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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”-
- 0 replies
Picked By
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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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
Picked By
Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
allan
Citation Nr: 0836956
Decision Date: 10/27/08 Archive Date: 11/05/08
DOCKET NO. 05-25 483 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Oakland,
California
THE ISSUE
Entitlement to service connection for a left shoulder
disability, including as secondary to a service-connected
cervical spine condition.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
S. Richmond, Counsel
INTRODUCTION
The veteran had active military service from December 1952 to
October 1958.
This matter comes to the Board of Veterans' Appeals (Board)
from a December 2005 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Oakland,
California, which denied service connection for a left
shoulder disability. The veteran was scheduled for a Board
hearing in March 2007 but failed to appear or indicate any
desire to reschedule.
The Board remanded this case for additional development in
June 2007.
FINDING OF FACT
The medical evidence shows that the veteran's service-
connected cervical spine disability has aggravated the left
shoulder disability beyond its natural progress.
CONCLUSION OF LAW
The criteria for service connection for a left shoulder
disability have been met. 38 U.S.C.A. §§ 1110, 1131, 5103,
5103A, 5107 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.159,
3.102, 3.303, 3.310(a)(b) (2007).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
The veteran seeks service connection for a left shoulder
disability, which he contends is related to his service-
connected cervical spine disability.
In seeking VA disability compensation, a veteran generally
seeks to establish that a current disability results from
disease or injury incurred in or aggravated by service. 38
U.S.C.A §§ 1110, 1131. "Service connection" basically
means that the facts, shown by the evidence, establish that a
particular injury or disease resulting in disability was
incurred coincident with service in the Armed Forces, or if
preexisting such service, was aggravated therein. This may
be accomplished by affirmatively showing inception or
aggravation during service or through the application of
statutory presumptions. Where chronicity of a disease is not
shown in service, service connection may yet be established
by showing continuity of symptomatology between the currently
claimed disability and a condition noted in service. A
veteran may also establish service connection if all of the
evidence, including that pertaining to service, shows that a
disease first diagnosed after service was incurred in
service. 38 C.F.R. § 3.303.
In addition, service connection can be granted on a secondary
basis. Except as provided in 38 C.F.R. § 3.300©,
disability which is proximately due to or the result of a
service-connected disease or injury shall be service
connected. When service connection is thus established for a
secondary condition, the secondary condition shall be
considered a part of the original condition. 38 C.F.R.
§ 3.310(a). Any increase in severity of a nonservice-
connected disease or injury, which is not due to the natural
progress of the nonservice-connected disease, will be service
connected. However, VA will not concede that a nonservice-
connected disease or injury was aggravated by a service-
connected disease or injury unless the baseline level of
severity of the nonservice-connected disease or injury is
established by medical evidence created before the onset of
aggravation or by the earliest medical evidence created at
any time between the onset of aggravation and the receipt of
medical evidence establishing the current level of severity
of the nonservice-connected disease or injury. 38 C.F.R.
§ 3.310(b).
When all the evidence is assembled, VA is responsible for
determining whether the evidence supports the claim or is in
relative equipoise, with the veteran prevailing in either
event, or whether a preponderance of the evidence is against
a claim, in which case, the claim is denied. 38 U.S.C.A. §
5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
The record shows a present left shoulder disability. An
August 2000 VA examination report notes that the veteran had
loss of motion in the left shoulder joint. The continued
left shoulder difficulty involved the trapezius muscle and
glenohumeral joint. The trapezius symptoms were diagnosed as
muscular strain and the glenohumeral joint pain and loss of
motion were diagnosed as frozen shoulder syndrome secondary
to chronic rotator cuff impingement and tendonitis. An
October 2004 VA x-ray examination report shows moderate to
severe degenerative joint disease in the left shoulder. A
June 2008 VA examination report shows degenerative arthritis
in the left glenohumeral and acromioclavicular joints.
The service medical records show the veteran fell and injured
his neck and upper back in February 1958 and had complaints
of pain in the neck and left shoulder. A September 1958
medical record shows complaints of intermittent pain in the
left shoulder and neck of increasing severity and frequency.
X-ray studies of the left shoulder were normal.
As the record shows a present disability in the left shoulder
and in-service injury to the neck with complaints of pain in
the left shoulder, the determinative issue is whether there
is any relationship between these. Associated with this
determination is whether there is any relationship between
the left shoulder disability and the service-connected
cervical spine disability.
An October 1959 VA examination report, one year post-
discharge, showed full range of motion in the left shoulder.
Neurological evaluation showed some poorly defined mild
tenderness located over the upper border of the left
trapezius and extending upward toward its insertion in the
cervical spine area. An April 1962 VA orthopedic examination
report showed full range of motion in the upper extremities.
The shoulder joints also were reported to be "okay" on a
December 1996 VA examination report.
An August 2000 private medical record shows the veteran
apparently was lifting a bucket in February and felt a pop in
his left shoulder. On physical examination, he had
limitation of motion in the left shoulder. The assessment
was at least partial tear of the rotator cuff, which scarred
and resulted in a frozen shoulder.
In August 2000, a VA examination report shows that some of
the left shoulder pain was diagnosed as referred pain from
the neck. The examiner found that the veteran definitely
recalled some left shoulder difficulty in the military but he
stated that it was feeling well one year after the military.
The shoulder continued to do well for many years and started
with pain one year ago and progressed to loss of motion about
six months ago. The examiner determined that the shoulder
problem was separate from the neck and that the veteran
probably would have developed the shoulder symptoms even
without the neck problem. However, the examiner also
determined that the trapezius portion of the shoulder
symptoms was part of the neck problem; so it was related to
the neck. The veteran always had some degree of trapezius
difficulty on the left since the military. Considering that
some of the left shoulder difficulty was related to the neck
and military and some was probably unrelated, the examiner
concluded that the present loss of motion could be partially
considered secondary to the military. For instance, it would
be reasonable to say that five degrees of the loss of
external rotation and five degrees of the loss of internal
rotation at the left shoulder would relate to the trapezius
muscle portion of the difficulty and this would relate to the
military. A 20-degree loss of elevation and 30-degree loss
of abduction also would relate to that.
The veteran underwent surgical injection and closed
manipulation of the left shoulder in November 2000.
A February 2004 VA examiner determined that the veteran's
service-connected cervical spine disability affected the
range of motion of the left shoulder but did not cause
intrinsic damage to it.
A June 2008 VA examination report shows the veteran thought
his left shoulder problem was caused by the neck. He did not
recall any orthopedic difficulty before the military or in
basic training. The neck became painful later in the
military when he was injured as a cook. He also had some
shoulder discomfort at that time. He was able to resume full
duties and stated that he was at full duty status in the last
three months of the military. At one year after the military
he thought he was still having some left trapezius muscle
discomfort; he did not recall whether he had pain at either
shoulder. He also did not recall any upper extremity
symptoms at that time. The neck continued to be bothersome
but the left shoulder apparently did well for many decades.
There might have been some left trapezius muscle discomfort
off and on that was associated with the neck; however, the
shoulder joint itself apparently was not bothersome. The
first time he could recall pain or difficulty in the left
shoulder joint was in about 2000. The left shoulder pain
started at that time with lifting.
In the examiner's opinion, the veteran would have had the
left shoulder problem even without the neck difficulty or the
military experience; neither the neck nor the military caused
a weakness of the shoulder. If the shoulder was related to
the neck or the military the examiner would have expected
symptoms much sooner than 2000. It was the examiner's
opinion that it was less likely than not that the present
left shoulder symptoms were related to the neck or the
military. In addressing aggravation, however, the examiner
found that the veteran's favoring of the neck probably made
the left shoulder symptoms more bothersome. If this was
considered to be an aggravation, the baseline status for the
left shoulder would be the same as the present examination
except for less pain. A percentage on this was that 80
percent of the present left shoulder difficulty represented
the basic problems at the left shoulder. Twenty percent of
the present left shoulder difficulty represented increased
pain due to favoring the neck.
The medical evidence shows that the present left shoulder
disability is not directly related to service or the service-
connected cervical spine disability. Although the veteran
had complaints of pain in the left shoulder in service, his
left shoulder arthritis and frozen shoulder did not manifest
until after his post-service injury in 2000. The February
2004 VA examiner found that the cervical spine disability did
not cause any intrinsic damage to the left shoulder and the
VA examiners in August 2000 and June 2008 further found that
the veteran would have had his left shoulder disability with
or without his cervical spine disability or military service.
The medical evidence does show, however, that the veteran's
service-connected cervical spine disability has aggravated
the left shoulder disability. Both the August 2000 and June
2008 VA examiners were very specific in the percentage of
left shoulder symptoms they attributed to the cervical spine
disability and those they did not. The baseline level of
disability has been established by the medical evidence prior
to August 2000 showing full range of motion in the left
shoulder. After the injury in February 2000, the cervical
spine disability was shown to affect a portion of the
veteran's limitation of motion in the left shoulder. Thus,
the cervical spine disability has aggravated the left
shoulder disability beyond its natural progress. To the
extent that the impairment in the left shoulder has been
aggravated by the cervical spine disability, the veteran is
entitled to compensation for the left shoulder disability.
See 38 C.F.R. § 3.310(a)(b).
The veteran's service connection claim for a left shoulder
disability secondary to the service-connected cervical spine
disability has been considered with respect to VA's duty to
notify and assist. Given the favorable outcome noted above,
no conceivable prejudice to the veteran could result from
this adjudication. See Bernard v. Brown, 4 Vet. App. 384,
393 (1993).
ORDER
Entitlement to service connection for a left shoulder
disability, including as secondary to a service-connected
cervical spine condition is granted, subject to the rules and
payment of monetary benefits.
____________________________________________
RONALD W. SCHOLZ
Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs
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