Clаrence W. KOWALSKI, Appellant, v. R. James NICHOLSON, Secretary of Veterans Affairs, Appellee.
No. 02-1284.
United States Court of Appeals for Veterans Claims.
June 8, 2005.
19 Vet. App. 171
v.
R. James NICHOLSON, Secretary of Veterans Affairs, Appellee.
No. 02-1284.
United States Court of Appeals for Veterans Claims.
June 8, 2005.
Before GREENE, KASOLD, and HAGEL, Judges.
GREENE, Judge:
Veteran Clarence W. Kowalski appeals, through counsel, a June 21, 2002, Board of Veterans’ Appeals (Board) decision that denied his claims for VA service connection for bilateral hearing loss, cold-weather trauma, arteriosclerotic heart disease, and pulmonary disabilities. Record (R.) at 1-25. On appeal, he raises arguments concerning only his hearing-loss claim, and he specifically withdraws his appeal of the Board decisions on his claims for cold-weather trauma, arteriosclerotic heart disease, and pulmonary disabilities. See Appellant‘s Brief (App.Br.) at 1. Any issues surrounding those withdrawn claims are deemed abandoned. See Bucklinger v. Brown, 5 Vet.App. 435, 436 (1993). Mr. Kowalski maintains that the Board erred by denying his hearing-loss claim on the basis that he had abandoned it by refusing to report for a VA medical examination and by also concluding that a private audiologist‘s opinion, which stated that his hearing loss “quite likely” began in service, had no probative weight because it was based solely on Mr. Kowalski‘s uncorroborated reports of incidents during his service. App. Br. at 5-13. He contends that the audiologist‘s opinion established service connection. Id. He further asserts that because VA gаve him no compelling reason as to why another examination was necessary, he was not required to report for a scheduled VA medical examination. Id. The Secretary contends that, should the Court conclude that the Board erred by denying Mr. Kowalski‘s claim on the basis that he abandoned it by failing to report for a VA medical examination, that error is harmless because the Board adjudicated Mr. Kowalski‘s claim on the evidence of record and had a plausible basis for finding that the evidence did not support awarding him sеrvice connection. Secretary‘s Brief (Sec.Br.) at 6-15. The Court has jurisdiction under
I. FACTS
Mr. Kowalski served honorably in the U.S. Army from April 1954 to February 1956, including service in Korea. R. at 28. His military records indicated that his service in Korea began on December 22, 1954, during the final month of the Korean Conflict period. Id.; see also
[Mr. Kowalski has] a moderate bilateral high[-]frequency sensorineural hearing loss with good discrimination ability. From [Mr. Kowalski‘s] history of being exposed to the noise of small arms and tanks while in the military, during the mid 1950[s], it is quite likely that this was the beginning of [his] hearing loss. The type and degree of [his] hearing level on [his] audiogram is consistent with noise[-]induced hearing loss.
R. at 110-12. In April 2000, Mr. Kowalski appealed to the Board and requested a “thorough and contemporaneous [medical] examination.” R. at 121-22. In May 2000, however, Mr. Kowalski requested that VA expunge from the record his December 1999 VA medical examination report; he asserted that the examination was inadequate for rating purposes. R. at 128-30. Mr. Kowalski also maintained that he would not undergo another VA medical examination. Id. He stated, through counsel:
Should the [RO] submit to Mr. Kowalski compelling reasons, as required by [VA Adjudication Procedure Manual M21-1 (M21-1)], for the scheduled compensation examination ... he would willingly comply with the [RO‘s] request for [an] examination.
R. at 130. In July 2000, the RO issued a Statement of the Case (SOC) stating, inter alia, that Mr. Kowalski had not presented evidence of a hearing loss or evidence of a likely connection of any hearing loss to military service. R. at 138-44. The SOC noted that “the veteran submitted evidenсe regarding his hearing loss” but that a VA examination was being scheduled to evaluate that condition. R. at 143. In August 2000, Mr. Kowalski‘s counsel advised the RO that Mr. Kowalski would not attend any scheduled VA examination and reiterated that unless Mr. Kowalski was given compelling reasons for doing so, he would not attend any VA medical examinations. R. at 152-53. Mr. Kowalski‘s counsel also filed a Substantive Appeal and stated:
[Mr. Kowalski] has submitted medical evidence sufficient for [VA] to rate from. . . . . The [December 1999] VA compensation examination is arbitrary, capricious, and, thеrefore, clearly and unmistakably erroneous. . . . . The [RO] has denied benefits by scheduling an improper VA compensation examination. Denial was further confirmed by the notification that the adjudication of his claim was solely dependent upon the outcome of a VA compensation examination. Due to the clearly adversarial position demonstrated by the [RO], Mr. Kowalski moves the [Board] to accept jurisdiction of his case and to make a final decision based upon the evidence currently of record.
R. at 164-65 (emphasis added). Based on this statement, VA cancelled Mr. Kowalski‘s scheduled audiological examination. R. at 176. In a March 2001 letter to the RO, Mr. Kowalski‘s counsel asserted:
Mr. Kowalski [has] submitted a proper and timely appeal and [NOD]. Your blatant refusal to timely promulgate Mr. Kowalski[‘s] appeal is an abuse of his rights to a timely appeal. It is without legal merit and entirely inappropriate that Mr. Kowalski[‘s] appeal has not been promulgated. Mr. Kowalski has been advised to take this matter to the [VA] Office of Inspector Gеneral.
R. at 250. In April 2001, VA provided to Mr. Kowalski a letter notifying him of the information and evidence necessary to substantiate his claim and indicating which portion of any such information or evidence he needed to provide and what VA would provide. R. at 252-56. In response, Mr. Kowalski‘s counsel asserted:
It has been approximately 20 months since Mr. Kowalski filed his original claim for benefits. It has been [15] months since he was first denied these benefits. It has been [12] months since he submitted his ... VA [S]ubstantive [A]ppeal. The [RO] has repeatedly refused to provide deferеnce to submitted private evidence, instead choosing to schedule Mr. Kowalski for an inappropriate VA compensation examination. This [is] in direct contradiction to statute, regulation[,] and [the VA] adjudication manual. . . . . Mr. Kowalski moves that his appeal be immediately promulgated to the [Board] for timely adjudication. Any further delay can only be construed as a willful and wanton disregard of Mr. Kowalski‘s right to a timely appeal.
R. at 259-60. In August 2001, after Mr. Kowalski refused to report for a VA examination and did not submit any additional evidence following the April 2001 notification letter, the RO denied his claim. The RO found that the evidence did not show that his hearing-loss condition was related to his military service. R. at 270. Mr. Kowalski appealed to the Board, and on June 21, 2002, the Board found that Mr.
[The] preponderance of evidence is against the veteran‘s claim. The evidence in essence consists of the nexus opinion of an audiologist based on the veteran‘s own reports of noise exposure during service. The Court has held on a number of occasions that a medical opinion premised upon an unsubstantiated accоunt of a claimant is of no probative value. Although the statement from the veteran‘s audiologist is the only medical evidence of record pertinent to the question of whether the veteran‘s currently-shown hearing loss had its inception during his period of service, the Board declines to give it probative weight. The statement was based entirely upon the veteran‘s own reported history of having been exposed to noise during service in Korea.
R. at 17-18. Mr. Kowalski appealed to the Court. On appeal, Mr. Kowalski maintains that VA sсheduled a medical examination solely for the purpose of rebutting his private audiologist‘s opinion and that VA did not explain what probative evidence would be gathered from a VA examination. App. Br. at 10. He argues that his audiologist‘s examination and opinion complied with the rating requirements in
II. ANALYSIS
A. Abandonment of Claim
The Board found that Mr. Kowalski, without good cause or adequate reason, had refused to report for his scheduled VA audiological examination, and thus, under
First,
With
For purposes of establishing any claim for benefits ... a report of a medical examination administered by a private physician that is provided by a claimant in support of a claim for benefits under that chapter may be accepted without a requirement for confirmation by an examination by a physician employed by the Veterans Health Administration if the report is sufficiently complete to be adequate for the purpose of adjudicating such claim.
Regarding Mr. Kowalski‘s reliance upon the M21-1 provisions as a basis to require the RO to give him compelling reasons to report for an examination, we recognize that, under M21-1, part IV, chaрter 1, paragraph 1.07(b)(6), “the rating activity may request that the claimant be reexamined by another medical examiner if compelling reasons exist.” However, that section applies only to the sufficiency of a previous VA examination. See generally M21-1, pt. IV, ch. 1, para. 1.07 (“Sufficiency of VA Examination“). Mr. Kowalski cites only to M21-1, part VI, chapter 1, paragraph 1.13(a), concerning the scheduling of VA examinations subsequent to a private examination, which admonishes the RO “not [to] request an examination solely to confirm evidеnce listed in
The Court‘s caselaw on a claimant‘s cooperation in the adjudicatiоn process is clear: “If a veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence.” Dusek v. Derwinski, 2 Vet.App. 519, 522 (1992) (quoting Wood v. Derwinski, 1 Vet.App. 190, 193 (1991)). We also recognize that a veteran is free to refuse to report for a scheduled VA examination. However, the consequences of that refusal may result in the adjudication of the matter based on the evidence of record under
B. Claim on the Merits
Having resolved that any error by the Board in finding that, under
When rendering its decision, the Board must consider all relevant evidence of record and address in its decision all potentially applicable provisions of law and regulation. See Schafrath v. Derwinski, 1 Vet.App. 589, 593 (1991); see
In its adjudication of this matter, the Board, relying upon Reonal and Swann, both supra, determined that it would not give probative value to the private audiologist‘s letter. That letter, dated almost 46 years after Mr. Kowalski‘s separation from service, provided an opinion based on service history related by Mr. Kowalski. Indeed, there was very little detail in that letter, and the Board had a basis for attributing less prоbative value to the letter. Cf. Reonal and Swann, both supra. The Court is not satisfied, however, that the Board accomplished all that it was required to do in this matter. First, although the Board may reject a medical opinion that is based on facts provided by the veteran that have previously been found to be inaccurate (Reonal) and may reject such a medical opinion because other facts present in the record contradict the facts provided by the veteran that formed the basis for the opinion (Swann), the Board may not disregard a medical opinion solely on the rationale that the medical opinion was based on a history given by the veteran. See Wilson v. Derwinski, 2 Vet.App. 614, 618 (1992) (stating Board must evaluate the credibility and weight of the history upon which medical opinion is predicated). Further, because Mr. Kowalski‘s records were lost, the Board had a heightened duty to provide a full explanation of the reasons or bases for its findings. See Moore and O‘Hare, both supra. This duty recognizes the Board‘s
In the case of any veteran who engaged in combat with the enemy in active service, ... the Secretary shall accept as sufficient proof of service-connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of suсh incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran.
Mr. Kowalski‘s report of separation indicated that his service in Korea began on December 22, 1954. See R. at 28. VA regulations state that the Korean Conflict period extended from June 27, 1950, through January 31, 1955, inclusive.
On remand, the parties are reminded that “[t]he duty to assist is not always a one-way street. If a veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence.” Wood, 1 Vet.App. at 193. As we hold above, VA has not only the discretion, but in this case, the duty under
III. CONCLUSION
After consideration of the pleadings and a review of the record, the Court holds that the Board has committed prejudicial error that warrants remand. Therefore, the June 21, 2002, decision of the Board is VACATED and the matter is REMANDED to the Board for further adjudication in accordance with this opinion. On remand, Mr. Kowalski is free to raise additional arguments to the Board and the Board must address them. See Kay v. Principi, 16 Vet.App. 529 (2002); Kutscherousky v. West, 12 Vet.App. 369 (1999) (per curiam order).
