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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
hurryupnwait
Decision
Service connection for Lumbar spondylolisthesis (no diagnostic code) is granted with a evaluation of 10 percent effective November 9, 2001.
Reconsideration
I would like to have a reconsideration of this rating. After reviewing my latest independent medical examination, October 2007, by Craig N. Bash M. D., Neuro-Radiology, a highly credentialed specialist in the field of my disability. Dr. Bash's exam was a physical examination with a review of my complete claims file.
Diagnostic Code 5239
Gives a 40% rating for forward flexion (range of motion) of the thoracolumbar spine 30 degrees or less.
Mine is 25 degrees. This causes me _____.
Diagnostic Code 5239-8520
22% moderate incomplete paralysis sciatic nerve, bilateral ( this is pain shooting down the legs). The pain in my legs ____
Secondly, this claim was opened in January 1973 and according to my remand letter from the Board of Veterans Appeals I was not sent a determination letter. On April 24, 1973 .I received the decision letter on this claim, I responded on May 18, 1973 telling them I disagreed. I was not advised that my claim was reopened. However, I was sent to a C&P exam on October 11, 1973, yet they never sent a Statement of Case on the NOD I filed with them on May 18, 1973.. Therefore, I was not provided with any information that the claim was denied, reasons for the denial, or information of how to further appeal. My claim remains pending.
If The VA did not consider the NOD I filed in May, 1973, a disagreement with their decision, they apparently considered it New and Material Evidence - and re-opened my claim at that time, as they sent me for a C&P exam after receiving it. However, I still never received any notification from the RO about the status of my claim after that point. Therefore, I was not notified of any decision.
If the RO considered my May 18, 1973 communication to be a NOD, my effective date would be Jan 1, 1973, the day I filed my original claim, as I never received a SOC following their receipt of my NOD.
If the RO considered my May 18, 1973 communication to be a request to reopen with new and material evidence, then my effective date would be June 1, 1973, (the date they reopened the claim), as I never received any notification of denial of my claim from the time it was reopened.
Under ___ I request that my claim for increased rating not be delayed -- Anyone know the reg that says that I can have the increase rating decided now and the EED issue decided later.
When I count my blessings I count my family and friends twice.
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