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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 rating
Picked 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.
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Lemuel, -
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Question
broncovet
For ME, the temptation is to look up every CFR, every USC, for each one of my conditions on appeal, and resend the lawyer the C and P exam, or case law which shows the VA was wrong.
Dont do it. I have to bite my fingers.
Alex had good advice. After you hire the lawyer you have got to trust them. They dont want every one of your 400 legal entitlement theories that you thought of before you hired the law firm. Just let them pick the one(s) they think are "at least as likely as not" to ring the bell. Dont get mad at them, "hey, you forgot in the appeal to mention the 2001 doctor exam who said....."
If you dont trust your attorney, fire them.
If you do, then let them do their job. I understand Alex Attorney asked him for a "timeline". Now that seems like a good idea. I also supplied my attorney what I call
Instead, make something like a "RBA Index". You can do the same thing with a C file, if you dont have the RBA. It will save your attorney hours if you do a great job. Mine took about 100 of my hours to do it.
You see, my RBA ( Record Before Agency) is 1400 pages long. It includes about 19 RO decisions, medical reports, and about 140 pages of stuff when I went to college under GI bill in the 1970's that is totally irrelevant, all in no particular order. So, I started with RBA page 1-39. Thats the 2012 BVA decision.
page 40-48 is the 2008 RO decision. Page 49-80 is medical history 2002-2005. Page 81 is a c and p exam in 2004, where Dr. P opined, "its as least as likely as not" my hearing is related to noise exposure in milatary. ...and so on. If the medical report has a significant, relevant finding, I quoted it in the index.
I went throught the whole RBA, and quoted, verbatum, key staments or key facts in medical exams, RO decisions, etc.
Then, I rearranged the index in Date order, making a "history" of each significant medical finding, each RO decision findings, and facts. NONE of my opinions, unless I sent a 21-4138 and filed a NOD, for example, that is in the rBa.
By doing this, (organizing the RBA by date and what happened in an index) I kept myself busy
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broncovet
For ME, the temptation is to look up every CFR, every USC, for each one of my conditions on appeal, and resend the lawyer the C and P exam, or case law which shows the VA was wrong. Dont do it.
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