Have Questions About the Disability Claims Process for Social Security or Veterans Benefits? Check Out Our FAQs
Dealing with the disability application or appeals process always comes with plenty of questions. Whether your questions are about Social Security or VA Disability, here are some of the questions we hear the most at our Omaha law firm.
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What illnesses and medical conditions are linked to the Gulf War?
After returning home from the Persian Gulf War, you may have experienced unexplained illnesses and symptoms that have no apparent link to specific medical conditions. These symptoms are often referred to as Gulf War Syndrome (GWS), “Desert Storm Disease,” and/or “Gulf War Illness.”
Initially, veterans who suffered these unexplained symptoms were believed to have problems psychologically, and their pain, fatigue, and cognitive issues weren't considered serious or real. However, researchers analyzed more than 100 studies focused on these illnesses, and the results revealed that exposure to certain chemicals could be linked to the symptoms veterans experienced. These chemicals included:
- The nerve gas Sarin
- An anti-nerve gas drug, pyridostigmine bromide
Gulf War veterans may qualify for benefits from the United States Department of Veterans Affairs (VA), but there are challenges involved in filing a claim for GWS. Because the VA denied approximately 80 percent of claims by Gulf War veterans in 2015, veterans often have many questions about how to get medical evidence for these illnesses and the best way to file a claim. An attorney experienced in the VA application process can answer your questions and help with your claim.
Questions About Unexplained Gulf War Illnesses and Conditions
Of the 700,000 soldiers who served in the Persian Gulf War from 1990–1991, approximately 30 percent developed GWS. The symptoms of GWS can be varied, debilitating, and different for every veteran; thus, they’re hard to classify with a single diagnosis. This is one reason why the VA prefers not to use the term "Gulf War Syndrome" and instead refers to the condition as a "chronic multisymptom illness" or an "undiagnosed illness." This makes it difficult to determine if a veteran's condition is related to service and eligible for VA benefits.
How Do I Know If I Have GWS?
There are many different symptoms of GWS, and no veteran experiences the condition the same way. However, here is a brief look at some of the typical symptoms of GWS:
- Neurological issues
- Memory problems
- Arthritis and joint problems
- Gastrointestinal and respiratory disorders
- Rashes and skin conditions
- Headaches and fatigue
Do Veterans Who Suffer From GWS Also Have Chronic Fatigue Syndrome?
Chronic fatigue syndrome (CFS) is definitely a condition associated with GWS. Veterans with CFS often experience long-term, severe exhaustion that isn’t related to another illness and doesn’t resolve after resting. To be diagnosed with CFS, the Centers for Disease Control and Prevention states that the exhaustion must persist beyond six months and be present in combination with at least four other conditions, including headaches, memory loss, muscle pain, and tender neck or armpit lymph nodes.
If you’re a veteran seeking VA disability for CFS, you need medical evidence that shows that the new onset of fatigue is debilitating and has decreased your normal daily routine by 50 percent for at least six months. It’s also important that your medical reports show evidence that there is no other possible illness or condition that could produce similar symptoms.
Why Have I Returned Home From the Gulf War With Gastrointestinal (GI) Problems?
GI disorders present in a wide range of symptoms, including abdominal pain, dyspepsia, constipation, bloating, vomiting, and irritable bowel syndrome (IBS). Many civilians have IBS; however, many combat soldiers were diagnosed with IBS after returning home from war. Of those veterans who served in the military and did not have IBS, approximately 20 percent returned from active duty in Afghanistan and Iraq and developed this disease. The VA presumed a service connection and defined new guidelines for benefit eligibility.
Veterans appear to have a greater risk for IBS because the condition is more prevalent in people with a high level of anxiety. This is especially true if that anxiety is associated with specific life events that are particularly stressful. Combat soldiers who experience trauma, life and death situations, and worry about being away from family and friends may suffer from stress that could increase their risk of developing IBS.
Am I Eligible for VA Disability?
Possibly, if you meet the following qualifications:
- Proof that you served in active duty in Southwest Asia in the Red Sea; the Gulf of Aden; the Persian Gulf, or the Gulf of Oman; the neutral zone between Saudi Arabia and Iraq; or the United Arab Emirates, Kuwait, Iraq, Bahrain, Saudi Arabia, Oman, Qatar, or Afghanistan. This active duty also includes flying in the airspace above these areas. If you served in Turkey, you're not considered a Gulf War veteran.
- Documentation clarifying you're a veteran of the Persian Gulf War.
- Medical records detailing your chronic disability and how it may qualify for benefits.
- Proof you sustained the disability while on active duty.
- Proof your disability is service-connected if it developed after you returned home.
Keep in mind that the VA must assign a 10 percent or higher rating to your disability before any consideration of benefits.
We Can Help
Obtaining VA benefits for GWS can be a challenge. If you’re a veteran who suffers from service-related symptoms and wonder if you're eligible for benefits; or if your GWS disability claim was denied, call Cuddigan Law at 402- 933-5405. We can help determine if you qualify for VA disability.
How does the VA rate Gulf War Syndrome?
Soon after the Persian Gulf War, the American Legion Service Officers received complaints from veterans about medical issues they sustained while serving in Southwest Asia. They suffered from a broad range of unexplained illnesses and symptoms, including skin rashes, memory loss, joint and muscle pain, fatigue, and headaches.
However, both the U.S. Department of Veterans Affairs (VA) and the Department of Defense (DoD) dismissed these symptoms as being psychological in nature or stress-related. Some of these veterans were prescribed mood altering drugs such as Prozac, and others were accused of feigning their illness or exaggerating their condition.
A major issue for Gulf War veterans was that they suffered from a cluster of symptoms which could not be easily diagnosed or attributed to a known disease or condition. Ultimately, these symptoms were referred to as Gulf War Syndrome (GWS) or “Desert Storm Disease,” and/or “Gulf War Illness.”
In 2009, the VA took steps to provide benefits for veterans of the Gulf War suffering from what it preferred to call "chronic multisymptom illnesses" or an "undiagnosed illnesses." This also included Amyotrophic Lateral Sclerosis, or ALS, Parkinson’s disease and Alzheimer’s disease.
While it’s possible for Gulf War veterans to qualify for VA benefits, getting a claim approved isn’t always easy. Because many GWS claims are denied, it may be helpful to hire an attorney experienced with the VA application process, especially one who understands GWS.
Three Symptom Categories the VA Rates for Gulf War Syndrome
GWS comprises a cluster of symptoms that are categorized into three main areas: undiagnosed illnesses, multisymptom illnesses, and presumptive disorders. Here's a brief look at these categories.
It’s possible for a veteran with one or more of the following unexplained illnesses to qualify for VA benefits through a presumptive service connection:
- Cardiovascular disease
- Joint and muscle pain
- Psychological and neurological issues
- Rashes and skin conditions
- Respiratory problems
- Trouble sleeping
The following conditions are included in the multisymptom illnesses category:
- Functional gastrointestinal disorders, including: IBS, bloating, constipation, abdominal pain, dysphagia, vomiting, and dyspepsia.
Those veterans who served in Afghanistan may have an infectious disease that the VA considers service-connected:
- Campylobacter jejuni
- Coxiella burnetii (Q fever)
- Mycobacterium tuberculosis
- Nontyphoid salmonella
- Visceral leishmaniasis
- West Nile Virus
Except for mycobaterum tuberculosis and visceral leishmaniasis, each of these diseases must have a 10 percent rating or more within one year of service.
Disability for Gulf War Syndrome
A successful VA disability claim must be able to prove that you were a veteran honorably discharged; that you have a current disability; that the disability occurred while in service; and there is a connection between the service event and your current disability.
However, to qualify as a Gulf War veteran, you must also prove:
- You served in active duty in Southwest Asia in the following countries or areas and/or airspace above them:
- The neutral zone between Saudi Arabia and Iraq
- The Red Sea, the Gulf of Aden, the Persian Gulf, or the Gulf of Oman
- The United Arab Emirates, Kuwait, Iraq, Bahrain, Saudi Arabia, Oman, Qatar, or Afghanistan.
- You served in Afghanistan on or after September 19, 2001.
- Your unexplained illnesses or condition occurred during active service prior to December 31, 2016.
- Your disability has a rating of 10 percent or higher.
- Your disability has no other cause other than your service in the Southwest Asia theater or Afghanistan.
- Your disability has been on-going for six months or longer.
We Can Help
The attorneys at Cuddigan Law understand how difficult it is for veterans of the Gulf War to get their GWS claims approved. They know that approximately 80 percent of GWS claims made in 2015 were denied. If you're a veteran suffering symptoms you believe are associated with your military service in the Gulf War; or if you've applied and were denied benefits, call Cuddigan Law at 402-933-5405. We can help determine if you qualify for VA disability.
How will a hepatitis C diagnosis impact my life, and can I receive disability benefits?
Known as the “silent epidemic,” hepatitis C is a disease caused by a virus—the hepatitis C virus (HCV) that infects the liver. This disease causes the liver to scar, swell, and sometimes fail. The infection is spread most often through contact with blood from an infected person. It’s possible for a person to have the infection for years and not know it.
Hepatitis C can affect people as an acute or a chronic infection. Acute hepatitis C is defined as a new infection that lasts for a short time and may or may not respond to treatment. If the infection does run its course and responds to anti-viral medication, it may clear up on its own. Chronic hepatitis C, however, does not resolve, and a patient may suffer permanent liver damage. It’s a long-term condition that can last a lifetime, and the virus will remain in the body and can cause liver cancer or cirrhosis.
Approximately 30,500 cases of acute hepatitis C were reported in the U.S. in 2014. And over three million people live with chronic hepatitis C. It is very likely that if you have acute hepatitis it will develop into the chronic infection.
Questions About Hepatitis C
Hepatitis C is found in people worldwide, but the regions most affected are Central and East Asia and Africa. Certain populations within countries can see a greater concentration of the infection, including areas where there is a higher rate of drug use. Because approximately 70 percent of people who have hepatitis C don’t know it, over 15,000 Americans die from this disease every year. Here are some of the most common questions about hepatitis C and some general answers to those questions:
Is it true there’s no cure for hepatitis C? Actually, this is not entirely true. Patients with this disease can be treated and “cured”—meaning that after your treatment has ended, the hepatitis C virus can no longer be detected in your blood. It is still possible, however, to have a relapse or suffer a reinfection, and you can still have liver disease.
How do people become infected with hepatitis C? This disease is a blood-borne virus. It’s passed from one individual to another when an uninfected person comes in contact with the blood of someone infected with the virus. There are a variety of ways a person can acquire hepatitis C, including:
- Sharing needles and snorting or injecting drugs
- Sharing clippers, razors, toothbrushes, and other items that may have touched infected blood
- Using piercing or tattoo equipment used on another person
Why do so many veterans have hepatitis C? Approximately 200,000 veterans suffer from hepatitis C. An estimated 60 percent of these veterans served during the Vietnam era. Most veterans contracted it in Vietnam, where it was thought to be spread by battlefield blood transfusions and vaccinations. The United States Department of Veterans Affairs (VA) believes there may be a relationship between the infection and immunizations that were administered using jet injectors—air-gun injections.
Can a person transmit HCV through a kiss? According to the CDC, you can’t acquire HCV if you kiss, hug, or hold hands with someone who has the virus. Additionally, HCV cannot be transmitted through a sneeze or a cough, through a mother’s breast milk, or by eating with utensils that were used by someone with the infection.
HCV has been called a “silent epidemic.” How do I know if I have the virus? Nearly 80 percent of people with acute hepatitis C present no signs or symptoms. If there are signs, they often show up two weeks to six months after a person is exposed to the virus. Typically, symptoms often mimic the flu and can include:
- Extreme fatigue
- Muscle soreness
- Pain in the joints
- Poor appetite or nausea
- Urine that is dark in color
- Jaundice—a yellow discoloration of the skin and whites of the eyes
The only way to know if you have hepatitis C is to get a blood test called the Hepatitis C Antibody Test.
Who is most at risk for contracting hepatitis C? Having the Hepatitis C Antibody Test is recommended for many people, including:
- People who were born between 1945 – 1965.
- Veterans who served in the Vietnam War and received vaccines through needle-less “jet guns”
- People who received organ transplants or donated blood prior to 1992
- People who have ever used needles to inject drugs, even if it only happened once or many years in the past
- People who have HIV or AIDS or chronic liver disease
- People who were exposed to the blood of a person with hepatitis C
- People who are on hemodialysis
- People who were born to a mother who has the virus
If you believe you’ve been exposed to hepatitis C or you’ve been diagnosed with this disease, let Cuddigan Law help you file for VA or Social Security Disability. If you’ve already filed and were denied, we can help with your appeal. Contact us at (402) 933-5405 for a free evaluation of your case.
How does the new Social Security ruling affect my fibromyalgia case?
Many people who suffer from fibromyalgia (FM) are denied Social Security benefits when they apply to the Social Security Administration (SSA) for disability. Administrative law judges (ALJs) and claims examiners are often reluctant to approve applications for FM for a number of reasons. The primary reason is that there is no listing for this condition in the Social Security “Blue Book” Listing of Impairments. Another reason is that examiners place less significance on an FM claim unless the applicant has some other type of condition along with it. If the secondary condition had medical evidence—for example, blood tests or x-rays—the claim is given more weight. Because the symptoms of FM can present like symptoms of other illnesses, the causes aren’t clear, and diagnosing the symptoms can be subjective, disability examiners are not always sure how to classify cases of FM. However, as researchers and medical personnel have learned more about FM, Social Security now has new standards for how to assess this condition.
To address these issues, the SSA published a new ruling that helps examiners and ALJs evaluate FM, even if the symptoms can’t be confirmed or validated by definitive testing, as with conditions such as degenerative disc disease or rheumatoid arthritis. The ruling should help those who are initially denied benefits to win during the appeals process.
Medically Determinable Impairments and the New 2012 SSA Fibromyalgia Ruling
To be eligible for Social Security benefits, you must have medical evidence of that disease that’s established through blood tests, scans, x-rays, and other definitive tests. Your impairment cannot be determined through personal accounts and details of your symptoms. Thus, you’re required to have a “medically determinable impairment” (MDI), and there must be medical signs of the impairment that the SSA can see cause your symptoms. But because these symptoms are often difficult to prove—widespread pain throughout the body, tenderness in the joints, muscles, and soft tissues, fatigue, fibro fog, and dizziness—it’s not easy to get a Social Security claim for FM approved.
In 2012 however, Social Security issued a new ruling defining when FM is considered an MDI. The ruling stated that examiners and ALJs were to use criteria established by the American College of Rheumatology to decide if an applicant’s FM was an MDI. This determination is made in the following ways:
The patient needs evidence that he suffers from widespread, chronic pain that has lasted for at least three months. The pain must be in his chest, neck, or back. Through the use of lab tests or x-rays, a doctor must have eliminated other diseases such as multiple sclerosis and lupus as the cause of the symptoms.
The patient must show signs of one of the following: Eleven of eighteen “tender points,” in specified tender point areas on the body. These tender points must be felt above and below the waist and on both sides of the body. Six or more FM symptoms must occur repeatedly, particularly memory problems, depression, anxiety, fatigue, or irritable bowel syndrome (IBS). A patient can experience other symptoms, including muscle weakness, seizures, and dizziness.
The examiner will review your medical records to ensure that they include enough evidence based on these criteria. After reading your doctor’s notes, the examiner may ask for more information: data on how long you’ve experienced your impairment; the doctor’s opinion of how well you can function on a daily basis or at a job; the type of treatments you were given and if you suffered any side effects; and the period of time he expects that your activity will be reduced. It’s important to note that these criteria only establish that your FM is an MDI; it does not establish whether you’re disabled. Even if you meet the listed criteria, you must prove to the SSA that you can’t work at your current job or any other U.S. job.
However, even with the new ruling, it is still possible that FM sufferers will continue to see their benefits denied initially. Even if they’ve been under a doctor’s care for an extended period of time for this condition, applicants may still need to appeal their claims.
We Can Help
If you suffer from symptoms of FM that make it impossible to sustain gainful employment, and you’ve been denied benefits in the past, the SSA’s new ruling you help you appeal the decision. If you need help applying for Social Security Disability benefits, or you’ve applied and were denied, call Cuddigan Law at 402-933-5405. We’ll schedule an appointment to discuss your eligibility for compensation.
How will the VA rating changes for sleep apnea affect my disability?
Sleep apnea is a breathing disorder that interrupts a person’s breathing. This interruption can last from 10 to 30 seconds and may occur up to 400 times a night for those who suffer from a severe case of this condition. Because sleep apnea is both a chronic and progressive condition, it usually worsens over time.
Those who suffer from this chronic condition are at risk of a variety of problems, including four times greater risk of stroke, three times greater risk of heart disease, and an increased chance of being involved in a traffic accident. According to the National Highway Traffic Safety Administration (NHTSA), drowsy driving related to symptoms of sleep apnea is responsible for 100,000 car accidents and over 1,500 deaths a year.
Veterans are particularly susceptible to sleep apnea. Over 420,000 veterans who served in the military following 9/11 and receive disability from the United States Department of Veterans Affairs (VA) have sleep apnea that is service-connected. And although there are many causes of this condition, including age, obesity, and a deviated septum, many doctors believe this condition is also caused by long-term exposure to chemicals and dust. Military personnel often work and fight in environments that contribute to sleep apnea.
Because sleep apnea has been associated with fatigue, heart problems, hypertension, and memory problems, it’s possible for this condition to interfere with your ability to work or sustain gainful employment. If so, you may be eligible for VA Disability benefits. However, the VA rating for sleep apnea is changing, and you may have questions about how those changes affect your current disability or your eligibility if you want to apply.
Questions About the New VA Rating Changes for Sleep Apnea
Because so many veterans are on disability for sleep apnea, the changes to the rating system could have a broad and significant impact. If you’re receiving VA compensation for sleep apnea, here are answers to some questions you may have:
- What are the new changes being made to the VA sleep apnea rating system? There are two changes being made to the rating. Change 1: A veteran must show that the CPAP he’s using is a medical necessity. Thus, a letter from your doctor will be needed to explain that the prescribed breathing device is needed for medical treatment of your sleep apnea. Change 2: Veterans can use breathing devices other than a CPAP and still be eligible for a rating of 50 percent. This is helpful for veterans because doctors can prescribe different devices to treat sleep apnea, including APAP and BiPAP machines and dental aids. Consequently, if your doctor prescribes a CPAP or any other breathing device, and he can provide evidence that in order to treat your sleep apnea condition, your device is medically necessary, it’s likely you’ll be approved for a 50 percent rating.
- Why did the VA make these changes? A primary factor is the cost of sleep apnea disability for veterans. Disability compensation claims for veterans suffering from sleep apnea increased by 150 percent from 2009 to 2014, and according to reports, annual compensation for this condition continues to rise. Additionally, approximately 9 of 10 veterans who receive disability for sleep apnea are given a 50 percent disabled rating. This can mean a monthly payment of over $800.00. Due to the increased cost of compensating for this condition, the rules were reviewed.
- Will the changes affect my current disability benefits or a pending claim? The M21 – 1MR VA Handbook does not specifically state how the changes will impact current and pending claims. It’s recommended that you look at your C-File to see if there is a doctor’s statement providing solid evidence that your breathing device is a medical requirement in treating your sleep apnea. If there is no such statement, it’s a good idea to get one from your doctor and add it to your file. Additionally, ask that your doctor explain why you need the device as if he is providing evidence to an insurance company. Ask that he be detailed and give clear reasons for prescribing the device. If you have a VA doctor, you may want to invest in getting this letter from a private physician. It’s possible that a VA doctor won’t agree to provide this letter for you.
- What if I don’t use my breathing device as often as I should or the way I’m supposed to? The VA rule change states: “If the competent medical evidence of record shows that use of a qualifying breathing assistance device is medically required, the fact that the claimant is not actually using it as prescribed is not relevant.” So for now, if your use of the breathing device is not compliant with the required use, the VA will not reduce or stop your benefits. However, all other medical systems require that, in order to be covered by insurance, a patient must use the breathing device properly and consistently. Thus, it’s possible that the VA will also require that a patient be compliant with his device.
If you are a veteran who suffers from sleep apnea due to your military service, and your symptoms make it difficult to work, or you were denied benefits for this condition, contact us at 402-933-5405. We’ll discuss your situation and determine how we can help get you the VA benefits you deserve.
I believe I’m suffering from fibromyalgia. What should I know about this condition, and can I get disability benefits?
Formerly known as fibrositis, fibromyalgia (FM) is a chronic condition that affects about five percent of the U.S. population. However, because the symptoms of FM vary by individual, it’s a difficult condition to diagnose. The statistics for people suffering from FM are often estimates rather than exact numbers.
While FM is a condition that affects many people, studies show that veterans of the Gulf War are more frequently diagnosed with FM than civilians or non-Gulf War veterans. Additionally, FM is more common in women and characterized by widespread pain in the body’s ligaments and muscles. Very often, people who suffer from FM have had the condition for years before their doctor makes the diagnosis.
According to the American College of Rheumatology, FM is the second most common medical condition that affects the musculoskeletal system (after osteoarthritis). Those with FM not only experience muscle tenderness and pain, they often have “trigger points” that are painful to the touch or with pressure. These trigger points are usually found on the shoulders, neck, arms, hips, and back. Interestingly, those suffering from FM find these trigger spots especially sensitive, but other similar spots on their body are not sensitive. Additionally, people who suffer from other chronic pain conditions such as arthritis don’t find that pressure on those trigger spots is painful.
If you suffer from FM, you may be eligible for Social Security Disability benefits or benefits from the United States Department of Veterans Affairs (VA). To navigate the appeal process to receive benefits for FM, you may want a legal expert to help with your claim.
The Causes of Fibromyalgia
There is no known cause of FM; however, most researchers believe FM is a result of a combination of many types of stressors—not just caused by a single event. Additionally, there are some known factors believed to contribute to or be associated with the development of this condition. Here is a brief look at some factors connected with FM:
- Genetics. While there is no direct genetic link between people who suffer FM—the condition is not passed from parent to child—studies show that people who develop FM are likely to have a family member with this condition. FM has been shown to run in families, especially in mothers and daughters. Thus, it’s possible that heredity is a factor in developing FM.
- A stressful event. Some studies suggest that those people who have experienced physical or emotional trauma or abuse are more likely to suffer from FM.
- Chronic pain from another condition. FM has been linked with other illnesses. The chronic pain of arthritis, systemic lupus erythematosus, and other autoimmune diseases can trigger or factor into the development of FM.
- Infection. Certain infections can bring about FM. Hepatitis C, the Epstein Barr virus, and other infections are linked to FM.
- Repetitive injuries. If you overuse your hands to perform a task repeatedly, such as working with the same tool throughout the day, typing, or writing, you may suffer from Repetitive Strain Injury (RSI). This can be a debilitating condition that has been linked to fibromyalgia.
- Age. While it’s possible for children to develop fibromyalgia, the ages of most who develop this condition range from 20 – 60 years old. Most people develop symptoms during middle age.
- Diet. It’s thought that certain foods may exacerbate the symptoms of FM, including caffeine, dairy, eggplant, potatoes, tomatoes, peppers, fried foods, salty foods, and alcohol.
Researchers do seem to agree that in those who suffer from FM, the brain and spinal cord seem to process pain sensations abnormally. The threshold for pain may be lower, and pain is felt more intensely because the abnormalities in the central nervous system amplify the pain.
We Can Help
FM isn’t a new disease, but only recently have researchers and doctors understood and accepted it. In the past, FM wasn’t always considered a real condition, and some believed it was “all in the head.” However, a 1981 scientific study confirmed FM symptoms and the associated trigger points. Since that time, more testing has been performed on the pain reactions in people with FM.
If you’re a civilian or a veteran and suffer from fibromyalgia and are unable to work, you may be eligible for Social Security or VA disability benefits. Or if you’ve applied and were denied benefits, call Cuddigan Law at (402) 933-5405. We’ll schedule an appointment to discuss your eligibility for compensation.
If I have a family history of RA, what signs and symptoms should I watch for?
Rheumatoid arthritis (RA) is the most common type of inflammatory arthritis. It’s a chronic disease that causes stiffness, pain, redness, and swelling in the joints. In time, any of the joints that are impacted may become damaged, misaligned, and possibly misshapen. The joint’s tissue lining can thicken and wear away at the ligaments, bone, and cartilage that surround it. Most often, if you have RA in one hand or one knee, the joint in the other hand or knee will also have it.
People of every ethnic background, race, age, and gender can suffer from RA; however, approximately 75 percent are women. While the cause of RA isn’t known, researchers have a clearer picture of how genetics and the body’s immune system influence the inflammatory processes that factor into the development of RA.
If you are one of the 1.3 million Americans who suffer from RA, you may be eligible for Social Security Disability benefits from the Social Security Administration (SSA). The SSA’s “Blue Book” Impairment Listing provides the criteria to qualify for benefits. Even if you’re eligible for disability, you may want a legal expert to help with your claim.
What Are the Symptoms of RA?
Morning stiffness is the trademark symptom of RA. Unlike stiffness from osteoarthritis (OA) that usually ends in about 30 minutes, the stiffness of RA can last for an hour or more. Patients usually experience worsened symptoms of stiffness after they’ve been sitting for a long time and after sleeping. Here is a brief look at other major symptoms of RA:
- Pain and swelling. Inflamed joints usually swell and feel warm to the touch. To be diagnosed with RA, joint pain and swelling must occur for six weeks or more. While symmetrical joints are usually affected—fingers on both hands, both knees, both shoulders—sometimes the pain may be more severe on one side of the body. Joints that are most commonly affected are the wrists and knuckles; however, the balls of the feet and knees are often impacted, too. Other joints may be attacked, including those in the shoulders, elbows, jaw, and cervical spine. It’s rare for RA to develop in the fingertips—it’s more common in OA. However, RA sufferers may feel pain at the base of the fingers.
- Nodules or lumps under the skin. When small blood vessels are inflamed, they can cause nodules or lumps under the skin. This occurs in approximately 20 percent of people who suffer from RA. These lumps are usually no larger than a pea and, although they can be located anywhere, they are most often found near the elbow. These nodules may occur throughout the duration of a patient’s condition. It’s possible for the nodules to become infected if they are in areas of the body that handle stress, such as the ankles; however, these infections are rare. Additionally, the occurrence of nodules may mean that the patient has rheumatoid vasculitis—which impacts the blood vessels in other organs such as the kidneys and lungs.
- A buildup of fluid. People who suffer from RA may accumulate fluid in certain areas of the body, especially in the ankles. Likewise, the joint sac behind the knee may collect fluid that can form into a Baker’s cyst—a tumor-like growth that can cause pain down the back of the calf.
- Characteristics of the flu. Sometimes the symptoms of RA present like the flu. Patients may feel tired, lose weight, and have a fever. These symptoms often occur in the early stages of RA and have been described as flu-like or similar to a cold.
- A rash. In children, juvenile rheumatoid arthritis (JRA)—also called Still’s disease—will often present with a pink skin rash along with a high fever, chills, and joint pain and swelling.
We Can Help
If you suffer from RA and are unable to work, you may be eligible for Social Security disability benefits. Because the SSA recognizes the severity of RA and how debilitating it can be, you can qualify with the appropriate medical evidence. Let the lawyers at Cuddigan Law help you provide that evidence and submit your claim. Or if you’ve applied and were denied benefits, call us at (402) 933-5405. We’ll schedule an appointment to discuss your eligibility for compensation.
How does the VA rate my arthritis disability?
According to an article in the 2012 Journal of the American Academy of Orthopedic Surgeons, U.S. soldiers and veterans have been significantly affected by osteoarthritis (OA) and rheumatoid arthritis (RA). OA occurs when cartilage—a connective, structural tissue in the body that’s more flexible than bone—breaks down. RA is an autoimmune disorder that attacks the lining of the joints. Both types of arthritis are painful and sometimes debilitating.
In active service personnel under 40, OA is the leading cause of disability and medical discharge, and those on active duty as well as veterans are two times more likely to suffer from OA than civilians. When a soldier is diagnosed with RA during active duty, the Medical Evaluation Board automatically sets up a hearing that usually results in the soldier’s medical discharge from service. Between 2003 and 2009, Army statistics reported that the number of soldiers medically retired from the Army with at least one type of musculoskeletal condition increased almost 10 times.
Because arthritis is so prevalent in soldiers and veterans, the United States Department of Veterans Affairs (VA) determined that this condition is service-connected if diagnosed within a year of discharge. However, if symptoms of arthritis present in later years, you may still be eligible for VA disability.
Why Soldiers Are At a Higher Risk for Arthritis
OA can impact any joint in the body, but it most often affects weight-bearing joints: the ankles, spine, knees, and sometimes fingers. Often called the “wear-and-tear disease,” OA is painful because when the cartilage breaks down, bare bones rub together. Over time, those bones can thicken, become malformed, and form bony spurs—all of which create pain that can be debilitating.
Soldiers are at an increased risk for OA because the wear and tear on their joints can be extreme and excessive. Those in active duty face rigorous training, multiple deployments, and carry heavy equipment and body armor that can create intense pressure on joints and contribute to arthritis. In the early years of the Iraq and Afghanistan wars, service personnel carried between 80 and 120 pounds of gear. While troops now have lighter tactical gear that is often less than 20 pounds, they may still need to wear heavier armor under certain circumstances.
Additionally, combat wounds such as joint injuries from shrapnel and broken bones from roadside bombs can eventually lead to OA. During the Iraq war, a study of service personnel who were injured on the battlefield found that OA was the main reason these soldiers were discharged.
How the VA Rates Arthritis
If you have service-connected arthritis, a VA rating specialist will look at the following factors when determining your rating:
- Functional loss. This rating focuses on the limitations of the joint’s range of motion. For example, the VA rating specialist will evaluate an arthritic knee by its ability to perform normal, working movements.
- Instability. The VA rating specialist will categorize instability of the joint in three ways: slight (10%), moderate (20%), or severe (30%). It’s important that your doctor use these three terms to explain your limitations due to arthritis. Additionally, he should explain why your condition falls into that particular category.
- Pain. Most veterans with arthritis experience pain. While the VA rating system doesn’t usually recognize pain as a disability, it may be factored in for arthritis—especially if it affects the knee. Even if your range of motion is fine, and there appears to be no functional loss, the VA may still grant a rating in this category if you can provide evidence that the range of motion is affected by pain when the joint is used in a normal, repetitive way. The VA may recognize that the pain is impacting your ability to use that joint.
If you suffer from OA or RA, and your symptoms make it difficult or impossible to work or sustain gainful employment, you may be eligible for VA disability benefits. Or if you’ve applied and were denied benefits, call Cuddigan Law at (402) 933-5405 Be sure to ask for a copy of our free book, The Essential Guide to VA Disability Claims.
Questions and Answers About Military Sexual Trauma
A significant number of service personnel have experienced military sexual trauma (MST), according to the United States Department of Veterans Affairs (VA). Defined by the VA as threatening, repetitive sexual harassment or sexual assault, including, rape, MST also includes other types of trauma, including pressure to engage in any type of sexual activity that has implied benefits or threatens negative consequences, unwanted sexual touching or advances, and objectionable and offensive remarks about any person’s body or sexual behavior.
In 1991, the Department of Defense (DoD) announced a Zero Tolerance Policy against acts of sexual misconduct. However, these incidents have steadily increased. In 2013, The Military Justice Improvement Act (MJIA) was introduced by Senator Kirsten Gillibrand to change how serious military crimes and offenses—specifically, sexual assaults—are taken to trial. The Act was meant to reform the court-martial trial process, requiring an officer outside of the victim’s chain of command to make the determination about whether the accused should be court-martialed. In 2014 and 2015, the Senate blocked passage of this Act.
Questions About MST
In what’s been called a “culture of sexual assault” in the military, there are many questions about what happens after experiencing a MST. Here are some of the most common questions about sexual trauma in the military and some general answers to those questions:
How many service members have experienced a MST?
Since 2006, it’s reported that over 95,000 military service members have been sexually assaulted. It’s also estimated that in the past 25 years, over 500,000 people in the military have been victims of this crime. In 2012, active duty members who participated in an anonymous survey reported approximately 26,000 incidents of unwanted sexual contact. This contact included aggravated sexual assault, coerced and abusive sexual contact, and rape.
Are women more likely to experience a MST than men?
Both men and women suffer from MST. In a recent, one-year study of service members on active duty, 5 percent of women and 1 percent of men reported experiencing a sexual assault; and 22 percent of women and 7 percent of men experienced sexual harassment. Moreover, of those military members serving in Iraq and Afghanistan who responded to a recent survey, 48,100 women and 43,700 men reported suffering a MST.
In a report released in 2014, the findings show that military sexual assault is a problem that affects both males and females. Nate Galbreath, senior executive adviser for the Pentagon’s sexual assault prevention office, says, “There’s still a misperception that this is a women’s issue and women’s crime.” Data analysis by the Associated Press (AP) found that 1.2 percent of the men surveyed said they’d been sexually assaulted compared to 6.8 percent of the women. “But there are vastly more men in the military,” says the AP. “By the raw numbers, a bit more than 12,000 women said they were assaulted compared with nearly 14,000 men.”
Are all MSTs reported?
According to the DoD, approximately 19,000 incidents of military sexual assault occur every year, and it’s estimated that 85 percent are never reported. Additionally, about 75 percent of both men and women who were sexually assaulted didn’t report these incidents.
What makes reporting a MST so difficult?
For any victim of a sexual assault, reporting the incident can be emotionally daunting and threatening. But there are special factors that make reporting a MST unique in the military. Here are a few of those factors:
- It’s likely that the victim may work in the same service area as the person responsible for the assault—a colleague or teammate—or may live in the same barracks. The victim may have to rely on that person for safety, food, and even health care.
- Victims may feel that speaking out or reporting the assault may make them appear vulnerable or weak in front of their units. They may also feel they’ll lose the respect of their peers.
- Victims may worry that reporting the assault will damage the team spirit or camaraderie of the unit if the assailant is in the same unit.
- Victims may worry because the assailant may have control over their career status and possibility for promotion, and the victim may feel helpless in reporting an incident to that person and may worry that another attack will occur.
Because of these factors, service personnel may feel they face a no-win situation and believe they are trapped by their special circumstances.
What are some of the emotional and psychological problems and outcomes military victims face after a MST?
Military personnel who suffer a MST may experience symptoms soon after the incident or may have psychological and physical symptoms years later. These symptoms can be debilitating and create the following long-term, severe problems:
- A MST can cause panic attacks, depression, anxiety disorders, as well as conditions related to substance abuse.
- It is nine times more likely that a female veteran who was sexually assaulted will develop post-traumatic stress disorder (PTSD).
- According to a 1996 study, female veterans become homeless “at a rate 3 to 4 times greater” than civilian women. Additionally, 53 percent of homeless female veterans have suffered MST.
- Military personnel who report a MST are three times more likely to suffer from PTSD, anxiety disorders, and mental disorders—most specifically depression. Additionally, female veterans are likely to develop PTSD over other female veterans who did not experience a MST.
- Female victims of a MST are likely to suffer from eating disorders.
- Headaches, gastrointestinal issues, and pelvic pain are also physical health issues experienced by those suffering from MST.
- MST can affect a victim’s life with a variety of problems, including, difficulty feeling safe, having disturbing nightmares or memories, feeling numb, feeling isolated, problems with irritability and anger, and problems sleeping.
Is there a connection between MST and the rate of suicide in military personnel?
According to a U.S. study, veterans who experienced sexual harassment or sexual assault are at an increased risk of suicide. VA researchers found that men who experienced a MST are more likely to commit suicide by 70 percent over veterans who did not suffer from MST. Likewise, female veterans were twice as likely to commit suicide if they had experienced MST. Moreover, Susan McCutcheon, national mental health director for family services, women’s mental health, and MST at the VA says, “The study found that those veterans who died by suicide were significantly more likely to be treated for mental health conditions that were related to their MST experience.”
How many of the assailants are prosecuted?
It’s likely that any military personnel who rapes or sexually assaults a service member won’t be punished, disciplined, or convicted of a crime. It’s estimated that an assailant of a sexual assault will have over and 85 percent chance of having the assault kept secret and over 90 percent chance of not being court-martialed.
In some respects, this may be considered a vicious cycle. Victims are discouraged from reporting the assault because of the military’s culture of acceptance along with few prosecutions and the intimidating chain of command structure, so the assaults continue.
Moreover, military personnel risk investigation of their sexual personal history, ridicule, demotion, and involuntary discharge if they report a sexual assault by a command officer. A reportedly 90 percent of MST survivors are involuntarily discharged; 80 percent of accused assailants are discharged with honor.
Am I eligible for disability if I’ve experienced a MST?
You may be eligible for VA disability after suffering a MST, but there is key information you must include when making your application. While the VA recognizes you may not have documentation that proves the assault happened and will accept other evidence, it does require evidence that you suffer from a disabling physical or mental disability and that disability was caused or made worse by the assault that took place during your service. Additionally, to submit a successful MST claim, it’s helpful if you have a doctor write a Nexus letter.
If you experienced a MST and suffer from a debilitating condition related to that incident, you may be eligible for VA disability benefits. Or if you’ve applied and were denied benefits, call Cuddigan Law at (402) 933-5405. We’ll schedule an appointment to discuss your eligibility for compensation. Be sure to ask for a copy of our free book, The Essential Guide to VA Disability Claims.
What evidence do I need to receive VA benefits for a military sexual trauma?
Sexual assault and sexual harassment occur all too frequently in the U.S. military. The United States Department of Veterans Affairs (VA) defines military sexual trauma (MST) as threatening, repetitive sexual harassment or sexual assault, including rape. According to the VA, significant numbers of female and male veterans have suffered sexual assault during their military service—nearly one in five females and one in 100 males.
While sexual assault and rape are the most common form of MST, the VA includes other types of trauma in this category, including:
- Pressure to engage in any type of sexual activity that has implied benefits
- Pressure to engage in any type of sexual activity under the threat of negative consequences
- The inability of a person to consent to any type of sexual activity
- Any type of unwanted sexual touching
- Any type of unwanted or threatening sexual advances
- Any type of offensive or objectionable remarks about the body or sexual behavior of any military person
Military personnel can experience an MST while on duty or off and while on base or off. Because the person responsible for the assault may be a colleague or teammate who works in the same service area, may have control over the victim’s service career and promotions, or may live in the same barracks, the victim may have heightened fears of helplessness and worry about the possibility that the attack will happen again.
If you’ve experienced a MST, it’s possible you’re eligible for VA disability; however, there are important elements you need to include with your claim.
Evidence for a Successful MST Disability Claim
The VA is committed to help MST victims because it recognizes the significance and seriousness of a sexual assault. The VA asks all veterans who seek health care if they’ve suffered an MST, and then the data is tracked to record and document how many times any type of incident has occurred. While it’s believed that many MSTs are not reported, the VA’s national screening program reports that approximately 1 in 100 men and 1 in 4 women have experienced some type of sexual trauma.
The VA also recognizes that veterans who experience an MST may suffer from follow-on conditions because of the traumatic incident. Consequently, you are eligible for VA disability benefits for a debilitating mental or physical condition that was due to the MST if you can prove the following:
- An MST incident occurred while you were on active duty.
- Your doctor has now diagnosed you with some type of mental or physical disability such as PTSD, depression, anxiety, or symptoms related to substance abuse.
- Your disability happened because of the MST incident that took place while you were in the service, or your condition was made worse because of that incident.
Because the VA realizes you may not have a military medical record that shows proof of the MST, it accepts other types of substantiating evidence, including:
- Any type of documentation or records showing that you requested a transfer out of your unit.
- Any proof that you have a problem with substance abuse.
- Any proof that shows your job performance has changed, you’re exhibiting changes in social behavior, or your economic situation has changed.
- Any proof that you’re exhibiting incidents of depression or anxiety.
- Any and all police or rape crisis center records.
- Any medical records that show you’ve had tests for sexually transmitted diseases or a pregnancy test.
- Any acknowledgement or statements from counselors, military co-workers, family, friends, or clergy who know what happened.
- Any documentation you’ve kept on your own, including journals or diaries that detail the trauma.
What to Do If Your Claim Is Denied
It’s possible that the VA will deny your claim because it believes you haven’t provided enough evidence. Even though the VA accepts that there’s a service connection even without medical records from your time in service that prove an MST, many times claims are denied because that evidence doesn’t exist. If you’ve been denied or your application is being processed, you’re still eligible to receive counseling and other health care services for medical issues related to your MST. The VA has improved and increased resourcing to help veterans address these related conditions.
If you experienced an MST and suffer from a debilitating condition like PTSD or depression, or the VA denied your MST compensation, it’s often difficult to win an appeal, and it’s helpful if you have a disability attorney to help you. Call Cuddigan Law at (402) 933-5405. We’ll schedule an appointment to discuss your eligibility for compensation. Be sure to ask for a copy of our free book, The Essential Guide to VA Disability Claims.