Baker Donelson lawyer Frank S. James, together with the veterans legal clinic at the University of California at Berkeley, scored a victory recently in a long and hard fought battle to obtain military insurance benefits for an injured veteran.
While serving in Iraq, our client contracted a damaging strain of staph bacteria, either through infection of a minor wound or from ingesting or inhaling it. This eventually led to debilitating bone and joint infections which required surgery and left him unable to even bathe or dress himself for an extended period. Nevertheless, he was denied coverage under a service members’ group insurance policy on the grounds that he had failed to show his condition resulted from a “traumatic event.”
After one unsuccessful appeal of that decision, our client sought help from the veterans law clinic at U. Cal. Berkley, which assisted him in compiling all the evidence needed to try again. Following further denials, he filed a federal court lawsuit. Frank was contacted by the law school clinic in early 2014 and worked with the clinic to litigate the case in the Northern District of Alabama. In late August of 2015, the District Court granted our client’s motion for summary judgment, finding that the administrative Board that rejected his appeal applied the wrong evidentiary standard, and further wrongly failed to provide our client “the benefit of the doubt” as required by statute. The Court ordered the Board to certify our client’s eligibility and process his benefits.
In his message of thanks for this great outcome, our client also expressed the hope that the work done on his case will be of help to other service men and women who are being wrongly denied the benefits they deserve:
Hopefully your attention to detail in my case will open the eyes of the TSGLI administrators in other cases. This decision was made over five years after the initial claim. Every day I think of our nations young wounded and sick WARRIORS and hopefully these young men and women will get what they are entitled without delay.
Congratulations to Frank, who is also a veteran, and the U.Cal. team for this great work, and to our client for persevering, not just for himself, but for veterans across the country.