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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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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
Picked By
Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
Hoppy
I have been helping a veteran understand his recent denial for service connection of a secondary condition. The veteran obtained the services of a large and popular law firm. The law firm got off to a good start by using their own doctors to write reports for the veteran. After that it went all downhill. When all was said and done the veteran had one favorable report from a C&P examiner and two favorable reports from doctor’s who were working in association with the law firm. There was also one negative report written by a C&P examiner.
The negative report said that it was “quite possible” the veteran’s condition was caused by post service employment. The cases I have read considers the word “possibly” or “probably” as not sufficiently definitive to establish anything one way or the other. That is why you should use the more, as, or less likely than not, format. The C&P examiner provided some supporting logic. However, the supporting logic was all based on some theory and he did not provide any specific event that supported his theory.
The rater gave weight to the C&P examiners unsupported theory and denied the claim. The reason for this is because the favorable reports also had significant flaws. It does not matter how screwed up the negative evidence is. What is most important is the favorable reports need to strong enough to win the claim.
The favorable report written by a C&P examiner reached a determination the veterans secondary condition was due to his service connected conditions. However, there was no discussion of how the C&P examiner reached his determination. The rater did not give any weight to this report.
One of the reports from the law firm’s doctors said the veterans condition was secondary to the veterans service connected injuries. However, his report also did not contain any supporting discussion or logic. The rater stated that this report lacked supporting logic. The report was written after the negative C&P exam and the report failed to discuss the C&P exam. The rater made it a point to state that the failure of this report to discuss the negative C&P exam gave him the impression the examiner did not review previous exam reports. The rate did not give weight to this report.
The other report from the law firm’s doctors also was written after the negative. This report did provide a foundation that could be equated to supporting logic. The clinician made a blanket statement that there was a known correlation between the service connected condition and the claimed secondary condition. However, the clinician did not cite and specific literature or research data. This report was also not given weight.
Considering that the evidence against the claim was based on supporting logic that was nothing more than an unsupported “quite possible” theory that raised the possibility of a post service injury as causing the claimed secondary condition, you would think that the rater would have remanded the claim for further development. I have seen claims remanded when the positive report failed to address previous negative reports. I have also seen cases remanded when a clinician identified a correlation between two conditions and failed to provide specific details supported by literature or research data.
The rater used every weak point in any of the favorable reports to deny the claim. I really think the claim should have been remanded for further development. However, the rater either failed to recognize that the C&P examiners determination of a “quite possible” post service cause was not supported by any specific events or glommed on to the very weak negative evidence and gave weight to the negative evidence. I have seen all these problems addressed in the hundreds of BVA cases I have read. I would never allowed a claim to go to adjudication with reports written after a negative C&P exam that did not attack the week points in the negative C&P exam and provide significant supporting logic that backed up blanket positive statements.
A bare conclusion, even when reached by a health care professional is not probative without a factual predicate in the record. Miler v. West, 11 Vet. App. 345, 348 (1998).
A medical opinion based on speculation, without supporting clinical data or other rationale, does not provide the required degree of medical certainty. Bloom v. West, 12 Vet. App. 185, 187 (1999).
Edited by HoppyHoppy
100% for Angioedema with secondary conditions.
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