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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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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
allan
VETERANS AND THE UNIVERSAL HEALTHCARE DEBATE
Posted on July 19, 2009 by gordonduff http://www.addthis.com/bookmark.phpvar addthis_pub = \'peapolzmedia\';
FEW VETERAN FAMILIES ARE COVERED BY ANY INSURANCE
HEALTH CARE RATIONED IN AMERICA BY MONEY
By Gordon Duff STAFF WRITER
As a 100% Disabled Veteran, I qualify for full VA health care, including dental and optical. It hasn't been a perfect relationship. I got glasses a decade ago. They were broken and didn't fit when I got them in the mail. The VA has sent me to private dentists as they have not had qualified people available. It has cost me thousands. Specialist referrals are never made or have had year long waits and most problems or illnesses have been misdiagnosed.
The point? The VA is batting about the same as our wonderful civilian health care system but it is getting better, endlesssly better than it was. The VA is crippled from a few directions that, we hope, will not hamper a national system:
Veterans come in 3 health care categories with many subcategories.
Category 3 is huge. It assumes that these vets are employed or retired with full health care covering their families. The VA assumes that the Veterans insurance carrier will cover co-pays and fees also.
The problem with this is that the number of people in the US with health insurance is plunging rapidly. Not only that, but those with coverage are watching that increasingly restricted with severe limitations on treatments and drugs.
Additionally, it has built a system tied to scamming money. The classic case is the endless number of new drugs being pushed onto the market that are either useless, if you are lucky, or totally dangerous. Unnecessary drugs are used because doctors are inundated with "drug pimps" and falsified scientific data. Can an entire country have "erectile dysfuntion?" If Congress is any indication, I would think we may have some fakers out there.
I have experience with the health care systems in Europe and find them superior to those in the US. Many say the French system is the best. Seeing a doctor in Britain didn't take more than 5 minutes, receiving treatment was frighteningly easy and they barely asked my name. When I took out a credit card to pay, they seemed insulted. They said, "Health care is a right, not a product."
It is my belief that we can get the DVA system on track, reform the medical ethics problem and deal with the disability pension problem that is both inundated with claims and totally mismanged.
We can do this the moment the VSOs step aside and a few key members of Congress get their own mental health issues taken care of. Current attitudes about veterans health care, in Congress and even Executive level show clear signs of delusion.
Perhaps those involved have previously existing personality disorders. I wonder if their insurance covers that?
In the interim, the vast majority of veterans have families either without insurance or at risk of losing coverage. Imagine a veteran running down to the local DVA medical center to receive treatment that he can't afford for his own children.
http://www.veteranstoday.com/modules.php?n...le&sid=8002
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