11-31 443
11-31 443
| Board of Vet. App. | Nov 30, 2017Background
- Veteran served 1976–1984 and 1999–2010; appeals from a January 2011 RO rating decision and subsequent remands (most recently May 2017).
- Service-connected diagnoses: blepharospasm, spasmodic dysphonia, and spasmodic torticollis (collectively Meige’s syndrome); separate ratings applied under DC 8103 (blepharospasm, torticollis) and DC 6516 (dysphonia).
- Current ratings at issue: blepharospasm 30% (since Oct 1, 2010), spasmodic dysphonia 10%, spasmodic torticollis 10%.
- VA obtained a July 2017 medical opinion after remand describing blepharospasm and torticollis as primarily moderate (blepharospasm noted as improved since prior exam) and dysphonia without the tissue changes required for a higher rating.
- Board found medical and lay evidence preponderantly show mild-to-moderate symptoms that fit existing schedular criteria and do not meet thresholds for higher or extraschedular ratings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether blepharospasm warrants >30% | Veteran contended symptoms justify more than 30% / extraschedular evaluation | VA/Board: symptoms fit schedular criteria; currently at highest schedular 30% and not severe enough for extraschedular referral | Denied — no higher or extraschedular rating warranted |
| Whether spasmodic dysphonia warrants >10% | Veteran argued voice impairment is more severe than 10% criteria | VA/Board: no evidence of thickening/nodules/polyps/submucous infiltration or premalignant biopsy changes needed for 30% | Denied — remains at 10% |
| Whether spasmodic torticollis warrants >10% | Veteran argued neck dystonia more disabling and limits function | VA/Board: medical records and exam describe mild–moderate symptoms, not the severe convulsive tic required for higher 30% | Denied — remains at 10% |
Key Cases Cited
- Scott v. McDonald, 789 F.3d 1375 (Fed. Cir.) (Board need not search record or raise procedural arguments not asserted by veteran)
- Dickens v. McDonald, 814 F.3d 1359 (Fed. Cir.) (applies Scott to duty-to-assist arguments)
- Gonzales v. West, 218 F.3d 1378 (Fed. Cir.) (VA must review entire record but need not discuss every piece of evidence)
- Pierce v. Principi, 18 Vet. App. 440 (Vet. App.) (interpretation of diagnostic code evaluations by analogy)
- Hart v. Mansfield, 21 Vet. App. 505 (Vet. App.) (recognizes staged ratings where different time periods warrant different ratings)
- Thun v. Peake, 22 Vet. App. 111 (Vet. App.) (standards for extraschedular consideration)
- Schafrath v. Derwinski, 1 Vet. App. 589 (Vet. App.) (Board must consider entire history and alternate provisions)
- Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir.) (lay evidence may be competent but must show functional equivalence to meet higher rating)
- Gilbert v. Derwinski, 1 Vet. App. 49 (Vet. App.) (when evidence is against claim, claimant bears burden; reasonable doubt rule explained)