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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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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
Quint7
I posted my 1st topic yesterday about having my C&P today and wanted to start a new thread just because of the way it went.
I had my "exam" done at the Rochester NY clinic which is affiliated with the Buffalo NY VA office. My examiner.... I have no clue what she was, doc, nurse, who knows... was a very nice maybe 30 y/o who I think was named Beth. She walked me back to the room, never asking how I was and introduced another mid 20's female who would be observing. Can't remember her name. She literally read off of a check off sheet asking about my knee and low back problems. I answered truthfully and maybe 2 or 3 times I elaborated on the question just because there was no way that I felt comfortable answering with a yes or no.
After a few minutes of that she asked about a MRI on my back. I told her that I had the docs report, but that I also brought the actual films with me. She said that all she wanted was his report and the radiologists report. She wrote down some info from those and when I asked again if she wanted to see the films she told me that she wrote down the docs info and that was good enough.
She then asked me to stand and bend forward. I did as far sa I could... maybe 35 degrees. She measured and had me do it two more times, only measuring the 3rd, not the 2nd time. She then had me lean back, no measurement. Then side to side where she took a measurement. She asked about pain in all directions and I said yes.
She then had me lean on a table and bend my bad knee 3 times. She took one measurement. She then palpated my back for pain and tenderness while I was standing and I told her where it hurt. She had me sit on the exam table and lean back so my knee could flex. She pulled my pant leg up and tried to move it through the range of motion by force. After that she palpated it for pain and I told her again where it hurt as she pushed on it.
She told me that she was all set and I kinda acted surprised. I said something like "well I don't know what, if anything I am supposed o tell you, but as far as my back, the doc said that I have he lower back of a 60 y/0 (I'm 38) and that my knee has been screwed up for so long due to misdiagnosis back in 1989 (until surgery in 2006) that my kneecap rides way off to the side now. She had me pull up both pant legs and compared my kneecaps.
She said that was it then and that they would send the report in to the rating board. She was friendly the entire time. As I was about to go, I asked if the file she had was mine from the VA and she pointed to 2 large files and told me that both were mine (I have never had a claim before). I thnaked them and walked out.
I then immediately filed for a copy of the exam with the "Freedom of Info" office or whatever it is.
During the exam I genuinely would become almost short of breath and almost grunt from the pain while bending, etc. We were all friendly, but I know as an firefighter/EMT that if I had a patient grunting and gasping as they tried to move that I would definately make a note of it on my paperwork. I also mentioned more than a few times that I was almost embarressed of my situation as I have a very high tolerance for pain. I also made a quick reference to my claim for the same things in 1994 that was denied due to "failure to report" (can see that in my other post).
Any thoughts anyone?
Thanks for a great site!
Jason
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