Why Does the Guard Call My Injury Pre-Existing

Spiritual Minded Military Washington Army National Guard: Why Does the Guard Call My Injury Pre-Existing? The Natural Progression Appeal Protocol

 

You were injured while performing your duty. Perhaps it was on a ruck march at Joint Base Lewis-McChord. Perhaps it was a back injury at annual training that occurred at Yakima Training Center. Perhaps the knee just went out at Camp Murray in PT. Perhaps it was a shoulder injury sustained during a state activation for wildfire support.

You reported it. You saw the medic. You filled out the paperwork. You were informed that you would be covered.

Eventually the letter arrived.

The medical condition has been determined as a natural progression of a pre-existing condition, and the line of duty determination is DENIED.

Your heart sinks. Your jaw clenches. Your mind races.

"What do you mean natural progression? I was okay before that ruck; my knee never hurt the way it did before the Guard broke me.

You are not alone. One of the most frequent methods of denying Guard members care is by their use of the term “natural progression.” The Natural Progression Appeal Protocol is your response.

"The Lord is close to the brokenhearted and saves those who are crushed in spirit." — Psalm 34:18

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WHAT THE GUARD MUST PROVE (AND WHY THEY OFTEN CANNOT)

The Guard must show that you failed to meet three elements to deny you your claim on natural progression.

1. Which was in existence prior to service.

The Guard will have to provide proof of the preexisting condition. Records of your medical history prior to enlistment. Entrance physical documentation. Statements from previous providers.

If the Guard is unable to establish that the condition existed prior to service, then the denial of the natural progression is not valid. The injury is assumed to be service connected.

2. The disease would have progressed at the same rate had service occurred or not.

This is the most difficult to establish for the Guard. They must have some medical determination that your condition was going to deteriorate at the same rate regardless of the fact that you were in service or not.

Why Does the Guard Call My Injury Pre-Existing

Medical science doesn't often make such specific predictions. The Guard's medical reviewer is giving her opinion. Other opinions can be offered as a challenge to opinions.

3. That the worsening during service is not due to service.

The Guard has to establish that the condition is the direct result of the natural course of the illness and that there was no part played on your part by your military obligations.

Any aggravation of your condition should be service-connected if your service played any role in increasing your condition. Aggravation is presumed under the law unless it is established by a specific finding that it is a natural progression.

This is not usually met by the Guard. You have to make them prove it! 

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THE JBLM CONNECTION

Thousands of Washington Guardsmen live at Joint Base Lewis-McChord. JBLM has a medical clinic. JBLM has doctors. JBLM has medical reviewers who decide on care.

JBLM is not against you. The medical reviewers who denied your claim are not your enemy. The enemy is the system that lets you claim but doesn't provide the evidence.

It's a tough job for the medical reviewer at JBLM. They are looking at hundreds of files. They want to find the quick patterns. If they get a sight of a condition that could be degenerative, they default to "natural progression." It is faster. It is easier. It is often wrong.

It's not your responsibility to hate the reviewer. Your task is to provide them with facts that they can't simply tune out. The Natural Progression Appeal Protocol is a discovery of that evidence.

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THE NATURAL PROGRESSION APPEAL PROTOCOL

The protocol has five phases. Execute them in order. Do not skip.

Why Does the Guard Call My Injury Pre-Existing

1. Request the Complete Medical File

You have the right to your complete medical records. Request everything. The initial LOD determination. The medical reviewer's notes. The specific finding that your condition is due to natural progression.

What to request:

  • Your complete military medical record
  • The LOD investigation file
  • Any medical opinions citing "natural progression"
  • The qualifications of the medical reviewer

You cannot challenge what you cannot see. Get the file.

2. Get a Second Medical Opinion

The Guard has a doctor who says your condition is natural progression. You need a doctor who says it is not.

What to look for in a second opinion:

  • A doctor who is familiar with military service and Guard duty
  • A doctor who will specifically address the "natural progression" claim
  • A doctor who will state, in writing, that your military service aggravated or caused your condition

Key language to request:
"It is my medical opinion that the patient's condition was aggravated by their military service. The worsening of the condition during their period of service is not consistent with the natural progression of the condition in a civilian population."

2. File a Supplemental Claim or Appeal

You have options for appealing a denial.

  • Supplemental Claim: File a supplemental claim with new evidence. Your second medical opinion is new evidence. The Guard must consider it.
  • Higher-Level Review: Request a higher-level review by a senior adjudicator. You do not need new evidence for this. A senior reviewer looks at the same file and determines if the original decision was correct.
  • Board Appeal: Request a hearing with the Board of Veterans Appeals. This is the longest path but gives you the most opportunity to present your case.

3. Do Not Quit

The Guard denies many claims. The Guard expects you to give up. Most soldiers do give up. The enemy wants you to give up.

The Remnant does not give up.

The Natural Progression Appeal Protocol is a process. It takes time. It takes patience. It takes documentation. It takes follow-through. It works for those who do not quit.

"But those who hope in the Lord will renew their strength." — Isaiah 40:31

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THE YAKIMA TRAINING CENTER LESSON

Yakima Training Center is where Washington Guardsmen train hard. The terrain is rough. The conditions are harsh. Injuries happen.

Yakima taught you to push through pain. The natural progression of denial expects you to push through the appeals process and give up.

The enemy uses the same tactics at Yakima and in the medical review office. Wear you down. Exhaustion to you. Make yourself quit.

The Natural Progression Appeal Protocol is your counter-tactic. You are not pushing through pain. You are executing a tactical appeal.

"And we know that in all things God works for the good of those who love Him, who have been called according to His purpose." — Romans 8:28

Why Does the Guard Call My Injury Pre-Existing

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THE TIMELINE OF APPEAL

The appeals process is not fast. Prepare yourself for the timeline.

  • Month 1-2: Request your complete medical file. Review the LOD determination.
  • Month 2-3: Get a second medical opinion. Find a doctor willing to write a strong opinion challenging natural progression.
  • Month 3-4: File a supplemental claim or higher-level review. Submit your new evidence.
  • Month 4-8: Wait for a decision. The Guard and VA are slow. The enemy uses the waiting to wear you down.
  • Months 8-12: If denied again, consider a board appeal or filing a VA claim separately.

Do not let the timeline discourage you. Every month you wait is a month the enemy wins. Every month you fight is a month you move closer to victory.

"My grace is sufficient for you, for my power is made perfect in weakness." — 2 Corinthians 12:9

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Conclusion

Washington Army National Guard, you got hurt on duty. The Guard called your injury a "natural progression" of a pre-existing condition. The enemy wants you to believe that denial is final.

The denial is not final. The Natural Progression Appeal Protocol is the counter-attack.

Request your file. Get a second opinion. Cite the law. File the appeal. Do not quit.

The law is on your side. A pre-existing condition is aggravated by service unless there is a specific finding of natural progression. The Guard rarely meets that standard. You must force them to prove it.

This is the Spiritual Minded Military Natural Progression Appeal Protocol for the Washington Army National Guard. The Guard denied your claim. The law says they are probably wrong. Appeal. Fight. Win. Fall in.

The Remnant does not transition. The Remnant re-enlists.

Spiritual Minded Military
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