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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
toomnyhats
After 30 months I’m finally there! Of course after the celebratory shock wore off I have lots of questions. On 11/30/2015 I was granted 10% tinnitus and 60% Neurogenic bladder. The bladder was granted because my str contained a notation of bladder spasms several days after having a c-section when in reality it was due to my spinal stenosis (pre-existing and not manifested until after discharge). We ask for reconsideration for the neck to get the LOU on legs (in wheelchair full time) and the connection to right arm weakness and bilateral shoulder issues. Denied. Filed NOD, received SOC and filed form 9. I already had a “more likely than not” from my VA doc but I obtained an IMO with same conclusion but it contained the magic phrases, “would not expect medical treatment for minor neck pain during service because degeneration doesn’t happen immediately”, “progressed quicker than natural progression”, plus a “more likely than not, condition was aggravated by service”. Bingo...never went to board - they granted locally.
I’m perplexed that they did not grant Neurogenic Bowel (I have an ileostomy and had to have my colon removed). I’m also wondering why they didn’t put two and two together and realize my Neurogenic bladder should also have been secondary to neck. I suspect my rep will deal with those issues.
My questions are:
1. Will I receive retro back to the original 11/15/2015 filing date?
2. I was granted SMC of M - does that seem right?
3. My daughter was attending college during that 30 month wait - can we get retro on that?
4. Does receipt of SMC preclude use of standard package home care or is it meant to supplement it?
5. For SMC O, one item listed is “complete paralysis of legs along with loss of bowel and bladder function” Is LOU considered complete paralysis or do they mean complete as in no capability to move them. I can slide my legs on my W/C foot plates but cannot stand or walk.
I’m so relieved to be at 100 P&T and appreciate the wealth of knowledge and experience provided by this site. I’ve gotten valuable information during what I consider to be a fairly fast trek.
Thanks in advance for any light shed on my questions and situation.
toomnyhats
100% P&T Effective Date 11/15/2015
10/30/1990 0% hematoma-abdominal wall with numbness and dysesthesia
11/30/2015 60% Neurogenic bladder, 10% Tinnitus
11/15/2015 20% degenerative arthritis, spinal stenosis, and incomplete paraplegia due to spinal cord injury C5-6 from ruptured disc, s/p cervical
Secondaries: 100% loss of use of the lower extremities, 30% radiculopathy - left upper extremity, 70% loss of use of the right upper extremity
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Re: Chapter 35 aka DEA: ":A child (between ages 18 and 26, with some exceptions) of a veteran who is permanently and totally disabled due to a service-related condition; or who died in service; o
toomnyhats
Thanks Buck! I don't have the official package yet...expecting that this upcoming week. When I do, I'll scan in a redacted version. Yes...the P&T benefits are exciting. Going to have to find a
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