VA Aid and Attendance

Brig. Gen. Carol Ann Fausone (Ret)

Veteran Advocate

If you’re a veteran who hasn’t heard of the Aid and Attendance and Housebound Improved Pension benefit (the “A&A”), you’re not alone. A&A is a lesser known veteran benefit which can cover the costs of caregivers in the home (including sons and daughters but not spouses) or be used for assisted living or a nursing home.

Despite it being relatively unknown, it’s not for a lack of significance….at a maximum, A&A can cover $2,019.00 monthly for a veteran and spouse and up to $1,904.00 for the widow of a veteran.

So why don’t more people receive this benefit?

“It’s probably one of the lesser known benefits,” said Randal Noller, a VA spokesman in Washington. Only 2% of surviving WWII veterans, as of 2011, were utilizing the benefit.  Mr. Noller said the VA’s size might be a reason for the A&A’s low visibility. “The VA is the second-largest agency in the federal government, and you can’t expect everyone to know everything.”

 

Be it as it may, more veterans need to know about the benefit, and websites like VeteranAid.org are helping. The site contains information about the A&A benefit, all the forms needed and instructions on how to apply.

As a general rule, to qualify a veteran needs:

1. To have clocked one day of his/her 90-day minimum military service during a time of war and be in need of caregiving for daily living.
2. Have maximum assets worth less than $80,000 (car and home excluded) although someone with higher assets could still qualify if medical expenses were very high.
3. Have a maximum income of around $20,000 to $23,000 after deducting costs for medical expenses, caregivers, assisted living or nursing home fees.

It is also important to remember that despite language within the A&A, a wartime veteran automatically becomes ‘totally disabled’ once they reach the age of 65. At that point, if the veteran were to meet the asset and income requirements, they could be eligible for the A&A.

To learn more or see the original article, please visit: http://newoldage.blogs.nytimes.com/2012/09/19/few-know-of-benefit-to-help-aging-veterans/

Increasing Public Visibility of Wounded Vets

Jim Fausone
Veteran Disability Lawyer

 

A record 2.2 million tickets were sold for the 2012 Paralympics, hosted by London August 29 through September 9. NBC, which covered the London Olympics in August 2012, will be covering the Paralympics Games for the first time, as well as airing four specials which highlight aspects of the Games. The United States' 2012 Paralympics team includes 20 military veterans and active-duty servicemen and women, some of whom were injured in combat.

The International Paralympics Committee has reported an increase in news coverage by the U.S., as well as record participation, with more than 4,000 Paralympians, from 165 countries, slated to compete in everything from archery to wheelchair tennis.

The increased audience for the Paralympics may be in part due to a growing awareness by Americans that some military personnel are coming back from Afghanistan and Iraq, among other places, with lasting reminders of their service. It is estimated that more than 47,000 military personnel have been injured in recent conflicts, and as many as 400,000 servicemen and women have some form of combat-related depression, post-traumatic stress disorder and anxiety. 

The public has also been exposed to wounded servicemen by seeing people like Army infantryman J.R. Martinez on the small screen. Martinez, badly burned in Iraq, won 2011's season of ABC's "Dancing With the Stars" and was a fixture on daytime TV, playing a wounded veteran on the soap opera "All My Children." He was just named the 2012 Outstanding Disabled Veteran of the Year.   

Meanwhile, the Wounded Warrior Project, a Jacksonville-based nonprofit organization, works with military veterans to become active in adaptive sports. Activities include abled, disabled and differently-abled participants doing things in communities across the U.S. and internationally; recent outings include scuba diving in an aqua park in Pennsylvania, bike riding in Germany, and surfing off California's coast.

And in Minnesota, the Minnesota Warriors are a stand up amputee hockey team made up of some 40 disabled men and women who served from Vietnam to Afghanistan. The team was started to help support veterans and get them out on the ice, but now also bringing in community involvement and support. 

A more homespun approach has been taken by a number of Pizza Hut franchises in North Carolina. Some 45 of the pizza parlors are placing signage in the parking lot that designates a "Wounded Warrior" parking spot to reserve the place for wounded veterans.

“They are not being thanked or seeing that we appreciate what they have done,” said Virginia Maloyed, the wife of Marine Iraq War veteran. It was Maloyed's idea to approach Pizza Hut to install the signs. “This is a way to say, we remember - we remember, and we appreciate your sacrifice.”

• http://www.london2012.com/paralympics/sports/
• http://www.huffingtonpost.com/2012/08/29/paralympics-2012-coverage_n_1840434.html?utm_hp_ref=impact
• http://www.seacoastonline.com/apps/pbcs.dll/article?AID=/20120828/NEWS/208280340/-1/NEWSMAP
• http://www.citizen-times.com/article/20120829/BLACKMOUNTAINNEWS/308290035/-Wounded-Warriors-honored?odyssey=mod%7Cnewswell%7Ctext%7C%7Cs
• http://minnesota.publicradio.org/display/web/2012/03/12/minnesota-warriors-disabled-vets-hockey-team/

$40 million Detroit-area Medicare Fraud Scheme

Tariq Hafeez, Esq.

 

A Detroit-area doctor, Hicham Elhorr, has been charged in federal court for his alleged leading role in a $40 million Medicare fraud scheme.

Dr. Elhorr was the owner and operator of House Calls Physicians (HCP), a physician home visiting service.  Elhorr allegedly submitted claims through HCP for physician home visits for patients that were never seen or visits conducted by doctors who were not licensed.  The complaint further alleges that Elhorr submitted claims to Medicare when he was out of the country, when beneficiaries were hospitalized, or even when the beneficiary was dead.

 
Additionally, Elhorr is charged with accepting kickbacks from home health agencies in exchange for referring patients to those agencies.  According to court documents, HCP has billed Medicare for approximately $9.2 million since January 2008.  In that same time period, the company has allegedly referred Medicare beneficiaries for home health services that resulted in approximately $30.8 million of reimbursements from Medicare.

Of course, these charges mean that Dr. Elhorr is suspected of committing these crimes but is considered innocent until proven guilty beyond a reasonable doubt in a court of law.

Medicare and Medicaid fraud are serious offenses that are harshly prosecuted and carry severe penalties and jail time.  Having quality legal advice is imperative when defending against such allegations.

The experienced fraud team at Fausone Bohn, LLP – Mark Mandell, Tariq Hafeez, and Breeda O’Leary – can provide a top-notch legal defense for those involved in a government investigation or prosecution.  The team can also provide counsel for “whistleblowers” looking to expose the fraud of their employers (or ex-employers).  Whistleblowers may be eligible to receive money from a settlement or verdict and this knowledgeable team has the expertise to obtain these positive results.

To learn more or read the original article, please visit:

http://www.examiner.com/article/michigan-doctor-charged-40m-medicare-fraud-scheme

Wisconsin's Special Veteran Court

Jim Fausone

Veteran Disability Lawyer

Wisconsin has created a new court specifically for military veterans. Court officials are in place to launch a multistep process which will send referred veterans to Veterans Treatment Court, processing those accused of breaking the law in Wisconsin's Second Judicial District. The court combines substance abuse treatment and mental health support, funded by federal benefits and services in place for veterans. The court's goal is to treat the potential underlying issues contributing to unlawful choices, while also addressing the legal ramifications of those acts.

"Often, marginalized veterans are simply processed through an overburdened system without their underlying needs being addressed, much less met," says Veterans lawyer James Fausone. "It is heartening to see Wisconsin address the very real problem faced by veterans with mental health issues and alcohol or substance abuse issues."

The first steps toward Veterans Treatment Court include the screening and assessment of potential participants to see if they are a good fit for the program. If accepted, legal teams and the prosecutor in place will negotiate a plea agreement and draft out terms of the proposed sentence, including Treatment court. If all goes according to plan, the defendant would then go to the plea and sentencing hearing, with potential for probation. If the defendant is ordered to treatment court, he or she would appear there. Part of the veteran defendant's sentence would include successful completion of Veterans Treatment Court; failing to complete the plan or adhere to all steps would potentially trigger jail or prison time, similar to other, more traditional probationary plans. In addition to treatment, the program may introduce veterans to untapped federal benefits and services available to them.

Initial emails to the district attorneys’ offices in Racine, Kenosha and Walworth counties, requesting recommendations for a first wave of potential defendants who would benefit from the program, were sent in August, with the goal of psychological evaluations to be completed before mid-November. Eligible veterans must have diagnosed mental health issues, an alcohol or substance abuse issue, or a combination of the two. The number of potential cases is not known at this time, as referrals are just starting to trickle in. The first vet defendants are set to meet in session on November.

Source:

http://www.journaltimes.com/news/local/first-veterans-court-date-set----cases-still/article_4854479a-f580-11e1-b282-0019bb2963f4.html

 

Who Owns Your Digital Content?

Matthew Worley, Esq.

You can transfer ownership of your iPod when you die, but who owns the music contained on that iPod?  The answer isn’t clear.

Today, consumers are buying more digital content than ever from companies such as Amazon, Apple, and Google.  The content ranges from ebooks to music to movies.  Further complicating matters is that many people store these files in the cloud on those companies’ remote servers.

Whether digital content can be transferred to next of kin through a will depends on ownership.  The difficulty is that many consumers may believe they are “buying” songs or ebooks, but the sellers’ terms of service state that they are merely buying a license, or a “long-term rental,” and the license of that content isn’t transferable. 

Heirs can, however, access a protected online account – as long as they’re given the password in advance.  Otherwise, the heir may have to go to court to gain access. 

The problem is that the law hasn’t caught up with technology.  In order to prevent these transfer problems, digital media owners should plan ahead.  Passwords and online accounts can be passed by a will.  There are even data-inheritance services that have emerged to facilitate this transfer upon the death of the account holder.

This is an unsettled area of the law.  Content sellers have been slow to react partly because this issue only affects a limited number of their customers.   However, as time goes on and more people die the pressure will build for these content sellers to develop clear policies and create practical solutions.

To learn more or read the original article, please visit:

http://www.usatoday.com/tech/story/2012/09/19/digital-inheritance/57804428/1

Missing Benches – No One is Thinking

Jim Fausone
Veteran Disability Lawyer

 

Even in a system notorious for the occasional bureaucratic bumble, this one had people scratching their heads. Outside the Washington, D.C. Veteran's Medical Center, where the sick, the disabled, the elderly and the tired would sit and wait for their rides, or to escape the heat, benches were missing. Hospital administrators recently removed a number of benches in front of the building, leaving disabled veterans and the elderly, among others, to stand outside or in the hospital foyer while waiting for the bus or a ride to pick them up.  Some even sat on radiators in the hallways. No folding chairs or other seating was provided.

In way of an explanation, a spokesperson for the VA hospital stated, "The facility is developing a new Front Drive Plan to alleviate congestion and move veterans and visitors through the area safely. The seating will be replaced once the new design plan is approved and completed." Why planners did not simply leave the benches in place until the new design plan was implemented is unknown. The new plan is slated to be approved, though not completed, according to reports, by this November.

According to Rep. Jeff Miller, Chairman of the House Committee on Veterans’ Affairs, “VA should put the comfort and safety of veterans visiting the DC VA first. If a renovation is being considered to alleviate traffic in that area, then the current seating should remain as long as possible to accommodate veterans using the facility and an alternate entry site, with seating, needs to be planned for in the meantime.”

The local "7 On Your Side" news crew headed out to cover the story on August 29; less than 24 hours later, a forklift appeared, and the benches were reinstalled.

 “We understand the hospital’s stance that this was part of an overall renovation plan," said Ryan Gallucci, Deputy Director of National Legislative Service for the VFW. "We would encourage hospital administrators to quickly come up with an interim solution to make sure veterans – many of whom are at the hospital because they are ill, injured or disabled – have reasonable accommodations while they wait for their ride."

 
http://www.wjla.com/articles/2012/08/veteran-s-medical-center-removes-benches--79370.html

http://www.wjla.com/articles/2012/08/washington-va-hospital-returns-benches-after-7-on-your-side-report-79410.html

Large State – Long Wait

Jim Fausone
Veteran Disability Lawyer

 

While the official U.S. policy is to support disabled veterans with medical care, financial support and retraining, the support they receive has been found to be less than timely. Veterans located in Northern California, for example, wait, on average, more than nine months for war-related disability claims filed with their regional VA office. Meanwhile, vets who live in Nebraska or North Dakota receive their benefits sooner than those who live in Atlanta, Chicago or New York. Geographic inequity has been found to be rampant in lower-populated areas, according to a report by The Bay Citizen and the Center for Investigative Reporting. 

"Everyone agrees that we need to do a better job supporting our veterans when they return home," says veterans disability lawyer James Fausone. "It's no surprise that the entire system is painfully overloaded, but knowing that doesn’t help get disability support into the hands of our vets."

On average, the Office of Veterans Affairs takes more than eight months to process a claim, and despite claims of improved processes, a new $300 million computer system, and more than 3,000 claims processors hired in the past two years, that time is only increasing: The Bay Citizen reports it takes 50 percent longer to have a claim processed in 2012 than in 2011.  The new computer system has been placed in only four VA offices; claims are still on paper, in files and must be handed from office to office and onto a claims representative's desk to be processed. Meanwhile, veterans in both New York and North Texas are waiting, on average more than 12 months. An appeal filed on a denied claim, the report states, can take as long as three-and-one-half years for resolution.

While the VA has publicly pledged to process all backlogged claims by 2015, the number of vets waiting is only growing. As of the end of this July, there were more than 907,000 claims, with 832,000 individuals waiting on disability or survivor benefits, and thousands waiting on pension or GI Bill education benefits. The agency reports that new claims filed annually have increased by 48 percent, though the number of new claims representatives has increased by only 5 percent.

The Bay Citizen has posted an online interactive map to help vets find out the wait times in store for them, based on their location. The map information updates weekly and can be accessed at http://www.baycitizen.org/veterans/interactive/map-disabled-vets-stuck-backlog-limbo.  

Curb Cutout Liability

By Mattew Worley, Esq.

Cities may be held liable for injuries to pedestrians caused by defects in the sidewalk “curb cutout,” according to a Michigan Court of Appeals decision in Antonio Moraccini v. City of Sterling Heights.

In Moraccini, the plaintiff fell and was injured by alleged defects in the portion of the sidewalk that meets up with the county-maintained road.  When the sidewalk was installed by the city in 1977, the raised portion of the existing curb was cut away in order to make the sidewalk level with the road.  The plaintiff alleged that this cutout area was “uneven, damaged, and unstable, with deep cracks and crevices.”

The Plaintiff sued the city for negligence.  The city responded and sought to get the case dismissed on governmental immunity.  The trial court rejected the city’s argument and the city appealed.

On appeal, the city argued that plaintiff’s injury was caused by an alleged defect in the curb and gutter portion of Macomb County’s roadway and thus, the city was not liable.  The appellate court again sided with the plaintiff and held that the curb cutout constituted a path for pedestrians and was designed to be used by pedestrians.  As such, that area is considered an extension of the sidewalk and the duty to maintain it rests with the city, not the county road commission.

The case was remanded back to the trial court to determine if the city is liable.  According to Michigan law, the city may be liable for plaintiff’s injury if the city knew, or should have known, of the alleged defect at least 30 days before the injury and the defect was the proximate cause of the injury.

To learn more and read the opinion, please visit:

http://caselaw.findlaw.com/mi-court-of-appeals/1600033.html

2012 Veterans Summit Sold Out!

We are pleased to announce that the 2012 Veterans Summit sponsored by the Canton Community Foundation, Legal Help for Veterans, PLLC and Fausone Bohn, LP, being held at Laurel Manor September 12 and 13, 2012 has been a huge success. We have a record breaking crowd of 350 participants signed up for the second day and no tickets available.   Hope to see you in 2013!

Getting Old Fast

Kristina L. Derro
Veteran Disability Lawyer

As if our veterans haven’t struggled enough while overseas, they appear to be facing new physical and psychological difficulties when they return home.

According to a study currently being conducted at a VA hospital in Massachusetts, veterans of Iraq and Afghanistan appear to be growing old before their time.  Scientists are seeing early signs of heart disease, diabetes, slowed metabolisms and obesity – maladies that are more common in middle age or later.

This study is in its early stages to determine if these veterans have a form of early aging.  These symptoms appear to be most common in those with blast-related concussion and PTSD.

The Army, mindful of the strain of combat is allowing troops more time between deployments.  The length of each deployment has also been decreased from a year down to nine months.

Matt Pierce, a veteran of multiple deployments in Iraq and Afghanistan, is participating in the study.  A young man who should be in the best shape of his life struggles with high blood pressure, vivid nightmares, and a body that always aches.

Another example is a former soldier who came through the VA hospital a couple months before the study officially started.  He was suffering from obesity, high blood pressure, diabetes, and brain legions.  His MRI scans looked like those of someone in their 70s; however, he wasn’t even 40.

This theory may not be proven until these veterans are studied over the next decade.  One thing is certain, though – we all benefit from the sacrifice of these veterans and must ensure that they receive the care they deserve when they return home.

To learn more or read the original article, please visit:

http://www.usatoday.com/news/military/story/2012-08-06/veterans-aging-study-trauma/57608072/1?loc=interstitialskip

900,000 Backlog

James G. Fausone

Veteran Disability Lawyer

The VA is currently dealing with a backlog of nearly 900,000 compensation and pension claims.  Why the hold up?  More complex disability claims are slowing the processing time on these claims.

The average claim from Iraq and Afghanistan veterans now includes more than nine disability issues – far more than any other generation of vets since World War II.

According to Gerald Manar of Veterans of Foreign Wars, there are several reasons for the increased number of disability issues per claim.  For one, these wars have utilized National Guard and reserve troops more than previous conflicts.  Reservists tend to be older than their active-duty counterparts and more prone to wear and tear on their bodies.

Also, many troops have been deployed multiple times to Iraq or Afghanistan – whereas most Vietnam vets were deployed for one year and then left active duty.  Multiple deployments means increased exposure to IEDs and other hazards and greater likelihood of injury.

Additionally, newer veterans are better informed about what benefits are available and how to access them.  This is due in part to pre-separation briefings for all troops.

Since 2001, claims to the VA have risen 94 percent, with 1.3 million received in fiscal 2011.  Processing time for these claims is slowing to a crawl.  In 2001, the average time to complete a claim was 181 days; now it’s 257 days.  

The VA has pledged to begin reducing this backlog by 2015; however, it may still be 20 years before the backlog is eliminated.

To learn more or read the original article, please visit:

http://www.federaltimes.com/article/20120827/DEPARTMENTS04/308270001/Complicated-claims-slow-down-VA-payments?odyssey=mod|newswell|text|Facilities,%20Fleet%20&%20Energy|p