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These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.

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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I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful.  We decided I should submit a few new claims which we did.  He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims.  He said that the VA now has entire military medical record on file and would find the record(s) in their own file.  It seemed odd to me as my service dates back to  1981 and spans 34 years through my retirement in 2015.  It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me.  He didn't want my copies.  Anyone have any information on this.  Much thanks in advance.  
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Caluza Triangle defines what is necessary for service connection
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL

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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Do the sct codes help or hurt my disability rating 

VA has gotten away with (mis) interpreting their  ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.  

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.   

Welcome to hadit!  

    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

 

Good 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. 

Lets have a coffee together. https://teams.microsoft.com/l/meetup-join/19%3ABtyd4tqFXgqa045rWAsSzbl0z_APTqq4yrsTUYGntaE1%40thread.tacv2/1707143581854?context={"Tid"%3A"09287ae3-b8f8-40c6-94c6-9e607e9c39fd"%2C"Oid"%3A"46502ac4-1b14-4863-b4d5-9ca568a0dc71"}
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HadIt.com Help You? Let Us Know!
Please take a moment and let us know.
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Volunteers Needed
If you are inclined to volunteer, let me know if any of this looks interesting or if you have something in mind. If you can, great if you can't, no hard feelings.
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We Closed the Notice for Request 1
Question Poised:
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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Understanding The Meaning Of VA Compensation Issue Status.
Question Posed: So my appeal was closed on July 15. I haven’t received my letter yet, but under the issues tab on va.gov, where it used to say the items I was appealing, it now says “compensation issue.” Is that normally what it says just when they close the review? Has anyone seen any other terminology in that section?

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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Members Create Your Blog
Create your blog.

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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Help HadIt.com Stay Online
If HadIt.com has helped you, please consider helping HadIt.com if you can.

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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VA C and P Exam Do's and Don'ts
you may find this post helpful


A Guideline for your VA compensation and pension exam

 

Some facts and reference on CUE (CLEAR UNMISTAKABLE ERROR)
Let's begin with the regulation on CUE: 

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:
...
  • 14 replies

Post in Missed filing a VA claim within one year presumptive...
Let me give you some guidance. But first I have to ask some questions.

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

 

 

VA Denial for Presumptive Conditions
I’m a gulf war veteran that was exposed to particular matter during military service in southwest Asia under the new pact act. My exposure in the golf war area is acknowledged by the VA and I am considered a veteran exposed to particulate matter in the new presumptive list has melanoma and any head face or neck cancers listed as presumptive conditions. I had a melanomas and a basal cell carcinoma removed from my right and left for head’s. The melanomas removed in 2013 and the basal cell carcinoma was removed in 2009. The VA has denied me service connection for the scars associated to these two cancers their reasoning for the denial is they requested an examination with medical opinion based on toxic exposure, they do acknowledge that there’s evidence that shows participation in toxic exposure. However, the medical opinion by the examiner does not show an association between my claim disability and in-service toxic exposure.

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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Post in "Exam request - processing -- No longer needed"
I could have done an internet search. I did, using this keyword phrase "VA exam request processing no longer needed" and from that I found dozens of hits, some old ones on Hadit too.  It's been answered a hundred times over.

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.

 

 

Post in Regulatory or Procedural Review
Have you ever heard of a regulatory or procedural review?

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.

I'm below 6.0 so I'm good.

Glossary, Abbreviations, Acronyms, Terms and the like in VA Claims
Glossary, Abbreviations, Acronyms, Terms and the like in VA Claims
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Eligibility for SMC-T requires that the Veteran be in need of nursing home care, residential institutional care without in-home aid and attendance services, or even hospitalization for their TBI.Jun 26, 2022 Hill and Ponton

Special Monthly Compensation S (Housebound)

How To Edit A Post
How To Edit A Post
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