Court eases benefits rules for VA hospital patients

December 13, 1994|By Lyle Denniston | Lyle Denniston,Washington Bureau of The Sun

WASHINGTON -- Wiping out a U.S. government rule that had stood for more than 60 years, the Supreme Court yesterday made it easier for veterans to claim disability benefits if their conditions worsen or they are injured while being treated in a VA hospital.

The ruling, which could cost the Department of Veterans Affairs an estimated $1 billion in added disability payments over the next five years, came on a unanimous vote in a case involving a Texas veteran of the Korean War.

Potentially, the case affects the legal risks faced by three veterans medical centers in Maryland: in Baltimore, at Perry Point and at Fort Howard. Nationwide, veterans medical facilities treat 830,000 patients a year in hospitals and provide outpatient care to an additional 22 million veterans through doctors' visits.

The medical problems covered by the ruling are those that veterans suffer after they have finished their military duties and are unrelated to that service.

Under the government's policy since 1926, a veteran had to prove two things to qualify for disability benefits after being in a VA medical facility: first, that the disability developed after the facility's treatment; and second, that the facility was to blame because of faulty treatment, or because of an accident during the stay.

As a result of the court's ruling, only the first kind of proof is required.

The agency asked the court to ratify its long-standing policy, but the justices declined. Nothing in federal law governing this veterans benefit requires proof that anybody was at fault or carelessly engaged in malpractice, the court ruled in an opinion written by Justice David H. Souter. The law, the court noted, says simply that the VA is to compensate a veteran for "an injury or an aggravation of an injury" that is not service-connected and that results from hospitalization, medical or surgical treatment.

Under the law at issue, the court stressed that the only instance when a veteran who is injured at a hospital is ineligible for disability is when the veteran personally caused the injury, or when the injury was the necessary result of a kind of treatment to which a veteran had consented.

Disability, the court noted, is available not only for injuries that happen for the first time while the veteran is a patient, but also to conditions that exist before the hospital visit but worsen as a result of the visit.

In the Texas case that led to the ruling, a Korean War veteran, Fred P. Gardner, was denied benefits after suffering leg and ankle pains after back surgery to remove a disc to ease earlier leg pains. Regional officials denied the benefits because there was no proof of flawed treatment or of an accident at the hospital.

The Supreme Court ruling apparently clears the way for Mr. Gardner to receive payments.

In another action yesterday, the court refused to step in to save from wreckers a Dallas office building erected in 1948 as a prime example of the decorative style known as Art Moderne.

The Dr. Pepper Building apparently can no longer be saved under federal law, according to Elizabeth Merritt, associate general counsel of the National Trust for Historic Preservation. But a Trust officer in Fort Worth, Libby Willis, said efforts would be made under the city landmark law in Dallas to save the structure, which is targeted for demolition to make way for a supermarket.

The building was taken over by a federal thrift agency, the Federal Deposit Insurance Corp., after the failure of the thrift institution that owned it. The FDIC agreed to sell the building, without clearing the sale plan with the Trust. FDIC won in lower federal courts, and the Supreme Court refused to disturb that result.

In a separate action, the court voted to leave intact a federal appeals court ruling that said police do not violate the Constitution when they use a heat-detecting device to gauge heat coming from a house that is suspected of manufacturing drugs.

The lower court said police need no warrant to use an infrared machine to measure the temperature of the windows of a private home. The case involves the conviction of a St. Louis man for manufacturing marijuana in his home. He claimed that his privacy was invaded because the infrared device gave police an electronic image of the interior of his home.

Other orders by the justices yesterday bypassed a new plea for a constitutional right of privacy for a single man and woman to engage in oral sex in private, and turned aside an appeal by the city of Chicago seeking the right under federal law to deny overtime pay to paramedics who work for the Fire Department.

Lower courts are split on that issue.

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