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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
rogus
This is the cover letter I plan on sending to the ACLU. I would appreciate any comments or corrections before I send it.
To: American Civil Liberties Union
From: Robert L. Anchors
Wichita Kansas
Dear Sir/Madam;
I am writing in hopes that you may be able to help United States military veterans that are facing what has now become institutionalized fraud against disabled veterans.
As you may be aware disabled veterans may file for disability payments based on injuries that occurred while on active duty at their nearest Veterans Affairs Regional Office (VARO). This process is similar to applying for Social Security Disability benefits in that documentation of events is gathered and medical examinations are both required and performed by or for the requesting agency (Social Security Administration or The Department of Veteran Affairs). However that is where the similarity ends.
Unlike applying for Social Security benefits a veteran is forbidden by law to initially hire an attorney to handle his/her case before the VA. Even though there is currently a law pending to allow veterans this right to legal representation it will do little to stem the fraud perpetuated against veterans applying for benefits. Chief Judge Frank Nebeker, Court of Veterans Appeals, states the problem quite clearly in his State of the Court address before Congress (1994):
“ Neither the Court, through the Board, the Board, nor the General Counsel has direct and meaningful control over the Agencies of Original Jurisdiction… Many ROs appear to do what they think they must when they get around to it…. The attitude in at least some of the ROs seems to be "I don't care what the Court says the law is. I care only what my boss says it is."
Although this was over a decade ago I submit evidence that veterans are still being denied due process of law. According to the American Federation of Government Employees (AFGE) in a letter to House Representative Lane Evans (2005):
“It has been an often repeated inventory reduction tactic by VA managers and supervisors articulated to VBA employee’s as ‘just get the claim done and let the veteran appeal’, knowing full well that the decision is flawed under law, regulation and internal policy. It is an often repeated statement that less than 10% of veterans appeal their decision therefore just getting the claim done by hook or crook has little negative impact on the agency in reporting its annual performance. Instead, VA policy makers boast about the number of claims completed, regardless of due process errors.
A year later the AFGE stated (The effect of Dingess/Hartman v. Nicholson on day to day VBA operations, 2006):
“In short, the Secretary’s decision fails to provide the veteran/citizen minimal procedural due process at every stage…. VA leadership fails to understand the basic nature of due process guaranteed to every citizen or is purposefully circumventing due process requirements in the name of administrative expediency… A fundamental practical problem was that VA was summarily denying meritorious cases as “Not well grounded” in order to meet unrealistic production numbers.”
Even when a veteran can get his claim to the Court of Veterans Appeals the case is most frequently remanded to the VARO that initially violated the veterans’ rights to due process. These are the same VA Regional Offices that the Court admitted to not having any control or influence over. And, the same VA Regional Offices that the AFGE claims are currently purposely denying veterans due process.
What is the end result for the veteran?
1. Veterans currently have to wait an average minimum of 3 years before they can have legal representation and as reported by the Knight Ridder News Service some cases have been drawn out as long as 55 years.
2. During this process a veteran may lose his/her home, possessions and even life. The veteran (or family thereof ) may not hold the VA liable for damages.
3. According to Knight Ridder News Service over 13,000 veterans have died over the last decade while awaiting resolution of their claims.
4. When the veteran dies his/her claim dies with them and the claim can not be pursued by the spouse or family of the veteran.
Veterans must be allowed the same constitutional rights of due process afforded every other citizen of the United States. Veterans must have the right to hold the Department of Veteran Affairs legally responsible for damages when the VA has denied or otherwise violated the veterans’ due process.
Earlier I compared this process to applying for Social Security Disability benefits. I should point out that the main difference is that if 13,000 people died while awaiting a claims decision; were locked into a system that denies them due process; or denied the right to legal representation the public outcry would be deafening.
Veterans deserve to know that the country they promised their lives too will treat them and their claims with the same constitutional rights afforded every citizen and not to be relegated to the whims of the politically or financially expedient.
Sincerely,
Robert L Anchors
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