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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
lamontino
Hi there I probably have one of the most complex case(well VA made it complex)ever. At the rip age of 14 I went to an doctors appointment to try to figure out why my legs was hurting, the doctor said that I was having pain in my back or that where i was getting the pain from, I told him that my back didnt hurt at all(which is documented in that report) just my legs. Instead the doctor did x rays on my back(which the films are not available and the doctor is decease as of this date) revealing that I had bilateral spondylolysis at the L5 and minimal Grade I anterior spondylolisthesis L5 S1 no acute injury or other abnormalities are recognized. I was give Mortin 800 and sent on my way in life under the understanding that I could do anything or be anything I wanted to be in life. I later went to job corp and recieved a state high school diploma. I went in the military in May of 1986, fresh out of job corps and eager to get started with my new potential found career in the military(11 Bravo 10th Mountain Div. I did the entry exam, medical exam etc.... to past and get accepted in the military at that time I also disclosed to the examing doctor that I had previous had a leg problem assoiciated with my back which I took mortin 800(which is documented in that report). The medical exam ask if my back or legs was still bothering me? I told him no. And than did a physical exam of my back etc......He cleared me to go in the army.
Two weeks into basic training I fell off a wall that had a bottom pedastel on the bottom(like a wall with a patform at the bottom, I went to sick call there I was exam dianoise as having tender points at L2 and L5. I was given meds(800mg of mortin)and a rectal exam and release back to basic training. A couple of days later I twisted my back out of place by repeating standing up and down at a rapid speed(just before that my unit was low crawling with backpack on and marching). I than went to sick call again where I was seen no through xray was done again and sent back out to basic training. As we where bidwacking in the field I became sick with pain now in my legs, back,and stomach. I went to sick call where they but me in the hospital for a two days. I was release again this time I got only a culture of my stomach which revealed that I had esophastis and gastrisis and given a appointment to see the otho doctor at army martin hospital and sent back out to basic training again.
At the doctors office, at army martin hospial I seen a otho doctor whom dianoise me as having "chronic mechincal low back pain and giving me a permanent L3 Profile with no running or lifting". Diagnosis of Lumbosacral spine with bilateral spondylolysis L5.
I got a honorable discharge with a reenlistment code of RE-3. I tried to fight from being discharge without getting some type of disability through the IG office and met with a person whom never got back with me on the issues that I was trying to address.
I continue to have severe back pain and proceeded to my local VA office for further care. I did disclose to the doctor at local VA hospital of the condition in the military and prior to me being in the military. There I was given a c&p exam. I was given an exam of my back which the radiologic report now says "No evidence of spondylolysis or spondylolisthesis apophyseal and sacroiliac joints are unremarkable no fracture or dislocation(basically alot of the paperwork on that date of exam which was a month later after i was discharge wasnt done).
During my life at that time I didnt have a place to stationary live my life so I was basically homeless. I never heard back from the rating peoples about how, what, and if I was going to recieve anything from this injury. Until years later when I requested documents of my complete file.
Which claim they wanted me to come in for a RHEUM EXAM(once I found out that i was wondering why would they schedule me for a rheumary arthisis exam if they didnt find anything on the radiologic report revealing anything inreference to my back).
I tried for years to get benefits from the VA but was denied each time because they say that I had a diease prior to service and that through my life as of today I had two previous auto accident(which in those reports I never had injuried my back which is well documented)and the new doctor exam says that his etiology say that it is the natural course of the diease as to why I still in pain.
I did apply for SSI and SSA which I did get approved(which social securtiy only pays for one year prior to your filing of your claim meaning they dont go back to the orgin of the time you was injury or permenantly disabled)but in those reports The ALJ for got to put in about the onset of the injury I got in the military. BUt I know for certain it was discuss at my finally hearing on that tape record statement of the onset, in reference to my back.
Through the years my back condition worsen developing to fibermyloa as well as other delvelopments including depression. As of today I about to go to a travel broad hearing. Wondering if I could get some advice on what is what. Thanks for your help
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