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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
Berta
Jerrel Cook from SVR asked me to post this- it is also coming to me via others-this is not the first time the Sec raised this idea-I dont know what support it would get-----
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Berta could you please post this on hadit for me...Jerrel
Jerrel <jeecook@sbcglobal.net> wrote:
Date: Wed, 1 Aug 2007 07:34:02 -0700 (PDT)
From: Jerrel <jeecook@sbcglobal.net>
Subject: Jim Nicholson 2
To: Jerrel Cook jeecook@sbcglobal.net
Army Times
Nicholson backs new benefits claims system
By Rick Maze - Staff writer
Posted : Thursday Jul 26, 2007 11:40:47 EDT
Veterans Affairs Secretary Jim Nicholson endorses a controversial idea to attack the huge backlog of veterans’ disability claims by automatically approving some claims.
In a Wednesday interview taped for C-SPAN’s Newsmakers program, which will air Sunday, Nicholson said he was willing, on a trial basis, to try to tackle the large and growing backlog of disability claims with a program that would assume anyone who filed for compensation deserves the payment. After the first check is issued, a claim could be reviewed, with the possibility that payments could be adjusted, Nicholson said.
This speedy process would apply only for initial claims, not for people already receiving disability pay who are seeking to have their ratings revised upward. More than half of the estimated 600,000 claims pending at any time are for people who are already receiving disability compensation for a service-connected injury or disease, Nicholson said.
The automatic payment process would take many changes in law and “a new cultural frame of mind,” Nicholson said, but added, “We want to do it quicker. It irritates people.”
“Everybody would have to understand the new system,” he said, including the possibility that the benefits they are receiving could be reduced, increased or even canceled.
“This would be quick but not necessarily permanent,” he said of the payment.
He won’t be around to see such a change, however, as he has announced he will retire no later than Oct. 1 to return to private business.
The Bush administration and many veterans’ groups have raised red flags over the initiative endorsed by Nicholson out of fear it could lead to widespread cheating by veterans who would assume they could get paid without having to provide any proof of their medical condition.
In the interview, Nicholson mentioned the possibility that veterans found to be ineligible or who receive a bigger payment than warranted could be forced to repay the government, something rarely required under current law because the initial claims process, which now takes an average of 177 days, weeds out most blatant errors and fraud.
Automatic processing of at least simple claims is getting a lot of attention in Congress as a potential way to speed initial paychecks while allowing VA to concentrate on the more difficult claims, such as veterans with multiple disabilities and complicated medical histories that make it challenging to determine whether there is a military cause for the problems.
A big push in Congress for automatic benefits approval came after a March discussion before the House Veterans’ Affairs Committee where Linda Bilmes of Harvard’s Kennedy School of Government warned that radical change is needed because the backlog of benefits is only going to get worse. By her estimate, 250,000 to 400,000 disability claims will be filed over the next two years by Iraq and Afghanistan war veterans. She proposed having VA pay all disability claims filed by new combat veterans under a streamlined system that included only four ratings levels instead of the current 10.
Bilmes’ idea has since been introduced as legislation by several lawmakers. Nicholson’s endorsement of the basic concept could be of limited help to sponsors because his Oct. 1 resignation date means he will not be around to see even a pilot project implemented.
www.angelfire.com/ca2/arresteddecaymusic/jerrelcook.html
www.angelfire.com/ca2/arresteddecaymusic/jerrelcook.html
GRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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