COMPENSATION FOR SECONDARY SERVICE CONNECTION AND FOR SECONDARY SERVICE CONNECTION BY AGGRAVATION

As the title of the regulation suggests, there are two categories of claims that can be granted secondary service connection under VA regulation 3.310,

“Disabilities that are proximately due to, or aggravated by, service-connected disease or injury.”

The first category includes claims for which there is an initial service-connected disability, and then a subsequent disability or disabilities found to be proximately due to (caused by) the service-connected disability. One example of this type of claim would be loss of limb due to amputation occurring subsequent to a service-connected diabetes diagnosis.The loss of a limb, it might be argued, should be service connected in addition to the diabetes because the amputation may not have been needed had the veteran not developed diabetes.

In the two-year period from October 2004 through September 2006, nearly 260,000 veterans were service connected for conditions proximately due to service-connected disabilities. This accounted for approximately 19 percent of the more than 1.3 million disabilities that were service connected during that period. Most of the disabilities were rated at 10 or 20 percent. Less than 10 percent were rated at 50 percent or higher.

Ten conditions accounted for 55 percent of the disabilities compensated as secondary to service-connected disabilities in 2005–2006.

In accord with a 1995 court decision (Allen v. Brown, 7 Vet. App. 439), VA will also grant service connection under this regulation in claims where there is an increase in the severity of nonservice-connected disability that is found to be due to aggravation by a service-connected disability. These are called secondary service connection by aggravation claims or, after the

In people with diabetes, an increased risk of amputation comes from damage to nerves and blood vessels through decreased circulation efficiency and diabetic neuropathy. According to the American Diabetes Association, more than 60 percent of nontraumatic lower-limb amputations occur in people with diabetes and the rate of amputation for people with diabetes is 10 times higher than for people without diabetes (ADA, 2007). What Is a Secondary Condition? Secondary condition is a relatively new term in the disability and public health arenas. It began to be accepted around 1990 as an expansion of the concept of comorbidity, which is used to refer to conditions that exist in a single person simultaneously, but that are not known to be related in any manner (CDC, 2004a). A person having coexisting skin malignancy and hearing loss would be said to have comorbidities, because there is no known relationship between these two conditions. From a strictly medical perspective, a secondary condition is a condition with its own pathophysiology that is due to, or caused by, the presence of a preceding primary condition. Secondary conditions can be distinguished from secondary manifestations, the latter referring to sequelae or subsequent complications arising from the same underlying pathophysiologic process as the primary condition. Diabetes is a good example of a condition with many secondary manifestations. Diabetes itself is an abnormal metabolism of glucose (that can be induced in several ways, including trauma), which has an associated abnormality in lipid metabolism, which leads to an accelerated process of arteriosclerosis. This combination leads to a higher frequency and earlier onset of, among other things, peripheral vascular disease, coronary arteriosclerosis, peripheral neuropathy, and premature cataracts of the eyes. These can be considered secondary manifestations because they are expressions of the person’s underlying diabetes and share the same underlying pathophysiology. At times the Rating Schedule treats what are in fact secondary manifestations as secondary conditions. The instructions on rating diabetes mellitus (diagnostic code 7913 under CFR 4.119 Schedule of ratings—endocrine system), for example, tell raters to evaluate compensable complications of diabetes separately, except in cases where they are a part of a 100 percent evaluation (diabetes ratings below 100 percent do not take into account compensable complications). Rating Secondary Service Connection Claims In a presentation before the committee, C&P Service staff stated that decisions on secondary claims are based on the facts of the individual case and the medical opinion solicited from the VHA examiner on the general medical examination form. Using this evidence, the rater determines whether it is at least as likely as not that each claimed secondary condition was caused by the primary service-connected condition. The process of assigning ratings in secondary claims is the same as in claims involving multiple individually service-connected conditions. Each condition is first evaluated separately and assigned a percentage rating. Starting with the condition with the highest percentage rating, the rater then uses VA’s combined ratings table to calculate an overall percentage rating for the primary condition and all conditions found to be proximately due to the primary condition.

Veteran Suicide FYI

Suicide is a big deal, it's killing more veterans than the war on terror!

6,500 former military personnel killed themselves in 2012. More veterans succumbed to suicide than were killed in Iraq. In 2012, 177 active-duty soldiers committed suicide, conversely 176 soldiers were killed in combat. In other words, more soldiers committed suicide compared to being killed in action. In 2012, the study concluded that Army had the highest number of suicides compared to any other service branch.

In 2013, the United States Department of Veterans Affairs released a study that covered suicides from 1999 to 2010, which showed that roughly 22 veterans were committing suicide per day, or one every 65 minutes. Some sources suggest that this rate may be undercounting suicides. A recent analysis found a suicide rate among veterans of about 30 per 100,000 population per year, compared with the civilian rate of 14 per 100,000. However, the comparison was not adjusted for age and sex.

The total number of suicides differs by age group; 31% of these suicides were by veterans 49 and younger while 69% were by veterans aged 50 and older. As with suicides in general, suicide of veterans is primarily male, with about 97 percent of the suicides being male in the states that reported gender.

In 2015, the Clay Hunt Veterans Suicide Prevention Act passed in the Senate and was then enacted as Pub.L. 114–2 on February 12, 2015.

"Combat veterans are not only more likely to have suicidal ideation, often associated with posttraumatic stress disorder (PTSD) and depression, but they are more likely to act on a suicidal plan. Especially since veterans may be less likely to seek help from a mental health professional, non-mental-health physicians are in a key position to screen for PTSD, depression, and suicidal ideation in these patients."

The same study also found that in veterans with PTSD related to combat experience, combat-related guilt may be a significant predictor of suicidal ideation and attempts.

Craig Bryan of the University of Utah National Center for Veterans Studies said that veterans have the same risk factors for suicide as the general population, including feelings of depression, hopelessness, post-traumatic stress disorder, a history of trauma, and access to firearms.

Veteran Takes His Own Life After No One Answers His Suicide Hotline Call

Sometime between July 22 and 23, 2015, Young called the VA’s suicide hotline in desperate need of help, but he didn’t get an answer. After leaving a message, Young went to the local Metra tracks, lay down, and was killed by an oncoming train. It wasn’t until the next day that the hotline returned Young’s call.

During an interview with an ABC News, Young’s brother Will said that Thomas tried to get help at the VA, but it was useless:

“The first two times he was turned away, told he didn’t qualify for treatment because he wasn’t suicidal. The third time he was suicidal and he was put on a waiting list.”

Thomas Young, right, with his brother Will. Image Credit: Facebook

According to The Daily Caller, Young had tried to kill himself before.

The Independent Journal spoke with Will Young about his brother’s suicide, and he had some stirring words for the VA:

“These people that the VA is working with aren’t disposable parts, they’re people’s family members, they’re real people with real issues. My concern–my reason for doing this was not to get my brother’s name in the paper, was not to have people call me and give me their condolences, it’s to promote change so it doesn’t happen again.

I would like the VA to learn from my brother’s story. If you serve in a combat zone, there should be zero red tape if you need help. Zero.”

The corruption and incompetence at the VA runs deep.

In 2008, CBS reported on leaked emails written by Dr. Ira Katz, the VA’s head of mental health at the time, that painted a damning picture of an agency deliberately covering up the volume of veteran suicides in the United States.

One email read:

“Shh! Our suicide prevention coordinators are identifying about 1,000 suicide attempts per month among veterans we see in our medical facilities. Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?”

Image Credit: Screenshot

After the email release, NBC reports that Senators Daniel Akaka (D-HI) and Patty Murray (D-WA) called for Katz’s resignation. Yet, six years later, Katz was not only still employed by the VA, but he was made Acting Director of Mental Health Operations.

After Senator Kirk questioned Dr. David Shulkin, the VA Under Secretary for Health, Thursday, he confirmed Katz is still with the VA.

As if the situation couldn’t get any worse, The Daily Caller adds:

“The government-run healthcare provider had been alerted to problems with its suicide hotline four months prior to Young’s death, but didn’t fix the issues.”

In February 2015, the VA claimed changes were being made. However, during Thursday’s hearing, Senator Kirk asked VA undersecretary, Dr. David Shulkin, why, if changes were being made, Young was left alone with no one to answer his desperate call. Shulkin deferred blame to a contractor, and called the incident “totally unacceptable.”

After hearing endless stories regarding the failures at the Department of Veterans Affairs over the last several years, it can become easy for many Americans to simply stop listening, but Young’s tragic story, as well as his brother’s powerful indictment, will hopefully serve to remind Americans that this issue is far from resolved.

Story Via IJReview

How to obtain your DD-214

     To often I have veterans reach out to me for help or questions regarding benefits.
My first question is always, do you have a copy of your DD-214 for service verification.
Seventy Five percent of veterans reply the same way; I moved after I separated and I
misplaced my 214.
Veterans please maintain a copy of your DD-214. You can't do anything regarding your 
benefits without this! Click the link below to obtain a copy of your DD-214 

Get my DD-214 today!!

Veterans and "ebenefits"

There just aren't a lot of guarantees in this world, however I think we can all agree that we will all eventually leave this world, we'll probably never see Leonardo Wilhelm DiCaprio win an award, yes that is his middle name. BUT there is a guarantee if you're a veteran. All veterans know that if you call the VA 1 (800) 827-1000, you are in for a long wait! Sometimes upwards of 2 hours It’s a reality too many Veterans are aware of in our modern time.

     I find that a lot of the Veterans that I interact with are often not aware of the VA website “eBenefits.” So, what is eBenefits? Essentially the eBenefits website is a web portal in which Veterans can access information about their disability benefits, healthcare records, and even enroll in programs for education and housing. I am a cynic, especially when it comes to the VA, and even I was impressed by everything you can do on this site. I was also surprised to learn that it has been around since 2007. I’m going to stop here and applaud the VA for making online access a priority. As someone who works with veterans and is active on social media, I will also say that the VA does a really great job with their social media presence. However, if you’re waiting months to see a doctor for your PTSD claim, a nicely worded Tweet isn’t going to do you much good. Maybe the social media team can share some of their efficiency with disability administrators.

You might be wondering why you, as a Veteran, should use eBenefits. That’s actually a simple answer. It offers a great alternative to calling the 1-800 number. Further, you have quicker access to your medical records. With eBenefits you can see what is going on with your VA Disability Claim, and you can even file for benefits by way of the site.  Honestly, from my personal experience, it is better than it used to be. It’s not flawless, but it works well enough for what most people need it to do. When I first started using ebenefits, my biggest complaint was that it was not very accurate and the status of a case was rarely updated. Now it’s not as much of an issue. It’s not completely without issue, but it’s getting there.

So, why am I telling you about eBenefits? Honestly, I have a vested interest in this site because it is helpful for what I do for clients and it has helped me also. Too often I encounter Veterans who aren’t aware of the status of their case. Well, with eBenefits a Veteran can get all of the up to date information needed to determine eligibility for their claim. This includes the status of their claim, their percentages, and what disabilities they have applied for in the past. So, if you want to get some answers a little quicker from the VA, check out the VA eBenefits site. It’s free, works pretty well, and can be pretty helpful. 

Army Ranger Dies On 14th Deployment

An Army Ranger who was on his 14th deployment to a combat zone has been killed in Afghanistan.

Sgt. First Class Kristoffer B. Domeij, 29, 

was killed Saturday when the assault force he was with triggered a hidden roadside bomb in Afghanistan's Kandahar Province.

Domeij served four deployments in Iraq and another nine stints in Afghanistan. During that time he was awarded two Bronze Stars. His third Bronze Star, earned during his final tour in Afghanistan, will be awarded posthumously, according to the U.S. Army Special Operations Command.

Also killed in Saturday's blast were First Lieutenant Ashley White, 24, a Cultural Support Team member, and fellow Ranger Private First Class Christopher A. Horns, 20, who was on his first combat deployment.

His battalion commander, Lt. Col. David Hodne, described Domeij as "one of those men who was known by all as much for his humor, enthusiasm, and loyal friendship, as he was for his unparalleled skill and bravery under fire."

"This was a Ranger you wanted at your side when the chips were down... He is irreplaceable … in our formation … and in our hearts," Hodne said.

Domeij, who grew up in San Diego, Calif. and Colorado Springs, Colo., and lived in Lacey, Wash., was married and had two young daughters.

Rangers are some of the Army's most elite special operations forces and have seen almost continual combat in Afghanistan since October 2001 when they were part of the original airborne assault into the country.

Rangers serve three to four month tours of duty that are significantly shorter than the year-long deployments served by soldiers in conventional units. But during those short deployments they see a constant churn of intense combat missions. On average, a Ranger battalion will conduct between 400 to 500 missions during a combat deployment.

Tracy Bailey, a spokesperson for the 75th Ranger Regiment, says Domeij had a combined total of 48 months deployed to Iraq and Afghanistan.

Higher ranking enlisted Rangers, like Domeij, typically have between nine and 12 deployments if they were with the 75th Ranger Regiment prior to or shortly after Sept. 11, 2001. Domeij had enlisted in the Army in July 2001 and joined the 2nd battalion, 75th Ranger Regiment in April 2002.

With his 14 deployments, Domeij becomes the Ranger with the most deployments to date killed in action. Just a year ago this month, fellow Ranger SFC Lance Vogeler was killed in Afghanistan during his 12th deployment, becoming at that time the Ranger with the most deployments killed in action.

Domeij had the distinction of being one of the first Rangers to be qualified as a Joint Terminal Attack Controller (JTAC), a position usually reserved for Air Force airmen who serve with ground combat units and call in airstrikes from fighters or bombers flying overhead.

Col. Mark W. Odom, commander of the 75th Ranger Regiment, called Domeij "the prototypical special operations NCO" whose abilities as a JTAC "made him a game changer on the battlefield—an operator who in real terms had the value of an entire strike force on the battlefield."