Mack A. McCORMICK, Appellant, v. Hershel W. GOBER, Acting Secretary of Veterans Affairs, Appellee.
No. 98-48
United States Court of Appeals for Veterans Claims.
Decided Aug. 18, 2000.
Argued July 11, 2000.
14 Vet. App. 39
Finally, I note the Board‘s erroneous citation of the Court‘s opinion in Williams v. Gober, 10 Vet.App. 447 (1997), in support of its conclusion that “an effective date should not be set prior to the creation of competent evidence establishing the existence of the particular disease or injury“. R. at 11. In that case, the Court affirmed as not clearly erroneous a BVA determination that the date of a medical record of the veteran‘s first admission to a hospital, which the Board found had served as an informal claim for service connection for that disability, was the appropriate effective date for a subsequent award of service connection based on that informal claim. Williams, 10 Vet. App. at 452. There, the Board found, as a matter of fact, that the date of the veteran‘s hospitalization was the first point in time at which it could ascertain, based on the medical evidence of record, that the veteran actually had the disability at issue in that case. Because the medical evidence at issue in Williams, supra was not retrospective and no medical evidence suggested an earlier manifestation of that disability, Williams, supra does not provide support for the legal conclusion for which it was cited by the Board.
III. Conclusion
For the foregoing reasons, the BVA decision should be vacated both on the matter of the proper effective date for the award of service connection based on the veteran‘s PTSD claim as well as on the matter of the proper rating for that service-connected disability and both matters remanded for readjudication consistent with Fenderson, supra.
Peter J. Meadows, of Winter Park, FL, for Appellant.
Monique Allen, with whom Leigh A. Bradley, General Counsel; Ron Garvin, Assistant General Counsel; and Joan E. Moriarity, Deputy Assistant General, Washington, DC, were on the brief, for Appellee.
Before KRAMER, IVERS, and STEINBERG, Judges.
STEINBERG, Judge:
I. Background
The veteran had active service in the U.S. Army from October 1953 to October 1955, including service in Korea. R. at 9. The record on appeal (ROA) contains February 1955 service medical records (SMRs) that described treatment for a right-wrist fracture. R. at 13-15. His separation examination medical record described his eyes as “normal” and indicated that his uncorrected vision was “20/20“. R. at 11. No other SMRs are contained in the ROA, and there is no record of subsequent National Guard service, although it seems clear that the veteran had such service. See, e.g., R. at 56 (statements from persons who served with veteran in “United States National Guard” in 1956); R. at 67 (affidavit from veteran‘s “unit commander while he was a member of the Florida National Guard“).
In April 1978, the VA regional office (RO) in St. Petersburg, Florida, apparently sent to the National Personnel Records Center (NPRC) a “Request for Information“. R. at 19. The NPRC‘s response indicated that in 1978 there were “[n]o medical records on file at NPRC” (ibid.)
In February 1995, the veteran submitted to the RO a claim based on an asserted “loss of vision as a result of having pink eye while stationed at Fort Benning[, Georgia.]” R. at 21. In April 1995, the RO sent to the veteran a letter stating: “Because of the long period of time that has elapsed since your discharge from military service, your [SMRs] may be difficult if not impossible to obtain.” R. at 42. The RO requested that the veteran provide evidence of any or each of the following: “[T]reatment in service” for his claimed condition; details regarding the “full organizational designation ... to which [he was] assigned at the time that the” claimed condition was “incurred or aggravated“; copies of any SMRs in his possession; “[s]tatements from persons with whom” he had served or from family members; and medical records “to demonstrate ... continuity of treatment” since service. Ibid. The RO did not advise the veteran that his SMRs had been destroyed by fire. See R. at 42-43. In June 1995, the RO obtained a release from the veteran and sought copies of any medical records in the possession of the Fort Benning Army Hospital (R. at 49), which responded that “[t]he requested medical records ha[d] been retired to [the NPRC]” (R. at 50). The Secretary conceded at oral argument that the RO did not thereafter “follow up” by contacting the NPRC for those or any other records located there. See also R. at 5 (BVA decision noting that “[a]lthough the [NPRC] reported in 1978 that the veteran‘s [SMRs] had been involved in the fire at that facility, the veteran‘s claims folder includes a copy of his examination for release from active duty in 1955“).
In August 1995, the RO determined for the following reason that the veteran‘s claim was not well grounded: “[SMRs] are completely silent for complaints, treatment[,] or diagnosis of any pink eye.” R. at 23. (The Court assumes that the SMRs referred to by the RO were the February 1955 SMRs (R. at 13-15) and the SMR of his separation medical examination (R. at 11) contained in the ROA, notwithstanding that the RO decision listed as the evidence before it “[SMRs] for the period 10-25-53 to 10-05-55” (R. at 23), because no other SMRs appear in the ROA, because the BVA did not address any other SMRs, and because the parties have not suggested that any other SMRs are of record to date.) Later that month, the veteran submitted additional recent medical evidence in the form of March and April 1993 VA medical records that diagnosed presbyopia of the left eye, early cataracts, and a remote cornea scar of the right eye. R. at 28-32. In October 1995, the RO issued a second decision denying his claim as not well grounded (R. at 38-39) and, later that month, the veteran submitted a statement in which he asserted that “pink eye developed in NCOS leadership school” at Fort Benning and that he had “had to wear glasses since that time“. R. at 53. He also stated: “Aggravation of that condition was caused by night-driving and welding, cutting[,] and torching at the shop/Ft. Benning, GA. (1953, 1954, 1955 time frame)“. Ibid.
In November 1995, he submitted a statement signed by three people who averred that they had served with him “in the United States National Guard during the year 1956” and that he “wore prescription glasses during [that] time period“. R. at 56. Later that month, Dr. Hazouri, a private opthamologist, submitted a statement that he had examined the veteran in August 1993 and had found that his “[c]orrectable vision was 20/20 on the right and 20/25 on the left“, that “[o]cular tensions were normal“, and that “[c]ataracts were present“. R. at 59. Attached thereto were copies of Dr. Hazouri‘s medical records showing treatment in March 1982, May 1989, August 1993, and October 1995. R. at 61-62. Also in November 1995, the
In April 1996, the veteran testified under oath before the RO that he had had pinkeye in service. R. at 74-75. He stated that he had been told to wear dark glasses and had “been wearing dark glasses ever since then“. R. at 75. He also stated that “ever since” he was in the service he had had pinkeye. R. at 76. At the hearing, the veteran submitted private medical records dated in April 1996 that diagnosed mild cataracts of both eyes. R. at 86-87. In his Substantive Appeal to the BVA, the veteran “noted” that his “complete [SMRs] are unavailable for review as they were assumed to have been destroyed by the fire at the [NPRC] in 1973.” R. at 94. In the December 16, 1997, BVA decision here on appeal, the Board denied as not well grounded the veteran‘s claim for service connection for loss of vision due to pinkeye. R. at 2.
At oral argument on July 11, 2000, the Secretary agreed to submit a supplemental memorandum regarding (1) the status of a proposed amendment to
II. Analysis
“[A] person who submits a claim for benefits under a law administered by the Secretary shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded.”
In this case, the Board denied the veteran‘s claim as not well grounded and, in so doing, did not require that the RO request copies of the veteran‘s SMRs from the NPRC. The Board concluded “that the veteran has not presented a well-grounded or plausible claim with respect to service connection for defective vision.” R. at 5. The Board also stated: “As a consequence [of the veteran‘s not having submitted a well-grounded claim], no duty to assist the veteran [was] triggered under
A. Manual M21-1 Arguments
The appellant‘s primary contention is based on what he asserts is VA‘s failure to
Recently, in Maggitt v. West, 202 F.3d 1370, 1377 (Fed.Cir. 2000), the U.S. Court of Appeals for the Federal Circuit (Federal Circuit) held that this Court “may hear legal arguments raised for the first time with regard to a claim that is properly before the court, [but] it is not compelled to do so in every instance.” Maggitt, 202 F.3d at 1377. The Federal Circuit explained:
[W]hether to invoke the exhaustion of administrative remedies doctrine against a party—with the effect that the party‘s arguments go unheard—is case-specific. [McCarthy v. Madigan, 503 U.S. 140, 146, 112 S.Ct. 1081, 117 L.Ed.2d 291 (1992)]. The test is whether the interests of the individual weigh heavily against the institutional interests the doctrine exists to serve. See id. Those institutional interests are, in the main, to protect agency administrative authority and to promote judicial efficiency. See id. at 145, 112 S.Ct. 1081.... If an agency self-corrects and amends its ways ... judicial resources are conserved. See id. And even if the agency rejects the individual‘s arguments, in some instances a better record is made ... for appellate review of the agency decision. See id. at 145-46, 112 S.Ct. 1081.
Maggitt, 202 F.3d at 1370. The Federal Circuit left for this Court to resolve whether, as a rule, to remand, address, or refuse to hear arguments first raised to this Court, reasoning “th[at this] Court is uniquely positioned to balance and decide the considerations regarding exhaustion in a particular case, and that, over time, it will develop of [sic] body of law in its unique setting that will permit [a] comparable certainty in outcome [to that] that has occurred in other fields of law.” Id. at 1378. Today, we take the first step toward creating that “body of law“. Ibid.
In this case, the appellant did in fact raise argument to the BVA based on the Manual M21-1; however, he did not raise to the BVA the fire-related-case provisions of the Manual M21-1 that he now raises to this Court. Compare R. at 6 (BVA decision regarding Manual M21-1 provisions raised to it) with Appellant‘s Additional Brief at 7-8 (raising argument regarding fire-related-case provisions) and Appellant‘s Response to June 28, 2000, Court Order (providing copies of fire-related-case provisions). Review of the appellant‘s arguments based on the fire-related-case provisions requires inquiry as to at least the following four questions:
- Were the Manual M21-1 fire-related-case provisions in effect at any time during the course of the adjudication of this case? Cf. Fugere v. Derwinski, 1 Vet.App. 103, 109 (1990) (without adherence to
Administrative Procedure Act notice-and-comment process and specific notice to public of intent to revoke Manual M21-1 provision protecting benefit entitlement, Secretary cannot revoke that provision). - If so, were those provisions authorized by
38 U.S.C. § 5107(a) or any other lawful authority (such as section5103(a) )? - If the fire-related-case provisions were authorized by law, were those provisions applicable to this case?
If so, were those provisions complied with in this case?
The Court believes that BVA determinations on these four questions would be helpful to the Court‘s review of this matter and, further, that the first and third of these questions are peculiarly within the competence of VA to address. Hence, we will vacate the BVA decision and remand this matter for consideration by the BVA of the appellant‘s arguments based on the fire-related-cases provisions and of, inter alia, the above four questions. A remand will likely benefit the Court by producing “a better record ... for appellate review of the agency decision” and, further, may result in the “agency self-correct[ing] and amend[ing] its ways“, which, in turn, would “protect agency administrative authority” regarding the interpretation of its own issuances as well as “promote judicial efficiency“. Maggitt, supra. The Court notes, however, that if the veteran‘s claim is found to be well grounded based on immediate development as a result of the remand that will be ordered pursuant to part II.B. of this opinion, then the question of the applicability of the fire-related-case provisions, at least at the well-groundedness stage, would become moot.
B. VBA Letter 20-99-60
In addition, the parties have addressed at length an August 30, 1999, issuance of the VA Veterans Benefits Administration, captioned “VBA Letter 20-99-60” and signed by the Under Secretary for Benefits, regarding “[c]laims [t]hat [a]re [n]ot [w]ell-[g]rounded“. August 30, 1999, VBA Letter 20-99-60 [hereinafter generally referred to as VBA Letter]. That letter was written in response to the Court‘s opinion in Morton v. West, 12 Vet. App. 477 (1999), en banc review denied, 13 Vet.App. 205 (1999), appeal docketed, No. 99-7191 (Fed. Cir. Sept. 15, 1999). It states under “New Policy” as follows:
Determine Well-Groundedness & Claimant Notification: Effective immediately, each [RO] must determine if a claim is well[ ]grounded prior to beginning development of evidence. There may be multiple issues in each application for compensation. Each individual issue must be reviewed to determine if it is well[ ]grounded. If any particular issue is not well[ ]grounded, the [RO] must send the claimant a letter describing the evidence needed to establish a well-grounded claim. Draft sample letters are enclosed for your review and comments.
Immediate Development: [SMRs] and VA medical center records are to be requested in all cases. These records are considered to be in VA custody. Private medical records or records from other Federal or State agencies are not in VA custody and will not be requested prior to a determination that the claim is well[ ]grounded.
VBA Letter, at 1. In other words, the VBA Letter provides that, although “each [RO] must determine if a claim is well[ ]grounded prior to beginning development of evidence“, VA has undertaken an ”Immediate Development” obligation to request SMRs and records from VA medical centers “in all cases” because “[t]hese records are considered to be in VA custody.” Ibid.
The appellant‘s arguments based on the VBA Letter Immediate Development provisions have not yet been raised to the BVA. However, at oral argument, the Secretary‘s representative asserted that this letter constitutes a VA directive that is binding on its ROs. In addition, we note that the Secretary has proposed a regulation that would require ROs to undertake the actions directed by the VBA Letter Immediate Development provisions. See Well-Grounded Claims,
The Court does not find that there is a need for prior Board review of this matter because, unlike with respect to the fire-related-case provisions, it is clear that the VBA Letter is a current document, that VA intended that the document be binding on its ROs, that the Secretary has taken a position as to the statutory authority for the duties set forth in that document, and that that position is binding on the BVA. See
At the outset, we note that although the Secretary‘s position taken at oral argument that the VBA Letter Immediate Development provisions were intended to have binding effect on the ROs to whom it was directed is persuasive, his position is not dispositive because “[t]he particular label placed upon [an agency issuance] by the [agency] is not necessarily conclusive, for it is the substance of what the [agency] has purported to do and has done which is decisive.” Fugere, 1 Vet. App. at 106 (quoting Columbia Broadcasting System, Inc. v. United States, 316 U.S. 407, 416, 62 S.Ct. 1194, 86 L.Ed. 1563 (1942) (citations omitted)); see also Schuler Indus. v. United States, 109 F.3d 753, 755 (Fed.Cir.1997) (discussing, inter alia, whether “the Secretary [of the Treasury] viewed his statutory authority [to issue regulations] as limited to interpretation” for purposes of determining whether regulation issued by him was substantive in nature).
Whether or not the VBA Letter Immediate Development provisions have the force of law and thus created a duty that is enforceable against the Secretary in this Court depends upon whether the document is properly considered to be a substantive or merely interpretative administrative issuance. In Fugere, supra, the Court held that a Manual M21-1 provision that “did not merely clarify or explain an existing rule or statute” was substantive, for the purpose of being enforceable against the Secretary, because it had “the force of law and narrowly limit[ed] administrative action“, and “prescribe[d] what action must be taken in the initial levels of adjudication“. Fugere, 1 Vet. App. at 107 (internal quotation omitted; citing, inter alia, Guardian Federal Savings & Loan Ass‘n v. FSLIC, 589 F.2d 658, 666-67 (D.C.Cir. 1978)); see also Paralyzed Veterans of America v. West, 138 F.3d 1434, 1435 (Fed.Cir.1998) (“case law has defined ‘substantive rules’ as those that effect a change in existing law or policy or which affect individual rights and obligations“); Guardian Federal, 589 F.2d at 664 (“an interpretative rule is merely a clarification or explanation of an existing statute or rule“). The Court noted that the Manual M21-1 provision at issue in Fugere, supra was “more than a mere procedural guideline” and that “its placement in a procedural manual [did not] disguise its true nature as a substantive rule.” Ibid.
As to the statutory authority for the action ordered by the VBA Letter Immediate Development provisions, at oral argument the Secretary‘s representative stated that that authority lies in
Our analysis here flows logically from the Court‘s holding in Morton, supra; in that respect, the VBA Letter Immediate Development provisions are unlike the Manual M21-1 provisions at issue in Morton, supra. There, the Secretary had issued Manual M21-1 provisions that obviated completely the well-grounded-claim requirement set forth in section
In contrast, the VBA Letter, by virtue of its limited application to SMRs and VA medical records, both of which are “considered to be in VA custody“, VBA Letter at 1, is more akin to the regulation (
Hence, the Court holds that the VBA Letter Immediate Development provisions are substantive in nature and have the force of law so as to require that VA request copies of SMRs and VA medical records prior to making a determination as to whether a claim is well grounded. The appellant is entitled, then, to have his claim adjudicated in accordance with the VBA Letter duty to request SMRs and VA medical records, notwithstanding that that Letter was dated in August 1999, subsequent to the December 1997 BVA decision on appeal. See Karnas v. Derwinski, 1 Vet.App. 308, 313 (1991) (“where the law or regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the version most favorable to the appellant should apply unless Congress provided otherwise or permitted the [Secretary] to do otherwise and the Secretary did so“); see also Dippel, 12 Vet.App. at 473 (“the Court has applied Karnas, supra to process-oriented administrative issuances that are binding on the Board” (citing Bernard v. Brown, 4 Vet.App. 384, 393-94 (1993) (holding that remand required for application of VA Gen. Coun. Prec. Opinion 16-92 (regarding BVA procedures), which was issued before appeal process was completed)). “[T]he Court has repeatedly applied Karnas, supra to changes in the regulation-like provisions in [the Manual M21-1] relating to evidentiary rules and case-processing requirements for claims of service connection for post-traumatic stress disorder“. Dippel, supra (citing, inter alia, Moreau v. Brown, 9 Vet.App. 389, 395 (1996)), and Doran v. Brown, 6 Vet.App. 283, 289 (1994) (applying, pursuant to Karnas, supra, a Manual M21-1 provision that “became effective after the date of appellant‘s appeal to this Court“)).
In this case, there is no evidence to suggest that VA complied with the VBA Letter Immediate Development duty as to the instant claim—and the Secretary‘s representative conceded as much at oral argument. Although the Secretary argues that his effort in April 1978 met that VBA Letter duty in this case, that April 1978 letter to the NPRC was sent in the context of a wholly different claim and thus cannot meet the duty to request SMRs in this case. R. at 19. Moreover, the Secretary‘s representative also conceded at oral argument that the Manual M21-1 fire-related-case provisions reflect an increasing ability at the NPRC to reconstruct information that was contained in records that were destroyed in the 1973 fire. Therefore, a request made today could very possibly yield a result different from that which the inquiry made in April 1978 produced. Hence, the Court will remand this matter for compliance with the VBA Letter 20-99-60 Immediate Development duty to request SMRs and VA medical records and for further adjudication, if necessary, consistent with this opinion. See Doran, supra and Karnas, both supra.
C. Miscellaneous Matter
Finally, the Court notes that the Board, in its adjudication of the instant claim, erred in its continuity-of-symptomatology analysis. In order to avoid repetition of that error on remand, the Court notes the following.
The second and third criteria for a well-grounded claim set forth in Caluza, supra, can also be satisfied under
[L]ay evidence submitted by the veteran ... is probative also to the extent that it suggests a continuity of symptomatology from the veteran‘s military service.
38 C.F.R. § 3.303(b) . However, ... [i]t is not sufficient to show that the veteran reported problems with his vision or even that he wore corrective lenses. In this case, competent medical evidence is needed to identify the reason for the symptoms described.... The veteran must submit competent medical evidence associating his current eye symptomatology with injury or disease during his active service.
R. at 5 (emphasis added). However, Savage, supra and
III. Conclusion
Upon consideration of the foregoing analysis, the ROA, and the submissions of the parties, the Court vacates the December 16, 1997, BVA decision and remands the matter for expeditious further proceedings and issuance of a readjudicated decision supported by an adequate statement of reasons or bases, see
VACATED AND REMANDED.
No. 99-106.
United States Court of Appeals for Veterans Claims.
Decided Aug. 11, 2000.
