UN IT ED ST AT ES CO UR T O F A PP EA LS FO R V ET ER AN S C LA IMS

N O
. 07-0790
D ENI SE L ORETH , A P P EL LA NT ,

V
. E RI C K. S HI NS EK I , S ECR ETA RY OF V ETER A N S A FF AI RS , A PP ELL EE
.
On Ap pe al f rom the Bo ard

of Ve ter an s' Ap pe als (Argued August 13, 2009 Decided Sept ember 29, 2009)
Judy J. Donegan , of Northville, Mi chigan, with whomMichael R. Vit erna , o f N orthville, Mic hig an , w as o n th e b rie f f or t he ap pe llant. Mic ha el A . C

ar r , wi th who m Pa ul J

. H utter , G en era l C ou

ns el; R. Ra nd

all Ca mp be ll , Assistant Gener al Counsel; and Jo an E. Mor iar ty , Deputy Assis ta ntGe neral Counsel, a ll of W ashington D.C., were on the br ief for the appelle e. Before HAGEL , MOORMAN and D AVIS, Ju dges . MOORMAN, Judge : D en ise Lo reth a pp eal s a N ov em

be r 15 , 2 00 6, d eci sio n of

th e B oard of Veteran s' Ap pe als (B oard) that de nie d e nti tle m ent to paym ent or rei m burse m ent f

or m ed ica l expenses incurred in connect ion with priva te trans por ta ti on of her late husband, William Loreth, pro vid ed byLi fe lin e A ir Am

bu lan ce from Antel op e V all eyHo sp ita l in Ca lif orn ia t o C arl e C lin ic Ho sp ita l in

Ill ino is o n D ece m

be r 12 , 2 00 0. Fo r th e re aso ns set forth belo w, the Co urt

wi ll v acate the Bo ard ' s N ov em

be r 20 06 de cis ion

an d re m an d th e m att er f

or f urt he r pr oc eed ing s co ns ist ent w ith this opini on.

I. FACTS Th e v ete ran , W ill iam

E. Lo reth, ha d a cti ve duty s erv ice in the U .S . A ir F orc e f rom Jan uary 1952 to August 1965. Record (R.) at 65. In Novem ber 2000, while vacati oning in California , the veteran suffered a sei zure and car diac event t hat left him in a persis tent veget ative st ate. R. at 14. He was first admitted to a pri vate hospit al i n Californi a for this condition on November 26, 2000,2

an d th entrans fe rre d to a p riv ate ho sp ita l in Ill ino is, his ho m e st ate , o n D ece m be r 12 , 2000. R. at 95-96. The vetera n was moved from California to I llinois by a private air ambulance servi ce, the $1 1, 62 2 c os t of

wh ich wa s p aid bywi re tran sf

er o n D ece m

be r 8, 20 00. R . at 88 -89 . V A l ate r received a n undated clai m signed by De nise Loreth, who indicat ed that she was t he wife and gu ard ian of the ve ter an , f

or the paym ent of

$1 1, 62 2. R. at 8 4; seeR. at 348-49 (Sept. 2004 St ate m ent of the Ca se ( SO C) no tin g th at c lai m wa s re cei ve d b y V A o n O cto be r 25 , 2 00 2). Th is claim was denied in November 2002. R. at 260. The denial lette r was addressed to the veter an and stated that "[ c] are and

serv ice s we re no t ren de red in a m ed ica l em erg en cyof

su chnatur e th at d elay
wo uld have be enha zar dous to lif e o r he alth. " Id. VA received a Notice of Disagreement (NOD) in De cem be r 2 00 2, in

whic h Ms. L ore th stated

that "[ a] s sp ou se- paye e f

or t he ve ter an , I w ish

to f ile a[n NOD] to your rece nt decisi on concerning t he denial of payment o f t ra nsport ation expense s." R. at 280. In a June 2004 statement, Ms. Loreth sta ted: "As Legal Custodian and Spouse-Paye e of the ve ter an , I w ish

to st ate that

the A mVe ts re pre sent him in the se m att ers ." R . at 31 2 (e m ph asi s in ori gin al) . An S OC wa s is su ed in S ep tem

be r 20 04 , and

the letter acc om pany ingit w as a dd

res sed to Ms. Loreth. R. at 345- 53. Ms. Loreth filed aSubstantive Appeal i n Nov embe r 2004, identi fying herself as the "Spouse Payee/Guardi an of the Veteran." R. at355-56. Th e v ete ran

die d o n F eb ruary 1 7, 20 05 . R . at 37 4. An Apri l 20 05 rat ingde cis ion grante d service c onnection for the ve teran's cause of death. R. at 374- 76. In the November 2006 decision on appea l, the Board deni ed entitl ement to payment or reimbursement for m ed ical expens es incurr ed in connecti on with privat e transpor tation of the
ve ter anfr om

the pri vate h os pit al i n C ali fo rni a to the pri vate h os pit al i n Ill ino is. R. at 1 -10 . T he tit le page of the Boar d's decision lists Ms. Lore th as the appellantand as " spouse-payee." R. at 1. The Bo ard expla ine d in

the int rod uc tor y p ort ion of th e de cis ion

that V A h ad

de ter m ine d th at the ve ter an was incompetent in a September 2002 rati ng decision. R. at 2. The de cision did notmention Mr. Loreth's death.

II. AN AL YS IS A. Jurisdict ion As a p re li m in ary

m att e r, th e re i s a

d is p ute i nth is c a s e o v e r w h e th e r th e B o ard ha d jurisdi ction over t he claim for reimbursem ent. The Secretary argues thatit was the vet eran, not theSubse quent ca se l aw has cl ari f i ed t hat vac at ur of

t he B oar d dec i si on and di smi ss al of t he a ppeal under 1 Landi cho a re n o t ap p ro p ria te if t h e re is a n a p p ro p ria t e su b sti t u t i o n by a q u ali fi ed ac cru e d -b e n e fits c la im a n t. S e e g e n e ra lly H yat tv. Shi nse ki , 5 6 6 F .3 d 1 3 6 4 (F e d . C ir. 20 0 9 ) (d isc u ss in g su b stitu tion ); Padget tv. N i chol son , 473 F. 3d 1364, 1366 (F e d . C ir.2 0 0 7 ); P e k u la r v . M a n sfie ld , 2 1 V e t.A p p . 4 9 5 , 5 0 5 (2 0 0 7 ); se e al so 38 U

. S. C

. § 5121A ( a) ( 1) ( 2008) ( added b y P u b

. L

. N o . 1 1 0 -38 9 , T i t l e II, S u b t i t l e A , § 2 1 2 (a), 1 2 2 S t at. 4 1 5 1 (O ct. 1 0 , 20 0 8 )) (prov i d i n g for su b sti t u t i o n w h ere claim an t died on or after O cto b er 1 0 , 2 0 0 8 ). 3 ap pe llant, wh o w as t

he cla im ant in

the No ve m

be r 20 02 V A m ed ica l c enter de cis ion fr om wh ich thi s app eal d eri ve s. Th ere fo re, b eca us e the v ete ran

d ied b ef ore th e Bo ard

is su ed a d eci sion, the Secretary argues thatth e November 2006 decision shoul d be vacated as a nullit y, and the prese nt appeal should be dismissed. Secre tary's Brief (Sec. Br.) at14. The appellantargues thatthe
ve ter an ' s d eat

h h as n o b ear ingon

thi s ap pe al b eca

us e sh e, as t

hir d-p arty p ay ee, ha s an

act ion in h er own right and thataction is presently and properly before the Court. A ppellant's Brief (App. Br.) at 5. Se cti on

71 04 of tit le 3 8, U. S. Co de , p rov ide s th at the Bo ard ha s ju ris dic tio n o ve r "[ a] ll questions i n a matter wh ic h un de r se ction 511(a) of this titl e is subjec t to a deci sion by the Se cre tar y. " Purs uant to the im

ple m entin g regulatio ns of se cti on 710 4, "[ a] n a

pp eal pe nd ingbe fo re the Boar d of Vete ran s' Ap pe als wh enthe ap pe llant d ies wi ll b e d ism iss ed ." 3 8 C .F .R . § 20 .1 302 (2009). Re vie w o f t

he regulator

y h ist ory of 38 C. F. R. § 2 0. 13 02 sh ow s th at i ts c urr ent language stems from

an amendment in 1997 to r eflect this Court's holdings i n Landicho v. Brown , 7 Vet.App. 42, 54 (1994), and Smith v. Brown, 10 Vet.App. 330, 333 (1997). Se e 62 Fed. Reg. 55,169 (Oct. 23, 1997). In Landicho , th is C ourt h eld that whe n a

vete ran di es during the pe nd en cyof anap pe al before this Court of the Boar d's denial of his claim for disabi lity compensation under chapter 11 of tit le 38 , U. S. C od e, th e Bo ard d eci sio n on

a pp eal is re nd ere d no nf

ina l b y the f

ili ng of the ap pe al i n this Court and becomes a nullity. The Court considere d the statutory scheme and specific provi sions of ch ap ter s 1 1, 13 , and

51 of tit le 38 , U .S . C od e, an d c on clu de d th at s uc h a sch em e "c reates a chapter 11 di sabilit y[-]com pensation bene fit that does notsurvive the eligibl e veteran's death" and dies with the veteran. Landicho , 7 Vet.App. at 47, 52; s ee also S mi th , 1 0 V et. Ap p. at 3 35 . T hu s, the Court found that t he proper re medy under such circumstances was to vac at e the unde rlying Board decision a nd dismiss the appeal for la ck of jurisdict ion. Id. at 5 4; see al so Zevalkink v. Brown , 10 2 F .3 d 12 36 , 12 43 -44 (Fed . Ci r.1 99 6) (e xp res sly agre ein g w iththi s C ourt' s Landicho ho ldi ng ). 1 Th e C ourt n ote d th at s uc h a cti on en sures that th e B oard d eci sio n and the un de rly ingregi on al o ff ice4

(R O) de cis ion (s) wo uld

hav e no prec lus ive eff

ect in the adju dic ati on

of any futur e ac cru ed

be ne fi ts claims derived from the veteran's entit lements. Such action also nullifies the merits adjudic ation by the RO because that decision was subsumed in the Board deci sion. See Yoma v. Brown , 8 Vet.App. 29 8 (1 99 5). In Sm ith , this Court hel d that when a vete ran dies whil e his or herappea l re la ti ng to a VA dis ab ili ty c om

pe ns ati on claim

is p en din g b ef

ore the Bo ard , th e B oard l ack s juris dic tio n to iss ue a decision on t he merits after the dea th, a subsequent ly issued Board de cision is not a final deci sion
su bje ct to app eal , an d the Court ac co rdi ng ly l ack s ju ris dic tio n o ve r an

ap pe al f rom that de cis ion

that is filed by the s urviving spouse

. Se e S mi th , 10 Vet.App. at 334. However, while the Court's holdings in Landicho and Smith we re cl earl y l imi te d t o c la ims for disabili ty compensation, 38 C.F.R. § 20.1302 contains no such li mitation. Rather, § 20.1302 broadly sta tes that "[a]n appeal pendi ng before the Board of Veterans' Appeals when the appellant die s w ill be dis m iss ed ." The rational e behind this broadening of the Court's holdings was that VA
co ul d "f in d no meaningful distinction bet ween claims for disabilit y compensation and claims for other benefits which would reach the Board with respect to survivabil ity." 62 Fed. Re g. 55 ,169. The Agency noted that i n Landicho, thi s C ourt " fo un d th at C on gre ss e sta bli sh ed a p roc ed ure , und er the ' acc rue d be ne fi ts' p rov isi on s of 3 8 U .S .C . § 51 21 , f

or a qu ali fi ed survi vo r to car

ry o n, to a lim ite d
ex tent, a de cea sed

v ete ran ' s dis ab ili ty co m

pe ns ati on cla im ." Id. Th e A ge nc y f urt he r ob ser ve d th at "th e law p rov ide s th ese sam e ' acc rue d b en ef it' rig hts to t

he same qu ali fi ed

survi vo rs o f a ll p ay ees who di e en title d to pe rio dicbe ne fit s wh ich rem ain un pa id. " Id. (em

ph asi s ad de d); see38 U.S.C. § 5 12 1 (d esc rib ingwh o is eli gib le f or th e paym ent of

"per iod ic m on etary be ne fi ts" upo n th e d eat h of a beneficiary). This case cl ea rl y il lu strate s the flaw in this reasoning, as it involve s a claim of
entit lem ent to a si ng le f

ixe d p aym ent, r ath er than p eri od ic p aym ents, an d is the ref ore no t su bje ct t o the accrue d benefits rule s create d by 38 U.S.C. § 5121. Whil e th e o ve rre ach

of § 2 0. 13 02 is t

rou bli ng , it is no t o utc om e de ter

m inativ e in thi s ca se because the Courtholds that t he appellantpr op er ly b ro ught t his clai m in her dual capacity a s the gu ard ian of the ve ter an and a thir d-p art y p ay ee. In i ts d eci sio n, the Bo ard expre ssl y id entif

ied Ms. Loreth as t he appellant , stating: "The vetera n was determined by the Departm ent of Veterans Af fa irs (V A) to b e in co m

pe tent in a S ep tem be r 20 02 rat ingde cis ion . T he app ell ant is his sp ou se payee." R. at 2. In a ddition, the appellantas "spouse- payee" filed t he NOD concerning the RO5

denial of reimbursement. R. at 337. Furthermore, l in e 1A of the VA Form 1-8 Certificati on of Appeal, which asks for "NAME OF APPELLA NT (if other than ve teran) ," i de nti fi es o nly "D en ise Loreth." R. at 36 9. As a m att er of

law, th e Co urt

f ind s no e rro r i n the B oard' s tre atm ent of Ms. Loreth as t he appel lant with r espect to t he cl aim of reimbursem ent because 38 U.S.C. § 1728 authorize s the Secret ary t o "make payment of the r easonable val ue of em ergency tr eatment directl y" to a person ororganizat ion who makes such expenditure on beha lf o f a veteran. 38 U.S.C. § 1728(b). Furthermore, 38 C.F.R. § 17.123 provides that cl aims for "reimbursem ent of services not previously authorized may be filed by the veteran who recei ved the servi ces (or hi s/her guar dian) or by the ho sp ita l, cl ini c, or c om m un ityres ource wh ich

pro vid ed the ser vic es, or b y a

pe rso n o the r than the vet eran who paid for the se rvices." In this case, at the tim e she filed her clai m, the appellant
wa s b oth the gu ard ian

of the ve ter anwh o re cei ve d th e ser vic es an d a

pe rso n who se n am e is inc lud ed on the wire tr ansfer of funds that paid for the se rvices, and a s spouse-payee , she filed an NOD and pursu ed anap pe al o f t

he RO ' s d en ial of

rei m burse m ent. R. at 8 8. Ac co rdi ng ly, the Co urt ho lds that the Bo ard

did no t er r in ex erc isi ng jur isd ict ion

ov er the ap pe llant' s cl aim , and the C ourt h as jurisdi ction to cons ider thi s matter. Se e Le dfo rd v. Wes t , 136 F.3d 776, 779 (Fed. Cir. 1998) (" [T]he [C]ourt' s jurisdi ction is pr emised on and defined by the Board's decision concerning t he matter being appealed." ( citing 38 U.S.C. § 7252(b)))

. B. Claim f

or Reimbursem ent W ithres pe ct t o th e m eri ts o f h er c la im fo r re im burse m ent, t

he ap pe llant argu es t

hat th e B oard erred in fail ing to discuss two relevant provisions of law: 38 U.S.C. § 1725 and 38 C.F.R. § 17.145 (2009). App. Br. at 6-7. The Secr etary conce des that t he Board did not discuss 38 C.F.R. § 17.145, but argues t hat this was a h ar mle ss e rror because "the Board made an affirmative finding that the veteran's 'm edical condi tion did not ne cessita te the move.'" Sec. Br. at 19 (citi ng R. at 8). When the appellant subm itted her claim f or reimbursem ent in October 2002, 38 C.F.R. § 17.143 (2002) provide d that tr ansportat ion at Government expense "sha ll be author ized" for (2) A v ete ran

or o the r pe rso n tr av eli ng bya spe cia liz ed mo de of tr an sp ort ati on

su ch as anam b u lan c e , am

b u le tt e , a ir

am b u lan c e , wh e e lc h a ir

v an , o r o th e r v e h icl e speciall y designed to t ransport di sabled indi viduals provi ded: (i) A p hy sic ian

de ter m ine s th at the sp eci al m ode of trav el i s m ed ica lly required; (ii) The pe rson is unabl e to defray the expe nses of the trave l; and (ii i) T he trave l is a

uth ori zed in a dv an ce or wa s und ert ak enin c onne cti on wi th6 a medical emergency such that dela y to obtain aut ho ri zation would be hazardous to t he person's life or heal th.
38 C. F. R. § 1 7. 14 3(c )(2 )(i -ii i). Se cti on 17. 14 5, title 38 of

the C od e of

Fed era l R eg ulatio ns , p rov ide d that expe ns es f

or t rav el p erf orm ed un de r §1 7. 14 3(a ) w ith out pri or a uth ori zat ion

m aybe rei m

burse d if "th ere wa s a n eed

fo r pr om pt m ed ica l care whic h w as a pp rov ed ," and

"[t]here was a

jus tif iab le lack of knowledge on the part of at hi rdp art y acting for the ve teran tha t a requestfor prior
autho riz ati on

wa s n ece ssary. " 38 C. F. R. § 1 7. 14 5(a ) ( 20 02 ). B oth § 1 7. 14 3 an d § 17 .1 45 have be en eli m inated

fr om the curre nt r eg ulatio ns , whic h n owstate that payment f or t rav el that in clu de s a "sp eci al m od e o f t

ran sp ort ati on ," s uc h a s an air ambulanc e, wi ll b e ap pro ve d if the trave l w as ap pro ve d "p rio r to trave l in the sp eci al m od e o f t

ransportation or t

he trave l w as u

nd ert ak enin
co nn ect ion w itha m ed ica l em erg en cy ." 3 8 C .F .R . § 70 .4 (d) (20 09 ); see73 Fed. Reg. 36,796 (June 30, 2008) (pr oviding for effective date of July 30, 2008). At the tim e o f t

he veteran's mov e f

rom Ca lif orn ia t o Il lin ois via

air am bu lan ce, he wa s
rec eiv ingVA -ap pro ve d m ed ica l care i n a pri vate h os pital. The reco rd i s unc lear as to what information the appellantreceived from VA as she was asses sing her opti ons for the ongoing treatment of the veteran. One document in the record indicates that the appellantwas told by a VA employee that if she could getthe veter an tr ansferred from the pr ivate hospi tal in Cali fornia to a VA facility, t hat the Danvil le , Il linois, VA facilit y would then "work with t hem on getting him to our [I lli no is VA ] f

a c il it y . " R

. a t 2 8 2

. G iv e nth e s e f a c ts , it s e e m s c le ar t

h a t t h e ap p e ll an t w a s ath ir d partywh o a cte d o n be ha lf o f the v ete ran , an d wh o arrang ed fo r tr an sp ort

of the ve ter anwi th what could qualify under 38 C.F.R. § 17.145 as a "j ustifiable lack of knowledge" thatprior aut horizati on was necessary. To det ermine whether the appel lant meets all t he require ments for reimbursem ent
un de r § 1 7. 14 5 re qu ire s an ap pli cat ion

of lawto f act . H ow ev er, the Co urt

do es n ot have be fo re i t sufficient factual findings by the Board to re ach a decisi on. Further, because the Board did not dis cu ss 3 8 C .F .R . § 17 .1 45 , th e B oard f ail ed to c on sid er a ll applicab le l aw s an d re gu lat ion s in arrivi ng at its decision. Se e 38 U .S .C . § 71 04 (a) , (d)(1 ) (p rov idi ng that de cis ion s o f t he Bo ard sh all be ba sed on ap pli cab le pro vis ion s o f l awan d re gu lat ion an d th at the Bo ard

sh all pro vid e a written statem ent of

rea so ns or bas es f

or i ts c on clu sio ns ); Sc ha

fra th v . D erw ins ki , 1 Vet.App. 589, 592-93 (1991) (st ating th att he Bo ard must consider and dis cuss all applicable provisions of law andThe par t i es have not r ai se d nor does t hi s C our t addr es s t he que st i on of w het her t he Sec r et ar y' s excl usi ve 2 aut hor i t y t o gr ant equi t abl e r el i ef pur sua nt t o 38 U

. S. C

. § 503 a nd 38 C

. F. R

. § 2. 7 ( 2009) nec es sa r i l y connot es t hat t he a u th o rity to d e n y su c h re lief a lso b e lo n g s e x c lu siv e ly to th e S e c re ta ry . 7 regulatio n whe re the y are m ad e "p ote nti all y a pp lic ab le thro ug h th e as ser tio ns an d is su es r ais ed

in the recor d"). Therefore, r emand is required for the Board to address the applic abilit y of 38 C.F.R. § 17.145 (2002), andt he re lationshi p of that regulat ion, if any, to 38 C.F.R. § 17.143 (2002), and to m ak e su chfa ctu al d ete rm inatio ns as m aybe req uir ed in o rde r t o ad dre ss 38 C .F .R . § 17 .1 45 as it exist ed at the r elevant time. Addit ionally, the appellant may present a ny additional evidence and argum ent in support of thi s m att er, an d th e B oard m us t co ns ide r any e vid en ce and argum ent so presented. See Kay v. Principi , 16 V et. Ap p. 5 29 , 53 4 (20 02 ). T his m att er is to be p rov ide d expeditious treatment on remand. Se e 38 U.S.C. § 7112. C. Eq uit ab le R eli ef On ap pe al b ef

ore the Bo ard , th e ap pe llant re qu est ed that the S ecr etary c on sid er g rantin g h er eq uit ab le r eli ef

pursu ant to 38 U.S.C . § 50 3. An d, in N ov em be r 20 06 , th e B oard r ef

err ed that request t o the RO for further action. On August 13, 2009, t he Co ur t iss ued an order di recting t he Se cr et ary t o fi le a s ta te mentat te st in g t o wh atac ti on , i f an y, ha d b ee n t ak e n a s t o the ap pe ll an t's req ue st f or e qu ita ble rel ief . O n Au gu st 2 7, 20 09 , th e S ecr etary f ile d a res po ns e ad

vis ingthe Co urt that he had alert ed the Of fice of the Chief of Staff, V eterans Heal th Administration, of the pendi ng req ue st f or equitable relief. A c op y o f t he ap pe llant' s V A F orm

9, on wh ich sh e h ad m ad e h er request, was subs equently d el iver ed to that office for consi deration. By le tter dat ed August 20, 20 09 , th e ch ief

bu sin ess of

fi cer of the Ve ter an s H eal th A dm ini str ati on inf orm ed the ap pe llant t

hat her requestfor equit able relief would not be forwarde d to the Secre tary becaus e he would not have
autho rity to grant i t. T he le tte r e xp lai ne d that u nd er sec tio n 50 3, th e Se cre tar y m ayg rant eq

uit ab le relief in onl y two situati ons, neitherof which the chief business of ficer found present i n the ap pe llant' s ca se. The Secre tar y' s autho rity to grant e qu ita ble rel ief un de r se cti on

50 3 is wh oll y 2 within the Secr etary's discre tion, and the Courtlacks jurisdicti on even to review the exerci se of the Secretary's equity discret ion. Zi mi ck v . We st , 11 Ve t.A

pp . 4 5, 50 -51 (19 98 ). S inc e th e autho rity to grant equit able rel ief is discr etionary, t he Court will notremand a m atter on t hat ground. Er sp am er v. Brown , 9 Vet.App. 507, 512 (1996). The Court als o does not ha ve t he p owe r t o compel the Secretary to exerci se his author ity to gra nt equitabl e relie f. Zi mi ck, 11 Vet.App. at 50-51.8 III . C ON CL US ION Afterc on si de rat ion of the appella nt's and the Secreta ry's pleadings, and a r eview of the record, the Board's Novem ber 15, 2006, decision denying entitl ement to paym ent or rei mbursem ent for m edical expe nses incurr ed in connecti on with privat e transpor tation of the vet eran from California to I llinois is VACATED and the matter is REMANDED for further adjud ic ati on consistentwith this opi nion.