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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
carlie
Well, this for sure is one damned looooong read, but for me it was worth
taking the time.
IMO - In totality, it's nothing more than politics and bull-sheet, at it's finest.
Please excuse me for just a moment _ - _ - _ - . . . . .
Sorry - I had to go wipe all the sheet out of my brain and a rag - - -
to clean the barf off my monitor.
Same old - good old boy bull-sheet - just with a few new faces,
dripping the same stinking sheet from between some different lips.
Most of it all goes something like this:
Schmuck #2 gets introduced and immediately congratulates the Schmuck #1 -
(that introduced him to speak) - for his accomplishments.
Schmuck #2 spends his time talking about looking forward to blah - blah -benefits will be administered
with optimum levels of efficiency and effectiveness, blah - blah, congress is working hard,
blah - blah . . . .
Then Schmuck #3 is introduced by Schmuck #2 and begins thanking and praising him
and Schmuck #1 for all the wonderful work they have been doing.
starts in babbling about the backlog of claims, says I've been at this for 30 years and it's been an issue.
Blah - blah, reinstated Priority 8 veterans, blah - blah - Agent Orange, blah - blah.
These Schmucks don't even know nor will most even hazard a guess as to what THEY define as, a claim that is in backlog.
Even one schmuck that feels veterans would be better served, if the VBA just let the doctor
make the decisions on if their diagnosis is related to service, the percentage and effective date.
ONE PERSON - having carte blanche authority on the whole ball of wax.
Here's his quote below.
"Fast forward three or four decades and you have very subtle, very difficult questions of medical causation and effect, which are beyond the ken of a lot of laypeople. Which causes me to think if we are going to spend massive sums of money training more and more people to try and do all of these different jobs at once, be both advocate, judge, jury and medical examiner all at once, you are going to get somebody who is not really good at doing any of them trying to do all of them.
Now if that is the nature of the problem challenging us it seems to me that we ought to look for places where folks do make these kinds of decisions on a snap basis all the time, and they have a lot on the line, and they make these decisions very effectively precisely because they have the expertise and they have a lot on the line.
I look at doctors as having to make decisions like this all the time. Every time a doctor cuts on a patient or prescribes a medicine they are taking their career in their hands. And if they do it negligently they can get sued. If they intentionally misprescribe or mistreat they can go to jail. So there are very, very severe consequences for people who make these life and death decisions all the time.
Now a death decision is a pretty good analogy, because we actually let doctors make the most awesome decision about whether or not to turn life support off when someone is no longer living, when they are brain dead. Now it seems to me if we can give doctors the awesome power to turn life support off, we ought to give them the authority to turn life support on."
Then more speakers and more blah,blah, blah.
IT innovations - computerized records Service Organizations, blah, blah.
NOW - over about the next 3 minutes of reading - I could feel the curd growing
inside my stomach - the kind where you feel the warmth start and your throat begin to spasm.
NOPE - NOT JUST MY GERD ACTING UP THIS TIME.
The next part might make you feel fairly close - even if only as a verbal metaphor - - -
here it comes . . .
" I will turn to our budget. As I noted in my statement it is really three categories, or best looked at that way. The pro bono funding, our operating budget, and the Veterans Courthouse.
I will speak to the Veterans Courthouse and defer to my statement for the others. The amount that we requested is that needed to continue toward construction of a Veterans Courthouse.
In these fiscally constrained times, the priority attached to this project can only be made
by you and Congress as a whole. We are not privy to the needs of the other entities that share your portfolio or the needs of the Nation.
Moreover, the need for a stand alone courthouse is not driven by space, equipment, or supply needs alone.
It is driven by the sense of major veterans groups and the sense of Congresses over the past several years that veterans, who only recently in the grand scheme of American history have been granted the right to judicial review of their claims, should have a courthouse
at least as equal to the courthouses provided to hear the claims of everyday citizens.
As you know, working in the grand house of the people, Congress, buildings, particularly government buildings, represent more than just a place to work.
They speak to the respect our Nation has for the work that is being done within them. Courthouses reflect respect for the rule of law and particularly in the case of our veterans, a Veterans Courthouse, as so aptly stated in H.R. 3936 would be,
and I quote, “symbolically significant of the high esteem the Nation holds for its veterans,”
and would, “express the gratitude and respect of the Nation for the sacrifices of those serving, those who have served in the Armed Forces, and their families.”
Whether a dedicated Courthouse is to be funded now or at some later date is a decision the Committee and Congress must make, weighing this project against others.
Although belts must be tightened, some buildings will be funded. As noted in my written statement, if a Courthouse is to be built we support those who suggest it should be a Veterans Courthouse.
As to the specific budget request, which is $25 million, it is the amount that GSA has advised can prudently be spent over the next year. I hasten to add that in addition to reexamining the latest projected costs of the Courthouse there remain two significant contingencies to constructing it on the currently identified location at 49 L Street. One is whether the City will close or restrict traffic on a side street to accommodate the security needs of the Court.
And the second is, can the additional property needed to properly site the Courthouse be purchased within the estimated amount. So those are two contingencies that still exist."
BLAH - BLAH -
"But I have programmed if we do have the funding this year, money for certain renovations to our current space. VA is supposed to move out of the building. We would then move into a good portion of the sixth floor. I would move some of our Central Legal Staff, if you will, down so that we could put the two new chambers on the secured top two floors. And so that type of construction, movement expenses, we would have to undertake with the additional chambers coming in. Short of that, yes sir. We have, we can perform our mission. The reason that we have a number of cases pending decision is because we are three judges down right now."
It just goes on and on and on . . . . .
<
<
<
<
<
with the same old type of bull-sheet, they always get away with,
and before too long - they will have their damned Court House built.
Seems like caring for veterans comes second to the honor they want to bestow upon veterans like having a fancy Court House.
Seems like they would concentrate on making the programs run right
so veterans no longer need - a Court House.
JMHO
Full Document:
http://veterans.hous...DAMA3-17-11.htm
Carlie passed away in November 2015 she is missed.
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