Resultados de los expedientes de discapacidad del Departamento de Asuntos de Veteranos (VA)

The following disability cases are representative of the work we do with our clients. These case studies are presented to help inform, educate and hopefully encourage you during these difficult times. Based in Houston, Marc Whitehead & Associates works directly with clients throughout Texas and across America.

A claimant is going through the toughest medical time of their lives. They are not equipped for a fight with an insurance company. We know the tactics that the insurance companies may use to deny the rights of unsuspecting people.

The disabled are not prepared for the uphill battle against the Social Security Administration and Veterans Benefits Administration. We are experts in the complexities of the Social Security Disability and Veterans Disability compensation programs.

If you become a client of our law firm, we will explain the laws that apply to your particular situation and work to help you understand your options. This information can help you make the right decision for you and your family.

Strict time limitations often apply to disability matters, so don’t delay calling us to learn how we can help you: Toll Free 800-562-9830 or in Houston, Texas call 713-228-8888.

Para una consulta jurídica gratuita con un abogado que presta sus servicios en todo el país, llama al (800) 562-9830

Resultados de los expedientes de discapacidad del Departamento de Asuntos de Veteranos (VA)

None of the VA matters below was won at the first attempt.

Each began as a denial, and two of the three as a series of denials stretching over years. That says something about the work rather than about the veterans. People arrive here after the system has already told them no, sometimes repeatedly, and the job is establishing what the file never established the first time.

Two patterns run through all three. The evidence was frequently already in the record, waiting for someone to argue it rather than add to it. And each claim was pursued continuously rather than abandoned and refiled, which is what keeps an effective date anchored to the original claim instead of resetting it to a later one. Over a matter that ran years, that distinction can be worth more than the rating.

Denied Four Times, Then Granted on Higher-Level Review

An Army veteran’s PTSD claim was denied four separate times before it was granted.

The route that finally worked was a Higher-Level Review, the decision review option in which no new evidence may be submitted and a senior reviewer looks again at the same file. 38 C.F.R. § 3.2601 requires that review to be conducted “giving no deference to the prior decision.”

In other words, everything needed to grant the claim had been sitting in the record through four denials.

Read the full case

Five Straight Years of Denials on a Back and Knee Claim

Five years, five denials, and a claim that was eventually paid.

Cases like this one are the reason the effective date matters as much as the rating. Under 38 C.F.R. § 3.2500, a veteran who keeps a claim continuously pursued rather than abandoning it and starting fresh preserves the date the entitlement runs from. Over five years, that distinction becomes the larger part of the award.

Read the full case

A Sleep Apnea Denial Overturned After Four Years

Sleep apnea claims run into a recurring problem: the condition is diagnosed years after discharge, so nothing in the service record connects it to service.

This one was denied and stayed denied for four years before it was overturned on appeal, with back pay running to the original entitlement date.

Read the full case

Abogado especializado en discapacidad cerca de mí (800) 562-9830

How Do You Read a Case Result?

As evidence about a firm, not as a forecast about you. Published results show what kind of matters a practice handles, at what stage, and against what obstacles. What they cannot show is what will happen in your claim, which turns on its own service record, its own medical evidence, and its own procedural history.

Every One of These Started With a Denial

If you are holding one, the useful question is which review route answers what your decision letter actually said. Our overview of VA disability appeals sets out the three options and what each is for.

Envíanos tu carta de resolución para que la revisemos de forma gratuita.

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Social Security Disability Insurance (SSDI) Cases

Many of our clients have medical conditions that “wax and wane.” These medical impairments, such as fibromyalgia, chronic fatigue syndrome, seizures, gout and migraine headaches, don’t show up on x-rays or other diagnostic tests and their impairing effects may not be present every day, making it difficult for the client to get benefits.

Situation: A 55 year old man with painful gout in his feet, was no longer able to do his job because it required standing on his feet for most of the day. We were able to show through testimony at the hearing that when he had a “flare-up” at his past work, his employer and co-workers helped him with his job duties. Of course, to get Social Security benefits, a person must be unable to do any job, including a “sit-down” job. His doctor felt that he would be able to work an easier job, but we were able to work with him to get a statement that indicated our client would probably miss 5-7 days of work, 3 to 4 times per year when his gout flared-up.

Result: At the hearing, we were able to show that he could not sustain a job because of so many missed days, and he was awarded benefits for himself and his minor children.

Chronic Back Pain

A common disability issue that we see in our practice is chronic pain due to back problems. Clients with back problems may have been injured in a car accident or had several back or neck surgeries, or experience chronic pain due to degenerative disc disease or osteoarthritis. Social Security acknowledges their problems and discomfort, but often rule that these claimants can work a sedentary job if they are able to change position throughout the day. The claimant’s doctor may feel that their symptoms are managed with medication. However, medication side effects can affect a person’s ability to work. Common side effects include sedation, fatigue, dizziness or drowsiness. At the hearing, we make sure the judge is aware of all medications our clients take and we use medical authority to bolster our client’s testimony regarding the side effects experienced and how it affects job performance.

Cognitive Problems

When people think of disabilities, they first think of a physical injury. However, people with major depression, schizophrenia or bipolar disorder can have symptoms great enough to interfere with their job performance. Cognitive problems can prevent a person from being able to follow detailed instructions or simply due to problems with pace or persistence, the person is considerably less productive than the average worker. Sometimes people with mental disorders hope that they will get better and become able to return to work. Unfortunately, they may wait several years to file for benefits. When this happens, they lose their “credits” under Social Security rules.

Situation: We had to prove that one of our clients, a woman with bipolar disorder, was disabled several years in the past even though at that point she wasn’t diagnosed with a mental condition. We had to read all her medical records very carefully for clues that she was experiencing symptoms of a mental disorder. Deeply embedded in her medical records were clues, including insomnia and racing thoughts.

Result: We were able to point out these symptoms at the hearing and the Medical Expert agreed with our analysis, allowing our client to receive benefits.

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Long Term Disability (LTD) Cases

Large national disability insurance carriers often use video surveillance as support for their contention that a claimant can work. Although they may tape a person simply sitting in a car as a passenger, in their denial letter they will state that the person had no problems entering and exiting a vehicle, as if that reflected the ability to work a full time job.

Situation: One of our clients, a 36 year old woman with chronic pain syndrome, had her benefits terminated after video surveillance. In the video, she was seen running a few errands including stopping at a car wash where she bent over and ran a cloth over a spot on her car for 1-2 minutes.

Result: We were able to refute the insurance company’s claim that this amount of activity reflected the ability to work a full time job in our administrative appeal. Our client provided us with articles and a book written by her doctor that accurately described her impairment, symptoms and treatment which we included in the appeal. We were able to get her several years of back benefits and the insurance company put her back on plan and resumed monthly benefits.

Unfortunately, some video surveillance is difficult to overcome.

Situation: One of our clients, a 45 year old man with back problems, was videotaped climbing ladders and working extensively on his roof. After an appeal, the insurance company affirmed their denial of benefits.

Result: We filed a lawsuit and worked closely with our client in a mediation with the insurance company. Despite the video, our client was very happy with the amount of money produced in the settlement.

Marc Whitehead & Associates will also help the same client with both their SSDI benefits and long term disability benefits. LTD carriers usually require that a claimant file for Social Security benefits. Even though the SSA and insurance carriers have different definitions of “disability,” we use the same records to prove our clients are unable to work.

This is very beneficial for our clients because while one matter is pending, we can help them receive benefits from the other source. For example, we were able to get SSDI benefits quickly for a woman with a mental disability. Her LTD case will take longer as the administrative appeal was denied and we are in the process of filing a lawsuit on her behalf.

Our phones are open 24 hours a day to take your calls regarding disability cases and denied insurance claims.

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403 Heights Blvd
Houston, TX 77007
(713) 929-2856

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