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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
hurryupnwait
This is from a post made on another forum. I have an attorney and it seems that my claim with him is following this pattern.
"To get back to the original question as to whether getting an attorney will speed up the claims process, I will say that in most cases, yes it does. Let me explain.
Current laws and regulations prohibit an attorney from charging more than a very nominal fee unless the claim for benefits is in appellate status. What this means is that if your claim is granted on the first go round your lawyer has essentially represented you for free. Let's just say that lawyers don't like to represent you for free.
So what many, if not most, lawyers do is to try to get the matter under appeal. They want the Regional Office to render a decision as quickly as possible so they do everything they can to encourage a quick decision even if all of the evidence is not of record. They don't want your claim granted at this point, they want it denied so they will have something to disagree with which let's them go "on the clock" as they say. Now they can start running a tab on you. That's why many lawyers start trying to waive all of your rights from the beginning in an effort to coax a quick decision out of VA. This is what I meant when I said that a lawyer will often speed up the claims process, but it isn't a speeding up that is to your advantage.
It's after the lawyer get's a Notice of Disagreement filed that they start dragging out the process. At this point they are essentially running up their bill. They tend to do very little actual work but they do send a litany of form letters to VA appearing to be claiming just about every benefit VA has to offer in all manner of legalese language. Not because they actually think you are entitled to any of this (heck, most don't have any idea one way or the other), but they hope to so bamboozle the non-legal claims processors at VA to the point that somewhere along the way they won't dot an i or cross a t or otherwise commit some due process error. At this point they will more often than not again waive your rights and demand that your claim be sent to BVA without any further action at the Regional Office.
So why do they do this? Two reasons.
First, should BVA actually grant your appeal they will get a cut out of your backpay. By this time there is usually a nice little bit of retroactive pay built up. Unfortunately in more cases than not your claim would have been granted anyway even without the lawyer, but this way the lawyer gets to share in your good fortune.
Second, even if your claim is not granted, if the lawyer has managed to accomplish his earlier goal of getting the Regional Office to miss something or otherwise make some mistake that results in BVA remanding the appeal to correct this mistake, the lawyer can collect a fee directly from the government under the Equal Access to Justice Act. This means that he collects whether you ever do or not. Unfortunately many of these remands by BVA are for shortcomings that were manipulated into happening by the actions of the lawyer.
In conclusion, until you have exhausted the claims process within VA itself and are ready to appeal a BVA decision to the Court of Appeals for Veterans Claim, you should stay away from lawyers. A much better bet is to find a good VSO who knows the VA claims process and who isn't trying to earn a fee off of you, and let that person help you "
Any comments?
Paul
Edited by hurryupnwaitWhen I count my blessings I count my family and friends twice.
If you don't know where you are going, any road will get you there.
Well done is better than well said.
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