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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
broncovet
At the VA watchdog site, in the comments section, a VA employee admitted to "cherry Picking" Veterans claims..looking for single issue, fast easy claims while passing over multiple issue claims. How fair is this? Could I suggest this, as follows:?
Employees go to supervisor desk for their next claim, which is done in order of date received, unless there is a valid "advance on the docket" claim which would have priority. Employees would not pick their claim..they would be assigned a claim to work..in date order.
As far as complex claims go, each employee would get hard ones and easy ones..in date order, so that it would all even out over a period of a year or so.
Is this really so hard? Even waitresses are often assigned customers by the hostess.
comment follows from the VA watchdog site:
- I will not identify my employment afilliation so take this for what you will....
What was left out of the VA special (aside from many other things) was that if an employee does not get their "points" it has a negative impact on their performance evaluation! Performance evaluations can get you promoted. I have never heard of them getting you bonuses, but i guess anythings possible. And consistently under performing can get you fired! I'm sure this points system had the intent of promoting high levels of production however, what it ends up promoting is working just hard enough to get those points. Many cases would benefit from a more thorough review but due to time limits forced by the required "points system" they are just shoved through as quick as possible. More importantly not all cases give the same value. For example a case with 15 different disabilities being claimed is worth the same amount as eight - A case with 7 different disabilities being claimed is worth the same amount as a claim with only 1. Which do you think is more likely to be done first? Of course, the one that takes the least time for the most points! Or how about claims that are already in progress that need a review to see if they are ready to be rated? Some are 5+ volumes thick and some are the size of a manila envelope. I ask again - what gets done first? Of course, the one that takes the least time for the most points! The same scenario can be applied in any number of situations: old cases vs. new, thick vs. skinny, complicated vs. easy etc etc. Many times employees will "hold" files that could be sent to the rating board, simply because they have enough numbers for the day and because they know they will need them the next day (or God forbid, next week). Easy quick claims are "cherry picked" over others or "stolen" from other employees because they require less output to get the points! As a Vet working within the VA, I do what I can to serve Veterans the way I want to be served, but in the end I to am bound by the "points" system and my ensuing performance evaluations.
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