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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
allan
Judge rebukes Bay Pines VA leaders
By William R. Levesque, Times Staff Writer
In Print: Tuesday, November 24, 2009
TAMPA — Four women who won a $3.7 million verdict in July against the Bay Pines VA Medical Center thought the big award would be a hard lesson learned for the facility's administrators.
But even after a jury decided that Bay Pines illegally retaliated against the women for filing workplace discrimination complaints, none of Bay Pines leaders were dismissed or reprimanded.
"The message Bay Pines gave employees is, 'No matter what you do, nothing is going to happen. We're not going to change,' " said Dr. Claudia Cote, one of the four who won the verdict.
That changed Monday when a federal judge offered a stunning rebuke of administrators at the nation's fourth-busiest veterans hospital, barring them from any further retaliation against their work force of 3,000 employees over discrimination complaints.
And the judge ordered administrators back to school, requiring Bay Pines director Wallace Hopkins, his chief of staff and his chief of medicine to undergo "remedial instruction" on preventing workplace discrimination and retaliation.
U.S. Magistrate Judge Tom McCoun said his order is necessary because "discriminatory conduct" would continue without court intervention.
"Indeed, it appears that no changes have been made at all at Bay Pines VA in response to the verdicts in this case," McCoun's order said.
A spokeswoman at Bay Pines in St. Petersburg declined comment, saying she had not yet seen the judge's order. Administrators have denied allegations of retaliation or discrimination.
Cote, who along with the other three plaintiffs still works at Bay Pines, said the judge's order sends a clear message to management that it must respect the law. (Because the law caps jury awards for pain and anguish, the final verdict had been expected to be reduced to $1.33 million.)
Federal law forbids retaliation against employees who file a complaint of workplace discrimination.
"The attitude after the trial is that there has been no change in the culture or atmosphere at Bay Pines," said Cote, a 17-year employee of the Department of Veterans Affairs. "There has been no accountability after the verdict. Nothing has changed. It's just a continued denial of wrongdoing."
If the court were to find that Bay Pines violated the terms of McCoun's order, hospital administrators could face sanctions, including fines.
Joe Magri, a Tampa attorney representing the four women, said, "I'm hopeful the climate at Bay Pines will now change."
McCoun also specifically barred Bay Pines from taking any disciplinary action without an independent review by someone outside the hospital against the four women who sued.
Aside from Cote, the four women are Dr. Sally Zachariah, Dr. Diane Gowski and Roxanne Lainhart-Bronner, who lawyers said was punished for speaking out against retaliation.
The four women painted an unflattering portrait of work life inside Bay Pines during a three-week trial in U.S. District Court in Tampa, saying their bosses made their work lives miserable after they alleged sex and age discrimination.
They received poor work evaluations from supervisors who also denied them choice assignments with higher pay, their lawyers argued.
They said management specifically targeted the Equal Employment Opportunity system, in which workers who allege discrimination can file complaints.
Hopkins and Dr. George Van Buskirk, medical chief of staff, and others wanted to crack down on those who filed discrimination complaints, the women said. The result: Complaints fell by over 50 percent.
Lawyers pointed to one 2007 memo as proof of discrimination.
Written by a Bay Pines program support assistant — not one of the plaintiffs — it said her boss warned her, "If I were you, I wouldn't file an EEO complaint. Trust me, you don't want to file. If you file an EEO complaint, you're only going to make it harder on yourself."
William R. Levesque can be reached at levesque@sptimes.com or (813) 226-3432.
http://www.vawatchdog.org/09/nf09/nfdec09/nf120109-2.htm
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