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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
saginaw
Can anyone tell me who would be the most appropriate govt or non-govt contact to pursue the following matter through?
Last year I had a pretty uncomfortable relationship developing with a care giver at my local VA who had a pretty unseemly (in my opinion) focus on the depression med Effexor. This doctor is the head of the mental health unit at this outpatient clinic. He had a little flyer that he'd personally printed out showing a hierarchical layout of most common antidepressants with Effexor at the top of the 'tree'.
He had originally agreed to see me in an initial visit in response to my questions regarding another medication. Almost immediately he was dissuading me from any consideration of the other med, and steering me very avidly toward Effexor. I cannot quite describe his manner except to say that he reminded me very much of a channel tv infomercial vendor. Effexor, Effexor. He was almost giddy about it.
Even then I wondered if he might have ulterior motives for pushing this single medication, but I dismissed any suspicion on the grounds that he was so highly placed in the clinic that he wouldn't possibly risk exposure of something like this.
So recently I discover in the papers an investigation into the questionable ethics of this rather widespread relationship between doctors, often very prominent doctors, and the drug companies. Well beyond coffee cups and inkpens or even ski vacations, these doctors are getting caught taking under-the-table cash to avoid both the taint of unprofessional conduct, and federal taxes! The chief medical correspondent of one of the media giants (cnbc, cnn, fox, or something or other) was caught redhanded.
I suddenly wondered again if this doctor I'd seen, for a genuine inquiry into the possibility of another medication, might simply have been 'selling' me Effexor. If this is possible I'd be greatly pissed! Heading up some of the investigations was the office of Sen. Chuch Grassely of Iowa. I sent him two letters concerning this and have yet to receive any response over a month later. I must be just another cracked-pot Veteran I guess.
Now where? I've not entirely comfortable taking something of this level to the patient advocate whose office is in the same building. She's a great person, and has been very square in the past. But I wonder if I'd be unwise to pursue something of this magnitude "internally".
Thanks so much for the great forum!
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