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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
Sabrina
Hi Everyone,
I have been a lurker on here for many years and all of the information here has help me so many times understand the VA system.
I am a 32yo female veteran. I was discharged in 2001 after being diagnosed with avascular necrosis of the right femoral head, and having a fibula graft surgery to help correct it and postpone a hip replacement.
When I got out, I had no idea what the VA even was. I went there and had my exam, didn't know what to expect or even what the benefits were. I got a rating back of 80%, which is not 90%. I also have individual unemployability, and have for a few years. All of this is due to serious chronic pain. Some days are worse than others...but it definitly inhibits me holding a job. Life and how I am feeling is so inconsistent, that working full time would be impossible. Due to the chronic pain...I have developed serious depression and anxiety issues. So that is the just of it without getting into serious detail.
Well, last year sometime...a friend opened up a fitness studio. I have a degree in health and wellness and she asked for my help, a meeting of the minds you could say. I taught her how to put together classes and went to some of the classes to help instruct...but limited in how much I participated. I only could help out for about a month, and then had to stop, due to the extra activity, seriously aggravating my condition.
Well, it is almost a year later, and my friend from the studio called me saying that an investigator was in asking questions about me! Asking if I have ever sold her my pain medication!!!!!! I am so embarrassed! It is something I have NEVER done! And continued to ask if I ever showed any pain, and why I was even there in the first place.
Today she called again, and I guess he went to see 2 of her clients. I have no idea what he asked them. They do know of me, but hopefully they filled him on that I was only there for a short time due to my condition.
Mind you, I was never paid. She is just a good friend and it was a way for me to stay sane and interact with adults, rather than hiding at home all the time. (it is in my medical records that my doctor would like me to engage in meaningful activity/volunteer ect outside the home, for sanity purposs).
Ok...so I know I have not done anything wrong, but I am still freaking out!!!! I have 3 small children, ages 1, 3, and 5 and am married. I stay home with the little ones of course and really keep to myself.
I am really not sure how to approach these accusations. I called the VA here in Maine, patient advocates and my rep, and in their offices they see no reports of investigation, but he definitely showed his badge, and I know he is from the government.
The fact that I am being followed and spyed on gives me the creeps!
Not to mention this is messing with me emotionally. I know that if i have done nothing wrong, then I shouldn't have to worry right, then why do I still feel so awful!
I feel I am a victim of something. I have a couple people that I know dont care for me....and have a weird feeling I may be a victim of slander, but who's to say.
Any advice?
Losing my mind a bit.
Warmly,
Sabrina
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