Thomas Nielson spent the better part of his adult life uncovering the cause of his Sjögren’s Syndrome, a medical theory that turned into a decades-long legal process with the Department of Veterans Affairs; a legal process Nielson won, but only after he passed away.
Nielson, a U.S. Air Force veteran who served in the Korean War, tried to figure out the cause of a condition that began when he started needing a suspicious number of teeth pulled. At the height of the war effort, the military’s focus was not centered on providing Nielson with dentures to replace his lost teeth, and when he did receive the dental prosthetic they did not fit properly.
In the early 1960s, after leaving the Air Force, did Neilson begin to suspect his ever-deteriorating health might have had something to do with his service. His problem then became convincing the VA his condition was service-related.
Eric Gang, an attorney who represented Nielson’s case and whose New York & New Jersey-based law firm advocates for veterans, said VA medical cases often play out with a problem where a culture of machismo and disdain for malingering causes veterans to downplay their medical problems until they worsen from lack of treatment.
“Most service people discharge from the service when they’re fairly young. Young men, particularly at that period of time are typically of the belief they’re invincible, that whatever problems they’re experiencing will go away and they will overcome it,” Gang told American Military News.
Gang said after a long span of time from their discharge, young service members do eventually concede their personal battle with illness or injury, but the VA is far more skeptical to consider their cases by then.
After filing various claims in the 1970s and exhausting appeals directly through the VA, Nielson eventually turned to Gang for help. Gang put in years of effort to demonstrate Nielson had personally documented the first manifestations of his illness while serving during the Korean War. Gang also paid out-of-pocket for a doctor and a dental expert who helped attest to the medical factors that may have caused the Air Force veteran’s condition.
Johanna Bliss, 62, Nielson’s eldest of five children, remembered her father as an always positive person despite his struggle with the VA. For much of her life, Bliss and her siblings watched their father try to make his case to the VA. She could tell when he was in pain, even though her father would try to hide it.
Nielson never lived to see his vindication, having passed away in October 2014 at 81.
After substituting in Nielson’s widow, the VA appeals board did eventually concede Nielson had a valid case in 2017 and awarded a total of $663,000 for some 20 years of back pay owed to Nielson. They also awarded $57,000 to Mrs. Nielson, who is in her 80’s and suffering Alzheimer’s.
Bliss said, “The day we got the first letter saying it was resolved I actually went down to the Arizona Veterans Memorial Cemetery to say ‘Dad, you finally won.'”
Though the VA appeals board awarded the $720,000 total, Gang said the responsibility of administering the payment belonged with Nielson’s local VA office in Phoenix, Arizona. He said a VA office typically takes three to six months to issue the payments, but Nielson’s family had only learned after a year of waiting that his widow failed to sign a single form required by the VA before they would release the money.
“I’m getting concerned because the widow, her health is failing and if she dies the claim dies with her,” Gang said of the case.
Gang said this particular case with the VA is one of a pattern he calls “deny until you die.”
“We have an elderly woman in her 80’s who inadvertently didn’t sign a form in the right place and they didn’t want to pay her on a technicality,” he said.
Gang said while the VA’s current appeal method is meant to be a non-adversarial process, it all too often behaves like a court cross-examination that burdens a medical non-expert to figure out the cause of their illness for themselves. He said the VA will put in the effort to disprove one potential explanation for a medical problem, but not work to determine cause of the medical problem themselves.
“If there is a service-related issue to it, like there was in my dad’s case, [the VA] should be looking for that,” Bliss said, “not looking to say ‘no that’s not what it is.'”
Gang believes one way to overcome the problem of service members underreporting their medical conditions before they leave the military is to point those service members to appropriate legal resources before they are discharged. He believes this will help them understand the importance of documenting their health, preventing them from allowing a lengthy period of time between their seemingly healthy leave from the military and later claims of medical problems.
“To be fair . . . the government cannot subject itself to situations where it’s too easy to fabricate claims,” Gang said.
On the other hand, Gang said the VA needs to take a greater interest in investigating medical claims, and streamlining the appeal process. He did credit the passage of the 2017 Veterans Appeals Improvement and Modernization Act in an effort to improve the VA reviews, but said it’s still too early to know how effective the law will be.
Christina Mandreucci, a spokeswoman for the VA, declined to comment on Nielson’s specific case in an emailed statement to American Military News. She did point to the 2017 law as a sign of improvement in the appeals process.
“In the last fiscal year, VA completed more than 95,000 appeals decisions, a record high and a sign VA is moving to provide more clarity to Veterans about their benefits,” Mandreucci said.