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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
Berta
I received another letter from Congressman Filner.
The VA's response from the AMC to my charges that they destroyed my evidence was
1.a copy of their February decision (which was great because -men and women I spent hours yesterday looking for it! I had a problem with my printer at the same time and have additional evidence to try to get to VA tomorrow-as well as copies of med recs to IMO doctor-and
I try to keep meticulous labeled files for all of my VA crapola- and advise to do that here all the time-but you know how it goes-
it is easy to mis -file stuff.
Then again I was so perturbed by the printer problem that I forgot what I was also looking for (the February VA Decision)however I continued to search relentlessly for what I forgot I was looking for -- ----why waste time.
Then the miracle occurred-in the midst of a fast moving squall with hailstones I went to my mailbox down at the road and got what I was looking for via Congressional Intervention! copy of the same decision. Ha Ha.
2. the Good part- attached to the decision was copy of email from me to H VAC and copy of response to Sub Comm liason, and to the VA liason person-
interesting-I have not been formally contacted on this at all by the VA.
"Please invite her to submit for the record (record being the H VAC) and forward her claim to VA as a lost/destroyed file inquiry."
The bad part is I have to make ANOTHER copy of this extensive evidence -working on my formal VA FAst Letter request as it is-a STACK of stuff they destroyed.
The good part- the H VAC will get it for the record and maybe give this some impetus.
At least I dont think the H VAC will lose either the request or all of the evidence.
This opened another bag of worms. I have been in contact with Congressman Filner by mail and spoke to him personally on other VA issues- that were not my claim situation.
The recent actual C & P exam results I got- where the C & P guy -a PA -didnt even come close to my knowledge of cardiology- is prime facie evidence of how piss poor these exams are-
exams that control the futures of disabled vets and their families.
I still have the VA exams I knocked down in the 1990s and apparently the BVA (by totally disregarding the initial VA opinion for my claim) saw how both Dr. BAsh and I knocked that one down to the curb.
You all DESERVE BETTER than having a C & P done by a PA or nurse who do not have MD next to their name and cannot possibly have the experience needed to opine on most claims.
I will respond and make this point as strongly as I can to Congressman FIlner.
Having anyone opining on a claim -who is also paid by VA or via a VA contract-is a total conflict of intrerest and this has got to stop.
The fact that veterans and widows DO succeed in combatting lousy C & P exams proves the point.If these VA medical 'examiner' people were legit in their opinions we could NEVER overcome their opinions.
The reality is that we often do.and sometimes even without an IMO.
The VA should refund our IMO money if we succeed.
If we ourselves are forced to obtain a real doctor- at an expense-to us to succeed in getting someone proficient enough to adequately medically opine-
either VA has to start providing real docs to us or pay for us to get them.
My medical evidence still remains unread by the VA, as their decision reveals under Evidence section.
Edited by BertaGRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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