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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
mssoup1
May 19, 9:27 PM EDT
House Conservatives Cut $500M Off Vet Bill
By JIM ABRAMS
Associated Press Writer
WASHINGTON (AP) -- House conservatives, rejecting protests from fellow Republicans who said they were depriving troops of needed support, stripped $500 million in military construction projects from a veterans spending bill Friday.
Democrats blamed GOP-backed tax cuts and a tight budget passed two days ago for creating a fiscal crisis leading to the cuts, most of which were for new facilities at various military bases. The bill provides a 10 percent increase for veterans programs.
"I don't know why they (the troops) should be stuck in the middle of a family squabble within the Republican Party," said Rep. David Obey of Wisconsin, top Democrat on the House Appropriations Committee.
The conservatives, led by Rep. Jeb Hensarling, R-Texas, used parliamentary procedures to delete some 20 projects worth $507 million from the $94 billion spending bill for military construction and veterans programs in fiscal 2007, which will begin Oct. 1. The overall bill passed 395-0.
Writers of the legislation, seeking to meet limits outlined in the just-passed budget, had taken the money for the projects from a $50 billion war reserve to fund urgent projects, a move characterized by both conservatives and Democrats as a budgetary gimmick.
Rep. Jeff Flake, R-Ariz., a fiscal hawk, asked how $18.1 million for a bachelor enlisted quarters at Camp Pendleton in California or $102 million for a brigade complex at Fort Lewis, Washington, could be considered emergency spending.
"The ink is not even dry on the budget and we are already attempting to violate it, and that's simply not right," said Hensarling.
The conservatives also noted the bill contained some 66 other earmarks, or projects requested by individual members, costing the same $500 million.
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But Rep. James Walsh, R-N.Y., chairman of the subcommittee that wrote the bill, slammed Hensarling, saying, "He does not understand that we are at war."
"Please don't come out here and lecture us," Rep. Ray LaHood of Illinois, another GOP member of the Appropriations Committee, told the conservatives. "Pick another bill, not this one."
Rep. Mike Pence, R-Ind., a leader of the conservatives, told reporters this would not be the last spending battle. "I think you are going to see an ongoing effort by House conservatives to see this Congress live within our means."
Democrats also pointed out that, while the bill approves record levels of spending for veterans' and active duty health programs, it falls $735 million short because the House did not go along with a White House request for fee increases for military retirees eligible for Tricare, the Defense Department's health care system.
Rep. Chet Edwards of Texas, top Democrat on the military quality of life and veterans affairs subcommittee, said that shortfall, coupled with $316 million in underfunding for base closings and the $507 million cut from construction projects, left the bill $1.5 billion short of what was needed.
"This sends a terrible message to our troops here at home, in Iraq, and Afghanistan," Edwards said.
Democrats proposed paying for the 20 projects, the $735 million for active duty health care and the $1.82 billion increase in veterans' health care by trimming tax cuts for those making over $1 million annually. The proposed amendments were ruled out of order.
The White House, while expressing support for the legislation, issued a statement questioning some of its components. It criticized the use of war reserve funds for military construction projects, and urged Congress to eliminate the 66 earmarks that the administration had not requested.
It also opposed cuts in spending to carry out the 2005 base closing act, and urged Congress to consider administration proposals to increase copayments and enrollment fees for higher-income non-disabled veterans and for military retirees under 65 using Tricare.
The bill provides $25.4 billion for veterans' health programs, up $2.6 billion from the current fiscal year, and $21 billion for the Defense Department health program, up $1 billion. Some $5.5 billion is funded for base closing activities, $6.6 billion for military construction and $4 billion for family housing construction.
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The bill is H.R. 5385.
On the Net:
Congress: http://thomas.loc.gov/
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