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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
KHJH
My husband died Nov 2006 from Cardio Pulmonary Arrest. I found out about 9 months ago that IHD was made presumptive to Agent Orange so I filed a claim for DIC.
I received a letter from VA that states "We need additional evidence from you"
During the veterans Lifetime, service connection was established for post traumatic stress disorder, chronic lumbar strain with painful left hip, and chondromalacia left knee. Service connection was not considered for Cardio Pulmonary Arrest. In order to support your claim, you need to submit evidence that shows a disability was incurred or aggravated during service and was the primary or contributory cause of death.
We will request medical records from any VA facility that treated the veteran.
If a private physician or facility has treated the veteran, we may be able to request these records on your behalf.
I sent the VA Medical Records from St. Mary's Hospital in 1990 where my husband had a heart attack a quadruple bypass. His diagnosis was: Atherosclerotic Coronary Artery Disease with Angina. His EKG report states: Consider Lateral Ischemia. The VA doesn't acknowledge these records in their list of what they have received.
I also sent them Medical Records From the VA Hospital
EKG report on 5-23-2003 states: Consider Lateral Ischemia
EKG Report on 10-29-2004 states: Consider anterolateral ischemia
EKG report on 5-23-2005 states: Consider anterior ischemia
EKG Report on 3-13-2006 states: abnormal ECG
EKG Report on 10-18-2006 states: Inferior infarct 2006 ?
VA medical reports 10-2-2001 : Ischemic Heart Disease, CAD/CHF, Angina
VA medical reports 12-2-2003 : Ischemic Heart Disease, CAD/CHF
VA medical records 4-18-2006 : Congestive heart Failure, Angina Coronary Artherosclerosis, coronary bypass
VA medical records 10-23-2006: CAD/CHF
VA medical records 11-5-2006: CAD
VA Medical records From the ER and hospital stay on the day he died.
Death certificate stating cause of death as Cardio Pulmonary Arrest
VA Hospital Autopsy Report
Then the letter states: We may consider that the veteran's cardio pulmonary arrest is associated with dioxin exposure if you send us scientific or medical evidence showing that the veteran's claimed condition is medically associated with dioxin exposures.
If a doctor expressed an opinion regarding the relationship of the veteran's condition to dioxin exposure, send us that opinion, the reasons and bases for that opinion, and the clinical treatment records. In addition, the doctor should provide literature that supports the opinion. Literature may consist of scientific or medical journal articles, etc., that supports the doctor's opinion that the veteran's exposure was related to the veterans diagnosed condition.
I don' know who to contact for a medical opinion and don't think I have enough time. I have until June 14th to send in additional information.
Also stated in the VA Letter (which really upset me)
Evidence of record indicates that you and the veteran did not live together continuously. Therefore we need statements from you and two other persons, with the following:
All dates and places where you and the veteran lived during any period of separation prior to the veteran's death. Include a statement explaining why each separation occurred. If there was a written agreement or court order of separation, please send up a copy.
A statement if whether or not you and the veteran intended to again live together.
Any attempts you or the veteran made to resolve or settle your problems
The amounts and dates of the veteran's contribution to your support during each separation.
Did you or the veteran ever apply for divorce or annulment? If so, give the date and results of the court action and furnish a copy of the divorce decree, if any.
Not sure where this came from. My husband and I were married for 30 years and were never separated. We lived in the same household for 30 years.
Not sure what to do now. I sure would appreciate any advice
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