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Citation Nr: 0508122
Decision Date: 03/18/05 Archive Date: 03/30/05
DOCKET NO. 00-11 875A ) DATE
)
)
On appeal from the
Department of Veterans Affairs Medical and Regional Office
Center in Wichita, Kansas
THE ISSUES
1. Entitlement to an effective date prior to March 8, 1996
for the grant of service connection for gastrointestinal
disorders, including the issue of whether a June 1996 rating
decision was clearly and unmistakably erroneous in assigning
an effective date of March 8, 1996 for the grant of service
connection.
2. Entitlement to an effective date prior to March 8, 1995
for the assignment of a total disability rating based on
individual unemployability, including the issue of whether a
September 1996 rating decision was clearly and unmistakably
erroneous in assigning an effective date of March 8, 1996 for
the total rating.
REPRESENTATION
Veteran represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
D. Hachey, Associate Counsel
INTRODUCTION
The veteran served on active duty from September 1943 to May
1946.
These matters come to the Board of Veterans' Appeals (the
Board) on appeal from August 1999 and October 1999 rating
decisions of the Department of Veterans Affairs (VA) Regional
Office (RO) in Wichita, Kansas. In the August 1999 rating
decision, the RO determined that a June 1996 RO rating
decision was not clearly and unmistakably erroneous in
assigning an effective date of March 8, 1996 for the grant of
service connection for gastrointestinal disorders. In the
October 1999 rating decision, the RO determined that a
September 1996 RO rating decision was not clearly and
unmistakably erroneous in assigning an effective date of
March 8, 1996 for a total rating based on individual
unemployability (TDIU).
The veteran's appeals were previously before the Board in
June 2001, at which time the Board granted an effective date
of March 8, 1995 for the assignment of TDIU, based on the
Board's finding that entitlement to TDIU was factually
ascertainable for one year prior to his March 8, 1996 claim
for an increased rating. The Board denied entitlement to an
effective date prior to March 8, 1995 for TDIU and denied
entitlement to an effective date prior to March 8, 1996 for
the grant of service connection for the gastrointestinal
disorders.
The veteran appealed the Board's June 2001 decision to the
United States Court of Appeals for Veterans Claims (the
Court). As the result of a Joint Motion for Remand, a March
2003 Order of the Court vacated the Board's decision, except
as to the grant of the March 8, 1995 effective date for TDIU,
and remanded the case to the Board for development and
readjudication. The Joint Motion requested that the
veteran's claim be remanded because the Board had not
presented sufficient reasons and bases to support its
conclusion that VA provided the veteran with adequate notice
of the information and evidence necessary to substantiate the
claim. The Joint Motion also sought remand due to the
Board's failure to address the veteran's claims of clear and
unmistakable error (CUE) in the June and September 1996
rating decisions, which granted service connection for
gastrointestinal disorders and entitlement to TDIU,
respectively, and assigned effective dates of March 8, 1996.
Following the March 2003 Order, the Board remanded the case
in October 2003 for the purpose of ensuring compliance with
the notice provisions of the Veterans Claims Assistance Act
of 2000 (VCAA). After the additional development requested
by the Board was accomplished, the veteran's claims were once
again denied in a September 2004 supplemental statement of
the case (SSOC). The case is now once again before the
Board.
FINDINGS OF FACT
1. The veteran's reopened claim for service connection for
gastrointestinal disorders was received by the RO on March 8,
1996.
2. The veteran's initial claim of entitlement to TDIU was
received by the RO on June 19, 1975 and was not acted upon by
VA.
3. As of March 20, 1975, the veteran's service-connected
psychiatric disability rendered him unable to secure or
follow a substantially gainful occupation. There is no
evidence showing that the veteran was totally disabled due to
a service-connected disability prior to this date.
CONCLUSIONS OF LAW
1. The veteran has failed to raise a valid claim of CUE in
the June 1996 rating decision. 38 C.F.R. § 3.105 (2004).
2. There is no basis in law for the assignment of an
effective date earlier than March 8, 1996, for the award of
service connection for stomach disorders. 38 U.S.C.A. § 5110
(West 2002); 38 C.F.R. § 3.400(q)(1)(ii) and ® (2004).
3. An effective date of March 20, 1975 for the award of a
total disability rating based upon individual unemployability
due to service-connected disabilities is warranted. 38
U.S.C.A. § 5110 (West 2002); 38 C.F.R. § 3.400(o)(2) (2004).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The veteran contends that he is entitled to an effective date
in May 1946 for the grant of service connection for his
service-connected gastrointestinal disorders because he has
had those disorders since his separation from service. He
also contends that he is entitled to an effective date in
March 1975 for the assignment of TDIU, because he then had to
retire from employment due to his service-connected
disabilities. In the alternative, he contends that an
effective date in 1989 be established so that following his
death his surviving spouse may be found entitled to
Dependency and Indemnity Compensation based on him having
service-connected disabilities rated at 100 percent for at
least 10 years prior to his death. Cf. 38 U.S.C.A. § 1318
(West 2002); 38 C.F.R. § 3.22 (2004).
In the interest of clarity, the Board will initially discuss
whether this case has been properly developed for appellate
purposes. The relevant law and regulations and factual
background will then be briefly set forth. Finally, the
Board will analyze the veteran's claim and render a decision.
Preliminary Matter
As noted in the Introduction, the Court remanded this case in
March 2003 in part to ensure compliance with the VCAA. In
particular, the February 2003 Court Order was based on a
Joint Motion in which the parties agreed that in its June
2001 decision the Board had not provided adequate reasons and
bases to support its conclusion that VA fulfilled its
obligations under the duty to notify provisions of the VCAA.
The Board in turn remanded this case in October 2003 so that
additional VCAA compliance action could be accomplished.
Pursuant to the Court's remand, the Board will now provide
reasons and bases as to why the VCAA was complied with.
The VCAA
Pursuant to the Court's remand, the Board has considered VA's
duty to inform the veteran of the evidence needed to
substantiate his claim and to assist him in obtaining the
relevant evidence. For reasons expressed in detail below,
the Board concludes that the veteran was provided with a VCAA
notice letter which satisfies the notice requirements of the
VCAA. The RO also assisted the veteran in obtaining certain
evidence with respect to his claim. The content of the VCAA
notice letter and the efforts undertaken by VA to assist the
veteran in gathering evidence with respect to his claim will
be outlined immediately below.
Notice
The VCAA requires VA to notify the claimant and the
claimant's representative, if any, of any information and any
medical or lay evidence not previously provided to VA that is
necessary to substantiate the claim. As part of the notice,
VA is to specifically inform the claimant and the claimant's
representative, if any, of which portion, if any, of the
evidence is to be provided by the claimant and which part, if
any, VA will attempt to obtain on behalf of the claimant.
See 38 U.S.C.A. § 5103 (West 2002); see also Quartuccio v.
Principi, 16 Vet. App. 183 (2002) [a letter from VA to an
appellant describing evidence potentially helpful to the
appellant but not mentioning who is responsible for obtaining
such evidence did not meet the standard erected by the VCAA].
To comply with the aforementioned VCAA requirements, the RO
must satisfy the following four requirements.
First, the RO must inform the claimant of the information and
evidence not of record that is necessary to substantiate the
claim. See 38 U.S.C.A. § 5103 (West 2002); 38 C.F.R. §
3.159(:((1) (2004). The Board observes that the veteran was
notified by the October 1999 and August 2000 statements of
the case (SOC) and the September 2004 SSOC of the pertinent
law and regulations (including those pertinent to effective
date claims), of the need to submit additional evidence on
his claims, and of the particular deficiencies in the
evidence with respect to his claims.
A VCAA letter dated February 9, 2004, which was sent to the
veteran pursuant to the Board's October 22, 2003 remand,
further apprised the veteran as to the issues on appeal. The
veteran was instructed to submit additional medical evidence,
as well as any additional evidence or information he had
concerning his claim.
Second, the RO must inform the claimant of the information
and evidence the VA will seek to provide. See 38 U.S.C.A. §
5103 (West 2002); 38 C.F.R. § 3.159(:((1) (2004). A letter
was sent to the veteran in February 2004 which advised him
that VA was responsible for providing "[r]elevant records
from any Federal agency" including "medical records from
the military, from VA hospitals (including private facilities
where VA authorized treatment), or from the Social Security
Administration." The veteran was further advised that VA
would obtain "[r]elevant records not held by a Federal
agency" including "records from State or local governments,
private doctors or hospitals, or current or former
employers."
Third, the RO must inform the claimant of the information and
evidence the claimant is expected to provide. See 38
U.S.C.A. § 5103 (West 2002); 38 C.F.R. § 3.159(B)(1) (2004).
The RO informed the veteran in its February 2004 letter that
he was responsible to provide "enough information about
[his] records so that [VA] can request them from the person
or agency that has them." The veteran was also cautioned
that "t's your responsibility to make sure that we
received all requested records that aren't in the possession
of a Federal department or agency" (emphasis in original).
The veteran was also instructed to "complete and sign a VA
Form 21-4142 . . . for each non-VA doctor and medical care
facility that treated you for the disorder." He was asked
to include on the VA Form 21-4142 "the complete name and
address of each doctor and medical facility and the
approximate dates of treatment so that we can request your
records." With regard to VA medical treatment, the veteran
was asked to "provide the name and location of the facility
and the approximate dates of treatment on the enclosed VA
Form 21-4138."
Finally, the RO must request that the veteran provide any
evidence in his possession pertaining to the claim. See 38
U.S.C.A. § 5103 (West 2002); 38 C.F.R. § 3.159(:)(1) (2004).
The February 2004 letter specifically requested that the
veteran provide "any additional information or evidence you
may have pertaining to your claim." This request
substantially complies with the requirements of 38 C.F.R. §
3.159 (:( in that it informed the veteran that he could
submit or identify evidence other than what was specifically
requested by the RO.
The Board additionally notes that even though the February
2004 letter requested a response within 60 days, it also
expressly notified the veteran that he had one year to submit
the requested information and/or evidence, in compliance with
38 U.S.C.A. § 5103(:( [evidence must be received by VA within
one year from the date notice is sent]. The one-year period
has since elapsed.
In short, the record indicates that the veteran received
appropriate notice under 38 U.S.C.A. § 5103 and Quartuccio.
One final comment regarding notice is in order. A review of
the record reveals that the veteran was not provided with
notice of the VCAA prior to the initial adjudication of his
claims in 1999. See Pelegrini v. Principi, 17 Vet. App. 412
(2004). The Board notes, however, that such a situation was
a practical and legal impossibility, because the initial
adjudication of this claim pre-dated the enactment of the
VCAA in November 2000. VA's General Counsel has held that
the failure to provide VCAA notice prior to the enactment of
the VCAA does not constitute error. See VAOGCPREC 7-2004.
VA General Counsel opinions are binding on the Board. See 38
U.S.C.A. § 7104© (West 2002); 38 C.F.R. § 14.507 (2004).
After VCAA notice was provided to the veteran, the claim was
readjudicated and a SSOC was provided to the veteran in
September 2004. Thus, any concerns expressed by the Court in
Pelegrini as to adjudication of the claim before issuance of
a VCAA notice letter have been rectified by the subsequent
readjudication. Therefore, there is no prejudice to the
veteran in proceeding to consider this claim on the merits.
Duty to assist
In general, the VCAA provides that VA shall make reasonable
efforts to assist a claimant in obtaining evidence necessary
to substantiate a claim for VA benefits, unless no reasonable
possibility exists that such assistance would aid in
substantiating the claim. The law provides that the
assistance provided by VA shall include providing a medical
examination or obtaining a medical opinion when such an
examination or opinion is necessary to make a decision on the
claim. An examination is deemed "necessary" if the
evidence of record (lay or medical) includes competent
evidence that the claimant has a current disability, or
persistent or recurrent symptoms of disability; and indicates
that the disability or symptoms may be associated with the
claimant's active military, naval, or air service; but does
not contain sufficient medical evidence for VA to make a
decision on the claim. See 38 U.S.C.A. § 5103A (West 2002);
38 C.F.R. § 3.159 (2004).
The Board finds that all relevant evidence necessary for an
equitable resolution of the issue on appeal has been
identified and obtained, to the extent possible. The
evidence of record includes service medical records as well
as VA and private medical records. The veteran and his
representative have not identified any outstanding evidence.
In short, the Board has carefully considered the provisions
of the VCAA in light of the record on appeal, and for the
reasons expressed above finds that the development of the
claim has been consistent with the provisions of the VCAA.
The Board has the fundamental authority to decide in the
alternative. See Luallen v. Brown, 8 Vet. App. 92, 95-6
(1995), citing Holbrook v. Brown, 8 Vet. App. 91, 92 (1995).
To the extent that the VCAA may be applicable, the Board
finds that the provisions of the VCAA have been appropriately
complied with, as discussed above. For reasons expressed
immediately below, however, the Board believes that the
provisions of the VCAA are not applicable to this case.
In Manning v. Principi, 16 Vet. App. 534 (2002), citing
Livesay v. Principi, 15 Vet. App. 165 (2001) (en banc), the
Court held that the VCAA has no effect on an appeal where the
law, and not the underlying facts or development of the
facts, is dispositive in the matter. As will be discussed
later in this decision, the Board finds that such is the case
with the veteran's earlier effective date claims. Because
the law and not the evidence is dispositive in the instant
case, additional factual development would have no bearing on
the ultimate outcome. Accordingly, VCAA can have no effect
on this appeal. See Dela Cruz, supra; see also Mason v.
Principi, 16 Vet. App. 129, 132 (2002) [VCAA not applicable
"because the law as mandated by statute and not the evidence
is dispositive of the claim"].
With respect to the veteran's CUE claims, the Court has
consistently held that the provisions of the VCAA do not
apply to a claim based on a previous decision having been the
result of CUE. See Livesay, supra. The Court found that an
attempt to obtain benefits based on an allegation of CUE "is
fundamentally different from any other kind of action in the
VA adjudicative process." Livesay, 15 Vet. App. at 178. As
such, an allegation of CUE does not represent a "claim" but
rather is a collateral attack on a final decision. The
provisions of the VCAA, and its implementing regulation, are
not, therefore, applicable to the adjudication of the issue
of CUE in a prior, final decision. A request for an earlier
effective date based on CUE, by its very nature, involves
only the evidence that was before the RO at the time it
rendered the decision in which the veteran is alleging CUE.
As a practical matter, the veteran could not submit any
evidence contemporaneous with the current appeal which could
potentially change the outcome. VA has no further duty,
therefore, to notify the veteran of the evidence needed to
substantiate his claim, or to assist him in obtaining that
evidence, in that no reasonable possibility exists that any
further assistance would aid the veteran in substantiating
the claim. See also Wensch v. Principi, 15 Vet. App. 362,
368 (2001).
The Board adds that general due process concerns have been
satisfied in connection with this appeal. See 38 C.F.R.
§ 3.103 (2004). The veteran engaged the services of a
representative, was provided with ample opportunity to submit
evidence and argument in support of his claim, and was given
the opportunity to present testimony regarding his claims.
The veteran indicated in his substantive appeal that he did
not want a hearing before the Board.
Accordingly, the Board will proceed to a decision on the
merits as to the issue on appeal.
Pertinent Law and Regulations
Effective dates
Unless specifically provided otherwise in the statute, the
effective date of an award based on an original claim for
compensation benefits shall be the date of receipt of the
claim or the date entitlement arose, whichever is later. 38
U.S.C.A. § 5110(a) (West 1991); 38 C.F.R. § 3.400 (2004).
With respect to service connection claims which are granted
following the submission of new and material evidence, such
as the grant of service connection for the veteran's
gastrointestinal disorders, governing regulation provides
that the effective date of the award will be the date of
receipt of the new claim or the date entitlement arose,
whichever is later. 38 C.F.R. § 3.400(q)(1)(ii) and ®
(2004).
In the case of claims for an increased disability rating, to
include claims for TDIU, the effective date assigned is
generally the date of receipt of the claim or date
entitlement arose, whichever is later. 38 C.F.R. §
3.400(o)(1) (2003). If, however, the claim is filed within
one year of the date that the evidence shows that an increase
in disability has occurred, the earliest date as of which an
increase is factually ascertainable will be used (not
necessarily the date of receipt of the evidence). 38 C.F.R.
§ 3.400(o)(2) (2004). See also Harper v. Brown, 10 Vet. App.
125, 126-27 (1997). Evidence contained in the claims file
showing that an increase was ascertainable up to one year
before the claim was filed will be dispositive. See Quarles
v. Derwinski, 3 Vet. App. 129, 135 (1992).
The applicable statutory and regulatory provisions require
that VA look to all communications from the veteran which may
be interpreted as applications or claims--formal and
informal--for benefits. In particular, VA is required to
identify and act on informal claims for benefits. 38
U.S.C.A. § 511(:((2); 38 C.F.R. §§ 3.1(p), 3.155(a); Servello
v. Derwinski, 3 Vet. App. 196, 198-200 (1992).
Claims
A specific claim in the form prescribed by the Secretary of
VA must be filed in order for benefits to be paid or
furnished to any individual under the laws administered by
VA. 38 U.S.C.A. § 5101(a) (West 2002); 38 C.F.R. § 3.151(a)
(2004). The term "claim" or "application" means a formal
or informal communication in writing requesting a
determination of entitlement or evidencing a belief in
entitlement to a benefit. 38 C.F.R. § 3.1(p) (2004).
Any communication or action indicating an intent to apply for
one or more benefits under the laws administered by VA, from
a veteran or his representative, may be considered an
informal claim. Such informal claim must identify the
benefit sought. Upon receipt of an informal claim, if a
formal claim has not been filed, an application form will be
forwarded to the claimant for execution. If received within
one year from the date it was sent to the veteran, it will be
considered filed as of the date of receipt of the informal
claim. When a claim has been filed which meets the
requirements of 38 C.F.R. §§ 3.151 or 3.152, an informal
request for increase or reopening will be accepted as a
claim. 38 C.F.R. § 3.155 (2004).
CUE
An unappealed decision of the RO or the Board becomes final
and binding and is not subject to revision on the same
factual basis in the absence of CUE. Previous determinations
which are final and binding will be accepted as correct in
the absence of CUE. Where evidence establishes such error,
the prior decision will be reversed or amended. 38 U.S.C.A.
§§ 5109A, 7111 (West 2002); 38 C.F.R. §§ 3.105, 20.1400
(2004).
The Court has defined CUE as "an administrative failure to
apply the correct statutory and regulatory provisions to the
correct and relevant facts. It is not mere misinterpretation
of facts." Oppenheimer v. Derwinski, 1 Vet. App. 370, 372
(1991). Clear and unmistakable errors "are errors that are
undebatable, so that it can be said that reasonable minds
could only conclude that the original decision was fatally
flawed at the time it was made." Russell v. Principi, 3
Vet. App. 310, 313-14 (1992). "To prove the existence of
clear and unmistakable error as set forth in § 3.105(a), the
claimant must show that an outcome-determinative error
occurred, that is, an error that would manifestly change the
outcome of a prior decision." Yates v. West, 213 F.3d 1372,
1374 (Fed. Cir. 2000).
Any claim of CUE must be pled with specificity. Andre v.
West, 14 Vet. App. 7, 10 (2000) (per curium), aff'd sub nom.,
Andre v. Principi, 301 F.3d 1354 (Fed. Cir. 2002). The
specific allegation must assert more than merely disagreement
with how the facts of the case were weighed or evaluated. In
other words, to present a valid claim of CUE the claimant
cannot simply request that the Board reweigh or reevaluate
the evidence. Crippen v. Brown, 9 Vet. App. 412 (1996). In
order to show that CUE occurred, the evidence must show that
the law was incorrectly applied to the facts as they were
known at the time and that, had the error not occurred, the
decision would have been manifestly different. Bustos v.
West, 179 F.3d 1378 (Fed. Cir. 1999).
When considering a claim of CUE, the determination must be
made based on the record and the law in existence at the time
of the prior, final decision. Damrel v. Brown, 6 Vet. App.
242, 245 (1994) [quoting Russell v. Principi, 3 Vet. App.
310, 313-14 (1992)]; Pierce v. Principi, 240 F.3d 1348 (Fed.
Cir. 2001). The Board observes that the substance of law and
regulations pertaining to CUE have not changed since 1996.
(CONTINUED ON NEXT PAGE)
1. Entitlement to an effective date prior to March 8, 1996
for the grant of service connection for gastrointestinal
disorders, including the issue of whether a June 1996 rating
decision was clearly and unmistakably erroneous in assigning
an effective date of March 8, 1996 for the grant of service
connection.
Factual Background
The veteran filed an initial service connection claim for a
stomach disorder in December 1986. The RO denied the
veteran's claim in a March 1987 rating decision. That
decision was duly appealed, and the veteran's claim was
denied in an April 1989 Board decision. The veteran was
notified of the Board's decision in a letter dated April 28,
1989. He could not appeal to the Court, since his NOD was
filed in April 1987, prior to the November 1988 effective
date of the Veterans Judicial Review Act, Pub. L. No. 100-
687, 102 Stat. 4105 (1988). The Board's decision was
therefore final. See 38 C.F.R. § 20.1100 (2004).
Following the Board's April 1989 decision, the veteran did
not communicate with the RO regarding his stomach or
gastrointestinal disorders until May 8, 1996, at which time
he sought to reopen his previously-denied claim for a stomach
disorder. In support of the claim, the veteran submitted a
medical statement from his treating physician to the effect
that his service-connected anxiety and depression aggravated
his stomach problems.
After obtaining additional private medical records and a VA
examination, in a June 1996 rating decision, the RO found
that the veteran had submitted new and material evidence
supporting his claim for service connection for
gastrointestinal disabilities, reopened the claim and granted
service connection for gastric ulcers with gastritis,
Barrett's esophagus with chronic reflux, post-gastrectomy
secondary to service-connected chronic anxiety reaction with
depression, conversion reaction and cephalgia. A 40 percent
disability rating was assigned, effective March 8, 1996,
reflecting the date the veteran's claim was received by the
RO. The veteran did not appeal the RO's decision.
The veteran filed a claim for an earlier effective date for
the grant of service connection for the gastrointestinal
disorders in August 1999. Included in this claim was the
veteran's contention that the June 1996 rating decision
contained CUE in assigning an effective date of March 8, 1998
for the grant of service connection for gastrointestinal
disorders. In support of this argument, the veteran contends
that service connection should be made effective May 18,
1948, the day following his separation from service. Such a
date is appropriate, the veteran contends, because his
gastrointestinal disabilities have existed since service.
Analysis
The Board wishes to make it clear that it is aware of the
Court's instructions in Fletcher v. Derwinski, 1 Vet. App.
394, 397 (1991), to the effect that a remand by the Court is
not "merely for the purposes of rewriting the opinion so
that it will superficially comply with the "reasons or
bases" requirement of 38 U.S.C.A. § 7104(d)(1). A remand is
meant to entail a critical examination of the justification
for the decision." The Board's analysis has been undertaken
with that obligation in mind. However, based upon a complete
review of the record and for the reasons and bases expressed
immediately below, the Board finds that as a matter of law
the currently assigned effective date of March 8, 1996 is the
earliest date assignable for the grant of service connection
for the veteran's gastrointestinal disabilities.
As discussed in the law and regulations section above, the
assignment of the effective date for the grant of service
connection for the veteran's gastrointestinal disorders
hinges on two factors: the date of receipt of the reopened
claim or the date entitlement arose, whichever is later. See
38 C.F.R. § 3.400(q)(1)(ii) and ® (2004). Thus, the Board
must review the evidence to determine whether a request to
reopen the previously denied claim of service connection for
gastrointestinal disorders was filed after April 28, 1989,
the date of notification of the last final Board decision on
this claim, but before the current effective date of the
award in question, March 8, 1996. See Servello v. Derwinski,
3 Vet. App. 196, 198-200 (1992); see also EF v. Derwinski, 1
Vet. App. 324, 326 (1991) [VA must liberally construe all
documents filed by a claimant in order to determine, or even
to infer, what claims have been filed].
Review of the claims file reveals that the veteran contacted
the RO on only three occasions between the Board's April 1999
decision and his request to reopen in March 1996. In July
1991 the veteran responded to an inquiry from the RO as to
his spouse's social security number; in January 1993 he
responded to another inquiry from the RO as to the status of
his dependents; and in February 1995, he requested a copy of
his service medical records.
These three contacts cannot suffice as a reopened claim for
service connection for gastrointestinal disorders, formal or
informal. In Brannon v. West, 12 Vet. App. 32 (1998), the
Court observed that while the VA must interpret a claimant's
submissions broadly, it is not required to conjure up issues
that were not raised by the claimant. The Court has further
held that VA is not held to a standard of prognostication
when determining what issues are presented. See Talbert v.
Brown, 7 Vet. App. 352, 356- 57; Allin v. Brown, 6 Vet. App.
207, 213 (1994) "[t]here must be some indication . . . that
[a claimant] wishes to raise a particular issue . . . The
indication need not be express or highly detailed; it must
only reasonably raise the issue." [These cases involve the
Board, not an RO, but it is clear that the reasoning employed
by the Court applies to all levels within VA. Cf. EF v.
Derwinski, 1 Vet. App. 324, 326 (1991).]
Thus, there is nothing which could be reasonably construed as
a formal or informal claim for service connection prior to
March 8, 1996, as the records reflecting these three contacts
contain no reference to the veteran's stomach disorder or to
a desire for service connection. The Board has identified no
correspondence or other communication from the veteran which
would serve as a claim for service connection after April
1989 and before March 1996, and the veteran has pointed to
none. Accordingly, the March 8, 1996 effective date for
service connection for a gastrointestinal disorder was
correctly assigned and the veteran's appeal is denied as to
that issue.
In reaching this conclusion, the Board has considered the
veteran's contention that his gastrointestinal disorders have
existed since service and that as a result service connection
should be made effective May 18, 1946 (the day after his
separation from service). As noted above, however, in cases
involving a reopened claim, the effective date of service
connection is not solely contingent upon the date entitlement
arose (i.e. the date the veteran first experienced a
gastrointestinal disorder). Rather, the effective date
assigned is the later of the date of receipt of the reopened
claim or the date entitlement arose, whichever is later. See
38 C.F.R. § 3.400(q)(1)(ii) and ® (2004). Therefore,
assuming arguendo that the veteran's gastrointestinal
disorders began during his time in service, the earliest
effective date of service connection would still be the date
his reopened claim was received. Review of the record
reveals that the veteran's reopened claim for service
connection for gastrointestinal disorders was received on
March 8, 1996. Therefore, this date was properly assigned by
the RO as the effective date for service connection.
It appears that the veteran is contending that because he had
gastrointestinal disabilities since service, he should be
compensated for that entire time. This amounts to an
argument couched in equity. However, the Board is bound by
the law and is without authority to grant benefits on an
equitable basis. See 38 U.S.C.A. §§ 503, 7104; Harvey v.
Brown, 6 Vet. App. 416, 425 (1994). The Board further
observes that "no equities, no matter how compelling, can
create a right to payment out of the United States Treasury
which has not been provided for by Congress." Smith (Edward
F.) v. Derwinski, 2 Vet. App. 429, 432-33 (1992) [citing
Office of Personnel Management v. Richmond, 496 U.S. 414, 426
(1990)]. Thus, while the Board does not dispute that the
veteran experienced gastrointestinal disabilities prior to
the effective date of service connection which has been
assigned above, it is constrained to apply the law as
Congress has created it and cannot extend benefits out of
sympathy for a particular claimant.
The Board has also considered the veteran's contention that
the June 1996 rating decision contained CUE in assigning an
effective date of March 8, 1996 for service connection for
his gastrointestinal disabilities. The arguments proffered
by the veteran and his representative with regard to the CUE
claim essentially mirror those contained in the non-CUE
aspect of the veteran's claim, namely that service connection
should be made effective the day after the veteran left
service, as the veteran claims his gastrointestinal problems
began on active duty.
In furtherance of his CUE claim, the veteran has not
referenced any facts that were not considered by the RO in
arriving at the assigned effective date, or any pertinent
statutory or regulatory provisions that were incorrectly
applied to the facts, which is required in order to establish
a valid claim of CUE. See Damrel v. Brown, 6 Vet. App. 242
(1994), citing Russell v. Principi, 3 Vet. App. 310 (1992).
In short, the veteran has not pled with any degree of
specificity any error of law or fact that allegedly occurred,
as required by law. See Andre, 14 Vet. App. at 10. The
Board finds, therefore, that the veteran has failed to raise
a valid claim of CUE in the October 1996 rating decision.
His claim of CUE in the October 1996 rating decision is,
therefore, denied as a matter of law. See Luallen v. Brown,
8 Vet. App. 92, 96 (1995) [if the veteran fails to plead a
valid claim of CUE, his claim should be denied as a matter of
law].
2. Entitlement to an effective date prior to March 8, 1995
for the assignment of a total disability rating based on
individual unemployability, including the issue of whether a
September 1996 rating decision was clearly and unmistakably
erroneous in assigning an effective date of March 8, 1996 for
the total rating.
Factual Background
The veteran was initially granted service connection for
cephalagia in a June 1946 rating decision; a 10 percent
disability rating was assigned. A September 1970 rating
decision recharacterized the veteran's disability to
psychoneurosis and conversion reaction with cephalagia and
continued the 10 percent rating. The assigned rating was
subsequently increased to 30 percent in a November 1970
rating decision. The assigned rating was increased to 50
percent in a February 1975 rating decision which again
recharacterized the veteran's service-connected psychiatric
disability, this time to "chronic anxiety reaction, with
depression, conversion reaction with cephalagia."
The evidence of record reveals that the veteran initially
submitted a specific claim for TDIU which was received by the
RO on June 19, 1975. Although a September 1975 rating
decision denied an increased rating for the veteran's service
connected anxiety reaction with depression, this decision did
not specifically address the TDIU claim.
The record reveals that in the years prior to his June 1975
TDIU claim, the veteran was receiving weekly VA psychiatric
treatment. The records from this treatment reflect that the
veteran suffered from a very high, and nearly continual,
level of anxiety and nervousness. The veteran also
complained of memory lapses and showed regular agitation and
tension regarding his business. In particular, the veteran
complained of problems with anger and intense conflict in
interpersonal relationships, including those with his
employees, clients, and family members. The use of multiple
prescription medications to treat the veteran's psychiatric
problems was also noted.
Also of record at the time of the veteran's June 1975 TDIU
claim is the report of a VA psychiatric examination dated in
December 1974. On mental status examination, the veteran
exhibited a flat affect and was found to be agitated and
tense. He was also found to have poor insight and judgment
and appeared discouraged and despondent. The examiner noted
that the veteran does not cope with situational stress very
well and gets quite depressed and will occasionally have
crying spells. Also noted was the veteran's extremely short
temper and the fact that he was easily irritable and
frustrated. The veteran also complained of poor peer
relationships, sleep disturbance, and frequently wondering if
life is worth living. The veteran also reported that he was
unable to work very much anymore due to his psychiatric
symptomatology and that his condition, especially his poor
peer relationships, were ruining what little business he had
left. Overall, the examiner noted that the veteran's
condition was gradually deteriorating and that his level of
incapacity was marked. The examiner also reported that the
veteran's "ability to continue functioning in his own
business is rapidly diminishing . . . [h]e is functioning on
a marginal basis now" and his "social and economic
adjustments are marginal".
Submitted with the June 1975 TDIU claim was a letter from the
veteran's private physician, Dr. H.J.W. Dr. W. stated that
on March 20, 1975 he informed the veteran that "he should
totally retire, effective immediately, due to the fact that
he is longer able to continue in his business or . . . any
other business . . . due to extreme nervousness, anxiety, and
depression." Pursuant to his physician's advice, the
veteran subsequently sold his private investigation business
and permanently retired. He was 49 years old at the time.
Also of record is the report of a September 1975 VA
psychiatric examination. During this examination, the
veteran voiced complaints similar to those found in his prior
treatment records and examination reports including feelings
of severe tension, depression, and nervousness to the point
of not wishing to live at times. He also reported several
episodes of memory loss and increased feelings of anger and
difficulty in controlling his temper. The veteran noted that
he had retired to due his psychiatric symptomatology in March
1975.
A letter dated in June 1975 was also received from J.V., the
veteran's former secretary, who stated that because of the
veteran's outbursts of anger he "has become almost
unbearable to work with . . . there have been a lot of times
that [the veteran] has caused me to cry because of his
actions and tantrums." J.V. also noted that the veteran
"has gone into fits of rage over minor incidents any number
of times." She also noted that the veteran's anger problems
cost his private investigation firm " a good deal of
business because of the way he talks to people on the
telephone . . . [t]here are times when he becomes rude to the
point of being insulting." J.V. further reported that on
several occasions she witnessed the veteran break down and
cry on the job. She also noted that she was no longer
employed by the veteran because he has "broken down and on
the advice of his doctor . . . retired completely from
business."
As has been described elsewhere in this decision, the veteran
submitted another claim of entitlement to TDIU in March 1996;
the RO granted TDIU and assigned an effective date of March
8, 1996; the veteran appealed; and the Board granted an
effective date of March 8, 1995. That aspect of the Board's
June 2001 decision was not vacated by the Court.
Analysis
The veteran is seeking an effective date of March 1975 for
the grant of TDIU. He essentially claims that this date is
appropriate because he stopped working due to his service
connected psychiatric disabilities at that time.
As noted in the law and regulations section above, the
effective date of a TDIU claim is generally the date of
receipt of claim or the date entitlement arose, whichever is
later. 38 C.F.R. § 3.400(o)(1) (2004). Under the provisions
of 38 C.F.R. § 3.400(o)(2), however, if the claim is filed
within one year of the date that the evidence shows that an
increase in disability has occurred, the effective date will
be the earliest date as of which an increase is factually
ascertainable.
In the instant case, the veteran filed an initial TDIU claim
in June 1975. The veteran's claim was presented via a letter
signed by his accredited representative, and specifically
stated that it was an "application for . . . benefits due to
unemployability as a result of [the veteran's ] service
connected disabilities." The letter was received on June
19, 1975. Moreover, received on June 29, 1975 was a VA Form
21-527, Income - Net Worth and Employment Statement. In item
10, "Did you have to quit your last job or self-employment
on account of your physical condition?", the veteran
responded "Yes" "Because of service connected disab." On
the reverse side of the form were the words "Application for
unemployability due to service connected disability." The
date the veteran claimed to have become totally disabled was
March 20, 1975 [item 4].
This TDIU claim, however, was not acted on by the RO. In a
rating decision dated September 24, 1975, the RO denied an
increased rating for the veteran's service-connected
psychiatric disability. In October 1975, the RO wrote to the
veteran, indicating that "the evidence does not warrant any
change in your prior evaluation." This was clearly meant to
signal a denial of the increased rating claim. There is no
indication that the RO considered the TDIU claim. Based upon
this unacted-upon TDIU claim, the Board finds that the claim
for TDIU was pending since June 19, 1975.
The Board must therefore review the record to determine if
the veteran was unemployable due to his service-connected
disabilities as early as June 19, 1975 (the day his TDIU
claim was received) or up to one year prior to that date.
See 38 C.F.R. § 3.400, 4.16 (2004).
After a careful review of the record, the Board finds that
the veteran has been unemployable to due his service
connected psychiatric disability since March 20, 1975. This
is the date which was provided by the veteran himself in item
4 of the VA Form 21-527 he filed later in June 1975. In
support of this finding, the Board notes that the veteran's
private physician, Dr. W, advised the veteran on that date
that that he was no longer able to continue in his business
or any other due to extreme nervousness, anxiety, and
depression. No contradictory medical opinion has been
associated with the claims file. The record reflects that
the veteran followed his physician's advice and sold his
private investigation business and permanently retired. As
noted above, the veteran was only 49 years old at the time.
The remainder of the medical and other evidence of record
appears to be consistent with Dr. W's conclusion, and it
reflects a significant deterioration in both the veteran's
business and his psychological well being in the years
leading up to March 1975. In particular, VA treatment
records in the years prior to the veteran's retirement reveal
that the veteran was suffering from a near continual
extremely high level of nervousness and anxiety. These
records also reflect the veteran's acute problems with anger
and the intense conflict in his interpersonal relationships,
including those with his employees, clients, and family
members.
The December 1974 VA psychiatric examination, conducted only
four months before the veteran stopped working, also confirms
his severe level of impairment. During this examination, the
veteran particularly noted that he was unable to work much
anymore due to his severe anxiety, nervousness and
depression. He also noted that his poor peer relationships,
irritability and outbursts of anger were ruining what little
business he had left. The veteran's reports of memory loss
and crying spells coupled with the examiner's finding that
the veteran was despondent and unable to cope with stress
also indicate his growing inability to work. The Board also
finds significant the fact that the examiner found the
veteran to be functioning on only a marginal level and that
his ability to continue functioning in his job was rapidly
diminishing.
The non-medical evidence also reflects the impact of the
veteran's psychological disability on his ability to work.
Of note is the June 1975 letter from J.V., the veteran's
former secretary, which confirms the severity of the
veteran's outbursts of anger and inability to maintain
professional relationships. She specifically reported that
the veteran was "almost unbearable to work with" and caused
her to cry on several occasions due to his tantrums. She
also noted that he treated clients of the business no better,
and reported that his fits of rage, rudeness, and insulting
behavior had caused the business to greatly suffer. She
further reported witnessing the veteran break down crying at
the office on several occasions.
In short, the record reveals that the veteran stopped working
in March 1975 due to his service-connected psychiatric
disability. This decision was made on the advice of the
veteran's private physician who advised him that he was no
longer able to work due to extreme nervousness, anxiety, and
depression. The other evidence of record supports this
conclusion and reflects the veteran's severe problems with
anger and maintaining interpersonal relationships.
Therefore, the Board finds that the veteran is entitled to
TDIU effective March 20, 1975, the date the veteran was
advised to (and did) stop working. Although the veteran's
service-connected psychiatric disability was undoubtedly
severe prior to this date, the record reflects that he was
still working before March 20, 1975. The veteran does not
contend otherwise, and indeed as discussed above he himself
has pointed to March 20, 1975.
Accordingly, the Board holds that the evidence supports a
grant of a total disability rating based upon individual
unemployability due to service-connected disabilities
effective March 20, 1975.
Because the Board has granted an effective date of March 20,
1975 for the grant of TDIU, the veteran's claim of CUE in the
September 1996 has been rendered moot, as the veteran has
been granted the benefit sought on appeal. In any event, as
discussed with respect to the first issue on appeal, the
veteran has not presented a specific, actionable CUE claim in
any event. See Andre, supra. Mere disagreement with a VA
decision does not amount to a valid claim of CUE. See
Crippen, supra.
In summary, for reasons and based expressed above, the Board
concludes that an effective date of March 20, 1975 is
warranted for TDIU. The benefit sought on appeal is
accordingly granted.
ORDER
An effective date earlier than March 8, 1996, for the grant
of service connection for gastrointestinal disorders is
denied.
An effective date of March 20, 1975, for the award of a total
disability rating based upon individual unemployability due
to service-connected disabilities is granted, subject to the
laws and regulations governing the award of monetary
benefits.
____________________________________________
Barry F. Bohan
Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs
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