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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
NavyWife
Game plan for C&P's
I feel like I have to have a strategy in place on hubby's claim now that we are getting down to the finish line. The C&P scheduler called us yesterday on a Saturday morning and Darnit we missed his call! Here's my plan with a counterpunch to every punch that VA might try to throw at us. At least the ones that I'm aware of...
1. Go to CNP exam. Take a type written single page of paper that hubby can hand to the doctor as well as keep a copy for himself. This will restate the symptoms he has already reported to VA as well as provide the answers to questions the doc would ask that affect the rating. These I will get by looking over the DBQ for the issues he has filed for. Also I will look over the clinicians guide for the issues he has filed for.
2. 3 to 5 days later go on my healthy vet and download the exams using the blue button notes feature. If the exams are favorable do nothing. If the exams are negative or say things that we didn't say, Then immediately go and pay for two IMEs. I already have two specialists that I have previously contacted ready and willing to do the IMEs. Immediately upload these IMEs to E benefits. Then the evidence would be two against one and if VA follows their own rules they would have to grant the claim.
3. Wait for the rating decision. If it is favorable do nothing. If it is not what we expected, Either the percentage granted or the effective date granted, Then review the reasons and bases section for any legal errors that VA made. If there are any, then use Bertas "go Cue yourself "template explaining to Va exactly the legal errors they made. If no response within one year then file NOD.
What other punches might VA try to throw at us that I haven't thought of here?
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Notorious Kelly
Oh, RU, how many of us felt like you at the beginning of a lengthy battle with denials, appeals, descent into poverty and despair etc. If the VA could be trusted to fairly rate veterans who are ju
RUREADY
No one is suggesting dishonesty or gaming the system; people have just learned how anything can be skewed for denial so the idea is to be sure that details of your worst times are shared to maybe cut
16 answers to this question
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