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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
PACBRED
Has anyone had a C & P exam with a nurse practitioner that wasn't interested in your disability but was looking for ways to state that your condition has improved? I've always had chronic lower back pain and was recently awarded 40% in 2016. After receiving that rating I then pursued IU and of course they set me up for a C&P exam. So after spending the morning with the nurse practitioner the exam lasted less than 30 minutes. So she had asked me to do certain movements which I was unable to perform and she did not measure or use any device to conclude her decision. So after weeks of waiting for the results I receive a letter stating that I had a normal range of motion. I was highly upset and was furious with the outcome. I then submitted evidence that my condition has not improved. I am also collecting Social Security disability due to my lower back and I sent them proof that I am no longer employed since 11/2016 and they sent me a form to give to my employer?? Go figure.... So they proposed to reduce my lower back % from 40 to 0. It is now a year and they have not reduced my lower back rating. So just recently I receive a call from the C&P clinic to have another examination for my lower back. So I asked the receptionist the same question is it a doctor that will be performing the examination? She stated no it will be a nurse practitioner. I informed the receptionist that I do not wish to have a nurse practitioner give her medical opinion due to the previous np and her medical opinion. So she told me to contact the Regional office to schedule me another C&P exam with a non va medical facility for this lower back C&P exam. So I receive an email from VES Services stating that I have a c&p exam with one of their medical providers at this facility. So it happens to be my old VA primary care Doctor who is no longer practicing at the VA clinic but with this VES Services agency. My concern is if I know this Doctor isn't a specialist for my lower back why bother going through with this examination knowing that she was a primary care physician and not a back specialist ? I tried calling several chiropractors to see whether they can perform my C&P exam on my behave rather than the VES Services and they all seem to say that they don't do that examination. So now I'm concerned that they are really trying to reduce my 40% to 0. Does anyone have any suggestion or advice to this matter or have gone through with this process??? I have until next week to find a back specialist who is willing to perform the C&P exam before attending this VES Service examination. Anyone help.
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paulstrgn
@GBArmy and @shrekthetank1 bring evidence to your exam. When I go for my back I bring a copy of my MRI and copies of x-rays, I just tell them in case they want to see them. All but one of them have be
GBArmy
Seems like you have to get an independent medical opinion, or exam, from your own specialist which can show how bad your back really is. You had one c&P and they knocked you down, you asked for a
ShrekTheTank
@GBArmy is right on about what you need to do. One thing though do not miss a C&P exam! They will reduce you if you do not show. So you have an opportunity to see a doctor you saw prior? This
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