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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
JustGettingStarted
I have another thread at the link below. Two years ago I filed for an increase on my skin condition and requested a back date to May 2009 when I retired. I have been through a lot since then. For skin conditions rated the same as eczema, the condition is rated on area of coverage or on how often you have to be on systemic (oral or needle) medications. I was given 0% in 2009 when I retired and didn't know that I was being low-balled because I did not know my condition was related analogous to eczema.
When I learned of this two years ago, I put in a claim requesting a higher rating and a back date to 2009. First, I had an inept examiner that left out my medications. I was denied and I reopened my claim for reconsideration saying the examiner had messed up. Then my claim was denied again because the VA said I did not attend a new exam; they later admitted the exam was never scheduled. Then I was scheduled for a new exam, but I noticed that someone had opened up a claim for increase on warts on my left hand, which was service connected at 0 when I retired. I was concerned this skin exam was for the wrong thing, but I was assured by IRIS, and the VA 1000 number, that it was a full skin exam. After travelling 1.5 hours to the exam, I learned the examiner could only look for warts on my left hand and could not discuss my other skin condition. I was denied again.
At this point, I asked my dermatologist to sign a DBQ I filled out for him although he had never treated this particular skin condition. However, I provided all the medical info and he signed the DBQ. I reopened my claim again, sent in the new DBQ, and was finally awarded 60% and became 100% P&T, but VA ignored my request for an earlier effective date. So I reopened the claim again. It only took 9 days for them to deny me saying my medication wasn't considered systemic and that due to a policy change they were able to reward me 60% in 2017 but they could not award 60% in 2009. I quickly pointed out that CUE had to be based on law, not a "policy change", and that the skin law in my case had not changed since 2002. There were also US Court of Veteran Appeal cases that supported my claim (see more at the link below). My claim was opened again.
This time VA sent me to another exam, which I felt was completely unnecessary since new evidence cannot be used in a CUE claim. According to my VSO, they wanted to know if my condition was as bad as had just been determined a couple of months prior. I felt like they were trying to prove fraud at this point, like I was only taking the medication I've been taking for 20 years to get a higher rating. The exam was on 9 May 2017 and went well. Despite being on suppressive medication, my skin disease made an appearance. I reviewed the exam with my VSO and it seems the examiner got all the facts necessary for a success.
I just got a copy of my decision from my VSO today. Once again, the letter completely ignored my request for a back date. Instead they acted as if I had requested an increase and denied that. I was already rated at the maximum for my skin condition.
So today, I filed a NOD and filed the Opt-in for RAMP. I have selected the Higher-Level Review with the "informal conference" which could increase the length of time for my RAMP decision. However, I don't want any surprises. But as long as I was filing RAMP for the skin disease, I added a request for an earlier effective date for my upper peripheral neuropathy.
I am so glad that RAMP has been opened to everyone (unless you have a docket number). I wanted to jump on the RAMP wagon early before it becomes back-logged like everything else. My VSO was all for this too.
I will keep you posted on how this goes.
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