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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
Berta
My decision is all wrong. They made a decision on DIC but I already get DIC.They said they cant pay me retro DIC . DUH. Of course not.I didnt file a AO IHD claim for DIC.
It says they used the veteran's c file to determine he did not have a diagnosis of IHD in his lifetime.
They didnt mention my actual AO IHD claim at all and didnt use any evidence I sent to them (in MY claims file and not in the Veteran's C file)
No mention either of the pending CUE claim I filed in 2004 that was put under Nehmer as well.
The veteran's IHD diagnosis came from me, a lay person and then from the General COunsel and VACO Cardio docs when I won a wrongful death claim. The very fact that Rod was not diagnosed or treated for IHD in his lifetime is one of the reasons (there were many) that I won the wrongful death and 1151 claim.
I laid this out for them, with extensive evidence and yet they failed to even consider what my actual IHD claim was for as well as the fact that when someone is malpracticed on by VA, those disabilities must be rated.
I am absolutely livid and contacted NVLSP as well as the VA -within a service complaint.
I expected the decision to have errors but nothing like this.
I wont be around here much until this gets resolved.
Every single f--king decision I ever got has been wrong.But I overcame ALL of those decision by fighting back with evidence.
If they are WRONG and you know it- you MUST fight back.
I guess I have to do that again. This time however it will be a different tactical maneuver.
I also suggested in my complaint via Iris that I seem to be the victim of a new Shreddergate -
because my actual claims (Aug ,2010 and CUE of 2004 that the VA told me were all in Philadelphia under Nehmer for this readhudication - as well as my extensive C file that holds all the evidence they needed for a proper award -
plus the echibit list and copies I sent to them just to make sure they had it-
none of those claims were ever mentioned in this decision- the decision was based solely on a few records in my husband's old C file from 17 years ago.
The odd thing is this decision opened a big can of worms regarding some FTCA issues the OGC couldn't give me a straight answer on.
That part of my next battle will be fun.
I am sending the Sec a formal complaint by week's end with a question-
If these raters do not have the ability to read -how the heck do they get employed by the VA?
GRADUATE ! 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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