Ask Your VA Claims Questions | Read Current Posts
Read VA Disability Claims Articles
Search | View All Forums | Donate | Blogs | New Users | Rules
- 0
-
Tell a friend
-
Recent Achievements
-
Our picks
-
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
Continue Reading on HadIt.com-
- 0 replies
Picked By
Tbird, -
-
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.-
- 4 replies
Picked By
RichardZ, -
-
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”-
- 0 replies
Picked By
Tbird, -
-
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, -
-
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, -
-
Question
jaimef361
I recently submitted for three claims. tinnitus, migranes, and left shoulder condition. I was denied compensation for all three of these conditions. In my denial letter from the VA each "favorable" finding shows that I was diagnosed through VA examination with each condition yet I was not compensated. I have three options to appeal, according to VA.gov. The options are submit a supplemental, ask for a senior reviewer, or appeal to a Veterans Law judge. My question(s) are what is the best appeal option for my situation, and what documents should I add to the appeal?
Thank you all in advance.
REASONS FOR DECISION
1. Service connection for bilateral tinnitus.
The claim for service connection for bilateral tinnitus is considered reopened. (38 CFR 3.156) However, the evidence continues to show this condition was not incurred in or aggravated by military service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.306)
Service connection may be granted for any disease or injury that is considered to have resulted in a period of war or service. To establish direct service connection for a claimed disorder, objective evidence must show a diagnosis of a current disability that is related to a disease or injury incurred in or aggravated during "active " service; or that manifested itself to a compensable degree within one year from the date of discharge (specified under 38 C.F.R. § 3.303).
We have denied your claim for service connection for tinnitus on a direct basis because your service treatment records do not contain complaints, treatment, or diagnosis for this condition. We then requested an examination and medical opinion. VA examination diagnosed the condition of tinnitus however the medical examiner stated your tinnitus was less likely than not related to your military service as the diagnosis of tinnitus is based on subjective factors only as there are no objective methods at this time to confirm the presence or absence of tinnitus. In addition, the examiner stated your hearing was normal and thus there are no objective factors seen on examination for which the etiology of tinnitus can be attributed.
To satisfy the requirements for service connection for a disability based on presumption, you must submit the following: (1) medical evidence demonstrating the existence of a current disability, and (2) medical evidence establishing that the disability manifested to a compensable degree within one year of your discharge from active service. (specified under 38 C.F.R. § 3.309) Longer time limits may apply for certain medical conditions.
We have denied your claim for service connection for tinnitus on a presumptive basis because we received no evidence that your tinnitus manifested to a compensable degree within one year of your discharge from active service.
The evidence does not show an event, disease or injury in service. (38 CFR 3.303, 38 CFR 3.304) Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. (38 CFR 3.307, 38 CFR 3.309) The VA medical opinion found no link between your diagnosed medical condition and military service.
Favorable Findings identified in this decision: VA examination dated August 11, 2014 provides a diagnosis of tinnitus
Certificate of Release or Discharge from Active Duty for the period of 08-18-2000 to 12-20- 2003 reports your MOS of Aircraft Electrician, also noted is Aircraft Crewman Badge and Parachutist Badge and service in Operation Enduring Iraqi Freedom (Qatar and Afghanistan) from 08-10-2002 to 04-21-2003.
Laws and regulations applicable to this issue:
38 C.F.R. §3.310 Disabilities that are proximately due to, or aggravated by, service-connected disease or injury.
.38 C.F.R. §3.322 Rating of disabilities aggravated by service.
38 C.F.R. §3.304 Direct service connection; wartime and peacetime.
38 U.S.C. § 3.2501 Supplemental Claims.
38 C.F.R. § 3.156 New and material evidence.
38 C.F.R. §3.155 How to file a claim.
38 C38 C.F.R. §3.151 Claims for disability benefits.
38 C.F.R. §3.150 Forms to be furnished.
38 C.F.R. §3.1 Definitions.
38 C.F.R. §3.400 General.
38 C.F.R. §3.303 Principles relating to service connection.
38 C.F.R. §3.306 Aggravation of preservice disability.
38 C.F.R. §3.159 Department of Veterans Affairs assistance in developing claims.
38 C.F.R. §3.307 Presumptive service connection for chronic, tropical, or prisoner-of-war related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminants in the water supply at Camp Lejeune; wartime and service on or after January 1, 1947.
38 C.F.R. "§3, 309 Disease subject to presumptive service connection
38 C.F.R. §3.321 General rating considerations.
38 C.F.R. §3.2600 Review of benefit claims decisions.
38 C.F.R. §4.1 Essentials of evaluative rating.
38 C.F.R. §4.2 Interpretation of examination reports.
38 C.F.R. §4.3 Resolution of reasonable doubt.
38 C.F.R. §4.6 Evaluation of evidence.
38 C.F.R. §3.401 Veterans.
38 C.F.R. 3.2500 Review of decisions.
2. Service connection for left shoulder condition (claimed as bilateral shoulder condition).
The claim for service connection for left shoulder condition (claimed as bilateral shoulder condition) is considered reopened. (38 CFR 3.156) However, the evidence continues to show this condition was not incurred in or aggravated by military service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.306)
Service connection may be granted for any disease or injury that is considered to have resulted in a period of war or service. To establish direct service connection for a claimed disorder, objective evidence must show a diagnosis ofa current disability that is related to a disease or injury incurred in or aggravated during "active " service; or that manifested itself to a compensable degree within one year from the date of discharge (specified under 38 C.F.R. §
3.303).
We have denied your claim for service connection on a direct basis for left shoulder condition because your service treatment records do not contain complaints, treatment, or diagnosis for this condition.
To satisfy the requirements for service connection for a disability based on presumption, you must submit the following: (1) medical evidence demonstrating the existence of a current disability, and (2) medical evidence establishing that the disability manifested to a compensable degree within one year of your discharge from active service. (specified under 38 C.F.R. § 3.309) Longer time limits may apply for certain medical conditions.
We have denied your claim for service connection for left shoulder condition on a presumptive basis because the medical evidence failed to show this condition manifested to a compensable degree within one year of your discharge from active service. .
Additionally we requested a medical examination with medical opinion. The examiner diagnosed left shoulder strain with full thickness tear of suoraspinatus tendon, mild subacromial-subdeltoid bursitis however the VA medical opinion found no link between your diagnosed médical condition and military service.
The evidence does not show an event, disease or injury in service. (38 CFR 3.303, 38 CFR 3.304) Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. (38 CFR 3.307, 38 CFR 3.309) The VA medical opinion found no link between your diagnosed medical condition and military service.
Favorable Findings identified in this decision:
VA Contract Examination dated 02-05-2019 diagnosed left shoulder strain with full thickness tear of suoraspinatus tendon, mild subacromial-subdeltoid bursitis
TEXAS VALLEY COASTAL BEND HCS dated 03-31-2019, 04-17-2019, 05-07-2019, 07-16- 2019 reports left shoulder pain.
Laws and regulations applicable to this issue:
38 C.F.R. §3.310 Disabilities that are proximately due to, or aggravated by, service-connected disease or injury.
.38 C.F.R. §3.322 Rating of disabilities aggravated by service.
38 C.F.R. §3.304 Direct service connection; wartime and peacetime.
38 U.S.C. § 3.2501 Supplemental Claims.
38 C.F.R. § 3.156 New and material evidence.
38 C.F.R. §3.155 How to file a claim.
38 C38 C.F.R. §3.151 Claims for disability benefits.
38 C.F.R. §3.150 Forms to be furnished.
38 C.F.R. §3.1 Definitions.
38 C.F.R. §3.400 General.
38 C.F.R. §3.303 Principles relating to service connection.
38 C.F.R. §3.306 Aggravation of preservice disability.
38 C.F.R. §3.159 Department of Veterans Affairs assistance in developing claims.
38 C.F.R. §3.307 Presumptive service connection for chronic, tropical, or prisoner-of-war related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminants in the water supply at Camp Lejeune; wartime and service on or after January 1, 1947,
38 C.F.R. §3.309 Disease subject to presumptive service connection
38 C.F.R. §3.321 General rating considerations.
38 C.F.R. §3.2600 Review of benefit claims decisions.
38 CF.R. §4.1 Essentials of evaluative rating.
38 C.F.R. §4.2 Interpretation of examination reports.
38 C.F.R. §4.3 Resolution of reasonable doubt.
38 C.F.R. §4.6 Evaluation of evidence.
38 C.F.R. §3.401 Veterans.
38 C.F.R. 3.2500 Review of decisions.
3. Service connection for migraine.
The claim for service connection for migraine is considered reopened. (38 CFR 3.156) However, the evidence continues to show this condition was not incurred in or aggravated by military service. (38 CFR 3.303, 38 CFR 3.304, 38 CFR 3.306) 7
Service connection may be granted for any disease or injury that is considered to have resulted in a period of war or service. To establish direct service connection for a claimed disorder, objective evidence must show a diagnosis of a current disability that is related to a disease or injury incurred in or aggravated during “active " service; or that manifested itself to a compensable degree within one year from the date of discharge (specified under 38 C.F.R. §3.303).
We have denied your claim for direct service connection for migraine headaches because your service treatment records do not contain complaints, treatment, or diagnosis for this condition.
To satisfy the requirements for service connection for a disability based on presumption, you must submit the following: (1) medical evidence demonstrating the existence of a current disability, and (2) medical evidence establishing that the disability manifested to a compensable degree within one year of your discharge from active service. (specified under 38 C.F.R. § 3.309) Longer time limits may apply for certain medical conditions.
We have denied your claim for service connection for migraine headaches on a presumptive basis because the medical evidence failed to show this disability manifested to a compensable degree within one year of your discharge from active service.
We scheduled you for a examination, Gulf War General Medical Examination dated August 11, 2014. This examination reported Headaches (including Migraine Headaches) however the examiner stated your disability pattern is a disease(s) with a clear and specific etiology and diagnosis. It is less likely than not that the disability pattern is related to a specific exposure event experienced by the Veteran during service in SW Asia. Each claimed condition either has no diagnosis or a physiological process that can explain it.
Service connection under this provision is precluded if there is affirmative evidence that the disability was unrelated to service in the Gulf War. Service connection for migraine is denied because evidence established that this disability resulted from an etiology other than Gulf War environmental hazards. The VA medical opinion found no link between your diagnosed medical condition and military service.
The evidence does not show an event, disease or injury in service. (38 CFR 3.303, 38 CFR 3.304) Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. (38 CFR 3.307, 38 CFR 3.309) The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. (38 CFR 3.303, 38 om
CFR 3.304) The VA medical opinion found no link between your diagnosed medical condition and military service.
Favorable Findings identified in this decision: VA examination dated 08-11-2014 diagnosed headaches. VAMC treatment records dated 05-03-2017 note a report of headaches.
Gulf War General Medical Examination dated 08-11-2014 notes Headaches (including Migraine Headaches)
Laws and regulations applicable to this issue:
38 C.F.R. §3.310 Disabilities that are proximately due to, or aggravated by, service-connected disease or injury.
38 C.F.R. §3.322 Rating of disabilities aggravated by service.
38 C.F.R. §3.304 Direct service connection; wartime and peacetime.
38 U.S.C. § 3.2501 Supplemental Claims.
38 C.F.R. § 3.156 New and material evidence.
38 C.F.R. §3.155 How to file a claim.
38 C38 C.F.R. §3.151 Claims for disability benefits.
38 C.F.R. §3.150 Forms to be furnished.
38 C.F.R. §3.1 Definitions.
38 C.F.R. §3.400 General.
38 C.F.R. §3.303 Principles relating to service connection.
38 C.F.R. §3.306 Aggravation of preservice disability.
38 C.F.R. §3.159 Department of Veterans Affairs assistance in developing claims.
38 C.F.R. §3.307 Presumptive service connection for chronic, tropical, or prisoner-of-war related disease, disease associated with exposure to certain herbicide agents, or disease associated with exposure to contaminants in the water supply at Camp Lejeune; wartime and service on or after January 1, 1947.
38 C.F.R. §3.309 Disease subject to presumptive service connection
38 C.F.R. §3.321 General rating considerations.
38 C.F.R. §3.2600 Review of benefit claims decisions.
38 C.F.R. §4.1 Essentials of evaluative rating.
38 C.F.R. §4.2 Interpretation of examination reports.
38 C.F.R. §4.3 Resolution of reasonable doubt.
38 C.F.R. §4.6 Evaluation of evidence.
38 C.F.R. §3.401 Veterans.
38 C.F.R. 3.2500 Review of decisions.
REFERENCES:
Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans’ Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our website, www.va.gov.
Link to comment
Share on other sites
Top Posters For This Question
2
1
1
Popular Days
Aug 22
3
Aug 23
1
Top Posters For This Question
jaimef361 2 posts
GBArmy 1 post
HONDOII 1 post
Popular Days
Aug 22 2019
3 posts
Aug 23 2019
1 post
3 answers to this question
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now