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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 rating
Picked 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.
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Lemuel, -
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Question
jjsmith2817
I’m a Marine Corps veteran that served about sixteen-months with the grunts in Viet Nam (VN). While in VN, on my second tour, I was medevac’d for what I believe was a nervous breakdown. I drew up in a ball with severe stomach pains and just froze-couldn’t move. The doctors found nothing physically wrong with me and referred me to a psychiatrist. I never saw the psychiatrist in VN because I was shortly sent to Okinawa under a Congressional Inquiry resulting from my brother and I both being in VN at the same time. I never saw a doctor or my records unit I was honorably discharged in November 1970. I was referred to the VA for dental work but nothing was ever said about my appointment with the psychiatrist.
I’ve had all kinds of problems with depression, anxiety, paranoia, night mares, sleep deprivation and stomach pains since being discharged. Over the years I’ve gone to several doctors at their offices and emergency room for help but it never got better.
I applied for PTSD benefits at the VA in 1993 but was turned down. The reason, I later learned, was because I didn’t have a PTSD diagnoses and I didn’t keep my appointment with the psychiatrist in VN. At that time the VA didn’t diagnose PTSD so I went to a private clinic in 2004 and was diagnosed with a severe case of PTSD and they started me on medication. With diagnoses in hand I went back to the VA and they then evaluated me as having a mild case of PTSD and gave me 10% disability. Sometime around 2000 the VA started diagnosing PTSD. I filed a Notice of Disagreement (NOD) and in January 2006 I was awarded a 30% compensation for PTSD. I appealed and in May 2012 was turned down.
If I had not received the medications from the private clinic, when I did, I would not be here now. The treatment I get at the VA hospital is great, but, I’m reluctant to place my trust in the VA because of how they have dealt with me over the years. Filing claims and appealing decisions really stresses me out.
I don’t even know where to start concerning the VA’s evaluation of my claim. I think I deserve a lot higher rating for PTSD than 30-percent. I also think they owe me benefits back to at least 1993 and possibly back to 1970.
Any advice on what I need to do would be appreciated.
Respectfully,
jjsmith2817
Veteran
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