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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
88mike101
Hello all!!! I need advice on what to do with my VA disability claim. I was medically discharged from the Army in 1999 for lumbar strain. Since being discharged my back has continually gotten worse. I am currently rated at 50% for the following disabilities: 40% for lumbar strain and 20% for radiculopathy for my right leg. Since I have received this rating I have had a laminectomy on my l4-l5 which my neurosurgeon didn't release me back to work for an entire year due to complications. I only received temporary 100% for 6 months. To say the least the surgery wasn't a success and I begged the doctor to release me to work because I couldn't afford to be out of work any longer. A year later I continued to see my neurosurgeon and he gave me a permanent lifting restriction of no more than 15lbs. I lost my job in 2013 that I held for 8 years due to my job requiring a me to lift up to 50lbs. I didn't work from Feb 2013 to September 2014 due to my lifting restriction. After running out of money and support from family and friends and being evicted from my apartment I reentered the work force. Since September 2014 I have had 5 jobs and I struggle physically and mentally everyday while at work. My current employer provides accommodations for my disabilities and doesn't hold me to the same standards as the other employees. I also have a letter from my employer stating how my employer accommodates me. I have exhausted much of my PTO at work due to my medical conditions. I also have a letter from my neurosurgeon stating that my surgery wasn't successful, how much time I was not able to work after my surgery and the course of treatment he has tried on me. The letter also stated that I have spinal Stenosis throughout my lumbar spine and if he was to perform surgery it would entail a fusion operation and major reconstructive surgery. My MRI states that I have congenitally short pedicles contributing to overall diminutive spinal canal diameter, bilateral neural foraminal stenosis from my l1-l5 with the l3-l5 being the most severe, bulging disc from l3-l5, flavum thickening l4-l5 and facet hypertrophy l4-l5. I also have been seeing a psychiatrist at the VA and was diagnosed with major depressive disorder due to chronic pain. I have also have been diagnosed with bilateral plantar fasciitis due to my flat feet. I was given custom heel inserts for this. I was also treated for this while serving on active duty and given the same inserts. Can anyone assist me on how to go about filling my claim?
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