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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
free_spirit_etc
I received my VCAA notice in June 2007. I kept asking for an extension of time to submit evidence, due to the VA NOT sending me a copy of my husband's C-file until right BEFORE that deadline - though I had requested it in June 2007.
I never heard one way or another on the extension - though I asked several times. So I DID submit the addtional evidence I HAD by CERTIFIED mail - BEFORE the deadline.
I also sent an IRIS that informed them of the certified mail being sent - and outlined what evidence I submitted - PLUS I informed them I sent them a copy (as they requested) of the Doctor Report - of which I only had the front page - and I was requesting the back page - as this is the medical report that was used to deny my claim.
We had a few more IRIS back and forth about that - They asked for the DATE of the medical report, I told them - the copy I SENT you didn't HAVE a date - THAT is one of the problems - there is NO date OR signature on the PART of the report I had.
I also informed them I had not received any decision on my request for extension - and that I had sent evidence by the one year deadline - but still wanted an extension for an IMO - AFTER the send me the rest of the doctor report.
They told me I had no active claims except for the burial claim. I have a few IRIS back and forth asking about THAT - and letting them know I had sent the evidence within one year - and I thought it would be readjudicated.
They just kept telling me that I had one year to file an NOD - but NEVER mentioned they did NOT receive the evidence I refered to (BY CERTIFIED MAIL RECEIPT NUMBER) in my IRIS.
And we played around with the getting the rest of the doctor report - again, with several IRIS about the CERTIFIED MAIL RECEIPT NUMBER. They finally said they had forwarded it to the Privacy Officer to get my a copy.
Still - No copy.
I followed up with an IRIS.
Was told they did NOT receive the copy I said I sent.
No one MENTIONED that in all the IRIS a couple months ago - when we were discussing the certified mail package I sent.
And they STILL keep telling me I have to file an NOD - and fail to acknowledge my requests to have my claim readjudicated as I sent additional evidence within one year.
SO when they said they didn't have the copy of the partial doctor report I sent - so they could find the rest of the report - I asked point blank - Do you have the OTHER evidence I sent in the SAME package. I even copied and pasted some of the previous IRIS where I had informed them that I sent the stuff - and the receipt number.
Got my response today.
"We carefully reviewed your file and we have no record of the information you submitted on 6-09-08. If you have additional information to submit, please resubmit by regular mail. It is not necessary to send it certified mail, sending certified mail does not offer any real advantage.
If you wish to appeal our decision, you have one year from the date of our notification letter to submit your Notice of Disagreement and initiate the appeals process. Submitting additional information will not start an appeal and we have not received the information you sent."
WHAT???
They are saying they do NOT have the evidence I sent by CERTIFIED mail - but now want me to resubmit it by REGULAR mail as "sending certified mail does not offer any real advantage."
What is that?
I am concerned because I sent evidence in regard to my son's disability / dependency in that packet. Now they will say they did not receive it within a year.
What is this stuff about sending it by certified mail offering no advantage?
They have lost my husband's dscharge physical. They have lost my burial claim. They have lost my father-in-law's burial claim. They have lost all the evidence I sent in June 2008 - and the copy of the parital doctor's report - and they are telling me to send things by REGULAR mail????
I am hoping that my certified mail receipt AND all the IRIS that I told them what I sent - gave them the receipt number - and they never mentioned they didn't get it until now - will help establish I DID send it.
And should they be advising vets/ dependents to NOT use certified mail (especially when they lose the certified stuff)?
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