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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.- 4 replies
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RichardZ, -
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
derrell
1995 service connection for scar below right eye has been established as directly related to military service. This condition is evaluated as 0 percent disabling from april 5, 1998. A noncompensable
evaluation is granted for slight disfigurement. A higher evaluation of 10 percent is not warrented unless evidence demonstrates moderate disfigurement. Service medical records for the period 1995
to 1998 shows that the veteran was in a MVA in august 1995 resulting in scar below right eye. VA examination dated 6-12-98 indicates that keloid formed below right eye from scar. The veteran report
some sharp pains and throbbing sensations in the scar area off and on at times. Examination of the face shows a slightly darker pigmented scar in the right zygoma area. The scar is slightly irregular
and meausures about 2 cm in length, and at its widest approximately 4 mm. There is palpable slight thickening suggesting some fibrotic changes. There is minimal keloid formation. That was first ruling.
Reason for decion to increase scar from 0% to 30%
The evaluation of scar, below right eye is increased to 30% disabling effective june 19, 2009. An evaluation of 30%is assigned whenever there is evidence of visible or palpable tisue loss and either gross
distortion or asymmetry of one feature or paired set of features(nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or; with two or three characteristics of disfigurement. A higher
evaluation of 50% is not warranted unless the record shows visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features(nose,chin,forehead,eyes(
includind eyelids), ears (auricles),cheeks, lips), or; with four or five characteristics of disfigurement. The 8 characteristics of disfigurement are: scar 5 or more inches (13 or more cm.) in length; scar
at least one-quarter inch (0.6 cm.) wide at widest part; surface contour of scar elevated or depressed on palpation; scar adherent to underlying tissue; skin hypo-or hyper-pigmented in an area exceeding
six square inches (39 sq. cm.); skin texture abnormal (irregular, atrophic, shiny, scaly, etc.)
You filed for an increase in your service connected scar, below right eye on 6-19-09. We sent duty to assist letter to you 7-29-09. You did not respond.
On VA exam dated 8-13-09 you reported no current complaints of pain, skin breakdown or other problems. You stated that the actual presence of the scar is frustrating and bothersome to you. You stated
that you are often asked questions about the scar due to its presence on your face. Physical exam including pictures showed the scar is located approximately three-fourths inches underneath the right eye
at the level of the outer canthus. The scar measures 1.5 centimeters in length and 1 centimeter in width at the widest part, with an area of 0.75. It is a nonlinear scar. The scar resembles a triangular shape
measuring an area of 0.75. There are no objective signs of pain to the scar with examination and palpation. There is no evidence of skin breakdown to the area of the scar. The scar is superficial. There is
no underlying soft tissue damage. There is no limitation of motion or other limitation of function caused by the scar. There is no inflammation or edema. The scar is adherent to underlying tissue. The surface
contour of the scar does have elevation with palpation. There is abnormal texture of the skin noted with irregularity and shiny appearances measuring approximately 1.5 square centimeters. There is
hypopigmentation noted to the color of the scar when compared to normal area of the skin with an area of 0.75. There is no induration or inflexibility. The face is symmetrical without gross distortion, and
there is no underlying soft tissue loss noted that is visible or palpable. Diagnosis was scar below the right eye post motor vehicle accident in 1995.
Based on findings on VA exam of scar that is adherent to underlying tissue, the surface contour of the scar does have elevation with palpation, and the scar measures 1 centimeter at the widest part, we have
increased the evaluation of scar, below right eye to 30% percent disabling. A higher evaluation is not warranted because objective findings do not meet the criteria for a higher evaluation.
We have assigned an effective date of 6-19-09 the date of your claim for increase.
I did not submit new evidence i just asked for an increase can i get my effective date changed to 1998
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