28 F.4th 1241
Fed. Cir.2022Background
- Veteran Luis Martinez-Bodon filed VA claims in 2016 for service‑connected diabetes and anxiety secondary to diabetes; VA granted diabetes but denied a mental‑condition claim after a VA examiner found his symptoms did not meet DSM‑5 diagnostic criteria.
- The Board of Veterans’ Appeals denied service connection for a mental condition; the Veterans Court affirmed, interpreting 38 C.F.R. §§ 4.125(a) and 4.130 to require a DSM‑5 diagnosis before compensating mental conditions.
- Martinez‑Bodon argued that Saunders v. Wilkie allows undiagnosed conditions that cause functional impairment to qualify as disabilities for service connection, so his symptoms alone should suffice.
- The Federal Circuit has jurisdiction to review Veterans Court legal and regulatory interpretations de novo but lacks jurisdiction to reweigh factual findings.
- The court analyzed the regulatory text and structure (including § 4.130’s preamble referencing the DSM‑5 and § 4.125(a)’s incorporation of the DSM‑5) and concluded a formal DSM‑5 diagnosis is a prerequisite for rating mental disorders under § 4.130.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether 38 C.F.R. §§ 4.125(a) and 4.130 require a formal DSM‑5 diagnosis before compensating a mental condition | Saunders extends to undiagnosed disabilities producing functional loss; symptoms alone can establish a compensable disability | The regulations and their structure plainly require a DSM‑5 diagnosis as a prerequisite to rating under § 4.130; Saunders is inapplicable where a specific ratings table governs | The court held §§ 4.125(a) and 4.130 require a DSM‑5 diagnosis before awarding service connection for mental conditions and affirmed the denial |
Key Cases Cited
- Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (held pain causing functional impairment can be a disability under 38 U.S.C. § 1110)
- Larson v. McDonough, 10 F.4th 1325 (Fed. Cir. 2021) (clarified Saunders does not control where a specific rating schedule applies)
- Gazelle v. Shulkin, 868 F.3d 1006 (Fed. Cir. 2017) (legal and regulatory interpretations by the Veterans Court reviewed de novo)
- Wanner v. Principi, 370 F.3d 1124 (Fed. Cir. 2004) (limits on reviewing content of rating schedules)
- Wingard v. McDonald, 779 F.3d 1354 (Fed. Cir. 2015) (similar jurisdictional limits on rating schedule review)
- United States v. Turkette, 452 U.S. 576 (1981) (avoidance of absurd statutory or regulatory results)
- Duncan v. Walker, 533 U.S. 167 (2001) (interpretive principle to give effect to every clause and word)