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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
Lemuel
Has anyone experienced the kind of treatment I have and finally come to the conclusion it is in retaliation for something you did?
This is my post from another site. A Veteran's blog, who is an attorney in response to an article on Whistle Blower retaliation:
Lem
Patient whistle blowers are also punished. I’ve come to realize going through my file that because of my activism on veterans with organic brain syndromes that began in 1987 I was immediately put on some black list or so it appears from my adjudication file. Refusal of evidence. Non-denial denials by providing something in response to FOIA requests but not what was ask for. A CUE of stating that a hospitalization from Aug 12 to Jan 15 was less than 21 days, and therefore not eligible for hospitalization compensation. Removal of documentation of disability from my C&P file. Currently, a 150 day delay in correcting the RBA by obtaining evidence referenced in documents not removed. But at least the CAVC Clerk was responsive to my complaint:
Not published
UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS
No. 17-2990
LEMUEL C. BRAY, APPELLANT,
V.
PETER O’ROURKE,
ACTING SECRETARY OF VETERANS AFFAIRS, APPELLEE.
O R D E R
On November 7, 2017, the Secretary transmitted the Record Before the Agency (RBA) to the appellant and filed notice of service with the Court. On November 18, 2017, the appellant filed a motion that the Court will accept as a motion disputing the RBA. On December 1, 2017, the Court ordered the Secretary to advise the Court, within 15 days after the date of the order, and every 15 days thereafter, which action the Department – including the responsible VA regional offices – have taken to resolve the dispute. For more than 6 months the Secretary has filed responses to the Court either asserting they are continuing to review and determine if any documents are missing from the RBA or that they are attempting to locate documents identified by appellant as missing from the RBA. On June 13, 2018, the appellant filed a response asserting, in pertinent part, that the RBA dispute process has taken a long time and the Secretary has not
provided any details of the status of the dispute. The Court agrees with the appellant and will ask the Secretary to provide a detailed status update. It is ORDERED that the Court’s December 1, 2017, order is hereby revoked. It is further ORDERED that, within 20 days after the date of this order, the Secretary provide a detailed response as to the items listed in the appellant’s RBA dispute filed on November 18, 2017.
Proceedings in this appeal are stayed pending further order of the Court.
DATED: July 17, 2018
FOR THE COURT:
GREGORY O. BLOCK
Clerk of the Court
By: /s/ Cynthia M. Brandon-Arnold
Cynthia M. Brandon-Arnold
Chief Staff Attorney/Deputy Clerk
2
Copies to:
Lemuel C. Bray
VA General Counsel (027) brw
Lem July 20, 2018 at 7:36 am
I’ve filed an appeal in the 10th Circuit for DCWD Case 17-CV-206-F which is a medical malpractice suit for treating my confirmed atypical absence seizures and atonic seizures with Tegretol which is listed in the 1990 PDR (Physicians Desk Reference, the go to book for Doctors on medications) as making such seizures worse. 5 months of complaining that the drug was making me worse and finally having to wean off and quit therapy whereupon my seizure diagnosis was changed to pseudo seizures. I was never compensated for my confirmed seizure disorder.
I started receiving successful treatment for my seizure disorder in August of 2016 with Keppra after 30 years of being unemployable. 28 years after the mistreatment with Tegretol.
The black list even reaches to attorneys. Even Ben’s office won’t take my case for fear of retaliation.
1) From: Boggs v. Peake, 520 F.3d 1330 (Fed. Cir., 2008) ”38 USC §7292. Review by United States Court of Appeals for the Federal Circuit:”
“…(d)(1) The Court of Appeals for the Federal Circuit shall decide all relevant questions of law, including interpreting constitutional and statutory provisions. The court shall hold unlawful and set aside any regulation or any interpretation thereof (other than a determination as to a factual matter) that was relied upon in the decision of the Court of Appeals for Veterans Claims that the Court of Appeals for the Federal Circuit finds to be—
(A) arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law;
(B) contrary to constitutional right, power, privilege, or immunity;
(C) in excess of statutory jurisdiction, authority, or limitations, or in violation of a statutory right; or
(D) without observance of procedure required by law.”
“…There are only two statutorily created exceptions to the rule of finality for veterans claims in §7104(b). Cook v. Principi 318 F.3d 1334, 1337 (Fed.Cir.2002) (en banc). First, under 38 U.S.C. § 5108, "f new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim." See also 38 C.F.R. § 3.156; Barnett v. Brown, 83 F.3d 1380, 1383 (Fed. Cir.1996) ("[T]he Board does not have jurisdiction to consider a claim which it previously adjudicated unless new and material evidence is presented, and before the Board may reopen such a claim, it must so find."). Second, a final decision "is subject to revision on the grounds of clear and unmistakable error." Cook, 318 F.3d at 1337 (quoting 38 U.S.C. §§ 5109A (decision by the Secretary) & 7111 (decision by the Board)).”
My amended (to date) Petition to Appeal VA adjudication decisions and refusal to certify CUEs because of a one year time limit are attached. (20180305... is the letter denying certification of CUE and wrongful closing of an appeal) Do you think I have a chance?
20180720 Amend Peti for CAVA & VA review.doc
CAFC Jurisdiiction Boggs v. Peake,.pdf
20171120 NOD Rating Dec 11-1 signed_Redacted.pdf
20180305 VA letter re issues_Redacted.pdf
Edited by Lemuelleft out important part
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"My amended (to date) Petition to Appeal VA adjudication decisions and refusal to certify CUEs because of a one year time limit are attached. (20180305... is the letter denying certification of CUE a
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