vet. app. no. 19-1540 in the united states court of

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Vet. App. No. 19-1540 _______________________________________________________________ _______________________________________________________________ IN THE UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS _______________________________________ MARION P. HARRIS, Appellant, v. ROBERT L. WILKIE, Secretary of Veterans Affairs, Appellee. _______________________________________ ON APPEAL FROM THE BOARD OF VETERANS’ APPEALS _______________________________________ BRIEF OF APPELLEE SECRETARY OF VETERANS AFFAIRS _______________________________________ WILLIAM A. HUDSON, JR. Acting General Counsel MARY ANN FLYNN Chief Counsel JAMES B. COWDEN Deputy Chief Counsel RYAN D. HARRISON Appellate Attorney Office of General Counsel (027K) U.S. Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 (202) 632-8331 Attorneys for Appellee

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Vet. App. No. 19-1540 _______________________________________________________________ _______________________________________________________________

IN THE UNITED STATES COURT OF APPEALS

FOR VETERANS CLAIMS _______________________________________

MARION P. HARRIS,

Appellant,

v.

ROBERT L. WILKIE, Secretary of Veterans Affairs,

Appellee. _______________________________________

ON APPEAL FROM THE

BOARD OF VETERANS’ APPEALS _______________________________________

BRIEF OF APPELLEE

SECRETARY OF VETERANS AFFAIRS _______________________________________

WILLIAM A. HUDSON, JR.

Acting General Counsel MARY ANN FLYNN Chief Counsel JAMES B. COWDEN Deputy Chief Counsel RYAN D. HARRISON Appellate Attorney Office of General Counsel (027K) U.S. Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 (202) 632-8331 Attorneys for Appellee

2

TABLE OF CONTENTS I. ISSUE PRESENTED ...................................................................................... 2

II. STATEMENT OF THE CASE ......................................................................... 2

A. Nature of the Case .................................................................................... 2

B. Statement of Facts .................................................................................... 3

III. SUMMARY OF THE ARGUMENT .................................................................. 8

IV. ARGUMENT ................................................................................................... 9

A. The Secretary concedes that vacatur and remand are warranted for the issue of entitlement to an effective date prior to February 20, 2011, for the grant of SMC(k) because the Board provided an inadequate statement of reasons or bases when it failed to discuss significant evidence of record concerning the nature of the September 2004 claim. ............................... 9

B. Appellant has abandoned all issues not argued in his brief. .................. 18

V. CONCLUSION .............................................................................................. 18

3

TABLE OF AUTHORITIES

Cases Akles v. Derwinski, 1 Vet. App. 118 (1991) ....................................................... 13 Allday v. Brown, 7 Vet. App. 517 (1995) .............................................................. 9 Beraud v. McDonald, 766 F.3d 1402 (Fed. Cir. 2014) ...................................... 14 Bond v. Shinseki, 659 F.3d 1362 (Fed. Cir. 2011) ............................................ 14 Breeden v. Principi, 17 Vet. App. 475 (2004) ....................................................... 3 Caluza v. Brown, 7 Vet. App. 498 (1995) ............................ 10, 13, 15, 16, 17, 18 Deloach v. Shinseki, 704 F.3d 1370 (Fed. Cir. 2013) ................................. 11, 17 Gilbert v. Derwinski, 1 Vet. App. 49 (1990) ........................... 9, 13, 15, 16, 17, 18 Hensley v. West, 212 F.3d 1255 (Fed. Cir. 2000) ....................................... 11, 17 Jarrell v. Nicholson, 20 Vet. App. 326 (2006) .................................................... 11 Manzanares v. Shulkin, 863 F.3d 1374 (Fed. Cir. 2017) ............................ 13, 14 Massie v. Shinseki, 25 Vet. App. 123 (2011) .................................................... 15 Norvell v. Peake, 22 Vet. App. 194 (2008) ........................................................ 18 Payne v. Wilkie, 31 Vet. App. 373 (2019) .................................................... 14-15 Pieczenik v. Dyax Corp., 265 F.3d 1329 (Fed. Cir. 2001) ................................. 18 Robinson v. Peake, 21 Vet. App. 545 (2008) .................................................... 15 Voracek v. Nicholson, 421 F.3d 1299 (Fed. Cir. 2005) ..................................... 14

Statutes 38 U.S.C. § 7104(d)(1) (2018) .............................................................................. 9 38 U.S.C. § 7261(c) (2018) ......................................................................... 11, 17

Other 38 C.F.R. § 4.16(b) ............................................................................................... 3

RECORD CITATIONS

R. at 3-12 (November 2018 Board Decision) ............................................... passim

R. at 559-60 (November 2014 Form 9) ..................................................................7

R. at 591-605 (September 2014 SOC) ...................................................................7

R. at 606-20 (September 2014 SOC) .....................................................................7

R. at 705 (January 2013 NOD)...............................................................................7

R. at 720-29 (October 2012 Rating Decision) ........................................................7

R. at 792-804 (May 2012 Rating Decision) ............................................................7

R. at 1393-1404 (April 2011 VA Examination) .......................................................6

R. at 1738-52 (March 2011 Board Decision) ................................................... 6, 16

R. at 1761-75 (February 25, 2011, Board Hearing) .......................................... 5, 6

R. at 1828 (May 2009 NOD) ...................................................................................5

R. at 1911-12 (January 2008 VA Form 9) ..............................................................5

R. at 1918-31 (November 2007 SOC) ....................................................................5

R. at 1941 (Letter from Dr. R, dated February 17, 2006) .......................................5

R. at 1942 (August 2006 Notice of Disagreement) ................................................5

R. at 1957-64 (January 2006 Rating Decision) ............................................... 4, 11

R. at 1965-67 (November 2005 VA Examination) ..................................................4

R. at 1968 (October 2005 Request for C&P Examination) .............................. 4, 10

R. at 1976-78 (October 2005 VA Examination) ......................................................4

R. at 2072-79 (November 2004 VA Letter) ..................................................... 4, 10

R. at 2083-85 (VA Email Correspondence) .................................................... 3, 10

R. at 2212-13 (September 2004 Claim) .......................................................... 3, 10

R. at 2434-35 (July 1977 Rating Decision) ..................................................... 3, 10

R. at 2579 (DD214) ................................................................................................3

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IN THE UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

MARION P. HARRIS, ) ) Appellant, ) ) v. ) Vet. App. No. 19-1540 ) ROBERT L. WILKIE, ) Secretary of Veterans Affairs, ) ) Appellee. )

ON APPEAL FROM THE BOARD OF VETERANS’ APPEALS

BRIEF OF THE APPELLEE SECRETARY OF VETERANS AFFAIRS

I. ISSUE PRESENTED

Whether the U.S. Court of Appeals for Veterans Claims (Court) should remand the November 9, 2018, decision of the Board of Veterans’ Appeals (Board) that denied entitlement to an effective date prior to February 25, 2011, for the award of special monthly compensation based upon loss of use of a creative organ (SMC(k)).

II. STATEMENT OF THE CASE

A. Nature of the Case

Appellant, Marion P. Harris, appeals, through counsel, the November 9,

2018, Board decision that denied entitlement to an effective date prior to February

25, 2011, for the award of SMC(k). [Record Before the Agency (R.) at 3-12]; see

[Appellant’s Brief (App. Brf.)].

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The Board remanded Appellant’s claim for entitlement to an effective date

prior to February 24, 2011, for a total disability rating based upon individual

unemployability (TDIU) on an extraschedular basis under 38 C.F.R. § 4.16(b) and

is therefore outside the Court’s jurisdiction. See Breeden v. Principi, 17 Vet.App.

475, 477-78 (2004).

B. Statement of Facts

Appellant served on active duty in the U.S. Navy from January 1973 to

October 1976. [R. at 2579].

In July 1977, the VA regional office (RO) granted Appellant service

connection for apophysitis of the lumbar spine, which stemmed from a back injury

sustained while lifting heavy weights during service and resulted in ongoing back

pain. [R. at 2434-35]. The rating decision assigned a noncompensable rating for

the condition under diagnostic code (DC) 5099-5003, effective October 16, 1976.

Id.

Appellant submitted a claim for entitlement to compensation for

degenerative back disease and for entitlement to a TDIU on September 24, 2004.

[R. at 2212-13]. At the time, VA was unable to locate Appellant’s claims file. See

[R. at 2085] (email dated October 15, 2004, requesting Appellant’s claims file); [R.

at 2084] (email dated October 19, 2004, “[w]e have conducted several searches

of our facility and were unable to locate the record you have requested. We have

“FLAGGED” our filing system to show your interest in the event the folder is found

in the future”); [R. at 2083] (email dated October 20, 2004, noting “[c]laims folder

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for [Appellant] is a no record at RMC. Please establish Rebuilt Folder”). A

November 2004 VA letter to Appellant acknowledged the confusion, stating, “[y]our

record could not be located…[w]e do show in the computer that you have

previously filed a claim and are service connected for…a bone condition-general

at 0%. We can not determine if the bone condition, general, was related to a back

injury or another part of the body.” [R. at 2072 (2072-79)]. Additionally, an October

2005 RO request for a C&P examination noted, “[Appellant’s] original C-file is lost.

Computer records show C for “bone condition-general” zero percent, which may

well be the back, but we don’t know.” [R. at 1968]. Thereafter, Appellant was

afforded a VA examination for his back in October 2005, [R. at 1976-78], and a VA

examination for his peripheral nerves in November 2005. [R. at 1965-67].

In a January 2006 rating decision, the RO denied Appellant’s claim for TDIU,

but granted entitlement to service connection for degenerative joint disease of the

lumbar spine (claimed as back condition), rated at 10% from September 24, 2004,

and service connection for polyradiculopathy to the right and left lower extremities

secondary to the degenerative joint disease of the lumbar spine, rated at 20% from

the same effective date as the primary condition. [R. at 1957 (1957-64)]. Under

the “subject to compensation” portion of the rating decision, the RO also listed a

general bone condition (unspecified), assigned a noncompensable rating from

October 16, 1976. Id.

Appellant submitted a Statement in Support of Claim in August 2006

(hereinafter August 2006 Notice of Disagreement (NOD)), stating “I disagree with

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your decision to not grant me IU.” [R. at 1942]. This August 2006 NOD is the only

NOD of record pertaining to the January 2006 rating decision. Along with his NOD,

Appellant also submitted a letter from Dr. R, dated February 17, 2006, which noted

that Appellant “is a patient” at his pain management facility, reported Appellant’s

ongoing pain, and provided a list of current medications back to 2004. [R. at 1941].

In November 2007, the RO issued a Statement of the Case (SOC)

continuing the denial of entitlement to TDIU. [R. at 1921 (1918-31)]. Notably, the

SOC solely addressed the issue of TDIU and did not also infer a claim for increased

compensation for Appellant’s back condition from his August 2006 NOD. In his

January 2008 substantive appeal to the Board, Appellant requested a Board

hearing and registered his disagreement with the denial of TDIU, reporting that he

was unable to perform even sedentary employment due to his pain that he

experienced daily. [R. at 1911 (1911-12)]. Absent from Appellant’s Form 9 is any

indication that he believed the SOC should have also considered a claim for

increased compensation for his back condition.

The RO issued a Supplemental Statement of the Case in April 2009, again

adjudicating, and denying, exclusively the issue of entitlement to TDIU. [1832

(1829-37)]. In May 2009, Appellant submitted a Statement in Support of Claim

(hereinafter May 2009 NOD) in which he continued his appeal of the denial of

TDIU. [R. at 1828].

On February 25, 2011, Appellant testified at a hearing before the Board. [R.

at 1761-75]. The presiding Veterans Law Judge (VLJ) identified the issue on

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appeal as entitlement to TDIU. [R. at 1762]. In the course of the hearing, Appellant

also testified as to other ongoing problems, such as pain in his legs and lower

back, erectile dysfunction (ED), a bowel condition, and depression. [R. at 1761-

75]. The following month, the Board remanded the issue of entitlement to TDIU

for further development. [R. at 1738-52]. In its March 2011 decision, the Board

noted that during the hearing, Appellant had “effectively raised new claims for

higher ratings for his service-connected low back and peripheral nerves disorders

and for service connection for an acquired psychiatric disorder.” [R. at 1741]. The

Board found that such claims were inextricably intertwined with the TDIU claim and

must be considered together with that claim. Id. Thus, the Board remanded the

TDIU claim and requested VA examinations to assess the severity of his service-

connected low back and peripheral nerve disorders, to include “his recent reports

of…related neurological symptoms of erectile dysfunction and bowel and bladder

abnormalities” and “depression secondary to his service-connected low back

disorder.” [R. at 1751].

During an April 2011 VA examination, Appellant reported a history of ED

with onset approximately 5-6 years ago and the examiner diagnosed Appellant

with ED. [R. at 1396, 1404 (1393-1404)]. The RO issued a rating decision in May

2012 granting entitlement to service connection for ED as secondary to the

service-connected back condition and granted entitlement to SMC(k) based on

loss of use of a creative organ, both effective from February 25, 2011. [R. at 792-

7

804]. Appellant was also granted entitlement to TDIU effective February 25, 2011,

in an October 2012 rating decision. [R. at 720-29].

Appellant submitted an NOD appealing the effective date for TDIU and

SMC(k) in January 2013. [R. at 705]. In September 2014, the RO issued an SOC

granting an earlier effective date of February 24, 2011, for TDIU, [R. at 619 (606-

20)], and an SOC denying entitlement to an effective date prior to February 25,

2011, for the grant of SMC(k). [R. at 604 (591-605)]. As to the effective date for

SMC(k), the RO stated that service connection for ED was granted effective

February 25, 2011, and that the grant of SMC(k) “related to your [ED]” “was

therefore granted effective the same date.” [R.at 605]. The RO also noted that

“[a] review of [his] claims file failed to show that [Appellant] raised the issue of [ED]

prior to the BVA hearing on February 25, 2011.” Id. Appellant submitted a

substantive appeal to the Board in November 2014 disputing the effective dates

for the grant of SMC(k) and TDIU. [R. at 559-60].

The Board issued the decision on appeal in November 2018, denying

entitlement to an effective date prior to February 25, 2011, for the grant of SMC(k)

and remanding the earlier effective date claim for TDIU for extraschedular

consideration. [R. at 4]. As to the denial of an earlier effective date for SMC(k),

the Board found that “[p]rior to February 25, 2011, there is no communication that

could be construed as an informal claim for either service connection for ED or an

increased rating for the lumbar spine disability.” [R. at 7]. The Board also found

that the “January 2006 rating decision awarded service connection for a lumbar

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spine disability is final,” reasoning that Appellant neither appealed this rating

decision nor submitted new and material evidence with respect to the claim within

one year of the January 2006 rating decision. [R. at 7-8].

This appeal followed.

III. SUMMARY OF THE ARGUMENT

Remand is warranted for the Board to address the overlooked evidence of

record that calls into question the Board’s finding that the January 2006 rating

decision awarded Appellant service connection for his back condition and that the

decision is final. Remand on this initial basis is the most appropriate remedy

because the Board will be required to engage in factfinding in the first instance in

order to properly address this evidence and discern the nature of the September

2004 claim. Moreover, the nature of the September 2004 claim colors the proper

legal analysis for downstream considerations and thus Appellant’s arguments

stemming from the nature of this claim are premature. Since the September 2004

claim is central to properly adjudicating whether Appellant is entitled to an earlier

effective date for the grant of SMC(k), meaningful judicial review of the Board’s

decision is frustrated. Therefore, the Court should remand the decision on appeal

for the Board to consider the overlooked evidence of record in the first instance

and provide an adequate statement of reasons or bases as to the nature of the

September 2004 claim.

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IV. ARGUMENT

A. The Secretary concedes that vacatur and remand are warranted for the issue of entitlement to an effective date prior to February 20, 2011, for the grant of SMC(k) because the Board provided an inadequate statement of reasons or bases when it failed to discuss significant evidence of record concerning the nature of the September 2004 claim.

The Court should remand Appellant’s claim of entitlement to an effective

date prior to February 25, 2011, for the grant of SMC(k) because the Board erred

when it failed to support its decision with an adequate statement of reasons or

bases, thereby frustrating judicial review. The Secretary concedes that the Board

failed to provide an adequate statement of reasons or bases for its denial of an

earlier effective date for the grant of SMC(k), which was predicated, in part, on its

finding that the January 2006 rating decision granted service connection for a

lumbar spine disability and that the decision is final, as it failed to address

significant evidence of record. [R. at 7].

A Board decision must be supported by a statement of reasons or bases

that adequately explains the basis of the Board’s material findings of fact and

conclusions of law sufficient to enable the claimant to understand the basis of the

Board’s decision and facilitate judicial review by the Court. Allday v. Brown, 7

Vet.App. 517, 527 (1995); see 38 U.S.C. § 7104(d)(1); Gilbert v. Derwinski, 1

Vet.App. 49, 56-57 (1990). To comply with this requirement, the Board must

analyze the credibility and probative value of the evidence, account for the

evidence it finds persuasive or unpersuasive, and provide the reasons for its

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rejection of any material evidence favorable to the claimant. Caluza v. Brown, 7

Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996).

In the decision on appeal, the Board denied entitlement to an earlier effective

date for the grant of SMC(k), reasoning that “[p]rior to February 25, 2011, there is

no communication that could be construed as an informal claim for either service

connection for ED or an increased rating for the lumbar spine disability.” [R. at 7].

In support of this conclusion, the Board specifically noted that the January 2006

rating decision “awarded service connection for a lumbar spine disability” and

made the factual finding that the January 2006 rating decision is final. Id. The

Secretary and Appellant agree that the Board failed to support this preliminary

finding with an adequate statement of reasons or bases by overlooking evidence

of record which strongly suggests that the January 2006 rating decision

mischaracterized the nature of Appellant’s September 2004 claim. [App. Brf. at

10-12]. Specifically, the Board overlooked records that not only indicate that the

RO lost Appellant’s claims file, [R. at 2083-85], but also highlight VA’s internal

confusion as to whether his September 2004 claim for “compensation for

degenerative back disease,” [R. at 2212], was related to the 1977 grant of service

connection for apophysitis of the lumbar spine, subsequently characterized as a

general bone condition. [R. at 2072]; [R. at 1968]; [R. at 2435]. The Secretary

observes that these overlooked records appear to shed light on the apparent

inconsistency between the 1977 rating decision and the 2006 rating decision as

they pertain to Appellant’s back condition. Compare [R. at 2435] (1977 rating

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decision granting service connection for apophysitis of the lumbar spine, evaluated

at 0% under DC 5099-5003 from October 16, 1976); and [R. at 1957] (2006 rating

decision noting service connection for a general bone condition (unspecified),

evaluated at 0% under DC 5099-5003 from October 16, 1976).

This evidence, overlooked by the Board, presents a threshold question that

is central to the proper adjudication of Appellant’s claim: whether Appellant’s

September 2004 claim should have been construed as a claim for increased

compensation for the 1977 service-connected condition rather than as an original

claim for service connection, as characterized by the RO in the January 2006 rating

decision. It is precisely for this question – which necessarily requires factfinding in

the first instance – that remand is warranted in this case. See Deloach v. Shinseki,

704 F.3d 1370, 1380 (Fed. Cir. 2013) (recognizing that 38 U.S.C. § 7261(c)

prohibits this “Court from making factual findings in the first instance”); Hensley v.

West, 212 F.3d 1255, 1263 (Fed. Cir. 2000) (stating that “appellate tribunals are

not appropriate fora for initial fact finding”); see also 38 U.S.C. § 7261(c). Indeed,

a finding that the September 2004 claim constituted a claim for increased

compensation for the 1977 grant of service connection for apophysitis of the

lumbar spine, rather than an original claim for service connection, would

fundamentally alter the appropriate legal analysis for determining whether

Appellant is entitled to an earlier effective date for the grant of SMC(k).1

1 The Secretary also notes that it is unclear whether Board could have revised the RO’s award of service connection for Appellant’s back condition in the January

12

The need for Board to adequately address this threshold matter is further

underscored by the fact that the vast majority of Appellant’s reasons or bases

arguments on appeal are either premised on the assumption that the September

2004 is indeed a claim for increased compensation or otherwise focused on

recharacterizing the September 2004 claim as pending by attacking the finality of

the January 2006 rating decision. Unless and until the Board addresses this

overlooked evidence in the first instance and provides an adequate statement of

reasons or bases as to whether the September 2004 claim constituted a claim for

increased compensation, those arguments are premature. Nevertheless, the

Board’s failure to address this evidence of record, contemplate the potential impact

of these records on the nature of the 2004 claim and the status of the January

2006 rating decision, and ultimately square the implications of such findings with

Appellant’s claim for an earlier effective date for the grant of SMC(k) fundamentally

2006 rating decision on its own initiative. Specifically, the grant of entitlement to SMC(k) is due to the grant of service connection for ED, which is secondary to Appellant’s back condition. Yet neither the effective date for the grant of ED nor the issue of Appellant’s back condition were directly on appeal before the Board – Appellant placed only the issues of entitlement to an earlier effective date for the grant of TDIU and SMC(k) directly within the Board’s jurisdiction. Given that Appellant did not directly appeal the January 2006 rating decision as it relates to his back condition, see infra [Secretary’s Brief at 15-16], it is unclear how the Board could have revised a grant of service connection in a prior rating decision to instead reflect a claim for increased compensation absent an allegation of clear and unmistakable error (CUE) made to the RO in the first instance. See Jarrell v. Nicholson, 20 Vet.App. 326, 333 (2008) (en banc) (recognizing that “requests for revision of an RO decision based on CUE must first be submitted to and adjudicated by the RO before the Board can attain jurisdiction over the request). Therefore, the Secretary reiterates his position that the most appropriate remedy here is for the Board to make such preliminary findings in the first instance.

13

frustrates meaningful judicial review of the Board’s decision. Caluza, 7 Vet.App.

at 506. Accordingly, the Secretary concedes that the Board’s statement of reasons

or bases is inadequate and submits that remand and vacatur of the Board’s

decision to consider the overlooked evidence of record and address the proper

nature of the September 2004 claim is the most appropriate remedy. See Gilbert,

1 Vet.App. at 56-57.

To the extent Appellant advances reasons or bases arguments premised on

the finality of the January 2006 rating decision being vitiated based on the asserted

submission of new and material evidence, the Secretary submits that these

arguments are premature because they are derivative of a determination as to the

nature of the September 2004 claim in the first instance. See [App. Brf. at 13-17];

compare Akles v. Derwinski, 1 Vet. App. 118, 120-21 (1991); and Manzanares v.

Shulkin, 863 F.3d 1374, 1379 (Fed. Cir. 2017). As argued above, the Board must

engage in factfinding to discern the appropriate nature of the September 2004

claim before any subsequent determinations can be made about the potential

implications the September 2004 claim may have on the status of the January

2006 rating decision.

Appellant’s references to Bond and Beraud are similarly premature prior to

this initial determination. See [App. Brf. at 13-17]. Specifically, the nature of the

September 2004 claim colors the proper analysis under both Bond and Beraud

given that central to the issue in both cases was the submission of additional

evidence involving a single disability and its impact on a prior claim for that same

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disability. See Bond v. Shinseki, 659 F.3d 1362, 1367 (Fed. Cir. 2011) (holding

that a claim for increased rating must be treated as potentially “new and material”

evidence in support of a pending claim for the same condition, if that evidence

satisfies the standard for new and material evidence under 38 C.F.R. § 3.156(b))

(emphasis added); Beraud v. McDonald, 766 F.3d 1402, 1404 (Fed. Cir. 2014)

(where additional evidence involving a claim for a single disability is submitted

within the appeal period, the claim for that disability remains pending until VA

provides a responsive determination as to whether the evidence is new and

material); see generally Voracek v. Nicholson, 421 F.3d 1299, 1305 (Fed. Cir.

2005) (noting that to qualify as "material" evidence under 38 C.F.R. § 3.156, the

evidence must "by itself or when considered with previous evidence of record,

relate[] to an unestablished fact necessary to substantiate [the] original claim")

(emphasis added). Until the Board addresses the nature of the September 2004

claim, it is further unclear whether the facts here – where the grant of SMC(k) is

due to the grant of service connection for ED, secondary to the lumbar spine

disability – fall within the ambit of Bond and Beraud since neither case dealt with

secondary service connection, much less suggested that ancillary benefits granted

as due to a grant of secondary service connection is part of a primary benefits

claim. See Bond, 659 F.3d at 1367; Beraud, 766 F.3d at 1404; see generally

Manzanares, 863 F.3d at 1379; cf. Payne v. Wilkie, 31 Vet.App. 373, 384-85

(2019) (finding that the Board erred in not addressing entitlement to SMC(k) where

appellant explicitly raised a multi-link causal chain between the service-connected

15

disability and the loss of use, but declining to consider whether the Board is

required to infer a multi-link theory of entitlement to SMC(k) absent an explicitly

raised theory) (emphasis added). Thus, Appellant’s new and material evidence

arguments further emphasize the need for the Board to engage in factfinding in the

first instance and to discern the nature of the September 2004 claim in light of the

overlooked evidence of record. It is precisely for this reason that remand is

warranted in this case. See Gilbert, 1 Vet.App. at 56-57; Caluza, 7 Vet.App. at

506.

Next, Appellant attempts to utilize the August 2006 NOD as a vehicle to

attack the finality of the January 2006 rating decision by asserting that the Board

failed to adequately consider whether his NOD appealed both the denial of

entitlement to TDIU as well as the lumbar spine disability evaluation. See [App.

Brf. at 18-19]. As an initial matter, the Secretary observes that this specific

argument was not raised prior to Appellant’s opening brief and thus the Board did

not have an opportunity to address this new contention. See Massie v. Shinseki,

25 Vet.App. 123, 126 (2011) (the Court may decline to consider arguments raised

for the first time on appeal on the ground that an appellant did not exhaust his

administrative remedies prior to appealing to the Court); Robinson v. Mansfield, 21

Vet. App. 545, 552-53 (2008) (the Board is not required "to assume the impossible

task of inventing and rejecting every conceivable argument in order to produce a

valid decision."), aff'd sub nom. Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir.

2009). Notably, Appellant did not disagree with or object to the RO’s sole

16

consideration of the issue of entitlement to TDIU in either the November 2007 SOC

or the April 2009 SSOC or at any time prior to his opening brief. Indeed, Appellant

did not raise any claim for an increased rating for his lumbar spine disability until

February 25, 2011, when the issue was inferred from his testimony at the Board

hearing. [R. at 1744].

Nevertheless, to the extent Appellant attempts to question the finality of the

January 2006 rating decision by reframing the August 2006 NOD and, by

extension, recharacterizing his September 2004 claim as pending, this argument

as to the adequacy of the Boards statement of reasons or bases again is premature

because it implicates the nature of the September 2004 claim. The Secretary

reiterates that until the Board addresses the nature of the September 2004 claim,

the proper legal analysis for determining whether Appellant is entitled to an earlier

effective date for entitlement to SMC(k) cannot be discerned. Moreover, a

determination as to the nature of the September 2004 claim necessarily requires

factfinding in the first instance, and thus the Board is best suited to address this

threshold matter on remand. Accordingly, this Court should remand the case for

that initial determination before entertaining arguments that are inherently

derivative of the nature of the September 2004 claim. See Gilbert, 1 Vet.App. at

56-57; Caluza, 7 Vet.App. at 506.

With respect to Appellant’s next argument that “[p]rior to the January 2006

rating decision, the issue of entitlement to SMC(k) was raised as part and parcel

of the September 2004 claim for increased compensation,” the Secretary again

17

submits that Appellant’s assertion of reasons or bases deficiencies on this matter

are premature. [App. Brf. at 20]. Implicit in the phrasing of Appellant’s argument

here is a finding of fact that the Board did not make in the decision on appeal –

that the September 2004 indeed constitutes a claim for increase rather than an

original grant of service connection. Indeed, Appellant’s characterization of this

issue is premised on Appellant’s own weighing of the evidence that the Board did

not address. To find that the September 2004 claim constituted a claim for

increased compensation, the Court would be required to make factual

determinations in the first instance regarding the evidence the Board failed to

address, which it may not do. See Deloach, 704 F.3d at 1380; Hensley, 212 F.3d

at 1263; see also 38 U.S.C. § 7261(c).

Appellant similarly assumes this underlying fact in his secondary reasons or

bases argument on this matter: specifically, that the Board failed to address

whether the January 2006 rating decision expressly or implicitly denied entitlement

to SMC(k). [App. Brf. at 21-24]. As outlined above, the Secretary concedes that

the Board’s statement of reasons or bases as to the nature of the September 2004

claim is inadequate and remand is appropriate for the Board to address the

evidence of record pertaining to that claim. Until the Board addresses this

threshold issue and determines whether a claim for increased compensation

existed at the time of the January 2006 rating decision, arguments of entitlement

to SMC(k) derivative of a claim for increased compensation are premature. See

Gilbert, 1 Vet.App. at 56-57; Caluza, 7 Vet.App. at 506.

18

Finally, as to Appellant’s remaining reasons or bases arguments which

assume, in the alternative, the finality of the January 2006 rating decision, the

Secretary again posits that the Board must address the threshold issue in this case

before addressing these downstream issues. Specifically, the proper analysis for

determining whether entitlement to SMC(k) was factually ascertainable within one

year prior to February 25, 2011, or whether an informal claim for entitlement to

SMC(k) was submitted between January 2006 and February 2011, may well turn

on the outcome of the Board’s findings as to the nature of the September 2004

claim on remand. Therefore, the Secretary submits that remand for the Board to

address this threshold matter is the most appropriate remedy available. See

Gilbert, 1 Vet.App. at 56-57; Caluza, 7 Vet.App. at 506.

B. Appellant has abandoned all issues not argued in his brief.

Any other arguments or issues not raised by Appellant in his opening brief

should be deemed abandoned. See Pieczenik v. Dyax Corp., 265 F.3d 1329,

1332-33 (Fed. Cir. 2001); Norvell v. Peake, 22 Vet.App. 194, 201 (2008).

V. CONCLUSION

WHEREFORE, in light of the foregoing reasons, the Court should vacate

and remand the November 9, 2018, Board decision that denied entitlement to an

effective date prior to February 25, 2011, for the grant of SMC(k).

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Respectfully submitted,

WILLIAM A. HUDSON, JR. Acting General Counsel

MARY ANN FLYNN Chief Counsel

/s/ James B. Cowden JAMES B. COWDEN Deputy Chief Counsel

/s/ Ryan D. Harrison RYAN D. HARRISON Appellate Attorney Office of General Counsel (027K) U.S. Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 (202) 632-8331

Attorneys for Appellee, Secretary of Veterans Affairs