
Supreme Court sides against veterans wanting stronger benefit of the doubt review in disability claims
Show Caption
Hide Caption
Supreme Court leans toward allowing ban on youth transgender care
The U.S. Supreme Court is considering a challenge to a Tennessee law banning puberty blockers and hormone therapy for patients under 18.
WASHINGTON − The Supreme Court on Wednesday rejected the argument by two veterans who said the government must err on the side of granting them disability benefits if it's unclear the evidence supports their claim.
The court ruled 7-2 that the Veterans Court doesn't have to start from scratch to review the evidence when evaluating a benefits denial in a close call. Instead, the court can reverse a denial only for a clear error.
Justice Ketanji Brown Jackson, in a dissent joined by Justice Neil Gorsuch, said the majority's decision "all but ensures that the Veterans Court will continue rubberstamping" the Department of Veterans Affairs' decisions despite steps Congress took to prevent that.
The case involved Norman Thornton, a veteran of the first Gulf War who says he rated a higher level of disability from PTSD, and Joshua Bufkin who was denied post-traumatic stress disorder benefits after leaving the Air Force because doctors didn't agree if he qualified.
Their lawyers had said the case could have "profound implications for untold numbers of veterans.'
The challengers had the backing of several veterans' groups who argued that veterans had been entitled to the benefit of the doubt for service-connected disability payments for more than a century. And Congress has twice stepped in to ensure that happens.
In 1988, Congress created the Veterans Court to review disputed determinations and codified the requirement that scales should be tipped in favor of the veteran in close cases.
However, veterans' groups complained that the new court was too deferential to the VA when reviewing the agency's decisions.
In 2002, Congress directed the Veterans Court to 'take due account' of the VA's application of the benefit-of-the doubt requirement.
Veterans say Congress wanted a more thorough review, especially since the evidence often isn't clear-cut. The federal government argued the Veterans Court must only review a decision for a clear error, not re-evaluate each piece of evidence.
More: Supreme Court weighs veterans' disability denials, affecting 'untold numbers' of vets
In Bufkin's case, the Veterans Court found nothing obviously wrong with the VA's determination that one doctor's assessment about whether he suffered from service-related PTSD was more comprehensive and persuasive than another's.
Leave the military or get a divorce
His lawyers argue the court failed to review whether the VA applied the benefit-of-the-doubt standard to the complete set of evidence. Bufkin said he was traumatized by being caught between his wife's threats to kill herself if he didn't leave the military and the military's alleged response that he could leave the service or get a divorce.
The federal government said Bufkin's case was not a close call as the preponderance of evidence was against him.
Similarly, in Thornton's case, the VA found that the cumulative evidence showed Thornton did not merit a higher level of disability payments.
Thornton has had difficulty with work and with social interactions, among other issues, qualifying him as 50% disabled, according to the VA. But Thornton said his disability rating should be higher based on one examiner's assessment of how "dissociative episodes" have affected his employment.
The U.S. Court of Appeals for the Federal Circuit agreed with the government that the Veterans Court properly reviewed both determinations.
The case is Bufkin v. McDonough.

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Fox News
a day ago
- Fox News
VA reverses Biden admin policy providing abortion services agency calls contrary to federal law
EXCLUSIVE: The Department of Veterans Affairs (VA) will announce Friday that it is reversing a Biden-era exception allowing abortion services to be provided to veterans, in what the department cited as likely counter to the current medical benefits package prescribed by law. In a memo obtained by Fox News Digital, the VA said it will return its medical package and "CHAMPVA" benefits to the time preceding a September 2022 agency rule that removed the long-standing abortion restrictions. The 1999 medical benefits package that remains intact, prescribed under the outline of a 1992 law, does not authorize abortion services because they are not considered "needed" under the statute. "It is without question that VA has the authority to bar provision of abortion services through the VA medical benefits package to veterans," the memo read, adding that the former VA leadership made its adjustment in favor of providing abortions in response to the Supreme Court's Dobbs decision that effectively overturned Roe v. Wade. Then-Rep. Gillespie Montgomery, D-Miss., laid out in his 1992 Veterans Health Care Act that the agency could provide women with multiple healthcare services, including Papanicolaou Tests ("Pap-smears"), mammography and "general reproductive care, including the management of menopause." However, the law explicitly precluded "infertility services [and] abortions" unless they relate to a pregnancy with "risks of complication [that] are increased by a service-connected condition." "Prior to the Biden administration's politically motivated change in 2022, federal law and longstanding precedent across Democrat and Republican administrations prevented VA from providing abortions and abortion counseling," a VA spokesperson told Fox News Digital in discussing the policy reversal. "VA's proposed rule will reinstate the pre-Biden bipartisan policy, bringing the department back in line with historical norms." The VA memo added that the Dobbs decision was intended to prevent federal overreach and return control of abortion policy to the states, and that the agency prior to current Secretary Doug Collins' tenure "did the exact opposite" of what it said its 2022 policy change was intended to do in that regard. "[It] creat[ed] a purported federal entitlement to abortion for veterans where none had existed before, and without regard to state law," the VA said. "For nearly 50 years, and across a slew of federal programs, including Medicaid, the Child Health Insurance Program, TriCare, Federal Employee Health Benefits Program, and others, Congress has consistently drawn a bright line between elective abortion and health care services that taxpayers would support." The agency also emphasized that its policy reversal will not prevent pregnant women facing life-threatening circumstances from receiving care in those instances.
Yahoo
a day ago
- Yahoo
Debt and delayed care forecast for some who lose insurance under tax and spending law
Delayed treatments, canceled doctor visits, skipped prescriptions. Losing insurance is bad for your health. The Congressional Budget Office forecasts that the U.S. uninsured population will grow by 10 million in 2034, due to the tax and spending bill signed into law by President Donald Trump. And, thanks to a natural experiment nearly two decades ago, researchers can forecast what that will mean for patient care. Among the problems they predict will develop as a direct result of these people losing coverage: — About 2.5 million people may no longer have a personal doctor. — About 1.6 million patients will take on medical debt. — The lack of care may cause nearly 22,000 deaths annually. 'There's really no questioning the basic reality that you can't take health care away from 10 million people without causing many preventable deaths,' said Dr. Adam Gaffney, lead researcher on a team that explored the new law's impact. Here's a deeper look at the research and challenges that could develop. How the law may affect coverage It will become harder for many people to enroll in Medicaid or individual insurance plans and then stay covered. Medicaid is a state and federally funded program that covers care for people with low incomes. States will have to verify every six months whether someone remains eligible for Medicaid. That could cause coverage lapses for people with incomes that fluctuate or for those who move and miss renewal paperwork. Many also are expected to lose coverage as states require Medicaid recipients to work, volunteer or go to school unless exempted. Enrollment in Medicaid has swelled in recent years. Republicans are cutting back in part to help fund tax breaks and pay for other priorities like border security. They also say they are trying to root out waste and fraud by rightsizing Medicaid for the population it was initially designed to serve — mainly pregnant women, the disabled and children. People covered through the Affordable Care Act's individual insurance marketplaces also will see shorter enrollment windows and no more automatic renewals. About the research Gaffney, of Harvard Medical School, and other researchers looked to past studies to measure how many people would experience detrimental effects, like going without prescriptions, from the upcoming changes. Gaffney updated the published analysis, which was originally based on the House version of the bill, at the AP's request. One study in particular was critical for their work: In 2008, Oregon offered a rare opportunity to compare groups of people enrolled in Medicaid with those who were not. After a four-year period of frozen enrollment due to budget limitations, the state determined it could enroll 10,000 more people in Medicaid. It used a lottery system to make the selection amid high demand. That gave researchers a chance to follow people who got coverage and those who did not, similar to how scientists testing a new drug might compare patients taking it to those given a placebo. 'This is a gold standard research design because it replicates a randomized-controlled trial,' said Christine Eibner, a senior economist at RAND Corp. who was not involved in the study. Applying results from that study and other research to the recent CBO estimate allowed Gaffney and other researchers to estimate specific effects of losing coverage. 'By taking coverage away, we are putting patients in a terrible position,' said Gaffney, a former president of Physicians for a National Health Program. Care could grow complicated Amanda Schlesier went four days without her cancer treatment Calquence this spring and wound up in a local emergency room, delirious with pain. The leukemia patient worries about what might happen if she stops treatment again for a longer stretch because she's lost Medicaid. 'God forbid I forget to fill out a page of documentation, and suddenly I lose access to my medication or my doctors or any of the treatment that I've been going through,' the 33-year-old Farmington Hills, Michigan, resident said. People can still receive care when they don't have coverage, but important steps often are delayed, said Dr. Gwen Nichols, chief medical officer of The Leukemia & Lymphoma Society. Patients may be able to visit a doctor, but they would have to line up coverage or help before they can receive expensive chemotherapy. Diagnosis also may be delayed. Meanwhile, the patient's cancer continues to grow. 'It's a ticking time bomb,' Nichols said. Preventive care may lapse The first thing patients often ditch when they lose coverage are screenings designed to catch health problems before they become serious, said Dr. Jen Brull, president of the American Academy of Family Physicians. That could mean patients skip tests for high cholesterol, which can contribute to heart disease, or colonoscopies that detect cancer. Researchers forecast that a half million fewer women will have gotten a mammogram within the past year by 2034. When patients struggle financially and lose coverage, they focus on things like keeping a place to live and food on their table, said Brull, a Fort Collins, Colorado, physician. 'Seeing a doctor because you don't want to get sick feels like a much lower priority,' Brull said. Financial pressure can build Patients start taking financial hits at all ends of care when they lose coverage. They may have to pay up front or start a payment plan before they receive care, said Erin Bradshaw, an executive vice president with the nonprofit Patient Advocate Foundation, which helps people with medical bills. Anyone with an outstanding balance will have to pay it before the next appointment. Financial assistance may be available, but patients don't always know about it. Getting help also may take time and require the submission of tax returns, pay stubs or some validation that the patient no longer has coverage. Bradshaw said letters stating that a patient has lost Medicaid sometimes arrive a couple months after the fact. That can contribute to treatment delays or missed medication doses. Some patients also try to avoid financial stress by skipping care. Schlesier said she delayed seeing a doctor when she first felt symptoms of her cancer returning because she had no coverage at the time. Staying on medications If prescriptions are too expensive, patients may simply not get them or split the doses to stretch the medicine. For Thomas Harper, it's a question of priorities. 'Sometimes you have to make a choice, how well do you want to eat this week versus taking your medicine,' he said. The West Monroe, Louisiana, truck driver has around $300 a month in prescriptions as he deals with diabetes and recovers from non-Hodgkin lymphoma, a type of blood cancer. Harper, 57, recently returned to work. That meant he lost Medicaid, which covered more of his prescription costs. He's balancing buying his meds with shopping for healthy food that keeps his blood sugar in check and builds his immune system. 'I'll survive, but I know there's people out there that cannot survive without Medicaid,' he said. ___ AP video journalist Laura Bargfeld contributed to this report. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group. The AP is solely responsible for all content. Tom Murphy And Nicky Forster, The Associated Press Sign in to access your portfolio


Fox News
a day ago
- Fox News
Democrats escalate anti-Trump lawfare by targeting Congress in Planned Parenthood funding fight
Abortion providers and Democrat-led states are bringing lawsuits over the Trump administration's decision to defund Planned Parenthood, a legal fight that raises the stakes by challenging the will of both Congress and the president. Planned Parenthood and several blue states have sued over the provision in the One Big Beautiful Bill Act that strips Medicaid funding from certain abortion providers for one year. The bill was passed by Congress and signed by the president in July. The legislation advances the pro-life movement's longtime goal of defunding Planned Parenthood, the nation's largest abortion provider, but a federal judge in Massachusetts has temporarily blocked the Trump Health and Human Services Department from carrying it out. Derek Muller, a professor at Notre Dame Law School, told Fox News Digital that taking on two branches of government sets this litigation apart from many of the hundreds of other lawsuits targeting the Trump administration. "Congress has the power of the purse," Muller said. "Congress has a lot of discretion [over] how it wants to spend its money, and this is not an instance where the executive has been engaged in overreach or doubtful conduct. … This is ordinary legislation, and when it comes to ordinary legislation, there's more deference given to Congress, and certainly more in how it chooses to subsidize things, where it wants to give money or where it doesn't want to give money." The judge's decision to temporarily block the funding cuts stemmed from a lawsuit brought by Planned Parenthood, a nonprofit with hundreds of facilities across the country that provide abortions and other reproductive health services. Planned Parenthood's attorneys alleged in court papers that the provision was unconstitutional, arguing it would deprive the nonprofit of millions of dollars in Medicaid reimbursements, causing it to lose half of its patients and forcing it to shutter up to one-third of its facilities. Katie Daniel, counsel at SBA Pro-Life America, told Fox News Digital Planned Parenthood was making a "desperate argument" that "totally undermines Congress' ability to determine how taxpayer dollars are spent." It also signals that Planned Parenthood was not a solvent business, she said. "It's a business that really can't keep itself afloat without getting hundreds of millions in taxpayer dollars," Daniel said. Planned Parenthood's attorneys noted that Medicaid does not typically cover abortions and that the funding cuts would affect other services. Cancer and sexually transmitted infections would go undetected, especially for low-income people, and more unplanned pregnancies would occur because of a lack of contraception access, the attorneys said. "The adverse public health consequences of the Defund Provision will be grave," the attorneys wrote. Daniel said the Medicaid marketplace includes other options for clinics and that those options "outnumber Planned Parenthood nationally 15 to one." Judge Indira Talwani, an Obama appointee, said she was inclined to agree with Planned Parenthood that the legislation violated several provisions in the Constitution and granted a preliminary injunction, which the Department of Justice is now appealing. That lawsuit has been joined by two others challenging the bill. A coalition of 21 states with Democratic attorneys general, along with the District of Columbia and Democratic Gov. Josh Shapiro of Pennsylvania, brought one of them on Monday. Maine Family Planning, which operates 18 health facilities in the Pine Tree State, has also sued over the legislation. While lawmakers have touted that the bill defunds Planned Parenthood, it was written to include other entities, including Maine Family Planning, as a way to pass parliamentarian scrutiny. Daniel told Fox News Digital she anticipates the higher courts will rule in favor of the Trump administration but that the bill's one-year limit on the funding cuts works in Planned Parenthood's favor. "At this point for Planned Parenthood, it's really about running out the clock," Daniel said. "The defund provision is for one year, so every single day that they can keep getting money. … That's existential to them." If the Trump administration ultimately wins the court fight, it could attempt to claw back the Medicaid funds it lost while Talwani's injunction was in place. Daniel noted, however, that "it's incredibly difficult, it's time-consuming, it's costly, and Planned Parenthood is relying on all of that." Among Planned Parenthood's allegations was a longshot claim that Congress's bill violates the Constitution's bill of attainder clause because it singles out and punishes Planned Parenthood without a trial. Bills of attainder are pieces of legislation that serve to bypass the role of judges and punish people or entities. The Constitution prohibits bills of attainder because they infringe on the function of the courts. Muller told Fox News Digital he believed the bill of attainder argument was a "nonstarter." "People have tried to argue that certain things that Congress does, singling out or targeting individuals, could rise to a bill of attainder," Muller said. "This has gotten some traction in lower courts. It has never really gotten traction in the courts of appeal because it is far afield from the original meaning of the Constitution on this topic."