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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.
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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
myround0
Put the VA on 12 hour shifts every other month for about 2 years.
When a case goes to claims, it SHOULD BE SOLVED THERE.
If a case is forwarded from claims to a DRO, then if the DRO awards the case then someone in claims should have to answer as to why the case was forwarded to the DRO.
The same should happen when a claim is sent from the DRO to the APPEALS process.
Once all the information for a case is in, the VA should have one month to review it and get a decision to the Veteran making the claim.
When you look at the VA metric. 95 percent of cases are solved at the Appeals process. That to me reveals either people at the regional office either don't know their job and are there just to collect a check, which is unacceptable, or they do know their job, but refuse to do it. Where are the leaders at these regional offices. I just don't understand how you can have an open ended timeline, when you are providing a service to someone. At what point do you as a service provider, who is getting paid to perform a service, feel the need to PROVIDE THAT SERVICE.
All of my documents are there at the VA since March 2008, I know they are there because the rendered a denial decision on January 13, 2009. I served an NOD on January 22, 2009. I selected a DRO. I was given a SOC in September 2009, and on October 7, 2009, I returned the VA form 9. I know some will say my case is moving rather quickly. However, that isn't the point. The case should have been decided favorbly in the claims portion, and it should not take a full year. Once you have all the information, a folder should be moved to the ready for review stack.
That is my case, but so many others have endured the same process. The Va has put the onus on the BVA appeals team, when it should be placed at the front end, the Regional office claims team should be held accountable, as well as the Regional Office appeals team. If I were the ships Captain, Veterans Service Center Manager, my first brief would include fixing and resolving matters in our OWN HOUSE. We would do our best to resolve claims locally, and not let them back up our system. Some tough love needs to be applied.
All the talk about adding electronic or automated files making rendering a decision faster and more accurate only works when the service provider works. So you can do whatever you like, it comes down to leadership and the staff willing to DO THEIR JOBS, at every level, and, STOP PASSING THE BUCK.
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