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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
john999
I made two claims for reimbursement in November 2014 and in February 2015 using the Claim for Unauthorized Expense form. I did this before when the VA owed me money for dental care they should have provided. It was the same situation this time. I have called numerous times to Fee Base, Congressman, and to the patient advocate to no avail. Finally, today the Fee Base office in Tampa responded to tell me they had no record of my claims. This really burned my azz since they had already acknowledged that they were processing the claims back in March of 2015. Now they can't find them. Thankfully, I have copies of the claims and the evidence I used. It has taken the Fee Base Office 9 months to tell me they lost my claims. Last time I made a claim like this the Fee Base Office just threw them away and admitted it to me when I complained about them taking 6 months to process my claim for reimbursement. I got paid on that one. I will probably have to gather more evidence on the recent reimbursement claims because they will probably lose the evidence, or not connect it to the right claim. They did not have my correct address at the fee base office even though I have been at the same address for 28 years.
How come my credit card company never loses statements? When and if I owe the VA they never lose these records. IRS never loses records of debts. Nobody I owe money to ever loses the records of my debts. The VA loses everything. If you carry it, and put it right into their hands they lose it. This means I must always keep copies of everything I send them and expect them to lose it. I made a complaint to the IG. The only way to get things done right is to devote yourself to seeing a claim is done, and be willing to submit, and resubmit evidence and claim forms over and over again.
I have to pay estimated tax to the IRS every quarter. They never lose my checks. They cash them within days of my sending them. Does he VA log in official claims at the Fee Base Office? Do they log in claims at the VARO? Is this incompetence or just a sinister way of cheating vets by delaying payment. The VA acts like a low life insurance company that wants to delay paying claims as long as possible until you hire a lawyer. I think the VA has lost every claim I ever sent them at least once. Vets and spouses who don't have that much experience with the VA system probably give up on trying to get their claims ever done right. When they screw up every single claim you send to them you have to wonder about a system that is supposed to be helping disabled veterans many of whom are elderly and without resources to fight for years. Enough is enough! What does it take to get the US government to treat us vets like human beings?
John
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john999
I made two claims for reimbursement in November 2014 and in February 2015 using the Claim for Unauthorized Expense form. I did this before when the VA owed me money for dental care they should have pr
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