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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
Bigred122
Last spring when I found Hadit I was abit cocky about my claim. I felt it was a No Brainer on the conclusion. Some of the folks here tried to shake me to wake up, but I stuck to my guns. I mean, I had no Hepatitis C before my colonoscopy which required a transfusion and the very next time they took blood out of me(about 6 months later) I had Hep C. Looked like a open and closed case of a claim. Unfortunately my Dr lied to me and told me I had no recourse against the VA or the surgeon. This was 1997. Last year, I read an article about the Miami vets and decided I deserved something for their screwup. Too much time had passed for the tort claim I got screwed out of, so all I could do was a 1151 claim. The folks here tried to warn me that the VA system wasn't a right or wrong system, but a right way ,wrong way and the VAs way. Being an old Vet, I should have remembered that from my military days, but that was 40 years ago. Well I tried to get a nexus letter from those VA drs in the past who unofficially agreed with me, but they now have turned their backs on me. I live paycheck to paycheck on SSD so no money for the hired Drs to write a nexus letter. So I did the best I could. The VA never asked for anything on that part of my claim so I thought I was ok. Well in Oct of this year I was completely denied. Even tho blood supply even today is not 100% safe, they played that since 1992 our blood supplies were the safest they had been. I even showed them evidence that the GAO was concerned that in 1999 blood supplies were still too contaminated.(Roughly 262 units out of 100,000 had HCV.At that time period Idaho was still getting blood from the prison system , but had just stopped because of the Arkansas scandal where govenor Clinton was getting alot of bad blood from their prison inmates. Well, I have since found a reknown Dr who will write me a nexus for my Hep C, but he confirmed to me that the VA probably won't except it. That was my last bubble that got burst this week. So I am now here to Eat my Crow like a good little boy. All I can do now is hope that the DRO person has a heart and sees my pleas.I have no other risk factors that the VA can use against me and they have tried to find them. I hate needles,so no drug user, yes I've been married 3 times, but I won't consider that risky sex with multiple partners,no tatoos or body piercings. They even did a CT on me that they said was a brain CT , yet records show it was to see if I had any nasal scarring from intranasal drug use. Sorry VA, you lose. I've tried to get records to see if the Vets before my colonoscopy and in between my first and second colonoscopy to fix a bleeder had any Hep C and they won't tell me. The night before my second surgery I was sharing a room with a Vet who had a oozing infected wound from a surgery and we both had to share the same bathroom. A big no no. They won't tell me. I swear if they had a pic of the surgeon holding a syringe with the letters HCV on the side of it and the needle stuck in my azz they wouldn't give it to me and would deny it. The only justice I have received was KARMA against the DR who lied to me. Once I had found out I was lied to, I hoped both Drs would experience a painful death sentence like the one they gave me. Last month my primary who lied to me died of a very painful throat cancer.Part of me felt sorry for his family,because at one time I thought he was my friend. Anyway, I am here to take my I told you SO's and promise to never use the terminology "No Brainer" when it comes to anything VA. I considered my 1151 my meat and Taters part of my claim and the AO stuff was the gravy.But being I was in Korea, I was already denied on it, so I will redo it for the DRO and pray. (Thinking of using Bikini clad models to display my evidence in hopes they will hopefully at least look at it this time.) Like everyone else they would ask for the same thing I had just sent them twice before.Thinking about translating evidence into brail for them. Anyway now your up to date on my claim. So far on this journey is that Phase 2 is even more vague on what to do than phase 1 was. I see on ebenefits they acknowledge my NOD even tho I have yet to receive any correspondonce since my decision.Since decision I have sent NOD, asked for C File, FOIA request on info asked for months ago that I never received and just recently sent my DRO request. They tried to get me to get in the reconsider line because other lines are back logged, but once I saw that all my old evidence would go bye-bye I said no way. It was too hard getting what I have , to try and find new evidence would be twice as hard to find and still no money for any IMOs.So until I get a letter stating that there is no more DRO process,This ole Bull is not going to be chuted down into another new line no matter how backed up they are.( that is why they are trying to push people into reconsideration process is to balance out the lines.) But I love their terminologys in describing the reconsideration process, too many use of maybe this or maybe that.When they know exactly what they are going to do to you without actually asking you to bend over!! Ok, last rant for 2011!! Hopefully all of all will get what is owed us in 2012. But I think we will need a whole new government from top to bottom and east to west. JMO Merry Xmas to all my Brothers and Sister Veterans and those who stand by Our sides!! Mike
Edited by Bigred122Link to comment
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