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60 Second Exam, Rude Doctor, Total Denial Despite 20+ Years Of Civilian Doctor Visits
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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.
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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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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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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
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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
skydealer
This past August I filed a VA claim. The issues were on items that I occurred while I was in the Air Force back in the early 1980s. These are not just things that were in my military records – the items I claimed were for chronic issues that I have spent thousands and thousands of dollars on medical bills over the past 30 years on. I never knew about being able to get the VA to take care of problems that arose while I was on active duty until recently or else I would have filed a long time ago.
I received a head trauma back in ’83 and have been seeing doctors and neurologists for constant headaches, memory loss and insomnia since the injury occurred. While I was in the service I was seen for chronic headaches after the trauma and the military records also reflect this. I also had pneumonia and developed a chronic cough. These are items that I have seen doctor after doctor about. The problem is that, even though I have over 100 pages of medical visits, they could never nail down a clear diagnosis… one doc said chronic sinusitis, another said it was chronic bronchitis, etc etc.
So, last summer I filed a compensation claim on these issues, along with a few others that were in my records that I have had to see civilian doctors on.
I truly had the CP doctor sent from Satan himself. At the beginning of the visit, Dr. Ngwa introduced himself and we shook hands. He sat down and started reading that I am being seen for chronic cough, chronic headaches, chronic bronchitis, etc., and the more he read the mode upset he became. I then received a five minute lecture on how this was a legal procedure and how dare I file something like this.
I had also sent in a copy of my civilian records as well as authorizations for the VA to retrieve any medical records directly. Dr. Ngwa said these did not exist (despite the fact that I did send them in over a month prior) and refused to acknowledge any existence of civilian records. He got even angrier when, after he accused me of hiring someone to fill out the claim form (of which I did NOT), I told him the phrases I had used, such as “chronic lung condition” and “bilateral knee pain” was straight out of my civilian records. He spoke with a heavy accent and I had to have him repeat things so I could understand, this also made him more hostile as we spoke.
The next 20 minutes were spent with me just sitting there while he typed away on the computer. From what I saw he was actually typing up the denial while I was sitting there and before he actually did any exams or any test results came in.
Eventually, he finally did get around to an actual physical exam – spending less than 60 seconds to exam my feet, legs, hands, and everything else.
A few months ago I asked the VA for what Ngwa reported. It turns out he shot down everything saying there were no issues. He answered questions on the report that he never asked me, such as items regarding my headaches, and on other incidents he did not actually report what I told him. I mentioned that I was on antibiotics 5 or 6 times for bouts of bronchitis and pneumonia in 2011 – he stated that I said I was sick twice last year.
So, everything was denied with the reason of “The evidence does not show a current diagnosed disability” with the exception of the chronic sinusitis, which stated there was no event in service. I had been in sick call at least 5 times for cough/fever/sinus problems.
I did not argue back during the exam and I kept my cool. He was insulting, even congratulated me on creating a whole new disease called chronic left leg syndrome (he was being sarcastic) and when we walked out to the receptionist to set up a breathing test I thanked him for his time and put out my hand. He looked down at it and turned his back and walked away. The receptionist and I just looked at each other in disbelief.
So, how does one appeal a mess such as this? A total “hands on” exam of less than 60 seconds? After getting a denial letter I went to the DAV, who told me that I needed to get letters from my doctors before they could do anything. You know how hard it is to get a NEXUS letter? Cripes, it was hard enough in the past to get them to do FMLA paperwork for my civilian job.
I did talk to the VA Patient Advocate and I stated that I wanted to file a complaint with the IG on the issue, but other people told me that if I did so I would be screwed for years on the claim.
How should one repeal something like this crap?? Should I just ask for a whole new CP exam? Should I get a lawyer?
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