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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
mssoup1
My husband has several claims in to the VARO. Some remands from the BVA, some new claims as a result of the BVA hearing. He had C & P exams set up for all of these claims and he went to each. One of the C & P exam reports was horrendous. Nothing in the report was at all accurate. Wrote the report based on a condition that my husband does not now have or never has had. What happened to what he was supposed to be writing the report on? We can't figure that out. He also had another C & P exam, by the same examiner, whereby he never even bothered to write up a report at all. During the examination, the examiner really seemed to be speaking in our favor, but that is as far as he got. Never wrote anything up. I did get the results of the inadequate C & P exam and discovered that nothing had been written up on the other exam. I sent this information to the VARO and explained in detail to them why these were inadequate exams and should not be used in deciding his claims. I also told them that we did not want this same examiner to redo the exam. Never heard anything. Called the VAMC and talked with someone affiliated with the Directors office in charge of the C & P examiners. I explained the problem and she told me that I would be contacted back by someone in that office. Never heard anything from them. I wanted to file a complaint against this examiner, as this is not the first time he has done this. Well, after several calls to the VARO during the last few weeks to find out where his claims stood, I then sent an e-mail thinking I would get more information. Well, I did, to a degree. Here is what they had to say:
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Mr. ,
Your remanded appeal is awaiting the processing of your new claims. With one exception, we have received the examination reports for your claimed conditions. The exception is the skin condition. We asked the VAMC for completion of the inadequate examination. They responded that because of your expressed disappointment with the examination, they were asking us to have another VAMC complete the examination. We replied that we had no such authority, that their manual said that this is their responsibility. Their manual says that they must find a facility willing to accept the examination and that you, the veteran, must agree to travel to the other facility. I assume that they will contact you soon on this matter.
Veterans Service Center Manager
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First, I am upset that I never heard back from the Directors office at the VAMC. Think I will call them again tomorrow and tell them that we want an appointment set up to speak with them. Secondly, since my husband just had another complete knee replacement (NSC), he could in no way be sent to another VAMC in an area that would be that far away. He couldn't make the trip. Also, from the response that I received back from the VARO (as I showed above), neither the VARO or the VAMC knows what they are doing. They assume I will be contacted. When? In the next century. Also, there were two inadequate exams, not one, but according to the reply from the VARO, they only spoke of one. How was the other inadequate exam handled? I am so frustrated with this whole system that I could scream. I have been dealing with some of these claims for over 6 years and those are remands back from the BVA back in February 2005.
Questions for the group:
Should I call the VAMC tomorrow and set up an appointment to speak with the Director over the C & P examiners in order to complain about these inadequate exams being done by this examiner and also about the problem my husband would have in making a long distance trip at this time to go to another VAMC for something that should have been able to adequately been done here?
How do I go about finding out what happened to the exam that was written up, but was considered inadequate based on the fact tht the exam was reporting on a condition my husband doesn't have and was not what the C & P exam was set up for?
Should I get the VARO involved with the problem in sending my husband to another VAMC?
Since my husband would not be able to make the long distance trip, how would he be able to get a new examination and would this go against him in any way? It kinda sounded like in the VARO reply to me that my husband would have to agree to travel the distance to another VAMC for an exam.
We have had other claims held up because of this examiner. He is not out to assist the veteran in any way. In fact, I think he does everything he can to help get the claim denied. We have filed other complaints in the past due to the inadequate exams that this examiner is giving. Why is he still employed there?
Any help or assistance on what direction I should take would be geatly appreciated. I am getting more frustrated and worn down as each day goes by. Trying to cope with my husbands needs with his knee replacement, along with his other problems, taking care of everything else by myself, along with my health problems, I don't need all of this on me as well.
Sorry for the ranting, but where else can you go, except HADIT, to be able to do this and everyone understands what you are going through.
Thanks for any help you can give me.
mssoup
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