VLJ Lauren Cryan: It’s just leukemia, so what?
“It is quite unclear to what extent the Veteran experiences impairment due to the hairy cell leukemia directly”.
- Veterans’ Law Judge Lauren B. Cryan, June 17, 2025
I should have known the writing was on the wall the second the hearing coordinator uttered “the Judge today is Judge Cryan”. Its just about unheard of to say a Board judge is anti-Veteran. Afterall, the whole point of working for the VA is about helping Veterans. Most judges go above and beyond to help our Veterans, especially ones like “Brad”. Brad never stepped foot in Vietnam, instead he was in nearby Thailand. He got the same douse of Agent Orange, though, as if he had been in Vietnam. As a result, Brad is ate up with leukemia—severely disabled is an understatement. However, Judge Cryan has her doubts.
The Writing on the Wall
Judge Cryan is no stranger to me. She first got on my radar when my good friend, Alex, had to have her recused from his very own case. The tone was the same along with the cold shoulder. Maybe she knows we’re buddies? Regardless, just like she thought Alex was cured, healthy as a horse, she thought Brad had been touched by the Lord and was cured! He doesn’t need that 100% anymore! Hell, he might even need to be referred to OIG for fraud, along with his doctors. They might be faking the tests and the chemo treatments. I’ll share some excerpts from our hearing later on, but I wanted to give her the benefit of the doubt. Surly she wouldn’t go out of her way to deny a Veteran with leukemia benefits he desperately needed? Well, that door sure hit me hard on the way out.
How we Got Here
Before I tell you how we got here, let me tell you just the type of guy Brad is. Brad is the type of guy who volunteered to go to Thailand in 1974. He was shipped off to Nakhon Phanom Royal Thai Air Force Base (NKP). His job was to transcribe incoming (classified) transmissions and hand them over to the Deputy Commander of operations for action. If any of you reading are recalling your history, the US was winding up operations during this time. Because of that, the manpower at NKP was very limited. As a result, everyone was pulling double duty. Brad would finish transcribing incoming messages, and then go pull guard duty in the tower or along the perimeter.
That’s where Brad had the first hand opportunity to brush up against Agent Orange. Little did he know what the future would bring. Fast forward, Brad gets his discharge papers and moves on with life. He worked in construction following his time in the Air Force and lived a normal life. Along the way, he even managed to adopt his grandson. Again, that’s just the type of guy Brad is. Always thinking of others. He always gives me a slap on the hand when I say “how’s your grandson doing?” “You mean my son”, Brad always responds with a friendly laugh. “I adopted him, you know. He’s mine now.”
The “c” Word
Then one day, Brad’s world came crashing down. His story starts out all too familiar. Fatigue, wanting to sleep all the time. Dizzy spells. You think to yourself its just a mild flu that you haven’t shaken off. Finally it is too much to ignore. You get some lab work. The doctor is concerned about that white blood cell count. More lab work. Until finally the doctor sits you and the wife down. Its hairy cell leukemia, Brad. How did this happen? Where could it possibly have come from? No one in my family has cancer. Brad’s life was about to change. Like most Veterans, Brad started doing some Facebook research and found a page for Thailand Veterans. From there, he got the idea to file a claim with the VA. Sure enough, during the middle of another c word (COVID), Brad filed his intent to file with the VA in November of 2020.
Once the doctor’s were convinced it was leukemia, he filed his claim in January of 2021. The VA muddled around for over a year, until they finally hit him with a denial in June of 2022. Wait a minute, you ask. He was in Thailand and has a recognized cancer? Its presumptive! You would be correct, today. However, in June of 2022, this is all pre-PACT Act. During all this time, he had contacted his Congressman’s office, sent in all sorts of evidence and statements concerning his Agent Orange exposure. Nothing was good enough. As Brad will tell you, his wife was praying for an answer to their problems. Not only a hope to cure the leukemia, but for something to change the VA’s mind about this. By this time, she had already quiet her job to take care of him. Brad has never directly said it, but I imagine the cupboard was getting pretty bare. If I recall correctly, Brad’s wife found my information on a local Facebook page for Veterans. They decided to give me a call. It didn’t even take 5 minutes of talking—I was all in—ready to go to bat for Brad. I began representing Brad on July 14, 2022. Stover v. McDonough was issued July 11, 2022.
Mr. Stover
You see, back before Thailand was recognized as an Agent Orange presumptive county, Veteran’s had to fight tooth and nail to prove to the VA they were actually exposed to Agent Orange. As always with the VA, the VA thinks they have the final say on that matter. As terrible of a situation as Brad was in, his case wasn’t unique in this regard, but his timing was. You see, Mr. Stover was just like Brad. He served at Takhli RTAFB. He gave the VA photos of his hooch (living quarters, shown in the picture), told the VA about how he traveled along the runway and the radio station to phone home, both of which put him at the perimeter where Agent Orange was sprayed. If that wasn’t good enough, he even explained to the VA how spray would float along drain ditched right where he was sleeping. Instead, the VA told Mr. Stover that wasn’t good enough. No dice.
Mr. Stover was wise enough not to accept that answer and promptly appealed this decision to the Veteran’s Court. Just a few days before I began representing Brad, the Court sent Mr. Stover’s case back to the Board, with a slap on the wrist. Judge Greenberg would have taken that slap a step further, as you can read in his concurring opinion. “I write separately because I believe the decision does not go nearly far enough and will result in more confusion and arbitrary decision-making regarding those veterans who served in Thailand during the Vietnam era and were exposed to herbicides. The Court has simply not helped Thailand veterans whose exposure to herbicides 50 years ago is still being questioned”. Judge Greenberg concludes his opinion, “The just result for veteran Stover, and all Thailand veterans, still sleeps”. It still was asleep for Brad.
Help is on the Way
The very same day Brad hired me, I pulled out all the stops. I filed a priority processing request. Somehow the VA didn’t have this joker flagged as terminally ill. Check. Next, I fired off a Request for Higher Level Review. Check. A lot of things within the VA are getting things to the right person, someone who cares enough and has an ounce of common sense. I knew if I got his claim sent out to the Seattle Decisions Review Operations Center, I had a fighting chance. So, I pulled a few strings to make that happen. Check. Not even a full month later, relief was on the way. I will never know if Mr. Stover helped play a role in this decision. Usually Court cases take months, if not years, to trickle down to the VA before they are understood and given the respect they are due. Regardless, Dale was now 100%, effective November of 2020, and it couldn’t have come sooner. Of course, that is not the end of the story. While Brad would get his 100%, to torture Veterans with cancer, the VA insists on “routine future exams” every 6-months to see if the Veteran is in remission. If so, they will pull the rug out propose to reduce based on the miraculous medical miracle! I knew Brad wasn’t getting better. I knew the 6-month window would come on us fast. I knew his wife wasn’t working. I knew he couldn’t take the stress. I knew she couldn’t either. So, I needed a way to make his 100% permanent and total.
I knew the second his 100% was approved we were up against a clock. Not just to get a claim submitted, but for the VA to actually process it in time. We went right away and filed for aid and attendance. I got clever and had the doctor write a letter explaining that “There is no known cure for Hairy Cell Leukemia, though, some patients can remain cancer free for periods of time following treatment. As discussed, Mr. [Veteran] is still undergoing treatment for active cancer. Even with successful treatment it is likely that residuals from his cancer including decreased bone density and hearing loss, along with his symptoms of pain, weakness, and limited range of motion from his arthritis, lumbosacral strain, and radiculopathy will still render him permanently and totally disabled. It is my professional opinion that the veteran is permanently disabled now and for the foreseeable future”. It just about makes you cry reading something so sad. Sad or not, it was our silver bullet.
So, with the aid and attendance claim, I threw in a request for permanent and total status. A total surprise to the VA. Sure enough, she worked like cold beer at a barbecue. The VA agreed, granted aid and attendance, as well as made his leukemia static.
The Fight Continues
Now, during all this time, Brad’s wife still wasn’t working. Sure, he was getting aid and attendance, but he had stopped working, his wife had quit work to take care of him, and their income had been cut in half, even with what they were getting from the VA. Of course, her Caregiver appeal was stuck in limbo. Not to mention that son they had to raise. I knew we could get Brad up to SMC R-1 ($9,929.27 at present) with a few more claims. Boy could they sure use it. All things considered by VA standards, things were going pretty smooth. I got the leukemia service-connected within a month instead of years. Managed to get the leukemia made static, so Brad’s 100% was not in jeopardy. I knew when we put in for R-1, the regional office would deny it. That was a given. I wasn’t shocked about the fight to come. I had just hoped we could get his case advanced on the Board’s docket. Actually, even that went smoothly. Now all we needed to do was the hearing, get some a little bit of evidence put in his file after the hearing, and call it a day.
The Sky Fell Out
You see, the truth is, SMC is so complicated as it is, even most Judges find it difficult to understand. What can and can’t be done with SMC is a mystery to 99% of attorneys out there. That is why I like a hearing. It gives you the opportunity to explain to a Judge how we get to R-1. What all letters we jump through, how we jump through them, etc. We do a little algebra during the hearing and sure enough, usually, at the end of the hearing, the Judge is on board and can see how you get to R-1. That is, when they let you speak.
Brad’s hearing started just after lunch eastern time. Hot damn. Everyone will be in a good mood. Not too early, not too late, having just ate lunch. This will be a productive hearing! Wrong. Before the hearing transcript even begins, “Judge” Cryan said off the record that Brad was already getting aid and attendance and that she was “confused” what we were asking for. No problem, I tried to give her a run-down prior to going on the record, but she wasn’t having it. Okay, so we go on the record. You will notice right away there are a few similarities between my friend Alex’s transcript and Brad’s. Interruption, after interruption, after interruption. As Forrest Gump might would say, mama always told me God gave you two ears so you could do twice as much listening as you did talking. Maybe she has never seen the movie? Again, I have never had a Board judge not allow me to present my case, even on legal questions, like are you entitled to two “L” ratings for SMC? Most Judges will listen and have a discussion—not Judge Cryan. You can see that from Alex’s transcript, and Brad’s.
JUDGE: Okay. So I’m not sure. Again, I haven’t had time to look thoroughly at the statute or the regulation, but I will, certainly, because it sounds like the legal issue here is whether you can assign two Ls based on the facts here, which you’re saying that he’s already getting the one L for the 100% --
MR. MCCAULEY: Correct.
JUDGE: -- leukemia, and you think he’s entitled to another L solely based on PTSD. So how does his PTSD --
MR. MCCAULEY: Not necessarily based on the PTSD, the vertigo, the migraines, and the back.
JUDGE: Okay.
MR. MCCAULEY: Not really necessarily on the PTSD.
JUDGE: Okay. So if he’s already getting Aid and Attendance, I’m still not clear as to why he’s entitled to more Aid and Attendance unless you meet the criteria for the higher level or the special Aid and Attendance.
MR. MCCAULEY: Well he’s entitled to as many L ratings as the law permits.
JUDGE: Okay. So what criteria from the psychiatric disorder meet the criteria for Aid and Attendance?
MR. MCCAULEY: We’re not focusing, Judge, on the psychiatric, we’re focusing on the vertigo, the back, and the migraines, that basket of disabilities --
JUDGE: Okay. Okay.
MR. MCCAULEY: -- separate and distinct from the leukemia, because these are all totally different disabilities.
JUDGE: -- I mean, are the headaches secondary to the leukemia, or is that a totally separate disability?
MR. MCCAULEY: Totally separate and distinct disability. Yes, ma’am.
JUDGE: Okay. So again, I mean, I can’t concede that L is warranted on all the other, based on all the other disabilities unless (CROSSTALK) you meet criteria for aid and attendance.
(Towards the end of the hearing.)
MR. MCCAULEY: Well, Judge, for one, he was given a half step bump just because he’s statutorily entitled to that under (f)(3), under 3.350(f)(3). So they finally realized that that had been wrong all along because he’s entitled to that half step bump because of those separate disabilities. Where I think we part ways with the regional office is, and I don’t mean this rudely or anything, but I think they just lack the understanding that there is a legal entitlement, a legal possibility that you can have more than one L rating, provided that the disabilities are separate and distinct, and that’s (INAUDIBLE) all day long. So I think that’s where we part ways --
JUDGE: Is that --
MR. MCCAULEY: -- and at this point, we’re not a --
JUDGE: Does the regulation or statute specifically say that? Again, I --
MR. MCCAULEY: Yes, ma’am. It’s specifically says, yeah.
JUDGE: Okay. Because I’ve done (CROSSTALK) over the years, but I --
MR. MCCAULEY: It verbatim says if you’re --
JUDGE: Okay.
MR. MCCAULEY: Right. It verbatim says if you’re entitled to two or more L ratings, provided that it’s not due to the same disability. So in other words, Mr. [Veteran] couldn’t come in here today and say, Judge, I’ve been receiving aid and attendance due to my service-connected legs, I’m entitled to an L rating, and I have lost the use of my legs, so I’m entitled to a second L rating. That is impermissible. I would --
JUDGE: Right.
It goes on and on like that.
Living in Limbo
One of the most difficult things after a Board hearing is living in limbo. That state of not knowing what ruling will come down after a hearing is tortuous to Veterans. However, the time can also be useful. After a Board hearing, you can take up to 90-days to submit any additional evidence. As you can tell from the hearing transcript, I would make good use of this time to plug up any holes and try and put this thing to rest. I did just that. We used this time to get a new aid and attendance form done, from a totally different doctor, discussing why Brad needed aid an attendance due to multiple service-connected disabilities, even when considered alone. In other words, SMC R-1. I wasn’t going to leave any stone unturned.
I pulled as many Board cases as I could find for Judge Cryan saying “yep, aid and attendance for two different disabilities equals R-1”. We got all our ducks in a row, filed all our evidence, filed a brief, and crossed our fingers. That is when the living in limbo really begins. Have you submitted enough evidence? Did you submit a brief that is easy to understand but also covers everything? More wait time. Then finally, you get that e-mail. The Board of Veterans’ Appeals has issued a decision in your appeal.
We’re not Done
When I pulled up the decision, I frankly couldn’t believe it. You see, I don’t mind a disagreement on what the evidence says. I don’t mind a disagreement on what the law says. What I do mind is going out of your way to deny a Veteran. Judge Cryan went above and beyond alright, above and beyond to deny Brad. Here are a few good excerpts:
“It should also be noted that the Veteran has never undergone a VA examination for hairy cell leukemia, and, as discussed further below, it is quite unclear to what extent the Veteran experiences impairment due to the hairy cell leukemia directly”.
“[G]iven the absence of evidence showing that the disabilities are separate and distinct, and the presence of evidence suggesting they are not (particularly the January and March 2023 VA opinions and October 2022 and May 2023 private opinions), such a finding was clear and unmistakable error, i.e., error that is obvious or undebatable, and, to the extent that it was a favorable finding, the Board is not bound by it”.
“However, the evidence persuasively weighs against the finding that there is a need for aid attendance due to service-connected disabilities that are separate and distinct from the service-connected hairy cell leukemia and associated vertigo”.
- Signed “L. B. Cryan”.
These Board Judges love anonymity, so they will use their initials to keep their decisions as anonymous as possible. Not today. Hm. What if you called your Congressman and asked them to require Board decisions include the full first and last name of the Judge? Reminds me of a star chamber. That first tidbit really gets me “[I]t is quite unclear to what extent the Veteran experiences impairment due to the hairy cell leukemia directly”. Brad has active hair cell leukemia, for which there is no known cure. How in the hell could anyone actually sign something that says it is unclear what “impairment” someone with cancer suffers from? As if that weren’t good enough, Judge Cryan went out of her way to call what the regional office had given Brad a “clear and unmistakable error”. My Lord. Cruel is a good adjective. Even a verb given that Brad will continue to live in limbo, waiting for the benefits he is entitled to.
If you thought we were done and intended to throw in the towel, then you just don’t know me, and you don’t know Brad. As I am writing this, I am waiting on the clerk to docket Brad’s CAVC appeal. His justice will come, as long as I am around.
One mistake is an accident (Alex’s appeal). Twice is a coincidence (Brad’s appeal). A third time is willful (will it be you?).
Below are two helpful links, by the way, in case you need them. Hmm.
VA OIG- Submitting a Compliant
Godspeed.
