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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
Warning - this is a long read and I appreciate your guidance and opinions.
Due to remand instructions from BVA, I have a C&P for a Heart Disorder next week.
*** The examiner is to determine the etiology and current level of disability.
*** Also, in the BVA Remand instructions the BVA Judge wrote,
"Moreover, in light of the action granting service connection for asthma
and bronchitis, further discussion of the Veteran's claim of service connection for a
Heart disorder to include on a secondary basis is required.
FYI - to add for consideration - I am service connected for Chronic Suppurative Otitis Media,
(draining infection), this will relate to one of my PCP letters of support you will read further down
in this same post.
The medical evidence I have of record that shows support for SC of Heart disorder is as follows :
June 2, 2000
From my PCP to DVA.
XXX has been a patient since 1998.
She has multiple,severe medical conditions which are more likely than not related to her military service.
2. Congestive Heart Failure - she did have congenital heart abnormality of endocardial fibroelastosis which
was treated at age 8 months at XXX Children's Hospital.
Currently has severe shortness of breath on exertion with 36 percent Ejection Fraction, which was
presumed to be normal when she went into service.
She is currently unable to work due to her Cardiac condition
3. Asthma and emphysema requiring multiple visits to our clinic, missed work, multiple medications.
There is evidence that she was having respiratory problems while in the military.
January 12, 2001
From my PCP to DVA - Memorandum - XXXXXX - Veteran's Service Center Manager
2. Congenital heart condition was severely aggravated this year requiring frequent Cardiology visits
and side effects from medications.
I feel that her lung disease is aggravating this condition. I feel that her heart condition existed
while in the military.
3. Asthma - I feel her recurrent episodes of Bronchitis in the military were highly related
to her Asthma.
January 12, 2001
From my PCP to DVA - Memorandum - XXXXXX - Veteran's Service Center Manager
Patient XXX was seen today for Congestive Heart Failure, Asthma and Depression.
I feel she is permanently disabled. If any questions please call XXX-XXXX.
January 18, 2001
The RO's - VSCM sent a Memorandum back to my PCP with these questions (and others).
2. What is the etiology of the veteran's current Heart condition ?
Reply from my PCP
She had endocardial fibroelastosis as a child.
Currently she has improved ejection fraction of 40 percent, but in 1999 before medication and
Cardiology titration of medication her ejection fraction was 36 percent with dilated Cardiomyopathy.
This type of Cardiomyopathy is very unusual for a woman this age (43 yrs old).
I feel it is related to her Congenital Heart disease.
I do not feel that recurrent bouts of bronchitis / asthma has helped this condition.
I feel that depression and smoking has worsened this condition.
3. What respiratory problem in service has resulted in her current asthma ?
Reply from my PCP
9/1/77 URI, treated with XXX antibiotics, 11/14/77 URI with shortness of breath,
1/12/78 URI with cough, 2/21/78 TMC 3 shortness of breath when running with chronic cough.
In view of her current diagnosis of asthma and chronic respiratory SX's since the military,
I feel that her respiratory downward spiral started in the military.
Asthma is a chronic process that is aggravated by stress, smoking and recurrent infections in the ears/sinus.
Soooooooooooo . . . .
Keeping in mind that the BVA did grant service connection for asthma and bronchitis in the
Order Section of this adjudicated appeal and I am service connected for
Chronic Suppurative Otitis Media (draining infection).
I know quite a bit will depend on what this C&P examiner states.
I am going to take copies of the above and try to get the examiner to accept them.
What's your opinion ?
Yes - I know - Stop smoking is one : )
Carlie passed away in November 2015 she is missed.
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