Justia U.S. Federal Circuit Court of Appeals Opinion Summaries

On active Army duty in the 1970s, Kennedy fell from a lawnmower and injured his knee. Although no disability was noted at his discharge, Kennedy received service connection for his knee injury in 2000. He later received service connection for depression secondary to his knee injury. In 2005, Kennedy died; his death certificate listed “melanoma, metastatic” as the immediate cause of death and listed “other significant conditions contributing to death,” including diabetes, hypertension, and “depression disorder.” Mrs. Kennedy three times unsuccessfully sought Dependency and Indemnity Compensation (DIC), 38 C.F.R. 3.114. The VA found no evidence that Kennedy’s death was related to military service.In 2013, VA “Fast Letter 13-04, “Simplified Processing of Dependency and Indemnity Compensation (DIC) Claims,” instructed personnel to grant “service connection for the cause of death when the death certificate shows that the service-connected disability is [a] . . . contributory cause of death.” In 2015, the VA granted Mrs. Kennedy DIC, effective July, 2015. The Board of Appeals denied her appeal of the effective date, explaining that Fast Letter 13-04 was a “change[] to VA procedural manuals and guidance provisions,” not a liberalizing law or liberalizing VA issue. The Veterans Court affirmed, reasoning that Fast Letter 13-04 does not constitute a VA issue approved by the Secretary because it does not bind the Agency. The Federal Circuit affirmed. Kennedy forfeited her argument that the Veterans Court erred in its interpretation of “VA issue.” View "Kennedy v. McDonough" on Justia Law

Slaughter served on active duty in the Navy, 1975-1995. In 2008, a VA Regional Office determined that Slaughter, who is righthanded, suffered right ulnar nerve entrapment as a result of his service and awarded a 10% disability rating under 38 C.F.R. 4.124a, Diagnostic Code (DC) 8516. Slaughter pursued a higher rating. VA examiners eventually additionally diagnosed Slaughter with a median nerve injury, not service-connected. In 2018, the Board of Veterans’ Appeals increased Slaughter’s rating for right ulnar nerve entrapment to 40%, finding that it could not distinguish the symptoms of his service-connected ulnar nerve entrapment from those of his non-service-connected median nerve injury and attributing the entirety of the disability to the service-connected injury. The Board determined that it would be inappropriate to rate Slaughter under DC 8512, which provides ratings for injuries to the lower radicular group, because only the ulnar nerve entrapment was service-connected.The Veterans Court and Federal Circuit affirmed. While the Veterans Court placed too heavy a burden on Slaughter to show prejudice, that error was harmless because the Board correctly interpreted section 4.124a. The section provides that “[c]ombined nerve injuries should be rated by reference to the major involvement, or if sufficient in extent, consider radicular group ratings” and refers to service-connected injuries, not to a combination of service-connected and non-service-connected injuries. View "Slaughter v. McDonough" on Justia Law

The 2010 Caregivers and Veterans Omnibus Health Services Act required the VA to establish two programs to help individuals who provide eligible veterans with personal care services. One program provided assistance to family caregivers, 38 U.S.C. 1720G(a); the other provided assistance to general caregivers, section 1720G(b). The VA promulgated implementing regulations, 38 C.F.R. 71 (2015). In 2018, Congress amended the Act.; the VA MISSION Act expanded the class of veterans who qualify as eligible under the family caregivers program. The program now applies to all veterans regardless of their service dates, and there are new avenues for a veteran to qualify as eligible for benefits. The VA overhauled its regulations that attempted to clarify, streamline, and regularize implementation of the Act.Objectors challenged six definitions in 38 C.F.R. 71.15 and a residency requirement imposed in 38 C.F.R. 71.10(b). The Federal Circuit addressed standing; rejected challenges to the definitions of “three or more activities of daily living,” “serious injury,” “inability to perform one or more activities of daily living,” and “monthly stipend rate”; and to the imposition of a geographic residence requirement. View "Veteran Warriors, Inc. v. Secretary of Veterans Affairs." on Justia Law

Wolfe, who was enrolled in VA health care, obtained emergency treatment at a non-VA health care facility, incurring expenses of $22,348.25. Her employer-sponsored healthcare contract covered most of the expenses. She was responsible for a copayment of $202.93 and coinsurance of $2,354.41. The VA denied reimbursement of those expenses; 38 U.S.C. 1725(c)(4(D) bars reimbursement for “any copayment or similar payment.” Wolfe filed a Notice of Disagreement; rather than await the outcome of her appeal, Wolfe also filed a mandamus petition. The Veterans Court certified her requested class and granted her petition, invalidating a VA regulation prohibiting the reimbursement of deductibles and coinsurance for being within the category of “similar payments,” and requiring the VA to re-adjudicate claims denied under the invalidated regulation.The Federal Circuit reversed. Deductibles are excluded from reimbursement under the correct interpretation of the statute and other adequate remedies (appeal) were available with respect to coinsurance, so mandamus was inappropriate. Coinsurance is the type of partial coverage that Congress did not wish to exclude from reimbursement. View "Wolfe v. McDonough" on Justia Law

Martinez-Bodon served on active duty in the Army, 1967-1969. In 2016, he sought benefits for diabetes and for anxiety secondary to his diabetes. At his VA psychiatric examination, he reported: “I can’t sleep well, my right eye trembles too much and that bothers me and I get very anxious about it.” He denied having other symptoms. The VA examiner found that these symptoms did not meet the “criteria for a mental condition as per DSM–5” and concluded that she could not establish a relationship between Martinez-Bodon’s diabetes and anxiety.The VA granted him a service connection for diabetes but denied him a service connection for a mental condition. The Board of Veterans’ Appeals affirmed. The Court of Veterans Claims rejected an argument that even without a formal diagnosis, his symptoms constitute a disability for service-connection purposes under Federal Circuit precedent defining “disability.” The Federal Circuit affirmed that 38 C.F.R. 4.125(a) and 4.130, “require a DSM–5 diagnosis as a precondition to compensate mental conditions.” View "Martinez-Bodon v. McDonough" on Justia Law

Nicely served in active duty in the Marine Corps (USMC) for more than 10 years. Between Nicely’s 2010 DUI arrest and his 2011 discharge, the state court dismissed the DUI charge but Nicely wrote a letter to his Commanding General admitting to having driven under the influence. After the Board of Inquiry proceedings began but before they ended, Nicely filed a reprisal complaint under the Military Whistleblower Protection Act (MWPA), 10 U.S.C. 1034. Nicely’s complaint was dismissed in 2012. Nicely unsuccessfully petitioned the Board for Correction of Naval Records (BCNR) to correct his military record.Nicely filed suit in the Claims Court, alleging that some BCNR members were not statutorily authorized to serve. The BCNR rejected his claim that retired military officers are precluded from sitting on military correction boards under 10 U.S.C. 1552(a), reasoning that neither BCNR’s authorizing statute nor governing regulations expressly define "civilian" and do not expressly exclude retired military members from those civilians who may serve as Board members. The Claims Court then dismissed for lack of jurisdiction. The Federal Circuit affirmed. The Claims Court correctly concluded that Nicely’s claim arose under the MWPA and not the Military Pay Act and that it, therefore, lacked jurisdiction. The use of the term “civilian” throughout Title 10 to include former and retired members of the military is consistent with the ordinary meaning of “civilians”—that is, a person who is “not serving on active duty in the military View "Nicely v. United States" on Justia Law

Gurley served in the Army, 1972-1974 (a period of war) and the National Guard, 1975-1982. As of 1997, VA was paying him service-connected disability compensation benefits at the 100 percent disability level based on individual unemployability. In 2011, Gurley was convicted of a felony and was incarcerated for nearly six months. When a veteran is incarcerated for a felony conviction, the veteran “shall not be paid” the full amount of awarded compensation benefits “for the period beginning on the sixty-first day of such incarceration and ending on the day such incarceration ends,” 38 U.S.C. 5313(a)(1). Gurley’s payment should have been reduced to the 10% disability level. Gurley, however, received his full benefits because VA did not learn of his incarceration until six days after his release.The VA notified Gurley that he had been overpaid by $10,461 and that it would reduce its payment of Gurley’s current benefits “until the amount . . . overpaid is recouped.” Gurley unsuccessfully requested a waiver under 38 U.S.C. 5302 and disputed the debt. The Board of Veterans’ Appeals, Veterans Court, and Federal Circuit affirmed. The retroactive benefit reduction and recoupment of the overpayment through the withholding of continuing benefit payments were proper. View "Gurley v. McDonough" on Justia Law

Breland served in the Army in Vietnam, 1965-1968, and was exposed to Agent Orange. In 2006, Breland was diagnosed with carcinoma of the tongue; he completed his treatments in January 2007. The VA Regional Office denied Breland’s claim for service connection. A January 2008 biopsy revealed the recurrence of Breland’s tongue cancer. He underwent surgery. Breland filed a Notice of Disagreement. In 2010, a VA examiner note Breland’s complaint of continuing dry mouth, found no recurrence of Breland’s cancer, and concluded that the condition was “less likely related” to herbicide exposure. Breland’s claim was again denied.In 2015, Breland submitted a medical opinion tying his tongue cancer to Agent Orange exposure and retroactively granted service connection, with a 100% rating for December 2006-August 2007, and a non-compensable rating, based on Breland’s inactive disease. Following a September 2017 VA examination, the Regional Office granted service connection for certain residual conditions and determined that a 100% rating for Breland’s tongue cancer was warranted retroactively for an additional eight-month period. The Board of Veterans’ Appeals and Federal Circuit upheld those determinations. Diagnostic Code 7343 does not require the VA to continue a 100% disability rating until it performs a “mandatory VA examination” six months following treatment when the disability rating is assigned retroactively after the six-month period has passed. Breland has been and is fairly compensated based on the actual state of his health. View "Breland v. McDonough" on Justia Law

Philbrook served in the Army, 2000-2004, then was awarded disability compensation for PTSD. In 2011, Philbrook stipulated to a judgment of “guilty except for insanity” in connection with a felony. He was ordered into the custody of the Oregon State Hospital “under the jurisdiction of the Psychiatric Security Review Board . . . for care, custody, and treatment for a maximum period not to exceed 20 years.” Philbrook then applied for total disability based on individual unemployability (TDIU).A VA regional office concluded that Philbrook’s PTSD did not entitle him to TDIU because it did not preclude gainful employment. The Board of Veterans’ Appeals denied TDIU “as a matter of law”; 38 U.S.C. 5313(c), precludes the assignment of a TDIU rating for any period “during which the veteran is incarcerated in a Federal, State, local, or other penal institution or correctional facility for conviction of a felony.” The Veterans Court affirmed.The Federal Circuit reversed. Philbrook was not confined in a “penal institution or correctional facility”; he was committed to a mental institution, “a hospital for people with mental or emotional problems.” The term “correctional facility” cannot encompass a hospital that treats civil patients, and a hospital cannot be a correctional facility for some patients and not others. View "Philbrook v. McDonough" on Justia Law

Larson served on active duty for training in the Navy Reserves in 1988 and on active duty in the Navy, 1989-1993. He gained a substantial amount of weight before, during, and after his active service. In 2009, Larson filed a claim for service connection for multiple conditions, including obesity and dysmetabolic syndrome (DMS). The VA denied the claims in 2010. The Board affirmed that denial in 2016, holding that neither DMS nor obesity was a disability because neither condition is ratable under the VA Schedule of Rating Disabilities. The Veterans Court affirmed the denial of service connection for DMS and obesity, holding that it lacked jurisdiction to review a Board determination of what constitutes a disability under 38 U.S.C. 1110 because such inquiry amounted to a review of the rating schedule, prohibited by 38 U.S.C. 7252(b).The Federal Circuit reversed, noting that it has previously held that the Veterans Court has jurisdiction to review a Board determination that a claimed condition did not constitute a disability for purposes of section 1110. Larson seeks only to establish a service connection for his conditions and is not asking the Veterans Court to invalidate or revise any portion of the rating schedule. View "Larson v. McDonough" on Justia Law