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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
admiral7
Public and Intergovernmental Affairs
VA Publishes Final Regulation on Clothing Allowance Eligibility
November 16, 2011
VA Publishes Final Regulation on Clothing Allowance Eligibility
Expands Criteria for Veterans with Multiple Qualifying Prosthetic and Orthopedic Devices or Skin Condition Medications
WASHINGTON – Secretary of Veterans Affairs Eric K. Shinseki today announced the publication of a final regulation in the Federal Register on clothing allowance that expands the eligibility criteria for Veterans with multiple prosthetic and orthopedic devices or skin conditions caused by prescribed medications.
“Veterans whose service-connected disabilities require prosthetic appliances and skin medications deserve financial assistance for the extra clothing they have to purchase,” said Shinseki. “A federal appeals court has ruled that Veterans may be entitled to more than one clothing allowance, and we are adjusting our regulations to make sure Veterans get the benefit of that decision.”
The new regulation provides the criteria for more than one annual clothing allowance in situations where distinct garments are affected, and ensures Veterans are adequately compensated for any damage to clothing.
Veterans, who because of a service-connected disability, wear or use a prosthetic or orthopedic appliance that tends to wear out or tear clothing, are eligible for payment of an annual clothing allowance.
Examples of appliances include an artificial limb, rigid extremity brace, rigid spinal or cervical brace, wheelchair, crutches or other devices prescribed for the Veteran’s service-connected disability.
Veterans, who because of a service-connected skin condition use a medication that caused irreparable damage or stains to outer garments, are also eligible for payment of annual clothing allowance.
The change makes VA’s clothing allowance regulations consistent with the U.S. Court of Appeals for the Federal Circuit’s holding in the case of Sursely v. Peake.
The application period for an annual clothing allowance is August 1 through July 31 of each calendar year. Payment of more than one clothing allowance to qualifying Veterans will occur in calendar year 2012.
VA is in the process of revising VA Form 10-8678, Application For Annual Clothing Allowance, to accommodate application for more than one annual clothing allowance. Currently, the single annual clothing allowance is $716.
In the meantime, if a Veteran wishes to claim more than one allowance, the Veteran may continue to download and complete the current forms at http://www.va.gov/vaforms/medical/pdf/10-8678-fill%204-08.pdf and http://www.vba.va.gov/pubs/forms/VBA-21-4138-ARE.pdf, to indicate that he or she desires consideration for more than one annual clothing allowance. Veterans are also encouraged to visit VA’s web portal eBenefits - Compensation for information on the clothing allowance and other VA benefits.
Veterans can also contact their nearest VA regional office at 1-800-827-1000 for more information about applying for more than one clothing allowance.
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