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VA Disability Claims: 5 Game-Changing Precedential Decisions You Need to Know
Tbird posted a record in VA Claims and Benefits Information,
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
Rating Issues
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Tbird,Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
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RichardZ,Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
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Tbird,Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
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yellowrose,Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
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Lemuel,Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
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Lemuel,Post in What is the DIC timeline?
broncovet posted an answer to a question,
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.
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Lemuel,General Chat With Tbird
Tbird posted an event in Tbird Chats,
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Tbird,HadIt.com Help You? Let Us Know!
Tbird posted a question in VA Disability Claims Research,
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Tbird,Volunteers Needed
Tbird posted a question in VA Disability Claims Research,
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Tbird,We Closed the Notice for Request 1
Tbird posted a record in VA Claims and Benefits Information,
We closed the notice for request 1. VA message states Closed the for Request 1 or 2 or some #. What does it mean?
It is a status message that doesn't tell you where your claim is in the process.
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Tbird,Understanding The Meaning Of VA Compensation Issue Status.
Tbird posted a record in VA Claims and Benefits Information,
Answer:
Compensation issue simply means your claim is for disability compensation as opposed to some other kind of claim Maybe an upgrade for discharge for example. Most claims that are submitted are designated compensation issues. Nothing to worry about.
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Tbird,Members Create Your Blog
Tbird posted a question in VA Disability Claims Research,
Sometimes you have more to say that doesn't fit a community discussion. Maybe you are passionate about fishing, cooking, reading, it's your choice. The same guidelines apply to the blogs that apply to the community. The two biggest are no politics and no religion. Facebook or someplace else is the place for that, it is not here. Creating your blog allows you to expand on what you have to say.
Do you find yourself typing the same content again and again?
Create a blog post with that content and then all you have to do is link to the blog post.
This gives you two main advantages
You only have to type the content once, a great time saver.
If your content changes due to law or regulations or for whatever reason, you only have to update your blog, and wherever you link to that post will be linking to the most current information.
Check out the video below.
Have questions? Ask it in this topic and I will do my best to answer.
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Tbird,Help HadIt.com Stay Online
Tbird posted a question in VA Disability Claims Research,
When the site was gifted to Rattler it became a nonprofit. A nonprofit cannot use some of the previous items I used to help finance the site.
Now it all comes out of Rattler's pocket. He will not be able to continue financing the site on his own.
If HadIt.com has helped you or you want to be part of the future of helping veterans like yourself, please consider
make a one-time donation or
subscribe to a monthly Patron plan
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Tbird,VA C and P Exam Do's and Don'ts
Tbird posted an answer to a question,
A Guideline for your VA compensation and pension exam
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Tbird,Some facts and reference on CUE (CLEAR UNMISTAKABLE ERROR)
broncovet posted a question in VA Disability Claims Research,
https://www.law.cornell.edu/cfr/text/38/20.1403#:~:text=Clear and unmistakable error is,different but for the error.
The Cue error, therefore, needs to be all these things:
1. Undebatable.
2. Outcome determinative.
3. Based on the records VA has in their possession at the time of the decision. If VA was/is missing critical evidence, consider filing a 38 CFR 3.156 (new evidence) instead of CUE.
4. May be filed at any time, such as after the one year appeal period expired.
___________________________________________
What CUE is NOT:
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Tbird,Post in Missed filing a VA claim within one year presumptive...
Rattler posted an answer to a question,
Did you file an "intent to file" with the VA. What this means is you filed with the VA saying I want to file a claim for XX. An "intent to file" claim basically says you are going to provide the VA with more information with in one years time. (Service Medical Records, Doctors Reports outside of the VA Etc.)
If you did not do an "intent to file" you filed a direct claim and you have started the claims process. Each can be time sensitive.
Hopefully I can give you a step by step on how to do this.
1. If you have not done so you will need to get your military records including you military medical records.
You need to do this now. You military records can take 1 to 3 Mo.
Your VA records can take 8 to 9 Mo.
Without them you are kind of shooting in the dark.
You need to sign-up with the VA at https://www.va.gov/?next=loginModal .
I recommend you use Login.gov to get your login above the others as it seems to work better than the others
https://secure.login.gov/sign_up/enter_email
This way you can track you claims, apply for other VA benefits'.
2. Go to the Non-VA doctors that have diagnosed you with XXX and get there medical records. Go through the records and pull out ONLY the ones that say you have XXX and submit ONLY THE RECORS THAT PROVE YOUR CLAIM. I can not stress this enough. The VA people who review your claim do not have the time to read through 500 pages of your medical history to pick out the 2 pages that says you have XXX. This will hopefully speed up your claim.
3. The quickest way to submit stuff to the VA is at this address. https://eauth.va.gov/accessva/#forVeterans . This is why you need to get the VA access through Login.gov.
Use the Quick Submit button and follow the instructions.
This should get you going in the right direction.
Two words to the wise.
1. Do not rely on Youtube or other videos on the internet. There is a lot of misinformation out there. There is a lot of old information that doesn't work in today's VA.
2. When seeking a VSO with a veterans service veterans service organization the first words out of your mouth should be, "Do you have VBMS access." VBMS access is real time access to your VA claims file. There are a lot veterans service organization that have suto VSO that kind of only do intake for veterans service organization. What I mean by this is they are not "VA Certified Claims Agents." they are only trained by the veterans service organization to fill out forms and submit them via fax or mail. Only "VA Certified Claims Agents" have VBMS access.
Please don't hesitate to come hear and ask your questions at Hadit.com
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Tbird,VA Denial for Presumptive Conditions
Chief1997 posted a topic in Denial Letters,
My frustration is I believe that a presumptive condition is supposed to be automatic approval, so I’m confused why they denied this claim and what should I do, when I appeal this should I go directly to the BVA or do a supplemental appeal?
I’ve been down this road before and here in Florida. It appears the supplemental appeals rarely get approved. It is if they just follow the local levels decision I have had better success at the board of veteran appeals , thoughts, ideas and recommendations are appreciated. Attached is the VA’s denial letter.
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Chief1997,Post in "Exam request - processing -- No longer needed"
Rivet62 posted an answer to a question,
I think what best describes this status is that it is an internal marker in the claims process.
I'll quote the comment I found on the PEB forum:
"I don't know if you can see this in eBenefits, but "Request for Examination" is used as an internal tracking device at the RO where I work. We use this when it is necessary for an RVSR to review a claim to see if any exams need to be ordered."
So, it seems this internal tracker is a consequence of VA trying to reduce excessive costs of unnecessary C&P exams (2018). It's like a page in the claim that logs the pre-exam review that is required prior to ordering a C&P exam.
See this link for context:
https://www.va.gov/oig/pubs/VAOIG-17-04966-201.pdf
If the status says "Exam request processing, no longer needed" it is just an indication of who has the claim in the claims process.
To quote another comment on another forum:
"When we look at ebenefits we see those nice status boxes going from left to right and expect it to be like a production line...Its not like that. The status is determined by who has it and how they have checked it in... The status has more to do with WHO HAS IT and not HOW CLOSE AM I TO BEING DONE."
And with these quotes it helps to understand the tasks of a VSR and a RVSR.
A screenshot of VA's "Careers at VBA":
As always, the proof of having to go to a C&P exam is in a physical letter or phone call you receive stating the need for a C&P exam. You can't rely on VA.gov or eBenefits to be up to speed on this. This appears to be the consensus, and after exploring all of the above I have to agree.
So, am I being scheduled for a C&P exam? I don't know yet.
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Tbird,Post in Regulatory or Procedural Review
porgee posted an answer to a question,
A "procedural review," as indicated in your electronic records and eBenefits, is generally associated with an internal review of a claims file to ensure a claim was processed correctly. When VA initiates certain actions, a three digit code is assigned to the action and is entered into the computer for tracking purposes. Since the three digit code has been entered into the computer system, it looks like a new claim has been established in eBenefits. We apologize for any concern this matter may have caused you.
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Tbird,Post in 100% TDIU Requesting dental implants - Phoenix
DeepDiverJoe posted an answer to a question,
Glossary, Abbreviations, Acronyms, Terms and the like in VA Claims
Tbird posted a question in VA Disability Claims Research,
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Tbird,Post in Am I eligible for SMC(T)?
Tbird posted a post in a topic,
Post in Housebound/SMC S question?
Tbird posted an answer to a question,
How To Edit A Post
Tbird posted a question in VA Disability Claims Research,
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