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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
spearhead91
Hello all,
I'm back again 3 years later. My situation has gotten worse and hence the increase/new claim request I have just submitted and learning how interwoven my issues are and secondary claims. I've spent the past few weeks reading off and on. Learning the latest from for the few names I remember. Good to see some familiar names still here and I'm grateful for your wisdom and support to the Veteran(s) and their families and the community as a whole. I wish I could do more and contribute my limited experience to the new members but one of my major disabilities is with my dominant hand and shoulder/neck.
I've been struggling for 3 years now and continuing to work for fear of loosing health benefits that have helped me and my wife(100% SSDI)non veteran with continuing medical care prescription coverage etc. But probably the quick access and no limit to specialist etc.
That said, I am at a major crossroads with continuing to work with the trade off being the continued use of private health care vs being dependent on the VA all the time. That is one my major concerns since my wife's and my health situations are so complex. I've started the IMO process this time for the professional and expertise because of the complexity and really needing to get it right as possible this time. My first go around with a VSO experience they did the one form for the claim and I did all the rest gathered all the medical info, release forms, ebenefits uploads etc and made it to 50%. I have to give the RO credit though he/she did help me SC something I didn't even think of which got my rating to 50% the first time with a secondary connection.
I would like to post my current and increase and new claims to compare but I'll hold off for now and see how these first couple of months go.
I do have one major question though for the claim and it's a broad based question. I had let my employer know I was partially disabled from the VA and really nothing was done for my type of work, office work high stress etc, that was over 2 years ago. Long story short new manger understands my limitations and worked with our HR and we now have a reasonable accommodation letter and DR form filled out with bare minimum instructions to my employer. ((I was really upset finding out prior manager did nothing, trusted them because I knew them so long. Yes read EEOC and all that and holding for now)) Back to main question should I upload the reasonable accommodation letter from my employer and DR to the claim? The wording is very generic but implies breaks every 2 hours etc for 10 minutes and some other minor things. Is that a hinder or help in regard to claim overall and the reasonable accommodation? In other words if I'm doing increase and new will that help or rather hurt my claim?
Thanks in advance.
spearhead91
Edited by spearhead91Link to comment
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