensation [Compensation and Pension], additional compensation for dependents, clothing allowance, dependency and indemnity compensation to surviving spouse, and dependency and indemnity compensation to children.
The Federal Trade Commission has provided the following information regarding financial scams directed towards veterans and their family members seeking needs-based Pension benefits.
Veterans' Pensions: Protect Your Money From Poachers
Veterans and their families are a target for some dishonest advisers who are claiming to offer free help with paperwork for pension claims. The scheme involves attorneys, financial planners, and insurance agents trying to persuade veterans over 65 to make decisions about their pensions without giving them the whole truth about the long-term consequences.
Specifically, these unscrupulous brokers try to convince veterans to transfer their assets to a trust or to invest in insurance products so they can qualify for Aid and Attendance benefits. What they don’t reveal is that these transactions could mean that the veteran loses eligibility for Medicaid services or loses the use of their money for a long time. Adding insult to injury, the advisers are charging fees that range from hundreds to thousands of dollars for their services.
Your best defense against someone who wants to poach your pension to get you a better deal? A firm “no, thanks.”
Questionable AdviceIf you’re a veteran over 65, you may be approached by people with convincing come-ons offering to help you apply for supplemental pension benefits. Whether it’s through an ad or a website, the offer usually involves a free seminar and claims that:
“We’ll show you – for free how to qualify for your benefits and stay in your home.”
“We guarantee you’ll get your Aid and Attendance pension.”
“As a veteran, you’re entitled to these benefits.”
The people behind these pitches, who may claim to be veterans’ advocates, also show up at assisted living facilities, senior centers, or other places in your community to help you submit your application for A&A benefits to the Department of Veterans Affairs (VA). But often, they’re unscrupulous lawyers, financial planners, or insurance agents who merely rent the space to deliver a lunch or some snacks along with a high-pressure sales pitch for their products and services. These so-called advisers may claim to be veterans to gain your trust and they appeal to your emotions to create anxiety and apprehension about your future. As a rule, they leave out important details; the truth is that if you follow their advice, you’re likely to end up without the supplemental pension benefits they promise, disqualified from other government benefits, and stuck in a financial investment that’s not in your or your family’s best interest for the long term.
The offers almost always involve the Enhanced Pension with Aid and Attendance (also called A&A), which supplements a military pension but is only available in limited circumstances. The qualifications for A&A are specific and strict: You must be over 65; be eligible for a military pension; fall under an income threshold; and need help with daily living tasks (bathing, feeding, dressing, and toileting), be incapacitated physically or mentally, have severely limited eyesight, or be confined to bed or in a nursing home. A&A is never granted automatically either to veterans of a certain age or those with particular disabilities.
The Rules in BriefThe so-called advisers offer to help you complete the paperwork to file your benefits claims. If your assets are above the required threshold, their goal is to convince you to restructure your finances so you can qualify for A&A. That’s how they earn their money: by selling you an annuity or creating a trust. For instance, the more money you put into certain insurance products, the more money the insurance adviser gets paid.
Here’s what you need to know:
The VA accredits three types of professionals to help you complete and file pension claims:
Navigating The Process
your state insurance regulator. If you think a lawyer has behaved unethically, complain to your state Bar Association.
Tagged with: military, pension, veteran
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Dr. Glenn Osborne is the Managing Director of EVLAG. He holds a doctorate in Gerontology and has over 15 years experience in veterans benefit issues and advocacy.