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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 initial denial - dated November 8, 2007.
I submitted the evidence they requested in the VCAA letter in June 2008, prior to the end of the one year deadline to submit the requested evidence.
Though I have requested they readjudicate my claim based on my submission of evidence within the one year time-frame, they now deny receiving the evidence.
Though I still think I have the right to have my claim re-decided (and remain open) as I submitted the evidence requested in the VCAA notice within the time-frame (and have a signed certified mail receipt - plus a copy of the IRIS I sent to let them know I had sent it) - I filed a NOD.
I did receive a letter dated October 17, 2008 telling me they were working on my claim for Compensation.
The deadline to submit my NOD was November 8, 2008.
I mailed my NOD November 7, 2008, certified mail, return receipt requested. I also had the post office postmark the letter while I was there to assure the postmark was legible.
I sent an IRIS to the VA on November 8, letting them know I had sent my NOD by certified mail, the receipt number, a copy of the online tracking showing it had been processed at the post office - along with a request to receive a date stamped copy for my records.
The response told me they could not send me a date stamped copy, but that I would receive a response.
I received a decision today telling me my NOD was not timely, as a decision was made on my claim November 8, 2007, my NOD was not received by them until November 12, 2008. (The day after Veteran's Day).
(It also said they attached information on how to appeal - but they didn't attach anything..)
I keep reading on the BVA sites:
http://www.va.gov/vetapp08/files4/0826555.txt
"When these rules require that any written document be filed
within a specified period of time, a response postmarked
prior to expiration of the applicable time limit will be
accepted as having been timely filed. In the event that the
postmark is not of record, the postmark date will be presumed
to be five days prior to the date of receipt of the document
by VA. In calculating this five day period, Saturdays,
Sundays, and legal holidays will be excluded. 38 C.F.R. §
20.305(a).
In computing the time limit for filing a written document,
the first day of the specified period will be excluded and
the last day included. Where the time limit would expire on
a Saturday, Sunday, or legal holiday, the next succeeding
workday will be included in the computation. 38 C.F.R. §
20.305(;)."
Do they have any justifiable reason to dismiss my NOD as untimely? Aside from the fact that I have evidence that I SENT it on November 7, 2008... And that I let them know IN WRITING by IRIS ON November 8 (the deadline) that I was filing a disagreement --- shouldn't the five day presumption apply?
(The 8th was a Saturday, the 9th was a Sunday, the 11th was a holiday. According to the above procedure for calculating the mailing date - the presumed mailing date should be November 4, 2008). So even if they manage to lose my postmarked envelope -- shouldn't their acknowledgement of receiving it on November 12th count as evidence of timely filing?
I am not quite sure why they didn't go by the date of the postmark, or use the five day presumption when they issued the decision to dismiss my appeal, except that they are the VA and that's what they do...
Am I missing something?
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