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

While serving in the Navy 1968-1970, Simmons experienced feelings of depression and homesickness. A VA physician diagnosed Simmons with situational depression but no permanent disability. Another VA physician diagnosed him with immature personality disorder and recommended he be discharged. In 1972, the VA awarded Simmons a non-service-connected pension on his polyarthritis claim. In 1974, Simmons sought additional compensation, asserting that his arthritis was service-connected and that he also had a nervous condition that justified compensation. The VA denied the claim. In 2005, after receiving a total disability rating for an unrelated asbestosis-based claim, Simmons claimed that there was clear and unmistakable error (CUE) in the 1974 decision, with respect to the denial of service connection, citing the presumptions of soundness and service connection in 38 U.S.C. 105(a) and 1111.The Board found that Simmons’s current psychiatric disorder was due to his non-service-connected arthritis and that the presumptions did not apply. The Veterans Court affirmed, finding that although the Board erred in analyzing the presumptions, that error was harmless because Simmons’s current disability was not causally related to his in-service condition. The Federal Circuit affirmed, rejecting an argument that a failure to apply an evidentiary presumption is per se prejudicial. A per se rule of prejudice for failure to apply the presumptions would undo any proper VA finding that the claimant had failed to establish a causal nexus. View "Simmons v. Wilkie" on Justia Law

While serving in the Navy, 1972-1073, Merritt sustained a concussion in an automobile accident. In 2006, a VA psychologist prepared a note. stating that Merritt had “[s]ymptoms of bipolar disorder[, which] first began ... on active duty,” and that Merritt’s “work performance began to suffer” after the in-service accident. In 2010, Merritt sought disability benefits for bipolar disorder, anxiety, and personality disorders. The Board determined that Merritt’s psychiatric disorders were not service-connected, relying solely on an independent medical expert opinion. On remand, the Board again denied Merritt’s claim, stating that the VA psychology note was entitled to little probative weight, apparently because there was no evidence that the VA psychologist had access to Merritt’s records, and there was a discrepancy between that note and Merritt’s treatment records as to the length of time that Merritt was unconscious following the automobile accident. The Veterans Court affirmed, finding the Board’s error in not following the remand order harmless because the VA note “described no symptoms that . . . supported . . . a retrospective diagnosis” of bipolar disorder, and “there [was] no possibility that the Board could have awarded service connection based on [the note].”Merritt died; Mrs. Merritt was allowed to substitute herself as the surviving spouse. The Federal Circuit subsequently dismissed her appeal as moot. Mrs. Merritt did not preserve her claim by filing a formal claim with the VA within one year of Merritt’s death as required. View "Merritt v. Wilkie" on Justia Law

Sellers served in the Navy in 1964-1968, and in the Army, 1981-1996. He suffers from major depressive disorder (MDD). Sellers has a 2009 effective date for his disability benefits. He seeks an effective date of March 1996, the date of his formal claim seeking compensation for specific injuries to his leg, knee, back, finger, and ears. On his application, under “Remarks,” Sellers wrote “Request for s/c [service connection] for disabilities occurring during active duty service.” Sellers contends that the law in effect in 1996 requires his remarks to be understood as a claim for compensation for his MDD, although his claim in no way refers to MDD. The Veterans Court agreed with Sellers. The Secretary of Veterans Affairs challenged that decision.The Federal Circuit reversed, finding that Sellers is not entitled to an earlier effective date. A legally sufficient formal claim must identify, at least at a high level of generality, the current condition upon which the veteran’s claim is based. The Secretary’s duty to assist begins upon receipt of a formal claim that identifies the medical condition for which benefits are sought, which triggers the Secretary’s duty to obtain the veteran’s medical records, 38 U.S.C. 5103A(c)(1)(A), and then to fully develop the stated claim. Until the Secretary comprehends the condition on which the claim is based, the Secretary does not know where to begin to develop the claim. View "Sellers v. Wilkie" on Justia Law

Jones served on active duty with the Army in 1967-1974 and in the Army National Guard in 1987-1990. In 1994, he sought disability benefits for a nervous disorder and a leg wound. A VA regional office granted service connection for a leg scar but found that disability non-compensable and denied the claim for a nervous condition. Jones did not appeal. In 2002, Jones filed a request to reopen his claim, asserting that he was assaulted by muggers while stationed in Germany, which resulted in his developing PTSD. The regional office denied his request. In 2008, the Board of Veterans’ Appeals granted the request to reopen, directing the regional office to obtain additional information from two individuals with knowledge of the assault. In 2010, the regional office granted Jones service connection for PTSD and a schizoaffective disorder, with a 100% disability rating effective from October 2002, when he sought to reopen his claim. Jones sought to have the effective date made retroactive to 1994. In 2016, after Jones’s death, the Board held that the effective date was 2002. The Veterans Court and the Federal Circuit affirmed, citing 38 C.F.R. 3.156(c); the decision in Jones’s favor was based on evidence created in 2003 and 2008, which did not exist in 1994. View "Jones v. Wilkie" on Justia Law

In July 2010, L.M. was born at full-term and developed normally for six months. In February 2011, L.M. received childhood vaccines, including the diphtheria-tetanus-acellular pertussis vaccination. By that evening, L.M. had a fever, was lethargic, had poor muscle tone, and would not eat., Any disturbance caused L.M. to scream. L.M. began to have several seizures a day. At seven years of age, L.M. could crawl and walk with the assistance of a walker. She had a poorly coordinated grasp, suffered cortical visual impairments, and was nonverbal, though she could use a few signs to express ideas such as “yes,” and “no.” Testing revealed that L.M. had a genetic mutation.In a claim under the National Vaccine Injury Compensation Program, L.M. alleged that the vaccinations administered to L.M. in February 2011, significantly aggravated L.M.’s pre-existing condition under two alternative theories. The Special Master denied the petition, finding that L.M.’s genetic mutation was “the most compelling explanation for her predisposition to develop a seizure disorder.” The Federal Circuit affirmed the denial of an “on-table” claim, finding no support for an argument that most encephalopathies do not become acute until after vaccination. The court vacated and remanded the denial of an “off-table” claim, which requires determining whether the child’s receipt of vaccinations significantly aggravated her seizure disorder in the face of an underlying genetic mutation. View "Sharpe v. Secretary of Health and Human Services" on Justia Law

Carr served Air Force active duty, 1976-1980, earning 45 months of education benefits under Chapter 34 (Vietnam-era GI Bill), Carr used 41 months and 11 days of those benefits for his own education before the entire Chapter 34 program expired. After September 11, 2001, Carr returned to active duty and would have been eligible for 36 additional months of benefits under Chapter 33 (Post-9/11 GI Bill), but 38 U.S.C. 3695 limited him to a cumulative total of 48 months. Carr transferred those benefits to his daughter, 38 U.S.C. 3319, who used paid for two semesters. Due to a VA error, she initially did not receive payments to cover the final days of the Fall 2010 semester and was informed, incorrectly, that she had exhausted her benefits. Later, it was discovered that she had 19 days of benefits remaining; one day was applied to the Fall 2013 semester. Chapter 33 permits extensions of education benefits “in a roundabout way” to the end of the semester, 38 C.F.R. 21.9635(o)(1). The regional office, the Board of Veterans’ Appeals, and the Veterans Court rejected Carr's Chapter 33 claim.The Federal Circuit reversed and remanded for consideration of the unaddressed regulatory challenge. . The Veterans Court resolved the appeal through statutory interpretation and did not address the transferred benefits regulation; 38 U.S.C. 3695(a)’s aggregate multi-program benefits cap does not preclude end-of-term extensions of benefits authorized under individual benefits programs. View "Carr v. Wilkie" on Justia Law

In 2012, Lozano gave birth to a baby. While still hospitalized, Lozano received a tetanus-diphtheria-acellular-pertussis (Tdap) vaccination. Two weeks later, Lozano reported a low-grade fever, body aches, and breast tenderness. Lozano’s symptoms persisted through visits to her physician and the emergency room. She developed abdominal pain, difficulty urinating, weakness, loss of balance, vision changes, neck pain, headache, vomiting, and dizziness. A brain MRI suggested that Lozano possibly had multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), or vasculitis. Lozano’s symptoms improved with steroid treatment, following a working diagnosis of MS. After several months, a repeat MRI “showed dramatic improvement, suggesting that ADEM was a more likely etiology, which was confirmed through later serological findings.” Lozano’s doctors opine that ADEM is the likely explanation for her symptoms.Lozano sought compensation under the National Childhood Vaccine Injury Act, 42 U.S.C. 300aa. Lozano’s expert opined that Lozano’s ADEM was the result of her receipt of the Tdap vaccine. The special master granted Lozano’s petition, finding that her expert’s testimony and the supporting medical literature demonstrated that the Tdap vaccine can cause autoimmune diseases such as ADEM and that Lozano offered preponderant evidence of a proximate temporal relationship between the vaccine and her injury. The Claims Court and Federal Circuit upheld the award of a lump-sum payment of $1,199,216.86, finding that the decision was neither an abuse of discretion nor contrary to law and that the fact-findings were neither arbitrary nor capricious. View "Lozano v. Secretary of Health and Human Services" on Justia Law

Attorney Ravin represented veteran Cook on a claim for past-due disability benefits. Their agreement provided for a contingent fee and contemplated that VA would withhold the fee from any past-due benefits awarded and pay that amount directly to Ravin under 38 U.S.C. 5904(d)(3). Within days of executing that agreement, Ravin sent a copy to the Board of Veterans’ Appeals, where it was date-stamped on December 11, 2009. No copy of the agreement was submitted to the Regional Office (RO) “within 30 days of the date of execution,” as required by 38 C.F.R. 14.636(h)(4). The RO awarded Cook past-due benefits in April 2010. On April 13, 2010, the RO’s Attorney Fee Coordinator searched for any attorney fee agreement and determined that “no attorney fee decision is required” and “[a]ll retroactive benefits may be paid directly to the veteran.” The RO paid the past-due benefits to Cook. On April 27, 2010, Ravin mailed a copy of Cook’s direct-pay fee agreement to the RO. The RO informed Ravin that it had not withheld his attorney’s fees because the agreement was “not timely filed.”The Veterans Court and Federal Circuit affirmed the Board’s denial of Ravin’s claim. Section 5904(d)(3) does not mandate withholding and direct payment; 38 C.F.R. 14.636(h)(4)'s submission requirement is valid. Ravin’s fees have not been forfeited; he may use all available remedies to obtain them from Cook, per their agreement. View "Ravin v. Wilkie" on Justia Law

In 2011, K.G., age 48, received an influenza vaccination in advance of knee replacement surgery. Over the next several months, she experienced increasingly severe nerve pain in her hands, arms, feet, and legs; she succumbed to alcoholism, spent months in the hospital, and developed amnesia. In 2014, an Iowa state court declared K.G. incapable of caring for herself and, against K.G.’s will, appointed K.G.’s sister as her guardian. K.G. regained her mental faculties by May 2016. She then retained an attorney who filed her claim under the National Childhood Vaccine Injury Act, 42 U.S.C. 300aa-1. A Special Master held that equitable tolling was not available during the period that K.G.’s sister acted as K.G.’s guardian and dismissed K.G.’s claim as not timely filed within the three-year statute of limitations. The Federal Circuit vacated. Equitable tolling is available in Vaccine Act cases and the appointment of a legal guardian is only one factor a court should consider when deciding whether equitable tolling is appropriate in a particular case. K.G. was not required to argue the legally irrelevant question of whether she personally was diligent while she was mentally competent and she preserved her argument that her legal representative exercised reasonable diligence under the circumstances. The Special Master erred in adopting a per se rule. View "K.G. v. Secretary of Health and Human Services" on Justia Law

Under the GI Bill, the VA provides monetary benefits to veterans enrolled in “approved” “course[s] of education,” 38 U.S.C. 3483. Approval must be provided by the state approving agency (SAA) for the state where the educational institution is located. For online courses, the educational institution must obtain approval from the SAA where the institution’s “main campus” is located. The VA may discontinue educational assistance, after following certain procedures, if this requirement is not met. Ashford is a for-profit educational institution that provides online courses to veterans and others. In November 2017, the VA sent a Cure Letter to Ashford stating that Ashford’s online courses were not approved by the correct SAA, expressing its “inten[t] to suspend payment of educational assistance and suspend approval of new enrollments and re-enrollments [for Ashford’s online programs] in 60 days unless corrective action is taken.” The Letter noted the availability of a hearing before the Committee on Educational Allowances. Ashford sought review, contending that the Cure Letter “announces” new “rules” and that 38 U.S.C. 502 provided the court with jurisdiction to review those alleged rules. The Federal Circuit dismissed the petition, finding that the Cure Letter is not rulemaking or any other reviewable action; it is also not a final agency action under the Administrative Procedure Act. View "Ashford University, LLC v. Secretary of Veterans Affairs" on Justia Law