Benefits and Claims
45 year old claim
Congressman Jeff Miller
Veteran Affairs Chairman
335 Cannon House Office Building
Washington, DC 20515
Attn: Chris Stone, Military Fellow
Dear Congressman Miller,
I recently saw you on major news channels discussing the present day VA Scandal and the death of veterans, due to no healthcare or poor healthcare.
Let me share a problem with “benefits and claims” that has resulted in far more deaths.
My original claim was filed in 1969, 45 years ago. I was discharged from the Marines upon my return from Viet Nam at El Toro California in September 1968. The doctor from my discharge exam instructed me to go to VA hospital in Birmingham, Alabama for a medical follow-up in November of 1968.
The hospital’s VA office notified me that I should file a service connection claim which I did in June 1969. It was explained to me that I could need long term care, which would get worse with age; they were right.
I received a letter from VA acknowledging my service connection and a small disability of approximately 10%. However by November 1969, my first claim was denied, due to no medical records. I was receiving treatment, my primary concern, at the time. Much later I discovered VA Birmingham lost files from approximately 1969-1975. By 1982, my shoulder problems required surgery. The same VA hospital in Birmingham advised me to file a claim #2; this claim was denied due to insufficient medical records. By this time I had approximately three surgeries.
In May 1999, I filed claim #3 and received notice that I had not produced “New and Material Evidence.” To date, I have now had five or six surgeries.
In September 2002, I filed claim #4. It was equally denied. However, I appealed the decision. Within a year Social Security granted Disability status, VA explained this meant little.
Now here is where it gets interesting. On October 11, 2003, I received my discharge medical records in the mail in a brown envelope with no return address, and no letter—just my files, anonymously. I still have the original envelope, copy enclosed.
My medical records clearly stated my Viet Nam injury. I sent a notice of disagreement February 6, 2004, and statement of claim June 2, 2004 and VA form 9.
On June 9, 2005, I had my first travel board hearing in Montgomery, AL. Prior to the meeting, a VA representative explained that all my questions would be answered. The primary question was about the anonymous medical records and how previous claims had been denied due to absence of the same records.
No answer was given.
On September 21, 2006, I was diagnosed with kidney cancer; I underwent surgery and was told my cancer was caused by chemical exposure; however they could not say if it was Agent Orange. I know it was.
On April 25, 2007, 38 years after discharge, the VA finally granted service connection with a 20% Disability in both shoulders. My condition had limited my work ability as early as 2002, however, now my objective was to get VA to acknowledge that my disability was far more that 20%.
On July 10, 2008, I appealed the Disability Rating.
On November 13, 2009, S.O.C. upheld the previous denial.
In 2010, again I was headed to VA for surgery. The doctors had recommended shoulder replacement in 2003; I was in real trouble by February 2010. My first operation went well, however, in less than 30 days I needed emergency surgery. I was awarded 100% temporary Disability. I was fed up with VA. I hired an attorney to represent me on a “clear and unmistakable error” on VA’s behalf.
Once I filed the “clear and unmistakable error” claim, VA questioned why I had not appealed earlier claims or produced new material evidence. I had no new material evidence and no medical records until October 11, 2003. The medical records document my claim of early effective date and clear and unmistakable error. My decision to hire an attorney drew criticism from VA officials, explaining I didn’t need one and was wasting any money I may receive. I felt the 20 % attorney fee was worth my sanity.
On October 6 2010, I realized just how important an attorney could be. A rating decision, after 41 years, was like buying a car. A VA representative phoned me and began negotiations that lasted a couple weeks. The first offer was 100% Disability that started February 10, 2010, with no back dated.
I referred to my file and documented medical records, only to listen to further negotiations that centered on total settlement of all claims. These conversations were informal and intimidating. I finally settled on a back date of September 1, 2007, after being told negotiations would end and I could be in appeal again. They also rejected the VA doctor’s suggestion of both right and left shoulders undergoing total replacement in 2003.
On the issue of “clear and unmistakable error,” I was told that that single issue would not be resolved. I insisted I would not settle the issue without an attorney, this did not go over well and I was told I probably would not get anyone in VA willing to admit to my claim.
This was my second attempt to resolve the issue, the June 9, 2005, travel board hearing being the first.
After 41 years I now found myself again requesting a second video conference for this issue only.
On March 29, 2011, my attorney and I attended my second video conference. As in the first video conference, I was told by a VA representative all questions would be answered.
To my dismay, the judge’s introduction and review of my case was riddled with mistakes. My attorney corrected the judge multiple times on facts and the current situation. If I ever needed an attorney, it was obviously then.
This was my third attempt to address “clear and unmistakable error,” and I was sitting before a judge making statements that were not true. The information provided him was either false or outdated.
After three years the judge on May 13, 2014, remanded a decision to AOJ, with no answer again; and again, for the fourth time, I was back where I started.
The irony of my case is that VA has already documented all of the facts I am asked to prove to substantiate my claim.
VA admits numerous claims were denied due to “lack of medical records.” The anonymous medical records mailed to me October 7, 2003, absolutely proved my service connection and medical claim, which was the evidence needed to prove my case.
It is obvious that VA did indeed make a clear and unmistakable error, and that VA refuses to even address the issue.
My medical files, anonymously sent to me, speak for themselves.
Congressman Miller, how many veterans, during the duration of my case—some 45 years, abandoned their cases out of frustration? How many suicides, divorces, property losses, and lack of education are credited to a failed benefits and claims system?
The financial losses to those veterans are in the billions of dollars, I believe VA depends on procrastination, bureaucracy and death to “settle” cases. I financially have lost hundreds of thousands through the years due to my injury.
My health care, hundreds of appointments, over a dozen operations, have all been at VA hospital Birmingham, AL., with the exception of three operations in the private sector. The care in 1968 vs. today is no comparison. My experience with medical treatment since the early 1990’s, is excellent. Primary care, operations, doctors and staff at the VA Birmingham hospital is excellent.
The VA administrative branch in Montgomery, AL has been consistently a broken, dysfunctional agency. I cannot begin to explain how deplorable an operation it is. Lost files, misinformation, delayed and forgotten cases, countless & needless mailings, unprofessional behavior, delayed hearings, etc., are the norm. I truly believe they operate on a mortality table, settling your case with your death.
Senators, Congressman, VA representatives, VA hospitals and veterans run into a brick wall when dealing with VA over claims and benefits.
The VA boasts that all claims favor the veteran and the veteran gets the “benefit of the doubt.” VA lost or displaced my medical records for 34 years, while denying claim after claim.
VA failed three times to address my claim of, clear and unmistakable error, and early effective date. It happened during the June 9, 2005 travel board, the February 10, 2010 settlement of disability and the March 29, 2011 video conference represented by attorney.
The result of March 29, 2011, was to remand the issue to AOJ, the Agency of Original Jurisdiction. Nine years later I am back at AOJ, the same entity which failed to address the issue three times and told me “No one at VA wants to settle a claim admitting guilt.” I wonder who got bonuses at VA in the last ten years while my claim went nowhere?
I cannot say enough about VA Birmingham Hospital, Doctors and Staff, that I have gotten to know over the last 45 years and approximately a dozen operations.
The only humans you get to talk with, related to claims and benefits are veteran affairs assistants and congressional aides.
My veteran’s assistant, encouraged me not to give up in 2003. Her assistance, patience and time are all the qualities her supervisors in Montgomery LACK.
What do I do now? Should I wait on AOJ to send me on another paper trail of appeals and dead ends?
I have appealed to VA Montgomery, Senators, Congressman, VA Assistants, VA Congressional Aides, and VA Directors, etc., all to no avail.
It’s a black hole and it’s meant to be.
Sir, with all due respect, I believe you already know this. If you cannot deliver what you pledged to Veterans, then stop sending us to wars!
45 Years and still waiting.
USMC Viet Nam Veteran