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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
TiredCoastie
Should I NOD or not? That's the big question right now. The problem is that there is some hope that the VA will increase my SC migraines from 0% to 50% and my SC knee arthritis from 0% to > 0 without having to appeal just based on this claim. My last claim was screwed up from stem to stearn - they even missed the informal claim date that the DAV established for me - with a little help from my outside neurologist who didn't read the DBQ form right and answered "no" where she should have answered "yes." My reconsideration claim was the first time I've submitted for an increase on my knee. So there's some prospect that they'll get at least part of this right this time...
What really may need to be appealed is the impact of the TIAs which began on active duty and my hearing loss. Because TIAs don't leave any lasting disability, that's going to be a hard battle to win until I actually have a stroke. Thanks to all, again, who've shared their history with this disability and the VA.
The hearing loss is the real kicker - I've been denied SC because there is an initial intake hearing test that shows some hearing loss. While my hearing loss increased in service and was never as bad as initially tested, as shown by a whole stack of hearing tests covering 24 years in uniform as well as the VA's initial audiology C&P right after I discharged, the VA has decided to disagree. And I'm wearing VA issued hearing aids. And the QTC audiologist was trying hard to help me out this last time. And one of the top ENTs in our area filled out the DBQ with the help of his Air Force O-4 intern. For fighting over principle at this point for what could be a very small percentage increase I could miss out on years of a much higher percentage increase which could come earlier.
I'm watching the calendar move by day-by-day without any movement on my request for reconsideration of my latest claim. My last claim was finalized on Dec 27, 2012, and I filed for reconsideration on April 11, 2013. According to eBenefits, my claim has rested in "gathering evidence" for a couple of months without any gathering of evidence activity other than the 5103 waiver request. Before that, it was inprocessed twice. Based on what the performance stats show for my RO, they aren't doing a lot of anything, particularly on claims less than a year old.
So, the probability of the RO coming up with and communicating a rating decision on or before December 27, 2013, at its present rate of speed seems pretty unlikely unless something changes pretty soon. There have been a lot of posts about the VA not honoring the initial claim date when a request for reconsideration is denied, so I'm concerned that I'll lose out on several years of backpay that would eventually make its way assuming I win the appeal.
Really could use some advice. Should I submit a NOD and put this reconsideration and increase claim into extreme slow motion? Or let it ride, hope for the best, take what I can get (if anything), and then go back through the process to resubmit a claim for the hearing loss and whatever else if they deny it again this time then slam a NOD as soon as it's denied the next time?
How come there isn't a service connection for the conditions and diseases caused by the VA disability system?
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