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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
MRRRR5
I would start by saying "Thank You" to all my fellow veterans in this forum who have honorably served our nation. I will be brief as possible.
My spouse was honorably discharged from the service in December 1990 after close to 3 years of AD as an 83E, Photo & Layout Specialist (Topographic Mapmakers). In May 2004, my spouse, who is also a SC veteran for bunions on both feet, was previously denied SC for ear problems (otitis media and otitis externa) and chest pains. We didn't know that she could claim "any disabilities" until i started my retirement ACAPing and got a briefing from the "VA Representative". The primary reasons for both denials from the VA rating decision stated "There is no evidence shown in the service medical records in service" for either of these conditions. As far as the ear problems, the VA decision goes on to state that the "first record of an ear condition is dated July 1991" and that since that date, "post-service treatment records show off and on treatment for ear pain, ear infections, otitis media, and otitis externa in both ears up to the present" from the various military hospitals (due to her being my dependent and me still being on AD). We were confused by this and requested a copy of her service medical records from St. Louis. We finally received copies of her medical records after several correspondence from St. Louis in July 2007 (3 years later). After reviewing her medical records, we discovered several medical treatment records for ear problems that she had on 11 May 89 (ear irritation, burning, swelling, and tenderness), 26 May 89 doctor wrote "routinely exposed to hazardous noise" due to PMOS 83E and an audiogram showing "mild hearing loss along with a DD Form 2215 with "hearing loss profile", and 25 Sep 90 (viral upper respiratory infection-URI- with zoster virus/infection in left ear". We also found treatment records for her chest pain in service dated 11 Feb 90, which was listed as "chest pain with light palpation". In June 07, she had bunion surgery on left foot, which resulted in severe complications and a Reflex Sympathetic Dystrophy (RSD) diagnosis in August 07 from the bunion surgery complications, which has been a mental, emotional, and physical nightmare for her and us all. Prior to the bunion surgery, she was very active, had enrolled in college courses, and had just received her Certified Phlebotomy Technician Certificate of Training. Has been on crushes since June 07 surgery and can not walk without them, started physical therapy in August 07, and was referred to a pain specialist in September 07. Also informed by the doctor that due to the RSD, "it may be 6 to 12 months or longer" before she would be able to possibly seek employment or go back to schooling. That information was a psychological and emotional bombshell. She had to go to the ER twice during the month of August 07 for severe spasms in the left foot and leg (via ambulance) and two weeks later for severe chest pains and difficult breathing. Both times the ER doctors did x-rays, blood work, etc. and concluded that it was all part of the RSD from the bunion surgery. She is severely limited in what she can do because of the pain from the RSD and the treatment medication she is on and has been on since the surgery (addictive narcotics). We were informed by the pain specialist that the RSD can and will most likely spread to other parts of the body and will most likely aggravate any other chronic conditions because of it's impact on the central nervous system. He also stated that she should keep her foot elevated as much as possible to help control the swelling in her foot. She informed the pain specialist and the PT that although the medication provides some relief (at least 50 to 60 percent relief), she is having problems with her lower back, both knees, and her non surgery right foot; she is also very sensitive to noise as it has her ears with a constant "ringing", which actually would be considered "normal noise level" in my opinion to the average person. Now to my questions, 1) do she have grounds to request that her ear and chest pain claims be reopened? If so, what effective date would she asked for since it has been more than a year from the initial decision denial date? Are there any secondary claims from the bunion surgery that she can possibly claim? Sorry for this being so long but I tried to provide as much info so those with the knowledge and experience in dealing with this can provide some insight with all relevant information available.
Respectfully,
MRRRR5
DAV Life Member - Thanks to all Veterans for your selfless service.
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