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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
Picked 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.
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Lemuel, -
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Question
Berta
http://www.syracuse.com/news/index.ssf/2011/06/syracuse_va_medical_centers_ma.html
in part:
“In eight cases that were settled administratively or in court, the Syracuse VA paid out more than $2 million in claims.
The new database provides a glimpse at 12,000 claims, many of them medical malpractice complaints, filed against VA medical centers nationwide between 1989 and 2008. The information was recently released by The Project on Government Oversight, a nonprofit government watchdog group that obtained the database from the Department of Veterans Affairs through a Freedom of Information Act request. “
The figures are wrong.
Syracuse was one of the malpracticing VAMCs I named in my FTCA case and I know for a fact that my settlement is not part of these figures.
Every time the VA fails to report a malpractice issue involving a cash settlement ,to the National Practitioners Data Bank (VA has a mandated agreement with the NPDB)-they successfully hide the true cost of VA malpractice from the public and allow negligent VA doctors who were involved to continue to practice at VAs without any disciplinary actions.
I am not done yet with VA General Counsel in this regard.They never reported my settlement to NPDB and the VA doctors from 2 VA facilities (including Syracuse) continued to treat veterans without discipline or even, as far as I know, efforts to get them medically up to par.
Per GAO I was not the only FTCA recipient whose settlement and malpracticing doctors were not reported.
Although I am quick to day VA saves lives, and also most 1151/FTCA issues I hear about have no basis at all -in my opinion-( and I could be wrong on that because it takes a full review of the clinical record)-still -any veteran who feels they have been harmed by VA health care should take action as described in the Please Reads first topic here without delay.
The NPDB mandate should be included in the settlement papers for any successful FTCA and should be followed through with one's lawyer.
About 2 years ago I was talking to a malpractice lawyer who deals with FTCA VA issues and he didn't even know of this mandate.
It is an internal VA agreement (fully accessible on the net)but if they honored it then we would know what doctors have been charged with negligence
and how many vets they really harmed or killed.
Edited by BertaGRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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