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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
ctbenja1015
I got my "white" envelope, guess brown is out of style now. I was declined for DJD of Cervical spine(not service connected). Reasons were:
1. The evidence shows that cervical spine arthritis existed prior to service. There must be objective evidence of worsening of a pre-existing condition in order to establish service connection by aggravation. There is no evidence that the condition permanently worsened as a result of service.
2. VAMC exam conducted on August 18, 2014, notes that you were treated for and diagnosed with DJD of the cervical spine with radiculopathy on March 20, 2009, which was 5 months prior to your active duty service of August 4, 2009.
3. VA exam conducted August 4, 2014, notes that your cervical spine arthritis was not aggravated by your military service,
Facts
1. excerpt from C&P exam: 2. Medical history
------------------
Describe the history (including onset and course) of the Veteran's cervical spine (neck) condition (brief summary):
veteran had sustained a vehicle accident while on orders 5 months before he deployed in Iraq ,it was a rollover accident. he was stationed in
Wisconsin and he believe he had normal cervical spine X-ray they were reporeted normal, without a fracture and it's only during deployment in 2- 3 2010 that he complained of bad neck pain and numbness in hands in Monterey VA in 2014 they had X-rays of his shoulders and was told that
his issues were coming from his neck , he had neck arthritis ; he was sent to TMC while in Iraq and complaining of his neck and was told that neck was
ok to continue his duties and he did current symptoms are constant 6/10 pain , and if turns his neck shoots to a 8/10 and disrupts his sleep. Re his MOS he was in transportation with lots of driving heavy truck and as well a s lifting daily about 35- 50 lb. daily plus all they usual weight they had to carry on ther back.
TYPE OF MEDICAL OPINION REQUESTED: Direct service connection
OPINION : Direct service connection
Does the Veteran have a diagnosis of (a)neck condition that is at least as likely as not (50 percent or greater probability) incurred in or caused by
(the) long term wear of ACH and poor road conditions while serving in Iraq? Rationale must be provided in the appropriate section.
c. Rationale: REVIEW OF VISTA WEB 3/20/09 SHOWS EVIDENCE OF THE ROLL OVER ACCIDENT; C SPINE X-RAY WERE TAKEN AT THE TIME WITH EVIDENCE OF MILD DDD AS WELL AS EVIDENCE OF WHIPLASH INJURY AS TYPICAL REPORTED FINDINGS WHICH IS A
RISK FACTOR FOR CHRONIC NECK ISSUES AND DJD/ DDD WITH RADICULOPATHY
No exam notes in my record show it was not service connected, no exam on August 4, 2014
They were given my detailed record of retirement points to verify any active duty or drill dates.
**********************************************
Thoughts?
Edited by ctbenja1015100% Service Connected P&T, SSDI
70% PTSD
50% Sleep Apnea
10% Left Shoulder Sprain
10% Right Shoulder Sprain
10% Bilateral Plantar Fasciitis
10% Cervical Arthritis
20% Upper-left Radiculopathy
20% Upper-Right Radiculopathy
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