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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
Commander Bob
Dear Honorable Senator Akaka,
I am concerned about my wife's DIC payments after I die. I am a former resident of Hawaii. I write you today as a combat wounded Vietnam veteran, recovering from cancer treatments and surgery. While putting my affairs in order, I came across a veterans website posting which brings me to you today.
I read this veteran's widow's posting on Christmas, . ...I have come to Hadit this time with a broken heart. My kind and sweet husband of 27 years died last Friday. ...
Saturday, January 3rd, the widow wrote, ...I was glad to see that VA had deposited his payment as usual for the month of his death. Auto payments were due to post in a few days -- and..... But late yesterday afternoon, VA withdrew the entire deposit. I'm wondering how VA could withdraw the entire amount.
Reference is made to the "Honolulu Star Bulletin," Dec. 20, 2008.;
<H1 id=storyTitle>VA to fix spousal-payment glitch</H1>"A Maui widow's plight highlights a computer error that wrongfully denied certain benefits
By Gregg K. Kakesako
POSTED: 01:30 a.m. HST, Dec 20, 2008
****The Department of Veterans Affairs will begin issuing retroactive payments this month to eligible surviving spouses of war veterans who have been wrongfully denied up to millions of dollars in government benefits over the past 12 years. The problem was pointed out to VA director James Peake last week by Sen. Daniel Akaka, chairman of the Veterans Affairs Committee, after the Hawaii Democrat received a complaint from Ruby Sasaoka of Kula, Maui, who was told by the VA that she wasn't entitled to her husband's last pension and disability check of $2,669.
Her husband, Raymond Sasaoka, died last December and she had used his last VA check to pay for funeral expenses. He had served in the Korean War as an Army corporal and suffered from post-traumatic stress disorder and hearing loss.
In January, the VA told Ruby Sasaoka to return the money and nine months later the U.S. Treasury took the money out of her checking account.
However, Congress passed a law in 1996 giving veterans' spouses the right to keep their spouses' final month of benefits.
But the VA never updated its automated computer systems, which sends out checks and notification letters. As a result, spouses were either denied the final month of payment or asked to send the checks back. If the checks were already deposited or spent, the U.S. Treasury moved to seize the money directly from their accounts.
"This flawed practice has caused serious hardship for many widows," Akaka said last week. "Now that this problem has been brought to light, I trust that surviving spouses will receive the benefits they are due."
Based on Akaka's inquiry, Peake established a special task force to identify and pay the beneficiaries who never received the benefit or were inadvertently required to repay the money issued for the month of a veteran's death.
The task force is reviewing VA's payment records for veterans who died after Dec. 31, 1996, and who are survived by a spouse. The review will identify those to whom VA owes retroactive benefits for the month of the veteran's death.
Because there are deceased veterans for whom VA does not have marital status information, a special Survivors' Call Center has been established for spouses who believe they may be entitled to this retroactive month-of-death benefit.
Surviving spouses are encouraged to contact the Survivors' Call Center at (800) 749-8387, Mondays through Fridays. Inquiries may also be submitted through online at www.vba.va.gov/survivorsbenefit.htm.
Akaka's committee estimates that 50,000 surviving spouses each year since 1996 could be affected, based on VA numbers. Out of that 50,000, some spouses might have received the payments they were due if they called the VA at the time to inquire about their rights.****
It is arrogant of the bureaucrats responsible for correcting the problem, to have failed you and the widow, whom I don't know. VA director Peake needs to be brought before the Senate Veterans Affairs Committee and be chastised for his slow action to your comments to him. It also makes you look easliy beguiled by those you are burdended to oversee, and if I may be blunt... ineffective as a leader. What are you going to do about this?
Again, I am concerned about my wife's DIC payments after I die.
Yours truly,
xxxx xxxxxxxxxx
Edited by Commander Bob 92-93"it shall be remembered"...
"We few"
"We happy few"
************************
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