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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.- 4 replies
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RichardZ, -
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
Feb 22, 2008 AMC RD: Entitlement for a Cervical Spine disability (DENIED); Entitlement for a Psy. Disorder (30%)
For the cervical spine issue: C&P examiner opinion was based on the fact that I suffer a motor vehicle accident (MVA) on 1997, the examiner never got to reconcile with various IMO nor considered the BVA assertions and statements relating the following facts, Evidence of the record clearly showed that I got medical treatment for this condition well before the 1997 (MVA) nor considered the fact that the BVA related to an IME, Nexus Opinion from 2003.
filed for cervical spine, service connection in 1996 and re-filed in 1997, because the VRO never responded, I re-submitted a 21-4138 in 1998 in which I requested to amend my claim in order to add serv. conn. for a Psy & GI disorders secondary to the s-c disabilities.
The VRO & the AMC both have ignored the fact and existences and evidence of the 1996-1997 claims.Could this be sufficient or good enough to consider a NOD base on a CUE action for this issue?
For the Psychiatric Issue: The AMC decision is base on the following facts: C&P Examiner provided an opinion that the current chronic dysthymic disorder was more likely than not related to the s-c disabilities. an evaluation of 30% is assigned for moderate symptoms of depression, anxiety, social isolation and lack of energy. Here is one contradiction - Examiner opinion of Chronic dysthymic disorder and from the AMC rating decision makers: opinion and evaluation for a decision was based on a 30% for moderate symptoms of depression, anxiety, social isolation and lack of energy.
Private IME-IMNO's and Diagnosis for the Psy. Disorder have been assigned before 1996 as Chronic, Recurrent, Major Depressive Disorders to present, with similar Diagnosis from VHA Psychiatric Doc. with Recurrent and Major Chronic depression and anxiety due to s-c disabilities, and pain.
Medical evidence of treatment and Diagnosis since 1996 to 2008 from Private and VHA Psychiatrist's records notes have been consistence with a Dx. of Recurrent, MDD, anxiety and sleep impairments and ED. In addition to the fact that I requested in 2006 before the BVA to allow me to perfect and to re-characterized my appeal, because I wanted to emphasized the fact that my claim was submitted for depression and that I wanted to have the anxiety and Dysthymia to be rated separately.
Obviously the AMC not only minimized this Issue but also did not considered my request to be have all mental disorder evaluated separately. Could this also be sufficient grounds to file a NOD base CUE claim, or a Reconsideration?
Your advise will be appreciated
lu12
Edited by lu12Link to comment
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