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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
Joe Everyman
I'm nothing and nobody special, but I'm here because I'm angry and have to speak up. This seems like a good place to say what needs to be said, and then maybe it will be easier for me to deal with life.
About me: I joined the service during the first Gulf War, but spent my entire time in the continental U.S. I enlisted in Mortuary Affairs and worked on a rotation to the local county morgue as part of a joint training program between the army and local government. During my time at the morgue, I saw all manner of wonderful things, including the frozen screams which you may often find on the charred faces of little babies killed in a fire. I also saw fathers and mothers killed by criminals and little children beaten to death by those who should have protected them. I never served in war, but I never can forget their faces just the same.
The army couldn't send everyone in my occupational group to the morgue all the time, so we were put to work in other useful ways, such as picking up cigarette butts and parading around to the satisfaction of touring generals. The other days? Inspection, equipment maintenance, reefer unit packing and unpacking 101, and, best of all, inventory--how many times do we have to count these body bags, sarge? Until I get tired, private. I joke, but this was life. Can't believe it? Oh, beautiful Fort Lee, how I've missed you. Only two hours from Washington, D.C. and no real peace time missions for my MOS. One day, they asked for volunteers and I, desiring a more meaningful service to our nation, stepped forward. That was my first mistake I guess. I was assigned to a battalion task force that would save Uncle Sam money by taking over the duties of a particular service mission that was previously contracted out to private industry. I possess an award certificate with my name on it proving that my efforts helped save our government $350,000. I did not serve in battle or take a bullet in the hip, but I was injured during the mission--doing my job and attempting to fulfill the honorable obligation of serving my country. I will not explain how I was injured, because it is a very personal matter. I will say that it was caused by another soldier through no mistake of my own manufacture. I was utterly blameless in the matter, and for my pains (pun intended) received an injury of a humiliating and intimate nature.
I was no longer able to perform the functions of my MOS (heavy lifting a requirement) and remained unable to do anything, sleep on my back, or sit down for a period of about two months. Did the army send me home with a disability rating so that I could sponge off the government for the rest of my life? Did I meet sympathy or support as a result of my sacrifice? No, quite the opposite.
I was put out of the army for failure to pass a physical fitness test and branded with "unsatisfactory performance" as the reason on my official paperwork. I did not know my rights or that I should have been examined medically to determine whether I was fit for service. I have lived for almost twenty years with the results of my decision to serve: constant pain and memories of mutilated babies. My VA disability rating upon exit from the service for my "service-connected" (non-combat related) injuries? 10%--that's right, I received about $90 a month and the humiliation of explaining to every potential employer why I was put out of the army for unsatisfactory performance.
My problems and the $90 did not seem equitable, so I requested that the VA reconsider my rating 9 years ago. They rated me 30% at that time, which was still very poor compensation considering that I wasn't disabled enough to get social security, but was essentially prohibited from ever making a living wage. I have been unable to keep a job long term because of the limitations of my injuries, but I know that all of us veterans are just sponges soaking up tax monies so that others can work to support our lazy butts (SARCASM) and that VA workers really do care about us... (gag me, right).
At that time, I also asked the VA to look at my depression symptoms, for which I was humiliated and called a liar by those wonderful VA representatives. One good and wise soul went so far as to claim that I was attempting to scam the government and should be ashamed of myself. I fought this battle for seven years, and won in the end. I also appealed the reason for my discharge (which has always been honorable) and was finally rewarded last year with a decision stating that I had not been treated fairly and the reason for discharge was changed to "physical standards". Basically, it means that the army was right to put me out of the service since I can't prove that I was unable to do my job when they made the initial decision, but they don't feel comfortable laying the blame entirely upon me.
I am now receiving an 80% disability rating and cannot get a job. I cannot provide health insurance for my family. I do not get loads of wonderful benefits. I get $1800 a month and accusing looks whenever I attempt to get help for my pain. Even so, after almost twenty years on disability, the money I helped save the government in six months of my three years ($350,000) of active duty service is still much more than I have received (wonder how much interest they made on that money I saved them).
I am currently dying of unrelated illnesses, so my family will be left with nothing shortly, as they get nothing unless I am rated at 100% disabled for at least ten years prior to death. So, it's a shame that I could not have died on the battlefield twenty years ago and saved American taxpayers all the money they've had to spend on me. Now, the punchline to this joke is that those unrelated illnesses are the result of a genetic condition that manifested during the service, but of course they denied my claim... immediately after I requested a congressional inquiry into why they were dragging their feet on the claim. Then they denied an increase in my service connected disabilities rating, and the reason? Well, if I'm reading the explaination letter they sent correctly, their reason is because the rating personnel misunderstood what the examiner put in her notes--which are quoted in the letter, and which the examiner explained to me during the C&P exam. Funny, huh? But the joke is one me, and all of you other vets who have been defecated upon by some drudge hack pissed about their boring government job and all those lying, complaining veterans like me (SARCASM AGAIN). Oh, yeah, while I'm at it... I had sleep apnea in the service but didn't know what the heck that even was... my bunk buddy complained about my snoring constantly, but no diagnosis until 5 years after service... I'm not even going to try to get that one service connected. But I'm a lazy sponging slug who is just trying to get over on the system, so don't mind me.
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