Mitchell E. Sims v. R. James NicholsonMitchell E. Sims v. R. James Nicholson
Case Information
*1 Before GREENE, Chief Judge , and LANCE and SCHOELEN, Judges .
GREENE, Chief Judge
: The appellant, Mitchell E. Sims, appeals a January 15, 2004,
decision of the Board of Veterans' Appeals (Board) that determined that he was not competent to
receive direct payment of his VA compensation benefits. Record (R.) at 1-20. This appeal is timely,
and the Court has jurisdiction under
I. BACKGROUND
Mr. Sims served honorably in the U.S. Navy from July 1983 to May 1987. R. at 22. In June 1990, a VA regional office (RO) awarded Mr. Sims VA service connection for an acquired psychiatric disorder. R. at 25-26. In February 1995, he was awarded service connection for schizophrenia, assigned a 100% disability rating, and advised that the RO proposed that a determination be made regarding his competency to manage his financial affairs. R. at 62-64. The *2 RO sent Mr. Sims a letter notifying him of the consequences of an incompetency finding and of his rights to contest the proposal. R. at 66-67. In April 1995, the RO determined that Mr. Sims was not competent to receive direct payment of his VA benefits and he did not appeal. R. at 68-69.
In October 2000, Mr. Sims requested that VA reconsider his competency status (R. at 81-82), and in January 2001, the RO determined that he remained incompetent for VA purposes (R. at 85- 89). The RO explained in its decision that Mr. Sims's wife, who was serving as his fiduciary, had been contacted to provide evidence to support his claim for restoration of competency and she had not responded. R. at 86.
In July 2001, Mr. Sims again requested that VA reconsider its competency determination.
R. at 109. Relying on an August 2001 VA examiner's report (R. at 100-03), the RO found that Mr.
Sims was still not competent to handle direct disbursement of his VA benefits (R. at 109-13). Mr.
Sims appealed that decision. In January 2004, the Board found that under
The only such evidence offered in support of [Mr. Sims's] claim was included in the December 2000 examination report conducted by Dr. J[eppson] for the purposes of continuation of Social Security Administration benefits. This medical provider did not, however, have a review of [Mr. Sims's] claims file in making this assessment. Moreover, this assessment represents the singular definitive opinion in the record of [Mr. Sims's] competency since he filed his claim in July 2001.
. . . .
[A] December 2000 VA [mental health clinic] record indicates that the medical provider refused to recommend that [Mr. Sims's] payee status be changed. Further, when he was examined by VA in August 2001, the VA physician . . . concluded that [Mr. Sims] had a fiduciary in place and was still not competent for VA purposes. . . . Moreover, the private physician that VA specifically called upon in January 2002 for evaluation of [Mr. Sims's] competency found [Mr. Sims] to not be competent to [handle] his monies and affairs. . . . Further, the findings of [] well-documented April 2001 and May and December 2002 VA field examination reports contained in the records . . . clearly support the conclusions reached by both the August 2001 and January 2002 VA examiners, that [Mr. Sims] is incompetent for VA purposes by virtue of the service-connected paranoid schizophrenia.
In summary, due to the relatively high probative value of the January 2002 VA
examination report and, due to the fact that the conclusion reached therein was
supported by the unilateral assessments of [Mr. Sims's] incompetency made by
*3
another VA physician in the well[-]detailed August 2001 report, the extensive field
examination, and the fact that the assessment of capability made in approximately
2000, has not been replicated in the record, the Board finds that the preponderance
of the evidence is against a finding that [Mr. Sims] is competent. . . . As the evidence
is not in equipoise, consideration of the benefit of the doubt rule under
R. at 16-18. Mr. Sims appealed to the Court and argues that remand is required because (1) the
Board failed to ensure compliance with the notice provisions of the Veterans Claims Assistance Act
of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096, codified in part at
II. LAW AND ANALYSIS A. VCAA
Mr. Sims contends that remand is required because the Board did not comply with the notice provisions of the VCAA. Appellant's Br. at 7-9. The Secretary counters that the VCAA is not applicable to this case. Secretary's Br. at 20. He asserts that the term "claimant" as used in the VCAA applies only to claims for benefits under chapter 51 of title 38 of the U.S. Code ("Claims, Effective Dates, and Payments"), and that Mr. Sims is not seeking benefits, but rather has already received a benefit and is instead requesting reconsideration as to how those benefits will be distributed in accordance with chapter 55 ("Minors, Incompetents, and other Wards"). Id.
We have addressed similar arguments and carved out exceptions where the provisions of the
VCAA are not applicable. In
Barger v. Principi
, we held that the requirement to provide VCAA
notice was not applicable to claims for waiver of overpayment under title 38, U.S. Code, chapter 53
("Special Provisions Relating to Benefits").
Barger
,
The reasoning in
Barger
,
Lueras
, and
Livesay
applies in this case. An applicant for
restoration of competency is not seeking benefits under chapter 51, but, rather, is seeking a decision
regarding how his benefits will be distributed under chapter 55.
Compare
B. VSO Involvement
Mr. Sims argues that
In a recent decision ( Coleman [ supra ]) the United States Court of Veterans Appeals interpreted§ 3.353(b) as requiring VSO participation prior to determination of the issue of incompetency. Although the VSO was meant to play an integral role in developing evidence relating to the veteran's ability to handle his or her affairs, the intent of the regulation was to give rating boards the sole responsibility for incompetency determinations without the VSO participating in the decision. Although it was intended that evidence produced by the VSO could lead to later reconsideration of the incompetency determination, it was not intended that the VSO's concurrence be a condition precedent to rating a beneficiary incompetent. The VSO's investigation was meant merely to provide an additional safeguard which could lead to later review.
The proposed amendment provides that the rating board has the sole authority to determine the competency of beneficiaries, but that if the VSO develops new information bearing on the issue of the beneficiary's incompetency, the rating board will consider that evidence together with all other evidence of record to determine if the prior determination of incompetency should remain in effect.
60 Fed. Reg. 22,016 (May 4, 1995);
compare
Moreover, Mr. Sims's argument that VA erred under
Coleman
in the adjudication of his claim
for competency because there was not adequate involvement of a VSCM is not supported by the
evidence. The record on appeal reveals that a VSCM, K.J. Swinson, developed information pursuant
to Mr. Sims's claim for competency. Specifically, the VSCM advised Mr. Sims (1) in a letter dated
December 2002 that a field examination to assess Mr. Sims's condition had been scheduled and was
going to be conducted (R. at 358); (2) that a VA medical examination needed to be scheduled and
the VA medical facility would be contacting him about setting up that appointment (R. at 308-09);
(3) that he had missed scheduled examinations in June 2003 and that he needed to reschedule those
with the nearest VA medical center and to contact him with any questions (R. at 314-15); and (4) that
his appeal was received and was being processed and that he must submit additional evidence for
consideration in his appeal to the Board (R. at 327). Under
C. Presumption of Competency
"A mentally incompetent person is one who because of injury or disease lacks the mental
capacity to contract or to manage his or her own affairs, including disbursement of funds without
limitation."
The Board's incompetency determination is one that is reviewed under the "clearly erroneous"
standard of review.
Sanders v. Brown
,
In reaching its decision, the Board considered (1) the August 2001 medical examiner's report stating that Mr. Sims remained incompetent for VA purposes (R. at 100-03); (2) September and October 2001 field examination reports that both stated that Mr. Sims lacked the mental capacity to independently handle his income (R. at 248-51); (3) a January 2002 private psychiatric examination report that recorded that Mr. Sims was not competent to manage his own funds (R. at 135-37); (4) May and December 2002 VA field examiners' recommendations for a continuation of VA's incompetency finding based upon Mr. Sims's schizophrenia and lack of mental capacity to independently manage his income (R. at 240-44, 303-06); and (5) an August 2003 RO memorandum that indicated that Mr. Sims was assigned to a secure facility of a VA medical center psychiatric unit (R. at 339). The Board also considered and discussed the only favorable evidence in support of Mr. Sims's claim–a December 2000 medical examination conducted by Dr. Jeppson, a private physician, who stated that Mr. Sims "does appear capable of handling his own financial benefits" (R. at 260- 63). See R. at 16.
"'It is not error for the [Board] to favor the opinion of one competent medical expert over that
of another when the Board gives an adequate statement of reasons [or] bases.'"
Boggs v. West
Further, to the extent that Mr. Sims is arguing that the Board erred by not adequately
discussing the presumption of competency, when there is no reasonable doubt as to the competency
of a claimant there is no obligation on the Board to fully discuss the presumption under
III. CONCLUSION
Based upon the foregoing analysis and the record on appeal, the Board's January 15, 2004, decision is AFFIRMED.