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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
Josephine
Dear Friends,
I picked up the telepone and talked to a lady at the Department of the Navy about the codes etc on my DD 214. She had all this information. Where did she get it? How did she know so much?
She told me just as it happened?
She told me that Dr. C was my treating physician and that he sent me to Dr. J who in turn sent me to a Board Certifed Psychiatrist. Dr. M, who recommended my discharge.
Next was the Board of 4 doctors. I knew that I saw an Army of doctors to receive my early discharge, just didn't know what they were all called.
My paper is called Evaluation Board - signed by 4 doctors with Honorable checked with Emotional Immaturity and the code of 460 - NOT TO BE SHOWN.
She stated that I was to get a Medical Discharge, but someone messed up?
Did she really see all of this, but if she didn't, how could she have told me their names.
Why didn't the BVA send me to a Board of three psychiatrist to end all of this?
My brain is still going over time as to why the BVA has placed this in my remand? What did they expect from the two psychiatrist. Did they honestly think that they would tell the truth?
7. After the above development has been completed, the veteran's claims file should returned to the board of VA psychiatrists who participated in the April 2005 examination for clarification
of the provided opinion. They should be requested to review the record and reconcile their opinion as to etiology in light of the evidence added since their examination of the veteran, including the May 2005 statement of Dr. B C. C and the January 2006 statement of Dr. M P.
If neither of these examiners is available, (I check with the Sxxxx Medical Center and they are employed and available) the RO should consider whether the veteran should be scheduled for an additional examination by a board of two VA psychiatrists for an opinion as to whether there is at least a 50 percent probability or greater that an acquired psychiatric disorder was incurred in or aggravated by active service. All indicated tests and studies are to be performed. Prior to the examination, the claims folder must be made available for review of the case. A notation to the effect that this record review took place should be included in the report. Opinions should be provided based on the results of examination, a review of the medical evidence of record, and sound medical principles. All examination findings, along with the complete rationale for all opinions expressed, should be set forth in the examination report.
8. The veteran must be given adequate notice of the date and place of any requested examination, if such is deemed necessary. A copy of all notifications, including the address where the notice was sent must be associated with the claims folder. The veteran is to be advised that failure to report for a scheduled VA examination without good cause shown may have adverse effects on her claim.
9. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed. If any benefit sought remains denied, the veteran and her representative should be furnished a supplemental statement of the case and be afforded the opportunity to respond. Thereafter, the case should be returned to the Board for appellate review.
As you all know the two psychaitrist received my claims folder in October from the AMC.
This is all the two of them wrote
Letter by Dr. C. read
Letter by Dr. P read
No evidence to alter initial conclusion.
Signed Dr. B.
Signed Dr. L.
I do not wish another C&P. I will go if I have too, but there is talk from the AMC - no more! The AMC is really nice to me. Don't know if it is a cover - up or not? I can't trust any of them, if they are employed by the Va.
Josephine
Edited by JosephineLink to comment
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