Is the VA supposed to tell you that you are being evaluated for a TDIU claim if you did not apply for it but they are inferring it? A family member was denied TDIU but he did not know he was being evaluated for it. He was rated at 30% went for an increase, got 70% and in that decision they denied him TDIU. Does anyone know if they should have given him notice, sent him the Form 21-8940 or anything like that?
On the topic, I found this:
1) 38 CFR 3.155 – Informal claims provides:
(a) Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by the Department of Veterans Affairs, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution.
And I also found this:
The Department of Veterans Affairs Reference Material, M21-1MR, Part IV, Section F states the following:
A decision concerning entitlement to an IU evaluation is based on a review of all available evidence, which should be sufficient to evaluate both the Veteran’s
•current degree of disability, and
• employment status.
Forward a VA Form 21-8940, Veteran’s Application for Increased Compensation basedon Unemployability, to the Veteran if a request for IU is
• expressly raised by the Veteran, or
• reasonably raised by the evidence of record.
There is a note that states the following:
Note: Although a VA Form 21-8940 can be an important development tool, it is not required to render a decision in an IU claim.
However, I would argue this:
the intent of that note was for the situation that refers to the specific instance in which a claimant was sent the form, but failed to return it. In the instant matter, claimant was never sent the form to make him aware that there was a viable unemployability claim and that a decision was being rendered for that claim.
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.
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.
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”
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.
Question
bigred1
Is the VA supposed to tell you that you are being evaluated for a TDIU claim if you did not apply for it but they are inferring it? A family member was denied TDIU but he did not know he was being evaluated for it. He was rated at 30% went for an increase, got 70% and in that decision they denied him TDIU. Does anyone know if they should have given him notice, sent him the Form 21-8940 or anything like that?
On the topic, I found this:
1) 38 CFR 3.155 – Informal claims provides:
(a) Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by the Department of Veterans Affairs, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution.
And I also found this:
The Department of Veterans Affairs Reference Material, M21-1MR, Part IV, Section F states the following:
A decision concerning entitlement to an IU evaluation is based on a review of all available evidence, which should be sufficient to evaluate both the Veteran’s
•current degree of disability, and
• employment status.
Forward a VA Form 21-8940, Veteran’s Application for Increased Compensation based on Unemployability, to the Veteran if a request for IU is
• expressly raised by the Veteran, or
• reasonably raised by the evidence of record.
There is a note that states the following:
Note: Although a VA Form 21-8940 can be an important development tool, it is not required to render a decision in an IU claim.
However, I would argue this:
the intent of that note was for the situation that refers to the specific instance in which a claimant was sent the form, but failed to return it. In the instant matter, claimant was never sent the form to make him aware that there was a viable unemployability claim and that a decision was being rendered for that claim.
Any thoughts?
Much thanks!
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