Long: Secondary service connection and extraschedular evaluations do not require a showing of direct causation

Long v. McDonough, 38 F4th 1063 (2022)

HELD: Neither 38 C.F.R. § 3.310(a) nor § 3.321(b)(1) require a showing of direct causation between the secondary symptoms and the primary service-connected disabilities.

Summary: Veteran was service connected for hearing loss. He testified that his hearing aids cause ear pain. The CAVC held that the Board did not need to consider ear pain in its extraschedular analysis because the pain was caused by the hearing aids, not the hearing loss. The Federal Circuit disagreed and found that the CAVC did not properly analyze the veteran’s ear pain under the extraschedular analysis.

The Court reiterated the Thun factors to state that “extra-schedular consideration is available to a veteran when (1) the schedular rating criteria are inadequate to describe the severity and symptoms of his disability; (2) the disability is exceptional or unusual, such as because of marked interference with employment or frequent periods of hospitalization; and (3) the award of an extra-schedular disability rating is in the interest of justice.” The Court held that the CAVC “erred in holding that direct causation between a secondary condition and an original condition is required for extra-schedular consideration of the secondary condition.”