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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
17to60s
Hello. I've been working to get a favorable character of discharge decision, off and on, for over 12 years.
I joined the navy about a month after my 17th birthday in the late 1970s.
I had some mental health issues when I was around 10 yo, depression, after my father's death.
I did mark this down on my 1st entry exam. I was deemed fit for duty and entered service.
I scored high on my asvab marks, 93, and chose to be an FTM in advanced electronics.
I had one and a half years of schooling, during which I had no disciplinary issues, completed my training, and recieved high marks and promotions.
During this time, I had many health issues, including infections, gastro/gerd issues, and a fall while on duty which caused lower back injury. I also had a severe reaction to steroid treatments for a skin issue, for which I ended up in the ER.
It also caused me to experience my first of many manic episodes.
Despite this, I finished my schooling and was assigned to a ship.
After the transfer, I again had mental health issue which became overwhelming after 6 months on board.
I was sent home on leave, but didn't return. After 6+ months I was returned, and went to a special court martial.
I was told I could avoid trial by taking an oth discharge, but I wanted to continue in service.
Eventually, I was returned to the same ship where I'd had trouble before.
We went to sea for a year and a half, including service in Lebanon in 1983.
After a change in command, the shipboard environment became very toxic, and I was assaulted multiple times, being knocked out twice.
After we returned, and right after the second time I'd been ko'd, I was given 2.0s across the board, had my FTM designator removed and was reassigned to the mess deck, due to an inability to perform my FTM duties anymore.
A couple months later, I was written up for not getting up for a urine test during the night. I just couldn't get up.
This was used to have me discharged for a pattern of misconduct, with an OTH.
Years later, when I applied for healthcare, I was denied vet status due to an awol of over 180 days. (197)
This is a statutory bar.
However, I've maintained that I was not discharged as a result of my awol, but for a pattern of misconduct years later. This is a regulatory bar, and I would at least be able to access healthcare.
I also showed that I was diagnosed with depression in the last year of my service, endorsed depression, excessive worry, sleep disruptions, and nervous troubles on my exit exam. I also endorsed head injuries.
I have provided 3 separate IMOs, including 2 that say it's more than likely that my Bipolar disorder began in service, prior to my awol. My therapist stated it was more likely than not that my Bipolar disorder caused me to exhibit mental health symptoms that lead to a prolonged deviations from my normal behaviour.
I have been denied several times now, yet, not once has the VA addressed or refuted any of my IMOs, evidence in my service records, lay statements from my brother and sister, or any other evidence.
My last supplemental specifically stated that I met the VA definition of insane. I pointed to all the evidence in support, the VAs definition of Insanity, and federal and agency statements and decisions that state that the benefit of the doubt extends to COD determinations.
The VA simply said that the evidence of record shows I was sane.
The point to no such evidence, and make no reference to any of the evidence I've supplied.
My local DAV rep says the VA doesn't have to do during a COD determination, what they do during a claim adjudication.
I know this is wrong. the VA has never called me/talked to me in over 12 years. Despite all the evidence, I've never been given an exam.
Am I wrong? Can the VA disregard my medical evidence? Can they dismiss my medical evidence, based on their own opinion?
Doesn't the VA have to show what evidence they use against me, if it exists?
Isn't it a CUE that they are denying me based on the awol, even though I was not discharged for that, but years later?
My dd214 clearly states it was due to a pattern of misconduct. Separation code HKA, and narrative both show pattern of misconduct.
Doesn't an IMO stating that my Bipolar disorder symptoms arose before my awol, and caused me to deviate from my normal method of behaviour, meet the VA definition for insanity?
I look forward to any useful comments.
Thank you.
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