My reaction reading several posts in this thread is "NO, NO, NO, Wrong, No, and no again." It is frustrating because I think that folks are misunderstanding the rules, the presumptions, and the standards for line of duty and compensability determinations....but, I also take it as an opportunity to make some points. (Recall, I am not the President, the SECDEF, the Secretary of any of the Military Departments, nor am I a federal judge. So, I could be wrong; I wouldn't bet on that, but, anything is possible. As soon as I hold one of those positions, I will clarify with force; apologies in advance for the preceding tongue in cheek statement).
One problem is that many folks are "talking past each other," and addressing different points (some of which could potentially be valid depending on the circumstances, but, in the abstract, miss the actual rules, criteria, and laws on the points raised).
I am posting this, not to shut down discussion, but to explain what my views are, and to save folks, in reading one of the posts, not appreciating the complexities, and thinking that they "have no case."
Mike,
LOD was approved at lower level. WING/CC.
approved with 8 year rule notation.
DENIED at NGB with justification of:
I was not on orders when diagnosed.
This NGB justification is so wrong.
Just take a look at AFI 36-2910; it is actually stated clearly on the second page of this regulation:
"This interim change authorizes automated/electronic line of duty (LOD) determination processing (paragraph 3.2.). HQ AFPC/JA previously approved the Air Force Reserve Command‟s development and fielding of automated processing. This interim change implements 10 U.S.C. Section 1207a‟s 'eight year rule,' which states members of the Air Reserve Component (ARC) called or ordered to active duty for a period of more than 30 days, who have
incurred a disabling condition and have at least eight years of active service, shall have the disability considered incurred while entitled to basic pay for the purpose of determining whether the condition was incurred in the line of duty (paragraph 3.4.1.2.3.)."
Being on orders when diagnosed is irrelevant. The issue is when the onset of symptoms occurred. The fact that the VA issued service connection would present a case where you could have challenged NGBs ruling.
This is dead wrong- on two potential avenues of analysis.
First, for purposes of the "Eight Year Rule" being on orders is actually dispositive.
Second, the presumption of sound condition applies.
Take a look at DoDI 1332.18:
b. Presumption of Sound Condition for Members on Continuous Orders to Active Duty Specifying a Period of More Than 30 Days
(1) The Secretaries of the Military Departments will presume Service members, including RC members and recalled retirees, on continuous orders to active duty specifying a period of more than 30 days entered their current period of military service in sound condition when the disability was not noted at the time of the Service member’s entrance to the current period of active duty.
(2) The Secretaries of the Military Departments may overcome this presumption if clear and unmistakable evidence demonstrates that the disability existed before the Service member’s entrance on their current period of active duty and was not aggravated by their current period of military service. Absent such clear and unmistakable evidence, the Secretary of the Military Department concerned will conclude that the disability was incurred or aggravated during their current period of military service.
(3) The Secretary of the Military Department concerned must base a finding that the Service member’s condition was not incurred in or aggravated by their current period of military service on objective evidence in the record, as distinguished from personal opinion, speculation, or conjecture. When the evidence is unclear concerning whether the condition existed prior to their current period of military service or if the evidence is equivocal, the presumption of sound condition at entry to the current period of military service has not been rebutted and the Secretary of the Military Department concerned will find the Service member’s condition was incurred in or aggravated by military service.
Not sure if being on orders when diagnosed is irrelevant and you can just point to symptoms. The rule is you need to be activated or in training when the illness or injury first occurred, from the way I read it. Some illnesses make this rule pretty messy. Lots of people snore, and apnea events during sleep are common, it takes pretty specific criteria to say, yes, this is sleep apnea and it can be notoriously hard to pinpoint the start without the sleep study. I'm not a doc, but my understanding of Parkinson's is it is a very slowly progressive disease with a very messy start time, I could see it being hard to say with any likelyhood, and not pure speculation, that it started on day x, instead of day x-60 or day x+60 to a time that brings you out of eligibility. You need a nexus to say it started in a specific time frame while on active status, that the symptoms were the true Parkinson's start instead of the date of diagnosis. I could see that being hard to obtain.
No...almost all of this wrong (with due respect and understanding that you are only trying to help).
The first part ignores/gets wrong the fact that despite a condition pre-existing service, it can still be (and is presumed to be) in the line of duty because of service aggravation. There is a presumption of service incurrence AND a presumption of service aggravation. The burden is on the military to show that BOTH presumptions are overcome. The evidentiary burden is high on the military's part to overcome the presumptions.
Most of the misunderstanding here is because of not understanding/applying the presumptions. (It is VERY EASY to understand how/why the above statements were made....I am not trying to sharpshoot, to shut down discussion, or to derogate from the help you are trying to provide).
The basic point is that you have to start with the presumptions- that a member who enters service for more than 30 days is PRESUMED to be in sound condition, and that any worsening of pre-existing conditions was the result of military service.
They seem very picky how these arguments are presented. See:
http://boards.law.af.mil/ARMY/BCMR/CY2005/20050007658C070206.doc
for a, IMO, very strange example, and I've seen stranger but I think this illustrates the problem with how this is applied clearly enough.
With all due respect, this example is very poor in addressing the issues; it was issued in 2005, well before many MAJOR changes in the regulations. That said, at the time the ABCMR decision was rendered, I think it "could have been won," except for the fact that the claimant basically "caved" and admitted no error:
"1.
The applicant is no longer arguing that his LODI should have been corrected from "not in line of duty" to "in line of duty" and the evidence submitted with his current request does not support a conclusion that such a correction is or was warranted. As such, that portion of his request pertaining to reconsideration of his original application warrants no further discussion or consideration. [I have no idea why this would have been admitted to or argued, but, it essentially means that the applicant agreed his condition was NOT IN THE LINE OF DUTY; bad findings followed this fatal flaw].
2. The applicant is now arguing, and claims that it has always been his argument, that
he did not receive the proper medical care after a lesion on his leg was shaved off and biopsied in September 1999 when he was on active duty and that he should have been retained in an active status until the possible resulting condition was resolved. He also now argues that because the September 1999 biopsy suggested that cancer was a possibility and because within 90 days after his separation such a diagnosis was made he is therefore also entitled to incapacitation pay and reimbursement of medical treatment cost. His argument is primarily based on two issues; one, that his condition was discovered within 90 days of his separation and, two; that medical treatment for various conditions during his current tour of duty, even if those conditions were not incurred or aggravated while in an active status, is evidence that treatment of the 1999 condition also warranted continued treatment."
This case is about condition discovered AFTER separation, and only has to do with TREATMENT, not compensability- for whatever reason, the applicant withdrew his claim that his condition was in the line of duty. (This is a prime example of why it is bad to not have qualified legal representation in fighting cases).
As long as the doctor can make a reasonable assumption that the disease occurred during the period of activation, and was subsequently made worse... the LOD could be overturned.
NO!!! This statement ignores the presumption of service incurrence and the presumption of service aggravation.
As long as the diagnosis date is subsituted by a supported argument that the disease process started at a specific time. Just noting the diagnosis date isn't a non-factor and more than evidence of a symptom being present in service is required. I don't think it is a stretch to say the diagnosis date is the primary evidence used to deny a disease or injury from being compensated.
NO!! I get the logic and reasoning behind the statement. But, again, this ignores the "rules" and the law that applies to cases generally.
First, for "Eight Year Rule" cases, the issue
is having the condition while being on orders (whether identified in that period of service of before).
Second, by application of the presumption of sound condition on entry, any symptoms not noted on entry, would seem to require that the condition be found in the line of duty. Once again, there are "weird" circumstances that might change the outcome (and some interesting questions- not derogating to the final final finding of compensability in as to why or how member passed medical screening for entry on active duty in the first place....however, there is no exception that would seem to apply UNLESS the member knowingly lied about their condition, concealed it, etc.; even so, there are more complicated issues that would impact the outcome in those rare circumstances).
Third, the issues are further complicated in the above bolded/quoted part as to whether or not the questions/issues raised turn only on the "symptom(s)" issue as requiring referral to the DES/IDES or whether the condition is compensable. This is horribly complicated, as a symptom (whether correctly diagnosed as part of a disease or disability process) may be just an indicator of a compensable condition (and the condition should be in the line of duty) or it may be a reason- unto itself- as a basis for referral to the Disability Evaluation System (which, the resulting of the analysis of the LOD issue would then matter as to how the case progresses) . However, it is NOT THE CASE that a definitive diagnosis (or diagnoses) is/are required before referral to the DES/IDES. (This point has come up many times in cases and I have seen it play out in practice varying ways). The issues are conflated here- compensability for conditions, requirements for referral to the DES/IDES, and proper diagnoses. Each are separate, and to some extent non-mutually exclusive (but, they are related) issues.
There are other issues and points that bear on this question....I won't try to write a treatise on this subject in this post.
I had some trepidation in tackling my above statement; mainly because of the mixing of issues and- therefore- mixing of standards that might apply. The above statements quoted, seems to be mixing at least two separate issues- LOD determinations with requirements for referral to the DES/IDES. It is always hard to parse out the issues without concrete examples of actual issues (and findings/actions) in cases.
As an example of some of the issues raised and the complicated nature of the issues- in some cases- folks might want to read this case, which I have litigated before the Court of Federal Claims:
http://www.pebforum.com/site/resources/wollman-v-united-states.59/