Buie v. ShinsekiBuie v. Shinseki
James E. Buie appeals through counsel a May 5, 2008, Board of Veterans’ Appeals (Board) decision that (1) granted an effective date of April 16,1998, for the award of a total disability rating based on individual unemployability; and (2) granted an effective date of April 16,1998, for the award of a 60% disability rating for a low back disability.
The novel legal issue raised by this case is whether a claimant may be awarded special monthly compensation under
Because the Board failed to consider whether the combination of Mr. Buie’s disabilities might entitle him to spеcial monthly compensation, and because the Board failed to consider the application of
I. FACTS
Mr. Buie served on active duty in the U.S. Army from December 1965 to June 1967. He was awarded VA disability benefits for a low back condition and assigned a 10% disability rating in June 1971.
In November 1995, Mr. Buie sought an increased disability rating for his low back condition and advised VA that he had been “approved for 100% disability by [the Social Security Administration] for this disability,” and that he had not workеd since
In May 1996, a VA regional office considered medical reports from the Social Security Administration “through” February 1983, and outpatient treatment records from the Fayetteville, North Carolina, VA medical center dated March to November 1995. The regional office determined that the medical evidence did not support a 20% disability rating and denied Mr. Buie’s claim. The regional office did not expressly consider or discuss entitlement to a total disability rating based on individual unemployability, but noted that the Social Security Administration records “primarily show disability due to neuropsy-chiatric impairment, with lumbar injuries noted in service, and again at work [on September 7, 1971,] and [January 7, 1973,] by history only. Older records refer tо Worker’s Compensation settlement with ongoing benefits for the 1971 injury.” R. at 2303.
In February 1997, Mr. Buie submitted a statement in support of claim:
I would like to reopen my claim to have my 10% [service-connected] back injury increased to a higher rating. I receive all my medical care at [the] VA [medical center in] Fayetteville. My back is worse because I have more pain and difficulty bending and standing for long periods of time.
R. at 2299. In July 1997, the regional office considered outpatient treatment records dated November 1995 to June 1996 from the Fayetteville VA medical center, as well as an April 1997 VA orthopedic examination reрort. The regional office found that the outpatient treatment records were “completely negative for complaints, symptoms, diagnosis!,] and treatment” of Mr. Buie’s service-connected low back disability. R. at 2265. Based on the April 1997 VA examination, however, the regional office increased Mr. Buie’s low back disability rating to 20%, effective February 17, 1997, though no explanation was given for the assignment of the effective date.
In August 1997, Mr. Buie again submitted a statement in support of claim:
I am requesting an upgrade for my condition — back strain[ — ]and please note the enclosed medical paperwork. I now have a 20% [service-connected] rating for the back strain but the condition has worsened. Also, I have been on medication for several years for the condition. The medical paperwork is from*245 [the Durham, North Carolina, VA medical center].
R. at 2260. In March 1998, the regional office considered VA outpatient treatment records from an unspecified VA medical center dated August 1994 and September 1995 (the later of which the regional office determined was a duplicate of a record already considered by VA) and a hospital report from the Durham VA medical center dated April to May 1997, as well as other evidence. The regional office noted that the August 1994 record showed that Mr. Buie had been seen for “recurrent low back pain.” R. at 2239. Based on an April 1997 VA examination (presumably the same examination on which the regional office relied in its July 1997 decision), the regional office increased Mr. Buie’s disability rating for his low back condition to 40%, effective February 5, 1997, the date the “[pjrior claim” was received. R. at 2239-40.
In April 1998, Mr. Buie wrote to VA requesting a 60% disability rating for his low back condition. He stated that the pain had increased, had moved closer to his spine, and was now so severe that he might have to be hospitalized. He advised that he had been treated by a private physician and had been prescribed medication for his condition. In May 1998, Mr. Buie again requested reevaluation of his back condition.
Also in November 1999, Mr. Buie submitted VA Form 21-8940, Veteran’s Application for Increased Compensation Based on Unemployability, and asserted that his service-connected back and knee disabilities rendered him unemployable.
In January 2000, thе regional office issued a Statement of the Case continuing the 40% disability rating assigned for Mr. Buie’s low back disorder. In November 2000, the regional office denied entitlement to a total disability rating based on individual unemployability, finding that the medical evidence did not demonstrate that Mr. Buie was unable to secure or follow substantially gainful employment. Mr. Buie, through his current counsel, filed a Notice of Disagreement with that decision in December 2000.
In July 2001, the regional office considered evidence dated as early as June 1998 and issued a rating decision granting Mr. Buie an increased disability rating of 60% for his low back disability, effective May 29, 1998, the dаte of Mr. Buie’s correspondence requesting “reevaluation” of his condition. The regional office also granted entitlement to a total disability rating based on individual unemployability, finding that Mr. Buie was unable to secure or follow substantially gainful employment as a result of his service-connected knee and back disabilities. The regional office assigned an effective date of May 29, 1998, finding that was the date that Mr. Buie’s service-connected disabilities first met the schedular requirements for such a rating.
In November 2001, Mr. Buie filed a Notice of Disagreement with the effective date assigned for entitlement to a total disаbility rating based on individual unem-ployability. The effective date was confirmed by a March 2002 Statement of the Case. In April 2002, Mr. Buie again disa
In the meantime, in May 2004, the Board granted Mr. Buie entitlement to benefits for post-traumatic stress disorder. Ultimately, Mr. Buie was granted a 30% disability rating for that condition, effective August 28, 1997, and a 70% disability rating from January 26, 2001.
In May 2008, after several years of additional develоpment, including two Board remands and a remand from this Court, the Board issued the decision on appeal, granting an effective date of April 16, 1998, but no earlier, for the award of a total disability rating based on individual unemployability and for the award of a 60% disability rating for a low back disability. The Board first determined that, although Mr. Buie’s April 1998 letter did not constitute a Notice of Disagreement with the March 1998 regional office decision, it did raise a valid claim of entitlement to a 60% disability rating. Accordingly, the Board determined that the effective date of the assignment of the 60% disability rating was April 16, 1998, rather than May 29, 1998. Likewise, the Board determined that April 16, 1998, was the proper effective date for the award of a total disability rating based on individual unemployability, as Mr. Buie met the schedular requirements for such a rating at the time he was granted an increased disability rating for his low back condition.
Next, the Board engaged in a long discussion of whether Mr. Buie’s various statements in support of claim and correspondence to VA throughout the adjudication of his claim for benefits for a back condition, including for entitlement to total disability rating based on individual unem-ployability, met the requirements of a Notice of Disagreement. The Board concluded that Mr. Buie’s February 1997, August 1997, April 1998, and May 1998 statements were not Notices of Disagreement, and therefore the regional office had not erred in treating all of those statements as new claims for entitlement to an increased disability rating for a low back condition.
With respect to Mr. Buie’s argument that his November 1995 claim for an increased disability rating for a low back condition should also have been construed as a request for consideration of entitlement to a total disability rating based on individual unemployability, the Board agreed that the 1995 statement included an “informal claim” for entitlement to a total disability rating based on individual unemployability. However, the Board determined that such an informal claim only triggered VA’s duty to send Mr. Buie an official application for that benefit, and that the regional office properly interpreted Mr. Buie’s failure to return the application form “as an indication that he did not believe he qualified for a [total disability rating based on individual unemployability].” R. at 24. Accordingly, the Board determined that the November 1995 statement could not provide a basis for an earlier effective date for entitlement to a total disability rating based on individual unemployability.
On appeal, Mr. Buie makes two arguments. First, with respect to his claim for benefits for a low back condition, he contends that the Board failed to consider
In response, the Secretary argues that the Board’s determination that the May 1996, July 1997, and March 1998 regional office decisions were final because Mr. Buie did not file Notices of Disagreement with those decisions is not clearly erroneous. He also contends that the Board considered and rejected the possibility of an earlier effective date for the award of total disability rating based on individual unemployability, and therefore “any argument that [Mr. Buie] argues is mooted and harmless.” Secretary’s Brief (Br.) at 10-11. Finally, the Secretary asserts that Mr. Buie is not entitled to special monthly compensation because the statute and regulation both require that the first prong of the
II. ANALYSIS
A. Special Monthly Compensation
Mr. Buie argues that the Board erred by failing to consider and apply all applicable provisions of law and regulation as required by
Mr. Buie contends that, because he was already granted entitlement to a total disability rating based on individual unem-ployability effective May 29, 1998 (prior to the Board’s grant of an earlier effective date for that rating), he was entitled to receive special monthly compensation effective January 26, 2001, the effective date VA assigned for the award of a 70% disability rating for post-traumatic stress disorder. In other words, Mr. Buie reads the words “a service-connected disability rated as total” in
In Bradley, the Court considered a similar factual situation. There, when confronted with an appellant seeking special monthly compensation based in part on receipt of a total disability rating based on individual unemployability, the Secretary raised the issue of “duplicate counting of disabilities,” whereby “allowing [a total disability rating based on individual unem-ployability] to satisfy the total disability requirement of
The Secretary hangs his hat on the wording in Bradley emphasized above and argues that because Mr. Buie’s total disability rating for individual unemployability is based on more than one underlying disability, he cannot be entitled to special monthly compensation. Mr. Buie argues that “[t]he fact that the VA’s 2001 award of a total rating based on unemployability was made based on a combination of disabilities is irrelevant.” Appellant’s Reply Br. at 11. Neither party is correct.
First, the Court notes that a total disability rating for individual unemploya-bility is a rating, not a disability. See Rice v. Shinseki,
The above analysis alone does not resolve the question the Court is presented with in this appeal. In Bradley, the Court did not address the question of whether the
“ ‘Statutory interpretation begins with the language of the statute, the plain
In Bradley, the Court examined the plain language of
Similarly, when drafting the implementing regulation,
Accordingly, based on the plain and unambiguous language of the statute, Congress’s demonstrated intent not to permit combined ratings to satisfy the first requirement of the statute, and the Secretary’s reasonable interpretation of the stat
That is not the end of the matter, however. The Secretary is also incorrect in asserting that this analysis means that Mr. Buie is necessarily ineligible for special monthly compensation under
Therefore, the Court holds that the order in which disabilities are service connected is not relevant to VA’s determination of a claimant’s eligibility for special monthly compensation under
In this case, there is evidence in the record to suggest that Mr. Buie may be eligible for a total disability rating for individual unemployability based on his service-connected post-traumatic stress disorder alone. The Board noted that:
there is at least some evidence indicаting that the veteran is. totally disabled, even though the reported symptomatolo-gy [for his post-traumatic stress disorder] has never been consistent with the criteria for a 100 percent [schedular] rating. In particular, the veteran’s private physician ... concluded in a May 2001 report that the veteran has not been able to sustain work or social relationships since he was discharged, and that he considered the veteran permanently and totally disabled because of this. A Global Assessment of Functioning (GAF) score of 25 was then assigned.
R. at 15.
Accordingly, on remand, the Board will determine whether Mr. Buie’s service-connected post-traumatic stress disorder alone would be sufficient to entitle him to a total disability rating based on individual unemployability. If so, in light of his other “disability or disabilities independently ratable at 60%,”
B.
Turning to Mr. Buie’s claim for benefits for a low back disability, the Board’s and the Secretary’s discussions of whether Mr. Buie’s February and August 1997 and April and May 1998 statements are Notices of Disagreement are not relevant and distract from the real issue in this matter. There is no dispute that those documents are not Notices of Disagreement with the prior regional office decisions in May 1996, July 1997, and March 1998.
That, however, does not end the inquiry, because those statements were submitted within one year of the regional office decisions they followed, and so, if those statements included the submission of new and material evidence, 38 C.F.R. 3.156(b) requires that any subsequent decision based on such evidence relate back to the origi
The Board did not discuss the application of
Although the Secretary contends that Mr. Buie’s various statements do not contain material evidence, the determination of whether evidence is material is a factual finding, and the Court is empowered only to review the Board’s findings in that regard. See Suaviso v. Nicholson,
On remand, the Board should consider the application of
III. CONCLUSION
Upon consideration of the foregoing, the May 5, 2008, Board decision is VACATED and the matters are REMANDED for re-adjudication consistent with this decision.
Notes
. The Board also denied entitlement to a disability rating in excess of 70% for post-traumatic stress disorder from January 26, 2001, and to an initial disability rating in excess of 30% for that condition prior to January 26, 2001. In his brief, however, Mr. Buie makes no arguments with respect to his claim for benefits for post-traumatic stress disorder, and the Court therеfore deems any appeal with respect to that claim abandoned. See Grivois v. Brown,
. Mr. Buie’s February 1997 statement is hand dated February 3, 1997, and appears to have been received by VA on February 10, 1997. See R. at 2299. The July 1997 regional office decision states that Mr. Buie’s "claim for increase" was received on February 5, 1997. R. at 2267. The regional office also noted that the April 1997 examination was the first evidence that an increased disability rating was warranted. Because VA treated Mr. Buie's February 1997 statement as a new claim for an increased rating, it appears that the effective date assigned in July 1997 was not in accord with
. At this time, Mr. Buie also sought to reopen previously denied claims for bilateral knee disabilities. Those claims were granted and Mr. Buie was ultimately assigned a 10% disability rating for each knee.
. A Global Assessment of Functioning score represents “the clinician’s judgment of the individual’s overall level of functioning” and is "useful in planning treatment and measuring its impact[] and in predicting outcome.” Diagnostic and Statistical Manual of Mental Disorders 30 (4th ed.1994); see Richard v. Brown,