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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
allan
VA worker, 13 others charged in fraud scheme
By Brett Barrouquere - The Associated Press
Posted : Thursday Nov 20, 2008 16:37:08 ESThttp://www.armytimes.com/news/2008/11/ap_v...dscheme_112008/LOUISVILLE, Ky. — A Veterans Administration employee and 13 other people have been charged with conspiring to steal nearly $2 million in disability claims.
Veterans Affairs service representative Jeffrey Allan McGill and Daniel Ryan Parker, a veteran and officer with the Disabled American Veterans, were among the 14 charged Wednesday by a federal grand jury with conspiring to defraud the U.S. of $1.9 million through the submission of false veterans disability claims to the Department of Veterans Affairs.
The indictment outlines an alleged scheme for veterans to falsely claim to have suffered from bipolar disorder, hearing loss, frostbite, back injuries and other ailments and disabilities.
The indictment says veterans received lump-sum payments for back pay and then kick backed as much as two-thirds of it to Parker and McGill.
“They’re all veterans,” U.S. Attorney David Huber said at a news conference Thursday. “That’s what’s sad about all of this.”
Parker, 37, of Crestwood, is free on $25,000 bond. He is also charged with stealing $47,000 from Disabled American Veterans. His attorney, Brian Butler of Louisville, said his client plans to plead not guilty.
“We’ve been aware of the investigation for months and have cooperated with investigators,” Butler said.
A phone message left for McGill, 37, was not immediately returned Thursday morning.
Huber said the remaining defendants, who live in Kentucky, Illinois and West Virginia, would voluntarily surrender at arraignment on Dec. 16 in Louisville.
Huber said Parker and McGill received between $500,000 and $600,000 in kickbacks, with the rest of the stolen money being split among the participants.
According to the indictment, starting in 2003 and continuing until this month, Parker and McGill recruited friends, relatives and acquaintances who were military veterans to file fraudulent claims with the VA.
Parker and McGill then allegedly either altered the veterans’ medical records, or created counterfeit medical records, to give the appearance that the veterans had service related disabilities.
That resulted in the veterans receiving 100 percent disability for problems such as depression or cancer due to Agent Orange exposure during combat in Vietnam, according to the indictment.
Huber said the case came to light after a tip from a confidential source. He declined to discuss how the source knew about the alleged plot.
“But for that confidential source, this case may not have been known for some time, if at all,” Huber said.
Michael Keen, the resident agent in charge for the Department of Veterans Affairs in Louisville, said the scheme could hurt veterans who needed the funds allegedly purloined.
“Obviously, the Department of Veterans Affairs doesn’t have a bottomless pit of money,” Keen said.
Huber said prosecutors will try to recoup the money taken during the scheme.
"Keep on, Keepin' on"
Dan Cedusky, Champaign IL "Colonel Dan"
See my web site at:
http://www.angelfire.com/il2/VeteranIssues/
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