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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
JamesPT
Hello everyone. I have been gone for several months and justhave been dealing with health issues, claims process etc. The latest action taken by the VA was to deny my claim for secondary ailments, (feet, knees and back) as I wrote several months ago these ailments are the result of a primary service connected injury to right foot which requred reconstructive surgery. Secondary issues have been confirmed by my surgeon and 2 additional Orthopedic surgeons who have provided support statements explaining the issues. The VA sem to have ignored these support statements by established medical Doctors, they just refer to the C&P exams I had at the VA Hospital. I had my last C&P exal almost 2 yeats ago, it was performed by a Physicians Assistant who upon my meeting him said "I am substituting for your exam for Doctor -------- , I really don't know what to do so it shouldn't take too long" it was a real quick simple exam; first he took my blood pressure three times, the measurements were: 142/84 - 168/86 - 201/109 - Now something is wrong here, these BP measurements are way off incorrect, the PA made no issue of it so we went ahead with the physical exam which consisted of manipulation of both feet, knnees, hips and back; had me walk a short distance then said: "Ok, put your shoes on, we're done". I assumed at the time that this young man might be a Doctor on resident status but the C&Pt reports him as a PA.
I have 2 Doctors appointments scheduled soon and a meeting with VSO, I will present a copy of the C&P performed by the PA; I need to find out if the C&P was or is valid as they denied my claims in accordance to that particular exam. The PA's diagnosis states that all secondary ailments are attributed to the age process. There are discrepancies in the report, and diagnostic comments are contrary to my Orthopedic Surgeon's diagnosis of my primary injury and secondary issues. My primary service connected injury was given a 10% rating 4 years ago. Anybody in the forum know if PA's exams are valid in the process of denial\approval of claims. Your opinions, answers are greatly appreciated.
Jim
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