COVA–Gilbert v. Derwinski (1990) –The Dawn of the Court

VetCourtAppealsPromoAt the dawn of time (as far as modern review of Veterans’ claims goes) pursuant to the passage of the Veterans Judicial Review Act (VJRA) of 1988, the Court Of Veterans Appeals (COVA) was created. Its stated purpose was to review appealed decisions of the Board of Veterans Appeals (BVA). Now, in order to do so, the new Court had to create a voluminous amount of precedent case law in a very short period of time. The reason being was that VA law was unique to Veterans. Many concepts of boilerplate U.S. law did not apply to our circumstances. Thus our new judges were tasked with picking through endless prior decisions from the Supreme Court as well as the Fed. Circuit to quote precedence- virtually none of which involved Veterans. More about this later.

In order to create new Veteran-specific precedents, the COVA (now known as the Court of Appeals for Veterans Claims [CAVC]or the Court) went into high gear throughout 89, 90 and 91 to produce an enormous amount of case law. This accelerated pace continued all the way into 1995 before it slowed down somewhat.  Much of this is still cited today in Court and BVA decisions. Some has been overturned at the Federal circuit level on appeal or superseded by new or more nuanced reading of existing law.

However, one precedential case Veterans will see over and over is Gilbert v. Derwinski, decided October 12th, 1990. Norman (NMI) Gilbert was a groundpounder serving in Korea in 1956 when he had the misfortune of tripping and falling while carrying an M-2 .50 calibre machine gun. If you have ever been saddled with carrying one of these beasts, you can appreciate what happened to him. As was the usual case, he filed for SC and was denied. Following in the footsteps of a lot of us, he failed to appeal. After reapplying, he was denied yet again. Fortunately this was the point at which he could avail himself of the appeal procedures of the Court, which he did. The Court, in fine form, looked at his defective BVA decision and noticed the absence of any discussion regarding the positive evidence in his favor. All discussion centered on the negative evidence with a conclusion that the benefit of the doubt rule was not applicable.

When the VJRA was passed in 88, one of the new requirements was that within the “Reasons and Bases” section of a BVA decision there must be a complete and coherent explanation for the decision that included a discussion of the positive and negative evidence to facilitate review in the event of an appeal. This explanation was also a platform for the Board to state whether the positive evidence was enough to prove the case or if the negative evidence against the claim was enough to deny it. The third alternative, the benefit of the doubt, enshrined in more than a century of VA case law since the end of the War of Northern Aggression in 1865, was for consideration when the positive and the negative evidence were in equipoise- that is, equally balancing one another so as to allow two permissible interpretations, both of which were plausible. In the event of equipoise, the benefit of the doubt doctrine, now enshrined in VA law as 38 USC § 3007 (subsequently renumbered as § 5107) was to be applied. This reading of law digressed from civil law which demands “clear and convincing evidence” in order to prevail.

One observation I feel needs to be illuminated is the prevalence (and propensity) of the BVA to come down, often through semantic gerrymandering, on the wrong side of said benefit of the doubt. This is what occurred to Mr. Gilbert and what prompted his Notice of Appeal to the Court. The Court spotted the discrepancy and decided to use this case as a vehicle for enunciating the right of Veterans to this important entitlement. The fact that it continues to be abused or simply paid lip service in the stampede to deny Veterans their claims requires the Court to dust off this precedent and take the VA Secretary to task on a fairly regular basis.

In the wake of this ruling, many other important decisions were handed down that further cemented Veterans rights. Almost all of them were the result of egregious errors on the part of the Secretary and his administrative law cohorts in determining how to interpret  38 USC. Ultimately, Mr. Gilbert did not prevail in his claim after remand. However, his name will live on for aeons in the annals of VA Law.

38 USC is simply the laws as enumerated by the Congress. 38 CFR, however, are regulations promulgated by the Secretary to implement that law. Quite frequently the Court strikes down all or portions of 38 CFR that conflict with 38 USC. Even more frequently,  we are now starting to see what is known in military parlance as “Mission Creep”. This occurs when our Exalted Leader takes out the legal scissors and proceeds to manufacture new interpretations of old laws from whole cloth. The fabric of 38 USC is fairly sturdy and has withstood the test of time for the most part. The same cannot be said of 38 CFR.

The mere fact that the VA General Counsel’s office constantly has to clarify the meaning of regulations contained in the CFR (VAOPGCPRECs)  for Regional Office personnel indicates there is ambiguity in them. What isn’t there is wiggle room. There are not two permissible views of how to interpret the law, nor is there implied permission to read new meanings into old regulations. Once we cure the predilection of the BVA and the Secretary to detect these new “revelations”(which you and I are certainly not allowed to do), we can proceed to a more amicable form of justice instead of the antagonistic format we now endure. What we are seeing nowadays at the Court is the Secretary getting caught with his proverbial legal pants down all too frequently. This is often followed by a defective,  tortured and poorly reasoned explanation to anyone who will listen as to how he arrived at this new legal epiphany. We at AskNOD have abrogated a  Yahoo term and now refer to this as “Shutdown Corner”. The frequency of this bad habit is  becoming frighteningly  redundant and makes the Secretary resemble the ex -general he is and not the accomplished legal scholar he purports and aspires to be. We certainly had high hopes for him upon his appointment in 2009.

When you know you have been denied by the BVA for erroneous reasons and seek redress at the Court, looking through these old decisions is like being a contestant on Supermarket Sweep or being the first one to dive into a large Whitman’s sampler box. You will invariably find ample precedent to remand, vacate or reverse your decision. The Court has a voluminous amount of VA law under its belt now and precedent abounds. New interpretations are still being uncovered on laws that have never been addressed minutely. Every time Congress adds to 38 USC, it provokes another round of misinterpretations by the VA on what, exactly, is permissible. I guess it doesn’t take Karnak the All-Knowing to illuminate how they will interpret it.

Remember, in VA law, you politely present your side and sit down for several years. VA then proceeds to demolish your case. They start by questioning your morals, impugn the memory and reliability of you and your witnesses and denigrate your evidence as immaterial. All this without any rebuttal or cross examination on your part. You then attempt to rebut their insinuations, correct their misconceptions and try to refine your theory. They, in turn, claim you have now changed your story and cannot corroborate your claim. Then they cite all these cases we have been examining and use them against you. This is known as ex parte justice

It’s time to turn the tables and utilize the same technique to your advantage. Mastery of reading comprehension is almost a prerequisite for this. If you find yourself challenged in this regard, we strongly recommend seeking out a lawyer rather than a VSO. VSOs are several steps below legalzoomdotcom and were raised by wolves in our estimation.

Ladies and Gentlemen Vets, meet one of your forebears who inadvertently immortalized his name in case law- Mr. Norman (No Middle Initial) Gilbert attached below as a PDF.

P.S. In the attached picture below, the fifth gentleman from the left (standing) is 1st Lieutenant Harold “Weird Harold” Mesaris (USAF). He is holding a M-2 .50 calibre machinegun like the one Mr. Gilbert tripped and fell with. You will notice Weird Harold’s left leg is resting on a .50 cal. ammo box in an effort to support the weight of the gun.  All these gentlemen were in uniform at the time (1970). We weren’t allowed to wear our military uniforms in Laos because a) we weren’t there legally in a military capacity and b) we were ostensibly civilians on vacation or USAID workers. Every one of these officers were volunteers for the Steve Canyon program. Their call sign was Raven.  From left to right (standing) Craig Duerhing, Bill Lutz, Park Bunker (KIA/BNR 12/30/70), Chuck Engle (KIA 2/21/71), Harold Mesaris, Ray DeArrigunaga,   (kneeling) Jeff Thompson(atop the T-28) A.D. Holt. Braver men never posed for a photo.

Gilbert_89-53b

Posted in Important CAVC/COVA Ruling, Tips and Tricks, Vietnam War history | Tagged , , , , , , , , , , , , , , | 2 Comments

Deciphering CAVC (cont.) Part 3

This is Part 3 of a 3 part analysis of a Court decision. To read the whole decision, please access the CAVC Forum and click on Part 1 followed by Part 2. 

C. Prejudice

The Court must next consider whether the appellant was prejudiced by the Board’s errors. See 38 U.S.C. § 7261(b)(2);Shinseki v. Sanders, 129 S. Ct. 1696, 1704 (2009). In his brief, the Secretary argues that the notice letters provided to the appellant under section 5103(a) eliminate any potential prejudice that might have been caused by the Board member’s failure to explain the issues because they sufficiently explained the need for the appellant to submit medical evidence. Secretary’sBr. at 13-14. However, section 5103(a) serves a different purpose in the statutory scheme than § 3.103(c)(2). See Wilson, supra. Further, the Court already has held that a hearing officer has the duty to suggest the submission of evidence even when the claimant has been provided a letter notifying him of the need to submit such evidence. See Cuevas, supra. Not only is this precedential opinion binding, see Bethea v. Derwinski, 2 Vet.App. 252, 254 (1992) (panel decisions constitute “binding precedent” unless overturned by en banc opinion of this Court or decision of the Federal Circuit or U.S. Supreme Court), to hold that the failure of a hearing officer to suggest the submission of evidence that might have been overlooked is rendered nonprejudicial simply because the claimant had been provided preadjudicatory notice of what was needed to substantiate the claim essentially would eviscerate the duty imposed by the Secretary in § 3.103(c)(2). There is no basis for rendering such a holding. Rather, the assessment of prejudice generally is case specific, demonstrated by the appellant and based on the record. See Shinsekisupra (appellant generally bears burden of demonstrating prejudicial error on appeal); Marciniak v. Brown, 10 Vet.App. 198, 201 (1997) (remand unnecessary “[i]n the absence of demonstrated prejudice”); see also Mlechick v. Mansfield, 503 F.3d 1340, 1346 (Fed. Cir. 2007) (Court must review the record to take due account of the rule of prejudicial error).

                                 1. Frostbite, Hearing Loss, and Tinnitus

 

With regard to the appellant’s claim for benefits for frostbite, hearing loss, and tinnitus, although the Board hearing officer did not explicitly lay out the material issues of medical nexus and current disability, the record reflects that they were developed by the Secretary – to include medical examination reports on each of these disabilities and any nexus to service – and there was no indication that the represented appellant had any additional information to submit. Accordingly, the “clarity and completeness of the hearing record” was intact with respect to these disabilities and the purpose of § 3.103(c)(2) was fulfilled. See Thomas and Marcinak, both suprasee also Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996) (service connection generally requires, inter alia, medical nexus).

Our dissenting colleague’s reliance on Moore v. Shinseki, 555 F.3d 1369, 1374-75 (Fed. Cir. 2009) for finding prejudice is misplaced. Moore confirmed and clarified the statutory duty of the Secretary to secure potentially relevant evidence when reasonably identified by a claimant, see 38 U.S.C. § 5103A, and is inapposite to the regulatory duties imposed on a hearing officer under § 3.103(c)(2); there is no suggestion that Mr. Bryant identified relevant evidence that was not obtained by the Secretary. Our colleague’s focus on the fact that a purpose of the hearing is to permit a claimant to submit evidence also is misplaced; there is no suggestion that Mr. Bryant was denied an opportunity to submit evidence. Rather, the prejudice identified by our dissenting colleague arises from a duty not imposed by regulation or statute; i.e., a duty to weigh conflicting evidence or otherwise preadjudicate the claim and advise the claimant of those areas where the evidence weighs against his claim. Congress or the Secretary might create such a duty, but as noted in our discussion above, they have not yet done so.Cf. Locklear, supra.

                                            2. Squamous Cell Carcinoma

 

In contrast to the above, the failure to explicitly lay out the material issues with regard to squamous cell carcinoma was combined with a failure to suggest to the appellant that he should secure and submit medical evidence on the key issue of nexus to service – evidence that was lacking at the time of the hearing, and that remained lacking through final Board decision. Had the appellant been notified that evidence may have been overlooked on this issue, he could have requested such

an examination from the Secretary or secured one on his own. Although it is not known whether the appellant can secure a favorable medical report, his prejudice arises from the failure of the hearing officer to assure the “clarity and completeness of the hearing record,” Thomas, 423 F.3d at1285 , and the lost additional opportunity to try and submit such evidence before his claim finally was adjudicated, which is one of the prima facie purposes of the regulatory requirement that the Board hearing officer suggest the submission of material evidence that the appellant may have overlooked. 38 C.F.R. § 3.103(c)(2);see also Parker v. Brown, 9 Vet.App. 476, 481 (1996) (stating that “‘[p]rejudice … means injury to an interest that the statute, regulation, or rule in question was designed to protect'” (quoting Intercargo Ins. Co. v. United States, 83 F.3d 391, 396 (Fed. Cir. 1996))); cfShinseki, 129 S. Ct. at 1708 (indicating as a factor for determining notice-error prejudice,  the identification of evidence that might have been obtained or sought if proper notification had been given); Wagner v. United States, 365 F.3d 1358, 1365 (Fed. Cir. 2004) (holding that “[w]here the effect of an error on the outcome of a proceeding is unquantifiable . . . , we will not speculate as to

what the outcome might have been had the error not occurred”).

So, the Court finds all the things wrong with the BVA decision and excoriates the Judge for his ineptness. As Judges never write in DickandJanespeak, this two or three paragraph screed has been turned into a Guttenberg Bible and several old growth trees had  to be sacrificed for their long winded diatribe.

 

                                                    III. CONCLUSION

 

On consideration of the foregoing, that part of the Board’s October 6, 2008, decision denying benefits for frostbite, hearing loss, and tinnitus is AFFIRMED, and that part denying benefits for squamous cell carcinoma is VACATED and the matter REMANDED for further adjudication consistent with this opinion.

The opinion of the Court is per curiam. LANCE, Judge, filed an opinion concurring in part and dissenting in part.

Finally, the men say Taa-Daa! They did at the beginning, but it took so long to get here they have to remind you what the outcome was again.

LANCE, Judge, concurring in part and dissenting in part: I believe that the majority does an excellent job in many respects in clarifying our previously disjointed caselaw on 38 C.F.R. § 3.103(c)(2) (2009). However, I think the opinion suffers from two serious problems.

First, I believe that the majority fails to sufficiently explain the distinction between its holding that the regulation does not require a preadjuication of the claim or weighing of the evidence and its requirement that the hearing officer must review the entire record to fully explain the issues on appeal. Reviewing the record to determine what issues it raises necessarily requires some evaluation of the evidence and some judgment about which issues are reasonably in dispute.

Determining that there is no favorable evidence in the record will often require making a decision about the nature or meaning of ambiguous documents or reports in the claims file. Hence, it is not

clear to me how these two conclusions coexist. More importantly, it is not clear how the Court provide a full explanation of the issues.

In my view, a better standard would be one that is similar to the one used in Kent v. Nicholson, 20 Vet.App. 1 (2006), to avoid requiring the preadjudication of claims. In Kent, the Court concluded that proper 38 U.S.C. § 5103(a) notice as to an attempt to reopen a previously denied claim requires the Secretary to look at the basis of the prior denial and tailor the notice to any findings of fact that would affect the type of evidence that the claimant must submit. 20 Vet.App.at 10. By analogy, 38 C.F.R. § 3.103(c)(2) should require the Board to look at the most recent RO decision—which may be the most recent Supplemental Statement of the Case considering additional evidence—and clearly explain to the appellant what element or elements of the claim were found deficient by that decision and what types of evidence would help the appellant prevail as to those issues. If the RO addressed multiple theories as to a claim, the Board would have to explain the issues related to each theory.

I believe that such a standard would be vastly easier for the Board to apply and for the Court to review. While there are certainly cases where the Board may ultimately spot an issue that was completely overlooked by the RO, the Court has recently held that the Secretary’s regulations prevent the Board from considering new legal theories in the first instance.Hickson v. Shinseki, 23 Vet.App. 394, 400-03 (2010). Thus, even if the Board later determines that the RO decision overlooked an issue, the claimant must receive notice of the issue and the opportunity to have it remanded to the RO. Id.Accordingly, even if a bright-line, Kent-style rule does not perfectly capture every issue,claimants are still protected from being blindsided by a Board decision that raises a new issue.

My second—and more serious—concern is that the majority’s prejudicial error analysis effectively guts the requirement to fully explain the issues in many cases. In this case, the opinion concludes that the 38 C.F.R. § 3.103(c)(2) error was harmless because the negative medical evidence of record proves that the appellant was not prejudiced. To do so, the opinion mistakenly frames the prejudicial error question as whether the error affected “the ‘clarity and completeness of the hearing

record.'” Ante at 12 (quoting 38 C.F.R. § 3.103(c)(2)). However, I believe that is the standard that should be used for the second prong of the regulation: the duty to suggest the submission of overlooked evidence. As to the first prong, the duty to fully explain the issues, the first sentence of 38 C.F.R. § 3.103(c)(2) explicitly states that the purpose of a hearing is to provide the claimant with an opportunity to submit favorable evidence. The duty to fully explain the issues exists to make that opportunity meaningful by ensuring that the appellant understands what issues most likely require the submission of favorable evidence before there is a reasonable possibility of prevailing on the claim. Where there is substantial negative evidence in the record on an issue, it is even more

important that the Board member explain the need for favorable evidence in order for the claimant to have a realistic opportunity to prevail on the claim. See Moore v. Shinseki, 555 F.3d 1369, 1374-75 (Fed. Cir. 2009) (concluding that failure to obtain potentially favorable, circumstantial evidence was prejudicial even though the record contained copious direct evidence against the claim).

In this regard, the majority opinion expresses confusion about my positions and presents a flawed rebuttal by unnecessarily mixing my two concerns together. First, I do not believe that I can be any clearer that preadjudication of claims by the Board is not required. Instead, I believe that the scope of the duty to fully inform should be defined by the findings of the actual adjudication done at the RO level prior to the Board hearing. Second, the opportunity to submit evidence is more than just a window of time in which new evidence will be received. When the issue in dispute requires expert evidence because it is beyond the common knowledge of lay persons, there is little reason to believe that such favorable evidence will actually be submitted unless the appellant understands the types of evidence needed to have a chance of prevailing. Indeed, my essential point is that the majority fails to acknowledge the possibility that the reason Mr. Bryant never identified any additional medical evidence in support of his claim was because he did not understand that he needed to do so. The fact that he did not submit such evidence earlier tends to suggest that is the case. In my view, there does not appear to be any explanation for creating the duty “to explain fully the issues” except to neutralize the inference that the failure to submit evidence was the product of ignorance. Under the totality of the circumstances in this case, it appears that Mr. Bryant’s failure to submit favorable medical evidence may be the product of ignorance and, therefore, he was potentially prejudiced by the violation of the duty directly targeted at avoiding such a situation.

I suppose there is some threshold where the negative evidence of record is so overwhelming or incontrovertible that denying a claimant the opportunity to rebut it would be harmless. However, in summary, I believe that the regulation exists to help claimants rebut negative evidence and, therefore, the existence of some negative evidence reinforces, rather than cures, the prejudice of not explaining the issue. Accordingly, I would remand all of the appellant’s claims based upon the Court’s conclusion that the Board erred so that the appellant would have a meaningful opportunity to present rebuttal evidence on the key issues in his claims.

So, in a more perfect world, we would have received this from on High. With all due respect to his Honor, this is basically a case of “Could of, would of, and should of.” It does nothing to change the decision. It supplants the decision of the panel with a discourse on how he would have decided it based on what he perceives as the truth. The decision would stand without this rejoinder, but then some law clerk on our nickel was paid to type it to make his Honor look more illustrious. Kind of like the Emperor’s new clothes. In the end its Lions 5, Christians 0. Mr. Bryant loses on all counts and gets a do over on the squamous cell carcinoma. I wonder how his do over will turn out? Any bets?

  

Posted in Important CAVC/COVA Ruling, Introduction-Read these first, Tips and Tricks | Tagged | 1 Comment

Deciphering A CAVC Decision (cont.) Part 2

(This is Part 2 of 3 parts. To access Part 1, go to the CAVC forum listing all cases and click on Part 1)

b. Secretary’s Limited View of Duty To Suggest the Submission of Evidence

Similarly, nothing in the regulation limits the Secretary’s duties to advise the claimant to submit evidence only to those situations when the existence of such evidence is raised at the hearing. Given the duty to fully explain the issues, there is no dispute that a hearing officer necessarily must review the record. Having done so, however, he cannot ignore a lack of evidence in the record on a material issue and not suggest its submission, unless the record (or the claimant at hearing) clearly shows that such evidence is not available. To do so would ignore the regulatory mandate to advise the claimant to submit evidence that might have been overlooked. See Martin at 150-51 (“In situations in which the meaning of [regulatory] language is not free from doubt, the reviewing court should give effect to the agency’s interpretation so long as it is reasonable, that is, so long as the interpretation sensibly conforms to the purpose and wording of the regulations” (internal quotations and citations omitted)). Moreover, applicable caselaw shows that such inaction is not permissible.

                                             2. Applicable Caselaw

In considering the issue at hand, we look to several decisions of the Court and to a decision of the U.S. Court of Appeals for the Federal Circuit. In Douglas v. Derwinski, 2 Vet.App. 103, 105 (1992), the appellant applied for service connection for skin cancer and testified extensively about treatment he received to remove growths from his skin. Nonetheless, the record did “not contain any medical records pertinent to these assertions.” Id. The Court denied the Secretary’s motion for summary affirmance of the Board decision and concluded that the veteran’s testimony raised the issue of direct service connection for his cancer and that the Board member should have suggested

the submission of evidence “necessary to establish that claim.” Id. at 110. The Secretary filed a motion for reconsideration arguing that the Court’s panel decision was incorrect because the regulation did not apply to the Board. Douglas v. Derwinski,2 Vet.App. 435, 437 (1992) (en banc).

The Court rejected the Secretary’s argument and stated that the Board “was obliged to have fully explained to the veteran that his exposure to the sun during service, his later development of basal-cell carcinoma, and his physician’s statement about his sun-damaged skin raised the issue of direct service connection for his illness,” as well as obligated “to have suggested to him the submission of additional evidence he may have overlooked that would have helped his case.” Id. at 442.

In Proscelle v. Derwinski, 2 Vet.App. 629 (1992), the appellant applied for an increased rating for his maxillary condition.Id. at 631. During the course of his hearing, the appellant asserted that his disability had gotten worse since his last examination. The Court held that the hearing

officer should have suggested the submission of “medical evidence of the then-current level of his service-connected disability.” Id. at 633. The Court also determined that the Board’s statement of reasons or bases was inadequate because it failed to address the appellant’s assertions during his hearing that his maxillary condition had caused his “nervous condition,” and, further, determined that the Board member should have suggested at the hearing that the appellant “submit medical evidence

supporting his claim.” Id.

In Cuevas v. Principi, 3 Vet.App. 542 (1992), a veteran whose service medical records had been destroyed by fire testified at a hearing in 1990 that he had undergone a hearing test in 1985 or 1986 that confirmed his hearing loss. Noting that § 3.103(c)(2) requires the Secretary to fully explain the issues and suggest the submission of overlooked evidence, the Court held that

VA’s statutory duty to assist includes, in cases such as this, having the Hearing Officer tell the veteran that, at a minimum, he should submit a doctor’s report or statement confirming the existence of current hearing loss, especially since the veteran had testified that a hearing test in 1985 or 1986 had confirmed a hearing loss. Id. at 548.

Although VA had sent Mr. Cuevas a notice letter informing him of the need to submit such evidence, the Court held that the hearing officer was nonetheless required to reiterate this concept.

In Costantino v. West, 12 Vet.App. 517 (1999), a veteran’s widow sought to obtain disability and indemnity compensation. The widow argued that the veteran’s service-connected mental condition caused him to refuse medication for illnesses, and that this refusal resulted in his death.

At a hearing, the widow’s representative contended that the veteran’s service-connected mental condition hastened his death. The Board noted that the record did not contain clinical documentation of the veteran’s final hospitalization or a medical opinion demonstrating a nexus to service. TheCourt stated:

[The Board erred] in failing to find error in the hearing officer’s failure to suggest to the appellant that she submit medical evidence regarding any relationship between the veteran’s service-connected condition and his refusal of treatment and any relationship between such refusal and his death, as well as any additional records concerning the veteran’s death. Id. at 520.

In Sizemore v. Principi, 18 Vet.App. 264 (2004), a veteran seeking service connection for post-traumatic stress disorder described at a hearing his experiences in Vietnam. Id. at 274. TheCourt stated that the appellant was not advised adequately by VA as to the types of information that may help to verify his claimed in-service stressors. In particular, at the May 1996 hearing, VA failed to advise the appellant that he could submit corroboration in the form of “buddy statements” as to some of the occurrences that he alleged were in-service stressors.

Id. Although the potential evidence was not yet in existence or obtained in Sizemore, the claimant’s testimony suggested that it might be obtained to corroborate the incident described.

In Prickett v. Nicholson, 20 Vet.App. 370 (2006), a widow of a veteran sought service connection for the cause of her husband’s death. The widow sought to establish that the cause of his death – heart disease – was due to his service-connected psychosis. At the hearing, the decision review officer “repeatedly informed Mrs. Prickett that medical evidence, in particular, a medical opinion demonstrating a nexus between the veteran’s service and the cause of death, was critical to the disposition of her claim and asked her to submit such evidence.” Id. at 373. Mrs. Prickett stated that there was no medical evidence to submit at that time. The Court found that the hearing officer did not violate his duties under § 3.103(c)(2) to fully explain the issues and suggest the submission of overlooked evidence because he informed the widow that (1) the most probative information with regard to determining her claim was “statements from medical types”; (2) she needed to have medical evidence related to nexus; and (3) she should submit any evidence she possessed, particularly medical evidence in support of her claim. Id. at 382.

In addition to the Court’s caselaw, the U.S. Court of Appeals for the Federal Circuit (Federal Circuit) also has issued an opinion addressing 38 C.F.R. § 3.103(c)(2). In Thomas v. Nicholson, 423 F.3d 1279 (Fed. Cir. 2005), the veteran was injured after he failed to respond to three orders from a sergeant who instructed him to leave a barracks. The veteran filed a claim for service connection for the injuries and testified at a hearing regarding the claim. His claim was denied, as the Board determined that his injuries were due to alcohol consumption. The Board reconsidered and found his injuries were due to his disobedience of a lawful order. The veteran argued that the hearing officer was required to ask him about the amount of time he had to respond to the sergeant’s orders, which could have shown that his actions were not willful. The Federal Circuit agreed with this Court that Mr. Thomas failed to demonstrate that the hearing officer was required to question the appellant on any particular theory in support of his claim. Specifically, the Federal Circuit held that the question was not necessary because it was not needed “to assure clarity and completeness of the hearing record” as required under § 3.103(c)(2). “Instead, we find the hearing officer fulfilled his duty in evaluating the record and that the evidence in the record adequately established the nature of Thomas’s conduct.” Id. at 1285.

    3. Scope of Duties To Explain Issues Fully and Suggest Submission of    Overlooked Evidence.

As previously stated, the relevant caselaw provides no support for finding a duty that the hearing officer preadjudicate the claim or that the hearing officer’s duty to explain the issues and suggest the submission of evidence is as limited as the Secretary suggests. Rather, the caselaw amply supports a finding that the hearing officer has a duty to fully explain the issues still outstanding that are relevant and material to substantiating the claim.3 See, e.g., PrickettCuevas, and Proscelle, all supra. Thus, when an element of the claim is not an issue in an appellant’s case, there is no need for the hearing officer to discuss it. For example, when veteran status or current disability is established, there is no reason for a hearing officer to discuss those issues. On the other hand, when the RO has denied a disability claim because there is no current disability, no nexus to service, or no incident in service, etc., then the Board hearing officer should explain that the claim can be substantiated only when the claimed disability is shown to exist and shown to be caused by an injury or disease in service, and the Board hearing officer’s explanation and discussion should be centered on these issues.

The caselaw also amply supports a finding that the hearing officer must suggest that a claimant submit evidence on an issue material to substantiating the claim when the record is missing any evidence on that issue or when the testimony at the hearing raises an issue for which there is no evidence in the record. See, e.g., ProcelleCuevas, and Sizemore, all supra. Because there is no requirement to preadjudicate an issue or weigh the evidence, the hearing officer’s review of the record in preparation for the hearing is one that should focus on the issues that remain outstanding, and whether evidence has been gathered as to those issues. If a claim has been denied for lack of evidence of a current disability, and no medical examination has been provided by the Secretary or medical evidence submitted by the appellant, then this lack of evidence gives rise to the duty of the Board hearing officer to suggest submission of this evidence. The hearing officer therefore must not

only be familiar with the claims file but also be engaged in the hearing process. The hearing officer also must suggest the submission of evidence when testimony during the hearing indicates that it exists (or could be reduced to writing) but is not of record. Moreover, VA’s issuance of a notice letter that complies with 38 U.S.C. § 5103(a) has no bearing on the duty to suggest the submission of evidence that may have been overlooked. See Cuevas, supra; see also Section C, infra.

To the extent the above scope of the duties to fully explain the issues and suggest the submission of evidence may not have been stated or held explicitly in prior cases, we so state and hold today.

3 The RO’s rating decision and Statement of the Case, which a hearing officer sho uld have encountered in his review of the record, will likely assist the hearing officer in identifying the outstanding issues.

Here, in the analysis section, the Court analyzes all the contentions put forth by the appellant and counterarguments from the VASEC. It analyzes past rulings and decisions to ascertain how laws in the past were promulgated and what precedence, if any, was forthcoming.

B. Application of Law to the Present Case

                                1. Duty To Fully Explain the Issues

 

In this case, the Board member began the hearing by stating: “The issues I have for appeal today are four. They are (1) entitlement to service connection for bilateral hearing loss, (2) entitlement to service connection for tinnitus, (3) entitlement to service connection for squamous cell carcinoma, and (4) entitlement to service connection for frostbite of both feet.” R. at 22. Although this statement explained the issues in terms of the scope of the claim for benefits, it did not “explain fully” the outstanding issues material to substantiating the claim, which in this instance were current disability and medical nexus. Even though the hearing officer made inquiries during the hearing regarding whether any doctor had ever related the appellant’s claimed disabilities to service and the basis for asserting a disability (R. at 25-31), at no point did the Board member explain that these issues were material to substantiating the claim – i.e., that they were the reasons the appellant’s claims were denied by the RO. Accordingly, the Board member erred as to the first duty – to fully explain the issues – under § 3.103(c)(2).

                      2. Duty To Suggest the Submission of Evidence Possibly Overlooked

 

As to the duty to suggest evidence that may have been overlooked, responses were elicited from the appellant as to frostbite, hearing loss, and tinnitus, as well as his basis for believing these claimed disabilities were related to service. At the time of the hearing, the record already contained VA medical examination reports stating that the appellant currently did not have frostbite, and that, although he had hearing loss and tinnitus, these disabilities were not caused by his service. Moreover, the hearing discussion did not reveal any evidence that might be available that had not been submitted. Under these circumstances, nothing gave rise to the possibility that evidence had been overlooked with regard to the appellant’s claim for benefits for frostbite, hearing loss, and tinnitus.

With regard to squamous cell carcinoma, the appellant’s representative at the hearing elicited information from the appellant about this claimed disability, and the appellant did not reveal any unsubmitted evidence that might be available. In contrast to the above circumstances, however, at the time of the hearing, there was no VA or other examination report addressing nexus, although the record on appeal contained VA treatment records for skin cancer and Bowen’s Disease, a type of squamous cell carcinoma.3 Under these circumstances, the lack of medical evidence in the record addressing a nexus between the appellant’s diagnosed squamous cell carcinoma and an in-service event or injury gave rise to the possibility that evidence had been overlooked, and the Board hearing officer should have suggested that the appellant secure and submit this evidence if he could; the hearing officer’s failure to do so was error.4See SizemoreCostantino, and Cuevas, all supra.

4  The Board stated that there was no evidence of a current diagnosisfor squamous cell carcinoma. R. at 12. However, a careful review of the appellant’s VA medical records indicates that on October 16, 2003, the appellant underwent a biopsy of an “8mm erythematous papule mid upper back/neck area.” R. at 302-03. A November 25, 2003, medical record states: “[P]athology came back as [B]owen’s with incomplete margins.” R. at 296; see also R. at 287. Bowen’s Disease is a type of squamous cell carcinoma. See DORLAND’S ILLUSTRATED MEDICAL DICTIONARY 536 (31sted. 2007).

5 Our dissenting colleague’s view that reviewing the record to identify the issues on appeal and assess whether evidence may have been overlooked equates to an evaluation of the evidence, post at 1, fails to recognize that the issues on appeal are readily identifiable in the RO’s decision and the statement of the case, and further fails to recognize that neither the identification of the issues nor the observation that there is no evidence on one of those issues (thus indicating that its submission may have been overlooked) requires any weighing or evaluation of the evidence.

End of Part 2. Proceed to Part three for final conclusion and synopsis

Posted in Important CAVC/COVA Ruling, Introduction-Read these first, Tips and Tricks | Tagged | Leave a comment

Deciphering a CAVC ruling — Part 1

Oftimes a Vet will set out to defend himself before the abortion we refer to as the Veteran friendly VA adjudicatory system. He/she soon discovers the “do as I say and not as I do” nature of the system with codicils inserted that relieve the VA of certain legal requirements while imposing them on the Vet. It certainly isn’t perfect, but it’s what we’re saddled with. Rather than complain, our suggestion is to make lemonade with the lemons. Afterwards, go out and find the guy who is making Vodka out of potatoes. Towards that end, we present a short “how to” course here to help the novitiate navigate the corridors of Appellate Justice at the CAVC level. You will find a similar road map for BVA decisions in that forum. 

     One thing that is paramount is that you, the Veteran, file your Notice of Appeal (NOA) within 120 days of a denial by the BVA. You do have the option of asking for a reconsideration of the BVA decision prior to filing the NOA, but this scenario is not going to be dealt with here. This will deal only with the CAVC to avoid confusion between the two legal bodies. 

     Once you file your notice of intent to contest the adverse ruling, you will file a brief with the Court (they are absolutely anal and love it when you capitalize the word Court) laying out the terms of your disagreement based on VA law. You obviously can’t say they “dissed” you and didn’t “give you no respect”. Those aren’t legal concepts that qualify as law. No, what you will need is actual violations of VA law such as a failure to address evidence that was favorable to you or a failure to explain their denial in the “Reasons and Bases” portion of their decision. BVA judges are required to examine all the evidence both pro and con in you case and weigh that at the end. In the event of a “tie” or equipoise, the tie goes to the runner. However, sometimes the VARO “forgets” to include important documents pertaining to your appeal or denies you a medical C&P exam when one is clearly warranted. If the BVA pulls a stunt like this and you don’t ask for reconsideration, your last recourse is to petition the CAVC judge(s) to right the wrong. As they are very exalted Grand Poobah types, and the sun rises over their shoulders, they feel that BVA judges are generally uncouth and love to find fault with their legal reasoning. Hell, that’s what they do for a living. Fortunately for you, the Vet, this works in your favor.

     There are three forms of appeal at the CAVC level. Your case will normally be assigned to a single judge for a ruling. This sets no precedence, but affords you a favorable platform for your appeal. Should the judge deny your claim and affirm the BVA decision, you may petition for a panel decision based on some facet of VA law that needs clarifying and a precedent setting decision. Or, in the alternative, if the decision is so sensitive that it will change VA law or be appealed to the Federal Circuit Court, your request for an en banc (full Court of 7) ruling may be entertained. Full court rulings are few and far between and panel decisions are generally reserved for case law that is destined to change existing law and needs to be decided in a precedent setting environment.  The Court has several different options before it based on the evidence presented. They may choose to leave the adverse BVA decision in place (affirmation),  set the decision aside and remand it with instructions on why it is defective and have the BVA or RO readjudicate it again (remand), or reverse the finding in favor of the Vet requiring the RO to sharpen it’s collective pencil and figure out how much %/$ they now owe you after holding up justice for 10 years. Additionally, you will find that some decisions are an amalgam of the above- i.e. Item A is affirmed, Item B is remanded and Item C is reversed and returned for a decision based on the Court’s findings. 

     You as the Vet, regardless of whether you represent yourself pro se or have a lawyer representing you, must lay out what you object to specifically, not generally. Each and every contention you make contesting your appeal must be laid out in advance. After you get to Court, you can’t change your legal arguments in mid stream based on what the VA Secretary and his minions pull out of their hat. You have to be prescient and prepared for these types of legal maneuvers. I suggest a broad brush or a 12 ga. that hits everything and then let the VASEC squirm as he tries to wiggle out of a tight spot addressing each of your contentions. It’s often better to raise specious arguments that have no rational legal basis than not raise them at all. Best of all, the Court affords great deference to those of us who choose to go it alone pro se. 

     We will pick a random panel decision now and disect it into its component parts with interjections in bold type so as not to confuse the reader into thinking our musings are part of the ruling. After searching, we found a recent decision from this year’s calendar that includes two of the three motions discussed above.  Ladies and Gentlemen, allow me to introduce Mr. Walter E. Bryant, a Veteran of the war to end all wars. As he is quite far along in years, the Court has advanced his claim on the calendar to give him a ruling before he ends up on the wrong side of the grass.

 

 

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

 

       NO. 08-4080

WALTER A. BRYANT, APPELLANT,

v

.

ERIC K. SHINSEKI,

SECRETARY OF VETERANS AFFAIRS, APPELLEE.

On Appeal from the Board of Veterans’ Appeals

 

 

 

(Argued March 10, 2010                                        Decided July 1, 2010)

Kenneth M. Carpenter, of Topeka, Kansas, with whom Peter J. Meadows, of Ft. Lauderdale, Florida, was on the brief for the appellant.

These (above) are the attorneys for Mr. Bryant (the appellant)

Penny C. Kahn, with whom Will A. Gunn, General Counsel; R. Randall Campbell, Assistant General Counsel; Edward V. Cassidy, Jr., Deputy Assistant General Counsel, were on the brief, all of Washington, D.C., for the appellee.

These are the hired law dogs for VASEC (Eric Shinseki, our exalted leader)

Before KASOLD, LANCE, and DAVIS, Judges.

(3 judges= a panel decision = precedence setting. However, there is nothing earthshaking about this decision.)

The opinion of the Court is per curiam.

per curiam (adjective) is Latin for “by the court,” defining a decision of an appeals court as a whole in which no judge is identified as the specific author.

LANCE, Judge, filed an opinion concurring in part and dissenting in part.

Any judge has a right to put in his two cents worth and wave his own flag as does Judge Lance at the end of this decision. Why, I have no idea. It won’t change the outcome. It’s just a convenient way to use up paper.

PER CURIAM: The appellant, Walter A. Bryant, through counsel, appeals an October 6, 2008, Board of Veterans’ Appeals (Board) decision denying his claims for service connection for bilateral hearing loss, tinnitus, squamous cell carcinoma, and frostbite residuals of both feet. Record R.) at 3-14. On December 9, 2009, the Court granted the appellant’s motion for expedited consideration of this appeal. This Court has jurisdiction to review the Board’s decision pursuant to 38 U.S.C. §§ 7252(a) and 7266(a). See Frankel v. Derwinski, 1 Vet.App. 23, 25-26 (1990). For the reasons discussed below, the Board’s October 6, 2008, decision will be affirmed in part, and vacated in part and the matters remanded for further proceedings consistent with this decision.

This is the synopsis in a nutshell. Like the BVA decisions, the Court likes to tell you up front what is going to transpire. I bet their friends hate them if they ask a judge whether he’s seen a particular movie (“Yeah and you’re not going to believe the ending. The guy shoots his girlfriend and then…. etc.)

 

                                       I. FACTUAL BACKGROUND

 

 

The appellant served in the U.S. Army from May 1943 to April 1946, and from September 1950 to October 1951. R. at 387, 394.

In February 2005, he filed a formal application for compensation benefits. R. at 357-68. During the development of his claim, the Secretary sent the appellant multiple letters explaining what evidence might be required to prove his claims. R. at 146, 250, 334-47. In June 2005, the Waco, Texas, regional office (RO) issued a rating decision denying the appellant’s claims to entitlement for bilateral hearing loss, for tinnitus, for squamous cell carcinoma, and for frostbite residuals in both feet. R. at 243-49. As to the appellant’s claims for bilateral hearing loss, for tinnitus, and for frostbite, the RO concluded that the record failed to show medical diagnoses for these conditions. R. at 246-47. As for the claim for service connection for squamous cell carcinoma, the RO explained the medical evidence showed “several areas of treatment” for this condition, but did not show this condition occurred in or was caused by service. R. at 244.

The appellant appealed this decision and a hearing was held before a Board member on August 28, 2008. R. at 21-33. In the October 6, 2008, decision on appeal, the Board, relying on VA medical opinions, issued a decision denying the appellant’s claim for benefits for frostbite because the appellant did not currently have this disability, and denying his claim for benefits for hearing loss and tinnitus because these disabilities were not related to service. The Board also denied benefits for squamous cell carcinoma because there was no evidence the appellant had this disability, although there was no VA (or other) medical opinion to this effect. R. at 4.

The central question to be resolved in this case is the extent of the Board hearing officer’s duty under 38 C.F.R. § 3.103(c)(2)(2009), see also 38 C.F.R. § 20.1304 (2009) (procedures to obtain a hearing at the Board), to explain fully the issues and suggest the submission of evidence that the claimant may have overlooked. 1 The hearing officer’s duties are established in 38 C.F.R. 1 § 3.103(c)(2) and a hearing may be requested duringthe initial adjudication of the claim or while the claim is on administrative appeal. See also 38 C.F.R. § 20.1304 (2009)(procedures for obtaining a hearing at the Board). Although the duties at either hearing are established by § 3.103(c)(2), this opinion generally addresses them in the context of a Board hearing.

     As you can see, this area sums up what has transpired to date, the appeals history and how it arrived at the CAVC’s corral. 

                                                   The Parties’ Arguments

 

The appellant’s main argument is that the Board hearing officer failed to explain to him that additional medical evidence was needed to support his claims. He asserts that the hearing officer did not fulfill the responsibilities ascribed to him under 38 C.F.R. § 3.103(c)(2) (2009). The appellant argues that it was error for the Board hearing officer to fail to suggest that he submit medical evidence, to include diagnoses for his claimed disorders as well as the etiology of such conditions. At argument, appellant’s counsel elaborated that he was arguing that the duty to fully discuss the issues and suggest the submission of overlooked evidence was “broad and totally encompassing” (Oral Argument at 11:35-43), so as to require the Board hearing officer to review the entire claims file prior to a hearing and make a preliminary decision so that the Board hearing officer can then explain at the hearing any deficiencies in the evidence that the appellant would need to overcome to receive a favorable decision (Oral Argument at 12:18-43).

The Secretary argues in his brief to the Court that the regulation applies to overlooked evidence, and “in light of the notification letters sent to Appellant . . . there simply was no overlooked evidence.” Secretary’s Brief (Br.) at 16 (emphasis in original). At oral argument, the Secretary detailed his argument, stating that “the Court has found that the hearing officer’s section 3.103(c)(2) obligation arises in a narrow set of circumstances in which the hearing officer, having been placed on notice of the existence of evidence that would help prove a claim, failed to suggest the submission of such evidence.” Oral Argument at 28:14-31.

The Secretary also argued that even if the hearing officer had a duty to inform the appellant that medical evidence was needed to substantiate his claim, failure to meet this duty resulted in no prejudice because the appellant had been so informed through the preadjudciatory notice he was provided pursuant to 38 U.S.C. § 5103(a).

As you can see, here Mr. Bryant and Mr. Shinseki cross swords and lay out the meat of their arguments. As usual, Mr. VASEC will say “yeah, We stepped on our necktie but it didn’t hurt Mr. Bryant. But if Mr. Bryant were to step on HIS necktie and do a face plant, Mr. Shinseki would be all over his ass like white on rice.

                                                      II. ANALYSIS

 

A. Hearing Officer’s Duties Under 38 C.F.R. §3.103(c)(2)(2009)

As the Court has observed, “a functioning system of laws must give primacy to the plain language of authorities.” Tropf v. Nicholson, 20 Vet.App. 317, 322 n.1 (2006). The language of the regulation is the necessary starting point because “[w]ithout standard word meanings and rules of construction, neither Congress nor the Secretary can know how to write authorities in a way that conveys their intent and no practitioner or—more importantly—veteran can rely on a statute or regulation to mean what it appears to say.” Id.see also Hickson v. Shinseki, 23 Vet.App. 394, 401 (2010) (concluding that Secretary’s interpretation of the regulation at issue was in conflict with the plain language used).

Section 3.103(c)(2) imposes, inter alia, two distinct duties on the hearing officer at issue in this case: The duty to explain fully the issues and the duty to suggest the submission of evidence that may have been overlooked. The regulation at issue reads:

The purpose of a hearing is to permit the claimant to introduce into the record, in person, any available evidence which he or she considers material and any arguments or contentions with respect to the facts and applicable law which he or she may consider pertinent. All testimony will be under oath or affirmation. The claimant is entitled to produce witnesses, but the claimant and witnesses are expected to be present. The Veterans Benefits Administration will not normally schedule a hearing for the sole purpose of receiving argument from a representative. It is the responsibility of the employee or employees conducting the hearings to explain fully the issues and suggest the submission of evidence which the claimant may haveoverlooked and which would be of advantage to the claimant’s position. To assure clarity and completeness of the hearing record, questions which are directed to the claimant and to witnesses are to be framed to explore fully the basis for claimed entitlement rather than with an intent to refute evidence or to discredit testimony. In cases in which the nature, origin, or degree of disability is in issue, the claimant may request visual examination by a physician designated by VA and the physician’s observations will be read into the record.

38 C.F.R. § 3.103(c)(2) (emphasis added).

Although the hearing officer’s duties to “explain fully the issues and suggest the submission of evidence which the claimant may have overlooked” are not further detailed in the regulation,2 the appellant’s argument that these duties necessarily involve the preadjudication of his claim is not supported by the language of the regulation, or its prior interpretation and application. Similarly, the Secretary’s view that his duties are limited to suggesting the submission of only that evidence that is already in existence, and only when the possible existence of such evidence is triggered at the hearing, has no basis in the plain language of the regulation, or its prior interpretation and application.

2 Although 38 U.S.C. § 7107(d) provides the right to a hearing, 2 it does not prescribe the duties imposed on the hearing officer discussed herein, which are imposed solely by regulation. No argument has been made that the duties imposed by the Secretary exceed his authority or are otherwise inconsistent with statute, and we perceive no such  conflict.  See Auer v. Robbins, 519 U.S. 452, 461 (1997) (“[The Secretary] is free to write the regulations as broadly as he wishes, subject only to the limits imposed by the statute.”).

                                                     1. Plain Language

 

a. Appellant’s Call for Preadjudication

Nothing in § 3.103(c)(2) supports the appellant’s contention that the regulation requires a hearing officer to preadjudicate or otherwise weigh conflicting evidence prior to or at the hearing. See Tropfsupra. Moreover, such preadjudication is not required to explain to the claimant that – for a disability compensation claim – the issues are status as a veteran, injury or disease in service, current disability, and nexus between the current disability and the injury or disease in service. See Caluza v. Brown, 7 Vet.App. 498, 506 (1995) aff’d per curiam, 78 F.3d 604 (Fed. Cir.1996) (table) (proving service connection requires (1) medical evidence of a current disability, (2) medical evidence or, in certain circumstances, lay testimony of in-service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus between the current disability and th in-service disease or injury).

Preadjudication or the weighing of conflicting evidence also is not required for a hearing officer to determine that evidence is not in the record with regard to a particular, material element of a claim. And, preadjudication or weighing evidence is not required in order to advise a claimant of the need to submit evidence on a material issue for which there is no evidence in the record. Moreover, the evidence does not have to be weighed or the claim adjudicated “to assure clarity and completeness of the hearing record,” which is one of the implicit duties imposed by § 3.103(c)(2). See Thomas v. Nicholson,423 F.3d 1279 (Fed. Cir. 2005) (discussed further, infra at 9); see also 38 U.S.C. §.7107(a) and (f)(1)-(2) (permitting “the screening of cases for purposes of determining the adequacy of the record for decisional purposes; or the development, or attempted development, of a record found to be inadequate for decisional purposes” even when a claim is not up for

consideration in the regular docket order). Accordingly, we find no basis for writing into the Secretary’s regulation a requirement that a hearing officer weigh the evidence in the record or otherwise preadjudicate the claim prior to or at the hearing. See Martin v. Occupational Safety and Health Review Comm’n, 499 U.S. 144, 150 (1991) (“it is well established that an agency’s interpretation of its own regulation is entitled to substantial deference”).

(Part one of three parts)

Posted in Important CAVC/COVA Ruling, Introduction-Read these first, Tips and Tricks | Tagged , | Leave a comment

Fed. Cir. –Groves v. Peake—2008– Our Holy Grail

This is a wonderful case of what we call “precedence”. This is the Holy Grail of Court Rulings for Hepatitis C sufferers. In order to understand this in the context of our continuing battle, substitute the phrase “Paranoid schizophrenia” from the Groves decision with the word “Hepatitis”. 38 CFR §3.303(a)(b) had always been the Vet’s path to SC for hepatitis if he/she had it documented in their records.  Vets still needed a nexus letter because one couldn’t get any traction  without one regardless of whether you legally needed it or not. Remember, VA always supplies one if you don’t. We don’t even need to tell Vets what they invariably will conclude. This has provoked an appeal nine times out of ten which is time-consuming.

Within the last 18 years (1992) a disturbing trend started to surface. Veterans were coming down in increasing numbers with a new, chronic, persistent form of hepatitis. The disease came to be known as Hepatitis C and the VA had to put their thumb in the dike, as more and more Vets began filing and winning. To staunch the flow, they resorted to various ruses, the foremost being IVDU or some other form of willful misconduct. Certainly, there were a number of cases that fell into the BAD BOYS category. However , there were a disturbingly larger number that didn’t. VA examiners started finding new ways to deny and the latest one became the: “Gee, buddy. You’re absolutely right. You did have documented Hepatitis in service-but hold the phone- the hep you had was Type A or B, not C. Our VA examiners got together and OPINED that it must have been A or B even though the Doctors never checked to see what type it was-sorry but you lose.”
Smart Vets started proving via nexus letters that they didn’t have A or B in service or if they did, that the C was a hitchhiker on one of the other two.   That poked a hole in this VA method of denial. In the last decade, scientists have started using RNA PCR techniques to determine what, if any, types of Hep. we have had or been exposed to. This further narrowed VA’s ability to deny based on bogus logic.  One facet it hasn’t dimmed is VA’s proclivity to say there’s no evidence of HCV in your 197os-era medical records. Well, duh? That would be akin to searching high and low in a junkyard for a 67 Mustang 2+2 in 1946 and coming up empty-handed. Who would have thunk it?

Here, we have a case that was appealed all the way up to the Federal Circuit Court that deals with our problem indirectly. It returns to the old argument that if the hep you had in the service was not documented as being A or B via testing(and they had no tests or a clue about C then), then the hepatitis “could” have been C or a combination of several including C. Then the benefit of the doubt doctrine kicks in and you don’t even need a Doctor’s nexus to state that “its more likely than not” to win. The Groves decision clearly states that no nexus is required assuming you had hep in service. VA is fond of using what you say against you to denigrate your facts and hence, your credibility. Your medical records don’t lie and they cannot be manipulated to arrive at a preconceived conclusion. VA has been doing this for so long that the Groves decision is going to rock them back on their heels for quite some time. I suspect VA examiners won’t get the “White Paper” on the update for a while. This will mean a lot more appeals until everyone is on board.

To look at this decision, you will need to click on the attachment at the bottom(Groves v. Peake). It’s too cool for school and will go a long way towards helping all of you who had hep in service win your case without resorting to flow charts, jetguns, and alien abduction theories. Vets have waited a long time for this decision. It won’t give you closure-just SC and perhaps some small measure of  financial peace of mind in your sunset years.

http://caselaw.findlaw.com/us-federal-circuit/1249037.html

Posted in Fed. Cir. & Supreme Ct. | Tagged , , | Leave a comment

COVA- Caffrey v. Brown–Duty to Assist?

When filing for Clear and Unmistakable Error (CUE), one case seems to get a lot of attention where failure in the duty to assist is claimed.  This is understandable because, like a cattle drive, VA counsel will push the Veteran in that direction. The seminal case on this quoted most frequently is Caffrey v. Brown (1994). While it appears on point on the subject, a closer examination is warranted.

Thomas A. Caffrey, a Veteran on the cusp of the new war brewing inSoutheast Asia, filed for psychiatric difficulties after his 1962 separation. He did what so many of us were guilty of and failed to appeal losses in 1964, 1975, 1977, 1978 and 1979. On his sixth foray in 1988, he finally obtained private hospital evidence that was available in 1962 to document his contentions and was granted SC.  Dissatisfied with the effective date, he pursued a new legal odyssey on appeal. After pursuing a higher rating for his schizophrenia and winning, he went after VA’s perceived failure in its duty to assist with respect to medical records he had identified and asked the VA to obtain in 1964. They had failed to do this and it cost him dearly for 24 years.

The Court had been created in 1988 to review BVA decisions and this is where Tombo’s case landed after a loss below. Certain CUE precepts had been ensconced in the years following the Court’s inception. One, in this same vein, Porter v. Brown (1993) held that CUE could not attach to a decision where medical records developed after the decision were introduced. However, that Court panel left open the possibility that CUE could be found in a failure in the duty to assist. Enter Mr. Caffrey.

The finding was that CUE couldn’t be considered a factor based on the principle that an incomplete record was not an incorrect record.  It was a very disheartening ruling for many of us on its face, but let us examine this more closely. At no point in this decision was the term “service medical records” introduced. This was all about private medical records generated subsequent to Mr. Caffrey’s  separation. This is an important difference.

While I hate to introduce myself personally into any of these posts about law, I will make an exception to illustrate a point. I currently have a CUE motion filed for a similar situation. I filed for back and hip problems in 1989 and some of my records were at a civilian hospital inThailand. The government contracted with them to provide care for us since we were in a very remote/isolated location hundreds of kilometers from the nearestU.S.military installation (Takhli RTAFB). The only way in or out was by small aircraft on what appeared to be an even smaller airstrip.. I was unaware that the AF had not retrieved these records and made them part of my military medical records. When I filed in 1989, I discovered there was no record of my injuries. I identified the location and nature of the records but the VA steadfastly refused to obtain them. I called the hospital long distance and got some, but not all, of the records I needed. I filed these with the VA and they thanked me but did little else to rectify the problem. In my BVA decision the Judges acknowledged my contention that the records were incomplete but proceeded to adjudication much like Mr. Caffrey. I guess it should not come as a surprise that I lost. There is a major difference here though. Even if my records were “private” as in non-military, the mere fact that they were generated and paid for by the U.S. Government made them quasi-military. This is where Mr. Caffrey’s and my circumstances depart in two decidedly different directions.

The Caffrey decision was very limited and most attorneys do not recognize this. A proper defense today should never permit this injustice. If you petition the VA to obtain records from your time in service, the VA is required to move Heaven and Earth to locate them. This was the precedence promulgated in Schafrath v. Derwinski (1 Vet.App. 589, 593-94 (1991):

In claims for disability compensation, such as is the case here, all of the veteran’s relevant service medical records (SMRs) must be obtained.  See 38 U.S.C. § 5103A(c)(1). However, records of relevant VA-provided or VA-paid-for medical treatment and other relevant records pertaining to a claimant’s service and maintained by a governmental entity must be obtained only if the claimant provides sufficient information to the Secretary to enable him to locate those records.  See 38 U.S.C. § 5103A(c)(1)-(2).  Similarly, the Secretary is obligated to attempt to obtain any other relevant records held by a Federal department or agency that the claimant adequately identifies and authorizes the Secretary to obtain.  See 38 U.S.C. § 5103A(c)(3).  The Secretary’s efforts to obtain Federal records must continue until the records are obtained or until it is reasonably certain that the records do not exist or that further efforts to obtain the documents would be futile. (emphasis mine)

The Court was adamant that this was mandatory, not optional. VA has become lackadaisical about the requirements over the intervening years and now routinely cites to Caffrey without realizing the narrow scope of its ruling. Schafrath stated otherwise and dictates a different , more forceful approach. Keep this in mind when constructing your case for CUE. All is not as it seems in VA law. Narrow exceptions can be carved out of what appears to be immutable law.

I characterize myself as an”Impossiblist”. When apprised of the situation and told it is not possible to get from A to B, I immediately examine the parameters of why this is. It has been said there is more than one way to skin a cat. Likewise, a legal precedent often embodies a narrow concept, no matter how it is characterized. A viable exception can be derived if you are willing to anally examine the precept and find the thread that will unravel it for you. Accepting it at face value condemns you to the fate all others are doomed to. Don’t settle for this.

CUE law is narrow and immutable. New concepts for denial have not been added for years so it is fairly static. One venue I do not think has been developed and should be is the concept of Clearly Erroneous. This was discussed in Gilbert v. Derwinski:

Congress has provided that this Court . . . to the extent necessary to its decision and when presented, shall . . . in the case of a finding of material fact made in reaching a decision in a case before the [Department of Veterans Affairs] with respect to benefits under laws administered by the [Department of Veterans Affairs], hold unlawful and set aside such finding if the finding is clearly erroneous. 38 U.S.C. § 4061(a)(4) (1988).

A “[m]aterial fact is one upon which [the] outcome of litigation depends.” Black’s Law Dictionary, 881 (5th ed. 1979). Under § 4061(a)(4), in order for a finding of material fact made by the BVA to be set aside, this Court must conclude that the finding is “clearly erroneous.” The Supreme Court has defined the “clearly erroneous” standard as follows: “A finding is ‘clearly erroneous’ when although there is evidence to support it, the reviewing court on the entire evidence is left with the definite and firm conviction that a mistake has been committed.” United States v.United States Gypsum Co., 333 U.S.364, 395 (1948).  Gilbert v. Derwinski (1990).

Most attorneys who venture into the CUE arena are cognizant of the pitfalls that await them. I do not believe most VSOs are as well-versed in the nuances of it, though. VA has opened a unique window that allows us to revisit past decisions and seek redress. Simultaneously, they have erected fences to corral the permissible boundaries. Obviously, using law and regulations extant at the time of the prior decision is prudent. Similarly, the codicil that no new evidence can be introduced that wasn’t a matter of record is legitimate as well. The duty to assist holding in Caffrey, while odious in nature, is also legitimate even though it seems incongruous to find it in a non-adversarial judicial setting such as ours. We are not allowed to parse the evidence and insinuate that something was not given enough weight. The determination to reverse and revise a prior decision based on CUE has to be a violation so egregious that it changed the outcome, hence the term “outcome determinative”.

I diverge from the pack when I advocate for a lower standard than Russell concerning a showing of a manifestly different outcome. When statutes or regulations are ignored or disobeyed, the Veteran is the one made to pay. True justice can only ensue when a wrong is righted and a new de novo adjudication is applied. I understand why it is otherwise but I do not agree with it. If a decision is clearly erroneous on its face and reasonable minds can agree to as much, it stands to reason that a higher duty to the Veteran must lodge rather than the en banc Russell precedent.  The benefit of the doubt is also removed from the equation. Either an error exists or it doesn’t. There certainly isn’t any grey area here. If you had a bone to pick with VA about the outcome at the time, the correct procedure was appeal. We are always Monday morning quarterbacks 30 years later.

So, in spite of what you may have been told what proposition Caffrey stands for, things are not always what they seem. The admonition of the right hand mirror on your automobile is similar- objects are closer than they appear.

Find the Thomster’s Adventures in Justiceland below (attached).

Caffrey_90-1511

Posted in CUE, Important CAVC/COVA Ruling | Tagged , | Leave a comment

CAVC–Garrett v.Shinseki(SJD) -Whoa! I’m a nurse.

Have you ever stepped in dog doo? Disgusting, isn’t it? If there’s nothing to lean against and no stick or water hose handy, you’re stuck with it-literally. If you’re wearing tennis shoes with one of those really nifty positraction soles, you have a stinky hitchhiker for a while.  

     Now imagine denying a claim and when it goes up to appeal and everyone at the BVA assumes a lot of things they shouldn’t. It sticks to their shoe and no matter how hard they try, they cannot divest themselves of it. Then something else sticks to the poo. Pretty soon you have a Bigfoot growing on you.

     Julia M. Garrett, the widow of a very brave soldier, applied for DIC based on her husband’s death. She rightfully believed he picked up his HCV in the service or, in the alternative, via a transfusion in a VAMC in 80. She was not an attorney and did not know to file a separate 38 USC § 1151 claim for SC, but she was a nurse. More about that later. She filed based on his passing from HCC. People with HCV get that quite frequently. VA looked up and blithely whistled past the graveyard and said no. Their theory was to ignore anything but what was filed for. VA does that a lot. The law has been around for a while and there is no ambiguity here. You help the  Vet with his /her claim wherever it leads.

In response, the Secretary argues that the examiner’s failure to note the blood transfusion is of no consequence because such evidence would only help to establish a claim for service connection for Mr. Garrett’s death under 38 U.S.C. § 1151.  See Sec. Br. at 13-14.  He avers that the Court does not have jurisdiction to consider this theory of entitlement because Ms. Garrett has never filed a claim for benefits under § 1151.  See id. VA “has a duty to ‘fully and sympathetically develop a veteran’s claim to its optimum.'” Moody v. Principi, 360 F.3d 1306, 1310 (Fed. Cir. 2004) (quoting Roberson v. Principi, 251 F.3d 1378, 1384 (Fed. Cir. 2001)).  Accordingly, VA must “determine all potential claims raised by the evidence, applying all relevant laws and regulations.”  Szemraj v. Principi, 357 F.3d 1370, 1373 (Fed. Cir. 1998)  (internal  quotations  omitted); see also  38  U.S.C.  §  7104(a) (2011)  (Board is required to consider, and discuss in its decision, all potentially applicable provisions of law and regulation).   Garrett v. Shinseki (2011)

     I have often mentioned that VA examiners and others in their employ are inherently unschooled and lazy. I don’t blame them per se.  They come to convoluted decisions because computer programs lead them there. Witness how this gets the VA in deep trouble because they didn’t read the records closely enough to discover Mr. Hayman J. Garrett’s wife is a documented nurse and has “medical training”.  In their haste to push print and get this over, they go to their Adobe Acrobat button and select “no medical training therefore her lay testimony is worthless” in matters medical. That one alone will provoke a remand, but there are even more errors…


Here, the Board stated “there is no indication in the record that the appellant is a physician or other health care professional. Therefore, as a layperson, she is not competent to provide evidence that requires medical knowledge.” R. at 13.  However, the record in fact indicates that Ms. Garrett is a nurse.  See R.  at  202,  856.  Furthermore, contrary to the Secretary’s argument, it was not incumbent upon Ms. Garrett to provide proof of her medical knowledge and training to the Board; it was not until after the Board decision that she became aware that the Board found her statements inadequate.  See Bernard v. Brown, 4 Vet.App. 384, 394 (1993) (“[W]hen . . . the Board addresses in its decision a question that had not been addressed by the RO, it must consider whether the claimant has been given adequate notice of the need to submit evidence . . . on that question.”) (Garrett supra).

This was just a single judge decision, but it illustrates how these fellows run slipshod over the facts in their headlong rush to deny. If caught in a lie, simply complain loudly that it’s immaterial anyway. I seem to remember a former President using a variation on that defense.

     I certainly get no joy in finding these examples that cause such embarrassment to the Secretary. I do it for you to illustrate VA’s marked propensity to give you short shrift. Fortunately. Ms. Garrett will undoubtedly get her DIC. When VA commits this many errors and is unmasked, they generally do not deny again and risk the wrath of the Judges all over. No, this one’s in the bag for the transfusion if nothing else. Her being a nurse is just icing on the cake. How do you overlook the word Nurse when it’s associated with her in the records? Looks like a reckless speed reading ticket is in order or dyslexia to me. “Well, your Honor. In all honesty, we didn’t know Nurse Garrett was actually a “nurse” nurse. She sure didn’t speak up and mention it to us. That’s bogus. And as for this §1151 business, we’re getting blamed for not doing anything. That’s no fair. What? We have to file everything around here now for the claimants?” It’s almost too bad the Judge didn’t just reverse and remand for a rating. 

http://search.uscourts.cavc.gov/isysquery/1086ce8f-3301-4f71-94eb-690f8cd2edb9/41/doc/

In the upper left hand corner are View, Download and Details. Click on Download to look at it.

Posted in Important CAVC/COVA Ruling | Tagged , , | Leave a comment

Fed. Cir.–Singleton v. Shinseki–(2011) Fed. Cir.

I understand the concept of justice.  I also understand interminable delays on VA’s part. They are famous beyond words for that. Look up delay in the dictionary and there’s undoubtedly a picture of the façade of 810 Vermont Ave. NW. Washington, D.C. 20420.

     George Singleton knows of this phenomenon. He’s been fighting VA since about 1980 for SC on his PTSD. The fact is he had it. No one will argue that any more. VA finally got around to acknowledging this about 2001 and only under threat of the Court.

     They gave him a glorified Fenderson “staged “rating with variable percentages predicated on the progression of the disease over time. Phase III of this progression entailed a slight drop from 100% down to 70% because he was able to hold employment during the ten year term on and off.  Phase IV went back to 100% to present. George felt this was tacky and against the law so he lawyered up with one of the finest VA lawyers around- Kenneth Carpenter. Ken must have thought there was some merit to the argument because they took this all the way up to here. Here being the Federal Circuit.

     Having now lost on appeal to the BVA and the Court, it is unclear why Ken and George thought they could find a sympathetic ear at the Fed’s bench. If you do not attempt it, you will never know, I guess.

     I’m not going to say things like gee, what a greedy bozo he was. I suppose it’s a lot of samoles, but Lord look at the settlement he received.

Period 1 is 8 months @ 50% (1980)= $800/mo.= $6,400.00 (approx.)

Period II is 10 years and 10 months @ 100% (1980)= $2600/mo.=$ 338,000.00 (approx.)

Period 3 is 8 years and 11 months @ 70%(1980)=$1300/mo.= $141,700.00 (approx.)

Period IV is 10 years and 8 months@ 100%(2000-10)=2750/mo.= $352,000.00 (approx.)

    On paper in percent form it doesn’t sink in. When translated into dollar figures it makes one stop and take pause. That’s $838K in rough figures,  slightly more or less for some rug rats.  Without interest for all those years makes it a crime, but we often don’t get a lime in our Corona either. So our buddy George is blowing an ass gasket over another $196,300.00. That’s no small sum and I’m sure Kenny egged him on since he gets 20% of all of it. In the scheme of things old George hit Monty’s cookie jar. I can think of a lot of Vets who might have been happy and gone home. Not George. He and the Kenster started kicking this can up the ladder  once they smelled the money tree. Their logic was infallible, but this was a rare form of justice being administered back into the past based on available evidence. To say that VA can or can’t do  something  they’ve  never been faced with is being pushy. When it’s an argument over 200K or so after over 4/5ths of a million dollars has been proffered is being petty. Maybe I’m just jaded and have different mores.

     The good news is they can take it up to the Supreme Court if they can get certiorari. That’s a big if. 


http://www.veteranslawlibrary.com/files/Fed_Cir_Cases/2011/Singleton_10-7106.pdf

Posted in Fed. Cir. & Supreme Ct. | Tagged , | Leave a comment

CAVC–Merczel v. Shinseki- Sorting out the Hickson Elements(SJD)

VetCourtAppealsPromoSweet. That’s what this decision is. It tunes in the ICU2TV and let’s us look at another example of what justice is, and isn’t, supposed to be about.  Although the decision is by a single judge and not an en banc precedent- setting one, the lessons to be learned are very important. Even I was a little taken aback by what St. Mary reasoned. You, as a pro se Vet, can use it as well.   VA’s propensity to use absence of evidence to prove a point or rebut lay testimony is well-known.  This decision explains it so well and provides the perfect example.

    Mr. Henry Merczel must be an incredibly patient Vet. He filed in 2002 and got the standard treatment we all do. He filed the NOD and everything moved up to the Board… and back for a remand . Then back to the Board…and back for remand #2. Then back again yet a third time to the Board for his final denial. Henry gladly took a number, moved up to the Court and waited. This why it took so long to get to this part of the story.  I print here the best as an hors d’oeuvres:

First, the Board’s discussion erroneously conflated the second and third elements of a service connection claim. The Board found that the appellant’s claim failed because “[t]he evidence [did]not show in-service incurrence or aggravation of hepatitis C.” (emphasis added).  The second element does not require such particularity; rather, the appellant must show an in-service disease or injury that he alleges caused or aggravated his current disability.    Proving a connection between an in-service disease or injury and a current disability is the requirement of the third element in a service-connection claim. The appellant alleges that either his in-service inoculations, scalp laceration, or index-finger laceration could be the “injury” that led to his contraction of hepatitis C. The Board did not question the credibility of the appellant’s assertions that such incidents occurred, and, in any event, they find support in the record.  When the Board discussed the unlikelihood that any of these incidents were connected with the appellant’s hepatitis C, however, it was making a nexus assessment and erroneously imposing a more demanding showing for the second element of a service-connection claim than is required. (stating that the incidents proffered by the appellant “are not known risk factors for hepatitis C”). This confusion renders the Board’s statement of reasons or bases for its decision inadequate because it prevents the appellant from understanding the basis for the Board’s conclusions and hampers review by this Court.  See Caluza and Allday, both supra.  Merczel v. Shinseki (2011)

VA has always dragged in the “Well, he didn’t have hep. c in service, so that pretty much tells you what you need to know.”. Judge Mary Schoelen has finally unwrapped the phraseology and exposed the error. We owe her a big favor

The second thing this decision represents is that the Court will not tolerate VA’s shenanigans when they are clearly in the wrong.  Here, VA forgot to give this guy SC and a rating for Reynaud’s Syndrome that he had in service. Then they tried to cover their asses by saying he needed a nexus. This is one of the few times you don’t. If you have a documented, chronic disease in service and documented medrecs of it being chronic, then it’s a done deal. You file, you win and you go home. VA, and especially the BVA, had no business denying this claim and Judge Mary reminded them by reversing and handing  Henry a blank SC slip for Reynaud’s.  We have always looked for a legal way to get around this and Groves did overturn established law in this vein. Judge Mary was also quick to point Groves out to the VASEC who begrudgingly acknowledged she was right. In order to maintain his ego, he wanted another do over (number 3) so he could hang old Henry out to dry for another 2 years.  Judge Mary wasn’t having any of that as you will read. She went into a long self-check legal menu of when it would be permissible to remand an error of this breadth and depth of perfidy. At the end, she delivered the riposte and said “Naw. No vacatur. I’m reversing. If you hadn’t been such assholes and wasted 10 years of his life, I might be inclined to remand.”

     It’s a relatively short read (10 pages) as legal filings go, and gives you a shiteatten grin when you observe Uncle Eric get the bitchslap. I apologize for my risqué language today but I feel colorful. Ebonics evokes such rich metaphors compared to  my dry, whitebread language.

MerczelH_09-3487

  And what should my wondering eyes behold today than Mr. Merczel’s win at the BVA. Not only that, but he nailed them for Reynaud’s Phenomenon in the right hand as well but he got it on presumptive in § 3.307. $100 says that’s related to the hep. It’s cryoglobulinemia and the buildup of IgG globulins in the small veins is like blood mud in cold weather. 

downloadThe reason the decision reads like a short story is the remand instructions from St. Mary Schoelen above at the CAVC. She’s onto the BVA for the asinine rationale for denial all the way up the ladder since 2002. They’ve been playing him like a small mouth bass and keeping him in deep water away from snags. Have you ever seen a BVA Judge say “Well, there are competing opinions so let’s blow off the VA examiner’s pipedream and give the benefit of the doubt to Henry.” Shit oh dear. Either Judge Deborah Singleton is a blood relative of Henry Merczel or she’s smoking some killer Matanuska Thunder f**K  and was too stoned to bang the gong. Perish the thought that Laura Eskinazi happened to run into her in the hallway at lunch and tell her to “rocket docket” old Henry  for SC.

Of course it could be the OGC realized they had stepped on their necktie and if it ever went back up to 625 Indian Ave. NW, there would be hell to pay. As we say at Asknod, the squeaky mouse gets what behind door number 3. This time it was Monty’s Cookie Jar for the full meal deal. Congratulations, Henry on a well-deserved win. Another twelve year claim finally extricated from the backlog. Onward through the fog.

Now serving BVA Vet

download (1)

Number 527,675

Posted in BvA HCV decisions, HCV Risks (documented), Important CAVC/COVA Ruling, Jetgun BvA Decisions, Jetgun Claims evidence, Nexus Information | Tagged , , , , , , , , , , , , , , , , , , | 2 Comments

CAVC–Clark v. Shinseki -SJD–Absence of Evidence is Not Negative Evidence

VetCourtAppealsPromoWhen I set out on my own to defend myself in early 2008, I did so with the idea that I couldn’t do any worse that the chuckleheads collecting a paycheck for it (my VSO). I began by starting in 1994 and reading every single BVA HCV or HBV decision to find out what I did so wrong in 1994.  No one had appealed this kind of thing up to the Court then so there was no precedent there. Besides noticing I didn’t have a nexus, I saw a pattern in the denials. Some Vets without nexi won, but they all had combat badges, medals or evidence of hep in service. 

     Then a sea change ensued. VA formed a huddle and a quick game plan emerged.  Suddenly Vets needed that nexus or all was lost. Some still won, granted, but there was a dramatic increase of denials. Face it; there was also a dramatic increase in claims for this (HCV) that were starting to be a noticeable blip on the VHA radar. More and more denials suddenly developed a drug overtone whether there was evidence of it or not. Alcohol abuse, “strange behavior”-even homelessness were often cited as evidence of a risky lifestyle. Soon after, any time spent in prison more than 3 days was accorded the same risk. All these items could be cherry picked to fit the claimant’s lifestyle.  New risks were added all the time-some almost inherently incredible. 

      When the jetguns entered the picture, a few got by. VA poobahs convened again and issued the FAST letter hoping that would quell it. By now, doctors could determine if you had ever had Hep. A or B and began the practice of denial based on only having had evidence of HBV in service. Suddenly, the absence of any C in the records in 1974 was grounds for denial. Or the opposite finding of Hep. A provoked the insinuation that your hep. in service was A and not C. Testing in the 70’s for which hep. you had was sporadic at best. If you survived and it only lasted a week or so, it was probably A . If you got puke sick and it gave you a raging case of OJ skin for 4 weeks then it was B. They finally developed a test later that determined if it was B. If it wasn’t positive for B then you had A.  Brilliant test idea.  Now, in the 90s to present, we have witnessed the beginning of the end for this logic. The judges are becoming educated and can see through that ruse.   

     VA had such wonderful success with that denial ploy that they convened again several years ago and moved on to a higher plateau. They had to come up with a new idea to deny. Can you imagine a smoky room with a bunch of perspiration-soaked VA lawdogs and their lackey doctors arguing for a new strategy to combat the utter tsunami of hep. c claims washing up on their shores? Suddenly the epiphany dawns on one. “What if? What if we begin denials based on no evidence of the risk in the SMRs (also known now as STRs)? Like, you know, the Vet claims he was exposed to sharing razors and toothbrushes, but it’s not in his medrecs? We could deny on that, right?” And so was born a new age of denials. Judges didn’t think this shittus up. They ruled on what was provided for them to rule on. The untermenshen did the dirty work and stuck it under their noses. Unless a judge had a good grip on the Hepatitis C disease process, he would be inclined to sign off on this.

     This has worked quite well for a time. Now it is starting to backfire. I saw it in a Single judge decision and wrote it up for the CAVC decisions forum under Strong v. Shinseki – Shared Razors:

 

First, there is no reason to believe that a soldier’s sharing of razors with other soldiers would be documented in the soldier’s service medical records, and this absence of “corroboration” cannot be dispositive.  Second, the examiner did not discuss the risk factors for hepatitis C at all, including the relative level of risk involved in intravenous or intranasal cocaine use versus the level of risk involved in smoking cocaine, which is how Mr. Strong has consistently alleged he abused the drug. Therefore, the examiner’s conclusion that Mr. Strong’s hepatitis C is more likely than not related to his drug abuse is presented without any rationale and renders the opinion inadequate Strong v. Shinseki (2011)

     Kahana v. Shinseki, recently decided, found another common error we are seeing. That is, the overlooking of obvious facts contained in the medrecs. VA has always done this, but was admonished to knock it off years ago. Apparently they need to be re-educated.

     The new reality is that non-evidence is now negative evidence. VA is knee-deep into this new cesspool. Now they are unmasked.  I posted a blurb with color illustration of the non-evidence method of denial in the Members Q&A under “What Wasn’t Said Is Important”. 

     What the Vet can discern here. I hope, is the constant shape-shifting aspect of VA’s denial process. As quickly as we can identify a new denial method, they shift to a newer one. They always seem to be several steps ahead of us in this respect. Remember the old Maxson v. Gober decision stating that claiming something 30+ years later is rather suspect? It, too, is listed in the CAVC forum. That worked until a judge noted that that is the very hallmark of Hep. C. It’s a stealth virus that surfaces decades later and goes undetected in the interim. Nevertheless, that was the banner for denial for years on Hep. C and is still cited on occasion by those who haven’t had “the briefing”. 

     The recent spate of decisions exhibiting this new ploy will slowly abate and a brand new, as yet unseen and unforeseeable “gottcha” will soon appear. Mark my words. What it will entail is classified and still being thrashed out in the aforementioned room somewhere at 810 Vermont Ave. NW by those perspiration-challenged attorneys and doctors. Rest assured they will not rest until this epidemic of hep. c claims is conquered- not the disease. This just confirms my belief that they start with a denial and extrapolate backwards to construct the scene of the crime, the drugs involved and the character of the claimant.  Mathematically it looks like this:

      Z= D + R(X) + N, where Z equals denial; D equals any form of drugs or alcohol; R equals risk factor multiplied by (X); X equals willful misconduct risks or risks experienced after service (intercurrent); and lastly, N equals a VA nexus by a VA examiner that concurs in the finding of “less likely than not”.  This formula is malleable and subject to reinterpretation when vacated and remanded by the Court to the BVA. Flexibility is a plus here.

     Gradually we will attain victory but I suspect there will be few of us standing when they finally issue the FAST letter that states all future claims for hep. C where the claimant was exposed to Pedojet or Munji guns will be approved based on a presumptive risk.  It’s small consolation to dead Vets. I know I will sleep better in my urn knowing this.                                                                                                                                                                                                  At any rate, the following single Judge decision enunciates all the hallmarks of the Kahana decision. The finding that absence of evidence is not negative evidence is refreshing and finally becoming a gale force wind rather than an occasional breeze. We hope to see more of this and less obfuscation by the lower tribunals. It’s way overdue. Mr. Clark will benefit from this and hopefully prevail.

ClarkEE_09-1496

Posted in Important CAVC/COVA Ruling | Tagged , , , | Leave a comment