David W. Boehringer v. Douglas A. CollinsDavid W. Boehringer v. Douglas A. Collins
David B. LeBlanc, with whom Richard J. Hipolit, Principal Deputy General Counsel; Mary Ann Flynn, Chief Counsel; Selket N. Cottle, Deputy Chief Counsel; and Mohammad R. Ricks, Appellate Attorney, were on the brief, all of Washington, D.C., for the appellee.
Before ALLEN, Chief Judge, PIETSCH, TOTH, FALVEY, LAURER, and JAQUITH, Judges, and BARTLEY,2 Senior Judge.3
LAURER, Judge, filed the opinion of the Court. BARTLEY, Senior Judge, filed a dissenting opinion, which TOTH and JAQUITH, Judges, joined.
LAURER, Judge: Context matters. And it especially matters when interpreting provisions under the Veterans Appeals Improvement and Modernization Act of 2017 (AMA).4 The AMA substantially changed VA‘s administrative appeals process, creating entirely new procedural pathways and tools that weren‘t available under the “legacy” review system. The AMA is complex. It has a lot of moving parts, many of which have been the subject of decisions before this Court and the U.S. Court of Appeals for the Federal Circuit. To add to that complexity, the AMA didn‘t1
Think of it this way. When it comes to the AMA, statutory interpretation without context is like looking at a Van Gogh painting through a soda straw. A single brushstroke viewed in isolation is just that: a dab of blue or yellow susceptible to many interpretations. Only by stepping back can the patron distinguish the full picture, and The Starry Night is clear. That‘s how we interpret
In this appeal, U.S. Army veteran David W. Boehringer, through counsel, challenges an October 27, 2023, Board of Veterans’ Appeals (Board) decision issued under the AMA5 that dismissed an appeal for an effective date before February 25, 2016, for a total disability rating based on individual unemployability (TDIU). The dispute centers on appellant‘s April 2022 claim, which he filed on a supplemental claim form within a year of an October 2021 Board decision, issued under the pre-AMA legacy review system, denying an earlier effective date for TDIU. Appellant argues that section 5110(a)(2)(D) allows a claimаnt to continuously pursue an effective date claim by filing a supplemental claim within 1 year of any Board decision, regardless of whether it‘s a legacy or AMA decision. As explained below, we hold that a claimant may not use a supplemental claim to continuously pursue an earlier effective date claim that was finally decided by the Board under the legacy system. Continuous pursuit applies only to AMA claim streams. And here, appellant didn‘t opt in to the AMA, and his TDIU effective date claim became final under legacy. So he couldn‘t continue his legacy appeal of his TDIU effective date through an AMA supplemental claim.
After we provide some background and recount the parties’ arguments, we‘ll consider the text of section 5110(a)(2). Next, we‘ll zoom out by looking at how the legacy and modernized review systems interact. Then we‘ll consider the standard for determining which system applies and the specific means Congress provided for a legacy claimant to opt in to the AMA. Finally,
I. BACKGROUND
In August 2012, VA granted appellant a 50% rating for posttraumatic stress disorder (PTSD), effective January 2012, the date VA received appellant‘s claim.6 While continuing to pursue a higher PTSD rating, appellant claimed TDIU due to PTSD in November 2013.7 As relevant here, in June 2014, the VA agency of original jurisdiction (AOJ) denied TDIU, and appellant appealed that decision to the Board a few months later.8 In May 2018, the Board remanded TDIU for further development as inextricably intertwined with appellant‘s PTSD,9 eventually leading to a December 2020 Supplemental Statement of the Case (SSOC) and a January 2021 SSOC denying TDIU before June 25, 2019.10 Both SSOCs informed appellant that he could continue his appeal in the legacy system or opt in to the AMA.11 He didn‘t opt in. Following an April 2021 Board remand,12 a June 2021 AOJ decision granted TDIU, effective February 25, 2016, which is the date VA assigned a 70% rating for PTSD.13 In July 2021, the AOJ issued an SSOC denying an earlier effective date for TDIU and providing appellant another oppоrtunity to opt in to the AMA.14 He didn‘t opt in at this point either.
In April 2022, appellant filed a claim for an earlier effective date for TDIU on a supplemental claim form (VA Form 20-0995, Decision Review Request: Supplemental Claim), identifying the October 2021 Board decision as the decision for review.17 In August 2022, the AOJ considered the merits of his effective date argument and denied an earlier effective date.18 Appellant then appealed the AOJ decision to the Board.19
In the October 2023 decision on appeal, the Board found that appellant‘s April 2022 claim amounted to a freestanding claim for an earlier effective date because the October 2021 Board decision was final.20 Relying on Rudd v. Nicholson, 20 Vet.App. 296 (2006),21 the Board explained that once an effective date determination becomes final, a claimant‘s only option to challenge the final decision is revision based оn clear and unmistakable error (CUE). The Board noted that continuous pursuit through a supplemental claim applies only to decisions issued under the AMA. Because the October 2021 Board decision was under the legacy system, the October 2023 Board determined that continuous pursuit “was and is not available.”22 The Board dismissed the appeal, and this appeal followed.
II. PARTIES’ ARGUMENTS
Appellant invokes the continuous pursuit rule to argue that his April 2022 claim isn‘t a freestanding claim for an earlier effective date. He asserts that the continuous pursuit rule applies
Appellant adds that “the AMA rules apply to ‘all . . . requests for reopening of finally adjudicated claims . . . for which VA issues notice of an initial decision,’ on or after February 19, 2019.”24 Aрpellant views the “initial decision” in this case as the August 2022 AOJ decision that addressed his April 2022 claim.25 And because he filed that claim within a year of a Board decision (the October 2021 legacy decision)—and received a decision on that claim—he contends that his claim stream is subject to the AMA.
The Secretary argues that continuous pursuit under section 5110(a)(2) is an AMA rule that doesn‘t apply to legacy decisions. He asserts that once an effective date decision issued by the Board becomes final under legacy, readjudication is warranted only upon “‘assertion of [CUE], an order from the Chairman granting reconsideration of a Board decision, or the Board‘s sua sponte correction of obvious error.‘”26 The Secretary contends that appellant chose to keep his claim in the legacy system despite multiple opportunities to opt in to the AMA. And the Secretary notes that appellant didn‘t pursue any of the legacy options for review of the October 2021 Board decision. The Seсretary defends the Board‘s conclusion that appellant‘s April 2022 claim amounted to an impermissible freestanding earlier effective date claim.
In reply, appellant acknowledges that his TDIU effective date claim was “finally adjudicated for Legacy purposes” in the October 2021 Board decision.27 But he argues that his claim “became an AMA claim when the AOJ issued a decision” in August 2022—the initial decision on his April 2022 claim that triggered the AMA.28 So he says his claim wasn‘t finally
III. ANALYSIS
The meaning of a statute is a legal question that the Court reviews de novo.30 To start, we first look at the language of the statutory provision, “giving the words used their ordinary meaning.”31 But we don‘t stop there because context “inform[s] any statutory provision‘s plain meaning.”32 So we also consider “‘the statutory scheme as a whole, the specific context in which [a] word or provision at issue is used, and the broader context of the statute as a whole‘” to determine a provision‘s plain meaning.33 But before we jump into the text, let‘s get a bird‘s-eye view of how the legacy and AMA review systems operate concurrently.
A. Two Distinct Review Systems
Congress overhauled VA‘s internal appeals system with the AMA.34 It created new procedural tools and processes in the administrative adjudication process—like supplemental claims and higher level review—and established a novel framework for how effective dates
To determine which review system applies, “we ask whether the initial decision that led to an administrative appeal was issued on or after February 19, 2019.”40 If the initial decision was issued on or after that date, the appeal falls within the AMA. If the initial decision was issued before that date, the appeal falls within the legacy system. Congress also provided that in specific, limited circumstances, a legacy claimant may opt in to the AMA. Shortly we‘ll dive deeper into opt-in rules, what we view as appellant‘s “initial decision,” and how we view his later claims. But for now, we keep it simple to focus on the rules Congress gave. Considering this dual-system framework, how does section 5110(a)(2) fit in? Let‘s turn there now.
B. The Text of Section 5110(a)(2)
The key disagreement between the parties is whether section 5110(a)(2), as amended by the AMA,41 allows a claimant to continuously pursue an earlier effective date determination that was finally decidеd in a legacy Board decision. Under the legacy system, once an effective date determination became final, it couldn‘t be readjudicated unless one of the limited exceptions to finality applied.42 In other words, a claimant couldn‘t pursue a claim to reopen a finally decided effective date determination.43 But the AMA amended section 5110 and added new provisions. So we start with the text of the provision at issue. Section 5110(a)(2) states as follows:
For purposes of determining the effective date of an award under this section, the date of application shall be considered the date of the filing of the initial application for a benefit if the claim is continuously pursued by filing any of the following, either alone or in succession:
. . .
(D) A supplemental claim under 5108 of this title on or before the date that is one year after the date on which the Board of Veterans’ Appeals issues a decision.44
Let‘s break this down. Section 5110(a)(2) gives a claimant another avenue to challengе a Board effective date determination through a “supplemental claim,” something that wasn‘t available under the legacy system. By filing a supplemental claim within a year of a Board decision,45 a claimant can forestall the finality of the decision and continuously pursue his effective date claim.46 If a claimant prevails on the merits, he could be awarded an effective date stretching back to the date he first filed his “initial application” for benefits.
Notice that this provision doesn‘t differentiate between legacy and AMA Board decisions. Instead, it says a supplemental claim must be filed within a year of the date on which the Board issues “a” decision. This provision also doesn‘t define what “initial application” means. But our inquiry continues because we don‘t read statutory provisions in a vacuum. Context is an essential
C. Opting in to the AMA
Congress provided that a legacy claimant may elect to participate in the AMA system “upon the issuance to a claimant of a[n SOC] or [SSOC] occurring on or after [February 19, 2019].”48 Congress also explicitly gave the Secretary discretion to manage a claimant‘s election between review systems.49 And the Secretary specified that a claimant could opt in to the modernized review system either (1) by participating in the Rapid Appeals Modernization Program, or (2) after receiving an SOC or SSOC.50
We interpret statutes with the understanding that Congress doesn‘t make significant policy changes cryptically.51 Allowing a legacy claimant to opt in to a different administrative appeal system was a significant policy change brought by the AMA. And allowing a legacy claimant to opt in through a supplemental claim would also be significant, effectively overriding legacy finality rules.52 A supplemental claim also isn‘t some “other” option to switch systems in addition to opting in. In fact, using a supplemental claim to enter the AMA would essentially act as an unintended opt-in loophole. And for all practical purposes, the supplemental claim would be another opt-in mechanism. If this was Congress‘s intention, we would expect it to be clear. Congress knew how to identify which review system applies to a claim and when a legacy claimant
To add another way for a legacy claimant to enter the AMA (like a supplemental claim), we‘d have to cоnclude that Congress was detailed and clear about opt-in procedures yet left us a breadcrumb in section 5110(a)(2). That‘s inconsistent with Congress‘s intentional design for how a claimant can opt in to the AMA. Congress didn‘t bury a revolutionary change to legacy finality rules inside section 5110(a)(2)(D), and a supplemental claim isn‘t a hidden back door into the AMA. We decline to read implicit opt-in mechanisms into the statute that Congress didn‘t provide for.
But if a supplemental claim isn‘t another way to opt in to the AMA, then why did Congress draft section 5110(a)(2)(D) so broadly? (Recall that the provision speaks of a supplemental claim filed within a year of “a” Board decision.) Why doesn‘t section 5110(a)(2)(D) specify supplemental claims within a year of an AMA Board decision? Context again clarifies a provision that would be susceptible to multiple interpretations when viewed in isolation. As we‘ll explain, section 5110(a)(2) presupposes that a claim stream is already in the AMA.
D. The Applicability of a Supplemental Claim
Section 5110(a)(2) reflects one of the most significant AMA features codified by Congress: continuous pursuit. Nearly every provision under section 5110(a)(2)—all except (C)56—was created by the AMA, meaning that section 5110(a)(2) lays out the rules for the new procedural options Congress afforded in the AMA.
Ditto for “higher-level review,” a term discussed in section 5110(a)(2)(A).62 This didn‘t exist before the AMA.63 It‘s unique to the AMA, designed by Congress as one of the review options for claimants whose claim strеams are already subject to the AMA. A higher level review isn‘t an option for a legacy claimant who hasn‘t opted in to the AMA, just as a legacy claim to reopen isn‘t an option for an AMA claimant. The higher level review, like the supplemental claim, operates with the understanding that a veteran is already in the modernized review system. So when Congress referenced higher level review and supplemental claims in section 5110(a)(2), it didn‘t import new rules into an old system. The provision gives new procedures for effective date
The application of section 5110(a)(2) is based on the premise above. Put clearly, section 5110(a)(2) applies to claim streams that are already in the AMA. A legacy claimant (one who hasn‘t opted in) can‘t continuously pursue an earlier effective date through a supplemental claim because—to state the obvious—his claim stream is under the legacy systеm. That claimant is bound by the procedural review options available under legacy.66 The supplemental claim is a procedural option available only for AMA claimants.67 So when section 5110(a)(2)(D) references “a” Board decision, we understand that to refer to AMA Board decisions that are in AMA claim streams. Section 5110(a)(2) makes sense only if we read it as an AMA-specific provision that operates independent of legacy procedures.
Any other result would be absurd.68 Recall that we consider the date of “the initial decision that led to an administrative appeal” to determine which system applies.69 If the decision is before February 19, 2019, then legacy applies; if the decision is on or after February 19, 2019, then the AMA applies. Also remember that section 5110(a)(2) provides that if the claim is continuously
Ultimately, appellant‘s position would require us to hold that a legacy claimant can divert his claim stream into the AMA by simply filing a supplemental claim. Such a claim would defy legacy finality rules, prescribed opt-in procedures, and Congress‘s design for concurrent appeal systems. Under this understanding of section 5110(a)(2), the legacy system effectively disappears. We reject interpreting the statute in such an illogical way.
Perhaps an analogy at this point will help clarify. Think of the legacy and AMA systems as two train tracks running parallel to each other. The “initial decision” determines which track a claimant starts out on. The tracks don‘t overlap except for very limited points where the legacy
So what happens if a legacy claimant (who hasn‘t opted in to the AMA) files a supplemental claim form within a year of a legacy Board decision? We view that claim as a new AMA claim that starts a new claim stream.76 Any “initial decision” relates to that new AMA claim, not any previous final legacy claim. Even if the claimant has attempted to continuously pursue the claim in the legacy claim stream, he can‘t. His old legacy claim isn‘t contemplated under section 5110(a)(2) because the AMA doesn‘t apply to legacy claim streams (assuming the claimant didn‘t opt in to the AMA). The fact that he filed his new claim on a supplemental claim form doesn‘t grant him access to the legacy claim stream. He‘s on a new AMA track starting with the new AMA claim.
Appellant asserts that our interpretation of the law is inconsistent with Held v. McDonough.77 In that case, we considered the meaning of the “initial decision . . . with respect to the case” for attorney fees under
To summarize this section, we hold that continuous pursuit by a supplemental claim under section 5110(a)(2)(D) is available only within an AMA claim stream. Section 5110(a)(2)(D) speaks to AMA Board decisions, not legacy Board decisions. So a legacy claimant who hasn‘t opted in to the AMA can‘t use a supplemental claim to continuously pursue an earlier effective date claim decided under legacy.
E. Legacy Finality Rules
A last note on legacy finality before turning to the application of law to the facts. As discussed above, Congress intended for the legacy and AMA review systems to operate concurrently, meaning they don‘t overlap.81 So the AMA didn‘t change legacy finality rules, and our reading of section 5110(a)(2)(D) adheres to that. Under the legacy system, when the Board denies a claim, there‘s only one option for further review: an appeal to this Court within 120 days.82 That‘s the only way to challenge an unfavorable legacy Board decision while still preserving the effective date attached to the initial claim. If there isn‘t a Court appeal, then the Board decision becomes final. Apart from a few limited circumstances (e.g., CUE, Board reconsideration, or the Board‘s sua sponte correction), once an effective date decision becomes final under legacy, it‘s not subject to readjudication.83 A claimant can‘t seek to reopen a final effective date determination by the Board.84
IV. APPLICATION
Appellant‘s TDIU claim fell under the legacy review system, a fact that no one disputes.86 Appellant also had multiple chances to opt in to the AMA throughout his appeal, yet he didn‘t. No one disputes this either.87 In October 2021—still under legacy—the Board denied TDIU before February 2016. Appellant didn‘t appeal the Board‘s 2021 decision to the Court. Because he didn‘t pursue the legacy options for abating the finality of the October 2021 Board decision, that decision became final.88 And because his claim stream was in legacy, he couldn‘t use a supplemental claim to preserve an earlier effective date claim or otherwise continue his legacy claim stream. As noted above, only a claimant whose claim stream is already in the AMA has the procedural option of continuous pursuit through a supplemental claim.
So when appellant filed his April 2022 claim for an earlier TDIU effective date, that began a new claim stream under the AMA. Although appellant filed his claim on a supplemental claim form (VA Form 20-0995, Decision Review Request: Supplemental Claim) and identified the October 2021 Board decision, this didn‘t transform his claim into a valid continuously pursued
In the October 2023 decision on appeal, the Board found that appellant couldn‘t continuously pursue an earlier effective date claim that was finally decided under the legacy review system.91 Noting that continuous pursuit applied only to supplemental claims filed within a year of AMA decisions, the Board dismissed the appeal.92 Appellant didn‘t opt in to the AMA, and he couldn‘t use a supplemental claim under section 5110(a)(2)(D) to bring his legaсy claim stream into the AMA.93 So we hold that appellant couldn‘t continuously pursue the earlier TDIU effective date claim that became final under legacy, and we affirm the Board‘s decision.
V. CONCLUSION
For these reasons, the Court AFFIRMS the Board‘s October 27, 2023, decision dismissing a claim for an effective date earlier than February 25, 2016, for TDIU.
Mr. Boehringer filed his supplemental claim after the AMA effective date and within 1 year of his October 2021 Board decision. The plain language of section 5110(a)(2)(D), a рrovision included in AMA public law number 115-55, is clear: A claimant who files a supplemental claim within 1 year of the date on which “the Board of Veterans’ Appeals issues a decision” continuously pursues their claim. Absent any indication that section 5110(a)(2)(D) refers only to an AMA Board decision, we cannot assume, as the majority does, that the indefinite article “a” refers exclusively to an AMA Board decision and excludes a legacy Board decision.
The majority acknowledges that statutory text doesn‘t explicitly require the Board decision to have been issued in the AMA system, ante at 8, but dispenses with clear public law and statutory directives to instead rely on unsupported assumptions about context to reach their conclusion. But courts have long looked askance at context-based arguments that add limiting words not included in the statutory text. Alabama v. North Carolina, 560 U.S. 330, 352 (2010) (declaring that courts “cannot[ ] add provisions to a federal statute“); Bates v. United States, 522 U.S. 23, 29 (1997) (advising courts to “ordinarily resist reading words or elements into a statute that do not appear on its face“); Keene Corp. v. United States, 508 U.S. 200, 208 (1993) (same). Plain meaning is conclusive “except in the rare cases” in which “the literal application of a statute will produce a result demonstrably at odds with the intentions of its drafters.” United States v. Ron Pair Enters., 489 U.S. 235, 242 (1989) (internal quotations omitted). And here, the majority fails to show that the literal application of section 5110(a)(2)(D) to veterans like Mr. Boehringer would be absurd or at odds with Congress‘s intent.
Their ruling not only disregards the plain language of section 5110(a)(2)(D), it also ignores or misinterprets the plain language of the “applicability” provisions of the AMA found in section 2(x) of the AMA public law. Ante at 10-15. Subsection 2(x)(1) states that “[e]xcept as otherwise provided in this subsection, the [AMA] amendments made by this section shall apply to all claims for which notice of a decision under section 5104 . . . is provided by the Secretary of Veterans Affairs” on or after February 19, 2019.94
Our colleaguе Judges assert that the “except as otherwise provided” language of subsection 2(x)(1), in combination with subsection 2(x)(5), dooms Mr. Boehringer‘s argument. Subsection 2(x)(5), “Treatment of Legacy Claims,” provides that a claimant pursuing a legacy appeal before the agency “may elect to participate in the new appeals system” mid-claim-stream—namely, upon issuance of an SOC or SSOC. Pub. L. No. 115-55, sec. 2(x)(5), 131 Stat. at 1115; see
So what happens if a legacy claimant (who hasn‘t opted in to the AMA) files a supplemental claim form within a year of a legacy Board decision? We view that claim as a new AMA claim that starts a new claim stream. Any “initial decision” relates to that new AMA claim, not any previous final legacy claim. Evеn if the claimant has attempted to continuously pursue the claim in the legacy claim stream, he can‘t. His old legacy claim isn‘t contemplated under section 5110(a)(2) because the AMA doesn‘t apply to legacy claim streams.
Ante at 14 (footnotes omitted).
The majority does not cite authority for this view, id., because not only is their reading contrary to the statute‘s (including the statutory note‘s) plain language, there is no indication in legislative history or legislative or statutory context that the election option laid out in subsection 2(x)(5) is the sole way for a claimant in the legacy system at AMA enactment (which included the vast majority of VA claimants in existence at that time) to access the beneficial processes of the AMA, including modernized review options and continuous pursuit, for their claims.96 As noted, statutory language provides that after February 19, 2019, subsection 2(x)(1) of the public law and section 5110(a)(2)(D) apply to a claimant who files a supplemental claim within 1 year of receiving
In fact, subsection 2(x)(5), which allows a legacy system claimant to elect the AMA system mid-claim-stream, at the point of having received an SOC or SSOC, is not relevant to Mr. Boehringer‘s case. Once Mr. Boehringer filed a supplemental claim in April 2022 and received a post-February 2019 notice of decision, he was not in the legacy system or continuing his legacy appeal, and we see no conflict between subsection 2(x)(5) and the plain language of amended section 5110 as applied to his case. This is the crux of our disagreement with our colleagues: We see the law as clearly providing that an AMA supplemental claim filed within 1 year after issuance of a final Board decision (any final Board decision) and with subsequent receipt of 5104 notice of decision issued on or after February 19, 2019, as an AMA supplemental claim subject to the AMA. It is not the continuation of a legacy appeal, as that view utterly lacks statutory support.
And, in any event, subsection 2(x)(5) is not an “exception” to subsection 2(x)(1). “Exception” is defined as “exclusion” and “one that is excepted[;] a case to which a rule does not apply.”97 Subsection 2(x)(5) does not purport to “except” veterans from 2(x)(1)‘s general rule that claimants who receive section 5104 notice on or after February 19, 2019, are automatically in the AMA system. Instead, making no mention of 5104 notice or February 19, 2019, subsection 2(x)(5) offers entry into the AMA system to legacy claimants who already received (legacy) notice under the old section 5104 and who are at the point of receiving a legacy SOC or SSOC. The fact that subsection 2(x)(5) does not qualify as an exception provides an additional basis for us to reject the majority‘s analysis.
And although our view is not grounded on a notice failure, we observe that the VA notices to Mr. Boehringer that he could elect the AMA system in the middle of his legacy claim stream did not apprise him, or the thousands of others who received this same notice, of any downside to remaining in legacy—let alone such a significant downside as the majority here creates, that of
The majority characterizes the filing of a supplemental claim as an unintended opt-in mechanism not contemplated by Congress, ante at 9, and contends that if Mr. Boehringer‘s arguments were to succeed, the legacy system would disappear automatically every time VA issued a legacy decision after February 19, 2019, ante at 13. But since enactment of the AMA removed for all future claims the legacy statute that permitted reopening of legacy claims,
In conclusion and for the foregoing reasons, the Court should reverse the Board‘s October 2023 dismissal of Mr. Boehringer‘s appeal and remand that matter for readjudication, including a