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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
allan
Subject: Data Spur Changes In VA Care
Wall Street Journal
March 29, 2011
Pg. D4
Data Spur Changes In VA Care
By Thomas M. Burton
Hospitals serving U.S. military veterans are moving fast to improve care after the government opened a trove of performance data -- including surgical death rates -- to the public.
The U.S. Department of Veterans Affairs in November started posting online comparisons of the nation's 152 VA hospitals based on patient outcomes: essentially, how likely patients are to survive a visit without complications at one hospital compared with the rest.
This unusually comprehensive sort of consumer information on medical outcomes remains largely hidden from the tens of millions of Americans outside the VA system, including many of those in the federal Medicare system.
While many of the nation's nearly 23 million veterans have yet to catch on to the program, the quick response by some poor-performing VA hospitals underscores the potential impact of releasing such data.
The information was released at the urging of VA Secretary Eric K. Shinseki. Among other things, it presents hospitals' rates of infection from the use of ventilators and intravenous lines, and of readmissions due to medical complications. The details have been adjusted to account for patients' ages and relative frailty.
Hospitals that fall into the bottom 10% of national results can expect the VA to intervene with actions ranging from urging medical improvements to dismissing doctors."The VA secretary pays attention to this," says William E. Duncan, the agency's associate deputy undersecretary for health quality and safety. "Unless people in the VA system have an organizational death wish, they will pay attention to this, too."
When VA hospitals in Virginia and Oklahoma learned an abnormally high number of their patients contracted pneumonia while on ventilators, they took steps to cut the rates. And a hospital in Kansas City, Mo., that recently ranked relatively poorly on surgical-death rates says it has improved by making staffing and other changes in radiology, cardiology and emergency medicine, including better avoiding hospital-borne infections.
Still, after seeing that the Kansas City VA Medical Center's posted surgical-death rate was about 79% higher than expected for the severity of its patients' illnesses, a veteran might opt for the VA hospitals in St. Louis; Columbia, Mo.; or Wichita, Kan.; which posted relatively lower surgical-fatality rates. Former soldiers, sailors, airmen and women and Marines are free to choose among VA facilities.
"Why would we not want our performance to be public? It's good for VA's leaders and managers, good for our work force, and most importantly, it is good for the veterans we serve," Mr. Shinseki said in an emailed statement.
The same sort of information is nearly impossible for most Americans outside of the VA system to get.
Medicare, the nation's largest medical-insurance program, publishes risk-adjusted death rates only on patients suffering from congestive heart failure, heart attacks and pneumonia. Medicare directly serves nearly 50 million patients, and most other Americans get essentially the same care and information about their hospitals as do Medicare recipients.
A November 2010 report from the Health and Human Services inspector general concluded that one in seven Medicare patients is harmed by medical care, nearly half of those avoidably.
Medicare spends billions of dollars every year for care of patients who have been rehospitalized or endure lengthy hospital stays after bleeding, infections and other post-surgery complications. Rehospitalization alone costs upwards of $15 billion a year, according to estimates by Medicare and others.
Medicare does publish extensive data about medical processes, such as whether a heart-attack victim was given an aspirin or a beta-blocker.
"More is planned in the way of outcomes measures," said Michael T. Rapp, Medicare's director of quality measurement. He says the agency later this year will publish details such as post-surgery respiratory failures, accidental punctures and surgery deaths from certain complications.
One reason the VA can offer such detailed data is that it operates a closed, centrally managed system, whereas Medicare and the broader health-care system encompass a wide array of hospitals with disparate management and computer systems.
The VA's November data release was the first version and will be made more user-friendly, Dr. Duncan says.
The system's results aren't broken down by specific type of operation-say, how a patient might fare in liver or prostate surgery-but the VA's Dr. Duncan says that is being considered. Nor has the VA embraced another step advocated by some medical-quality
experts: Checking to see, for instance, whether a patient is cancer-free a year after surgery, or whether a patient's reconstructed knee works right.
At VA hospitals in Oklahoma City and Salem, Va., the rate of pneumonia acquired by patients on ventilators was shown last fall to be significantly higher than the national VA average. The Salem hospital says a relatively low number of patients on ventilators skewed its infection rate higher, but staff members at both facilities say the numbers prompted action.
Seeing the data helped, says the Salem hospital's chief of surgery, Gary Collin, because "you can become kind of complacent."
VA officials say the data push hospitals to constantly improve. "There's always a bottom 10%," says VA Deputy Undersecretary William C. Schoenhard. "When one hospital improves, somebody else goes in the barrel."
Full Disclosure
Some information the VA publishes, by hospital:
*Surgical death rate, over the past 12 months
*Acute-care death rate
*Intensive-care unit death rate
*Ventilator-acquired pneumonia rate
*Rate of intravenous-line infections
*Hospital readmission rate
"Keep on, Keepin' on"
Dan Cedusky, Champaign IL "Colonel Dan"
See my web site at:
http://www.angelfire.com/il2/VeteranIssues/
http://www.facebook.com/dan.cedusky
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