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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
carlie
From: "Vets Commission" <veterans@vetscommission.intranets.com>
Subject: Social Security Disability Insurance (SSDI)
Date: Tue, 16 May 2006 15:32:30 +0000 (America/Los_Angeles)
Thank you for taking the time to express your experiences, thoughts, and opinions to the Commission
related to its pending decision whether or not to include Social Security Disability Insurance
(SSDI) in its analysis of compensation and earnings of service-connected veterans in order to assure
that they are properly compensated for their disabilities.
Your views are being considered in preparation for an anticipated decision on May 19, 2006, on this
matter.
In response to your concerns, we also wanted to provide you with additional background on the
Commission’s deliberations and intent as well as to address possible misconceptions that seem to be
surfacing in different forums.
There are allegations on the internet and distributed through (email) mailing lists, for example,
that claim the Commission intends to propose offsetting benefits or reducing benefits. These
allegations are misinformation and a serious disservice to both the Commission and all veterans.
This is definitely not the intent of the Commission.
Of the thirteen Commissioners, twelve are veterans and nine are combat veterans. Combined they have
over 260 years of military experience and many service honors, accomplishments, and awards. The men
and woman who serve on the Commission are dedicated to conducting a thorough, objective, and
impartial assessment of the full range of programs and services intended to meet the needs of
disabled service members, veterans, and survivors. The Commission exercises this mandate with an
acute awareness and deep appreciation of the service and sacrifices made by those who are most
affected—the service disabled and survivors.
There also seems to be some confusion between SSDI and Social Security retirement benefits.
Understanding the Differences between SSDI and Social Security Retirement Benefits
SSDI is a benefit for individuals who are below the normal eligibility (retirement) age for Social
Security and are unable to work. They must meet criteria within a narrow definition of disability
and have a medical condition expected to last a minimum of one year or result in death that prevents
them from working. At about age 65, recipients of SSDI then convert to Social Security retirement
benefits.
While the Departments of Veterans Affairs (VA) and Defense (DoD) programs compensate individuals
with partial disability, the Social Security Administration (SSA) does not. SSA regulations also
restrict how much a person may earn and continue to qualify for SSDI (VA and DoD do not).
Currently, the income limit for SSDI recipients is $860 per month.
The Commission’s consideration of SSDI does not extend to regular Social Security retirement
benefits.
Background on SSDI and Commission Discussions
There are some veterans in receipt of VA disability compensation who also receive SSDI. The SSDI
payment may cover the same disability, a combination of service-connected and non service-connected
disabilities, or disabilities completely unrelated to military service. The frequency and amount of
SSDI benefits received by disabled veterans are currently unknown. At issue is whether the
Commission should collect this information and include it in its assessment of the appropriateness
of the level of benefits provided to veterans for disabilities resulting from military service.
During the March 2006 meeting, the Commissioners discussed the law establishing the Commission
(Public Law 108-136) and its charter as background for further discussion on the SSDI matter.
Specific focus centered on interpreting the intent of Congress when creating the law and what that
means in terms of the Commission’s authorities. The Commission members also discussed how data
could be acquired from SSA and how it could be matched to data from VA as well as how results could
be interpreted if SSA data were collected.
At the end of the March meeting, the Commission elected to defer a decision on SSDI until the May
meeting so that the Commission staff could research the relevance and usefulness of SSDI data.
Commission Chairman Scott offered the Armed Services and Veterans’ Affairs Committees of the House
and Senate an opportunity to comment on the issue.
A combined document, reporting Chairman Scott’s request and the responses, is posted on the
Commission web site at: http://www.vetscommission.org/documents/SSDI_Clarification of Congressional
Intent.pdf
The Commission meets monthly (with a few exceptions). The meetings are open to the public and time
is set aside at these sessions for public comment.
You will find frequent updates to Commission materials and other information including announcements
of our monthly meetings on our website at http://www.vetscommission.org.
Carlie passed away in November 2015 she is missed.
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