Justia Public Benefits Opinion Summaries

Articles Posted in US Court of Appeals for the Federal Circuit
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Euzebio served in the U.S. Navy, 1966-1969, including two tours of duty in Vietnam, where he was exposed to Agent Orange. In 2009, Euzebio began experiencing problems swallowing. In 2011, medical examinations and testing by private physicians indicated that he had benign thyroid nodules. The Veterans Court affirmed the Board of Veterans’ Appeals’ denial of Euzebio’s entitlement to service connection for a thyroid condition due to exposure to Agent Orange. The Board noted that the Agent Orange Act requires that when the Secretary determines that a presumption of service connection based on herbicide exposure is not warranted for certain conditions, he must consider reports of the National Academy of Sciences (NAS), 38 U.S.C. 1116; Euzebio’s thyroid disorder was not among the conditions listed by the Secretary for presumptive service-connection.The Federal Circuit vacated. The Board is required to consider relevant documents within its constructive possession; all relevant and reasonably connected VA-generated documents are part of the record, constructively known by the VA adjudicator. The Veterans Court applied an erroneous legal standard when it concluded the Board did not have constructive possession of the NAS Update 2014. While the VA has not published that Update in the Federal Register, it appears on its website. Update 2014 includes statements that, “thyroid conditions overall showed an indication of increased risk with herbicide exposure” and that “consistent observations of exposures to herbicide agents” indicated that they were “related to perturbations of thyroid function.” View "Euzebio v. McDonough" on Justia Law

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Giles served on active Army duty, 1976-1982. He first claimed a service-connected nervous condition with the VA in March 1984; he was diagnosed with a personality disorder. While his claim was pending, he reported for Reserve training in June 1984. He soon was hospitalized, was diagnosed with organic delusional syndrome, and was discharged in November 1984. The VA denied his claim. In 1985, Giles was hospitalized, with an admitting diagnosis of schizophrenia. Upon discharge, he was diagnosed with bipolar disorder. The VA denied his request to reopen. The Board of Veterans’ Appeals affirmed in 1987, finding that “[a]n acquired psychiatric disorder was neither incurred in nor aggravated by service nor may a psychosis be presumed to have been incurred in active military service.”In 1995, Giles claimed service-connected PTSD. The VA awarded him service connection for bipolar disorder, effective in 1995. In 2012, Giles filed a request to revise the 1987 Board decision for clear and unmistakable error because the Board failed to recognize Giles’s claim on a presumptive basis for his 1984 diagnosis. The Board rejected the motion, stating, that 1987 regulations provided that the presumption of service incurrence of certain diseases, such as psychosis, did not apply to a period of active duty for training; a person serving on active duty for training was not considered a “veteran” during that service. The Veterans Court and Federal Circuit affirmed; “psychoses,” under 38 C.F.R. 3.309(a), refers to a category of diseases; whether diseases falling within this category are the same is a factual question outside of the courts' jurisdiction. View "Giles v. McDonough" on Justia Law

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James-Cornelius sought compensation under the National Vaccine Injury Compensation Program, alleging that her 17-year-old son, E.J., had suffered dysautonomia, postural orthostatic tachycardia syndrome (POTS), and other symptoms as a result of receiving three shots of the HPV vaccine, Gardasil®. While there are no records of medical visits between his first and second vaccinations, the records document his medical visits, symptoms, and diagnoses after his third vaccination. The petition identified medical articles hypothesizing that HPV vaccines can cause dysautonomia and POTS and alleged that the increasing severity of his symptoms is “evidence of re-challenge” and that the pattern of worsening reactions is “strongly probative of a causal relationship” between the vaccine and E.J.’s symptoms, some of which were listed as potential Gardasil® side effects.James-Cornelius unsuccessfully attempted to obtain medical records relating to urgent care visits that she believed occurred before E.J.’s second vaccination. She eventually dismissed her petition, explaining that “she [would] likely be unable to prove" entitlement to compensation. James-Cornelius sought $17,111.12 in attorneys’ fees and costs under 42 U.S.C. 300aa-15(e)(1), asserting that she had filed her petition in good faith and with a reasonable basis. . The Federal Circuit vacated the denial of the petition. The Special Master failed to consider relevant objective evidence. E.J.’s medical records support for James-Cornelius’s reasonable basis claim even without an express medical opinion on causation. The Special Master erroneously concluded that petitioners’ affidavits are categorically “not ‘objective" for evaluating reasonable basis. View "James-Cornelius v. Secretary of Health and Human Services" on Justia Law

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Murphy served in the Army, 1971-1974. In 2003, he sought disability benefits for PTSD; the VA regional office (RO) denied this claim because Murphy lacked a PTSD diagnosis. A private doctor had diagnosed Murphy with schizophrenia in 1982. In 2006, Murphy submitted another claim for disabilities, including schizophrenia. He requested that the RO reopen his PTSD claim. The RO denied the claim for schizophrenia for failure to show service connection and declined to reopen the PTSD claim for lack of material evidence. In 2007-2012, the RO denied multiple requests to reopen both claims.A 2012 request to reopen listed only PTSD. The VA physician found no PTSD but noted the schizophrenia diagnosis. The RO denied Murphy’s request to reopen his PTSD claim. Murphy filed a Notice of Disagreement. The cover page referred to PTSD; a handwritten attachment mentions “schizophrenia” and “PTSD” multiple times. His Form 9 included numerous mentions of both “PTSD” and “schizophrenia.” The RO determined that Murphy was also seeking to reopen his schizophrenia claim but denied that request for lack of new and material evidence. Murphy did not appeal. The Board remanded the PTSD claim; the RO maintained its denial.The Veterans Court determined that the Board correctly found it lacked jurisdiction over the schizophrenia claim, which was a request to reopen, not an initial claim. The Federal Circuit affirmed. Murphy’s request to reopen cannot be construed as seeking to reopen his schizophrenia claim. Although the lenient-claim-scope rule applies to requests to reopen, Murphy demonstrated an understanding that the conditions would be addressed separately. View "Murphy v. Wilkie" on Justia Law

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Perry served in the Wisconsin Army National Guard from January 1977 to March 1977, with active duty for training in February-March 1977. Active duty for training is “full-time duty in the Armed Forces performed by Reserves for training purposes,” 38 U.S.C. 101(22). Medical Board examiners at his March 1977 separation opined that enuresis and incontinence existed prior to service. Perry died in 2014. There was no claim for service-connected disability during his lifetime.The Board of Veterans’ Appeals held that Mrs. Perry was not eligible for nonservice-connected death pension benefits because Perry did not have active duty service during a period of war nor did he have a service-connected disability, as required by 38 U.S.C. 1541, that Mr. Perry did not attain veteran status, and that he “was not service-connected for any disability at the time of his death, and there is no evidence that his death was in any way related to" his 1977 military service. The Veterans Court and Federal Circuit affirmed. Service in the state National Guard including a period of active duty for training, without disability incurred or aggravated in line of duty, does not achieve “veteran” status for these purposes. View "Perry v. Wilkie" on Justia Law

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The National Organization of Veterans’ Advocates (NOVA), sought review under 38 U.S.C. 502. The Knee Joint Stability Rule, promulgated in 2018 and set forth in the Veterans Affairs Adjudication Procedures Manual, assigns a joint instability rating under Diagnostic Code (DC) 5257, 38 C.F.R. 4.71a, based on the amount of movement that occurs within the joint. The Knee Replacement Rule provides that evaluation under DC 5055, 38 C.F.R. 4.71a, is not available for partial knee replacement claims. The Replacement Rule was published in the Federal Register in 2015, stating that section 4.71a was amended to explain that “‘prosthetic replacement’ means a total, not a partial, joint replacement.” It was published in a 2016 Manual provision, which informs regional office staff that evaluation under DC 5055 is not available for partial knee replacement claims filed on or after July 16, 2015.The Federal Circuit referred the case for adjudication on the merits. NOVA has standing because it has veteran members who are adversely affected by the Rules. The Manual provision is an interpretive rule reviewable under 38 U.S.C. 502 and constitutes final agency action. The Knee Replacement Rule is a final agency action. The merits panel will determine whether the Manual provision or the Federal Register publication constitutes the reviewable agency action. The challenge is timely under the six-year statute of limitations, 28 U.S.C. 2401(a); Federal Circuit Rule 15(f), establishing a 60-day time limit for bringing section 502 petitions, is invalid. View "National Organization of Veterans’ Advocates, Inc. v. Secretary of Veterans' Affairs" on Justia Law

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Veterans sought certification for the class of veterans whose disability claims had not been resolved by the Board of Veterans Appeals within one year of the filing of a Notice of Disagreement (NOD), requesting judicial action to compel the Secretary of Veterans Affairs to decide all pending appeals within one year of receipt of a timely NOD. The Veterans Court requested that they separate or limit the requested class action into issues that meet the Federal Rule of Civil Procedure 23(b)(2) “commonality” standard. The veterans declined, stating that “systemic delay” exists in the VA claims system, and broad judicial remedy is required.The Veterans Court denied the requested class certification. While the case was pending, the Veterans Appeals Improvement and Modernization Act of 2017, 131 Stat. 1105 purportedly improved processing times by allowing claimants to choose: higher-level review, a supplemental claim, board review with a hearing and opportunity to submit additional evidence, board review without a hearing, but with an opportunity to submit additional evidence, or board review without a hearing or additional evidence, based on their priorities on appeal.The Federal Circuit affirmed the denial of class certification, citing the lack of proof of commonality. When Congress has crafted a comprehensive remedial structure, that structure warrants evaluation in practice before judicial intervention is contemplated. View "Monk v. Wilkie" on Justia Law

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Mote served in the Air Force, 1961-1965, participating in missions to Vietnam, where Agent Orange was deployed. Mote later developed coronary artery disease and lung cancer. In 2010, Mote filed a disability claim based. In 2013, Mote filed his Notice of Disagreement with the denial of that claim. He died months later. Mrs. Mote substituted for his claim and filed a dependency-and-indemnity compensation claim. The VA denied Mrs. Mote’s claim in 2015; she filed her Notice of Disagreement and requested a Board of Veterans’ Appeals “Travel Board hearing.”Mote sought mandamus relief, 28 U.S.C. 1651, alleging unreasonable delay. The Veterans Court denied the petition, applying the “Costanza” standard. The government claimed, due to limited resources, it “could not predict how long” Mote might have to wait for a hearing. The Federal Circuit consolidated her appeal with others and held that the Veterans Court should use the Telecommunications Research & Action Center v. FCC (TRAC) standard to evaluate unreasonable-delay mandamus petitions rather than the Costanza standard. On remand, Mote requested a “reasoned decision” from the Board (within 45 days) and periodic progress reports. In March 2019. the Board scheduled her Travel Board hearing for May 2019. The Veterans Court dismissed Mrs. Mote’s mandamus petition without applying the TRAC standard. The Board subsequently remanded for further factual findings.The Federal Circuit again remanded, for a TRAC analysis, noting that Mote sought progress reports, in addition to a decision, and that the Veterans Court was not powerless to fashion other relief, such as a more lenient, specific, deadline. Whether a delay is so egregious as to justify the extraordinary writ depends on issues that are likely to arise frequently among veterans. The Veterans Court is uniquely well-positioned to address these issues first. View "Mote v. Wilkie" on Justia Law

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John served in the Army in the 1960s. In 1972, John and Roberta married. In 2001, they separated. In 2005, a New York court issued a Separation Judgment, requiring John to pay Roberta $300 per month in spousal maintenance. In 2006, the VA granted John service connection for various disabilities; he began receiving monthly compensation. The New York court held a hearing where both parties appeared with counsel with a proposed settlement. That Stipulation provided that no later than December 2006 John was to pay Roberta $7,000 for past and future maintenance, health insurance, and other obligations. John made the payment. In 2010, following John’s relocation, a Pennsylvania state court issued a Divorce Decree.In 2008, Roberta had filed a VA claim for apportionment, 38 U.S.C. 5307, of John’s disability benefits. John objected, arguing only that the 2006 Stipulation “precluded” the claim. The VA denied Roberta’s claim, despite her demonstrated financial need, concluding she had “voluntarily renounced" maintenance or support. The Board of Veterans’ Appeals granted Roberta special apportionment from the 2008 date of her claim until the date of her 2010 divorce. The Veterans Court and Federal Circuit affirmed. A state court domestic relations separation agreement plays no role in VA’s determination of entitlement to special apportionment. John’s remedy lay in state court where he could sue for breach of contract. Special apportionment turns not on the veteran’s degree of support but on the dependent’s showing of hardship. View "Batcher v. Wilkie" on Justia Law

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Graham served in the Marine Corps from 1967-1970 and has been receiving disability compensation benefits since 2001. The VA regional office (RO) informed Graham in 2009 that authorities had identified him as a fugitive felon and the subject of an outstanding warrant issued in 1992. That warrant was withdrawn in February 2009. In May 2009, the RO issued a rating decision that retroactively discontinued Graham’s compensation from December 2001 through February 2009, due to his then-fugitive felon status, and informed Graham that he had been improperly paid $199,158.70 and that his monthly compensation would be partially withheld to pay back the debt.Graham appointed Gumpenberger as his representative on appeal and signed a direct-pay agreement stating that Gumpenberger’s fee would be “20 percent of all past-due benefits awarded … as a result of winning … as provided in 38 C.F.R. 14.636.” In 2013, the Board reversed the RO’s debt ruling, finding that Graham was not a fugitive felon for VA purposes because he had never been aware of the outstanding warrant. The VA had recouped $65,464 from Graham’s monthly benefits. The Veterans Court and Federal Circuit affirmed the RO’s determination that Gumpenberger was entitled to a fee of $13,092.80. Although the total debt invalidated was $199,158.70, the past-due benefit, per 38 U.S.C. 5904(d)(1), being awarded was $65,464. View "Gumpenberger v. Wilkie" on Justia Law