Andrews v. McDonough

Wendell Andrews, Appellant, v. Denis McDonough, Secretary of Veterans Affairs, Appellee.

No. 19-3227

United States Court of Appeals For Veterans Claims

May 28, 2021

Argued February 24, 2021

On Appeal from the Board of Veterans' Appeals

Richard V. Spataro, with whom Alexis M. Ivory and Barton F Stichman, all of Washington, D.C., were on the brief for the appellant.

Jonathan G. Scruggs, with whom William A. Hudson, General Counsel; Mary Ann Flynn, Chief Counsel; and Sarah W. Fusina Deputy Chief Counsel, all of Washington, D.C., were on the brief for the appellee.

Before GREENBERG, FALVEY, and LAURER, Judges.

LAURER, JUDGE:

United Sates Marine Corps veteran Wendell Andrews appeals, through counsel, a January 17, 2019, Board of Veterans' Appeals (Board) decision denying entitlement to a rating above 10% for chondromalacia of the right patella with degenerative joint disease (DJD) and a rating above 10% for DJD of the left knee.^[1] The parties agree that we should set aside and remand the Board decision. They disagree about whether we should instruct the Board that its obligations on remand are governed by Kutscherousky v. West^[2] and Fletcher v. Derwinski.^[3] The parties' dispute stems from changes to VA's claim process enacted in the Veterans Appeals Improvement and Modernization Act of 2017 (AMA)^[4] and its implementing regulations. As explained below, we hold that, because under the AMA the record in appellant's case is limited to the evidence of record at the time of the agency of original jurisdiction (AOJ) decision, Kutscherousky and Fletcher do not apply as far as they allow for submission of additional evidence or require the Board to independently develop a claim. Even so, we still expect the Board to critically examine the justification for the decision, reexamine the evidence of record, and issue a timely, well-supported decision.

I. BACKGROUND

Because the parties agree about the scope of the Board's error, we only briefly recount the facts underlying this appeal. Mr. Andrews has been service connected for his knee disabilities since the 1980s. Most recently, he sought increased ratings for his disabilities in September 2015.^[5]To help develop his claim, VA afforded Mr. Andrews an exam in September 2017.^[6] At that exam, he was diagnosed with DJD of the left knee and chondromalacia patella with DJD of the right knee.^[7] Mr. Andrews reported knee pain that increased with standing and walking and greater functional impairment after repeated use. ^[8] In addressing this information, the VA examiner explained that he could not opine without speculating about how pain, weakness, fatigability, or incoordination impacted functional ability with repeated use over time because appellant was not experiencing a flare-up at the time of the exam.^[9] Based on this exam, VA denied Mr. Andrews higher ratings for left and right knee disabilities in an October 2017 rating decision.^[10]

In response, Mr. Andrews filed a Notice of Disagreement (NOD) and elected to participate in VA's Rapid Appeals Modernization Program (RAMP) through the supplemental claim lane.^[11] VA also denied this supplemental claim.^[12] Mr. Andrews then appealed to the Board under the direct review docket, leading to the Board decision on appeal.^[13]

II. ANALYSIS

The parties agree that we should set aside and remand the Board decision because the Board failed to address the reasonably raised issue of whether 38 C.F.R. § 4.71a, Diagnostic Code (DC) 5259, applies to appellant's partial meniscectomies.^[14] They also agree that the Board erred by relying on the September 2017 VA exam, which they consider inadequate because the examiner did not adequately address why he could not opine, without resorting to speculation, whether pain weakness, fatigability, or incoordination limited Mr. Andrews's functional ability with repeated use over time.^[15]

Thus, the Court will remand the Board decision for VA to provide a new exam and for the Board to provide an adequate statement of reasons or bases.^[16] And because we are remanding the matter, we need not address Mr. Andrews's other contentions about the exam or arguments about Board error that would warrant no broader remedy.^[17] At this point, Mr. Andrews and the Secretary part ways.

They disagree about whether the Court should instruct the Board about Mr. Andrews's rights on remand, and if so, what that instruction should be. In his opening brief, Mr. Andrews argues that "the Due Process Clause of the Fifth Amendment, Title 38, U.S.C., and this Court's case law all require that the Board expedite the proceedings . . . and provide the [sic] Mr. Andrews with an opportunity for a hearing at the Board and to submit additional evidence to the Board."^[18]

For his part, the Secretary believes that it is premature for us to decide Mr. Andrews's rights on remand. Even so, he agrees with Mr. Andrews that the Board must expedite these proceedings on remand because that is required both by 38 U.S.C. § 7112 and 38 C.F.R. § 20.800(d).^[19] But the Secretary argues that Mr. Andrews cannot submit more evidence because this option is unavailable under the direct review docket that he selected when he appealed to the Board under the AMA.

In his reply brief, Mr. Andrews informed us that he no longer plans to ask for a hearing on remand.^[20] Thus, the question of expeditious treatment and entitlement to a hearing do not require resolution. Instead, the real dispute is whether Mr. Andrews can submit more evidence on remand and what the Board must do in response to this evidence. At its core, this is a question about how Fletcher and Kutscherousky apply within the new process Congress created through the AMA. Thus, we will next review these precedential decisions.

A. Fletcher and Kutscherousky

In Fletcher, we remanded a Board decision that denied a rating above 50% for the veteran's post-traumatic stress disorder because the Board failed to provide adequate reasons or bases.^[21] We then cautioned the Board that "[w]e do not mean to imply that a remand, such as is done here, is merely for the purposes of rewriting the opinion so that it will superficially comply with the 'reasons or bases' requirement."^[22] Instead, "[a] remand is meant to entail a critical examination of the justification for the decision. The Court expects that the [Board] will reexamine the evidence of record, seek any other evidence the Board feels is necessary, and issue a timely, well-supported decision."^[23]

Then in Kutscherousky we faced a situation like the one we have here. There was no dispute that the Board erred, but the parties needed the Court to delimit appellant's rights on remand. After the Court remanded the decision and mandate issued, the Secretary asked that the Court "(1) vacate the Court's order, (2) recall the Court's mandate, and (3) permit him to amend his February 2, 1999, remand motion."^[24] Among the language the Secretary wanted to add to the remand motion was an instruction that "[o]n remand, 'appellant should be free to submit additional evidence and argument on the questions at issue.'"^[25]

In addressing the Secretary's request, we noted that previously "th[is] Court stated that on remand 'the appellant will be free to submit additional evidence and argument on the question at issue, and the Board will seek any other evidence it feels is necessary to the timely resolution of this claim.'"^[26] We then noted that we would clarify whether this particular language "is . . . a holding or merely a term imposed by the Court for the carrying out of its mandate in a particular case."^[27] In the end we held that, unless stated otherwise, appellants had 90 days after the Board mailed them a postremand notice to submit evidence or request a hearing. We also reiterated our holding from Fletcher that "the Board may seek other evidence it considers necessary to the timely resolution of the remanded matter" and "if the Board remands the case to an AOJ, the Board must reiterate the appellant's foregoing right to submit additional evidence and argument on the remanded matter(s)."^[28]

As we explained, this holding rested on a Board Chairman's memorandum and 38 C.F.R. § 20.1304. The memorandum stated that on remand an appellant may submit new argument as a matter of right. At the same time, the memorandum made submission of additional evidence conditional on this Court permitting it in its remand directives. What's more, the memorandum said that "any additional evidence submitted by the appellant while the case is at the Board will be governed by 38 C.F.R. § 20.1304."^[29]

Merging these holdings, we have established a rule that requires the Board on remand to engage in a critical examination of the justification for the decision, "reexamine the evidence of record, seek any other evidence the Board feels is necessary, and issue a timely, well-supported decision in this case."^[30] What's more, the Board must allow a claimant 90 days to submit additional evidence and argument. The question before us is whether these holdings apply to cases adjudicated under the AMA. To help answer this question, we must review the difference between the new AMA system and the previous appellate system that VA has since renamed the "legacy" system.^[31]

B. Legacy v. AMA

1. Legacy System

In the legacy system, a claimant who disagreed with a VA decision could file an NOD.^[32]After receiving a claimant's NOD, VA would make another decision, either through a decision review officer or by issuing a Statement of the Case (SOC) summarizing the evidence it considered and explaining why the benefit remained denied.^[33] After VA issued the SOC or decision review officer decision, a claimant could appeal to the Board.^[34] Along with the appeal, the...