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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
Advocacy Tips (from the same link as Broncovets previous post)
1. Many of the written arguments VA receives in support of claims for VA benefits from veterans’ advocates do not appear to appreciate that the principal reason a written argument is submitted to VA is to persuade the VA decision maker to rule in favor of the claimant. Everything that appears in a written argument must focus on persuading the VA to grant the claim. Anything that does not help persuade VA to rule in favor of a claim should be omitted from a written argument.
2. When a veteran’s advocate files a written argument with VA on behalf of a claimant, the advocate is presenting
the VA decision maker with a problem. The advocate is also asking the VA decision maker to solve the problem.
Rather than simply asking the VA decision maker to solve the problem, the veteran’s advocate should provide the
VA decision maker with a recommended solution to the problem. For example, in a claim by a veteran for service connection, rather than simply stating that the veteran seeks service connection for a particular disability, the advocate should explain to the VA
decision maker—in detail—how the decision maker can award the veteran service connection based on the evidence and the controlling law.
3. The veteran’s advocate should make it easy for the VA decision maker to read the advocate’s written argument.
The advocate’s arguments should double-spaced, employ large fonts, and provide lots of white space.
4. Too many written arguments present VA decision makers with too many issues to consider and decide.
This is counterproductive. If possible, the veteran’s advocate should present no more than two or three issues to
VA. Presenting more issues to a VA decision maker may suggest to the decision maker that the advocate believes that he or she has a weak case; is unable to identify a “winning” argument for the VA; or expects the VA decision maker to identify a winning
argument for the veteran’s advocate because the advocate in unable to do so. Ask yourself this question: If the advocate is unable to explain to VA why it should grant a claim, why shouldthe VA grant the claim?
5. If the veteran’s advocate determines that the outcome of a claim is governed by a particular statute, regulation,
court opinion, VA manual provision, or VA general counsel opinion, the veteran’s advocate should quote the controlling language from the governing statute, regulation, court opinion, VA manual provision, or general counsel opinion in the advocate’s written
arguments to VA. By quoting the actual language from the governing statute, regulation, court opinion, VA manual
provision, or VA general counsel opinion, the veteran’s advocate will help make the job of the VA decision maker
easier.
6. The advocate should not present a policy argument as a replacement for controlling statutory or regulatory language.
The advocate should not argue about what Congress should have done while ignoring what Congress actually did in a statute. Do not argue about what the law should be. Instead, argue about what the law is and explain why the veteran is entitled to claimed benefits under that law.
7. Any written argument that a veteran’s advocate submits to a VA regional office or the BVA should contain an
accurate statement of facts. A good statement of facts will help orient the VA decision maker to the evidence and
issues involved in the case and will assist the VA decision maker to understand what the case is about.
8. Do not misstate the holdings of Court opinions. If an advocate misstates the holdings of court opinions
and the VA decision maker discovers these misstatements, the VA decision maker can make two conclusions: One,
the VA decision maker may conclude that the advocate intentionally tried to mislead. Two, the decision maker may
conclude that the advocate is sloppy and unprofessional. Neither conclusion will help achieve a successful result on
the veteran’s claim.
9. If the record contains evidence that is against the award of the veteran’s claim, the veteran’s advocate must not
ignore this evidence. Even if the advocate ignores unfavorable evidence, the VA decision maker will not ignore it.
Therefore, the veteran’s advocate must identify any evidence that is against the veteran’s claim and try to minimize
its adverse effects on the veteran’s claim.
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