Tag: Opinion

Single Judge Application; pain; functional loss; If pain causes functional loss, it “must be rated at the same level as if that functional loss were caused by some other factor.” Mitchell v. Shinseki, 25 Vet.App. 32, 37, (2011); For an examination to adequately capture functional loss, the examiner must opine whether pain could significantly limit functional ability and, if feasible, portray that opinion “‘in terms of the degree of additional range-of-motion loss due to pain on use or during flare-ups.’” Sharp, 29 Vet.App. at 32 (quoting Deluca v. Brown, 8 Vet.App. 202, 206 (1995));
Single Judge Application; Hensley prohibits the Board from denying service connection for hearing loss solely because the audiometric test results did not constitute a disability under § 3.385 during service. 5 Vet.App. 155, 160 (1993); Hensley does not prohibit examiners from discussing in-service audiometric test results or relying on audiometric results that reveal normal hearing to form their opinion if they also consider other factors. Id.;
Single Judge Application; Pain limits ability to function; Deluca factors; in rating musculoskeletal disabilities, the Board must rely on VA examinations that consider whether and to what extent pain, or other factors listed in 38 C.F.R. §§ 4.40 and 4.45 (the Deluca factors), limit a veteran’s ability to function. Sharp v. Shulkin, 29 Vet.App. 26, 32 (2017). If pain causes functional loss, it “must be rated at the same level as if that functional loss were caused by some other factor.” Mitchell v. Shinseki, 25 Vet.App. 32, 37, (2011). For an examination to adequately capture functional loss, the examiner must opine whether pain could significantly limit functional ability and, if feasible, portray that opinion “‘in terms of the degree of additional range-of-motion loss due to pain on use or during flare-ups.’” Sharp, 29 Vet.App. at 32 (quoting Deluca v. Brown, 8 Vet.App. 202, 206 (1995)). If an examiner is unable to offer a nonspeculative estimate of a veteran’s functional loss due to pain, the examiner must explain why such an opinion cannot be offered. Id. at 32;
Single Judge Application; reason and bases; Dela Cruz v. Principi, 15 Vet.App. 143, 149 (2001); failure discuss all the evidence favorable to a claimant; Gabrielson v. Brown, 7 Vet.App. 36, 40 (1994); the Board cannot “evade [its] statutory responsibility [to state the reasons or bases for its conclusions] merely by adopting [a medical opinion] as its own” where the medical opinion “fails to discuss all the evidence which appears to support [the] appellant’s position.” Gabrielson v. Brown, 7 Vet.App. 36, 40 (1994). Gabrielson does not require that a medical opinion discuss all the evidence favorable to a claimant, only that the Board, in relying on an opinion that does not do so, discuss any additional favorable evidence to comply with its duty to provide an adequate statement of reasons or bases for its decision. See id.; 38 U.S.C. § 7104(d)(1); see also Dela Cruz v. Principi, 15 Vet.App. 143, 149 (2001) (holding that, although the Board must consider all of the evidence of record, “a discussion of all evidence is not required when . . . the Board has supported its decision with thorough reasons or bases regarding the relevant evidence”);
Single Judge Application; the Board did not discuss the veteran’s contention that the RO’s request improperly described the contents of the record, constrained the August 2012 VA expert’s view of the file, and thereby essentially tainted the medical opinion; The Board is obligated to ensure that it provides appellants with fair process in the adjudication of their claims. See Smith v. Wilkie, 32 Vet.App. 332, 337 (2020) (citing Thurber v. Brown, 5 Vet.App. 119 (1993); Bernard v. Brown, 4 Vet.App. 384, 392-94 (1993)); In Smith, this Court held that the principle of fair process applies throughout the process of evidentiary development and is implicated when “the Board fails to procure a medical opinion in ‘an impartial, unbiased, and neutral manner’ when the opinion request contains a Board member’s own negative linkage opinion or otherwise suggests that an examiner should reach a predetermined conclusion.” Id. at 337-38 (citing Austin v. Brown, 6 Vet.App. 547, 551-52 (1994));
Single Judge Application; obesity; Walsh v. Wilkie; Gen. Coun. Prec. 1-2017 (Jan. 6, 2017); A 2017 VA General Counsel (VAGC) precedent opinion determined that “[o]besity may be an ‘intermediate step’ between a service-connected disability and a current disability that may be service connected on a secondary basis under 38 C.F.R. § 3.310(a),” VA Gen. Coun. Prec. 1-2017 (Jan. 6, 2017), at 2, ¶ 5. The VAGC explained that, in these cases, the Board would be required to resolve (1) whether the service-connected disability caused the veteran to become obese; (2) if so, whether obesity as a result of the service-connected disability was a substantial factor in causing the claimed secondary disability; and (3) whether the claimed secondary disability would not have occurred but for obesity caused by the service-connected disability. Id. at 9-10, ¶ 15. See also Walsh v. Wilkie, Vet.App., 2020 WL 878798 (Feb. 24, 2020) at *5 (holding that G.C. Prec. 1-2017 requires the Board to consider aggravation in the context of these claims when the theory is explicitly raised by the veteran or reasonably raised by the record).;
Single Judge Application; Wise v. Shinseki, 26 Vet.App. 517, 531 (2014); apply the correct standard of proof for determining that issue; The examiner rejected the scientific evidence because it did not definitely establish a causal link as a generally accepted principle. However, “Congress has not mandated that a medical principle have reached the level of scientific consensus to support a claim for VA benefits.” Wise v. Shinseki, 26 Vet.App. 517, 531 (2014). Although the examiner rejected the scientific research evidence, “this did not relieve the Board of its obligation to consider and discuss the potentially favorable medical literature of record” that supported Mr. Lardinois’s theory of service connection and “to apply the correct standard of proof for determining that issue.” Id. at 531-32; see R. at 353-37 (scientific literature submitted by Mr. Lardinois). However, the Board did not discuss the scientific research evidence submitted by Mr. Lardinois; instead, it adopted the examiner’s opinion and his rejection of the scientific evidence without addressing or reconciling that opinion with the proper adjudicative standard of proof; » HadIt.com For Veterans Who’ve Had It With The VA
Panel Application; Mitchell v. Shinseki, 25 Vet.App. 32, 44 (2011) (holding that, for a VA joints exam to be adequate, the examiner must portray the extent of functional loss or limitation due to pain and the other factors set forth in 38 C.F.R. §§ 4.40 and 4.45, including pain with repetitive use and on flare-up); see also Sharp v. Shulkin, 29 Vet.App. 26, 34-35 (2017) (holding that an examiner’s refusal to offer a flare opinion without resort to speculation is adequate only when it is “clear that [it] is predicated on a lack of knowledge among the ‘medical community at large’ and not the insufficient knowledge of the specific examiner”); 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; » HadIt.com For Veterans Who’ve Had It With The VA