Floyd v. BrownFloyd v. Brown
Lead Opinion
IVERS, Judge, filed the opinion of the Court. STEINBERG, Judge, filed an opinion concurring in part and dissenting in part.
Charles E. Floyd appeals a May 21, 1992, decision of the Board of Veterans’ Appeals (BVA or Board) that denied an increased schedular rating for service-connected residuals of a fracture of the left mandible with temporomandibular joint pain (currently rated 10% disabling), granted an additional 10% evaluation for that condition on an extra-schedular basis, and did not reopen service connection claims for bilateral hearing loss and bilateral tinnitus secondary to the service-connected left mandible condition. Charles E. Floyd, BVA 92-12610 (May 21, 1992). The Court has jurisdiction over the
I. FACTUAL BACKGROUND
The appellant served on active duty in the United States Marine Corps from September 21,1965, to October 17,1969. Record (R.j at 17. According to service medical records, on February 18, 1968, the appellant was struck on the left side of the mandible. R. at 46. On physical еxamination, “[t]here was deviation of the mandible to the left on opening.” Ibid. In addition, “[r]adiographs ... revealed a fracture of the neck of the condyle with slight anterior angulation deformity and slight lateral displacement of the condyle.” Ibid. The final diagnosis provided was a fracture of the mandible in the left subcondy-lar area. R. at 47.
On October 14,1975, the appellant filed an application seeking service connection for a broken jawbone and hearing loss and ringing in his ears. R. at 60. A January 1976 VA special ear examination report diagnosed the appellant with a history of tinnitus, which was not confirmed by the examination, and normal hearing in the right ear and very mild neurosensory hearing loss in the left ear. R. at 73. On April 29, 1976, a VA regional office (RO) granted service connection for residuals of a fracture of the mandible (rated 0% disabling) and denied service connection for neurosensory hearing loss of the left ear and tinnitus. R. at 74-75. On January 26,1977, the RO also denied service connection for tinnitus as secondary to a claimed nervous disorder. R. at 76.
On January 31, 1983, the appellant sought аn increased evaluation for the service-connected left mandible fracture residuals and sought service connection for hearing loss and tinnitus. R. at 187. On January 11, 1984, the RO denied the appellant’s claim for a higher evaluation for the left mandible fracture residuals and denied service connection for bilateral hearing loss with tinnitus. R. at 197. In describing the appellant’s hearing loss and tinnitus claim, the RO rating decision stated: “The veteran claimed a hearing loss as a result of exposure to substantial noise in Vietnam, and some intermit tent tinnitus without other neurological symptoms.” Ibid. On July 22, 1985, the RO denied an increased evaluation for residual fracture of the left mandible with temporal mandibular joint pain. R. at 209. In denying an increased evaluation, the RO rating decision noted: “No separate evaluation is being given for temporal mandibular joint pain but is being included based on medical request.” Ibid. On December 19, 1985, after the appellant filed a Notice of Disagreement (NOD), the RO increased the evaluation for residuals of a fracture of the left mandible with temporomandibular joint pain to 10% disаbling. R. at 228-29. On August 19, 1988, the Board denied an evaluation greater than 10% for the service-connected residuals of a fracture of the left mandible with temporomandibular joint pain. R. at 292. The Board also denied direct service connection for defective hearing and tinnitus (due to in-service noise exposure) and service connection for sensorineural defective hearing and tinnitus secondary to the service-connected residuals of a fracture of the left mandible. R. at 293.
On August 30, 1989, the appellant sought an increased evaluation for the service-connected left mandible condition. R. at 294. On December 29, 1989, the RO denied an evaluation greater than 10% for the left mandible condition and denied service connection for headaches secondary to the left mandible condition. R. at 326-27. The RO also denied a total disability rating based on individual unemployability (TDIU rating) on a schedular basis but recommended granting a permanent and total disability rating for non-service-connected pension purposes on an extra-sehedular basis under
II. ANALYSIS
A. Left Mandible Condition
The appellant’s claim for an increased rating for the service-connected left mandible condition is a new claim, and the Court reviews the Board’s findings of fact under a “clearly erroneous” standard of review.
In its May 1992 decision, the Board evaluated the appellant’s left mandible condition under
A September 1989 VA radiologic report stated:
Examination of the left side of the mandible fails to reveal any evidence of fracture or other significant osseous abnormality. Examination of the [temporomandibular joint] shows that there is no motion on the right side and somewhat limited motion on the left side. The condyles and fossa appear grossly normal.
R. at 314. In addition, a September 1989 VA examination report stated: “The tempero-mandibular [sic] joints seem to move smoothly with no palpable dislocation.” R. at 316. The VA examination report noted the appellant’s complaints of pain. R. at 315 (“[The appellant] states that he can not [sic] eat or sleep secondary to pain and he can only chew on the right side of his mouth.”). The report also concluded with an impression of “[c]hronic left facial and jaw pain with tinnitus secondary to fracture of jaw.” R. at 316. Consequently, the BVA found that the appellant’s condition did not warrant an evaluation greater than 10% on a schedular basis. Floyd, BVA 92-12610, at 6, 8.
The September 1989 VA examination report is, however, inadequate, and this inadequacy frustrates judicial review. See Ardison v. Brown,
Under
VET[ERAN]: It is a constant pain. It is not dull, it hurts. It is frustrating, it is unbearable.
REPfRESENTATIVE]: Okay and you don’t take any medication because medication [doesn’t] help[;] you drink alcoholic beverages and do exercises up to the time you get exhausted.
VET: Right.
REP: Now, what about any kind of food you eat, what kind of influence does your condition hаve on your eating habits?
VET: Well I can’t chew. I’m like on soft foods, soup, mashed potatoes, grits, anything that I don’t have to chew.
R. at 335. As this passage reflects, the pain appears to have affected the appellant’s masticatory function, which is a consideration under DC 9904. Nevertheless, despite the history of pain and loss of masticatory function, the September 1989 VA examination did not discuss whether that pain had indeed resulted in ratable functional loss. In its May 1992 decision, the Board cited
The appellant also argues that the Board failed to seek to obtain certain x-rays. Appellant’s Brief (Br.) at 8. In its May 1992 decision, the Board stated: “Based on the description by the appellant at his [July 1990] hearing, we conclude that the February and April 1986 reports [received pursuant to a request by the Board] are the records he has been adamant that the VA seek.” Floyd, BVA 92-12610, at 5. As the appellant concedes, “The VA did in fact get the records requested by Appellant but did not obtain[ ] the x-rays themselves and thus, they were never put into Appellant’s claims file.” Appellant’s Br. at 8. The appellant does not argue that the x-ray reports are inconsistent with the x-rays or that the reports are insufficient when viewed without the x-rays. Indeed, the Board appears to have exhausted all possible efforts in seeking to obtain all relevant, specified records. See R. at 365. Therefore, the Court holds that the BVA’s efforts to obtain the requested information fulfilled its duty to assist and provided an adequate statement of reasons or bases for its conclusion that it has done so. See Hayes v. Brown,
2. Extra-schedular Consideration
This ease also presents an interesting issue involving extra-schedular consideration of the appellant’s left mandible condition. In its May 1992 decision, the Board sua sponte considered whether the appellant was entitled to an extra-schedular rating pursuant to
Under
an extra-schedular evaluation commensurate with the average earning capacity impairment due exclusively to the service-connected disability or disabilities. The governing norm in these exceptional cases is: A finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular sehedular standards.
(In 1992, VA’s Chief Benefits Director was redesignated as the Under Secretary for Benefits. Veterans’ Medical Programs Amendments of 1992, Pub.L. No. 102-405, § 302(b), 106 Stat.1972 (1992). The regulation, however, does not reflect this change.) As the regulation indicates, in certain individual instances, the rating schedule will be inadequate; extra-schedular consideration permits VA to rate veterans who do not meet the criteria precisely.
In its May 1992 decision, the Board granted an additional 10% rating on an extra-schedular basis because the appellant had demonstrated that the pain attendant to his condition had markedly interfered with employment. In support of this evaluation, the Board stated:
We find that the evidence satisfies a reasonable construction of marked interference with employment. We find that the demonstrated interference with employment is sufficient to warrant an additional 10 percent evaluation on an extra-schedu-lar basis. We distinguish that basis for the award from a finding of 20 percent disability under a[DC] because the physical disability does not genuinely approximate the criteria for 20 percent evaluation under [DC] 9904, nor is it better analogized with a higher evaluation under [DC] 9905.
Floyd, BVA 92-12610, at 6.
The regulation involved,
Under
Except as otherwise provided by law, the Secretary may assign functions and duties, and delegate, or authorize successive re-delegation of, authority to act and to render decisions, with respect to all laws administered by the Department, to such officers and employees as the Secretary*95 may find necessary. Within the limitations of such delegations, redelegations, or assignments, all official acts and decisions of such officers and employees shall have the same force and effect as though performed or rendered by the Secretary.
One such delegation of authority is found in title 38 of the Code of Federal Regulations, part 3, subpart A, which deals with VA adjudication of pension, compensation, and dependency and indemnity compensation claims. Under
Authority is delegated to the Chief Benefits Director and to supervisory or adjudicative personnel within the jurisdiction of the Veterans Benefits Administration designated by the Director to make findings and decisions under the applicable laws, regulations, precedents, and instructions, as to entitlement of claimants to benefits under all laws administered by the Dеpartment of Veterans Affairs governing the payment of monetary benefits to veterans and their dependents, within the jurisdiction of Compensation and Pension Service.
Another such delegation of authority is found at
Thus, as the delegations of authority found at
This holding is further supported by the statute delineating the jurisdiction of the Board. Under
All questions in a matter which under section [511(a) ] of this title is subject to decision by the Secretary shall be subject to one review on appeal to the Secretary. Final decisions on such appeals shall be made by the Board. The Board shall decide any such apрeal only after affording the claimant an opportunity for a hearing. Decisions of the Board shall be based on the entire record in the proceeding and upon consideration of all evidence and material of record and applicable provisions of law and regulation.
(Emphasis added.) In this case, the applicable laws and regulations provide only for assignment in the first instance of an extra-schedular rating by the individuals specified in
Unlike the determination involving an increased disability rating on a schedular basis, the determination involving an increased disability rating on an extra-sehedular basis is subject to the procedural requirements laid out in
When, during the course of review, it is determined that further evidence or clarification of the evidence or correction of a procedural defect is essential for a proper appellate decision, a Section of the Board shall remand the case to the agency of original jurisdiction, specifying the action to be taken.
(Emphasis added.)
The procedural requirements of
Our dissenting colleague states that the Board has the authority to assign an extra-schedular rating in the first instance. He relies, in part, on the principle of expressio unius est exclusio alterius (“the expression of one thing implies the exclusion of others”). See Smith v. Brown,
Moreover, it is precisely because the Board is also bound by the regulations under part 3 that the Board must follow the procedures imposed on the rest of VA under
Contrary to our colleague’s dissent, our analysis is not inconsistent with Court precedent. Neither Bernard v. Brown, 4 Vet.App. 384 (1993), nor West v. Brown,
It is clear that the procedures followed by the Board in this case contravened the Secretary’s own regulations. It is equally clear that the Board’s action here resulted in the granting of an extra-schedular rating and thus did not result in prejudice to the veteran. Taking “due account of the rule of prejudicial error,”
In the instant case, the Board also erred when it considered the applicability of
If the Board does proceed in compliance with the correct regulatory procedures and
The Board’s failure to clearly articulate reasons or bases is not altogether unexpected, given the lack of concrete standards for assigning ratings on an extra-sehedular basis. ' As written,
B. Resubmitted Claims
In its May 1992 decision, the Board also refused to reоpen claims for service connection for bilateral hearing loss and tinnitus.
The appellant’s claims were previously denied by a final BVA decision in August 1988. R. at 293. Pursuant to
In connection with the resubmitted claims, the appellant testified at a July 1990 personal hearing. R. at 338-39. At this hearing, he discussed his hearing loss and tinnitus. His testimony is cumulative of statements submitted in connection with the August 1988 BVA decision and is thus not new with regard to either the hearing loss or the tinnitus claim. As there is no other new and material evidence regarding the resubmitted hearing loss claim, the Court will affirm the Board’s decision not to reopen that claim.
The VA examination report contains no report of any hearing, otology, or audiology examination or testing. The examiner’s impression of secondary tinnitus was apparently based on the appellant’s history. As such, it lacks the probity necessary to make it material evidence, especially when viewed in the context of the previously considered evidence that contradicts the examiner’s clinical impression.
Floyd, BVA 92-12610, at 8.
Insofar as the Board focused on the lack of a specialized examination in support of the VA physician’s opinion, the Board was, in effect, erroneously attacking the credibility of the evidence in violation of this Court’s rule that the credibility of evidence is to be presumed for purposes of determining whether to reopen a claim. Justus v. Principi,
However, the Board also indicated that the physician’s impression was “apparently” based on the appellant’s history. Floyd, BVA 92-12610, at 8. In Reonal v. Brown,
III. CONCLUSION
Accordingly, upon consideration of the record, appellant’s brief, and the Secretary’s brief, we AFFIRM in part and VACATE in part the May 1992 decision of the BVA and REMAND the matter for readjudication consistent with this opinion.
Concurrence in Part
concurring in part and dissenting in part:
I basically agree with the Court’s opinion, except for portions of part II.A.2, regarding the extra-sehedular rating. Specifically, I disagree with the majority’s conclusion that the Board of Veterans’ Appeals (BVA or Board) lacked authority to award an extra-schedular rating in the first instance but rather was required to refer that matter to
A. Regulatory Interpretation
It is essential to consider the full text of the regulatory provision in question,
(b) Exceptional cases — (1) Compensation. Ratings shall be based as far as practicable, upon the average impairments of earning capacity with the additional proviso that the Secretary shall from time to time readjust this schedule of ratings in accordance with experience. To accord justice, therefore, to the exceptional case where the schedular evaluations are found to be inadequate, the Chief Benefits Director or the Director, Compensation and Pension Service, upon field station submission, is authorized to approve on the basis of the criteria set forth in this paragraph an extra-schedular evaluation commensurate with the average earning capacity impairment due exclusively to the service-connected disability or disabilities. The govеrning norm in these exceptional cases is: A finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards.
At the outset, I acknowledge that the regulation is not totally clear insofar as the Board’s authority to award an extra-schedu-lar rating in the first instance. However, there is no doubt that all the adjudication regulations in part 3 of title 38 of the Code of Federal Regulations generally apply to the BVA in its adjudication of cases, even where a particular regulation does not specifically refer to the Board. See Douglas v. Derwinski,
The regulation in question is broadly titled “Exceptional cases”,
I can find no reason for concluding that the Board is not authorized to apply the first and third sentences of the regulation to provide, in the first instance, an extra-schedular rating where the criteria for such a rating are satisfied. Indeed, subject to the holding in Bernard v. Brown, discussed in note 9, infra, I believe that the Board is bound to do so when those circumstances are present. The regulatory scheme, as well as the statutory scheme addressed in part B, infra, does not support the majority’s conclusion that the Secretary has, by inference, limited the plenary adjudicative authority of the Board. Echoing the Board’s statutory grant of authority in
The Secretary has made broad delegations of authority both to the Board Chairman (and Vice Chairman) “in addition to authority vested by law ... regulations and manuals”, to authorize “assumption of appellate jurisdiction of adjudicative determination which has not become final” as well as to the CBD and supervisory or adjudicative personnel within VA’s Veterans Benefits Administration to make “findings and decisions under applicable laws, regulations, precedents, and instructions, as to entitlement of claimants to benefits under all [VA-administered] laws”.
In view of the Board’s separate jurisdictional statutory base, I believe that any limitations on the BVA’s jurisdiction sought to be imposed by the Secretary by regulation would need to be express or at least clearly indicated and certainly should not be found by implication. Cf.
As a matter of regulatory interpretation, binding precedent of the U.S. Court of Appeals for the Federal Circuit contradicts the majority’s conclusion (ante at 96) that the Secretary’s regulatory silence on whether the BVA must, as clearly AOJs must, refer the extra-schedular question to the VACO should be construed as imposing a limit on the BVA’s authority. First, the Federal Circuit has expressly concluded that the same canons of construction that apply to statutes apply to regulations. See Smith (William) v. Brown,
Additionally, the Federal Circuit’s opinion in Gardner v. Brown rejecting the Secretary’s position therein did so in part on the ground that Congress had not expressly required the veteran to prove VA fault and had shown that it knew well “how to legislate expressly liability for fault and negligence.” Gardner,
B. Statutory Interpretation
The majority suggests that its holding as to the meaning of
That brings us to the holding in Bernard v. Brown not discussed by the majority (except in response to the ensuing discussion).
Applying this holding from Bernard to the present facts, the Court should now hold that the question of an extra-schedular rating is a component of the veteran’s claim for an increased rating and thus is part of the same “matter” over which the Board has jurisdic
C. Advisory Opinion and Premature Adjudication
Finally, the Court reaches out to rule on whether the Board has authority to decide, in the first instance, the extra-schedular-rating question when resolution of that issue is not necessary to the disposition of this appeal. It is unnecessary because the majority is upholding the Board’s award of a 10% extra-schedular rating and because the Board’s error in failing to apply Bernard warrants a remand and moots the question because we do not know whether the Board would proceed to award the extra-schedular rating itself without referral to the AO J if it were first to comply with Bernard.
Although the Court declares that it “hold[sj” that the Board is precluded from awarding an extra-sehedular rating in the first instance, ante at 94, no amount of saying so makes it so; rather, the Court has digressed into an area of analysis that is pure dictum — an advisory opinion — on the question of the Board’s authority. A holding as to the Board’s lack of authority would compel the Court to direct the Secretary to withdraw the 10% rating that it awarded. Instead, the Court has concluded that becаuse the veteran was not prejudiced by the award, it must affirm the Board’s decision granting the extra-schedular rating. Ante at 97. The majority fails to explain (1) how it can proceed to affirm the Board’s award after it has concluded that the Board erred in not abiding by the Bernard requirements to ensure due process; (2) how an award of a 10% extra-schedular rating cures any prejudice caused by the Board’s failure to apply Bernard and consequent failure to afford the appellant the opportunity to submit to the AOJ evidence or argument on the extra-schedular-rating issue; and (3) its authority for allowing to stand the Board’s award of a 10% rating (that is, by not declaring the award to be invalid), given the majority’s conclusion that the Board had no authority to award such a rating and that such action was in contravention of the Secretary’s own regulations.
In view of the appellant’s having argued to the Court, in his December 12, 1994, memorandum, that the Board has no authority to make initial extra-schedular-rating determinations not previоusly addressed by the AOJ and that, in any event, the appellant should be given the opportunity to build a record before the AOJ on the extra-schedular-rating question before that question is decided in the first instance, it seems quite likely that if this matter were to be remanded for the Board to apply Bernard to this case, the Board would decide to allow the veteran to build such a record and present the case first to the AOJ. Such action by the Board would moot the question that the Court has extended itself to decide unnecessarily at this time — that is, whether the Board had authority to award the rating in the first instance. Hence, the Court should face this issue only if action by the Board on remand would require it to face that issue.
Finally, having affirmed the Board’s grant of an extra-schedular rating in this case, the majority then goes on to state: “If the Board does proceed in compliance with the correct regulatory procedures and the appellant then continues to appeal the extra-schedular rating aspect of this claim, the Board will be required to articulate its findings of faсt and sufficient reasons or bases thereupon on the extra-schedular consideration issue.” Ante at 96-97. Given the majority’s affirmance of the rating, it is unclear how the Board is to “proceed in compliance” with any regulation or how the appellant can “eontinue[ ] to appeal” the.rating. The majority has not remanded the extra-schedular-rating issue under Bernard, as it should do, and so there is no basis on which the Board can proceed unless it decides sua sponte to reconsider the increased-rating claim after issuance of the Court’s mandate. The Court’s affirmance of the Board’s 10% rating otherwise brings this particular rating-increase claim to a close.
For the foregoing reasons, I respectfully dissent to the extent I have indicated above.
Notes
. In this case, no explicit Notice of Disagreement (NOD) was filed as to the question of an extras-chedular rating, and that question was not addressed by the Department of Veterans Affairs (VA) regional office (RO) in its December 1989 decision. See Veterans' Judicial Review Act, Pub.L. No. 100-687, 102 Stat. 4105, 4122, § 402 (found at
. See Fisher v. Brown,
. See Fisher,
. See Malgapo v. Derwinski,
. See infra note 11.
. The majority’s circular analysis extends to citation of another, regulation,
. See Johnson (Gary) v. Brown,
. See, e.g., Douglas v. Derwinski,
. I agree with the majority that the other holding of Bernard, (that a claimant be given adequate notice of the need to submit evidence or argument on a question so as to ensure that his or her rights to "full and fair assistance and adjudication in the VA claims adjudication process” are protected) requires the Board to consider the procedural requirements and possible prejudice to the clаimant of deciding the issue based on the evidence before the Board and that the Board erred in not considering such prejudice here before it awarded the 10% extra-schedular rating, Bernard v. Brown,
.This language, drawn from
. Given the Board's broad statutory jurisdiction to decide all matters in a claim appealed to it from an adverse decision by a VA field station, it might even be questioned whether the Secretary would have the authority, absent Bernard-type prejudice to the claimant (see supra note 9), to preclude the BVA from awarding an extra-sche-dular rating in the exercise of its jurisdiction over a case appealed to it under