Dale S. Horn v. Eric K. Shinseki
2012 U.S. Vet. App. LEXIS 1264
| Vet. App. | 2012Background
- Horn, a U.S. Army veteran, appealed a Board denial of service connection for a left hip disorder.
- Induction examination showed no hip condition, invoking the presumption of soundness.
- An MEB report contained only an unexplained X in the aggravation box, raising the issue of whether this proves lack of aggravation.
- The MEB found the condition preexisted service and was not aggravated, but provided no narrative analysis to support that conclusion.
- The Board conflated the presumption of soundness with the presumption of aggravation and relied on the unexplained MEB conclusion.
- The Court held the unexplained MEB box is insufficient to rebut the aggravation prong and reversed as to that issue, remanding for further development on remaining service-connection issues.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the MEB's unexplained X constitutes clear and unmistakable evidence of no aggravation. | Horn argues the X is not probative without explanation and cannot rebut the presumption. | The Secretary treats the X as adequate to support lack of aggravation. | Unexplained X is insufficient to rebut aggravation; reversal on this prong. |
| Whether the presumption of soundness was properly rebutted by the evidence. | Evidence including preexisting Legg-Perthes and postservice history supports aggravation. | Board properly found no aggravation based on lack of in-service worsening and MEB finding. | Presumption of soundness not properly rebutted; remand for development consistent with this decision. |
| What is the proper remedy when the Secretary fails to prove lack of aggravation with adequate medical reasoning. | Remand is appropriate to obtain proper medical analysis under 38 C.F.R. § 3.304. | Remand is not needed; reversal may be warranted where the evidence is clearly adequate. | Remand not necessary for aggravation; the court reverses as to aggravation and remands for further proceedings on remaining issues. |
Key Cases Cited
- Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004) (clarifies burden on Secretary to show lack of aggravation by clear and unmistakable evidence)
- Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007) (lay evidence can establish medical history in certain contexts)
- Nieves-Rodríguez v. Peake, 22 Vet. App. 295 (Vet. App. 2008) (articulated medical reasoning required; unsupported conclusions carry little weight)
- Adams v. Principi, 256 F.3d 1318 (Fed. Cir. 2001) (remand appropriate where medical evidence is ambiguous or inconclusive)
- Maxson v. West, 12 Vet. App. 453 (Vet. App. 1999) (consideration of absence of treatment and time since service as relevant factors)
- Colvin v. Derwinski, 1 Vet. App. 171 (Vet. App. 1991) (limits on Board relying on medical judgment without adequate foundation)
- Routen v. West, 142 F.3d 1434 (Fed. Cir. 1998) (presumption of soundness burden allocation and evidentiary standards)