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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
Tbird
I filed a claim in February in case it leads to other mobility-related benefits as my arthritis gets worse. I expected to lose, but I won. I didn’t use a service officer or lawyer; I filed the claim on my own.
I hope it helps another veteran.
Here it is
REASONS FOR DECISION
1. Service connection for ventral hernia as secondary to the service-connected disability of status post-hysterectomy-laparotomy. Service connection for ventral hernia has been established as related to the service-connected disability of status post-hysterectomy-laparotomy. (38 CFR 3.303, 38 CFR 3.310)
The effective date of this grant is February 22, 2024. Service connection has been established from the day VA received your intent to file (ITF) a claim for compensation. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date the VA receives the intent to file when a prescribed form is received within a year of the ITF. (38 CFR 3.155, 38 CFR 3.400)
An evaluation of 100 percent is assigned from February 22, 2024.
We have assigned a 100 percent evaluation for your ventral hernia based on:
This is the highest schedular evaluation allowed under the law for ventral hernia. (38 CFR 4.114)
2. Service connection for degenerative arthritis, other than post-traumatic, left knee as secondary to the service-connected disability of status post-hysterectomy-laparotomy.
Service connection for degenerative arthritis, other than post-traumatic, left knee has been established as related to the service-connected disability of status post-hysterectomy-laparotomy. (38 CFR 3.303, 38 CFR 3.310)
The effective date of this grant is February 22, 2024. Service connection has been established from the day VA received your intent to file (ITF) a claim for compensation. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA receives the intent to file when a prescribed form is received within a year of the ITF. (38 CFR 3.155, 38 CFR 3.400)
An evaluation of 30 percent is assigned from February 22, 2024.
We have assigned a 30 percent evaluation for your degenerative arthritis, other than posttraumatic, left knee based on:
The provisions of 38 CFR §4.40 and §4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and were applied based on additional joint limitation.
A higher evaluation of 40 percent is not warranted for limitation of extension of the knee unless the evidence shows:
3. Service connection for left shoulder strain with degenerative arthritis, other than posttraumatic and post-traumatic arthritis and labral tear, including SLAP with tendinosis as secondary to the service-connected disability of status post-hysterectomy-laparotomy.
Service connection for left shoulder strain with degenerative arthritis, other than posttraumatic and post-traumatic arthritis and labral tear, including SLAP with tendinosis, has been established as related to the service-connected disability of status post-hysterectomy-laparotomy. (38 CFR 3.303, 38 CFR 3.310).
The effective date of this grant is February 22, 2024.
Service connection has been established from the day VA received your intent to file (ITF) a claim for compensation. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA receives the intent to file when a prescribed form is received within a year of the ITF. (38 CFR 3.155, 38 CFR 3.400)
An evaluation of 20 percent is assigned from February 22, 2024.
We have assigned a 20 percent evaluation for your left shoulder strain with degenerative arthritis, other than posttraumatic and post-traumatic arthritis and labral tear, including SLAP with tendinosis based on:
Additional symptom(s) include:
The provisions of 38 CFR §4.40 and §4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and were applied based on additional joint limitation.
A higher evaluation of 30 percent is not warranted for limitation of motion of the arm unless the evidence shows:
4. Service connection for degenerative arthritis, other than post-traumatic, right knee as secondary to the service-connected disability of status post-hysterectomy-laparotomy.
Service connection for degenerative arthritis, other than post-traumatic, right knee has been established as related to the service-connected disability of status post-hysterectomy-laparotomy. (38 CFR 3.303, 38 CFR 3.310)
The effective date of this grant is February 22, 2024. Service connection has been established from the day VA received your intent to file (ITF) a claim for compensation. When a claim of service connection is received more than one year after discharge from active duty, the effective date is the date VA receives the intent to file when a prescribed form is received within a year of the ITF. (38 CFR 3.155, 38 CFR 3.400)
An evaluation of 10 percent is assigned from February 22, 2024.
We have assigned a 10 percent evaluation for your degenerative arthritis, other than posttraumatic, right knee based on:
Additional symptom(s) include:
The provisions of 38 CFR §4.40 and §4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, incoordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and applied under 38 CFR §4.59.
A higher evaluation of 20 percent is not warranted for degenerative arthritis, other than posttraumatic unless the evidence shows:
Additionally, a higher evaluation of 20 percent is not warranted for limitation of flexion of the knee unless the evidence shows:
Tbird
Founder HadIt.com Veteran To Veteran LLC - Founded Jan 20, 1997
HadIt.com Veteran To Veteran | Community Forum | RallyPoint | FaceBook | LinkedIn | About Me
Time Dedicated to HadIt.com Veterans and my brothers and sisters: 65,700 - 109,500 Hours Over Thirty Years
I am writing my memoirs and would love it if you could help a shipmate out and look at it.
I've had a few challenges, perhaps the same as you. I relate them here to demonstrate that we can learn, overcome, and find purpose in life.
The stories can be harrowing to read; they were challenging to live. Remember that each story taught me something I would need once I found my purpose, and my purpose was and is HadIt.com Veterans.
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I filed a claim in February in case it leads to other mobility-related benefits as my arthritis gets worse. I expected to lose, but I won. I didn’t use a service officer or lawyer; I filed the claim o
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