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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
anxiousinMD
My claim was in prep for decision to pending decision approval and back to pfd last Friday on ebenefits. Monday it moved back to gathering of evidence and completion date moved to next year. After a meltdown, I pretty much mentally let go and checked out of the process at that point. But yesterday I went back on because I needed to add my kids that just started college as dependents and noticed "decision notification sent" next to the "development letter sent" that's been there forever, even though my claim status still said gathering of evidence. Thanks to ya'll here about ways to check, I looked at my disabilities and my AB8 and my PTSD-MST was increased from 30% to 70% (total 50% to 80% combined rating). I'm guessing the TDIU is deferred and that's the status that's reflecting in ebenefits, but deferred is better than denied. I haven't gotten any retro or BBE or monthly pay change yet. I feel relieved that SOMETHING happened, and I no longer feel so angsty about the process. I was afraid of outright rejection and having to wait forever for a denial, and basically the VA not acknowledging these conditions that have been killing me slowly.
Anyway, I learned a few things in terms of the questions that I asked before (thank you all for your answers, advice, and support):
- Checking ebenefits all day, everyday is unhealthy (and usually meaningless)
- The "needed from you/others" section in my ebenefits has been particularly worthless except to cause additional anxiety (in my case) as things have randomly appeared and disappeared
- In my case, I was concerned about other diagnosed and treated mental conditions in my med records not being inferred as symptomatic or comorbid with existing SC PTSD, but looks like they accepted those treatment notes as evidence
- Since the status of my claim went back to GOE with completion date changing from 9/16 out to 2/17, I went ahead and submitted additional evidence, like Dr's notes to my employer and FMLA forms for medical leave to support IU. I know it's supposed to kick you out of FDC if you add additional evidence...mine moved my status back to Under Review but only pushed the estimated completion date out a month. I'd rather that month to weigh stronger evidence than spend extra months for DRO or years waiting for BVA. And my 70% increase didn't suddenly disappear. Even if it does, I can't imagine they downgrade it with the additional evidence.
- I plan to NOD the effective date for the increase (they used the day I was hospitalized which was after I was placed on medical leave with severe/chronic diagnosis, which is still within the year limit), and I do have those dated documents from both doc and employer.
In a nutshell, I learned to worry less about ebenefits and more about qualifying evidence, and thanks to this forum I learned about things like NODs, EEDs, and secondaries. It's not over, but just wanted to share in case it helps anyone. THANK YOU ALL for bearing with me and for your service to our country and fellow vets on this site.
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Gastone
Does any of the IU Evidence verify that you are unable to do even "Sedentary Work," that could provide the VA SGI cutoff Earned Income amount of $12,400 per yr ($238 per week)? Any chance you cou
Gastone
The IU Claim is in, so the wait is on, Deferred or Inferred, don't sweat it. I know, that's very hard to do. What else can you really do at this point? Keep in mind, any Retro over, I think $25K
6 answers to this question
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