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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,
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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Tbird, -
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Are all military medical records on file at the VA?
RichardZ posted a topic in How to's on filing a Claim,
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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RichardZ, -
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Caluza Triangle defines what is necessary for service connection
Tbird posted a record in VA Claims and Benefits Information,
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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Tbird, -
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Post in ICD Codes and SCT CODES?WHAT THEY MEAN?
Timothy cawthorn posted an answer to a question,
Do the sct codes help or hurt my disability ratingPicked By
yellowrose, -
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Post in Chevron Deference overruled by Supreme Court
broncovet posted a post in a topic,
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.Picked By
Lemuel, -
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Question
free_spirit_etc
http://www.geocities.com/vfw9951/docs/AFNEWS.html
VA CLAIM BACKLOG UPDATE 06: The worst city in which to file a veterans’ benefits claim is Washington, where 63% of claims take longer than six months to resolve, according to a major veterans’ service organization. AMVETS, a 60-year-old group that helps veterans with about 24,000 claims a year, says a survey has shown veterans in Fargo, N.D.; Boise, Idaho; and Providence, R.I., have the fastest service, with only 6 to 7% of claims taking longer than six months to resolve. Washington may be the worst, but other major cities also are slow. AMVETS national service officer and Navy veteran Luz Rebollar said in Chicago, Detroit, Pittsburgh, New Orleans and Montgomery AL about 40% of the claims take longer than six months to process. One reason for the differences is that the number of people assigned to process claims in some VA regions does not match the claims caseloads in those areas. For example, VA workers in Hartford CT handle 92 cases a year, while workers in Augusta ME handle 57 cases a year.
The Bush administration has proposed hiring 450 additional claims processors to try to reduce the backlog, but AMVETS officials have warned that more people will not solve the problem and, unless the caseloads are more evenly spread, will not eliminate delays for some people. AMVETS is pushing the idea of allowing electronic claims filing and other efforts to use technology to help process claims. “The backlog issue is not going to go away until the federal government rolls up its sleeves and takes a serious look at expediting the resolution of claims,” Rebollar said. “Until that happens, young veterans just returning from service in Iraq and Afghanistan are going to continue to be frustrated with our government and with a system they believe is failing to fulfill the promises that were made to them when they entered the service.” To review the delay time in your city refer to www.navytimes.com/projects/pages/042007vastats. [source: NavyTimes Rick Maze article 20 Apr 07 ++]
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That kind of surprises me --NOT the backlog - but the case load. I actually thought the VA case loads would be much higher than that.
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