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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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Post in Re-embursement for non VA Medical care.
broncovet posted an answer to a question,
Welcome to hadit!
There are certain rules about community care reimbursement, and I have no idea if you met them or not. Try reading this:
https://www.va.gov/resources/getting-emergency-care-at-non-va-facilities/
However, (and I have no idea of knowing whether or not you would likely succeed) Im unsure of why you seem to be so adamant against getting an increase in disability compensation.
When I buy stuff, say at Kroger, or pay bills, I have never had anyone say, "Wait! Is this money from disability compensation, or did you earn it working at a regular job?" Not once. Thus, if you did get an increase, likely you would have no trouble paying this with the increase compensation.
However, there are many false rumors out there that suggest if you apply for an increase, the VA will reduce your benefits instead.
That rumor is false but I do hear people tell Veterans that a lot. There are strict rules VA has to reduce you and, NOT ONE of those rules have anything to do with applying for an increase.
Yes, the VA can reduce your benefits, but generally only when your condition has "actually improved" under ordinary conditions of life.
Unless you contacted the VA within 72 hours of your medical treatment, you may not be eligible for reimbursement, or at least that is how I read the link, I posted above. Here are SOME of the rules the VA must comply with in order to reduce your compensation benefits:
https://www.law.cornell.edu/cfr/text/38/3.344
Picked By
Lemuel, -
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Post in What is the DIC timeline?
broncovet posted an answer to a question,
Good question.
Maybe I can clear it up.
The spouse is eligible for DIC if you die of a SC condition OR any condition if you are P and T for 10 years or more. (my paraphrase).
More here:
Source:
https://www.va.gov/disability/dependency-indemnity-compensation/
NOTE: TO PROVE CAUSE OF DEATH WILL LIKELY REQUIRE AN AUTOPSY. This means if you die of a SC condtion, your spouse would need to do an autopsy to prove cause of death to be from a SC condtiond. If you were P and T for 10 full years, then the cause of death may not matter so much.Picked By
Lemuel, -
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Question
Sergeant G
The other day I came across an internal memo from someone at the Appeals Management Center. The memo was submitted to the Director of the Compensation and Pension Service as a recommendation for denial of extra-schedular IU, and I could not believe what I read. The author of the memo was apparently hell bent on NOT recommending IU to the Director, and the “reasons” were absolutely ridiculous and show malicious intent from the author. So much for the VA’s so-called pro-claimant, non-adversarial claims process.
First, let me provide a little background information. I was awarded 70 percent with IU for bipolar disorder effective on the date I originally filed my claim in December 2007. It took several appeals to finally get the IU, and to get my current effective date, which was ultimately awarded by the BVA in November 2012. In the same decision from the BVA, it denied my claim for an even earlier effective date (one year) for the 70 percent rating and IU. (38 USC 5110(b)(2) allows for an EED—up to one year—if evidence shows an increase in disability in the year prior to a claim being filed.) The BVA also remanded my appeal and directed the AMC to refer my claim for consideration of an EED for IU on an extra-schedular basis. I am claiming that I am entitled to an EED because my disability increased to the point where I met the criteria for IU prior to my current effective date. I was initially misdiagnosed with depression and rated at only 10 percent; therefore, until my diagnosis was corrected in October 2007, my treatment providers didn’t recognize the manic component of bipolar disorder. Also, I didn’t know that I was experiencing manic symptoms, so I did not know or have the insight to report the symptoms to my providers.
I have a lot medical and lay evidence supporting my EED claims for 70 percent and IU, but the BVA ignored it (as is often the case with the VA in general). I appealed the 2012 denial to the USCAVC and my appeal was remanded to the BVA for a few reasons, including the BVA’s failure to consider the evidence I presented, or at least explain why it did not find such evidence to be persuasive. So now I have an appeal at the BVA for an EED for 70 percent and schedular IU, and claim with the AMC for EED for 70 percent and extra-schedular IU. (Actually, the later claim is now with the BVA for review.)
(Back to the reason for my post.) The remand order from the BVA directed the AMC to issue a supplemental statement of the case (SSOC) for any issues denied. Unsurprisingly, I did indeed receive an SSOC because all issues were denied. Again, the VA failed to consider the abundant amount of evidence supporting my claims/appeals. The SSOC basically said there was no evidence supporting my claims for both 70 percent and extra-schedular IU, without providing reasons as to how they arrived at that conclusion, nor did they cite any independent medical evidence against my claim. While drafting my response to the SSOC, I came across the above-referenced memo.
The reasons and bases section of the memo consisted of eight paragraphs, and all but one paragraph—the one merely citing the procedural history of the appeal—were wrong. Not only was the content inaccurate, the author’s clear intent was to fabricate reasons for denial. Therefore, the C&P Director was not fully or accurately informed regarding the merits of my case. (Who knows if it would have made a difference anyway, even if the memo were legitimate.)
The most ridiculous “reason” the author gave to support his/her recommendation for denial is because, in the author’s opinion, the evidence I submitted to the BVA, “written in [my] own hand” shows my ability to write a “concise and well documented legal brief.” I am totally pissed off about this. Basically, I am being penalized for being well informed and articulate. Also, the author reviewed my 20-page “brief” enough to opine that it is well documented, yet does not address any of the content, and has the audacity to use my own evidence against me. I did attend law school and briefly practiced at one point—over 10 years ago—and the author uses this as “evidence” against me as well. He/she seems to imply that I am able to churn out “legal briefs” consistently and efficiently, and therefore, I must not disabled. That is not the case. Thanks to all the appeals I’ve had to file because most people at the VA do not do their jobs, I have had the “benefit” of almost seven years to acquire the knowledge pertinent to my claims, and a lot of the content in the documents I submit is copy and pasted from earlier documents because no one ever bothers to read the evidence. With every document I submit, I present my case in a thorough and organized manner, include excerpts from medical records supporting my claim (along with specific dates, providers, etc.), and cite pertinent statutes, case law, and VA regulations, and apply them to the facts of my case. I do this to make it easier for whomever reviews my 2,000-page claim file. All they have to do is read the document and verify the content of the treatment notes, if they so choose. So, for some a$$hole to use the evidence I submit to make it easier on him/her to their job against me adds insult to injury.
The author also had the audacity to use my mother’s three-page lay statement against me. In the second paragraph of her statement, she briefly remarked how I graduated from law school and passed the bar exam on my first attempt (in 2002). The entire point of mentioning this was to show the difference between how I was functioning at a high level before my disability drastically increased and how I was unable to function afterward. I graduated from law school and passed the bar exam over four years prior to the time period being considered for the EED; therefore, this fact is irrelevant. He/she disregarded the rest of the detailed statement, which is supported by medical evidence.
The memo also improperly relied in part on the portion of the BVA’s 2012 decision denying the EED for 70 percent and IU—the same part that was the primary reason for the USCAVC remanding it to the BVA. Furthermore, evidence from the relevant time frame that should have been under review is between December 2006 and December 2007. Yet, the author notes that I was able to graduate from law school and pass the bar exam—again, over four years before the time period in question—and also notes that I didn’t start receiving SSDI until January 2010. This is also irrelevant and it seems like the author is implying that I must not have been unemployable since I didn’t start receiving SSDI until then. I didn’t apply until July 2009 because I had been trying to work, but ultimately was unable to work in a gainful capacity. Social Security approved my application the first time. For the year in question, due to my disability, I was only marginally employed and earned less than $3,000. My medical records—from the VA, nonetheless—confirm that my “severe psychiatric impairment” was responsible for my inability to work in a gainful capacity for several years, including all of 2007. My VA therapist even expressly stated that in her opinion, I met the criteria for IU during this time.
I won’t get into the problems with the other three paragraphs since this post is so long, but I’ll note that he/she did not include even one piece of positive evidence in the memo, nor was any included in the SSOC.
I will definitely be addressing these issues in the memo—none of which were reasons included in the SSOC—when I submit my response to the SSOC to the BVA.
I didn’t mean to write such a long post, but I just had to vent. Thanks to all for reading and for any input.
G
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broncovet
The VA has to rate you on the criteria listed in the regulations. This is established precedence. Many BVA decisions use the phrase , "The criteria for xxx condition have(or have not) been met".
bobz
I agree this is ridiculous! The fact you got a copy of the idiots reasoning is amazing usually they "lose" something like that. Have you considered getting your congressperson involved? Good luck to y
Navy04
Sad, but you are right on Pete.
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