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.

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.

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.

 

Tampa VA Loses Director Who Is Heading ‘Home’

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

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

Tampa’s VA hospital director Kathleen Fogarty is leaving her post permanently to take a similar position with the Kansas City VA Medical Center.

She made the announcement, she said, so that VA could begin hunting for Haley’s new leader.

Fogarty has been absent from James A. Haley VA Medical Center since November. That’s when she was tapped to temporarily take over as the acting network director responsible for the Phoenix VA which had documented cases of delayed veterans care and long claims waiting lists. That assignment was going to last at least three months.

In an email message sent to her colleagues at James A. Haley VA, Fogarty announced her decision to take the Kansas City position.

“… Kansas City is home to our family and this opportunity allows me to go home,” Fogarty wrote.

She has worked for more than three decades with the VA Health Care administration.

Veteran Suicide: A Look Into the Numbers

veteran_suicide_crisisline_graphicThere’s a statistic on veteran suicide that is repeated often: VA officials say an average of 22 veterans commit suicide every day. But what is not widely known about that statistic is that a majority of veterans committing suicide are age 50 or older and did not serve in combat.

For our series Off the Base, WUSF reporter Bobbie O’Brien talked with Dr. Larry Schonfeld,  a professor in the Department of Mental Health Law and Policy at the University of South Florida’s Florida Mental Health Institute.

Schonfeld is a psychologist who specializes in research on veterans and aging and knows it can be difficult to gather  data on veteran suicide.

“I think we’re still trying to understand what the statistics mean and where they’re coming from,” Schonfeld said. “I don’t know what they’ve done as to age distribution but in the general population and the veteran population the older white male becomes the higher risk population for committing suicide.”

But he said just because they’re not the majority, suicide among younger veterans is a growing concern.

“We’ have younger people committing suicide and this country has got to do something for those who have served our country so well,” Schonfeld said.

He said it’s important to find the reasons behind veteran suicide so effective treatment and prevention programs can be developed. Yet, Schonfeld said he and other researchers in academia are challenged to find Post 9-11 veterans willing to participate in research studies.

What is certain, according to Schonfeld and others, the need for mental health services by Post 9-11 veterans will only grow over the coming decades.

“I think that’s absolutely certain that the wave,” Schonfeld said. “Because of the age of the population, if they don’t get the help now, we’re going to be seeing it later. It’s in a sense a time bomb in itself.”

Information on VA Suicide Prevention including warning signs and links to resources are on the Crisis Line website. If you need immediate help as a veteran, a family member or friend, call 1-800-273-8255 and Press 1 to talk to someone.

American Legion Seeks Input on VA Care

As part of a national campaign to improve VA health care, the American Legion is planning a town halls throughout the country. On Jan. 12, 2015, a public meeting is set in Madeira Beach, Fla., to discuss veteran care at the Bay Pines VA Healthcare System and other local Department of Veterans Affairs medical facilities.american_legion_logo

The town hall meeting, scheduled to begin at 7 p.m. on Jan. 12, will be at American Legion Post 273 on 600 American Legion Dr. in Madeira Beach. Local veterans, especially those currently receiving VA health care, are encouraged to attend.

The Legion will also set up a Veterans Benefits Center to help veterans enroll in VA health care and schedule VA medical appointments in Room 100 of the C.W. Bill Young VA Medical Center, located at 10000 Bay Pines Blvd. in Bay Pines, Fla. Hours of operation are 8 a.m. to 8 p.m. on Wednesday, Jan. 14 and Thursday the 15th.

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