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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
cwk05
I just received copies of my C&P Exam results in the mail and would like some feedback.
I currently have two pending claims. One for entitlement to service connection for anxiety disorder secondary to the psoriasis and the second for an increased rating for psoriasis currently evaluated at 30%.
1st Exam: Mental Disorder Exam Results
Diagnosis #1: Anxiety Disorder, with Generalized Anxiety, due to residuals of psoriasis.
Diagnosis #2: Mood disorder, with depressive features, due to residuals of psoriasis.
Medical History:
Patient has been in psychiatric treatment with a civilian psychiatrist since May 20, 2007. He has been treating him for OCD and GAD. In a letter dated 1/24/2011, his psychiatrist indicates that the patient's symptoms of anxiety and depression have increased due to his psoriasis which covers a large part of his body. "The itchiness causes sleep deprivation, which amplifies the frequency and severity of his anxiety and depression." He also reports that it affects his ability to teach because he loses concentration. He is irritable and unapproachable to his students. He is embarrassed about how he looks and does not participate in many activities. His psychiatrist also indicates the patient is having panic attacks at home and work. He is treating the patient with Zoloft 100 mg qd and Ativan 1mg prn.
In today's exam the patient reported that his doctor recently increased his Zoloft to 125 mg qd and increased his prn dos of Ativan to 2 mg. The patients psoriasis is affecting every aspect of his life from work, to family, to friends and leisure activities.
Symptoms:
Level I: Depressed Mood, Anxiety, Chronic sleep impairment.
(Not sure why he did not check off Panic Attacks that occur weekly or less often?)
Level II: Disturbances of motivation and mood.
Level III: None
Level IV: None
Other Symptoms:
The patient has symptoms of feeling self conscious about his psoriasis. He is embarrassed when his skin starts bleeding. Once he has a flare up he gets very anxious, irritable, and depressed.
Occupational and social impairment
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation.
Current global assessment of functioning (GAF) score: 60
QUESTION #1:
Any idea what percentage I might qualify for, if any, based on this examination?
I've been seeing a private psychiatrist for 3 years regarding the anxiety created by the psoriasis. All records were sent in to RO. I see him once a month.
2nd Exam: Increase in service connection for psoriasis
My VA Derm. stated an increase to more than 50% over the last year.
QUESTION #2:
Would I qualify for an increase from 30% to 60%?
Thanks for any feedback
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