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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 rating
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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.
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Lemuel, -
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Question
shrlee
My brother injured his back and fractured his ankle during a fall while on manuvers in Korea 1957.
He applied for comp. in 1985. His records were one of the many they claim are missing due to the St. Louis fire. The only proof he has is a Buddy Statement and a picture that was taken while in Korea with his leg in a cast. After years of denials in 1995 he received 10% for the fractured ankle. Although the Buddy Statement stated he injured his back AND left leg they have never given him a service connection on his back.
My brother and his wife had been working his claim, she passed away last year. In April he received his letter denying an increase on the ankle ( he has had 3 knee replacements on that leg since 1999, private doctor) and a denial on SC of the back injury. After I got to talking to him I found out he never attempted to get an outside medical opinion.
His original claim is for the ankle, back and arthritis.
I want to add his knees as secondary and tinitus to his claim. Left knee is the one with replacements right knee dr says needs replaced.
When my husband filed his claim he had three fantastic service officers, although I have been lurking on this board since 1998, this is a new to me and I don't want to $crew him up anymore than he is. We went thru boxes and boxes of papers, and made copies of his medical papers and rating decision for the dr. and SO.
I made him an appt. with a dr. for an evaluation letter, there was not an opening until Sept. Should he wait until he gets the drs evaluation letter before he sends in the NOD? He has no new proof until he receives a letter hopefully connecting the knees to the ankle and stating as least likely as not the back was injured in the fall.
Should we wait to file the knees and tinitus until after there is a decision on the NOD? If we file the additional claims will they slow down the original claim? He only has one Buddy Statement would it help if the family wrote statements concerning the letters he wrote home about the injuries? We are going to contact a service officer to file the NOD but I don't know what he can do until we get more proof.
I applogize for such a long post, trying to get 20 years onto one page is difficult.
Thanks for any input, Shirley
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