King: Existence of higher schedular rating is irrelevant to extraschedular analysis

King v. Shulkin29 Vet.App. 174 (Dec. 21, 2017)

HELD: “[T]he availability of higher scheduler ratings plays no role in an extraschedular analysis and [] it is inappropriate for the Board to deny extraschedular referral on this basis.” 

SUMMARY: Dudley King is service connected for hearing loss, rated 0%. He appeals for a compensable rating. VA examiners noted “significant effects” on occupation, “poor social interactions,” “hearing difficulty,” “balance problems,” and “dizziness.” One VA examiner summarized the effect of his hearing loss on his life and his work as “difficulty hearing.” 

At a Board hearing, he testified that he could not hear the phone ring; he needed to turn up the volume on the television, which made his wife leave the room; he could not hear bird sounds; and he got angry at having to ask people to repeat themselves. The Board remanded for a new examination, and the subsequent VA examiner stated that his hearing loss did not impact his life or work. The Board denied a compensable rating and extraschedular referral because it found that the rating criteria “reasonably describe” his disability and “provide[] for higher ratings for more severe symptoms.”

He appealed to the Court of Appeals for Veterans Claims. The Court framed the issues as (1) whether the rating criteria adequately contemplated the function effects of his hearing loss such that extraschedular referral was not required and (2) whether the availability of a higher schedularrating is relevant to the extraschedular analysis. 

The Court began its analysis by explaining the relevant law regarding schedular and extraschedular ratings. The Court emphasized that “[t]he goal of the entire rating process is to appropriately compensate veterans. The schedular and extraschedular analyses are just different means of doing so.” 

The Court described the “three-part inquiry” in determining whether referral for extraschedular consideration is warranted. The first element of 38 C.F.R. § 3.321(b) –whether the evidence “presents such an exceptional disability picture” that the schedular ratings are inadequate –requires VA to “compare a veteran’s specific symptoms and their severity with those contemplated by the plain language of the rating schedule.” With respect to this element, the Court noted that “impact on employment is not a symptom.”

If the Board determines that the symptoms or their severity are not contemplated by the rating schedule, the second step requires the Board to determine whether the exceptional disability picture exhibits “other related factors,” such as “marked interference with employment or frequent periods of hospitalization.” In this case, the Board determined that extraschedular referral was not warranted because it found the rating criteria reasonably describe Mr. King’s disability and provide for “higher ratings for more severe symptoms.” It was this second rationale that caught the Court’s attention. 

As the Court recently held in Doucette v. Shulkin, 28 Vet.App. 366 (2017), the hearing loss ratings “contemplate the functional effects of decreased hearing and difficulty understanding speech,” but do not “contemplate all functional impairment due to a claimant’s hearing loss.” The Court in Doucette “provided a non-exhaustive list of functional effects” that are outside the rating schedule – such as “pain, dizziness, recurrent loss of balance, or social isolation” – and “acknowledged the existence of effects that would be inherently outside the rating schedule,”

The Court held that ”[t]he availability of higher schedular ratings plays no role in an extraschedular analysis and [ ] it is inappropriate for the Board to deny extraschedular referral on this basis.” The Court explained that the Board’s logic in such a denial “would functionally invalidate § 3.321(b)(1) entirely,” and provided the following example: Assume a disability is rated 30% for symptoms A and B; and 50% for symptoms A, B, X, and Z. What happens to a veteran who’s rated 30% - but has symptoms A, B, and X, but not Z? “Under the Board’s logic, no matter how significantly that veteran’s earning ability were impaired,” VA would be able to deny extraschedular referral just because the rating schedule provided for a higher schedular rating. The Court stated that “[t]his example is precisely the situation § 3.321(b)(1) was created to address.”

The Court further clarified that the holding of King is not limited to hearing loss claims. “Section 3.321 is applicable to all claims.”

FULL DECISION

Yancy: EXTRASCHEDULAR; COMBINED EFFECT OF MULTIPLE DISABILITIES

Yancy v. McDonald, 27 Vet.App. 484 (Feb. 26, 2016)

HELD: “[T]he Board is required to address whether referral for extraschedular consideration is warranted for a veteran’s disabilities on a collective basis only when that issue is argued by the claimant or reasonably raised by the record through evidence of the collective impact of the claimant’s service-connected disabilities.”

SUMMARY: Mr. Yancy was service connected for bilateral foot conditions, including pes planus, rated 10%, and hallux valgus of the left and right great toes, rated 0%. He appealed and the Board ultimately awarded a 30% rating for his bilateral pes planus under DC 5276. The Board also denied a compensable rating for his hallux valgus, finding that he did not meet the criteria for a compensable rating under DCs 5277 through 5284, and found that referral for extraschedular consideration was not warranted.

On appeal, Mr. Yancy argued that the Board failed to adequately explain why he was not entitled to higher or additional disability ratings under DC 5281 (for hallux rigidus) or DC 5284 (for “foot injuries, other”), and failed to properly assess whether referral for extraschedular consideration was warranted.

The Court agreed. DC 5281, for “hallux rigidus, unilateral, severe,” requires the condition to be rated as “severe hallux valgus under DC 5280.” The Board determined that Mr. Yancy was not entitled to a rating under DC 5281 because “it found that he had not been diagnosed with hallux rigidus.” However, the record contained a diagnosis of “hallux valgus et rigidus on both sides” that the Board failed to address. Because of this, the Court found the Board’s reasons or bases inadequate and remanded for the Board to discuss whether this evidence contains a diagnosis of hallux rigidus and, if so, whether it is severe enough to warrant a compensable rating.

The Court similarly found that the Board failed to adequately explain its denial of an evaluation under DC 5284, the DC for “foot injuries, other.” The Court noted that it had recently considered the word “other” in that DC in Copeland v. McDonald, 27 Vet.App. 333, 337-38 (2015). In this case, the Court turned its attention to the word “injury,” and held that “the plain meaning of the word ‘injury’ limits the application of DC 5284 to disabilities resulting from actual injuries to the foot, as opposed to disabilities caused by, for example, degenerative conditions.” The Court found that Mr. Yancy “has been diagnosed with conditions not explicitly listed in the rating schedule,” and that the Board failed to discuss whether those “unlisted conditions could be rated by analogy pursuant to DC 5284.” The Court thus remanded for the Board to address this question.

Finally, the Court found that the Board failed to adequately explain its extraschedular determination in light of the Federal Circuit’s holding in Johnson v. McDonald, 462 F.3d 1362 (Fed. Cir. 2014), which states that “§ 3.321(b)(1) provides for extra-schedular consideration based on the collective impact of multiple disabilities.” The Court first discussed the three-part extraschedular analysis required by Thun v. Peake, 22 Vet.App. 111, 115 (2008), which requires adjudicators to refer a case for extraschedular consideration if (1) the evaluation in the rating schedule does not contemplate the severity of the claimant’s disability level or his/her symptoms and (2) the claimant’s overall disability picture involves other factors such as “marked interference with employment” or “frequent hospitalizations.”

The Court stated that the “first Thun element compares a claimant’s symptoms to the rating criteria, while the second addresses the resulting effects of those symptoms.” The Court added that an error on one element does not necessarily affect the analysis of the other element, and that if “either element is not met, then referral for extraschedular consideration is not appropriate.”

The Court held that “the Board is required to address whether referral for extraschedular consideration is warranted for a veteran’s disabilities on a collective basis only when that issue is argued by the claimant or reasonably raised by the record through evidence of the collective impact of the claimant’s service-connected disabilities.” In this case, Mr. Yancy acknowledged that he did not expressly raise the issue of extraschedular consideration to the Board. However, the Court found that the issue was reasonably raised by the record and that “the Board erred by failing to discuss the combined effects of Mr. Yancy’s disabilities in its analysis.”

FULL DECISION