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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
j92mike
A little on my timeline. My original claim was filed in June 2010 upon exit of the Army. In July 2012 I got 30% for TB and everything else was denied. At the time I was in a really bad place and hired a lawyer. He submitted an NOD and almost a year later my appeal was canceled because the NOD was written incorrectly. Before the deadline he had another one on the way which was accepted. I chose a review with a DRO someone I could meet with face to face.
That meeting came in September 2015. My lawyer wasn't notified and no letter was sent until after my hearing was already over. She my DRO Ms. Thomas seemed like a nice person. (I'm being treated at an outpatient patient clinic in Athens and maybe the smartest thing my lawyer has done was had my mental health provider rate my condition. I waited until the day of the DRO hearing to see what she marked....70%. I was a little sad by this but I know I have some things to work on.) At my original mental health C&P the doctor marked that I did have a mental health condition at the 10% level but the person rating still denied me and did not give a reason.
Ms. Thomas said that I should have been rated on several other conditions coming right out of the military there was no way those conditions could have developed outside of service. Of course she mentioned this only after the hearing was over.
It was in December 2015 when I was scheduled for additional C&P exams. At my original exams the Doctors did not have my records.
I am appealing Low back condition, neck condition, knees, anxiety and depression, elbow.
I went to QTC and the doctor who did my physical seemed to be in a hurry she was almost half hr late and rushed through everything. She also made it seem like it was the size of my breasts that caused my issues. I really wanted to punch her in the face.
The Doctor that did my mental health exam was kinda laid back, I honestly was not expecting it. Because the Dr who did my first C&P seemed cold and heartless. I also got some xrays done which won't show anything cause I know I needed an MRI.
On February 3rd 2016 my case was officially ready to rate. Here I am three months later...waiting like Uncle Sam taught me to do.
I haven't been able to see my provider in a while and won't be able to for several months. So I came here. I'm a little more clear minded than I was a few years ago. I know pending case load and all the conditions I filed for will factor in how long it takes to get a decision back but sometimes I just feel like it hasn't been rated cause they set my file on fire. I feel forgotten to say the least but I know that I'm not the only one, and I know that there are people who have been waiting much longer than me.
Anyway, can anyone speak on how long they've waited from being ready to rate to when they actually received a rating? Apparently that's the only thing Peggy doesn't have a timetable for.
-Natalie
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Palma114
j92mike, I had a C & P Exam done in Oct 2015, I'm still waiting a decision from Atlanta VARO
Fat
That's a long time to awaiting. Was it ordered by the BVA or is it an initial claim?
6 answers to this question
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