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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
toimi
8/4/05
With regard to your veterans benefits, my claim, (search)VA violation of 38 USC 1722a, I had asked, the Board of Veterans’ Appeals, in accordance with the Code of Federal Regulations, 38 CFR 20.900 “© Advancement on the docket. (1) Grounds for advancement..A case may be advanced on the docket..may be granted only if the case involves interpretation of the law of general application affecting other claims...appellant is seriously ill..severe financial hardship..other sufficient cause..administrative error resulting in significant delay in docketing the case or the advanced age of the appellant…defined as 75 or more years.”
In a letter, dated 7/27/05, from the Board of Veterans’ Appeals my request for early adjudication, because, as they suggested, of severe financial hardship, was denied. I made no such claim! My 6/20/05,request for advance, I wrote, “My claim, VA violation of 38 USC 1722a, involves 1.1 million veterans’ co-payment over-charges. It is evident that a clear and unmistakable error’ based on RO ’statement of the case’, i.e., “interpretation of law of general application effecting other claims,” and “sufficient cause shown” has occurred. Subject to Sec. 7107(2) motion for early consideration.
Where the BVA got the ‘financial hardship’ from,..I guess, they saw the reference to the problems of 1.1 million veterans over-charges as the ‘financial hardship’. And any question regarding illegal over-charges of 1.1 million veterans therefore carries no weight. Nor does interpretation of law effecting other claims, administrative error, or delay, as to any early settlement of 1722(a).
Justice delayed, is justice denied, again. On the back of the VA billing statement, it states, “When a notice of dispute is received..suspend further notices..while we resolve the question.” My property (over-charges held) was seized without explanation or due process rights (5th, 14th Amendment Rights). To reach the Board, and VA to recognize my 1st Amendment Right, to redress grievances, has taken over 3 years. Now more delay. Is this the “administrative error resulting in significant delay” mentioned in 38 CFR 20.900? Apparently not.
I, as a Korean War era veteran, when you die, this claim dies with you. However, this is were they have it wrong. Because this claim, filed on behalf of all veterans. It is about every veterans’ right to benefits. This is where you veterans, many returning from Iraq and Afghanistan, take over. It will then be up to you, to fight the VA.
I need your help, and it’s now all up to you veterans. I can’t do no more. So that the VA understands, “interpretation of law of general application affecting other claims” and what this fight is all about, every veteran reading this message who receives pill medication that requires splitting (and those that do not), I want you to write, using a .23 cent post card, for a copy of, “How Do I Appeal” from.... Department of Veterans Affairs, Board of Veterans’ Appeals, 811 Vermont Ave. N.W., Washington, D.C. 20420. It’s free, and you do not have to file. We need to show them these “other claims“.. YOURS! Something they may understand.
It seems the “clear and unmistakable error (CUE)” based on interpretation of a law effecting approx. 1.1 million veterans is not sufficient cause to advance, and settle 1722, i.e., illegal taking of hundreds of thousands of unrecoverable veterans’ much needed dollars. That is what is behind this denial. You know, and I know who.
Will the “interpretation of law of general application affecting other claims” , in veterans medication costs, be upheld? It’s your duty to see that a question, regarding your veterans’ benefits, before the BVA, is answered. Even if your understanding is vague. Request “How Do I Appeal”. Veterans will be counting on you. Reunion? Spread the word!
REPLY TO BVA
Mr. Charles Hogeboom 8/20/05
Deputy Vice Chairman
Board of veterans Appeals
810 Vermont Ave. N.W.
Washington DC 20420
Dear Mr. Hogeboom;
Re:0141NT/13
The BVA went against my docket advance request, and their own criteria. As you had explained to me, in part, “Interpretation of law of general application. This exception contemplates a situation where the interpretation of a question of law in your case would affect other claims and is of widespread interest and application…a motion submitted under this exception should clearly identify the specific legal question presented and explain why a board decision on this issue would affect the claims of other appellants.”
You read, because I had requested that illegal over-charges in violation of 38 USC 1722a, be returned to me. You then denied my request, because of ‘severe financial hardship’. I did not say in my request, or indicate, I had a severe financial hardship. I said, “Upon a favorable decision, I request all monies secured, in the violation of 38 USC 1722a be returned to me.” I was asking that money taken from me, illegally, be returned. You made it a severe financial hardship! I had no idea when a favorable decision would be made? After which, in my 3rd paragraph, I then asked that my case docket be “moved forward as to a decision, for the following reasons.”
Violation of law, i,e., an infraction or breach of the law; a transgression. Is this not a question of law? A inter-pretation of law issue? “..a situation where the inter-pretation of a question of law in your case would affect other claims and is of widespread interest and application…” If someone accused me of a violation of law, the first thing I would do is look up the law, and see if they know what they are talking about.
If the BVA were concerned with ‘Interpretation of law of general application’, you would have read my entire letter. I mentioned the, “..alleged violation of VA law, pigeonholed while penalizing thousands of veterans in illegal co-pay over-charges, which continue to this day. Over-charges many veterans can ill-afford, in the years awaiting a decision. Over-charges that may not be recoverable.” This you avoided, or ignored, and failed to consider! But you
invented, ‘severe financial hardship’. Having nothing to do with my request. In a follow-up letter, I wrote, “..involves 1.1 million veterans’ co-payment over-charges. It is evident that a ‘clear and unmistakable error’ based on RO ‘statement of the case’, i.e., ‘interpretation of law of general application affecting other claims’ and ‘sufficient cause shown’ has occurred.” Is this not ‘sufficient cause’?
Federal Register 9/12/03, 38 CFR part 20. (c.) “Advancement on the Docket. (1) Grounds for Advancement…Involves interpretation of law of general application affecting other claims,.. severe financial hardship.. shall include.. administrative error resulting in a significant delay in docketing the case of advanced age of the appellant. For the purpose of this rule, ‘advanced age’ is defined as 75 or more years of age. This paragraph does not require the Board to advance a case on the docket, in the absence of a motion, of a party to the case or the party’s representative.”
First of all, I am not seriously ill. And not, contrary to your ruling, under severe financial hardship. Not, at the advanced age of 75 years, yet. This case is a question about a violation of law. Second, this is about 1.1 million veterans affected by this violation. The problem is, a favorable VBA ruling, regarding the mis-appropriation of illegally collected co-pay over-charges of 1.1 million veterans, would be a victory for veterans.
Of this 1.1 million veterans’ affected by this claim before the VBA, how many seriously ill veterans, would be affected? How many with a severe financial hardship? How many veterans of the advanced age of 75, or more years? It must be assumed there are many. Is this “other sufficient cause shown”? We know that there may not be veterans that do not fall under these considerations, but they are all affected by a violation of law.
Law, as explained and referenced in Black’s Law Dictionary, “All law is the law of a group of individuals or of groups made up of individuals. No one can make a law purely for himself.” Does law mean,.. all individuals (veterans)?
If I bring up, a violation of law, any law, this is not just about one persons law. This is in everybody’s ‘widespread interests’. A law basically includes, or is ‘general application‘. Does it not? Which the VBA refuses to recognize. You chose to ignore, the illegal co-pay charges affecting the ‘widespread interests’ of 1.1 million veterans. It is obvious why this is, and not hard to figure out.
I’ve been at this for over three years, all the while the VA has fought against, but forced finally, allowing me to bring this to appeal. If it was about me, I would have given up long ago. Add 1.1 million veterans to the VA claims backlog. Veterans have a right to their benefits law. You state, “While these criteria are strict, please remember that there are other appellants waiting for the Board to issue decisions in their appeals..,” I agree. You must also agree, there is the possibly many, of the 1.1 million veterans, that fall under this criteria. They will have to wait, and be purged. And this is exactly what the VA counts on, either the veteran gives up, or the death of the veteran, in order to expedite and purge the huge backlog of claims.
I want to know why, you substituted ‘severe financial hardship’ as my claim, and why ’interpretation of the law of general application affecting other claims’ was not considered.
Sincerely;
William H. Heino Sr.
P.S. Where I said, I would have given up long ago, that was a lie.
Cc: Senator Durbin
Senator Obama
Rep. Gutierrez
Veterans file
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