Knockout
United States Army Special Forces soldiers scan for threats while protecting a checkpoint construction operation in Tagab, Afghanistan - 2010
The VA has a way of making just about everything harder than it needs to be. But every now and then you get a case that feels less like filing paperwork and more like a no-holds-barred street fight. You keep swinging with everything you've got, and the VA dodges, blocks, or refuses to do the bare minimum it's supposed to do for America's Veterans.
When that happens, you have to get creative. After enough years doing this work, you learn there are a few buttons inside the VA that are worth pushing when you've hit a brick wall. Over the years, I've been lucky enough to learn a few of those tricks from some very savvy advocates, and every once in a while I get to pull one out when all else fails.
This was one of those cases.
YA-10 aircraft is refueled on the ground by a KC-135 Stratotanker aircraft
The Veteran—we'll call him "Scott"—was a platoon mate of a close friend of mine. He survived some of the fiercest fighting of the wars in the Middle East and came home with a raging case of PTSD. He was homeless, unemployed, and barely hanging on. The VA had jerked him around for years. They low-balled his initial PTSD rating, then later added insult to injury by reducing it. Years passed before we connected.
I had never met a Veteran who I believed more clearly deserved a 100% PTSD rating.
The first thing I did was have Scott write a statement describing what his life actually looked like day to day. We submitted it with a Supplemental Claim, fully expecting the VA to schedule a new PTSD examination. His statement painted a crystal-clear picture of total occupational and social impairment. Anyone with half a brain could see that his existing 50% rating didn't come close to matching reality.
Instead, the VA denied the claim within days—without even ordering an exam.
So I punched back by filing a Claims Accuracy Request (CAR) Higher-Level Review.
Shockingly, the adjudicator at the illustrious Seattle DROC reached the exact same conclusion and denied it again without ordering an examination. I was floored by the level of incompetence. So much for the VA's Duty to Assist.
That's when it became clear the usual process wasn't going to cut it.
I won't get into every detail, but I sent a detailed, pointed email requesting a quality review of the decision to a VA office that oversees part of the claims process. I also copied several influential VA higher-ups along with every VA employee who had touched this train wreck of a claim. I made sure to point out the obvious—that Scott was homeless and unemployed, facts that alone should have raised serious questions about whether a 50% PTSD rating made any sense.
That finally got someone's attention.
101st Airborne LRRP team member applying camouflage - Operation Harrison 1966
Suddenly people at the Regional Office were falling all over themselves to order an examination. It's unfortunate that some people at the VA only seem motivated to do their jobs after their bosses find out what they've actually been doing.
Scott went to the exam, but we had another problem.
The examiner was lousy—judgmental, dismissive, and completely failed to build any rapport. Scott also has a deep-seated mistrust of the VA and the government, and frankly, given everything he'd been through, I don't blame him. He wasn't exactly an open book during the examination.
The VA predictably came back with what amounted to a slap in the face. They increased him from 50% to 70% but insisted he still didn't meet the criteria for 100%.
So it was time to strengthen the record.
AN Air Force C-130B Hercules aircraft at remote airstrip in Vietnam
I obtained a killer 15-page independent psychological evaluation for Scott from a psychologist I work closely with. It was far more thorough than anything the VA had produced and carefully documented why Scott met the criteria for a 100% PTSD rating.
The VA dodged again.
Instead of granting the claim, they ordered yet another C&P examination despite already having more than enough evidence to make a decision and grant the higher rating.
Scott was devastated. He thought he was going to have to sit through another VA examination and relive some of the worst experiences of his life all over again.
I rarely tell Veterans to skip a VA examination.
This was one of those rare cases.
U.S. Army Special Forces soldier provides security Afghanistan - 2014
So instead of sending Scott back for another exam, I told the VA—in more professional language than I'm using here—to pound sand.
I submitted a detailed statement explaining why another examination wasn't just unnecessary—it would be harmful. Scott also wrote a statement explaining how being forced through another PTSD examination would negatively affect him.
The VA's response?
Claim denied.
I was furious.
Here's a man who repeatedly put his life on the line for this country, survived hell overseas, and came home carrying scars most people can't imagine. And after all that, the VA's response was to keep jerking him around instead of doing the right thing.
Oiler USS KENNEBEC off the coast of Vietnam
So I filed another CAR Higher-Level Review along with a several-page brief laying out the entire history of the case and why the evidence overwhelmingly supported a 100% PTSD rating. I also made sure to explain exactly what happened the first time they botched the CAR, so they'd think twice before trying to punt it again.
This time we finally landed the knockout punch. The decision came back.
100% for PTSD—granted.
I may have yelled and walked around my office throwing a few fist pumps after reading that decision.
Calling Scott to give him the news was even better. Hearing the relief in his voice reminded me exactly why I do this work. Those phone calls make every frustrating battle worth it.
4th Infantry Division soldiers watching artillery strike - Task Force Oregon 1967
The funniest part?
Even while granting the claim, the adjudicator still tried to argue that the VA's pitiful examinations were more persuasive than our independent evaluation. Instead, they claimed it was the separate evidence showing Scott's homelessness and unemployment that justified the 100% rating.
Come on.
Even when the VA loses, sometimes it just can't bring itself to admit it got things wrong.
One of the unfortunate parts of this job is that I rarely get to meet the Veterans I represent because they're scattered all over the country—and sometimes all over the world.
Scott, thankfully, lives close enough that we're planning to meet this summer for a well-earned celebratory cigar.
After everything it took to win this fight, it'll be good to finally put a face to the name.
If you need help cutting through the red tape with your VA claim or appeal, you can contact me here.