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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
kathyred
I wanted to pose this question to all you wonderful people out there.
First a little back ground
My husband initially filed a claim for chronic asthma in Dec. 2005 after being denied for emphysema in1994.
6/06/2006 RATING DECISION the medical description was Chronic Asthma.
2/03/2007 SOC ISSUE was service connection of lung disorder. In the reasons and bases it states “Your report of asthma in service is not a medical finding. Your bronchitis in service was acute. You do not now have chronic bronchitis. Based on the VA examiner’s finding, service connection for a lung disorder is not shown….”
05/17/07 Filed VA-9 On his VA9 he checked the box that states “I Want To Appeal All Of The Issues Listed On The Statement Of The Case And Any Supplemental Statements Of The Case That My Local Va Office Sent To Me.”
6/04/2007 SSOC ISSUE was service connection of lung disorder. In the reasons and bases it states “…the evidence does not show that the veteran’s current lung condition, chronic obstructive pulmonary disease was incurred in or aggravated by his military service…”
10/12/2007 SSOC ISSUE was service connection of lung disorder. In the reasons and bases it states “…chronic obstructive pulmonary disease is not caused by or a result of the veteran’s military service….no formal diagnosis of asthma by a medical care provider…..no documentation found of a diagnosis or treatment of bronchitis…..”
May 2009 The case was remanded to the AMC for developing additional evidence on “...you appeal for a respiratory disability, to include as due to asbestos exposure.”
9/29/2009 SSOC from AMC ISSUE Service connection for a respiratory disability, to include as due to asbestos exposure. In Reasons and bases “….we are unable to establish service connection for a respiratory disability. For the most part, the evidence of record indicates your emphysema is not related to your period of military service.”
Jan 2011 In the denial from the BVA the Board “defines the current issue on appeal as entitlement to service connection for respiratory disability other than COPD/emphysema to include chronic asthma and pulmonary disease due to asbestos exposure.” And goes on to state “….In this regard, to the extent that the clinical evidence indicates that the Veteran’s COPD/emphysema was aggravated by his alleged exposure to diesel exhaust fumes in service, the Veteran is hereby advised at this juncture that as service connection was previously denied in a prior final rating decision and as he has expressly stated that he present claim on appeal is for VA compensation for a respiratory disability other than COPD/emphysema, he may wish to pursue a claim for new and material evidence and apply to reopen his COPD/emphysema claim, per 38 CFR 3.156 (2010).”
The Va first referred to this claim when we filed the claim in Dec 2005 as Chronic Asthma and then in Feb 3 2007 on SOC referred to the claim as lung disorder. On 5/17/2007 we filed VA-9 and wanted to appeal all of the issues listed on the SOC and SSOC that were sent to me. Even the remand on 5/19/09 the Issue was entitlement to service connection for a respiratory disability, to include as due to asbestos exposure. The last time this claim was being referred to as Asthma was 2006 and now in 2011 on the BVA decision it was referred to as "respiratory disability other than COPD/emphysema to include chronic asthma and pulmonary disease due to asbestos exposure.”
The main question I have is when the VA started referring to this claim by names other than Chronic Asthma did that open a claim for all respiratory disabilities. Especially since this was done on the SOC prior to the VA-9 being filed?
Thanks for any help you can give me on this Issue.
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