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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
broncovet
Res judicata is a latin word meaning:
This means if I was denied benefits by the VARO, denied again by the BVA, denied again by the CAVC, denied byThe Federal Courts and the US Supreme court, I can not raise that issue again.
However, Veterans CAN apply for benefits at any time and "any" time means that you could re apply with the VARO even if the US Supreme court denied you, but you should have "new and material evidence" that the judges did not have in the past.
"Res" cuts both ways. It can hurt you or help you. If you have already been awarded benefits, The VA isnt supposed to revisit your service connection, but they can in the face of clear, unmistakble error. An example is if you did not have the requisite period of service (that is, you are not a Veteran), and the VA awarded benefits, those benefits could be removed as you clearly were not entitled.
Most Vets claims are "not" black and white. Most of us actually served, and that is of record.
The VA has to follow their own regulations and the court sometimes compells them to do so. One of the rules they have to follow is to give you an adequate reasons and bases as to why you were denied.
The BVA has every right to "weigh" the evidence. Maybe doc "A" says your condition was related to service, while doc b said it was not. The BVA can "pick" one of the doctors opinions, over the other, as long as he gives a reason why he did so:
For example, Dr. "A" said yours was related to service, but Doc B, says no. Doctor B did a more thorough exam and was your doctor for 10 years. Dr. A, saw you for 10 minutes and said it was related to service. The Board could then explain why doc B's opinion was more probative because it was more thorough. This denial would likely stick and not be overturned as they explained their reasons.
However, if the Board did not explain why it picked DR. B over Dr. A's opinion, then the court could rule the evidence was "in equipose" and the benefit should be given to the Veteran.
The Court generally does not dispute "factual findings" of the Board unless they find them to be clearly erroneous. If the Board said there was "no evidence of a disease" and the court found a medical exam where the doc diagnosed and treated the disease, then the court could overturn the Board's "finding of facts", but only if the Court was convinced the facts were in error, and not a judgement call.
In other words, a CAVC judge wont overturn a well reasoned BVA decision if there was at least a plausable bases to the Boards opinion.
However, many times CAVC appeals are based on an "inadequate reasons and bases". This usually works. The Veteran deserves a good answer as to why he was denied. And, the reaonsing needs to be based on the critieria, too. The Board can not deny the Veteran because he did not like his VSO..as that is not part of the criteria. The board needs to explain why the criteria was not met.
If you read BVA decisions, they often state that "the critieria has not been met", or, the critieria has been met. Sometimes it does not even say whether it was awarded, just that the critieria has been met. If the critieria has been met, then you get the benefit.
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