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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
Berta
The Director of Buffalo VARO received copy of a letter and again,with it ,copies of my IMOs that I has sent to Dep Sec Manfield.
She states Issue one as a claim in appeal status. (this specific claim has never been denied and the VSM promised me a decision on it 2 or 3 tmes since Jan 2003.It involves a legal question issue)
How can it be in appeals staus without any denial?
Issue # she states is my main AO death claim,currently in appeals status.
Issue # 3 she states-as the VA stated erroneously in 2006-
is a claim cutrently in appeal status to be considered by the BVA.
(I already informed the BVA that this claim was withdrawn when I filed the 2 CUE claims. needed to make sure this issue was a final one before filing the CUE claims)
The letter states that an SSOC was prepared "after additional evidence was received." for my AO claim.
WRONG- the SSOC indicates clearly that my vet rep never presented my IMO and that I had not presented additional evidence.
On Jan 17, 2006 I again responded to the SSOC with the initial IMO and referred the VA to the additional other medical evidence they have never addressed.
This recent letter states:
"We accepted your letter dated January 17,2006 in lieu of a substantial appeal (VA form I-9)" (this happened within a second conference -with my vet rep-unknown to me at the time)
I filed a formal I-9 on Feb 4, 2006 fully within the appeal period-again attaching my medical evidence.
"These issues are ready to be transferred to the BVA.
However an appeal cannot be transferred to the BVA while there is an active issue before the Buffalo Regional Office."
It goes on to give status of my CUE claims- with a DRO.
During the week the second conference occurred with my vet rep- at that time they decided to send my AO claim to the BVA.
I didnt know for 6 months.They decided to use my SSOC response as a formal appeal.???
Is that kosher?
As you all know due to their illegal 2003 VCAA letter and the fact they still had not considered my IMOs (2 at that time) the BVA,upon receipt of my letter requesting immediate remand,, remanded the whole thing back to them in a few weeks.The BVA had the I-9 and the IMOs and sent this all back.Sept 2006.
In Dec 2006 VA states in Iris that they never received the IMOs.
I sent them again.
I should have asked if the I-9 was there too.
The VSM stated to me in recent email that this claim is with a DRO.
My phone log shows this AO claim has been to rating and specialist and back to DRo, rating, DRO etc numerous times since Sept 2006.
I am correcting her letter and sending the whole thing back to Mansfield so I get a response from her-
Question-could it be that NYSDVA
(I charged them with failing to properly handle my evidence at the first conference in 2005 with the DRO in complaint to the OGC)
made sure my actual I-9 was ignored too?
With 2 strong IMOs I feel I am still good to the gitgo and with the prior FTCA malpractice award ,that also lends credence to my IMOs.
Question-what benefit would a state service agency have to deliberately insure my claim would be in the system for over 5 years already without having my medical evidence being addressed?
Especially when not once but twice vet reps from NYSDVA has conferences first with a DRO and then with the VSM?
If I could come up with a logical answer to that -
maybe I could understand why this happened-
Better yet -I have more evidence for my complaint filed with the OGC.
Maybe the OGC can get an answer.
The Director clearly states in this letter as I quoted-
andf she is correct-
"An appeal cannot be transferred to the BVA while there is an active issue before the Buffalo Regional Office."
But they did just that in 2006 and my vet reps stood by and allowed that to occur.
One thing is for sure- the VA once they put something on paper-
is giving claimants documentation as to how messed up the system is.
Ad when they do that-it can be used against them.
Sorry for long gripe-I have never seen any claim so messed up like mine is and I wonder how many vets or widows got the same crap either from this VARO or NYSDVA-or worse yet-
both of these entities-joining together to make sure certain claims would
not succeed.
GRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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