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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
Colorado1135
to start off I'm a 31 y/o Navy vet, I injured my back while in the Navy. I fell while responding to a fire out to sea with all my gear on, pain started getting worse everyday until I went in to medical. the sawbones told me it was a pulled muscle and gave me motrin. this went on for a year until the radiating pain, numbness and loss of mobility made me demand to see a specialist. I got in to see one, he said I should have come in a year ago when I was hurt by now it was too late to fix it and it would bother me the rest of my life. after a year and a half of countless injections, manipulations, physical therapy nothing worked and I was discharged at 20% for degenerative disk disease, and a few other back problems that were part of it. on one of my last doctor visits my orthopedist said I likely need surgery, was going to put me in for a consult but said there wasn't enough time and after I was discharged the VA would take care of it (I was out of limdu time to be able to recuperate.) I get lost in the system for 2.5 years, I called numerous places trying to get in to a VA doctor and I must not have been talking to the right people. I had filed all my VA paper work before separating, but didn't get any findings back until 1.5 years later. they diagnosed me with a "lumbar strain" gave me 10% and then said they would keep my compensation payment until 2014 to "recoup" the separation pay. I filed an appeal, but later found out I needed to file for a reevaluation, so I do that. yesterday the results come back. they said since the MRI and xrays looked ok, that there must not be anything wrong with me, they found no evidence of DJD and maintained it was a lumbar sprain. and because I was in noticeable pain and my abilities shown during the exam didn't reflect my xrays that they suspected me of malingering or faking it. they even went as far as saying I made no mention of radiating pain or episodes of extreme pain. so because they disagreed with my orthopedist in the Navy then
I have chronic pain that never goes away. a few times a day my back will pop out of place and back in within seconds to several minutes, causing excruciating debilitating pain. I have to wear a back brace to limit this popping out that happens. walking isn't too hard most of the time, sometimes it can hurt just to put pressure on my legs and stand. the pain is so severe it has caused me to get light headed and is nauseating at times and will stiffen way up, sometimes taking days to go down, chiropractor visits help from time to time to reduce the intensity of the constant pain, but do nothing for the extreme pain episodes. I can't lift anything without risking my back to go out, sometimes the popping is audible when it goes. If I try to do chores around the yard/house the pain grows in intensity and if I don't stop and take all pressure off the spine I'm in for a world of hurt. I don't know what to do. I finish college in December, I'm afraid of how much pain or further damage I will do once I start working full time, since I can barely go to class and take care of myself and my 2y/o son. I can see the writing on the wall unless something happens
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