Tyra K. Mitchell v. Eric K. Shinseki
2011 U.S. Vet. App. LEXIS 1791
| Vet. App. | 2011Background
- Mitchell appeals a Board denial of an initial rating in excess of 10% for residuals of left knee ACL reconstruction.
- Question: whether pain alone throughout a joint's range of motion constitutes functional loss warranting higher VA ratings.
- Court distinguishes pain alone as not constituting functional loss under the ROM-based rating framework.
- Board relied on a 2006 C&P exam that did not quantify ROM impairment due to pain or flare-ups; exam deemed inadequate.
- Opinion vacates the Board decision and remands for readjudication with adequate DeLuca-style analysis and testing of functional loss due to pain.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether pain throughout ROM equals functional loss for VA ratings. | Mitchell asserts pain on motion equals limited motion warranting higher ratings. | Secretary argues pain on motion may indicate functional loss but does not automatically yield maximum ratings absent ROM loss. | Pain alone does not equal functional loss; remand for proper evaluation. |
| Adequacy of the October 2006 C&P exam under DeLuca and 38 C.F.R. §§ 4.40, 4.45. | Examination failed to quantify ROM loss due to pain or flare-ups. | Examination deemed adequate for rating. | Exam inadequate; remand required for DeLuca-compliant assessment. |
| Proper application of DC 5003 vs DCs 5260/5261 for this case. | Painful motion should trigger higher ratings under DCs 5260/5261. | Painful motion under DC 5003 context does not justify higher non-arthritis ratings absent ROM loss. | Painful motion alone does not justify max ratings under 5260/5261; context limited to DC 5003. |
| Duty to assist and adequacy of the Board’s remandability finding. | Duty to assist was satisfied by the cited exams. | Board properly found duty to assist satisfied. | Board's finding of adequate duty to assist was clearly erroneous; remand. |
Key Cases Cited
- Lichtenfels v. Derwinski, 1 Vet.App. 484 (1991) (painful motion deemed limited motion under DC 5003 context)
- Hicks v. Brown, 8 Vet.App. 417 (1995) (deLuca framework; pain on motion must be connected to functional loss)
- DeLuca v. Brown, 8 Vet.App. 202 (1995) (exam must address functional loss due to pain; flare-ups and use impact)
- Schafrath v. Derwinski, 1 Vet.App. 589 (1991) (pain must be considered in rating joints; functional loss analysis)
- Arnesan v. Brown, 8 Vet.App. 432 (1995) (requires consideration of pain on range of motion in rating)
- Powell v. West, 13 Vet.App. 31 (1999) (pain on motion influenced higher spine rating in context; not the sole basis for highest rating)
- Barr v. Nicholson, 21 Vet.App. 303 (2007) (duty to assist; adequacy of medical opinions)
- Bowling v. Principi, 15 Vet.App. 1 (2001) (duty to remand for inadequate examination)
- Zang v. Brown, 8 Vet.App. 246 (1995) (avoid illogical, absurd ratings when interpreting regulations)