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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
My Monster
I will attempt to not get long-winded. I have been going to PT for my neck and shoulder. PT won't touch my shoulder until I go to Ortho, well I did that today. He says he wants to do surgery but won't do surgery on my rotator cuff until I get some more ROM in it first. He did give me a Cortizone shot and a note to PT to start on my shoulder. With me so far? Ortho says, yes there is arthritis, yes there is separation and yes RC is a fricken mess that will require surgery. He looked at my neck x-rays, (they were on the same CD) and stated that I need to get to a Neurosurgeon, that it looks "real bad". Great. He spent a lot of time looking and talking about my neck. He said that I am looking at surgery on my neck based off the x-rays and wanted to know why I was going to a Neurologist before a Neurosurgeon. I told him that my Primary wanted an EMG done first to figure out where my nerves were getting pinched off. So it ended with him telling me I needed to prioritize my surgeries.
1. Epidural for my lumbar spine. (Kinda want to hold off on that until I get my "new" C&P exam, SC for 10% DDD.)
2. Knee surgery to clean out some of my meniscus (10% SC for arthritis, didn't know you could claim meniscus separately but will put in for it.)
3. Shoulder surgery (VA denied and diagnosed shoulder strain, well I am going to fight that one with them as it is now diagnosed as arthritis, separation and R/C.)
4. Cervical neck surgery ( based off of the Ortho doc's opinion, and my Primary's.)
Which to do first...? I put in a claim for my neck, received the Notice to Assist, will send it back asking for more time to gather my "evidence" ( doc write-ups, MRI's and Radiologist's Report ). My VSO is waiting for my EMG results to fight my CTS denial, the Ortho and PT report to fight the shoulder denial. I am so fricken' confused on what to do...I am coming up on my 1-year post retirement date. I don't want to take the damn "shot-gun approach, but several of my doc's have said that I have a multitude of problems that I should of had addressed while I was on Active Duty and are amazed that I made it this far before bitching about the pain.
HELP!!!
Monster
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