In a study, conducted by Alexander Neumeister of Yale University School of Medicine, he found that veterans diagnosed with PTSD along with another syndrome, such as depression, alcohol abuse, substance abuse or suicidal ideation, had different brain images on a CT scan than did those who had been diagnosed only with PTSD.
Neumeister also said that depression with trauma is “biologically distinct” from depression without a history of severe trauma.
In a second Duke University Medical Center study, Christine Marx of Durham Veterans Affairs Medical Center, showed that blood neurosteroid levels correlated to brain neurosteroid levels, so Marx measured the blood neurosteroid levels of 90 male Iraq and Afghanistan veterans. She found that the neurosteroid levels correlated to symptom severity in PTSD, depression and pain issues, and that those levels might be used to predict how a person reacts to therapy as well as to help develop new therapies.
Full Article at: 2 studies: PTSD is chemical change in brain
By Kelly Kennedy - Staff writer
"Two new studies seem to provide more evidence that post-traumatic stress disorder is a chemical change in the brain caused by trauma — and that it might be possible to diagnose, treat and predict susceptibility to it based on brain scans or blood tests.
In one study, Christine Marx, of the Duke University Medical Center and Durham Veterans Affairs Medical Center, wondered why PTSD, depression and pain often occur together.
Researchers already knew that people with PTSD show changes in their neurosteroids, which are brain chemicals thought to play a role in how the body responds to stress.
Previous animal studies showed that blood neurosteroid levels correlated to brain neurosteroid levels, so Marx measured the blood neurosteroid levels of 90 male Iraq and Afghanistan veterans. She found that the neurosteroid levels correlated to symptom severity in PTSD, depression and pain issues, and that those levels might be used to predict how a person reacts to therapy as well as to help develop new therapies.
Marx is researching treatment for people with traumatic brain injuries using the same kind of brain chemical, and early results show that increasing a person’s neurosteroid level decreases his PTSD symptoms.
Marx’s work was funded by the Veterans Affairs Department, National Institutes of Health, the Defense Department and NARSAD, an organization that funds brain and behavior researcher.
A second study, conducted by Alexander Neumeister of Yale University School of Medicine, found that veterans diagnosed with PTSD along with another syndrome, such as depression, alcohol abuse, substance abuse or suicidal ideation, had different brain images on a CT scan than did those who had been diagnosed only with PTSD.
Neumeister became curious after realizing that veterans dealing only with PTSD responded differently to treatment than did those with PTSD and another diagnosis.
He said the finding is important for two reasons.
First, these differences “can have huge implications for treatment,” he said in a statement issued by the American College of Neuropsychopharmacology, which released the two studies during its annual meeting this week.
For example, he said, treating a person with antidepressants addresses only the depression diagnosis — not the PTSD or the substance abuse issues. All of the issues need to be addressed, he said.
His second reason addresses the stigma behind seeking help for PTSD. Service members have said they fear being perceived as weak or cowardly, or their military careers will be hurt, if they seek help for mental health issues.
“Once veterans see this is a neurobiological disorder in which their brain acts differently in terms of circuitry and chemical function, oftentimes it motivates them to seek treatment,” he said.
In his report, Neumeister also said that depression with trauma is “biologically distinct” from depression without a history of severe trauma.
Tuesday, December 8, 2009
Mandamus, Delays, FedCir. Hawkins v. Shinseki, No. 2009-7068
The Federal Circuit case being presented today, Hawkins v. Shinseki, No. 2009-7068, is due to the Dissent, these are good points to consider when filing a mandamus motion with the Veterans Court.
Indeed the 19 yrs delay in this claim is far more common than the FedCir would like to admit.
It is to be hoped that Appellant’s nineteen-year wait does not represent the experience of most veterans, but rather stands as an outlier that this Court should address.
However, until and unless more veterans present such delays to the FedCir. they will be unable to have the evidence needed to reach a decision that delays at the VA are unacceptable.
==================================
Appellant has shown that he lacks adequate alternative means to attain the desired relief and that he has a right to the writ, Cheney v. U.S. Dist. Court, 542 U.S. 367, 380-81 (2004), because the delay in a final appealable adjudication of his case has been “so extraordinary, given the demands on and resources of the Secretary, that it is equivalent to an arbitrary refusal by the Secretary to act.” Ribaudo v. Nicholson, 20 Vet. App. 552 (2007) (citing Costanza v. West, 12 Vet. App. 133, 134 (1999)). The government’s numerous errors in adjudicating Appellant’s claim, which have required multiple remands, cannot be excused as products of a burdened system. See Costanza, 12 Vet. App. at 134. A writ requiring the RO to act within three months would not constitute a substitute for the appeals process, nor would it involve a review of the merits of Appellant’s case. See 38 U.S.C. § 7292(d).
====================================
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
J. Myers Morton, Morton & Morton, PLLC, of Knoxville, Tennessee, argued for claimant-appellant.
Allison Kidd-Miller, Trial Attorney, Commercial Litigation Branch, Civil Division, United States Department of Justice, of Washington, DC, argued for respondent-appellee. With her on the brief were Tony West, Assistant Attorney General, Jeanne E. Davidson, Director, and Brian M. Simkin, Assistant Director. Of counsel on the brief were David J. Barrans, Deputy Assistant General Counsel, and Y. Ken Lee, Attorney, Office of the General Counsel, United States Department of Veterans Affairs, of Washington, DC.
Appealed from: United States Court of Appeals for Veterans Claims
Judge Mary J. Schoelen
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
Appeal from the United States Court of Appeals for Veterans Claims in 08-2336.
__________________________
DECIDED: December 7, 2009
__________________________
Before MAYER and RADER, Circuit Judges, and WILKEN,* District Judge.
Opinion for the court filed by Circuit Judge MAYER. Dissenting opinion filed by District Judge, WILKEN.
MAYER, Circuit Judge.
Elmer A. Hawkins challenges the Court of Appeals for Veterans Claims (“Veterans Court”) refusal to issue a writ of mandamus. Hawkins v. Peake, Sec’y of Veterans Affairs, No. 08-2336 (Ct. Vet. App. Feb. 23, 2009). We affirm.
Hawkins seeks a writ of mandamus to instruct the Secretary of Veterans Affairs ____________________________
* Honorable Claudia Wilken, District Judge, United States District Court for
the Northern District of California, sitting by designation.
2009-7068 2
to: disclose medical files, records, reports, and other documents pertaining to the petitioner’s claim; grant the petitioner service connection; abide by the Veterans Court’s remand instructions; and “adjudicate petitioner’s claim under general principles of fair process according to law of this case and Thurber v. Brown, 5 Vet. App. 119 (1993).”
We review this case under the All Writs Act. See 28 U.S.C. § 1651(a). A writ of mandamus will issue if a petitioner can show: (1) no other adequate means to attain the desired relief; and (2) an indisputable right to issuance of the writ. Cheney v. U.S. Dist. Ct., 542 U.S. 367, 380-81 (2004). Hawkins has not met this burden.
The Veterans Court remanded Hawkins’s appeal to the Board of Veterans’ Appeals. The board has remanded to a regional office (“RO”) of the Department of Veterans Affairs (“VA”) to ensure compliance with a March 2006 order of the Veterans Court. The RO may yet grant Hawkins VA benefits. Even if no VA benefits are granted by the RO, Hawkins has access to appellate review. As such, adequate means exist to attain the desired relief. Additionally, remand to the RO for developing a more complete record benefits Hawkins. The RO’s March 25, 2008, Supplemental Statement of the Case denied service connection. Without service connection an indisputable right to the expansive relief sought in Hawkins’s petition for a writ of mandamus does not exist. Accordingly, the Veterans Court did not abuse its discretion in denying the writ.
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
Appeal from the United States Court of Appeals for Veterans Claims in 08-2336.
WILKEN, District Judge, dissenting.
I respectfully dissent. I would grant Appellant’s writ.
Appellant, a Vietnam War veteran, has waited almost two decades for a final decision on his benefits application. His claim, filed on October 22, 1990, asserts that his chronic and severe medical conditions are connected to his service due to exposure to Agent Orange. Over the past nineteen years, the Department of Veterans Affairs (“DVA”) and its predecessor, the Veterans’ Administration, have made repeated errors which have prolonged the decision-making process. Appellant’s case is currently again before a regional office (“RO”) of the DVA, on remand from the Board of Veterans’ Appeals.
I would issue a narrowly-tailored writ to expedite the resolution of Appellant’s claim. The writ would require the RO to adjudicate his claim within three months. This
2009-7068 2
Court would retain jurisdiction to monitor the progress of the case to a final, appealable decision.
Appellant has shown that he lacks adequate alternative means to attain the desired relief and that he has a right to the writ, Cheney v. U.S. Dist. Court, 542 U.S. 367, 380-81 (2004), because the delay in a final appealable adjudication of his case has been “so extraordinary, given the demands on and resources of the Secretary, that it is equivalent to an arbitrary refusal by the Secretary to act.” Ribaudo v. Nicholson, 20 Vet. App. 552 (2007) (citing Costanza v. West, 12 Vet. App. 133, 134 (1999)). The government’s numerous errors in adjudicating Appellant’s claim, which have required multiple remands, cannot be excused as products of a burdened system. See Costanza, 12 Vet. App. at 134. A writ requiring the RO to act within three months would not constitute a substitute for the appeals process, nor would it involve a review of the merits of Appellant’s case. See 38 U.S.C. § 7292(d).
Issuing a writ here would not expose the Court to a flood of similar claims. It is to be hoped that Appellant’s nineteen-year wait does not represent the experience of most veterans, but rather stands as an outlier that this Court should address.
Indeed the 19 yrs delay in this claim is far more common than the FedCir would like to admit.
It is to be hoped that Appellant’s nineteen-year wait does not represent the experience of most veterans, but rather stands as an outlier that this Court should address.
However, until and unless more veterans present such delays to the FedCir. they will be unable to have the evidence needed to reach a decision that delays at the VA are unacceptable.
==================================
Appellant has shown that he lacks adequate alternative means to attain the desired relief and that he has a right to the writ, Cheney v. U.S. Dist. Court, 542 U.S. 367, 380-81 (2004), because the delay in a final appealable adjudication of his case has been “so extraordinary, given the demands on and resources of the Secretary, that it is equivalent to an arbitrary refusal by the Secretary to act.” Ribaudo v. Nicholson, 20 Vet. App. 552 (2007) (citing Costanza v. West, 12 Vet. App. 133, 134 (1999)). The government’s numerous errors in adjudicating Appellant’s claim, which have required multiple remands, cannot be excused as products of a burdened system. See Costanza, 12 Vet. App. at 134. A writ requiring the RO to act within three months would not constitute a substitute for the appeals process, nor would it involve a review of the merits of Appellant’s case. See 38 U.S.C. § 7292(d).
====================================
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
J. Myers Morton, Morton & Morton, PLLC, of Knoxville, Tennessee, argued for claimant-appellant.
Allison Kidd-Miller, Trial Attorney, Commercial Litigation Branch, Civil Division, United States Department of Justice, of Washington, DC, argued for respondent-appellee. With her on the brief were Tony West, Assistant Attorney General, Jeanne E. Davidson, Director, and Brian M. Simkin, Assistant Director. Of counsel on the brief were David J. Barrans, Deputy Assistant General Counsel, and Y. Ken Lee, Attorney, Office of the General Counsel, United States Department of Veterans Affairs, of Washington, DC.
Appealed from: United States Court of Appeals for Veterans Claims
Judge Mary J. Schoelen
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
Appeal from the United States Court of Appeals for Veterans Claims in 08-2336.
__________________________
DECIDED: December 7, 2009
__________________________
Before MAYER and RADER, Circuit Judges, and WILKEN,* District Judge.
Opinion for the court filed by Circuit Judge MAYER. Dissenting opinion filed by District Judge, WILKEN.
MAYER, Circuit Judge.
Elmer A. Hawkins challenges the Court of Appeals for Veterans Claims (“Veterans Court”) refusal to issue a writ of mandamus. Hawkins v. Peake, Sec’y of Veterans Affairs, No. 08-2336 (Ct. Vet. App. Feb. 23, 2009). We affirm.
Hawkins seeks a writ of mandamus to instruct the Secretary of Veterans Affairs ____________________________
* Honorable Claudia Wilken, District Judge, United States District Court for
the Northern District of California, sitting by designation.
2009-7068 2
to: disclose medical files, records, reports, and other documents pertaining to the petitioner’s claim; grant the petitioner service connection; abide by the Veterans Court’s remand instructions; and “adjudicate petitioner’s claim under general principles of fair process according to law of this case and Thurber v. Brown, 5 Vet. App. 119 (1993).”
We review this case under the All Writs Act. See 28 U.S.C. § 1651(a). A writ of mandamus will issue if a petitioner can show: (1) no other adequate means to attain the desired relief; and (2) an indisputable right to issuance of the writ. Cheney v. U.S. Dist. Ct., 542 U.S. 367, 380-81 (2004). Hawkins has not met this burden.
The Veterans Court remanded Hawkins’s appeal to the Board of Veterans’ Appeals. The board has remanded to a regional office (“RO”) of the Department of Veterans Affairs (“VA”) to ensure compliance with a March 2006 order of the Veterans Court. The RO may yet grant Hawkins VA benefits. Even if no VA benefits are granted by the RO, Hawkins has access to appellate review. As such, adequate means exist to attain the desired relief. Additionally, remand to the RO for developing a more complete record benefits Hawkins. The RO’s March 25, 2008, Supplemental Statement of the Case denied service connection. Without service connection an indisputable right to the expansive relief sought in Hawkins’s petition for a writ of mandamus does not exist. Accordingly, the Veterans Court did not abuse its discretion in denying the writ.
NOTE: This disposition is nonprecedential.
United States Court of Appeals for the Federal Circuit
2009-7068
ELMER A. HAWKINS,
Claimant-Appellant,
v.
ERIC K. SHINSEKI, Secretary of Veterans Affairs,
Respondent-Appellee.
Appeal from the United States Court of Appeals for Veterans Claims in 08-2336.
WILKEN, District Judge, dissenting.
I respectfully dissent. I would grant Appellant’s writ.
Appellant, a Vietnam War veteran, has waited almost two decades for a final decision on his benefits application. His claim, filed on October 22, 1990, asserts that his chronic and severe medical conditions are connected to his service due to exposure to Agent Orange. Over the past nineteen years, the Department of Veterans Affairs (“DVA”) and its predecessor, the Veterans’ Administration, have made repeated errors which have prolonged the decision-making process. Appellant’s case is currently again before a regional office (“RO”) of the DVA, on remand from the Board of Veterans’ Appeals.
I would issue a narrowly-tailored writ to expedite the resolution of Appellant’s claim. The writ would require the RO to adjudicate his claim within three months. This
2009-7068 2
Court would retain jurisdiction to monitor the progress of the case to a final, appealable decision.
Appellant has shown that he lacks adequate alternative means to attain the desired relief and that he has a right to the writ, Cheney v. U.S. Dist. Court, 542 U.S. 367, 380-81 (2004), because the delay in a final appealable adjudication of his case has been “so extraordinary, given the demands on and resources of the Secretary, that it is equivalent to an arbitrary refusal by the Secretary to act.” Ribaudo v. Nicholson, 20 Vet. App. 552 (2007) (citing Costanza v. West, 12 Vet. App. 133, 134 (1999)). The government’s numerous errors in adjudicating Appellant’s claim, which have required multiple remands, cannot be excused as products of a burdened system. See Costanza, 12 Vet. App. at 134. A writ requiring the RO to act within three months would not constitute a substitute for the appeals process, nor would it involve a review of the merits of Appellant’s case. See 38 U.S.C. § 7292(d).
Issuing a writ here would not expose the Court to a flood of similar claims. It is to be hoped that Appellant’s nineteen-year wait does not represent the experience of most veterans, but rather stands as an outlier that this Court should address.
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