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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
Two weeks ago I had a C&P exam due to instructions from my BVA remand.
The examiner was to review all evidence, order any test they deemed necessary and opine
as to if my SC'd respiratory conditions are aggravating my NSC heart conditions.
The examiner in my opinion was quite good.
He ordered a new Echocardiogram to determine my surest level of
Pulmonary Artery Pressure (PAP). He said this was needed to help
him write his opinion.
I was scheduled for a Echocardiogram last week.
Here I am laying on the table doing the test - (the echo is just like a ultra sound procedure) and I asked the tech -
hey, this test will give the examiner a reading for my PAP right ?
The tech told me NO - I said get your supervisor.
I was told by the technician and her supervisor that there is new policy in
doing Echo's ordered by the C&P examiner's.
They will now be doing 2 types of Echo's.
1) Is an INCOMPLETE echo test that will provide the ejection fraction (EF).
2) A COMPLETE echo that will provide the EF and the Pulmonary Artery Pressure
(PAP).
The supervisor continued on to tell me that the C&P examiner had ordered an echo for me
(BUT that the C&P examiner probably did not know about this above change in policy yet).
The echo department decided I would get an INCOMPLETE echodue to AO - IHD.
I said OH NO - This is BS - and the supervisor told me that's all they could do on me
and I needed to speak with my service officer - I told her I represent myself.
I continued on stating I am not AO - I am Not IHD.
I am here due to a BVA remand - she said she already knew this.
I quickly and concisely stated:
The C&P examiner needs to know my current PAP
and you are not going to provide the correct test for this.
Your results will go to the examiner - then his C&P results to the RO,
the RO will deny and pass it back to BVA - I will be notified of the Denial,
I will tell BVA I had an inadequate exam - BVA will again remand to the RO,
the RO will send me for an ADEQUATE exam and I will end up right back her.
I told her by doing an inadequate exam she personally will be costing me another 2-3 years of not getting my benefits !
The supervisor told the tech to call the C&P examiner and tell him what
the veteran is saying - with the I must be lying attitude.
The tech went away for about 10 minutes, came back in and said -
well you are going to get the COMPLETE echo to include a PAP reading,
and DR. XXX didn't even need to pull you up on the computer - he knew
who you were.
I told her that the examiner had discussed this at length last week
and that's exactly why he ordered this specific test.
Anyways - I just want other claimants to be aware there are now (supposedly)
2 different levels of echo's being done at VAMC's in relation to C&P exams.
How about all the vets that will go thru BS like this - not knowing at all
what is supposed to be done and what, in reality is actually being done.
They will have absolutely no clue.
Carlie passed away in November 2015 she is missed.
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