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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
Continue Reading on HadIt.com-
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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
deltaj
I had my husband complete a records request recently for copies of some V.A. basis records on a claim. Yesterday we got a call from a local V.A. official in Ft. Harrison, Montana.
Back in 1995 my husband had sent V.A. some additional Navy service medical records which he obtained from the National Personnel Records Center and when my husband got his C file I discovered that when V.A. made a request for records in 1998 from the National Personnel Records Center they only used his Army service number on the records request. A rating decision in 1998 which was in his C file was not sent to him. That rating decision stated that the veteran told V.A. that he was entitled to an effective date of 100% in April 1966 [at the time of the first rating decision] because the Naval Medical Evaluation Board found him unfit for duty. He doesn't remember writing this. The Naval Medical Evaluation Board report from November 1965 was not of record at the time of the April 1966 decision.
Yesterday on the telephone I explained to this V.A. official that my husband wanted to reopen his December 1965 claim under 38 CFR 3.156 ( c ) using newly acquired service records. During the telephone conversation yesterday, I asked the claims assistant whether V.A. had ever requested additional service records from the U.S. Navy in about 1998. He told me, "We are not going there" and would not answer the question. He had already answered some other questions about whether documents missing from the file at BVA were in the local claims folder like a May 1991 BVA hearing transcript, the July 1990 rating decision and notification letter, etc. I am extremely angry that V.A. is simply pretending this November 1965 report of the Naval Medical Board was in the file at the time of April 1966 rating decision. That medical evaluation board report shows some very severe symptoms of this veteran's service-connected condition and was not received by V.A. until 1995 when my husband sent it to them. Furthermore, I had sent a recent request for records from a V.A. outpatient clinic in Sacramento which had reviewed medical records from Livermore and denied my husband vocational rehabilitation because of the severity of his service-connected condition. That facility didn't bother to try to get its file back. It just forwarded my request for complete medical records to VARO Ft. Harrison. I explained to this guy that my husband wanted those records because an earlier claim was still pending because of a wrong zip code on the notification letter and mentioned Huack v. Brown. He said, "Well, we can't try to get the records unless we have some evidence they exist." I told him about the March 1989 letter in the file and he said he'd look for it in the file. I don't expect him to do anything because BVA determined my husband had abandoned his earlier claims. This vet rep also told me the records from Livermore might be archived. I told him that sooner or later my husband was going to file a NOD with the April 1971 rating decision but he wasn't going to do it until I got some stronger evidence.
Right after the conversation with this V.A. official, I called my husband's rep at Montana Dept of Veterans Affairs for my husband. During that conversation I told him the name of a hospital outside V.A. where he had been hospitalized and told that rep, "I've seen enough examples of cases online to know that if my husband files a NOD under Huack v. Brown he'd better be able to show what evidence he would have submitted had he been notified of the decision." I told him the evidence if it still exists is an informal claim under 38 CFR 3.155 and 38 CFR 3.157 (b) and that the evidence was records of treatment at a hospital within the presumptive period of 38 CFR 3.309 after his Army service which was within one year prior to the date that he filed his V.A. claim for a service connected condition. I am unsure whether this would be considered a unformed services hospital. V.A. may have paid for this hospitalization under V.A. fee basis.
These kind of shenanigans by V.A. are why I volunteer at hadit. I want to prevent this kind of suffering by other veterans and their families. I believe that knowledge of V.A. laws and regulations is one of the few weapons that veterans have to fight creepy V.A. officials with.
Edited by deltajLink to comment
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