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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
tdak
hi all,
A follow up on my SSDI case. OK, filed for SSDI OCT.06, had state doctor exam about a month ago (April). I had called my claims rep/case worker, I forget the exact title of the person handling the case, in regards to m medical conition and because of the rarity, should I bring any additional information for them. He told me yes, bring what I thought might help the doctor examing me a better knowldge of my condition and to call him back in 2 weeks and he should have an answer for me on my claim. So I did, MRI copies, and surgical reports things like that. So I go, exam was a joke, the psych eval was twice as long as the general medical eval. So no biggie, now it's 2 weeks later, I call and call til the rep answers the phone, now he says to me, oh, I see here that you have an eye exam at a opthamologist, and they referred you to a neuro-opthamologist, did you go? Yes, I told him and that I had already given that information back in Oct with all my other doctors names. OH, he says, I do not have any of the medical records from his office, we will have to send out a medical release to him. I mentioned that I have a 2 page report that was sent to my original eye doctor from him in regards to the referral and the diagnosis, exam etc info and could I fax that to him and would it be acceptable instead of waiting for the doctor report. At this point another week or so isn't going to matter now, so he said go ahead and fax it to him. So I did that day. He also told me to call him and follow up in a week to 10 days. I called the SSA rep yesterday to make sure he had everything they needed to make a decision on my case,he said he was still waiting on the neuroopthamologist doctor's records and I said, wasn't that why I faxed you a copy of the letter from him 10 days ago, he was like, hold on let me check. He gets back on the phone and says, oh someone just had the fax listed as a coorespondence and not as medical information so it was never fowarded to the doctos here who make the decision on your case. He then told me he would send all that info diectly to the doctor who makes the final decision today and I would know by the end of the week. I was in awe, he asked me to fax it, so I did, then doesn't do anything with it, You just gotta love the SSA.
My advice to everyone waiting on the SSA for a decision in a claim, give the rep/claim person working on you case a call, just to make sure they have all the information they need to make a decision. I called the toll free # and they gave me the claims reps direct extension to call him. If I didn't call I would be waiting a few more weeks or even months because of the oversight on my eye specialist doctor to begin with.
Sorry it was so long winded, I tend to do that from time to time.
Regards,
Tamara
Edited by tdakHave a great day!!!
tdak
"Government is like a baby. An alimentary canal with a big appetite at one end and no sense of responsibility at the other. "...Ronald Reagan
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