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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
Soldier81
My appeal for sleep apnea has a five year old effective date in April. I originally filed for the claim in April 2010. I had a C&P examiner that either doesn't do her job at reading STRs or just had something against my claim which is be. The examiner should do what the law says and her job entails. She stated that there was no mention of my sleep disturbances and excessive snoring or waking up at night having to readjust in order to breath. However after the denial I sent evidence of just that to the BVA. They decided to remand it back to the RO with these instructions
If the September 2010 examiner is available request that the VA examiner offer an addendum opinion regarding the Veterans sleep apnea. If the 2010 examiner is not available schedule the veteran for another examination.
The entire claims file must be reviewed by the examiner in conjunction with the opinion. The examiner should confirm in the examination report that she she has reviewed the folder in conjunction with the examination.
Therefore the examiner should opine as to whether it is at least as likely as not (50 percent chance or higher) that the Veterans sleep apnae had its onset during, or is due to service.
The opinion should specifically address the veterans March 2009 diagnosis of sleep apnea which occurred prior to his weight gain from 207 to 242 pounds.
The opinion should also address the reported instances of snoring and difficulty sleeping contained within the Veterans STRs.
Then readjudicate the issue on appeal. If any of the benefits sought on appeal remain denied furnish the Veteran and his representative with a supplemental statement of the case and afford them the opportunity to respond before the file is returned to the board for further consideration.
Another thing wrong with the C&P examiners opinion was that she tried to make it look like weight gain was at fault for my sleep apnea stating I gained 35 pds from 2008 to 2010 but I weighed 207 pds during my sleep study in 2009. I stand 6 ft 3 inches tall 207 pds is not fat by any means. The remand is in the decision approval status anyone know how long it generally takes to finish up. Straight forward non jealous feed back is much appreciated. If you come off like a jealous jellyfish green with envy then I will just blow you off.
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Soldier81
USMC, I had little knowledge of SA during service all I knew about were my symptoms. My statements should be more than enough for them to play connect the dots. I had my sleep study done after servic
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