Robinson v. Wilkie
Opinion of the Court
Stoll, Circuit Judge.
*1355Mr. Bennie Robinson, a veteran who served in Vietnam as a member of the United States Marine Corps, appeals the effective date of his disability rating for coronary artery disease. Mr. Robinson's effective date coincides with the date of his diagnostic testing results, but it took 14 months to schedule the tests. According to Mr. Robinson, he should be entitled to an earlier effective date because he did not cause the 14-month delay. Be-cause there was no legal error in determining the effective date, we affirm the judgment of the United States Court of Appeals for Veterans Claims ("Veterans Court").
I
Mr. Robinson served in the Marine Corps in the late 1960s, and his service included a deployment in Vietnam. After returning from deployment, he began to suffer heart problems. Mr. Robinson saw his Department of Veterans Affairs cardiologist, Dr. Ali Sadoughian, on February 23, 2006, for "evaluation of chest pain." J.A. 71. Dr. Sadoughian recommended that Mr. Robinson undergo diagnostic testing, but the testing was not performed. Nine months later, Mr. Robinson returned to Dr. Sadoughian after spending a week in the hospital with blood clots in his right leg. Dr. Sadoughian again recommended that Mr. Robinson schedule diagnostic testing "as planned in my previous consult." J.A. 69-70. Mr. Robinson finally received the prescribed diagnostic testing on April 2, 2007-5 months after his follow-up visit and 14 months after Dr. Sadoughian's initial recommendation. The record does not explain the cause of the delay, but the test results indicated that Mr. Robinson had "[c]oronary artery disease with prior inferior wall myocardial infarction." J.A. 67.
Mr. Robinson did not receive any disability benefits at that time for his coronary artery disease because he could not establish that it was service connected. That changed in August 2010 when the VA amended its regulations to add ischemic heart disease-including coronary artery disease-to its list of conditions that are presumptively service connected for veterans who were exposed to certain herbicides.
Then, in 2011, the VA retroactively granted disability benefits to Mr. Robinson for his coronary artery disease pursuant to a Nehmer
*1356After Mr. Robinson filed a notice of disagreement, the VA issued a new rating decision. That decision awarded Mr. Robinson a 100 percent disability rating effective January 26, 2003 and a 10 percent disability rating from May 1, 2003 through April 1, 2007. The VA did not change the effective date for the 60 percent disability rating, however, and Mr. Robinson appealed that decision to the Board of Veterans' Appeals. The Board denied Mr. Robinson's claim because the April 2007 test results were the earliest medical evidence demonstrating that he satisfied the criteria for a 60 percent disability rating.
Mr. Robinson appealed the Board's decision to the Veterans Court. On appeal, Mr. Robinson argued for the first time that the effective date for his 60 percent disability rating should be the date Dr. Sadoughian ordered the diagnostic testing rather than the date on which the testing occurred. Although the cause of delay is not reflected in the record, Mr. Robinson asserted that he should not be penalized for the 14-month delay in scheduling his test, and that he would have received an earlier effective date for his 60 percent disability rating if the VA had provided him with prompt treatment. The Secretary asked the Veterans Court not to consider the argument because Mr. Robinson did not raise it before the Board. Instead, the Veterans Court "balance[ed] the competing interests" and "determine[d] that it [wa]s appropriate to remand this matter for the Board to address in the first instance." J.A. 39.
On remand, Mr. Robinson cited
The Veterans Court affirmed the Board's decision. Applying
Mr. Robinson appeals. We have jurisdiction pursuant to
II
Our jurisdiction to review decisions of the Veterans Court is limited. Martin v. O'Rourke ,
Mr. Robinson contends that he is entitled to an earlier effective date for his 60 percent disability rating for three interrelated reasons. First, Mr. Robinson asserts that his 60 percent disability rating is a staged or increased rating and therefore
The dissent likewise relies on the general effective date statute,
Mr. Robinson next cites
Our review of § 17.33 indicates that it was not intended to create rights that would impact the handling of compensation claims, and Mr. Robinson has not directed us to any evidence suggesting otherwise.
*1358Section 17.33 is located in part 17 of chapter I of the VA's regulations, which governs the VA's administration of medical treatment. It lays out certain rights to which patients are entitled, including the right to be treated with dignity,
Finally, Mr. Robinson faults the Veterans Court for not awarding equitable relief in the form of an earlier effective date. The Veterans Court had stated that "[a]lthough the Court is sympathetic to Mr. Robinson's plight and delays in the VA health system are concerning, the Court is not a court of equity."
We agree with the Veterans Court that the facts of this case are troubling. The 14-month delay for coronary artery disease testing strikes us as excessive. But our court's jurisdiction generally is limited to reviewing legal errors,
III
We have considered Mr. Robinson's remaining arguments and find them unpersuasive. No medical evidence in the record supports his entitlement to an effective date earlier than April 2, 2007. Although we are sympathetic to Mr. Robinson's plight, the Veterans Court did not err in its analysis. The judgment of the Veterans Court is affirmed.
AFFIRMED
COSTS
No costs.
In response to orders from the U.S. District Court for the Northern District of California in Nehmer v. U.S. Department of Veterans Affairs , the VA promulgated special rules for determining the effective date of claims for diseases that are presumed to be caused by exposure to Agent Orange. See Nehmer v. U.S. Veterans' Admin .,
Dissenting Opinion
Mr. Robinson, a veteran of the war in Vietnam, experienced heart problems including a heart attack in 2003. By regulation adopted in August 2010, coronary and other diseases were deemed service-connected for veterans who, like Mr. Robinson, had been exposed to Agent Orange in Vietnam:
38 C.F.R. § 3.309 (e) (Disease associated with exposure to certain herbicide agents)
If a veteran was exposed to an herbicide agent during active military, naval, *1359or air service, the following diseases shall be service-connected .... Ischemic heart disease (including, but not limited to, acute, subacute, and old myocardial infarction ; atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm ) and coronary bypass surgery ....
Mr. Robinson then sought the statutory compensation for his cardiac condition.
After various proceedings not here relevant, the VA assigned Mr. Robinson an initial effective date of January 26, 2003, the date of Mr. Robinson's heart attack, with 100 percent disability rating for the period between January 26, 2003 and May 1, 2003. The VA then assigned a 10 percent disability rating between May 1, 2003 and April 1, 2007, followed by a 60 percent disability rating starting on April 2, 2007, the date of a cardiac test that a VA cardiologist had first ordered 14 months earlier. The issue on appeal is the start date of the 60 percent rating, in view of the 14-month test delay.
Mr. Robinson states that he should not be prejudiced by the VA's inordinate delay in performing this test, and that the effective date of the 60 percent rating should be the date the test was first ordered, or a reasonable period thereafter. The Secretary responds that the regulation requires that the rating runs from the date the test was performed, and offers no explanation for the 14-month delay. The regulation states:
38 C.F.R. § 3.400 (o)(2). (Disability compensation)
Earliest date as of which it is factually ascertainable based on all evidence of record that an increase in disability had occurred if a complete claim or intent to file a claim is received within 1 year from such date, otherwise, date of receipt of claim. When medical records indicate an increase in a disability, receipt of such medical records may be used to establish effective date(s) for retroactive benefits based on facts found of an increase in a disability only if a complete claim or intent to file a claim for an increase is received within 1 year of the date of the report of examination, hospitalization, or medical treatment. The provisions of this paragraph apply only when such reports relate to examination or treatment of a disability for which service-connection has previously been established.
My colleagues hold that Mr. Robinson's increase in compensation should be limited to the date of testing, because there is no evidence of the extent of disability during the 14-month period of delay in testing.
The court and the VA have incorrectly constricted the regulation, beyond its purpose and beyond the intent of the veterans' statutes. Mr. Robinson's cardiac health history and the results of this belated medical test demonstrate cardiac illness of several years, in ready conformity with the VA's statutory obligation to assign the earliest ascertainable effective date. From my colleagues' contrary ruling, I respectfully dissent.
DISCUSSION
The VA is required to determine the effective date of compensation "in accordance with the facts found."
The Court of Veterans Appeals has considered
*1360date the disability is "ascertainable," not the date a particular test was administered:
[T]he Secretary's contention that § 4.85(a) requires the effective date for an increased disability claim to be set in accordance with the date a Maryland CNC test is administered not only adds words to the regulation that are not there, but it also conflicts with the plain meaning of section 5110(b)(3), which requires the effective date of an award of increased compensation to be 'the earliest date as of which it is ascertainable that an increase in disability had occurred.'
The panel majority disagrees with any relevance of
Section 3.816(c) sets forth the earliest effective date for disability compensation resulting from a covered herbicide disease. Its subsections (1-4) are directed to the timing of the claim and the earliest starting date for disability compensation. This regulation does not speak to determining the effective date for increased compensation resulting from a veteran's worsening covered herbicide disease once service connection under Nehmer is established. That is the role of § 3.400(o).
The panel majority argues that Mr. Robinson "had to rely on the special regulations *1361applicable to Nehmer class members" and no other statutes or regulations are applicable. Maj. Op. at 1357. Yet no "special regulation" absolves the VA for the 14-month delay in testing Mr. Robinson. No "special regulation" mandates that the effective date is the date of testing and not the earliest ascertainable date that an increase has occurred. The panel majority's "special regulation,"
Per the majority's interpretation of § 3.816(c)(2), Nehmer class veterans suffering from a covered herbicide disease, nearly all of which are chronic (see
(2) Patients have a right to receive, to the extent of eligibility therefor under the law, prompt and appropriate treatment for any physical or emotional disability.
When the VA fails in the duty of promptness, the consequences of such failure cannot be imposed on the veteran. To summarize: Mr. Robinson consulted a VA cardiologist on February 23, 2006, and the cardiologist ordered certain tests. The tests were not performed. Mr. Robinson again consulted the VA cardiologist on November 27, 2006, and the tests were again ordered. The tests were performed on April 2, 2007, showing an ejection fraction of 44%. The VA measured the 60% disability rating from the date of this test:
38 C.F.R. § 4.104 [Rating of 60%]: More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent.
The BVA stated that "[t]he treatment records do not demonstrate that [Mr. Robinson] met the criteria for a 60 percent rating for coronary artery disease ... until ... testing was accomplished on April 2, 2007." J.A.30. The Veterans Court affirmed, stating that Mr. Robinson "does not demonstrate clear error in the Board's decision because he does not identify any medical record prior to the April 2007 testing that would support a 60% disability rating." Vet. Ct. Op. at *2. Mr. Robinson states that he should not be penalized for the VA's 14-month delay in providing the ordered tests.
The BVA, the Veterans Court, and now my colleagues, ignore the requirement of measuring disability compensation from the earliest ascertainable date based on all the evidence. The record includes the earlier heart attack showing an existing cardiac condition and the consultations with the VA cardiologist. The panel majority states that "we do not know whether Mr. Robinson would have satisfied the requirements *1362for the 60 percent disability rating had he received the testing at an earlier date." Maj. Op. at 1358. However, the entirety of the record must be considered and reasonably evaluated based on sound medical opinion. It is incorrect for the VA to automatically resolve any gap in evaluation against Mr. Robinson; this court has observed that a condition may have existed before it was verified. See Collins v. Shinseki ,
Mr. Robinson states that if the VA is authorized to measure disability only from the date of a specific test, despite sound evidence that the disability existed, then the VA must conduct the test in a timely manner. Reply Br. at 2-3. The Secretary does not argue that the 14 months' delay is reasonable; the Secretary's only response is that Mr. Robinson could have gone to a private physician for the test. Secretary Br. at 20 ("Mr. Robinson was at liberty to obtain documentation of the status of his condition on his own prior to April 2007 ....") The record does not show that Mr. Robinson was so advised when the VA cardiologist ordered the VA to conduct the test.
After concluding that Mr. Cary had sufficient symptoms to warrant the 70 percent rating as of June 17, 2011, the Board failed to take the next, necessary, step to examine the record to determine whether the increase in symptomology was "ascertainable" before this.
It is error to mechanically limit the effective date for a disability rating to the date of performance of a specific test related to that disability. See id . ; see also Blanchard v. McDonald , No. 15-4290,
Mr. Robinson's situation is not of the unknown existence of a disability until basic diagnostic tests were conducted. His coronary illness had been manifested for years; the only new event was the regulatory presumption of service-connection based on herbicide exposure. With presumptive service connection, and clear manifestation of coronary illness, it is incorrect to ignore the entirety of the medical record, and limit the effective date of compensation to the date a specific symptom was measured. See Thomas ,
To the extent that
"The government's interest in veterans cases is not that it shall win, but rather that justice shall be done, that all veterans *1363so entitled receive the benefits due to them." Barrett v. Nicholson ,
The panel majority writes that the Veterans Court "cannot invoke equity to expand the scope of its statutory authority." Maj. Op. at 1358. No statute, no constitutional requirement, excludes equity from the scope of the Court of Appeals for Veterans Claims. Here, equitable principles are sought not to "expand the scope" of the court's jurisdiction, but to implement the statute in accordance with its legislative purpose.
Reference
- Full Case Name
- Bennie C. ROBINSON, Claimant-Appellant v. Robert WILKIE, Secretary of Veterans Affairs, Respondent-Appellee
- Cited By
- 2 cases
- Status
- Published