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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
I have notes on the very few calls I made to 800# over the past 14 months.
I have the names of the reps and everything they told me,but come to find out,it was ALL the WRONG info.
Also I have 2 IRISes, my only IRISes over the past 16 months, and they too contain blatant lies.
You all know I was spitting fire when I got a ridiculous Nehmer decision the first week in December and I took action.
When VA Central called me, they said my C file (which I thought per 800 and IRIS ,was at Phila Nehmer for over a year per IRIS and the 800$ reps)
was being transferred to Phila right away and also they would obtain an expeditious medical opinion.
( I told the VACO caller that this expeditious opinion is about 23 years too late based on what my Nehmer EED should be)
( The EED is date of an ER med cert that called for cardio tests that never occurred)
I have no idea yet where my actual claims are.The first one was sent to wrong Nehmer VARO, then lost and then found per VA in 2010 and I sent a copy of it again with the evidence directly to the Phila VCSM (just in case it was missing again) and this second submission might now be lost too.
My tip is this- widows cant use E benefits so I have to click on the e -benefits thing to speak to a rep.
I started asking in last 2 calls for the rep's name and ID code.
If you call 800# have their name AND ID code and they give you false info, you can file a complaint that identifies who they are.
The rep I got the other day got very upset when I asked for his ID code.Then he gave me the wrong info on my CUE claim.
I questioned that and then he apologized and gave me the right info.(I think)He verified the C file and med recs had been transferred 10 days ago to Phila so I believe that as it confirms what VA Central said.
I have already requested the name of the doctor who will do this new opinion (which is a waste of taxpayers money and time because they have enough medical info already to rate the claim )
and I asked for the doctor's field of expertise because I also told VACO I am ready to get a forensic cardio IMO if needed if the opinion is wrong.
There already is a VACO medical opinion and a Peer Review from VA in my C file and 3 IMOs.
The veteran has not had any sustained improvement since his last posthumous C & P and he is still dead.
I did argue against this new VA opinion because I had muliple other VA opinions over the past 17 years that were all completely medically wrong.
There have been more Nehmer awards lately on some other sites,like VBN, but ours have trickled down.
I think the new Nehmer deadline might be 12-31-2011.
I also think mine might be the last Nehmer claim they do. It is a little unusual but not medically difficult.
Since VA wants these Nehmer claims off their back ASAP, maybe it is now my turn to string them out.
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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