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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
Berta
I didn't know where to put this....these issues come up often as to EEDs.
Better EEDS-38 CFR 3.156© and CUE:
Every vet who was denied SC for anything that they finally award SC for should go over their older denial carefully
Chris Attig has an excellent article on 38 CFR 3.156 ©, in part the regulations state:
If those records lead to a grant of service-connection for a previously denied claim (even if finally adjudicated), then 38 CFR 3.156(c)(2) contains the following requirement:
“An award made based all or in part on the records identified by paragraph (c)(1) of this section is effective on the date entitlement arose or the date VA received the previously decided claim, whichever is later, or such other date as may be authorized by the provisions of this part applicable to the previously decided claim;”
https://www.veteranslawblog.org/2-times-that-veterans-should-argue-for-an-earlier-effective-date/
We have discussed this regulation many times here but it bears repeating.
Of Course a CUE can garner a better EED as well…as long as the denied claim , for the same SC, was at a ratable level when they denied it.
A Re opened claim - 38 CFR 3.156 (a) is far different as to the EED.
38 CFR 3.156(b) is pretty obvious as most of us do send in more evidence prior to expiration of the appeal date.
This is a long but good read of how the re opened claim did not garner this vet a better EED.
In Part:
“He stated that he had originally
applied for service connection for a neck disorder in
January 1996, and therefore the effective date for service
connection should be February 1, 1996. In a January 2008
rating decision, the RO denied the Veteran's claim for an
earlier effective date. The RO explained that as the RO's
original May 1996 denial of service connection was final, the
law did not provide for an earlier effective date than May
15, 2001 (the date the Veteran filed his petition to re-open
his claim).”
VA was correct.
The veteran then claimed CUE on the 1996 decision but that CUE had not been adjudicated yet at the RO level so they claim was remanded.
https://www.va.gov/vetapp10/files1/1009109.txt
Here is the whole 9 yards on the three facets of 38 CFR 3.156
https://www.law.cornell.edu/cfr/text/38/3.156
Successful better EEDS due to proving CUE in a past decision are also explained her in the CUE forum.
The regulations above make sense.
You must give the VA New and Material evidence under 38 CFR 3.156(a) to re- open a claim.
Your EED will be the date of the Re opened claim.
There are a few unusual exceptions to this regulations - very unusual – my DMII AO claim was one of those exceptions. I filed claim to re open DIC claim in 2003 ,( had a 1151 DIC award), VA refused to re open,then after a battle they re- opened the claim and my EED was 1994.(DIC claim)
I already rattled off how that occurred here, and have never seen a similar re open case like it.
This regulations and also CUE ( 38 USC 5109A) are like the Watergate question…..
“What did the President know and when did he know it”. Same thing…what did VA know and when did they know it.
If a Re open awarded a claim that was denied in the past and was at a ratable level at that time (or should have been –if a Nehmer III issue- Footnote One)
then a CUE claim ,following the exact CUE criteria here, can bring a far better EED to the claimant, when filed on the older denied decision.
CUEs are not really “ claims,” they are frontal attacks on a past decision.That is why they do not fall under VCAA provisions. Lindsay V. Principi.
This EED subject comes up here often and it is worth while to read the 3 specific parts of the 3.156 regulations carefully to see how they might apply to any EED question you have.
GRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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Berta
Thanks Tbird. Chris Attig has excellent info at his site! We all need to check out his info! I hope the VSOs and vet reps out there read it as well.
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