Readers of Tom Philpott’s Military Update column sound off.
Former Rating Specialist Attests to ‘IU’ Problem
Regarding your column on the Department of Veterans Affairs’ lax oversight of disability ratings for Individual Unemployability (IU), I can say from first-hand experience it has been a poorly kept secret for many years.
I worked for the VA from 1973 to 1988, spending four of those years as rating specialist and four more as supervisory claims examiner. While I was a rating specialist, the VA conducted a nationwide review of IU cases. As I recall, it found that a third of cases were decided correctly, a third were questionable or lacking sufficiently developed evidence, and a third contained “clear and unmistakable error.”
An example of a clear error was a 60-plus WWII veteran who worked his whole life in a physical job and retired due to a job-related injury after he was 60. He had static combat-related wounds that combined to a rating of 60 percent disabled. He had been placed on IU with nothing more than his application. He had not even claimed his service-connected injuries had in any way made him unable to work.
Many years ago the adjudication officer of the Seattle VA Regional Office had made it policy that veterans with qualifying percentages would get IU when they retired at any age, and without any examination to see if their service-related condition had worsened to cause them to be unable to work.
By the late 1970s, the WWII generation of rating specialists were retiring and being replaced by Vietnam-era veterans. We all knew that the former practice was not permitted by VA regulation, so we did not do that. Your article indicates that 79 percent of new IU ratings go to veterans over age 60. So it sounds like that long-ago discredited policy has resurfaced.
When I left the VA in 1988 the Court of Veteran’s Appeals was just being organized. Friends who continued to work at the VA said the court imposed huge procedural burdens on the rating process. Cases that were clear-cut and required only a short rating narrative to support findings became pages long to comply with court requirements. Case after case was remanded for further paperwork. The court’s effect on the rating process should be studied.
Congress gets involved periodically too and enacts “VA Medicine.” That means making causal connections between medical conditions that are not supported by science but favored by veterans’ groups.
The VA employees I knew were competent and hardworking. The problem is a rating schedule that has not been scrutinized for half a century, "medicine" influenced by powerful political forces and a legal review system that dramatically burdens the whole process.
ROBERT CARPENTER
Bremerton, Wash.
The GAO recommendation that VA tighten its oversight of the IU rating is long overdue.
While working as a Vocational Rehabilitation and Employment Officer, I complained about IU decisions for several years. In extreme cases, veterans said they had been prompted by their service officers to make these claims and to abandon jobs and rehabilitation programs to support their claims.
This occurred following a determination by the vocational rehabilitation staff that the veteran is "employable" and that the opportunity for rehabilitation to a suitable job is feasible.
While working as a Vocational Rehabilitation and Employment Officer, I complained about IU decisions for several years. In extreme cases, veterans said they had been prompted by their service officers to make these claims and to abandon jobs and rehabilitation programs to support their claims.
This occurred following a determination by the vocational rehabilitation staff that the veteran is "employable" and that the opportunity for rehabilitation to a suitable job is feasible.
M. FARMER
MMC(SS)DV USS SHANGRILA CV-38, DSDS Class 67-02 WNY DC, AMSU Little Creek, SEALAB, MK-II DEEP DIVE SYS, ELK RIVER IX-501, NEC 5342/5311.
"Message to ND's: Where ever you are going, I've been there.
"If you are planning for retirement, you are not planning far enough.
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
Question
Old 5311
Disgust Over IU Problem
Tom Philpott | June 23, 2006
Readers of Tom Philpott’s Military Update column sound off.
Former Rating Specialist Attests to ‘IU’ Problem
Regarding your column on the Department of Veterans Affairs’ lax oversight of disability ratings for Individual Unemployability (IU), I can say from first-hand experience it has been a poorly kept secret for many years.
I worked for the VA from 1973 to 1988, spending four of those years as rating specialist and four more as supervisory claims examiner. While I was a rating specialist, the VA conducted a nationwide review of IU cases. As I recall, it found that a third of cases were decided correctly, a third were questionable or lacking sufficiently developed evidence, and a third contained “clear and unmistakable error.”
An example of a clear error was a 60-plus WWII veteran who worked his whole life in a physical job and retired due to a job-related injury after he was 60. He had static combat-related wounds that combined to a rating of 60 percent disabled. He had been placed on IU with nothing more than his application. He had not even claimed his service-connected injuries had in any way made him unable to work.
Many years ago the adjudication officer of the Seattle VA Regional Office had made it policy that veterans with qualifying percentages would get IU when they retired at any age, and without any examination to see if their service-related condition had worsened to cause them to be unable to work.
By the late 1970s, the WWII generation of rating specialists were retiring and being replaced by Vietnam-era veterans. We all knew that the former practice was not permitted by VA regulation, so we did not do that. Your article indicates that 79 percent of new IU ratings go to veterans over age 60. So it sounds like that long-ago discredited policy has resurfaced.
When I left the VA in 1988 the Court of Veteran’s Appeals was just being organized. Friends who continued to work at the VA said the court imposed huge procedural burdens on the rating process. Cases that were clear-cut and required only a short rating narrative to support findings became pages long to comply with court requirements. Case after case was remanded for further paperwork. The court’s effect on the rating process should be studied.
Congress gets involved periodically too and enacts “VA Medicine.” That means making causal connections between medical conditions that are not supported by science but favored by veterans’ groups.
The VA employees I knew were competent and hardworking. The problem is a rating schedule that has not been scrutinized for half a century, "medicine" influenced by powerful political forces and a legal review system that dramatically burdens the whole process.
ROBERT CARPENTER
Bremerton, Wash.
The GAO recommendation that VA tighten its oversight of the IU rating is long overdue.
While working as a Vocational Rehabilitation and Employment Officer, I complained about IU decisions for several years. In extreme cases, veterans said they had been prompted by their service officers to make these claims and to abandon jobs and rehabilitation programs to support their claims.
This occurred following a determination by the vocational rehabilitation staff that the veteran is "employable" and that the opportunity for rehabilitation to a suitable job is feasible.
While working as a Vocational Rehabilitation and Employment Officer, I complained about IU decisions for several years. In extreme cases, veterans said they had been prompted by their service officers to make these claims and to abandon jobs and rehabilitation programs to support their claims.
This occurred following a determination by the vocational rehabilitation staff that the veteran is "employable" and that the opportunity for rehabilitation to a suitable job is feasible.
M. FARMER
MMC(SS)DV USS SHANGRILA CV-38, DSDS Class 67-02 WNY DC, AMSU Little Creek, SEALAB, MK-II DEEP DIVE SYS, ELK RIVER IX-501, NEC 5342/5311.
"Message to ND's: Where ever you are going, I've been there.
"If you are planning for retirement, you are not planning far enough.
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