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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
1lonewolf
I got hurt while serving during the Gulf War. They performed reconstructive surgery on both of my Feet(screwed them Together) This has caused me allot of pain and an abnormal gait for all these years. Now I have misalignement and degenerative arthritis in both hips which also catch and pop out every so often. I also have Degenerative Disc Disease, Degenerative Arthritis, 5 bulging discs, a pinch sciatic nerve, and facet syndrome in my lower back. I never went to the VA for treatment for over 19 years other than in 1997 when one of my feet broke and they had to redo it. When My hips and back finally got so bad I could not manage it anymore with over the counter Motrin (Which also caused me to have Barrett's Espophagus). I started going to the VA again. All of my doctors from Podiatry to Ortho said the same thing. That my hips and my back were in the shape they are because of my abnormal gait all these years because I walk on my heels and the sides of my feet for obvious reasons. I am in constant pain and they have prescribed my morphine 60 mg a day and hyrdrocodone 10s 4 times a day. I have to go every 6 months for nerve burns in all five lower vertebra. I also take sleeping pills prescribed by them. I was told by all my doctors that this would only get worse with age and I am only 40 and can barely move now. There was however one very brash and rude older female doctor in Ortho who has always had an overall demeanor with me that my conditions are not related to walking on my heels and my abnormal gate. This is the same doctor who pushed bruised on me and sent my to Physical Therapy before she even knew what was wrong with my back or hips. She is also the Doctor who showed up to perform my C and P examination btw! I knew when I saw her that This was a waiste of my time and what she would do for my claim. Keep in mind that I was granted 10 percent for my right hip last Jan for Degenerative Arthritis and popping. This C and P exam was done by another Honest Doctor who followed procedure and code 38 regs. So here I am with the Doctor who treats all Vets like animals about to do a C and P exam on my back and left hip. She pulled the muscles in my right ribs during trunk rotation by grabbing my arm and extending me and she forced me to squat when I cannot and I cound not back up. Needless to say when I left I was hurting so bad I had to go home and take some med and lay down for a few hours. I hurt for over a week! I just got my claim back today and Not only was it denied but they took the 10 % away for my right hip. She wrote that my conditions were not related to abnormal gate. Not only that she answered the questions using her own opinion and not medical facts and did not even perform all the tests she was supposed to in accordance with the 38 references. They can do and put whatever they want and put your life on hold. Now I have to appeal. Gait causes all kinds of problems! You can find evidence to the contrary as she has but there is plenty of information all over the internet to prove that. It is common sense. Now here I am appealing because of one doctor who should not even have a job treating Vets they way she is. I feel everyones pain and wear ankle braces and walk on a cane both issued by the VAMC! The letter I got today should have been and would have been 100% if it had not been for her and her plight to disprove and mistreat all Vets she treats or examins! Now my life continues to be on hold thanks to her and I have lost everything and can barely walk. I am mad as hell right now and disgusted. All those years I tried my best to not go to the VA and now here I am almost crippled, in constant pain even with the meds they give me, and alone. I cannot work as I cannot sit, stand, walk, or even lay down for any period of time. I sleep very little even with sleeping pills they gave me, and I am denied and they even took the 10 % they gave me in Jan 09 for my right hip. I welcome any and all replies, support, and even guidance. I am at the end of my rope, have lost everything, and I am a former Executive that is penniless and virtually crippled at 40. I have listed my current conditions below and will start my appeals process Monday. If I could move or walk or sit or do anything I would go back to work but now I cannot!
Pes Planus with Plantar Fasciitis, Bilaterally 10 %
Right Hallux Valgus Post resection 10 %
Lef Hallux Valugus Post resection 10 %
a few other feet conditions and resections that go into the descriptions above.
degenerative Arthritis Right Hip 10 % (taken away and severed as of today by the VA)
degenerative Arthritis Left Hip Denied
Degenerative Disc Disease of spine Denied
5 Bulging Discs Denied
Pinched Sciatic Nerve
We never hesitated when they asked us to fight for our country and now they drag us through the MUD when we need compensation for our injuries in doing so. 1_Lone_Wolf. US ARMY 1988-1991. Disabled but not going to give up!
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