Did Secondary VA Claims Really Get Harder?

0:06Leah Bucholz Hey, guys. It's Leah Bucholz here from Prestige Veteran Medical Consulting. I am a US army veteran physician assistant and former CMP examiner. So today, I have Rebecca Deming on, an amazing accredited VA attorney that we've we've had several times in the past. Many of you guys may know her.

0:22 And we have a really cool topic today, but I wanted to for those of you who don't know her, I wanted to have her kind of introduce herself so you guys can get to know her. So Rebecca, welcome. You want to tell everybody about yourself?

0:35Rebecca Deming Leah? Yeah. So I'm the founding attorney of ProVet Legal. We are a law firm based in Florida that work exclusively on veteran disability claims. So you and I have a lot of intersection because we're helping, we're both helping from different angles, veterans get their benefits that they deserve and the surviving spouses and surviving family members as well.

0:59Leah Bucholz Yeah. For sure. So I'm gonna just jump right in because there's been a lot of questions recently about this topic, and there's been a lot of kind of misinformation going around and just confusing veterans, especially on YouTube. And I'm a YouTuber, and now you're a YouTuber. But, you know, there's a lot of misinformation out there that I think is scaring some people.

1:20 So I thought it would be best to hear it, you know, directly from somebody that can really speak on it. And and I'm gonna just jump right in. So there's been a lot of this discussion online about the term but for causation. What does that mean in plain English? And and can you give us a little bit of background on what's been going on recently?

1:39Rebecca Deming Rebecca Sure. So the term but for is a term that we learned in law school and kind of first year of law school when you're talking about causation and what caused something, what's responsible for something. And so it is kind of like the straw that broke the camel's back. It is anything that happens, although it doesn't have to be the last piece. Like when you say the straw that broke the camel's back, that's like the last thing that triggered the camel's back to break.

2:12 But for causation, that piece of the puzzle could kind of fall anywhere in the causal chain. So you could have something that's kind of attenuated like, but for the fact that you have surface connected depression, you wouldn't be depressed and you probably would have gone to the gym and you would have eaten healthier. For that, you wouldn't have gained weight. But for your weight gain, wouldn't have developed sleep apnea or knee issues or whatever the diabetes, whatever kind of the third order effect is. But it can be more attenuated than the very specific thing that causes the condition.

3:02 That's different than proximate cause, which kind of was the understood standard before the spot for causation became clarified by the courts. So proximate causation is really, if I punch you in the nose, that's what broke and your nose breaks, it was my fist hitting your nose that broke your nose. But the but for causation is, but for the fact that you broke into my house, I wouldn't have punched you in the nose. And so there's multiple factors that go into the whole Mhmm. Whole situation about what ended up causing your nose to break.

3:45 So the background on this is in 2023, there was a case that was decided called Spicer v. McDonough. And the veteran had, I believe it was leukemia, but he had a systemic disability that was service connected. Because of his leukemia, he couldn't get knee surgery for his knees weren't connected to service. He had knee issues that were completely unrelated to service, but he was going to go get surgery that would have made his knees better.

4:17 But the leukemia prevented him from getting that surgery. But for the leukemia, he would have been able to get the surgery, his knees would have gotten better. And so he put in a claim for his knees and Vee was really struggling with this idea of like, well, knees weren't caused by his knee injuries weren't caused by service, but his service connected condition was the piece that was stopping him from getting the treatment he needed that stopping it from getting better. And so the case in the court in Spicer v. McDonough said that it's but for causation, it's not proximate causation.

4:50 And so they did give him benefits for his knee condition because of his- Wow. Inability to get the treatment. And so that case came out in 2023.

5:00Leah Bucholz And

5:01Rebecca Deming at the time we're filming this, it's 2026 in case people watch this later on. It's difficult May 2026 for VA to update their internal manual, the M21, to reflect that very clearly. So the change came out 05/01/2026 and kind of everyone, it is kind of a confusing term, the term but for sounds different than what it means from a legal perspective. And so I think people kind of freaked out about it and thought, Oh, just kind of caused pandemonium. We got a lot of questions about, know, should I even go secondary service connection?

5:35 Am I ever gonna be able to get secondary service connection? These people think they're raising the standard of proof. It it just kind of created a snowball of questions.

5:44Leah Bucholz Sure. So again, I mean, things have not dramatically changed for secondary service connection. Is that accurate? You know? Yeah.

5:57 It

6:00Rebecca Deming date to the m twenty one manual is supposed to be a clarification of the policy. Actually even the court case, the court decision that came down in 2023 wasn't a change, it was a clarification of what the standard is. And it's making it It should be making it easier veterans get secondary service connected benefits. That said, could VA get it wrong? Is it likely that VA is going get it wrong?

6:25 I mean, given the mass hysteria on the internet about this topic, obviously a lot of people don't understand it. So yeah, I'm fully expecting VA to make mistakes, even though this is supposed to clarify it. No, it's not a change in what the law is. Nothing's really changed. It's just, at least in theory, become more clear on what the standard is for VA to grant secondary service connection.

6:52Leah Bucholz So you don't think medical providers need to do any drastic changes to the way that they write their opinions

6:58Rebecca Deming to I satisfy don't think so. I think if so first of all, the standard of proof has stayed the same, still at least as likely as not. So when we're talking about but for causation versus proximate cause causation, those are kind of how close in the chain of connection do the two items have to be. But the standard of proof is how likely does it have to be that that happened. And so the standard proof, I think medical providers should still be using the term at least as likely as not where they can support it.

7:31 Approximate balance of evidence, it's at least as likely as not, it's the term that they should be using. If they want to use but for causation in their opinions, they they could add that in and say, you know, but for this service connected condition, the non service connected condition or this secondary claimed condition wouldn't have happened or wouldn't have been as bad as it is. So

8:10Leah Bucholz can you talk can you talk a little bit about the BUT for causation involving multiple contributing factors?

8:18Rebecca Deming Sure. So where you're trying to show what caused something, I mean, there's always a lot of pieces that kind of contribute to it. And I think before, VIA was really looking for that proximate cause. So what's the main cause of the condition? What caused your cancer?

8:37 What caused your diabetes? Was it the Agent Orange that caused your diabetes? But with any condition, there's a lot of pieces that kind of can contribute to it and make it worse. And so if you have hypertension, if you have depression, if you have And I'm just kind of listing conditions that often can exacerbate. Otherwise, if you have medications that you can't take certain medications because of a service connected condition, those pieces all sort of factor in.

9:11 And so with the but for causation, if any one of those plays kind of a material role or a critical role in the causal chain, then the veteran can get service connected benefits for the secondary condition. So

9:29Leah Bucholz do you think we and we touched on this earlier about kind of veterans panicking about this kind of stuff. So the things that are all these alarming videos that are coming out online, do you have any thoughts on that? I think there's

9:41Rebecca Deming a few reasons why there's misinformation. I think one, like we said, the but for standard, it's just the language is kind of confusing for somebody who's not a legal professional. And so I think there really is even from people who are meaning well and who have helped people with claims in the past, think there's some confusion there. They're trying to mislead veterans. I really don't think anyone's out there trying to mislead veterans, but it kind of highlights the importance of working with someone who is a legal professional or at least an accredited claims representative because these legal terms that are in the regulations and in the statutes have meaning that are very nuanced and very important to kind of dissect and apply correctly.

10:24 If you have somebody who doesn't have that legal training, they would potentially get it wrong. So I don't think people are doing it intentionally. I do think that with the way that kind of some YouTube channels run and I'm not speaking about anybody in particular, but I think some of them sort of clickbait or they're trying to kind of get people, you know, click here for the one tip that's going to change your life, the one tip that's going to revolutionize the way that you approach your VA claim. Here's the thing you need to hear before VA ruins your life. It kind of creates a panic and a sense of urgency and people click on that.

11:08 I mean, we could just make that a commentary on the way the internet works and the way people gain followers. If that's the way that people are gaining followers, is that somebody that you really want to be following? Is kind of the question that I would pose. Then the other thing, and I think we've sort of talked about this, VA does make changes, VA stuff does happen that may not be always veteran friendly or in veterans' best interests. But in general, I don't think any administration or any political party wants to be the party or the administration that ruined veteran benefits.

11:50 And so if something seems like it's just devastating or really, really bad, there are advocacy groups that can change stuff, but it could also be a misinterpretation because, or it could be that they were trying to put something forward and they didn't understand the As the government, the government might have been putting something forward that they didn't understand the third and fourth order effects of. And so there are advocacy groups that can kind of help pull that back and help have those discussions. But I don't think that there's kind of this evil out there that's trying to take away benefits for veterans intentionally on a whole or on a mass scale. I I just don't see that coming down the pipeline anytime soon.

12:32Leah Bucholz So I guess just circling back to this specific issue at hand, like, what this is my final question. So what's what is, in your opinion, the biggest misconception veterans have about this particular set of legal standards?

12:48Rebecca Deming So the I think people are really worried about how it's going to impact their secondary service connected conditions and that it's going to make it harder for them to get secondary service connected conditions. And it's actually the exact opposite if VA applies it correctly. And I think it's really important for people to understand how secondary service connected conditions factor in and that basically anything that is service connected can kind of open the window or it can have a chain order effect on your body and anything that's kind of downstream from that, you could get benefits for from VA. And so sometimes people just think like, Well, I had this injury in service when we rolled over and I hit my elbow. My elbow is the service connected injury.

13:34 But they don't think about how that elbow condition caused overuse of a shoulder injury. They don't always think about kind of those second, third order effects that they could be getting benefits for. And it, you know, depending on what their total rating is, those benefits can really be life changing.

13:52Leah Bucholz Yeah. I I think this was super insightful because it definitely has shifted my you know, I was like one of those people too. I'm just a veteran. Right?

14:00Rebecca Deming It's just a veteran. I'm just

14:02Leah Bucholz a veteran. I'm not

14:03Rebecca Deming a legal professional. I just protected our our freedom and

14:07Leah Bucholz No. But I I didn't really quite understand either, and and the way that you've broken it down really helps to reframe and and provide better understanding. And I hope that this has been helpful to other veterans out there to not be so worked up or scared about kind of these not changes, but these clarifications and and things like that. So thank you for joining us today as always. So I really appreciate you being here, and I want you guys to out there watching to really consider jumping over to Rebecca's channel because she puts out a lot of really great topics that I think you guys would benefit from.

14:44 And so we'll put some of her information in the description of this video if you would like to go check out our website, consult with her about your legal issues, or just watch some of our content. Rebecca, did you have anything else you wanted to

14:57Rebecca Deming say to the folks out there? No. I just thank you for having me on your podcast again, and I'm sure there's gonna be more questions that come up around this topic. It's kind of a a really nuanced topic. So I'm looking forward to this the ongoing discussions.

15:10 For sure.

15:11Leah Bucholz Alright. Well, thank you again for joining us. And for all y'all out there, please like and subscribe, and we'll see you guys soon. Alright.