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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
lu12
Northeastern Chiropractic Center, Inc. December 17, 2007
Patient: DOB:
Chief Complain
A 41 years old Hispanic male presents to chiropractic office on 04/03/2007 with neck pain, bilateral shoulder pain and low back pain with Radioculopathy to both legs.
The onset of symptoms started suddenly after having an accident while attending the military in 1988. Mr.--------- reported that he initially hurt his lumbar region and his right knee then his cervical spine. Mr. --------- reported some improvement with Flexeril and Neurontin medications but also reported that walking, prolonged sitting, driving and activities of daily living makes condition worse.
Patient described the quality of pain as achy/stabbing on lumbar spine, numbness/tingling on left foot (lateral aspect) and dull/achy on cervical region. He reported that pain radiates to hands and feet bilaterally. Patient described the pain as constant. Mr. --------denied any bladder or bowel dysfunction at the time of initial examination but reported pain during sexual relations.
There is a history of multiple motor vehicle accidents (MVA) on 1997, 2000 and most recent on 2005 (all of them were rear impact) according to Mr. --------Medical care provided by the Veterans Affair and other private practitioners including physical medicine specialist, neurologist, orthopedic surgeon and chiropractic care by Dr. ---------- on 2003 had been provided since the onset of symptoms with minimal improvement according to patient.
Vital Signs
BP: 130/90 L Pulse: 80 ppm Resp: 16 bpm Temp: NP Weight: 234 Ibs Ht: 5'9"
Neurological Examination
Alert x 3
Cranial nerves were intact.
Cerebellar test was unremarkable.
Motor: 5/5 C5-T1 and LI-SI
DTK's: +2 bilateral on upper and lower extremities.
Sensation: Decreased sensation on right leg L4 and L5 dermatome
Decreased Active ROM
Cervical region: j extension 35°, J, left lateral flexion 35°, right lateral flexion 40°,
J, rotation 65° Bilateral
Thoracic region: j, extension.
Lumbar region: I flexion 45°, j extension 15°, J, bilateral lateral flexion 20°, J, bilateral rotation 20°
Orthopedic Examination
Pain elicited upon Cervical compression, right shoulder depression test, positive minor sign, positive Kemp's test, SLR @ 45°, Braggard's test, Ely's test, Yeoman's test, Apley's compression right knee.
Postural Evaluation
Mr. ---------- posture showed an anterior head carriage, rounded shoulders,
hypolordosis of lumbar spine and a high right pelvis.
Spinal Evaluation
Segmental fixations were found between C3/C4, C7/T1, T4/T5, L4/L5 and L5/S1
vertebral segments.
Soft Tissue Evaluation
Spasms were found upon palpation of left lumbar spinal muscles, right trapezium muscle
bilateral rhomboid muscles.
Radiological and Advance Studies (*) Lumbar MRI done on 06/19/2007 revealed:
1. Moderate central disc protrusion at L5/S1.
2. Right posterolateral disc protrusion at L4/L5.
3. Lumbar Spine disc desiccation at L3/L4, L4/L5 and L5/S1 discs.
Cervical MRI done on 04/30/2007 revealed:
1. Small central disc protrusion at C3/C4.
2. Small central disc protrusion at C2/C3 causing mild impression upon the
anterior thecal sac.
3. Moderate to severe bilateral neural foramina narrowing at C4/C5 disc with
degenerative spondylosis.
4. Cervical disc desiccation of C5/C6 disc.
Whole Body Bone Scan done on 02/27/2007 revealed inflammatory changes at the acromioclavicular joints, right knee, right ankle and dental process of the maxilla.
Pelvis Radiograph done on 09/15/2006 revealed mild degenerative changes at sacroiliac joints.
Thoracic Radiograph done on 09/15/2006 revealed mild thoracic levoscoliosis.
Electrodiagnostic studies (NCV/EMG) revealed:
1. L5 and S1 right radiculopathy on 08/25/2005.
2. Mild bilateral median nerve entrapment across the carpal tunnel on 08/02/05.
3. Bilateral ulnar nerve entrapment below elbow on 10/01 /2003.
(*) See study impression.
Diagnosis:
Lumbar disc protrusion L4/L5 and L5/S1
Lumbar degenerative disc disease L3/L4
Cervical disc protrusion C3/C4 and C2/C3
Cervical neural foraminal stenosis and spondylosis C4/C5
Cervical degenerative disc disease C5/C6
Myofascial pain syndrome of cervical, thoracic and lumbar paraspinal muscles
Upper cross Syndrome
Tension Headaches
Scoliosis thoracic spine
Osteoarthritis right knee (post traumatic)
Prognosis:
Prognosis at this stage is poor to fair if patient follows recommendations and avoids
Trauma.
Treatment Provided:
Chiropractic care consisted of Flexion/Distraction therapy Cox Protocol, Chiropractic
Manipulative therapy (CMT) of cervical, thoracic, lumbar and sacroiliac regions.
Physical therapy consisted of Hot/Cold packs 15 minutes intervals as needed, interferential current (IFC) x IS minutes 1-150 Hz and soft tissue manipulation (ischemic compression/cross friction massage).
Recommendations:
In my professional opinion Mr.------- presents with a chronic condition cause
Initially by trauma while in service in the military followed by moderate to severe
Degenerative process of the spine as a result of disability and repetitive trauma from
MVA's. His spinal and extremities conditions although slightly improve after more than
25 chiropractic visits since 04/03/2007 may aggravate or worsen due to anatomical
changes such as degenerative process, disc herniations, postural changes, increase body
weight and also emotional disorders cause by pain, inability to performed normal
activities and inability to exercise properly due to physical disabilities.
It is necessary to continue chiropractic care with medical co-management to maintain Mr.
--------- functioning to the best of his functional capabilities.
Berta, Pete I think this is not good enough as supporting evidence for my cervical spine issue?
your advice will be truly appreciated.
lu12
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