A little background before I get started. I filed for compensation for my lower back condition back in 2009 and was subsequently denied. Then I applied again with new evidence and was denied again because the VA stated that my condition was not service connected and no evidence was in my SMR. I was awarded other service connected disabilities and others denied. Anyway, I appealed the denial of service connection for my back and requested a DRO to review my case. I went to my hearing in April of this year and was approved for service connection at 10%. She stated that she is not sure why they denied my claim because all of the evidence showed that I was clearly service connected. Keep in mind that I brought my own SMR to prove this during my hearing. This just tells me that they did not request it back in 2009 or review what I sent to them. So I disagree with the percentage I was rated by the DRO and I think it should be much higher. I am filing for TDIU for my migraines rated at 50% and my lower back. Should I file the NOD and the TDIU at the same time? Also do I file the NOD and request a DRO to review it again or file the NOD and ask for BVA review? Please help. Also I think that there could be a CUE for the effective date for my initial denial for my back. Not sure what to do next.
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.
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.
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”
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.
Question
Adrianaj
A little background before I get started. I filed for compensation for my lower back condition back in 2009 and was subsequently denied. Then I applied again with new evidence and was denied again because the VA stated that my condition was not service connected and no evidence was in my SMR. I was awarded other service connected disabilities and others denied. Anyway, I appealed the denial of service connection for my back and requested a DRO to review my case. I went to my hearing in April of this year and was approved for service connection at 10%. She stated that she is not sure why they denied my claim because all of the evidence showed that I was clearly service connected. Keep in mind that I brought my own SMR to prove this during my hearing. This just tells me that they did not request it back in 2009 or review what I sent to them. So I disagree with the percentage I was rated by the DRO and I think it should be much higher. I am filing for TDIU for my migraines rated at 50% and my lower back. Should I file the NOD and the TDIU at the same time? Also do I file the NOD and request a DRO to review it again or file the NOD and ask for BVA review? Please help. Also I think that there could be a CUE for the effective date for my initial denial for my back. Not sure what to do next.
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Berta
INDEED! It is certainly a CUE and/or 38 CFR 3.156 error. "I filed for compensation for my lower back condition back in 2009" Was the NSC rating at 10% then? "I went to my hearing in April of this
FormerMember
Yeppers. This has a Fenderson v. West staged rating all over it, too. File the NOD and make darn certain sure you ask for the higher rating percentage but more importantly, the earlier filing date tha
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