12-34 685
12-34 685
| Board of Vet. App. | Jul 31, 2017Background
- Veteran served in USAF (1965–1969) and has service-connected degenerative disc disease of the lumbar spine currently rated 40%.
- Appeal from an October 2009 RO rating decision; multiple remands and VA examinations (2009–2016) with most recent exam in Nov 2016.
- RO granted temporary 100% for Jan 12–Apr 30, 2016; Veteran seeks increased rating >40% and entitlement to SMC under 38 U.S.C. § 1114(s) from May 1, 2016 onward.
- Medical records and VA exams show no unfavorable ankylosis, no incapacitating IVDS episodes totaling ≥6 weeks in past 12 months, and no single service‑connected disability rated 100% since May 1, 2016.
- VA examined scar and neurologic findings; separate ratings for peripheral neuropathy already in place and scar is noncompensable.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether lumbar degenerative disc disease warrants a rating >40% | Veteran: pain, limited motion, and flare-ups warrant higher rating or evidence of unfavorable ankylosis/≥6 weeks incapacitating episodes | VA: exams and records show no unfavorable ankylosis and no incapacitating IVDS episodes ≥6 weeks; 40% already compensates functional loss | Denied — no unfavorable ankylosis or qualifying incapacitating episodes shown; 40% affirmed |
| Whether Veteran is entitled to SMC (housebound) under 38 U.S.C. § 1114(s) from May 1, 2016 | Veteran: SMC should continue after Apr 30, 2016 | VA: no single service‑connected disability rated 100% and not permanently housebound or substantially confined to home | Denied — not permanently and totally disabled nor permanently housebound since May 1, 2016 |
Key Cases Cited
- Akles v. Derwinski, 1 Vet. App. 118 (1991) (SMC issue is part and parcel of an increased-rating claim while that claim is pending)
- Correia v. McDonald, 28 Vet. App. 158 (2016) (VA joint exams must, when possible, measure active/passive motion in weight-bearing and nonweight-bearing)
- Soyini v. Derwinski, 1 Vet. App. 540 (1991) (remand unnecessary when it would not benefit the veteran)
- Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (Board need not address procedural arguments not raised by appellant)
- Mitchell v. Shinseki, 25 Vet. App. 32 (2011) (functional loss from pain must be considered under §§4.40 and 4.45 when rating limitation of motion)
- DeLuca v. Brown, 8 Vet. App. 202 (1995) (consideration of functional loss factors—pain, weakness, fatigability—in joint ratings)
- Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (competence and credibility of lay evidence in VA claims)
- Gilbert v. Derwinski, 1 Vet. App. 49 (1990) (preponderance of evidence standard in VA adjudication)
- Hart v. Mansfield, 21 Vet. App. 505 (2007) (staged ratings considerations)
- Francisco v. Brown, 7 Vet. App. 55 (1994) (application of staged ratings)
