Winning Appeals for Denied Veteran Benefits Claims

Stetson Veterans Advocacy Clinic director Stacey-Rae Simcox goes over a case file with paralegal Shirley Wells. Both women are Army veterans.

Stetson Veterans Advocacy Clinic director Stacey-Rae Simcox (left) goes over a case file with paralegal Shirley Wells (right). Both women are Army veterans.

There’s no shortage of stories about veterans who have had their disability benefit claims denied by the Veterans Administration, or their appeals paperwork lost.

The VA claims process can be complex, time consuming and downright frustrating.

But there’s help for veterans who have hit a roadblock in their quest for benefits they earned while serving in the military.

The new director at the Stetson University College of Law Veterans Advocacy Clinic has forged some creative partnerships resulting in an 81 percent success rate appealing denied VA benefits claims.

“With this legal-medical partnership and law students bringing evidence to the table for the VA and making it easy to understand, we’ve been able to get the VA to change their mind about 81 percent of the time, the very first time we present evidence to them which is impressive,” said Stacey-Rae Simcox, Veterans Advocacy Clinic director.

Stetson recruited Simcox from William & Mary where she helped establish a veterans’ legal clinic in 2008.

VLI_sign_exterior“My husband, Mark Matthews, actually helped me start that clinic at William & Mary. And the reason we started it was when we got off active-duty, we messed up my husband’s claims with the VA so badly that we missed all the deadlines and the claims died,” Simcox said. “We couldn’t get all the benefits he deserved. We thought “Jeez!” if two JAG officers can’t figure this out, how is the average service member who gets off active-duty going to figure this out. So we decided to become experts.”

And they also became innovators setting up a partnership at William & Mary between the veterans’ clinic and the psychology department. Psychology students did mental health assessments of veterans who had been denied a disability claim. The results were include in their appeal to the VA.

“Any veteran who has gone through the process of veterans benefits will tell you that medical evidence is really important to what they do and if you can’t prove to the VA through medical evidence that your disability somehow has to do with your service, then you’re not going to get that benefit,” Simcox said.

Because of their limited staff, veterans seeking help with a claims appeal are asked to call or contact the clinic through their website.

Because of their limited staff, veterans seeking help with a claims appeal are asked to call or contact the clinic through their website.

At Stetson she’s forged an even broader partnership teaming up with the University of South Florida Morsani College of Medicine.

“To create a partnership with the medical school for this purpose is a huge boon to the veterans and the VA because not only are we able to help veterans with mental health condition like post-traumatic stress disorder or traumatic brain injury, but now we can collaborate with medicine on the issues that most veterans have: hearing loss, back problems, knee problems,” Simcox said.

By the time a veteran walks into the Stetson Veterans Law Institute – they’ve usually knocked on every door there is to knock on. As soon as they enter the converted one-story home across from the Gulfport campus, they will meet Shirley Wells, a paralegal, and Army veteran who handles intake.

“We have some cases where soldiers have been looked over for 20-30 years,” Wells said.

Eighty-percent of their cases are appeals of denied disability claims, but occasionally they help on unique first-time claims.

Second year law student Daniel Flanagan couldn't join the Marines because of health issues. So, he wanted to serve by helping veterans with their disability claims appeals.

Second year law student Daniel Flanagan couldn’t join the Marines because of health issues. So, he wanted to serve by helping veterans with their disability claims appeals.

Stetson law students are a key to the success of the Veterans Advocacy Clinic. They do much of research and reading of files as thick as 1,000 pages. Daniel Flanagan, a second year student, works 18 hours a week at the clinic.

“This is practical. You don’t get to chew through a case file in any of your other classes. When you get Torts you go through a whole bunch of Supreme Court cases, but you don’t actually sit down with a case file that is a 1,000 pages thick,” Flanagan said.

What are practical lessons for the law students can become life-changing cases for the veterans.

“The people we’re getting are kind of at the end of their rope. They don’t have anywhere else to go,” Flanagan said. “For me, it makes it stressful because ‘Oh my goodness!’ I’m your last hope. Hope I don’t mess this one up.”

That’s not going to happen because their work is supervised by Simcox and other law professors at Stetson

Simcox is working toward the day when the VA and the veterans clinic can have a strong, two-way relationship so they can work together fixing veterans’ benefit claims and getting the assessments right the first time.

Meet the Top NCO from Florida’s 53rd Infantry Brigade

Florida National Guard SSG Aidana Baez with her practice "ruck" weighing 45 pounds - 10 more pounds that in competition - for training marches.

Florida National Guard SSG Aidana Baez with her practice “ruck” weighing 45 pounds – 10 more pounds than what is used in the competition.

The top Non-Commissioned Officers from the Florida Army National Guard this weekend are at Camp Blanding vying for the title of “Florida NCO of the year.”

It is two days of physical competitions, weapons and skills contests, a six-mile “ruck” march and tests on Army regulations.

Representing the 53rd Infantry Brigade Combat Team, headquartered in Pinellas Park, is Staff Sergeant Aidana Baez. She won NCO competitions at the company level and battalion level to earn the top brigade honor.

“I like to joke that the Non-Commissioned Officer of the year for the infantry brigade wears a skirt,” Baez said. “Cause I wear a skirt with my uniform and I think that’s fantastic.”

Active Guard Reserves from the 53rd Infantry Brigade Combat Team do PT, physical training, in the parking lot of their Pinellas Park, FL headquarters.

Active Guard Reserves from the 53rd Infantry Brigade Combat Team do PT, physical training, in the parking lot of their Pinellas Park, FL headquarters.

The petite soldier beat out competitors from the two infantry battalions, a field artillery regiment and a cavalry unit.

“They were all men, and I was just another competitor,” Baez said. “Maybe they didn’t see it until the “ruck March” that I meant business. But, it wasn’t like a blowout. They all did really well and we all encouraged each other.”

Baez said her strength in the competition is knowing the Army regulations which is a sweet irony because she almost got thrown out of the regular Army 11 years ago.

“My first duty station was Fort Drum, New York, not an easy duty station and I was not an easy soldier to deal with,” Baez confessed. “I had attitude, I was insubordinate, I got in plenty of trouble. And then, the day had come where I did too much. I was getting kicked out of the Army. My paperwork was done.”

Baez holds some of the ribbons and medals she's earned during 14 years in the military and two deployments, one to Iraq and the other to Kuwait.

Baez holds some of the ribbons and medals she’s earned during 14 years in the military and two deployments, one to Iraq and the other to Kuwait.

But the base chaplain and several NCOs stepped up in her defense. She was given a rehabilitative transfer to a new unit. Baez finished her hitch with the regular Army and then moved back to Florida and joined the National Guard.

She’s now a staff sergeant known for giving second chances to her soldiers, but they have to earn it.

With 14 years of service to her credit, Baez is on a mission to become Florida’s Top Non-Commissioned Officer of the Year. If she wins, Baez will advance to the regional NCO completion in the Virgin Islands.

Sec. Chuck Hagel’s Farewell – ‘People Depend on You’

TAMPA, Fla. (Aug. 28, 2014) -- Secretary of Defense Chuck Hagel attends a Change of Command ceremony for U.S. Special Operations Command at the Tampa Convention Center in Tampa, Fla. August 28, 2014. DoD photo by Petty Officer 2nd Class Sean Hurt/Released

TAMPA, Fla. (Aug. 28, 2014) — Secretary of Defense Chuck Hagel attends a Change of Command ceremony for U.S. Special Operations Command at the Tampa Convention Center in Tampa, Fla. August 28, 2014. DoD photo by Petty Officer 2nd Class Sean Hurt/Released

Below is the farewell message from Defense Secretary Chuck Hagel – dated – February 13, 2015.

To the men and women of the Department of Defense:

When I joined the United States Army 48 years ago, I could not have imagined one day serving as secretary of defense. It has been a tremendous privilege to serve with you.

As I leave office, I am immensely proud of what we have accomplished together over the past two years.

We have responsibly ended our combat operations in Afghanistan and begun the follow-on mission to preserve our achievements there.

We have bolstered enduring alliances and strengthened emerging partnerships, while successfully responding to crises around the world.

We have launched vital reforms that will prepare this institution for the challenges of the future.

We have fought hard – and made real progress – against the scourge of sexual assault in our ranks.

And after 13 years of war, we have worked to restore our military readiness and ease the burdens on our people and their families.

Through it all, many of you, and your families, coped with shutdowns and furloughs; weathered hiring and pay freezes; and endured long hours and longer deployments. You did so because we each took an oath to defend our nation, our fellow citizens, and our way of life. And you have lived up to your word.

But as you know well, the world is still too dangerous, and threats too numerous. I know you will remain vigilant, continuing your important work under the leadership of Ash Carter.

A special note to our men and women in uniform: of all the many opportunities my life has given me, I am most proud of having once been a soldier. The lessons from my time in uniform about trust, responsibility, duty, judgment, and loyalty – I have carried these with me throughout my life. As your secretary of defense, I have seen those same traits in each of you.

Whether you serve in uniform or as a civilian, you are the reason why our military is the finest in the world and the most admired and most trusted institution in America. Nothing has clarified my thinking, nothing has renewed my hope, and nothing has made me prouder than getting to know, work, and serve with so many of you who have put the nation’s interest above your own.

If I had any parting guidance, it would be the same reminder that my drill sergeant, Sgt. 1st Class William Joyce, gave to me after I finished basic training in 1967: “People depend on you. They’ll always depend on you.”

That was true for me then, and it is true for all of you today. People depend on you – America depends on you – to live up to your oath, to conduct yourselves in keeping with our highest standards, and to perform as the greatest military the world has ever known. After two years serving with you, I am confident you will continue to do so.

You and your families have my deepest gratitude and admiration.

Thank you for your unflagging service and your commitment to this country. May God bless America and each and every one of you.

 

Haley VA Making Strides for Paralyzed Veterans

 (April 2014) Lead therapist Michael Firestone adjusts the Exoskeleton computer backpack for veteran Josh Baker, paralyzed after a motorcycle accident. Credit Bobbie O'Brien / WUSF Public Media


(April 2014) Lead therapist Michael Firestone adjusts the Exoskeleton computer backpack for veteran Josh Baker, paralyzed after a motorcycle accident.
Credit Bobbie O’Brien / WUSF Public Media

Tampa’s James A. Haley VA Hospital is using cutting edge technology to help injured veterans rehabilitate.

One of the devices, at the Spinal Cord Injury Center, helping paralyzed veterans stand and walk again is the Exoskeleton.

Using a computer backpack, robotic leg braces and a walker, veteran Josh Baker demonstrated the Exoskeleton during the April 2014 ceremonial opening of Haley’s new Polytrauma Center.

Baker said it didn’t require much effort on his part.

“If you get a good rhythm and you’re good upright, you can actually walk right along and the machine simulates it,” Baker said.

His VA therapists were impressed by how quickly Baker advanced after just two weeks of practice. Baker was on the device’s most advanced setting, where the device takes automatic steps once it senses the veteran’s foot is in the correct position.

One of the features of the Exoskeleton is that it can be programmed with each individual’s weight, height and gait which individualizes the simulated walking, therapists said.

For the first time since his motorcycle accident in November 2013, Baker said the ability to walk with the Exoskeleton gave him “a jubilation feeling.”

Witnessing their wheelchair-bound son walk again that day at Haley was emotional for his parents Laurie and Robert Baker.

Courtesy of Ekso Bionics website

Courtesy of Ekso Bionics website

Laurie Baker said anything that makes her son feel better makes her feel better. His father agreed.

“It was incredible,” Robert Baker said. “That’s the first time I got to see him walk since November and it just means so much.”

He said the device also will help other veterans living with disabilities.

“It’s going to help so many other servicemen to just give them the hope that they can stand again when they’re just stuck in a wheelchair,” said Robert Baker. “It’s just a blessing.”

Haley is one of two Ekso Bionic Centers in Florida. The other is located at the University of Miami Project.

Senate Passes the Veterans Suicide Prevention Act

Chairman Jeff Miller calling for a vote to subpoena the VA Secretary's emails pertaining to an "alternate wait list" at the Phoenix VA Medical Center.

Chairman Jeff Miller calling for a vote to subpoena the VA Secretary’s emails pertaining to an “alternate wait list” at the Phoenix VA Medical Center.

A bill aimed at improving veteran accessibility to mental  health care has passed the US Senate and now only needs President Obama’s signature to become law.

The US House passed the Clay Hunt Suicide Prevention for American Veterans Act on January 12, 2015 for a second time.

The House also passed the Clay Hunt SAV Act in early December 2014. But the bill was killed in the Senate by outgoing, US Sen. Tom Coburn, a Republican from Oklahoma.

The bipartisan legislation not only embraces new ideas to improve the effectiveness of VA mental health care it also requires annual reviews of program effectiveness.

“The Senate did the right thing today by passing the Clay Hunt SAV Act. The bill is an important step toward helping stop the epidemic of veteran suicides,” said US Rep. Jeff Miller (R-FL), Chairman of the House Committee on Veterans’ Affairs, in a news release.

The Tillman Scholar Featured During Super Bowl Pre-Game

Photo a screen capture courtesy of NBC Sports.

Photograph is a screen-capture courtesy of NBC Sports.

Just like the former NFL player the scholarships are named after, every Pat Tillman Scholar has a story.

And their stories can be counted on to be filled with compassion, service and sacrifice just like their scholarship namesake who gave up his professional football career to join the Army Rangers after the 9-11 terrorism attacks in New York City, Pennsylvania and Washington D.C.

The Super Bowl network, NBC, featured Ed Woodward, a medical student at the University of South Florida, in their piece on the Tillman Scholars. Take five minutes to watch his story here as the nation saw it just prior to the Super Bowl this year.

Or you can watch Woodward tell his story below why he choose to become a physician.

 

Lessons Learned as Director of Tampa’s Haley VA Hospital

Kathleen Fogarty is leaving one of the nation's busiest VA hospitals after almost four years at the helm.

Kathleen Fogarty is leaving one of the nation’s busiest VA hospitals after almost four years at the helm.

Tampa’s James A. Haley VA Medical Center will soon have a new director. Marjorie Hedstrom, the medical center director at the VA in Popular Bluff, Missouri, will take over in just over a week.

The current director, Kathleen Fogarty, is leaving Haley by choice.

She’s taken the same position at a smaller, less hectic VA hospital in Kansas City. That’s after almost four years at one of the nation’s busiest veteran medical centers serving some 200,000 veterans living in the Tampa Bay Region.

 

“I began my career at the Kansas city VA medical center as a clinical dietician in 1986,”Fogarty said.

The 55-year-old director said she’s breaking her rule – to never go back to a previous place of employment. But after serving 32 years in the VA system, she said she is ready to “go home.”

Haley VA director Kathleen Fogarty chats with a veteran inside the American Heroes Cafe.

Haley VA director Kathleen Fogarty chats with a veteran inside the American Heroes Cafe.

She said the Kansas City VA is not as complex or as busy as Haley, but it will help her ease into retirement while bringing lessons learned at Haley.

One of those lessons became very public when a family went to the news media about the VA placing a surveillance camera inside the smoke detector of their family member’s room.

“Do I have regrets? I don’t have regrets. I know the decision was made for the safety of that patient,” Fogarty said. “Would I do something differently? I would make a huge sign on the camera. And would I choose that camera? No I’ve said I wouldn’t choose that type of camera ever again.”

She said the episode prompted other changes like the creation of a code of conduct for families.

Youth volunteer Mairyn Harris, 14, and Kathleen Fogarty, director of James A. Haley VA Medical Center. (July 2014)

Youth volunteer Mairyn Harris, 14, and Kathleen Fogarty, director of James A. Haley VA Medical Center. (July 2014)

Another issue prevalent throughout the Veterans Health Care system has been long waiting lists for care. It’s one of the reasons why Fogarty was temporarily tapped to take over VISN 18, the VA network that oversees the troubled Phoenix medical center which sparked the whole VA scandal.

“I don’t want you to believe that we have fixed all access problems here at James A Haley because we still, we have a tremendous amount of requests for specialty types of care,” Fogarty said.

To handle that demand, Fogarty extended clinic hours and added Saturday appointments especially in the area of mental health. And for women veterans, Fogarty was instrumental in getting features like a separate entrance designed in the women’s clinic at the VA’s primary care annex.

“I don’t think that there are a lot of VAs that have put lactation rooms in. It was pretty rare to even have a child’s play area,” Fogarty said. “We listened and we really think we have a model.”

Other milestones under her watch at Haley:

  • The first VA hospital in the country to have a USO day room.
  • The opening of the new Polytrauma Medical Center with a climbing wall and other X-Game type recreation.
  • The opening of the American Heroes Café – a restaurant setting inside the hospital.
  • The opening of a 10 bed palliative and hospice unit.
  • A new urology unit.
  • A 100 bed spinal cord injury unit that mirrors the same family resources as the polytrauma center
  • The opening of a 1,501 space parking garage and valet parking at Haley’s two main entrances.

Fogarty will remain as the interim director of VISN 18 until a permanent director takes over then she will settle into her new post in Kansas City. She wasn’t sure of her last day at Haley, however, her replacement starts Feb. 2, 2015.

 

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