VA Research: Diabetes & TBI

Jim Fausone

Veteran Disability Attorney

VA Healthcare does a tremendous amount of research and works to get that information out into the public.

As part of an effort to inform Veterans and others about their risk for developing the disease, Timothy, of VA's Office of Research and Development, appeared on The National Defense, a syndicated radio program provided to radio stations nationwide by the Veterans of Foreign Wars.

According to Dr. O'Leary, type 2 (adult onset) diabetes affects nearly 20 percent of Veterans who use VA health care, compared to about 8 percent of the general public.

Diabetes is the leading cause of blindness, kidney, disease, and amputation in the United States, and that up to 80 percent of patients with diabetes will face a heart attack or stroke. Dr. O'Leary said that VA is finding that group therapy is proving to be a successful method to help people control their blood sugar levels; that using pedometers encourages physical activities to help keep diabetes under control; and that coaching and counseling is an important aspect of managing the disease.

If you are a veteran and have diabetes you should get treatment.  The VA may be able to help and you may be entitled to disability compensation.  Do not ignore this condition.

Veterans exposed to blasts may still have brain damage even if they have no symptoms, according to a study led by researchers at VA's Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC) in Durham, N.C., and Duke University. The results of the study were reported on in U.S. News and World Report and a number of other publications.

The research suggested that a lack of symptoms of traumatic brain injury after a blast may not indicate the extent of brain damage caused by the blast.

In the study, researchers divided 45 Iraq and Afghanistan Veterans into three groups: those who had been exposed to blasts and had symptoms of TBI; those who'd been exposed to blasts and had no TBI symptoms; and those with no blast exposure. The participants underwent scans to look for damage in the brain's white matter, as well as tests to assess their mental abilities. Veterans who were exposed to blasts but had no symptoms had brain damage similar to that seen in those with symptoms of TBI.  So this contradicts a position taken by VA Benefits that a lack of symptoms in service means no injury. 

http://www.research.va.gov/pubs/varqu/spring2014/spr14-11.cfm#3

VA Reports Low But Wrong Numbers

Jim Fausone
Veterans Disability Lawyer

The VA is reporting that 10 % of veterans are waiting over 30 days for a medical appointment. 

That number does not reflect the poll LHFV did of its veterans.  Our survey shows that 21% of the veterans are waiting over 180 days.

Veterans read the articles about VA and its reported wait times and wonder why their experiences are so different.  I would tell you that the VA numbers probably underreport the wait times. So read this article with a grain of salt.

http://bigstory.ap.org/article/va-chief-more-vets-wait-30-days-appointment

 

Building Cultural Bridges between Doctors and Troops

Jim Fausone

Veteran Advocate

There has long been a divide between service members and civilian health care providers. According to a Pew study, 77% of veterans say they are not understood by the civilian population, and 71% of civilians say they don’t understand the military.

It is vital to good patient care for civilian health care providers to understand what these patients have experienced during their time in service. Only 36% of veterans are treated at the Veterans Affairs Department, which means millions of family members, as well as troops, are treated by civilian physicians. To start bridging the gap between service members and civilians, the Pentagon is gearing up to promote a new eight-hour course for health care providers to gain a deeper understanding of military culture, titled “Military Culture: Core Competencies for Health Care Providers.”

After a decade of war, the military is breaking new ground during a decade of war, not only helping service members but driving development in the entire psychiatry field.  Before the development of this program the only course available for civilian physicians was a short online course to cover rank, military occupational specialties, histories, and traditions.  Only 20% of the nation’s medical schools teach military culture, and barely half mention the military when teaching about post-traumatic stress disorder and traumatic brain injury. 

According to William Brim, a former Air Force psychologist who is now deputy director of the Defense Department's Center for Deployment Psychology (CDP), this indicates that a much broader outreach is needed. “If a service member were to go in for treatment and their therapist takes an approach of, ‘You poor person, they brainwashed you and took way your individualism,’ that might work for some but a lot of service members would nod their heads, walk out and never be seen again,” Brim said.

Brim strives to change that dynamic. After 4 years of development, the course covers four main subjects; health care provider beliefs and biases, military definitions, language and culture, military functions, and the role of military ethos in health behavior.  The program doesn’t shy away from difficult topics such as sexual assault, physical injuries, traumatic brain injury, and mental health conditions either. The course aims to convey a sense of the warrior ethos, or how service members and veterans view themselves, and how health care providers can use that information to provide the best treatment for the patient.

In its development, the program sought input from veterans, troops, wounded warriors, civilian providers, spouses, and National Guard reserve members, to get their perspective.  The primary goal, if nothing else, is to have health care providers learn to ask a few basic questions that would ultimately improve care for service members, veterans, and their families.

The new course awards those who take it with continuing education credits and will be available through several different websites.  The course was developed in part by the White House’s Joining Forces initiative, so the course will be available on the CDP’s website, the VA’s internal training site, the Pentagon’s website, the Substance Abuse and Mental Health Services Administration, the American Psychiatric Association, and others. 

Brim’s organization is also developing a one-hour course for primary care providers, the National Guard, service members, and families, to help them get the most out of doctors’ appointments.

These programs are a big step in improving the care veterans and service members receive.  New advancements in the field of psychiatry and providing health care providers with a deeper understanding of military culture promises to bridge the gap between service members and civilian health care providers. This means better, more efficient care for some of our nations most valued community members.

You can read more in the Army Times Article here: http://www.militarytimes.com/apps/pbcs.dll/article?AID=/201405091134/BENEFITS06/305090063

Drafting Non-Compete Clauses to ensure that they don’t become “Compete Clauses”

Matt Worley, Esq.

  

Non-compete clauses are an essential tool for business owners looking to protect their business interests.  These restrictions are typically used in two situations.  First, upon the sale of a business, this tool can prevent the seller from competing with the person who purchased the business.  Second, they’re used to prevent key employees who leave the company from going to work for a competitor or taking the business’s customers with them.

However, not all non-compete clauses are enforceable.  As a “general” rule, these non-compete clauses are permitted in Michigan; however, in order to be enforced, a particular clause must be “reasonable” under the circumstances. It is important for the employer (and their attorney) to have a clear understanding of the law when carefully drafting these clauses.  Otherwise, a court may strike down a poorly drafted clause that it finds unreasonable.

When determining if a particular clause is reasonable, and therefore enforceable, a court looks primarily at two questions – is the clause reasonable (1) in its duration, and (2) in its geographic scope.  Courts take an in depth look at the facts and circumstances of each situation when determining reasonableness.

Michigan courts have been known to enforce these covenants, in some situations, for long periods such as five years.  When reviewing the geographic scope, courts will typically look to see if the clause mirrors the territorial scope of the business.  If so, it is more likely to be upheld.  For example, if the business involved is a local business that only services customers within a 20 mile radius, a covenant not to compete that restricts the person in the entire state of Michigan is probably too broad and unenforceable.

Are you buying a business, or own a business and are concerned that key employees may leave your business and compete with you?  If so, it is imperative to have enforceable non-compete agreements in your purchase agreement and employment agreements.  The danger of copying a non-compete clause off the internet, for example, is that a court may find it unreasonable and unenforceable, leaving your business interests unprotected.

For advice on drafting ironclad non-competes and other business documents, contact the experienced attorneys at Fausone Bohn, LLP.  We can be reached at (248) 380-0000 or on the web at www.fb-firm.com.  Let us help you protect your business.

Staying Above Water: What You Need To Know About Drinking While Boating

Mark Mandell, Esq.

As we approach summertime and holidays like the Fourth of July, Michiganders will soon flock to their cottages and their boats. Michigan actually has one of the highest rates of boat ownership per capita in the nation.¹

And have you ever stopped to think, “Is it really legal to drink while driving a boat?” If you’ve been a spectator at Jobbie Nooner on Lake St. Clair, MI, surely this thought might have crossed your mind at some point.

The short answer is, yes. It is lawful to drive a boat with an open container or two of alcohol. But you have to be careful not to cross the line.

Indeed, the rules for drinking and boating differ in some important ways from drinking while driving. The laws for drinking while boating are governed by the Marine Safety section of Michigan’s Environmental Protection Act

Many Michigan boaters will be surprised to find out that the legal limit for Blood Alcohol Content (BAC) on the water is .10, as opposed to .08 on the roads.

Further, Zero Tolerance laws do not apply on the water as they do on the road. That means you cannot be charged for boating while intoxicated (BUI) if you have taken a prescription medication, and boaters under 21 are held to the same standards as adults.

All this might sound great and more lenient, but boaters should also take caution. When you’re out in the sun all day, just a few drinks could get you to that .10 threshold quickly if you don’t hydrate with water. And just like on the roads, there’s implied consent on the water. (Check out our Fraud Blog’s latest post on Implied Consent in Michigan: click here)

Under implied consent on the water, when you get behind the wheel of a boat you are considered to have consented to a BAC test. Even if you don’t take a breathalyzer test, you can still be detained and taken back to shore if you appear to be disorientated, confused, smell of alcohol, or were driving recklessly.

It’s also important to note that these laws not only apply to boats. Jet skis, kayaks, canoes, and any other type of water craft that can be used for transportation fall within the reach of these laws.

It is also unlawful for the owner of a vessel to allow anyone else to operate their vessel if that person is under the influence of alcohol or drugs.

The penalties for a BUI?

• For a first conviction, up to 93 days in jail, 45 days of community service, a fine of up to $500, or any combination of those penalties.
• Another offense within seven years may lead to jail time up to one year, with a minimum of 48 hours of consecutive jail time, fines ranging from $200-$1,000, and up to 90 days of community service.
• Upon a third conviction within 10 years, a person will be guilty of a felony, saddling you with a punishment of no less than one year and up to five years of jail time, a fine of $500 to $5,000, or both.
• Enhanced penalties for causing death or disfigurement for another are sentences of up to 15 years and 5 years respectively.

It’s important to note that a prior drunk-driving offense cannot be used to enhance a drunk-boating offense, and vice-versa. And while drunk driving offenses have a lifetime “look back” period for felonies, the drunk-boating look back period cuts off at 10 years.

So if you and your family head out on the water this summer, as many Michigan families do, boat safely and drink responsibly. A few Corona and limes on a nice summer day could get you into more trouble than you think if you’re not careful, even with a BAC limit of .10 on the water.

¹ Keeping Your Head Above Water in Drunk Boating Cases, Patrick Barone. https://www.michbar.org/journal/pdf/pdf4article1300.pdf

Implied Consent: Know the Rights You Don’t Have

Mark Mandell, Esq.

Did you know that each time you get into the driver’s seat in Michigan, you are considered to have consented to a BAC test? Before heading out for a few drinks with friends, there are some important points everyone should keep in mind if you’re thinking of getting behind the wheel, in addition to having a designated driver.

Under Michigan’s Implied Consent Law, all drivers are considered to have given their consent to chemical tests to determine their Blood Alcohol Content (BAC). It does no good to refuse a BAC test, as there are significant penalties.

First of all, if you refuse the test, six points will be added to your driver’s record and your license will be automatically suspended for one year. This is a separate penalty from any subsequent convictions resulting from the traffic stop. Secondly, there is always a judge on-call for the police to get a warrant for a blood-draw.

Further, if you refuse a test, or if the test shows your BAC is 0.08 or more, your driver's license will be destroyed by the officer and you will be issued a 625g paper permit to drive until your case is resolved in court.

If you are arrested a second time in seven years and again unreasonably refuse the test, six points will be added to your driver's record and your license will be suspended for two years. 

The suspension may be appealed to the Traffic Safety Division, but the request for a hearing must be submitted within 14 days – if you do not submit a request for a hearing, your license will be automatically suspended.

Implied consent hearings place a huge burden on the accused, but there are ways to soften damages in the process.

The implied consent hearings are conducted by attorneys from the Department of State. You must show that the refusal to take the test was not unreasonable – and this is extremely difficult to prove. However, the Michigan Supreme Court has ruled that you may request a call to your attorney before submitting to a breath test (Hall v. Secretary of State, 1975): if you are not allowed this opportunity, you may reasonably refuse a breath test.

You should also be informed about the “One Hour Rule,” whereby you generally have one hour to change your mind about submitting to a test. For example, if you refuse at first, but change your mind 15 minutes later, then you have not unreasonably refused the test.

Although the burden of proof is incredibly difficult to overcome, first-time offenders can petition the circuit court for a restricted driver’s license. You can also appeal any legal defects in the implied consent procedure to the circuit court. Having an experienced and knowledgeable attorney at your side to fight for your rights can make a huge difference.

If you have been charged with refusing to take a breath test, contact attorney Mark Mandell at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

The Brutal Legacy of War Left on Military Members

A new study released Thursday has started to unveil the brutal legacy that has been left on members of the U.S military and its veterans after more than a decade of war.

The study found that over the past year, on average, each service member visited the doctor more than once a month. This marks the highest rate ever for out-patient treatment of U.S. military members.

Doctors have encountered out-patient visits at a shocking pace of 14 out-patient visits per service member in the past year of 2013. This is a whopping 60% increase from average out-patients visits by U.S. military members in 2004. 

Among the most frequently treated problems, more than 20 million out-patient visits by troops were primarily for joint and back problems and mental disorders.  Rates for both of these ailments have increased by 30% since 2009.

The study also found that women in the service visited doctors more frequently than their male counterparts, even after discounting issues related to pregnancy. The most common behavioral health problems men were treated for were alcoholism, anxiety, and adjustment issues.  For women, the most common issues were anxiety, adjustment disorders, and depression.

The negative effects of war on the health of those serving in the military are becoming ever more apparent. Veterans who have served are struggling through a growing list of medical problems, making the need for veteran aid more apparent.

With this new study, and reports of poor veteran treatment like the “secret waiting list” at the Phoenix VA*, this country needs to renew its dedication to properly caring for those who have protected our freedoms in times of war.

*Read LHFV’s past post on the “secret waiting list” issue here: http://www.legalhelpforveterans.com/2014/04/an-absolute-disgrace-veterans-dying-on-va-hospitals-secret-list/

You can read more in the Army Times article here: http://www.armytimes.com/article/20140508/BENEFITS06/305080052/Troops-go-doctors-more-than-ever-new-survey-shows

To read the full report, check out the April edition of the Pentagon’s Medical Surveillance Monthly Report. It can be found here: http://phc.amedd.army.mil/PHC%20Resource%20Library/MSMRv21_n04.pdf