Robert L. Trafter v. Eric K. Shinseki
26 Vet. App. 267
Vet. App.2013Background
- Trafter seeks §1151 benefits for a mental disorder allegedly due to VA treatment.
- Board denied entitlement in an October 5, 2010 decision, finding no fault or resulting disability.
- Question presented: whether §5103A(a) or §5103A(d) governs the duty to assist in §1151 claims.
- Court holds §5103A(d) applies to §1151 claims, but remands due to misapplication of a §5103A(d)(2) factor.
- Appellant argued VA should obtain a medical opinion under §5103A(d) and that the Board erred in relying on lay evidence.
- The Board failed to discuss §5103A(d)(2) factors with specificity and to obtain/consider relevant private records (KUMC).
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proper duty-to-assist standard for §1151 claims | Trafter asserts §5103A(d) applies. | Secretary argues application of §5103A(d) is reasonable pending legislative clarity. | §5103A(d) applies to §1151 disability compensation claims. |
| Application of §5103A(d)(2) factors to §1151 | Busines argues factor B requires evidence of VA fault; no need for nexus proof. | Secretary contends factor B may indicate fault/foreseeability when assessing §1151. | Factor B may indicate a connection to VA treatment; Board must determine adequacy using §5103A(d)(2) and related McLendon guidance. |
| Duty to provide a medical opinion under §5103A(d)(2) in §1151 cases | Record indicates possible association between VA treatment and disability; opinion required. | Record lacks competent medical fault evidence; no opinion necessary. | Board erred by not providing a medical opinion and by misapplying §5103A(d)(2). |
| Failure to obtain private/KUMC records | KUMC records may be relevant and were not adequately secured. | VA had obtained available records; ROI concerns require updating authorization. | Remand required to obtain KUMC records and incorporate them into the file. |
Key Cases Cited
- Wood v. Peake, 520 F.3d 1349 (Fed. Cir. 2008) (5103A(a) applies to dependency/DIC; 5103A(d) to disability compensation)
- DeLaRosa v. Peake, 515 F.3d 1319 (Fed. Cir. 2008) (5103A(a) applies to any benefit; §5103A(d) to disability compensation claims)
- Gardner v. Brown, 513 U.S. 110 (U.S. 1994) (statutory interpretation in veterans benefits; harmony within scheme)
- McLendon v. Nicholson, 20 Vet.App. 79 (2006) (low threshold for when a medical opinion is necessary under §5103A(d)(2))
- Kilpatrick v. Principi, 16 Vet.App. 1 (2002) (section 1151 claims discussed as disability compensation-like but distinct)
- Anderson v. Principi, 18 Vet.App. 371 (2004) (distinction between §1151 claims and disability compensation)