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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
Ztmiller8
Hey everyone,
Need some insight here... I filed a triple issue appeal with the VA some time ago, I lawyered up and everything was handled very professionally. I asked my lawyer this; however, he has told me that if it is not a “next day due” issue, it will have to wait. I get both sides of that, 1 being, okay i get it, stuff is hectic! Other side is, well I’m paying for this, why are you not getting right back to me...none the less that’s why I’m here.
Appeal Issues: 1. PTSD: increase from 50 to 70
2. Back: Get service connected (We already ruled this out)
3. Iritis: Raise from 10 to 60
Our goal is 100% like many others.
Story: Got word my case was to be expedited due to financial hardships, we’ll leave it at that. On 3/25/2020 I was told via the 1000 VA number that all 3 issues were denied and an SOC was sent out. Shit...a few days later I and checking my Ebenefits and I am at 90% overall...okay...lets call them back...Idiots on the other line tell me that all three issues were SOC’d and that a decision packet was being sent out on the 29th of march...okay lets back up...did you just hear yourself? This is where it gets confusing... So I call back the following day to try and get some solid word (I know, foolish me) and I ask simply if they worked on my final issue within my appeal, they said they were all SOC’d and the iritis is waiting on a decision, thats new.... (again)...call right back for someone different...guy was a dick, name was Larry...wouldn’t give me an inch after explaining everything.
The iritis is maxed out at 60% when the individual has gone to 7 or more clinical appointments within one year, I presented a letter signed from my optometrist stating I went to one each month for one year, I’m not great at math but that sounds a few more than 7 times. So I go to my C&P exam and the guy remembered me as I was his only case or this issue and he wrote down the same thing on his paperwork. So with such hard evidence within and out of the VA system...why are they saying it is denied and not just waiting for a decision???
Fast forward to today, I’m left questioning this in a few routes:
Route #1: They are dicked up and are being lazy...
Route #2: I was actually denied the remaining two issues (back and iritis)
Route #3: They are handling each one individually and the telemarketers at the 1000 number just don’t have the correct or updated info in front of them. Since some still tell me all three are denied... while then proceeding to say I am getting a decision packet for the ptsd...
I hope someone can shed some light on this as it simply makes no sense, and yes I am well aware that the VA never makes sense, as you can see, this is just all messed up, thanks for any of the replies!
- Z
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