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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
EODMOMMY
I am new to the board, but I have lurked for a little while. I just recently started posting.
My husband was medically retired from the Air Force in October of 2002, after serving for 21 years. We started his VA disability claim when we where notified he was going to be medically retired.
The Air Force Physical Evaluation Board retired him on these Categories:
Category I: Unfitting Conditions which are compensable and rateable: Gastroespohageal Reflux Disease associated with non-cardiac chest pain and dyspnea on exertion. (I actually think the PEB board messed up on this one, because his doctor who did the package to the board listed Cardiac Syndrome X as a reason also). The Air Force gave him a 10% rating, not that it did anything for us, since he would get his retirement pay.
Category II: Conditions that can be unfitting but are not currently compensable or rateable: Chronic knee and Shoulder Pain. He did injure his shoulder and knee while on active duty and had surgery on both of them. His shoulder was separated, but the ER docs made it worst, because they thought it was dislocated and tried to manipulate it back in place, finally an orthopedic doctor who was in the next room came into the room we where in and said that his shoulder should have gone back into the joint by then and asked what my husband's name was and looked at the x-ray and came in and said that it was not dislocated, but it was separated. So he had surgery on his shoulder in which they pinned it, but it didn't work, because he bent the pins somehow and they had to remove them. If you look at a shoulder x-ray of him now, he is missing part of his clavicle, because the pinning process never got to take effect to grow new bone. Plus it got worsen when he got shot by a Sherman Tank....he is not a WWII vet, but he got shot by a Sherman tank...you should see the doctors' faces when they hear that one. He was at a 50th Anniversary of VJ day and was setting up charges for a plane flyover, so it would look like they where bombing. This person driving the tank thought it would be funny to shoot over the EOD guys' heads and when he aimed the tank (which was moving) hit a dip and a wad from a 75mm shell hit him square in his injured shoulder. It took an old retired Marine to get the guy out of the tank after it happened, he wouldn't open up the hatch. Of course I didn't find out about any of this till after he was seen at the ER, the doctors wanted to call me and he said "NO!" and the other EOD guys told the doctor it wasn't wise...they knew me too well!! Anyways, he also reinjured the shoulder again while on a range clearance, he got hit by some bar that was sticking out of a truck. The VA did give him 10% for his shoulder.
Once he got his first VA decision which was 20% for his shoulder and knee. They did put the GERD as service connected, but gave him a 0%, because they said it was being controlled by medicine. That is debatable, he still has a lot of acid reflux, regurgitation and he gets chest pains, which is part of our NOD on the decision. The gastroenterologist doesn't feel the chest pains are related to the GERD, because he put him on a course of meds (basically overdosing him on reflux medication) for a few weeks and it didn't help the pain any. His cardiologist came up with the Cardiac Syndrome X or vasospasms. He has had 3 cardiac caths (2 while on active duty) which came back normal (no blockages or other abnormalities) and echocardiograms, stress tests, etc. He does show some occassional EKG changes when he gets near max exhertion and starts to have some chest pains. He has high cholesterol and high triglycerides and is on 3 meds at the moment for that and was diagnosed as being borderline insulin intolerance. Which is common in Caridiac Syndrome X. When he gets a chest pain episode and the nitroglycerine doesn't help he ends up in the ER, he doesn't have to be doing anything ot get the attacks. He has had several admissions to the hospital to run tests when these episodes happen, but they usually come back normal or inconclusive. The cardiologist can't say if the chest pains are cardiac related, GERD related or both. All I know is I am tired of the VA saying that angina is a symptom (yes, I know it is), but his is chronic and started while on active duty. So they will not give him a rating other then 0% for this under his heart or under GERD. It has gotten to the point that my husband will ignore the attacks unless they are so bad that his gets diaphoresis and will almost pass out. It has worried his co-workers many times. I am afraid that one day he will ignore it and it will be the real thing.
I need to get him to call the VA, but he is working and going to school, so most of the time he is asleep or at school or work. The VA won't talk to me and the our state's Department of Veteran Services is suppose to be helping out, but I haven't seen or heard from them.
When he was retired, I found a job before he did and was working full time, but my boss and I came to blows over favortism in the office and the fact that I was not getting out of work when I was suppose to and was always late to pick up my kids at daycare. By that time my husband had found a job and told me to quit. This was before his first VA decision came thorugh. I am in school at the moment and work part time subbing for our school district, but that isn't enough live on with three kids. My husband's first job actually put him in the hospital because of his condition...they had him working 18 hour days, because the district manager wouldn't get off his butt to find another manager to help him out. He was working 40 miles away and I wouldn't let him drive home, because I was affraid he would fall asleep at the wheel. So I had him stay at a motel near his work. If he did get home, he would almost have to turn around and go back to work. This went on for about a month. I went up to visit him at work and he looked awful, he had lost a lot of weight, which I had noticed before this, but this one night he was so pale and in pain. I called 911, but he refused to go to the hospital, because he didn't have anyone to close the store. So the kids and I stayed till closing time and I took him to the ER. He was admitted to the hospital for a week. All his cardiac enzymes elevated, except the one for his heart and his metabolism was way out of wack. It was only a matter of time and he could have gone into heart failure. His district manger was pissed when the store didn't open the next day and called me (BTW, I forgot to mention I called him on his cell phone and left over a dozen messages up till about 3 a.m. in the morning), he said he was out of town and that it was his answering service I got, which I knew was B.S. Luckily, someone steered us towards another job and they hired my husband knowing his condition and have been wonderful working with him when he has had chest pain episodes.
So any suggestions on my husband's situation?
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