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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
I previously had asked about filing a CUE for a cervical condition my husband claimed. I have found I cannot submit a CUE for the condition - but am wondering if it can be raised as an "inferred claim" for accrued benefits.
My understanding is that inferred claims for increased ratings for conditions that have already been service connected that have not been recognized by the VA - and addressed - are still "pending claims"
Correct me if I am wrong on that.
My husband claimed his cervical condition at retirement. Though his SMR's showed he had a cervical injury in service - he was denied SC as both the RO and BVA stated he did not show a "current disability."
His first C&P in 1999 said his x-rays didn't show ANY disability.
He continued to complain of chronic neck pain - and his C&P in 2002 found only a slight problem at the C4-C5 level - which they still didn't think was enough of a disability to be a "current disability" to grant him SC. I have NO idea why they didn't grant the service connection and rate it at 0 percent at that point, instead of denying SC based on the "No current disability."
In 2003 - the C&P exam for headaches --for his "Desert Storm" C&P denied him SC for the headaches because they C&P examiner indicated they were a diagnosed illness (therefore not compensable under Desert Storm as an undiagnosed illness).
THe C&P examiner indicated the headaches were caused by osteoarthritis of the cervical spine - which affected C1 - C7 - but by some miracle happened to appear the greatest at the C4-C5 level with hypertrophic spurs, significant restrictions in flexion and extension, etc. etc.
My question is:
As my husband WAS Service Connected for DEGENERATIVE ARTHRITIS in 1998 - based on the arthritis that had manifested in his lower back from a low back injury in service - wouldn't a VA report that indicated that arthritis affected ANOTHER joint that had a documented injury in the SMRs raise an INFERRED claim for an increased rating for ARTHRITIS - as now affecting two or more joints?
So if the VA failed to recognize the inferred claim for an increased rating for degenerative arthritis (and just denied the SC of an undiagnosed illness) - would this still be a "pending claim" that is before the VA?
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