Veterans Benefits Blog

The Department of Veterans Affairs offers two major disability benefits programs: (1) service-connected disability compensation and (2) non-service connected disability pension. Both benefits are based on the disability of the veteran and the disability’s effect on employability. VA pension is a needs based program. To be eligible for pension, a veteran must have wartime service, low income, and be totally and permanent disabled. Because this benefit is for low income people who are totally and permanently disabled, VA will reduce VA pension dollar-for-dollar for “countable” income. Compensation is not based on need or income. Compensation is based on a disability being caused by or otherwise related to the period of military service.

Social Security Administration, offers two major benefit programs: (1) Social Security Disability (SSDI) and (2) Social Security Income (SSI).

Generally, veterans can receive both SSDI and VA Compensation Benefits concurrently. For pension purposes, however, VA will count income from almost all sources, including SSDI income (but not SSI) to determine income for pension purposes. See 38 C.F.R. § 3.261 (2012). This means that if a veteran is receiving VA pension benefits and he/she begins receiving SSDI benefits, VA will offset the amount received from Social Security from the pension payment.

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On June 4, 2012, the Department of Veterans Affairs announced that its Advisory Committee on Disability Compensation will hold a meeting, open to the public, on June 25-26, 2012, at the St. Regis Hotel, 923 16th and K streets, NW, Washington, D.C.

The Committee advises the Secretary of Veterans Affairs on the maintenance and periodic readjustment of the VA Schedule for Rating Disabilities. The Committee assembles and reviews information relating to the nature and character of disabilities arising during service in the Armed Forces, provides an ongoing assessment of the effectiveness of the rating schedule, and gives advice on the most appropriate means of responding to the needs of Veterans relating to disability compensation.

The purpose of the meeting is for the Committee to receive briefings on issues relating to compensation for Veterans with service-connected disabilities. Public comments will be allowed in the afternoon and will be limited to three minutes each. Individuals wishing to make oral statements before the Committee will be accommodated on a first-come, first-served basis.

Any member of the public wishing to attend the meeting or seeking additional information should contact Robert Watkins, Designated Federal Officer, Department of Veterans Affairs at (202) 461-9214 or Robert.Watkins2@va.gov.

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On June 6, 2011, Sen. Richard Blumenthal (D-Conn.) introduced a bill which specifically requires VA to have a doctor of chiropractic staff at all of its major facilities by 2014. The bill was co-sponsored by Sen. Charles Grassley (R-IA), Sen. Thomas Harkin (D-IA), Sen. Jerry Moran (R-KS), Sen. Jon Tester (D-MT), and Sen. Sheldon Whitehouse (D-RI).

Currently, chiropractic care is only available at a few VA facilities across the country, and many major metropolitan areas are currently without doctors of chiropractic care. If enacted this legislation would presumably allow all veterans to have access to chiropractic care at any VA facility and would also allow VA to have more treatment providers on hand to assist veterans that suffer from musculoskeletal disabilities. This could potentially increase the number of veterans who seek treatment from a chiropractor and possibly reduce the length of time veterans with musculoskeletal disabilities wait for treatment.

Without this bill, further expansion of chiropractic care to VA facilities would be on a case-by-case basis and would probably experience significant delays.

The text of the legislation may be found at http://www.opencongress.org/bill/112-s1147/text.

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Many veterans know of the existence of VA’s “benefit of the doubt” doctrine, but question how the doctrine is applied in a case.

I. What is the “benefit of the doubt” doctrine?

VA claimants have the burden to prove their claim to the VA, that is, when making a person makes a claim to VA that person has the responsibility to present evidence that will establish entitlement to the benefits that person is seeking. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA will give the “benefit of the doubt” to the claimant.” 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102 (2010); see Gilbert v. Derwinski, 1 Vet. App. 53, 55 (1990) (the benefit of the doubt standard is similar to the sandlot baseball rule that the tie goes to the runner).

II. Does this mean the VA has to always give me the benefit of the doubt and therefore believe all of the evidence I submit to support my claim?

No, as the adjudicator of the claim, VA has the duty to weigh the evidence and determine whether that evidence if probative or not. Sometimes VA will find some evidence has more probative weight than other pieces of evidence. The “benefit of the doubt” doctrine only comes into play when two pieces of evidence are of equal weight, in that instance, VA must give the favorable evidence the “benefit of the doubt.” For example, let’s say that a veteran is trying to establish service connection for a right knee condition that developed due to an in-service fall. VA affords him an examination where the examiner reviews his claims file and determines that the condition is not related to service. The veteran then obtains a medical opinion from his doctor that is also based on a complete review of his claims file, and provides a thorough medical opinion and rationale as to why his right knee condition was caused by service. In that instance, having all things be equal between both examinations, VA should give the “benefit of doubt” to the favorable medical opinion and thus probably grant the claim.

Here’s one way to look at when the benefit of the doubt applies and when it doesn’t.

Let’s say that Joe Veteran is trying to get service connection for the arthritis in his back. Joe had an accident in service in 1968 when he fell out of the back of a moving jeep, hitting his low back. Now, 40 years later, he has arthritis in his lumbar spine and believes that his low back problem was caused by the Jeep accident. In order to be service-connected, VA rules require that there be a medical opinion that relates the currently diagnosed disability to the Jeep accident. Here, Joe gave his service medical records to his doctor who wrote an opinion saying that the current arthritis is likely due the in-service accident. VA then gets its own opinion; but its doctor says that the back problem is more likely caused by old age. In this case, there are two pieces of evidence both addressing the same question—was Joe’s Jeep accident the cause of the arthritis 40 years later. If there’s nothing about either opinion that makes it better than the other, VA is required to give the benefit of the doubt to the veteran and accept the favorable opinion.

Now, let’s change the facts around. In this case, Joe has explained that he believes the Jeep accident caused the current back problems, saying that this was the only injury he ever had to his back. In this case, however, Joe doesn’t get a medical opinion from his doctor and VA doesn’t get one either. Here, there’s no medical opinion at all answering the question about whether the arthritis was caused by the Jeep accident. Because there’s no favorable opinion, there’s just not enough evidence to allow VA to grant the claim, and no evidence to which the benefit of the doubt rule can apply.

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VA has proposed extending presumptive service connection to veterans who have served in Southwest Asia Theater of Operation on or after September 19, 2001 and who develop one of the following infectious diseases:
1. Brucellosis
2. Campylobacter jejuni
3. Coxiella burnetii (Q fever)
4. Malaria
5. Mycobacterium tuberculosis
6. Nontyphoid Salmonella
7. Shigella
8. Visceral leishmaniasis
9. West Nile Virus.
With the exception of Malaria, Mycobacterium tuberculosis, and Visceral leishmaniasis, the infectious disease must have become manifest to a degree of 10 percent or more within one year from the date of separation from a qualifying period of service.
Malaria must have become manifested to a degree of 10 percent of more within one year from the separation from a qualifying period of service or at a time when standard or accepted treatises indicate that the incubation period commenced during a qualifying period of service. There is no time limit for Mycobaterium tuberculosis or Visceral leishmaniasis.
If the regulation passes, these diseases will be the first diagnosed illnesses entitled to presumptive service connection associated with service in the Persian Gulf.

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Many veterans who served in Operations Desert Shield and Desert Storm are suffering from a range of physical disabilities, chronic ailments, and unexplained illnesses which may be due to an “undiagnosed illness.” Thousands of veterans who served in the Gulf War have come down with a pattern of symptoms that include rashes, joint and muscle pain, sleep issues, and gastrointestinal problems. However the cause of these problems remains unclear.

What is clear is that many Gulf War veterans are suffering from very real physical problems, and they are concerned along with their families about the long and short term consequences of these health problems. Many of these veterans suffering from what’s commonly called “Gulf War illness” have turned to the Department of Veterans Affairs (“VA”) for assistance. Congress has recognized, however, that “many ill Gulf veterans report having been told when they sought medical treatment that their ailments were ‘all in their heads.’” Report of the Special Investigation Unit of Gulf War Illness, 105th Congress. See http://www1.va.gov/rac-gwvi/docs/USSenate_ReportoftheSIUonGulfWarIllnesses_ReportNo105-39PartI_1998.pdf

The Washington Post has recently reported that in an effort to change this attitude on the part of VA, Secretary of Veterans Affairs, Eric K. Shinseki, has confirmed that VA will be re-examining the disability claims of what could be thousands of Gulf War veterans suffering from ailments. VA does not have an estimate of the number of veterans who may be affected, but it could be in the thousands. See http://www.washingtonpost.com/wp-dyn/content/article/2010/02/25/AR2010022506625.htmlVA also plans to improve training for medical staff working with Gulf War veterans and a review of “Gulf War illness” regulations to ensure that veterans receive the compensation they are entitled to by law.

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Many veterans pursuing a claim for VA benefits have already been granted Social Security Benefits or are pursuing Social Security benefits for the same disability. A common belief among veterans is that VA should make the same conclusions and/or decision as the Social Security Administration (“SSA”). For instance, many veterans believe that because SSA found them totally disabled, that decision should be binding on the VA, and therefore VA should also find them totally disabled. This is a common misconception. VA is a separate administrative agency form SSA, and therefore is bound by different regulations. Simply put, SSA regulations do not apply to VA claims. See Beaty v. Brown, 6 Vet.App. 532 (1994) (noting that there is not statutory or regulatory authority for the determinative application of SSA regulations to the adjudication of VA claims.) In addition, there are significant differences between SSA regulations and VA regulations. For example, SSA and VA define disabilities differently. Under SSA law 42 U.S.C. § 423(d) and 20 C.F.R. §404.1509, a disability need not be reasonably likely to last a lifetime. VA regulations on the other hand, do require that it be reasonably certain that a disability will continue throughout the life of a person. 38 U.S.C. §1502(a)(1) and 38 C.F.R. § 3.340(b).
While VA is not legally bound to follow SSA decisions, however, it is obligated to take the SSA decisions into consideration when rendering a decision on a claim and provide adequate reasons or bases for why the SSA conclusions are not accepted. Brown v. Derwinski, 2 Vet.App. 444 (1991). Moreover, once VA has been put on notice that SSA documents exist, and those documents are pertinent to the VA claim, VA has a duty to assist the veteran in obtaining the SSA records prior to adjudicating the claim. See Murincsak v. Derwinski, 2 Vet.App. 363 (1992).

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