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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
Berta
https://www.nvlsp.org/news-and-events/press-releases/nvlsp-dismayed-over-gao-report-on-va-disability-exams-and-the-need-for-impr
NVLSP Dismayed Over GAO Report on VA Disability Exams and the Need for Improved Performance Analysis and Training Oversight for Contracted Examiners
"FOR IMMEDIATE RELEASE – November 16, 2018
WASHINGTON – National Veterans Legal Services Program (NVLSP) executive director and co-founder Bart Stichman was dismayed at the findings of the Government Accountability Office (GAO) Report on disability exams conducted by the U.S. Department of Veterans Affairs and the need for performance analysis and training oversight for Veterans Benefits Administration (VBA) contractors.
“This report confirms our worst fears that the VBA examiners are ill-prepared to properly assess a veterans’ disability. A bad assessment can have catastrophic consequences on a veteran and his or her family,” said Stichman. “Veterans served nobly and expect their government to take care of them when they have suffered injuries or illnesses due to their military service. This is no way to treat our veterans.”
“Moreover, the recommendations put forth by the GAO do nothing to help our veterans right now who must deal with the negative consequences of the bad exams already conducted by these contractors, who are getting paid $6.9 billion dollars for their “unsatisfactory performance.” According to the VBA, only one contractor met its target of 92 percent of exam reports with no errors. The vast majority of contractor scores were classified by VBA as “unsatisfactory performance” with quality ratings as low as 62 percent."
“The efficacy of the exams and the training of the examiners has to be a priority. Timeliness hardly matters if the exams are poorly conducted,” said Stichman.
“The outcomes of these exams have life-changing impact on our veterans, especially those who may be suffering from post-traumatic stress. All the veterans who have been denied disability compensation based on these faulty exams since these contractors were employed should have their claims reopened immediately and a new exam provided by VA in house.”
“These contractors are a prime example of the waste in the system that should be eliminated and the money spent directly on our veterans. I applaud Congress for holding a hearing to examine the report findings and hope more can be done to help our veterans be treated fairly.”
About NVLSP
The National Veterans Legal Services Program (NVLSP) is an independent, nonprofit veterans service organization that has served active duty military personnel and veterans since 1980. NVLSP strives to ensure that our nation honors its commitment to its 22 million veterans and active duty personnel by ensuring they have the benefits they have earned through their service to our country. NVLSP has represented veterans in lawsuits that compelled enforcement of the law where the VA or other military services denied benefits to veterans in violation of the law. NVLSP’s success in these lawsuits has resulted in more than $5.2 billion dollars being awarded in disability, death and medical benefits to hundreds of thousands of veterans and their survivors. NVLSP offers training for attorneys and other advocates; connects veterans and active duty personnel with pro bono legal help when seeking disability benefits; publishes the nation's definitive guide on veteran benefits; and represents and litigates for veterans and their families before the VA, military discharge review agencies and federal courts. For more information go to www.nvlsp.org."
MEDIA CONTACT: Patty Briotta, office 202-621-5698, cell 703-517-1796, patty@nvlsp.org
(Maybe this will be the impetus for NVLSP to start a Class Action against the VA- I dont know- I will try to find out ore as well as the GAO report they refer to.I thought this was important enough to put in the main forum)
GRADUATE ! Nov 2nd 2007 American Military University !
When thousands of Americans faced annihilation in the 1800s Chief
Osceola's response to his people, the Seminoles, was
simply "They(the US Army)have guns, but so do we."
Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.
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Berta
https://www.nvlsp.org/news-and-events/press-releases/nvlsp-dismayed-over-gao-report-on-va-disability-exams-and-the-need-for-impr NVLSP Dismayed Over GAO Report on VA Disability Exams and the Need
Berta
https://www.gao.gov/assets/700/694986.pdf Also if anyone is willing to contact NVLSP ( Bart Stichman- NVLSP) on this matter ( I am emailing him later today-on this and a different issue) wit
hollywoodnc
Hello Berta! I hope you're doing well & had a wonderful Thanksgiving! I'm GLAD that this topic is FINALLY being EXPOSED!!! I've CONSTANTLY criticized the VA's idea of conducting a C
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