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2010 Bva Decision Grants Cue On 1973 Rating Decision
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carlie
http://www4.va.gov/vetapp10/files1/1001265.txt
Citation Nr: 1001265
Decision Date: 01/08/10 Archive Date: 01/15/10
DOCKET NO. 08-04 783 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Jackson,
Mississippi
THE ISSUE
Whether there was clear and unmistakable error (CUE) in a
December 1973 rating decision that denied service connection
for paranoid schizophrenia.
REPRESENTATION
Appellant represented by: Samuel M. Tumey, Attorney-at-
Law
ATTORNEY FOR THE BOARD
K. Fitch, Counsel
INTRODUCTION
The Veteran had active military service from August 1969 to
September 1971. He had been adjudicated as incompetent
prior to September 2006, but in a rating decision dated in
September 2006, the RO found that the Veteran was competent
for VA purposes. As such the Veteran is the appellant in
this case.
This matter comes before the Board of Veterans' Appeals
(Board) on appeal from a May 2007 rating decision of a
Department of Veterans Affairs (VA) Regional Office (RO),
that found no clear and unmistakable error in a December
1973 rating decision that denied entitlement to service
connection for paranoid schizophrenia. The Veteran filed a
notice of disagreement with respect to this decision in June
2007, and the RO issued a statement of the case dated in
December 2007. The Veteran's substantive appeal was
received by the RO in February 2008.
In a June 1997 statement from the Veteran, he requested an
earlier effective date for the grant of the 100 percent
evaluation for his schizophrenia. As this matter has not
yet been adjudicated by the Board, it is referred to the RO
for appropriate disposition.
FINDINGS OF FACT
1. Entitlement to service connection for paranoid
schizophrenia was denied by the RO in a December 1973 rating
decision. The Veteran was notified of this decision and his
appellate rights in a January 1974 RO letter, and he did not
file a notice of disagreement.
2. In a July 1981 rating decision, the RO denied the
Veteran's application to reopen his claim of entitlement to
service connection for schizophrenia; the Veteran appealed
the RO's decision to the Board which, after further
development, reopened the claim and granted entitlement to
service connection for paranoia in a decision dated in
August 1983.
3. The RO effectuated the August 1983 Board decision by way
of a September 1983 rating decision, and service connection
was established, effective April 1, 1981, the date of
receipt of the application to reopen the service connection
claim.
4. The December 1973 rating decision was clearly and
unmistakably erroneous in that it contained undebatable
error, and as a result manifestly changed the outcome of the
decision.
CONCLUSION OF LAW
The December 1973 rating decision which denied service
connection for paranoid schizophrenia was clearly and
unmistakably erroneous. 38 U.S.C.A. §§ 5110 (West 2002);
38 C.F.R. § 3.105 (2009).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
As a preliminary matter, the Board finds that the Veterans
Claims Assistance Act of 2000 (VCAA) is not applicable to
this case as a matter of law. The United States Court of
Appeals for Veterans Claims (Court) has held that the VCAA
does not apply to CUE actions. See Livesay v. Principi, 15
Vet. App. 165 (2001)(en banc) (holding VCAA does not apply
to Board CUE motions); Baldwin v. Principi, 15 Vet. App. 302
(2001) (holding VCAA does not apply to RO CUE claims). The
general underpinning for the holding that the VCAA does not
apply to CUE claims is that regulations and numerous legal
precedents establish that a review for CUE is only upon the
evidence of record at the time the decision was entered
(with exceptions not applicable in this matter). See Fugo
v. Brown, 6 Vet. App. 40, 43 (1993); Pierce v. Principi, 240
F.3d 1348 (Fed. Cir. 2001) (affirming the Court's
interpretation of 38 U.S.C. § 5109A that RO CUE must be
based upon the evidence of record at the time of the
decision); Disabled Am. Veterans v. Gober, 234 F. 3d 682
(Fed. Cir. 2000) (upholding Board CUE regulations to this
effect).
Criteria & Analysis
The Veteran in this case contends that the December 1973
rating decision which initially denied service connection
for paranoid schizophrenia contains CUE and, therefore,
service connection should be awarded as of the date he filed
his original claim.
Following notification of an initial review and adverse
determination by the Regional Office (RO), a notice of
disagreement must be filed within one year from the date of
notification thereof; otherwise, the determination becomes
final. 38 U.S.C.A. §§ 5108, 7105; 38 C.F.R. § 3.156.
Under the provisions of 38 C.F.R. § 3.105(a), previous
determinations that are final and binding, including
decisions of service connection, will be accepted as correct
in the absence of clear and unmistakable error. In order
for a claim of CUE to be valid, there must have been an
error in the prior adjudication of the claim; either the
correct facts, as they were known at the time, were not
before the adjudicator or the statutory or regulatory
provisions extant at the time were incorrectly applied.
Phillips v. Brown, 10 Vet. App. 25, 31 (1997); Damrel v.
Brown, 6 Vet. App. 242, 245 (1994); Russell v. Principi, 3
Vet. App. 310, 313-14 (1992) (en banc). Further, the error
must be "undebatable" and of the sort which, had it not
been made, would have manifestly changed the outcome at the
time it was made, and a determination that there was CUE
must be based on the record and law that existed at the time
of the prior adjudication in question. Id. Simply to claim
CUE on the basis that the previous adjudication improperly
weighed and evaluated the evidence can never rise to the
stringent definition of CUE, nor can broad-brush allegations
of "failure to follow the regulations" or "failure to
give due process," or any other general, non-specific claim
of "error" meet the restrictive definition of CUE. Fugo
v. Brown, 6 Vet. App. 40, 44 (1993).
Clear and unmistakable error is 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). It is a very specific and rare
kind of error of fact or law that compels the conclusion, as
to which reasonable minds could not differ, that the result
would have been manifestly different but for the error.
Fugo v. Brown, 6 Vet. App. 40, 43 (1993).
Where evidence establishes CUE, the prior decision will be
reversed or amended. For the purpose of authorizing
benefits, the rating decision which constitutes a reversal
of a prior decision on the grounds of CUE has the same
effect as if the corrected decision had been made on the
date of the reversed decision. 38 C.F.R. §§ 3.104(a),
3.400(k).
The Court has propounded a three-pronged test to determine
whether clear and unmistakable error is present in a prior
determination. First, either the correct facts, as they
were known at the time, were not before the adjudicator
(i.e., more than a simple disagreement as to how the facts
were weighed or evaluated) or the statutory or regulatory
provisions extant at the time were incorrectly applied.
Second, the error must be "undebatable" and of the sort
"which, had it not been made, would have manifestly changed
the outcome at the time it was made." Third, a
determination that there was clear and unmistakable error
must be based on the record and the law that existed at the
time of the prior adjudication in question. Damrel v.
Brown, 6 Vet. App. 242, 245 (1994) (quoting Russell v.
Principi, 3 Vet. App. 310, 313-14 (1992) (en banc)).
The relevant laws and regulations in effect in December 1973
with respect to awards of service connection were
essentially unchanged from those in effect at present;
although the relevant code numbers have since been revised.
Service connection will be granted if it is shown that the
veteran suffers from disability resulting from an injury
suffered or disease contracted in line of duty, or for
aggravation of a preexisting injury suffered or disease
contracted in line of duty, in the active military, naval,
or air service. 38 U.S.C.A. §§ 310, 331 (West 1970) (now
codified as 1110, 1131 (West 2002)); 38 C.F.R. § 3.303
(1973, 2009). That an injury occurred in service alone is
not enough; there must be chronic disability resulting from
that injury. If there is no showing of a resulting chronic
condition during service, then a showing of continuity of
symptomatology after service is required to support a
finding of chronicity. 38 C.F.R. § 3.303(b). Additionally,
for veterans who have served 90 days or more of active
service during a war period or after December 31, 1946,
certain chronic disabilities, such as psychoses, are
presumed to have been incurred in service if manifested to a
compensable degree within one year of discharge from
service. 38 U.S.C.A. §§ 312, 333 (1970) (now codified as
1112, 1133 (West 2002)); 38 C.F.R. §§ 3.307, 3.309. Service
connection may also be granted for any disease diagnosed
after discharge, when all the evidence, including that
pertinent to service, establishes that the disease was
incurred in service. 38 C.F.R. § 3.303(d).
On September 24, 1973, the Veteran filed a claim of service
connection for paranoid schizophrenia. The evidence on file
at that time consisted of service treatment records and VA
medical records.
The Veteran's service treatment records indicate that in
June 1971 the Veteran was hospitalized for heroin addiction.
He was noted to be taking part in an amnesty program for his
addiction, but went AWOL. The Veteran was also diagnosed
with paranoid schizophrenia. A Clinical Record Cover Sheet
dated in June 1971 reflects that paranoid schizophrenia was
incurred in the line of duty, and heroin addiction was not
incurred in the line of duty and was due to the Veteran's
own misconduct. A July 1971 Clinical Record Cover Sheet
reflects a diagnosis of drug addiction, heroin, manifested
by withdrawal symptoms; treated and cured. He was also
noted to have predisposition of history of mental illness in
his father and other family members, and minimal impairment
for further military duty. It was noted that the drug
addiction was not incurred in the line of duty, and was due
to his own misconduct. The Veteran was recommended to be
returned to duty for an "Early out - ETS" discharge. The
Veteran's separation examination indicated that the Veteran
was normal in all respects.
VA treatment records on file reflect that the Veteran was
hospitalized in September 1973, with a diagnosis of
schizophrenia, paranoid type. The physician indicated that
personality disorder should be ruled out and that further
treatment and testing were in order. A November 1973
treatment record reflects that the Veteran reported being
treated and hospitalized at Searcy Hospital in Mobile,
Alabama, for one and a half months but was vague about when.
Based on the foregoing, the RO, in December 1973, denied
service connection for paranoid schizophrenia. The RO
reasoned that the Veteran had paranoid schizophrenia as a
result of his heroin addiction, but that this diagnosis was
dropped at the time of the Veteran's discharge from the
hospital. The RO also noted that the Veteran's separation
examination made no reference to treatment for a nervous
condition or for the heroin addiction. The RO noted that
the Veteran was presently hospitalized with a diagnosis of
schizophrenia, paranoid type, but with personality disorder
to be ruled out. The RO concluded that the schizophrenia
diagnosed in service was drug induced and of an acute nature
without permanent residuals or continuity thereof, and
determined that the presently diagnosed schizophrenia was
not related thereto. The Veteran did not file a notice of
disagreement, thus the rating determination is final.
38 U.S.C.A. § 7105.
After the December 1973 RO decision became final, the
Veteran submitted an application to reopen his claim of
entitlement to service connection for schizophrenia on two
additional occasions. In October 1975 and September 1979,
the RO denied reopening the Veteran's claim on the basis
that new and material evidence had not been received. The
Veteran was advised of the decisions in October 1975 and
September 1979, respectively, and his appellate rights. The
Veteran did not file a notice of disagreement with regard to
either rating decision, thus such rating determinations are
final. 38 U.S.C.A. § 7105.
In April 1981, the RO received an additional application to
reopen his claim of entitlement to service connection for
schizophrenia. In a July 1981 rating decision, the RO
denied the Veteran's application to reopen his claim of
entitlement to service connection for schizophrenia. The
Veteran filed a timely appeal of this decision to the Board
which, after further development, reopened the claim and
granted entitlement to service connection for paranoia in a
decision dated in August 1983. Such decision was based on
receipt of two medical opinions, one from a VA physician,
and another from an independent medical expert. The VA
physician opined that the Veteran's paranoid schizophrenia
was present during the Veteran's service, and the
independent medical expert opined that the Veteran's
paranoid schizophrenia manifested during the one-year period
for presumptive service connection for a psychosis. On such
basis, the Board concluded that at the very least, the
Veteran's acquired psychiatric disability manifested during
the presumptive period, and service connection was
warranted.
In this case, the Veteran, through his representative,
contends that the December 1973 RO decision contains clear
and unmistakable error in that schizophrenia was
presumptively service-connected as a chronic disability
under 38 C.F.R. § 3.303(b) in effect at the time of the
December 1973 decision. He also contends that the RO should
have requested the records of the Veteran's treatment at the
Searcy County Hospital in Mobile, Alabama from 1973. These
records, he contends, would have demonstrated that the
Veteran's condition was entitled to presumptive service
connection as having been manifest to an extent of 10
percent or more within one year of his discharge from the
service.
Initially, the Board notes that while the failure of the RO
in 1973 to obtain the requested medical records may have
affected the RO's decision in December 1973, a breach of the
duty to assist creates only an incomplete rather than an
incorrect record. See Cook v. Principi, 318 F.3d 1334,
1344-47 (Fed. Cir. 2002) (en banc); Elkins v. Brown, 8 Vet.
App. 391, 396 (1995); Caffrey v. Brown, 6 Vet. App. 377,
383-84 (1994). VA's breach of its duty to assist cannot
form a basis for a claim of CUE. See Tetro v. Gober, 14
Vet. App. 100, 109 (2000).
The Board, however, does note that upon review of the
evidence of record on file, there was incontrovertible
medical evidence that the Veteran's schizophrenia was
incurred in service.
As detailed hereinabove, paranoid schizophrenia was
diagnosed in June 1971, and a determination was made that
such mental disability was incurred in the line of duty. It
is clear that in rendering an adjudication in December 1973,
the RO did not consider the fact that trained military
medical personnel were of the opinion that his psychiatric
disability was incurred in the line of duty. The RO
concluded in December 1973 that the Veteran's schizophrenia
was drug induced and of an acute nature without permanent
residuals or continuity therof. Such conclusion though is
in complete contradiction with the findings of trained
military medical personnel in June 1971 that while his
heroin addiction was not incurred in the line of duty and
was due to his misconduct, his paranoid schizophrenia was
incurred in the line of duty. The service treatment records
are devoid of a finding that such paranoid schizophrenia was
drug induced or an acute condition. It is clear that if the
RO had duly considered the fact that trained military
medical personnel had concluded based on observation,
evaluation, and treatment of the Veteran that his
schizophrenia was incurred in service, that such
consideration would have manifestly changed the outcome of
the decision. Moreover, per a recent decision of the U.S.
Court of Appeals for the Federal Circuit (Federal Circuit),
when a chronic disease is shown in service, subsequent
manifestations of the same chronic disease at any later
date, however remote, are service connected. 38 C.F.R.
§ 3.303(b), see Groves v. Peake, 524 F.3d 1306 (Fed. Cir.
2008) (holding that when a chronic disease is identified in
service and at any time after service, service connection
will be granted without the need for nexus evidence). In
this case, service treatment records reflect a diagnosis of
paranoid schizophrenia in June 1971, and the evidence of
record on file at the time of the December 1973 decision
reflects that he was hospitalized in September 1973 (two
years after separation from service) due to paranoid
schizophrenia. Thus, a chronic disease was shown in
service, and subsequent manifestations of the same chronic
disease was shown within two years of separation from
service.
Thus, based on the following, the evidence supports a
finding that the December 1973 rating decision contained CUE
in denying the claim of service connection for paranoid
schizophrenia.
ORDER
The December 1973 rating decision which denied service
connection for paranoid schizophrenia contained clear and
unmistakable error. The appeal is granted.
____________________________________________
M.W. KREINDLER
Acting Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs
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