UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

NO. 04-0584

LARRY G. TYRUES, APPELLANT,

V.

ERIC K. SHINSEKI,

SECRETARY OF VETERANS AFFAIRS, APPELLEE.

On Remand from the U.S. Court of Appeals for the Federal Circuit

(Argued September 9, 2008 Decided October 2, 2009)

Kenneth M. Carpenter of Lawrence, Kansas, with whom Mark R. Lippman of La Jolla,

California, was on the brief for the appellant.

Nisha C. Wagle, with whom Paul J. Hutter, Acting General Counsel; R. Randall Campbell,

Assistant General Counsel; and Joan E. Moriarty, Deputy Assistant General Counsel, all of

Washington, D.C., were on the brief for the appellee.

Before GREENE, Chief Judge, and KASOLD, HAGEL, MOORMAN, LANCE, DAVIS,

and SCHOELEN, Judges.

MOORMAN, Judge, filed the opinion of the Court. KASOLD, Judge, filed a separate

concurring opinion. HAGEL, Judge, filed a separate opinion concurring in the result and dissenting

in part. LANCE, Judge, filed a separate opinion concurring in part and dissenting in part, in which

SCHOELEN, Judge, joined. 

MOORMAN, Judge: The appellant, Larry G. Tyrues, through counsel, seeks review of an

April 7, 2004, Board of Veterans' Appeals (Board) decision that denied disability compensation for

a lung disorder as a chronic disability because the evidence did not support a finding that it resulted

from an undiagnosed illness and therefore did not warrant service connection on a presumptive basis

under 38 U.S.C. § 1117. Both parties filed briefs, and the appellant filed a reply brief. On

November 15, 2005, the Court affirmed the Board's decision and held that it did not have jurisdiction

to review a September 1998 Board decision that denied the appellant disability compensation on a
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direct basis. Tyrues v. Nicholson, 20 Vet.App. 231 (table), 2005 WL 3157695 (2005). On

March 11, 2008, the U.S. Court of Appeals for the Federal Circuit (Federal Circuit) vacated this

Court's decision and remanded the matter for the Court to reconsider its decision in light of two

decisions reached after the Court issued its November 2005 decision in this case: Joyce v.

Nicholson, 443 F.3d 845 (Fed. Cir. 2006), and Roebuck v. Nicholson, 20 Vet.App. 307 (2006).

Tyrues v. Peake, 273 F. App'x 921, No. 2006-7040, 2008 WL 907458 (Fed. Cir. Mar. 11, 2008).

A panel of the Court heard oral argument on September 9, 2008. Thereafter, this case was called

before the full Court. This appeal is timely, and the Court has jurisdiction pursuant to 38 U.S.C.

§§ 7252(a) and 7266(a). 

For the reasons set forth below, the Court holds that the Secretary permissibly processed and

issued a final decision denying benefits based on direct service connection, and remanded for the

consideration of benefits based upon presumptive service connection, in separate decisions, in 1998

and 2004. We further hold that because benefits based on direct service connection were finally

decided in a 1998 Board decision that was not timely appealed, nor reopened and considered in the

2004 Board decision, we lack jurisdiction to now review the denial of benefits for service connection

on a direct basis. As discussed more fully below, the Court will dismiss, for lack of jurisdiction, that

part of the appeal finally decided in the September 1998 Board decision, and we will vacate the 2004

decision of the Board now on appeal and remand the matters addressed therein for further

adjudication consistent with this opinion. 

I. FACTS

Mr. Tyrues served on active duty in the U.S. Army from September 1969 to April 1971, and

from September 1990 to May 1991. Record (R.) at 16-17. He served in the Persian Gulf from

November 1990 to April 1991. R. at 17. In March 1994, Mr. Tyrues was hospitalized for treatment

of refractory pneumonia and tonsilitis. R. at 227. In March 1995, he sought VA benefits for a lung

disability on the basis of direct service connection. R. at 112. In December 1996, following a VA

hearing officer's suggestion that his lung symptoms and various other complaints, including sore and

aching joints, may warrant a claim for "Persian Gulf Syndrome," Mr. Tyrues sought service

connection on that basis as well. R. at 146-47, 150.
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In a March 1997 decision, the Board remanded the matter of Mr. Tyrues's entitlement to

service connection for a lung disorder for further development, including the procurement of

medical records and a VA medical examination to obtain a current diagnosis of his claimed

respiratory disability and to assist in a determination as to whether any current lung disorder was

related to his periods of active service. R. at 155. The Board directed that following development,

the VA regional office (RO), if it issued an adverse decision, should provide Mr. Tyrues with a

Supplemental Statement of the Case (SSOC) and return the case to the Board. R. at 156. The

following month, the RO notified Mr. Tyrues that it had received his claim for benefits based on his

Persian Gulf War service and requested further evidence. R. at 163-65. An April 1997 RO

Compensation and Pension Examination Worksheet noted that the Board had remanded an appeal

from Mr. Tyrues and directed compliance with the Board remand as to Mr. Tyrues's claim for

service connection "for a lung disorder due to Persian Gulf War service." R. at 168. The RO also

noted that Mr. Tyrues "has amended his claim to include s/c [(service connection)] for aching joint,

memory loss, [and] a stomach condition." R. at 168. 

A May 1997 VA medical examination report identified the then-present complaints of

Mr. Tyrues to be lung disorder, joint pain, and memory loss. R. at 190. The VA examiner

diagnosed Mr. Tyrues as having "1. Possible Persian Gulf Syndrome with shortness of breath, joint

pain, and memory loss. 2. Degenerative arthritis feet with bilateral Hallux valgus deformity." R. at

191. The examiner opined that "[i]t is only speculation on my part, but, he did not have a lung

disorder prior to his service in the Persian Gulf as he does now." Id.

On April 20, 1998, the RO issued a decision denying service connection for a lung disorder,

which the RO noted was a "remanded issue." R. at 242. In its discussion of the lung disorder, the

RO specifically stated that "service connection for a lung disorder on a direct basis remains denied"

and that, in addition, "service connection for lung problems, diagnosed on VA examination as

shortness of breath, as due to an undiagnosed illness is denied." R. at 243. The RO also denied

service connection for three other separately identified conditions – joint pain as due to an

undiagnosed illness, memory loss as due to an undiagnosed illness, and a stomach condition as due

to an undiagnosed condition. The RO concluded that (1) the joint pain was determined to result

from known clinical diagnoses of degenerative arthritis of the feet, tendonitis of the right shoulder,

and lumbar strain; (2) the memory loss was not shown with chronic symptoms of a certain duration
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within the requisite period; and (3) the stomach condition was determined to result from a known

clinical diagnosis of irritable bowel syndrome. R. at 243-45. The record on appeal does not contain

any subsequent document from Mr. Tyrues to the RO, or from the RO to Mr. Tyrues, as to these

three conditions. See R. at 1-402.

On April 20, 1998, the RO notified Mr. Tyrues that it was returning to the Board the matter

of service connection for a lung disorder and enclosed an SSOC that discussed "service connection

for a lung disorder." R. at 248-54. The SSOC reiterated the findings contained in the rating decision

of the same date – denying benefits for a lung disorder on a direct basis and for lung problems,

diagnosed as shortness of breath, as due to an undiagnosed illness. R. at 254. Mr. Tyrues responded

to the SSOC stating that the issue in this case is entitlement to service connection for a lung disorder.

R. at 256. 

In September 1998, the Board (1) denied disability compensation based on direct service

connection for a lung disorder because it found that the matter was not well grounded, and

(2) remanded to the RO the issue of disability compensation based on presumptive service

connection for an undiagnosed illness manifested by shortness of breath for further development to

include an additional VA medical examination. R. at 265-76. The Board discussed the evidence

of record as it pertained to symptoms of the lung and chest, including congestion, colds, and flu-like

symptoms, and discussed evidence regarding pulmonary function tests, breath sounds, any

pulmonary or pleural abnormalities, as well as diagnoses of pneumonia. R. at 269-70. The Board

did not refer to any symptoms other than those involving the chest and lungs. The Board did not

make any reference to the joint pain, stomach condition, and memory loss. See R. at 265-75. The

Board instructed that, in regard to the remanded matter, the VA medical examiner should render an

opinion as to whether, for each symptom alleged by Mr. Tyrues, the symptom is attributable to a

"known" clinical diagnosis, in light of the medical history and examination findings, and, if so, the

examiner should identify the diagnosed disorder and render an opinion as to its etiology and date

of onset. R. at 274. At the time it rendered the 1998 decision, the Board furnished Mr. Tyrues a

notice concerning his appellate rights, which included notification that he could appeal the decision

with regard to matters that had not been remanded. R. at 275-76. Mr. Tyrues did not file a Notice

of Appeal (NOA) of this Board decision.
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In December 1998, Mr. Tyrues underwent a second VA examination. R. at 285-87. The

examiner reviewed Mr. Tyrues's claims file and opined that "[t]he history obtained from the veteran,

the claim folder review, and the examination findings indicate that the veteran probably has chronic

bronchitis, which gets worse when he gets exposed to dust, paint, etc." R. at 287. 

In February 2000, the Board denied Mr. Tyrues's claim for disability compensation for

"shortness of breath as a chronic disability resulting from an undiagnosed illness" because it found

the evidence of record did not establish presumptive service connection. R. at 313. In December

2000, the Court vacated the February 2000 Board decision and remanded the matter to the Board

pursuant to the parties' joint motion for remand. See R. at 339. The Court ordered that VA provide

Mr. Tyrues a respiratory examination and that it accomplish any notification and development

required under the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat.

2096. R. at 340-41. In December 2001, Mr. Tyrues underwent a VA medical examination during

which the examiner, Dr. Plump, diagnosed Mr. Tyrues as having "mild chronic bronchitis" with a

history of refractory pneumonia and stated his "medical opinion that the patient's shortness of breath

due to an undiagnosed illness is at least as likely as not due to the Gulf War service." R. at 350. 

In July 2002, the Board's Case Development Unit (CDU) found that because Dr. Plump had

attributed Mr. Tyrues's symptoms to both chronic bronchitis and to an undiagnosed illness, the

results of the December 2001 VA examination were inconsistent, and additional development was

needed. R. at 365-66. It ordered a further examination, by another examiner. It directed that the

new examiner must (1) identify the diagnosed disorder to which he attributed any of Mr. Tyrues's

symptoms; (2) explain his diagnosis; and (3) render an opinion as to the etiological basis and date

of onset of such diagnosed disorder. R. at 371-72. Or, if the examiner was "unable to attribute the

identified symptoms to a diagnosable disorder, he should so indicate" and also indicate "whether or

not this could be related to Gulf War service." R. at 372. In October 2002, Mr. Tyrues underwent

an additional VA medical examination, by a different VA examiner (not Dr. Plump), after which the

examiner stated that Mr. Tyrues "does not have any respiratory problems, symptoms[,] or signs at

this time. . . . In my opinion he is allergic to certain paints and vapo[r] and these occa[s]ional

respiratory symptoms are not related to the exposure of fumes in Gulf War." R. at 370. In

April 2004, the Board issued the decision on appeal here. R. at 1-12.
Section 1110 of title 38, U.S. Code, provides basic entitlement to compensation for a disability resulting from 1

an injury or disease contracted in the line of duty in active military service. 38 U.S.C. § 1110; see 38 C.F.R. § 3.303(a)

(2009) (provides compensation for "a particular injury or disease resulting in disability [that] was incurred coincident

with service"). In order to establish entitlement to direct service connection for a disability, the appellant must show (1)

"competent evidence of current disability [by way of] a medical diagnosis"; (2) "incurrence or aggravation of a disease

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II. ANALYSIS

A. Scope of the Appeal

1. Position of the Parties

The appellant argues that the Court has jurisdiction to review the September 1998 Board

decision that both denied service connection for a lung disorder on a direct basis and remanded the

issue of presumptive service connection for an undiagnosed illness manifested by shortness of

breath. The appellant asserts that the 1998 Board decision "concerns the same claim" decided by

the April 2004 Board decision here on appeal. Appellant's Brief (App. Br.) at 5. He contends that

because both decisions address the same claim, i.e., service connection for a lung disorder, he has

not lost his right to appeal the September 1998 Board decision denying direct service connection

because, under Harris v. Derwinski, 1 Vet.App. 180 (1991), it would have been premature to file

an appeal from that decision prior to the Board's finally deciding the matter of his entitlement to

service connection on a presumptive basis in the April 2004 Board decision. App. Br. at 5; Harris,

1 Vet.App. at 183 (holding that a Board decision that both denied one claim and remanded a second

claim was not final because the denied claim was inextricably intertwined with the remanded claim).

During oral argument, the appellant maintained that he was seeking compensation for one

disability, that is, a disability resulting from a lung problem (or a disability related to his lung), and

that there are two separate theories of entitlement to VA compensation for his lung disorder:

presumptive service connection under section 1117 and direct service connection. In support of his

argument, the appellant argued that under Roebuck, supra, the finality of the September 1998 Board

decision, which he contends incorrectly split the appellant's claim for service connection based on

two theories of etiology, was "held in suspense" until the Board issued the April 2004 decision, and

thus, the Court has jurisdiction to review the September 1998 Board decision.

The Secretary, on the other hand, argues that there are two separate claims involved here –

a claim for entitlement to service connection for a diagnosed disability, i.e., a diagnosed lung

condition, under the provisions of 38 U.S.C. § 1110 and a claim for entitlement to service

1
or injury in service [by way of] lay or medical evidence"; and (3) "a nexus between the in-service injury or disease and

the current disability [by way of] medical evidence." Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff'd per curiam,

78 F.3d 604 (Fed. Cir. 1996) (table); see Hickson v. West, 12 Vet.App. 247, 252 (1999). 

In order to establish entitlement to service connection under section 1117, the evidence must show that the 2

appellant is a Persian Gulf veteran who (1) exhibits objective indications; (2) of a chronic disability; (3) which became

manifest either during active military service in the Southwest Asia theater of operations during the Persian Gulf War,

or "to a degree of 10% or more not later than [September 30, 2011]"; and the evidence must show that (4) such

symptomatology by history, physical examination, and laboratory tests cannot be attributed to any known clinical

diagnosis." Guiterrez v. Principi, 19 Vet.App. 1, 7 (2004). Section 1117 provides for entitlement to compensation on

a presumptive basis to a Persian Gulf War veteran who complains of having an undiagnosed illness that is (or illnesses

that are) 10% or more disabling during the presumptive period established by the Secretary. 38 U.S.C. § 1117(a)(1)(A)

and (B); see Gutierrez, 19 Vet.App. at 6. By definition, section 1117 only provides compensation for symptoms of a

chronic disability that have not been attributed to a "known clinical diagnosis." 38 C.F.R. § 3.317(a)(1)(ii) (2009); see

Stankevich v. Nicholson, 19 Vet.App. 470, 472 (2006) ("The very essence of an undiagnosed illness is that there is no

diagnosis."); Guiterrez, 19 Vet.App. at 10 (a Persian Gulf War veteran's symptoms "cannot be related to any known

clinical diagnosis for compensation to be awarded under section 1117"); 60 Fed. Reg. 6660, 6665 (Feb. 3, 1995) ("The

undiagnosed illness provisions of Public Law 103-446, as implemented by § 3.317, were specifically intended to relieve

the unique situation in which certain Persian Gulf War veterans found themselves unable to establish entitlement to VA

compensation because their illnesses currently cannot be diagnosed.").

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connection for an undiagnosed disability under the provisions of 38 U.S.C. § 1117. Secretary's Br. 2

at 18-20. He asserts that the claims involve two separate legal and factual bases for entitlement to

service connection. Id. He contends that the Court lacks jurisdiction to review the 1998 Board

decision because the NOA was filed with the Court 51⁄2 years after the September 1998 Board

decision, long past the 120-day filing deadline for an appeal to this Court and the record reflects no

motion for reconsideration was timely filed with the Board to toll the statutory deadline. Id. at

16-17. 

As discussed below, the Court need not decide whether the appellant had two separate claims

– one for direct service connection for a lung disability and one for presumptive service connection

for a chronic disability resulting from an undiagnosed illness – or a single claim for disability

compensation based on two separate theories that might support service connection and the award

of benefits. This is because, in either case, the 1998 Board decision was a final decision, and the

appellant failed to file an NOA with the Court within 120 days after notice of the mailing of that

decision, as required under 38 U.S.C. § 7266(a) to invoke our jurisdiction.
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2. General Law

This Court's jurisdiction is governed by 38 U.S.C. §§ 7252(a) and 7266(a). Section 7252

provides that this Court "shall have exclusive jurisdiction to review decisions of the [Board]."

38 U.S.C. § 7252(a). Section 7266(a) provides that to obtain review by this Court "of a final

decision of the Board of Veterans' Appeal," a person "adversely affected by such decision" must

file an NOA "with the Court within 120 days after the date on which the notice of the decision is

mailed pursuant to section 7104(e) of this title." 38 U.S.C. § 7266(a). Accordingly, this Court has

appellate jurisdiction to review final Board decisions. See Breeden v. Principi, 17 Vet.App. 475,

478 (2004). 

The Federal Circuit in Maggitt v. West discussed our jurisdictional statute. The Federal

Circuit held that our Court erred when it held that it did not have jurisdiction to hear arguments

raised for the first time before our Court. In reaching that decision, the Federal Circuit said that

"[t]he government is correct in the assertion that the jurisdiction of the Veterans Court by statute

only reaches to a 'decision of the Board.'" 202 F.3d 1370, 1375 (Fed. Cir. 2000) (quoting 38 U.S.C.

§ 7252(a)). The Federal Circuit then said: "A 'decision' of the Board, for purposes of our Court's

jurisdiction under section 7252, is the decision with respect to the benefit sought by the veteran:

those benefits are either granted . . . , or they are denied." Id. at 1376. In Kirkpatrick v. Nicholson,

the Federal Circuit subsequently noted that this definition of "decision" in section 7252 was "in line

with the definition of a Board decision in 38 U.S.C. § 7104, the Board's jurisdictional statute," which

provides that "'[e]ach decision of the Board shall include– . . . an order granting appropriate relief

or denying relief.'" 417 F.3d 1361, 1364 (Fed. Cir. 2005) (quoting 38 U.S.C. § 7104(d)).

The Board's 1998 decision in this case contained an order denying relief. See Maggitt, supra.

It specifically denied benefits – entitlement to service connection for a lung disorder on a direct

service-connected basis. Pursuant to its remand directives, however, the Board decision also left

open the possibility that the appellant may be entitled to benefits for a chronic disorder manifested

by shortness of breath, due to an undiagnosed illness, on a presumptive basis. Therefore, the Court

must decide whether the remand of entitlement to service connection for a chronic disorder

manifested by shortness of breath rendered nonfinal the Board's decision to deny benefits for a lung

condition based on direct service connection. In other words, the question is whether the 1998

Board decision that adversely resolved direct service connection for a lung condition and also
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remanded to the RO another matter was "final" with regard to the resolved matter for purposes of

judicial appeal to this Court such that the appellant was required to appeal that decision within 120

days after it issued. 

3. Roebuck and Joyce 

In resolving the question, the Federal Circuit's remand of the instant case suggested that we

specifically consider two recent decisions. We first consider this Court's decision in Roebuck, supra,

where the Court addressed the finality of a Board decision. The Court notes that Roebuck, by its

terms, involved a "unique" set of circumstances where the Board issued a decision in two separate

parts, explicitly stating its intent to do so, without remanding a matter to the RO. Roebuck,

20 Vet.App. at 316. Specifically, Mr. Roebuck claimed entitlement to service connection for a lung

disorder as secondary to tobacco use and nicotine dependence and also as secondary to asbestos

exposure. In December 2002, the Board issued a decision denying service connection for a lung

disorder as secondary to nicotine dependence and, in the same decision, expressly stated that it

would also issue a separate decision concerning the asbestos exposure theory of causation. Less

than one year later, the Board issued another decision denying service connection for a lung disorder

as secondary to asbestos exposure. Id. at 317. The Court held that the first Board decision was not

final where, "in the unique circumstances" presented, the Board (1) bifurcated its decision of Mr.

Roebuck's lung disorder claim, (2) denied service connection for a lung disorder under a nicotine

dependence theory, and (3) "stated that it would 'prepare a separate decision addressing [the issue]'

of service connection for a lung disorder under an asbestos exposure theory." Id. at 309, 316.

The Roebuck Court held that

when a claimant raises more than one theory in support of a claim during the time

while that claim is still pending before VA, if the Board bifurcates those theories or

arguments and addresses them in separate decisions, the time for appeal is not ripe

until the Board issues a final decision denying all theories [and, u]nder those

circumstances, the 120-day requirement for filing a[n NOA] will not begin to run

until the Board has denied all theories in support of the claim that it has identified

for consideration.

Id. at 315-16 (emphasis added). In holding that the first Board decision was nonfinal, the Court

noted that "to adjudicate a claimant's appeal of one theory of a claim while the Board is still

deliberating on another theory supporting that same claim, our efforts would be potentially

duplicative and unnecessary." Id. at 315 (emphasis added). Thus, among the unique circumstances
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of Roebuck was the Board's issuance of its decision in two parts without remanding either theory to

the RO for further development and readjudication. Id. at 316 (noting that the Board's decision "was

issued by the Board in two parts separated by less than a year"). Accordingly, Roebuck is limited

to the situation where the Board, in its decision denying one theory, specifically states that the Board

will be issuing, without a remand to the RO, a second decision on another theory of the same claim.

To read Roebuck more broadly creates a new exception to the rule of finality and ignores the fact

that Roebuck explicitly was based on unique circumstances. 

Thus, Roebuck is not dispositive of the issue here regardless of whether the appellant is

deemed to have filed two separate claims or one claim. First, if we assume the appellant sought

benefits for two separate disabilities – a diagnosed lung disorder, described as both pneumonia and

bronchitis, and an undiagnosed chronic condition manifested by shortness of breath alleged to be

the result of his service in the Persian Gulf – Roebuck is simply inapposite because the Court in that

case found that there was one claim. Id. at 315-16; see also Elkins v. Gober, 229 F.3d 1369, 1376

(Fed. Cir. 2000) (holding that "[b]ecause . . . each 'particular claim for benefits' may be treated as

distinct for jurisdictional purposes, a veteran's claims may be treated as separable on appeal").

Second, if we assume the appellant raised two theories in support of a single claim for VA benefits

for a lung condition – direct service connection and presumptive service connection available to

Persian Gulf War veterans – the facts are distinguishable from Roebuck because here the Board

issued a final decision with regard to benefits based upon direct service connection, and remanded

to the RO for consideration of benefits based upon presumptive service connection, whereas in

Roebuck, the Board denied one theory and expressly stated that it would issue a second Board

decision on the second theory. 

We next consider the Federal Circuit's decision in Joyce, supra, which held that a decision

of our Court was not final where our Court had affirmed in part, reversed in part, and vacated in part

a Board decision finding no clear and unmistakable error (CUE) in an RO decision denying

disability compensation benefits and remanding a matter to the Board. 443 F.3d at 849-50. Our

Court affirmed the Board's determination of no CUE as to the RO's finding that the presumption of

soundness was rebutted. We reversed the Board determination of no error in the RO finding that

the presumption of aggravation had been rebutted under the applicable regulation and remanded for

the Board to determine whether the RO's error was outcome determinative. We vacated the Board's
11

denial of CUE and remanded for readjudication on the service-connection question. The appellant

appealed to the Federal Circuit. 

The parties in Joyce disagreed as to whether there was a single claim – one for service

connection that is established either through the presumption of soundness or the presumption of

aggravation – or two separate claims – one for service connection and one for aggravation. The

Federal Circuit stated that it need not decide which view of the underlying claims was correct

because under either view "there is a lack of finality." 443 F.3d at 849. The Federal Circuit

concluded that if there is only a single claim, review by the Federal Circuit was unavailable because

the remand order did not satisfy the test announced in Williams v. Principi, 275 F.3d 1361 (Fed. Cir.

2002), which held that the Federal Circuit may review a nonfinal remand order if three conditions

were met. Joyce, 443 F.3d at 850. The Federal Circuit stated that if there were separate claims for

service connection and aggravation, Elkins, 229 F.3d at 1376, was applicable, and the "assertedly

separate claims are inextricably intertwined because both claim compensation for the same

disability." 443 F.3d at 850. The Federal Circuit concluded that "[r]eview of the Veterans Court's

decision as to the service connection claim is unavailable under Elkins because it would 'disrupt the

orderly process of adjudication.'" Id.

We conclude that the Federal Circuit's decision in Joyce, similar to Roebuck, does not answer

the question now before the Court. Joyce discussed the reviewability of decisions of this Court by

the Federal Circuit. Joyce did not discuss the finality of a Board decision and the jurisdictional basis

on which this Court reviews Board decisions. In Joyce, the Federal Circuit expressly noted: "Our

review of decisions of the Court of Appeals for Veterans Claims is governed by 38 U.S.C. § 7292.

While that statute does not explicitly impose a final judgment requirement, we have nonetheless

'generally declined to review nonfinal orders of the Veterans Court' on prudential grounds."

443 F.3d at 849 (quoting Williams, 275 F.3d at 1363). Accordingly, the Federal Circuit in Joyce did

not review or interpret the statutes from which this Court derives its jurisdiction – 38 U.S.C.

§§ 7252(a) and 7266(a). To the extent Joyce is argued to be instructive, it did not resolve the issue

of one claim versus two claims, instead finding that either approach would yield the same result.

And, it did not resolve the issue of whether a decision deemed final by the Board with regard to one

claim or one theory supporting a claim for benefits, and for which notice of appellate rights had been

provided to the claimant – but for which no appeal was filed within 120 days of that Board decision
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– nevertheless could be appealed when the Board ultimately rendered a decision on the remaining

claim or theory that might support an award of benefits. 

4. Elkins and Administrative Finality

 In Elkins, the Federal Circuit provided guidance as to the applicable jurisdictional finality

standard in the context of appeals from decisions that do not dispose of all claims but instead include

a remand. Elkins established that judicial review is available for a claim for which final judgment

has been entered even if other claims presented in the same appeal have been remanded. Id. The

Federal Circuit in Elkins held that it had jurisdiction to review the veteran's headache claim and neck

argument on appeal from our Court notwithstanding our remand of the veteran's back claim and

notwithstanding the fact that all claims were related to the same accident and were presented to this

Court in a single appeal. Elkins, 229 F.3d at 1374. This Court had affirmed the Board's denial of

the headache claim and had rejected Mr. Elkins's argument that the medical evidence regarding his

headaches also established a claim for service-connected neck pain. The Federal Circuit explained

that in deciding that it could treat the claims as separable on appeal, it was adopting the approach

in Dewey Electronics Corp. v. United States, 803 F.2d 650, 654 (Fed. Cir. 1986). The Federal

Circuit stated that "[t]he relevant consideration, in determining whether an administrative

adjudication is sufficiently 'final' is 'whether the process of the administrative decision-making has

reached a stage where judicial review will not disrupt the orderly process of adjudication and

whether rights or obligations have been determined or legal consequences will flow from the agency

action.'" Elkins, 229 F.3d at 1373 (quoting Dewey, 803 F.2d at 654). Applying this Elkins standard

to an appeal from our Court, the Federal Circuit concluded that, because the legal issues presented

on appeal were all distinct (i.e., whether Mr. Elkins had presented "new and material evidence"

sufficient to reopen his claim for back injuries, whether he had presented a "well grounded" claim

for headaches, and whether the medical reports furnished with his headache claim support a claim

for neck injuries), its review of our Court's decision with respect to the headache and neck matters

would not "disrupt the orderly process of adjudication below with respect to the remanded [back

injury] claim." Id. at 1375-76.

In discussing its practice of treating a veteran's distinct issues as separable on appeal (and

in allowing sequential appeals on separate issues or claims), the Federal Circuit in Elkins discussed

its prior decisions regarding similar matters. See Elkins, 229 F.3d at 1374-75. The Federal Circuit
 The Court recognizes the Federal Circuit's decision in Bingham v. Principi, 421 F.3d 1346 (Fed. Cir. 2005), 3

which held that all theories of service connection were disposed of when the Board decision there had denied service

connection. Unlike the factual circumstances presented in Bingham, however, where the Board denied a claim for

service connection on one theory and was silent as to other theories of service connection, in the present case, the Board

specifically remanded a separate theory for development, thereby foreclosing any argument that its denial of direct

service connection could be interpreted as a final decision on the separate theory of presumptive service connection.

See also D'Aries v. Peake, 22 Vet.App. 97 (2008) (exercising jurisdiction over appeal of Board decision that denied

service connection for cause of veteran's death even while claim for DIC was denied in a separate Board decision and

remanded in a separate Court decision); Andrews v. West, 16 Vet.App. 384 (1999) (table) (exercising jurisdiction over

appeal of Board decision denying benefits based on direct service connection while benefits based on secondary service

connection were still being adjudicated).

13

noted its prior holdings that a veteran's overall claim for benefits is comprised of separate issues and

that our Court has jurisdiction to consider an appeal concerning one or more of those issues. See,

e.g., Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (elements of a claim may be

appealed sequentially to U.S. Court of Appeals for Veterans Claims);see also Barrera v. Gober, 122

F.3d 1030, 1032 (Fed. Cir. 1997) (holding that the U.S. Court of Appeals for Veterans Claims has

jurisdiction to review a decision concerning one of the issues that comprise a claim, i.e., the issue

of disability rating). The Federal Circuit stated that, unlike district court cases where a plaintiff must

present all claims for relief arising from an event in a single complaint and then appeal all at once,

"there is no requirement that a veteran's various claims for relief be simultaneously filed and

adjudicated, either upon initial review or on appeal." Elkins, 229 F.3d at 1375. The Federal Circuit

further stated: "Rather, we have recognized that the unique statutory process of adjudication through

which veterans seek benefits may necessarily require that the different issues or claims of a case be

resolved at different times, both by the agency of original jurisdiction and on appeal." Id. 

Against this backdrop, we conclude that a final Board decision denying VA disability

compensation based upon direct service connection, while the consideration of benefits based upon

presumptive service connection is still under adjudication, constitutes a final decision subject to

separate appeal to the Court. Our conclusion is consistent with the recognition in Elkins that VA's 3

"unique statutory process of adjudication" does not necessarily require different issues to be resolved

all at once. See Elkins, 229 F.3d at 1375-76. In meritorious cases where the Board denies benefits

based on a particular issue with distinct criteria and remands for further adjudication another issue

of establishing entitlement to benefits, a veteran might otherwise have to wait years for resolution

and possibly benefits to which he or she is entitled. Indeed, as illustrated by the circumstances in

the instant case, it took VA more than five years after its decision denying direct service connection
14

for a lung disability under section 1110 to complete the remand proceedings pertaining to

entitlement to the presumption of service connection for undiagnosed illnesses incurred in, or

manifested during a presumptive period following, service in the Persian Gulf under section 1117.

In addition, to require a final decision with respect to all claims for benefits, or theories in

support of a claim for benefits – regardless of whether they raise distinct questions, are based on

different statutory provisions, or rely on different causes of a disability – may have the unintended

effect of encouraging the Board to delay making a determination on any matter until all matters are

fully developed and ready for disposition. In such a case, if the Board decides one matter and

remands another matter, when the remanded matter is later ready for the Board's disposition (after

all instructions on remand have been fulfilled), the Board would be required to revisit its decision

on the first matter to ensure that it currently complies with all law and regulations. It is unlikely that

the Board will spend its resources adjudicating the first matter if that were the law, and the Board

might very well decide that it would be more efficient to delay any adjudication until all claims for

benefits, or theories in support of a claim for benefits, were ready for a decision. The veteran would

thus be denied the opportunity of judicial review of an adverse decision until all issues addressed

in the Board decision or all possible bases for supporting a claim for benefits have been finally

decided. Such an outcome would serve neither the veteran nor the VA's interest in providing a

timely award of benefits or achieving final resolution of claims. 

5. Reviewability Versus Finality of a Board Decision 

The Court recognizes that this Court's decision in Harris discussed this Court's jurisdictional

statutory requirement of a "final Board decision" and the question of when a Board decision is

appealable. 1 Vet.App. at 181-83. In Harris, the Court held that a Board decision that denied an

increased rating for service-connected anxiety neurosis was not a final decision over which this

Court had jurisdiction because the claim was "inextricably intertwined" with a claim for service

connection for a heart disorder that the Board had referred to the RO. Id. at 183. The Court in

Harris stated that it would neither review Board decisions "in a piecemeal fashion nor unnecessarily

interfere with the [VA] deliberative process." Id. The Court stated:

A decision by the RO to grant appellant's referred heart disorder claim could have

a significant impact upon appellant's claims for an increased rating for anxiety

neurosis. This, in turn, could render any review by this Court of the decision on the

anxiety neurosis claim meaningless and a waste of judicial resources. 
15

Id. at 183. Accordingly, the Court determined that piecemeal review could render a decision on one

claim "meaningless" and would be a "waste of judicial resources." Id. The Court noted that the

evidence in support of both claims was "replete with statements that the veteran's mental state was

a result of his physical condition," and further noted that the crux of the appellant's claim for benefits

was that "his heart disorder [was] the cause of his anxiety neurosis." Id. Because the claims

appeared "so closely tied" together, the Court concluded that the Board decision did not constitute

a final decision and dismissed the appeal for lack of jurisdiction. Id.

The Harris court determined that a holding by the Court that claims are inextricably

intertwined – i.e., where a referred claim could have a significant impact on a denied claim that is

being appealed – mandates dismissal of the appeal. The Court today overrules Harris to the extent

it stands for the proposition that this Court has no jurisdiction over a Board decision that denied a

claim if that claim is "inextricably intertwined" with another claim that the Board remanded. The

Court has jurisdiction over such matters on direct appeal, but may decline to exercise its jurisdiction

in such cases, as we frequently do. See, e.g., Hunt v. Nicholson, 20 Vet.App. 519, 525-26 (2006)

(declining to review denial of entitlement to vocational rehabilitation benefits and remanding for

readjudication because issue was dependent on – "inextricably intertwined" with – whether, on

remand, the Board reopens and grants a claim for service connection) (citing Harris, supra); Anglin

v. West, 11 Vet.App. 361, 367 (1998) (remanding claim for a bladder disorder, for which there was

medical evidence that it was connected to a back problem, because it was "inextricably intertwined"

with a claim for a back condition that the Court was remanding) (citing Harris, supra); Holland v.

Brown, 6 Vet.App. 443, 447 (1994) (holding that a Board decision denying an increased rating for

service-connected rheumatoid arthritis is final even though Board referred to RO "a TDIU rating

claim" based on rheumatoid arthritis because referred claim "may not necessarily affect the claim

on appeal"). Overruling Harris, we now hold that where a Board decision purports to be a final

decision, the Board issues a notice of appellate rights, and the appellant timely appeals to the Court,

this Court has jurisdiction to review the Board decision for error. However, on review, the Court

retains its discretion to determine at the threshold that a claim or theory denied by the Board in any

such decision or portion of a decision on review is so inextricably intertwined with matters still
 Contrary to the view expressed by Judge Hagel in his separate opinion, we observe that this Court's decision 4

in Harris v. Derwinski, 1 Vet.App. 180 (1991), is implicated, and its discussion necessary, regardless of whether this

case involves one claim or two claims. Even if this Court were to hold that there are two claims involved here, Harris

dictates that we determine, as part of this appeal, whether the "claim" for service connection for a lung condition on a

direct basis that was denied in 1998 is "inextricably intertwined" with the "claim" for presumptive service connection

for a chronic disability resulting from an undiagnosed illness based on service in the Persian Gulf. If so, Harris would

not have permitted this Court to have jurisdiction over an appeal filed within 120 days of the 1998 denial but would

permit jurisdiction now to review the 1998 denial as part of the current appeal of the denial of service connection under

the presumptive provisions for Persian Gulf War veterans. Because a determination as to whether claims are inextricably

intertwined does not properly determine this Court's jurisdiction, we overrule that aspect of Harris. 

16

pending before VA that it should be remanded to VA to await development or disposition of a claim

or theory not yet finally decided by VA. 

4

 We make clear today, that this Court's jurisdiction to review a Board decision denying a

claim is not controlled by whether the claim denied by the Board is "inextricably intertwined" with

another claim that was either remanded or referred by the Board to the RO because the facts

underlying the two claims are so closely tied together. Rather, this Court's jurisdiction is controlled

by whether the Board issued a "final decision" – i.e., denied relief by either denying a claim or a

specific theory in support of a claim and provided the claimant with notice of appellate rights.

38 U.S.C. § 7266(a); see Percy v. Shinseki, 23 Vet.App. 37, 45-46 (2009) (noting imprecise use of

term "jurisdictional" in caselaw and VA regulations); see also Bowles v. Russell, 127 S. Ct. 2360,

2365-66 (2007) (defining as jurisdictional, limits in statute as to when and under what conditions

a court may hear a case). We hold that only after the Court determines that it has jurisdiction does

it then engage in consideration of questions concerning whether the appeal involves multiple claims

or issues that are inextricably intertwined. If we find that the matter on appeal is inextricably

intertwined with an issue or claim still pending before VA, the Court generally will decline, for

reasons of judicial economy or on prudential grounds, to review the merits of the claim or issue

adjudicated in the Board decision then before the Court, and remand it for further adjudication, as

appropriate, with the other "inextricably intertwined" matters still being adjudicated below.

Following today's decision, a claimant will no longer be presented with the dilemma of

whether he should appeal or risk having his right to appeal vitiated for failure to timely appeal. See,

e.g., Gurley v. Nicholson 20 Vet.App. 573, 575 n.1 (2007). It is not the Court's province to dictate

how VA implements its statutory authority to dispose of appeals in a timely and efficient manner

so long as it permissibly does so within controlling statutes. See Ramsey v. Nicholson, 20 Vet.App.
17

16, 27 (2006) ("The general authority of the Secretary to interpret and apply the relevant law and

of the Board to dispose of appeals in a timely manner authorizes the Secretary to manage the Board

in its dispositions of cases and to consider the relevant law in its control of the dispositions of the

appeals pending on the Board's docket and to do so with economy of time and effort."). 

While it does not fall to this Court to design or redesign the VA adjudication process, it is

our province to consider a timely appeal from a claimant who has been denied relief based on one

theory, has received notice of his appellate rights, and who argues that the Board erred in issuing

the denial. See, e.g., Colo. River Water Conservation Dist. v. United States, 424 U.S. 800, 821

(1976) (Stewart, J., joined by Blackmun and Stevens, JJ., dissenting) ("[F]ederal courts have a

'virtually unflagging obligation . . . to exercise the jurisdiction given them.'"). In such a case, the

Court can then determine whether the benefits denied or limited are inextricably intertwined with

a remanded issue or claim, or whether the Board erred in issuing the denial or limitation of benefits

that was appealed. Parties are well-served by a process that allows the Court to review assertedly

final decisions to determine (1) whether one issue on which the Board denied benefits is inextricably

intertwined with other issues that the Board remanded, and (2) whether such a Board decision should

be reversed, modified, or the matter remanded, based on Board error, including misapplication of

the law, failure to develop a complete record, or other defects that would otherwise not be addressed

for years thereafter. By a veteran's timely exercise of appellate rights, errors by the Board may be

corrected as early in the process as possible, rather than many years later, when remand proceedings

on a separate matter are completed. Claimants not satisfied with a clear, final decision of the Board,

accompanied by notice of their appellate rights, should appeal any such decision in a timely manner

(or request Board reconsideration) to preserve those appellate rights. A claimant should understand

that "Board denial" on the issues coupled with a notice of appellate rights means "file an appeal or

the denial becomes final," because it is in the control of the claimant, not the Court or the Secretary,

whether to appeal once the Board issues its decision. If an appeal is filed, the Court will determine

issues of finality and whether the issues or claims are inextricably intertwined on a case-by-case

basis. Failure of a claimant to appeal (or seek reconsideration) presents the risk, as we see in the

case before us, that the matters finally decided by the Board will not be appealable after the time to

appeal passes.
 The law in effect in 1998 provided that claims must be "well grounded" in order to invoke VA's duty to assist 5

in their development. See 38 U.S.C.§ 5107. The Veteran's Claims Assistance Act of 2000, Pub. L. No. 106-475,

114 Stat. 2096 (Nov. 9, 2000), amended section 5107 to eliminate the requirement of well-groundedness. See Luyster v.

Gober, 14 Vet.App. 186 (2000) (per curiam order). 

18

B. The Finality of the September 1998 Board Decision

In the September 1998 decision, the Board considered the issues of appellant's entitlement

to benefits for a lung disability based either directly or through the presumption of serviceconnection under section 1117. The Board took two actions with respect to his appeal for benefits.

First, the Board denied benefits based on entitlement to service connection on a direct basis. R. at

272 ("The claim for entitlement to service connection for a lung disorder on a direct basis is

denied."). The Board determined that there was "no competent medical evidence linking the

veteran's current lung disorder on a direct basis to service" (R. at 267), and thus found that issue not

"well-grounded" (R. at 267, 271). Second, the Board remanded, for further development, 5

entitlement to service connection under 38 U.S.C. § 1117 for a chronic disorder manifested by

shortness of breath, due to an undiagnosed illness, secondary to Persian Gulf War service. R. at 272.

The Board stated that it was "unclear whether there [was] medical evidence to support the veteran's

claimed respiratory symptoms or whether any of the symptoms are affiliated with a diagnosed

illness" and directed the RO to schedule a VA Persian Gulf examination. R. at 273-74.

At the time of the 1998 decision, the Board considered its denial final and so notified the

appellant. At the time the Board issued its September 1998 decision, the Board notified the

appellant as follows:

NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.[] § 7266 . . . , a decision of

the Board of Veterans' Appeals granting less than the complete benefit, or benefits,

sought on appeal is appealable to [the Court] within 120 days from the date of

mailing of notice of the decision, provided that a Notice of Disagreement concerning

an issue which was before the Board was filed with the agency of original

jurisdiction on or after November 18, 1988. . . . The date that appears on the face of

this decision constitutes the date of mailing and the copy of this decision that you

have received is your notice of the action taken on your appeal by the Board of

Veterans' Appeals. Appellate rights do not attach to those issues addressed in the

remand portion of the Board's decision, because a remand is in the nature of a

preliminary order and does not constitute a decision of the Board on the merits of

your appeal. 38 C.F.R. § 20.1100(b) (1997).
19

R. at 275-76. As quoted above, the Board specifically noted that the appellate rights did not attach

to the matter that was remanded, which constituted only a "preliminary" decision of the Board, and

that a remand "does not constitute a decision of the Board on the merits of your appeal." R. at 276.

The Board's notice, therefore, informed the appellant that the appellate rights pertained to the

Board's denial of service connection for a lung disability on a direct basis, as the matter that was not

remanded. R. at 276. This is consistent with the Court's caselaw that the Board's remand of a

veteran's claim is not an adverse final decision over which the Court had jurisdiction. See Acosta

v. Principi, 18 Vet.App. 53, 59 (2004); Breeden, 17 Vet.App. at 475. The appellant was thus on

notice that VA considered the September 1998 decision of the Board to be a final decision on direct

service connection for a lung disability. The Court notes that the appellant does not raise any

argument that challenges either the sufficiency of the notice of appellate rights accompanying the

Board decision or his receipt of that decision or his receipt of the notice of appellate rights.

See App. Br. at 1-16; Reply Br. at 1-7. 

The appellant did not file an NOA of the Board's September 1998 decision within 120 days

of the date that VA mailed notice of the September 1998 decision to him nor did he seek

reconsideration from the Board. See Reed v. Peake, 23 Vet.App. 64 (2008) ("The only exception

to this 120-day rule is in those cases in which the claimant has (1) filed a motion for Board

reconsideration within 120 days after the mailing date of the Board's decision; and then (2) filed an

NOA within 120 days after the Board Chairman has denied the reconsideration motion); Rosler v.

Derwinski, 1 Vet.App. 241, 249 (1991). Just as an appellant has an obligation to cooperate in the

development of evidence pertaining to his claim because failure to do so could subject him to the

risk of an adverse adjudication based on an incomplete and underdeveloped record, see Kowalski

v. Nicholson, 19 Vet.App. 171, 178 (2005), failure to appeal a purportedly final Board decision may

adversely affect an appellant if the Court agrees that the decision is final and therefore we have no

jurisdiction over the claim. Thus, as stated above, veterans who receive a purportedly final decision

denying benefits from the Board should timely appeal that denial, regardless of whether other claims

or issues remain pending, or they run the risk of finding years later that in failing to appeal they have

thereby forfeited their appellate rights concerning the earlier decision. Here, rather than protecting

his appellate rights at the time of the 1998 Board decision, the appellant waited and only filed an
 In viewing the September 1998 Board denial as a nonfinal decision, our colleagues, Judges Lance and 6

Schoelen, read our panel decision in Roebuck as creating a new exception to the rule of finality that is inconsistent with

established precedent. See Cook, 318 F.3d at 1337 (discussing two statutory exceptions to the rule of finality: (1) a

finding of clear and unmistakable error under 38 U.S.C. 5109A or 7111, and (2) the receipt of new and material evidence

to reopen a claim under section 5108); see also Knowles v. Shinseki, 571 F.3d 1167 (2009) (noting that "the law does

not recognize a freestanding 'finality claim' filed after the period for direct review has expired"). Contrary to this view,

we observe that if Mr. Tyrues believed that the Board had erred in 1998 in denying him relief under a direct theory of

service connection, his avenue to remedy that error was to file a direct appeal of the 1998 Board decision and argue for

a remand to correct any errors, including any error in adjudicating the matter or in not remanding the matter for further

development. Moreover, the dissent ignores our caselaw in which this Court reviews a Board decision and determines

whether a matter decided by the Board is inextricably intertwined with a matter remanded to the Agency. See, e.g.,

Bagwell v. Brown, 9 Vet.App. 337, 339-40 (1996). In addition, our colleagues' current view is difficult to reconcile with

their recent opinion in Brokowski v. Shinseki, 23 Vet.App. 79, 86-90 (2009) (exercising jurisdiction and affirming Board

decision as to effective date issue even though Board had remanded the issue of an appropriate disability rating).

Significantly, the dissent's current view disregards the Court's role in providing prompt judicial review of Board decisions

that deny relief to veterans and would have this Court's role reduced to a small, flickering light of hope at the end of the

seemingly endless processing tunnel that often characterizes VA adjudications. 

20

NOA after the April 2004 Board decision. He now argues that the September 1998 decision was

not final (App. Br. at 5), but that argument is not persuasive. 

Based on the totality of the circumstances of this case, the Court holds that the

September 1998 Board decision was final concerning the issue of section 1110 compensation for

direct service connection for a lung disability. See Bingham, 421 F.3d at 1349 ("We cannot create

a third exception to the rule of finality."); Cook v. Principi, 318 F.3d 1334, 1337 (Fed. Cir. 2002)

(en banc) (recognizing only two statutorily recognized exceptions to the rule of finality, neither of

which are applicable here). Because the appellant did not file an NOA within 120 days after VA

mailed notice of the Board's final September 1998 decision, the Court lacks jurisdiction to review

the September 1998 Board decision. See 38 U.S.C. § 7266(a). The Court is thus limited to a review

6

of the merits of the April 2004 Board decision denying service connection on a presumptive basis

for symptoms of a chronic disability resulting from an undiagnosed illness from military service in

the Persian Gulf.

C. Merits of the August 2004 Board Decisions

With regard to the April 2004 Board decision, the appellant argues only that the Board erred

because it had a duty, under 38 C.F.R. § 19.9, to seek clarification of Dr. Plump's December 2001

medical opinion "before[,] or in addition to," ordering an additional VA medical examination. App.

Br. at 10. He contends that, in ordering an additional VA medical examination in lieu of seeking

clarification of Dr. Plump's opinion, VA violated its duty to assist. App. Br. at 10-12. At oral
21

argument, counsel for the appellant asserted that VA's request for an additional medical examination

"impermissibly narrowed" VA's consideration of Dr. Plump's December 2001 opinion and that the

appellant was prejudiced by VA's failure to seek clarification of Dr. Plump's opinion because his

opinion was favorable evidence that, if clarified, could have substantiated the appellant's claim for

service connection on a presumptive basis for symptoms of an undiagnosed illness.

The Board's CDU noted that in providing the December 2001 VA medical opinion,

Dr. Plump "found that the veteran suffered from a known diagnosis of mild chronic bronchitis, but

offered an opinion that the veteran's 'shortness of breath due to undiagnosed illness [was] at least

as likely as not due to his Gulf War service.'" R. at 365. The CDU concluded that because "these

findings appear to be inconsistent, another examination must be scheduled." Id. The CDU then

ordered that VA schedule the appellant for a VA Persian Gulf examination and indicated that the

appellant "must be scheduled with an examiner other than the examiner of 12/13/01, Dr. Plump."

Id. 

At the time of the CDU's July 2002 request, § 19.9 provided, in relevant part:

(a) General. If further evidence, clarification of the evidence, correction of a

procedural defect, or any other action is essential for a proper appellate decision, a

Board Member or panel of Members may:

(1) Remand the case to the agency of original jurisdiction, specifying the action

to be undertaken; or

(2) Direct Board personnel to undertake the action essential for a proper appellate

decision.

38 C.F.R. § 19.9 (2002). The plain language of § 19.9 does not limit the Board to seeking

clarification of the evidence, nor has the Court adopted the "mandatory clarification" interpretation

of § 19.9 that the appellant advances in his brief. Rather, the regulation contemplates situations in

which the Board may choose to obtain "further evidence" instead of requiring clarification of the

existing evidence; and, it is well established that the Board has the discretion to determine whether

further development is needed to make a decision on a claim. 38 C.F.R. § 19.9(a) (2002); see

Shoffner v. Principi, 16 Vet.App. 208, 213 (2002); Winsett v. West, 11 Vet.App. 420, 426 (1998)

("[W]hether the Board chooses to refer a particular case for an independent medical opinion is

entirely within its discretion."); see also 38 U.S.C. § 7109(a) (the Board may seek an advisory

medical opinion when such an opinion "is warranted by the medical complexity or controversy
22

involved"); 38 C.F.R. § 3.304(c) (2009) ("The development of evidence in connection with claims

for service connection will be accomplished when deemed necessary.").

However, it is equally well established that VA must develop claims and gather evidence in

a neutral manner. See Austin v. Brown, 6 Vet.App. 547, 553 (1994) ("[B]asic fair play requires that

evidence be procured by the agency in an impartial, unbiased, and neutral manner."). In seeking a

medical opinion, VA "may not suggest an answer or limit the field of inquiry by the expert."

Bielby v. Brown, 7 Vet.App. 260, 268 (1994); see Colayong v. West, 12 Vet.App. 524, 534 (1999)

(holding that the RO's request to a VA medical examiner to "feel free to refute the private

physician's report" was fatally flawed and compromised the fairness of the adjudication process).

Moreover, "VA may not pursue . . . development if the purpose is to obtain evidence against the

claim." Hart v. Mansfield, 21 Vet.App. 505, 508 (2007);see Mariano v. Principi, 17 Vet.App. 305,

312 (2003) ("Because it would not be permissible for VA to undertake such additional development

if a purpose was to obtain evidence against an appellant's case, VA must provide an adequate

statement of reasons or bases for its decision to pursue further development where such development

reasonably could be construed as obtaining additional evidence for that purpose."); Rose v. West,

11 Vet.App. 169, 172 (1998) (noting that "it is not the function of judicial review simply to accord

the government a remand to obtain . . . evidence" that rebuts the appellant's showing of a nexus

between his in-service injury and a current diagnosed disability).

In its April 2004 decision, the Board found that VA "ha[d] made reasonable and appropriate

efforts to assist the appellant in obtaining the evidence necessary to substantiate the claim currently

under consideration, to include several VA examinations." R. at 4. With regard to Dr. Plump's

December 2001 medical opinion, the Board noted "that despite the finding of an undiagnosed illness

relating to respiratory symptomatology, it is noteworthy that the examiner did indeed offer a specific

diagnosis of mild chronic bronchitis." R. at 11. The Board found that "[a] diagnosis of both an

undiagnosed illness and a diagnosed condition pertaining to the same symptoms is inconsistent."

R. at 11-12.

Dr. Plump rendered the following opinion in December 2001:

DIAGNOSIS: 1) Mild chronic bronchitis. 2) Diffusion capacity and spirometry

within normal limits. 3) Refractory pneumonia March 1994.
 Although the Board's view is that Dr. Plump's opinion is inconsistent with his diagnosis, the Court notes that 7

it is also possible that Dr. Plump intended to diagnose the appellant as having both mild chronic bronchitis and an

undiagnosed illness manifested by shortness of breath. Pursuant to 38 U.S.C. § 1117, governing compensation for

disabilities occurring in Persian Gulf War Veterans, compensation is available for either an undiagnosed illness or a

"medically unexplained chronic multisymptom illness," manifested by "signs or symptoms involving the upper or lower

respiratory system." 38 U.S.C. § 1117(a)(2)(B), (g)(8). Dr. Plump's opinion therefore need not be read as inconsistent.

Read as diagnosing the appellant as having both chronic bronchitis and an undiagnosed or "medically unexplained"

illness, Dr. Plump's opinion would be favorable evidence in support of the appellant's claim for service connection for

an undiagnosed illness.

23

OPINION: It is this provider's medical opinion that the patient's shortness of breath

due to an undiagnosed illness is at least as likely as not due to the Gulf War service.

This provider is unable to render an opinion as to the etiological basis of the disorder

and its date of onset.

R. at 350. 

Accepting the Board's view that Dr. Plump's diagnosis and opinion are inconsistent, it is

7

wholly unclear why the Board directed that VA provide a new medical examination, rather than

simply seek clarification of Dr. Plump's opinion. It is equally unclear why the Board directed that

the new examination be provided by an examiner "other than" Dr. Plump. R. at 365. 

The Board's failure to adequately explain the reasons for its order leaves the Court to

speculate as to its reasoning; such speculation reasonably includes the possibility that the purpose

was to avoid a possible favorable opinion from Dr. Plump. This is not permitted. See Austin, supra;

see also Hart, Mariano, and Rose, all supra. Under these circumstances, the Board's statement of

reasons or bases is inadequate. See Mariano, 17 Vet.App. at 312 ("VA must provide an adequate

statement of reasons or bases for its decision to pursue further development where such development

reasonably could be construed as obtaining additional evidence for that purpose."); Caluza,

7 Vet.App. at 506 (the Board's statement of the reasons or bases for its decision must "account for

the evidence which it finds to be persuasive or unpersuasive, analyze the credibility and probative

value" of the evidence, and "provide the reasons for its rejection of" any material evidence favorable

to the appellant). The Board's rejection of Dr. Plump's December 2001 VA medical opinion, without

seeking clarification or adequately explaining why such clarification was unnecessary, frustrates

appellate review. See Allday v. Brown, 7 Vet.App. 517, 527 (1995) (the Board's statement of the

reasons or bases for its decision "must be adequate to enable a claimant to understand the precise
24

basis for the Board's decision, as well as to facilitate review in this Court"). Accordingly, remand

is necessary. 

On remand, and given the Board's view that Dr. Plump's diagnosis and opinion are

inconsistent, the Board either must seek clarification of Dr. Plump's December 2001 medical opinion

indicating that the appellant had an undiagnosed illness manifested by shortness of breath resulting

from Persian Gulf service; or, the Board must provide a well-reasoned statement, adequate to

facilitate the Court's review, explaining its decision not to seek such clarification. The Board must

further ensure that VA has complied with the notice requirements of 38 U.S.C. § 5103(a).

See Mayfield v. Nicholson, 444 F.3d 1328, 1333 (Fed. Cir. 2006) (holding that section 5103(a)

notification is not satisfied by an aggregation of pre- and postdecisional notices from which a

claimant might have been able to infer what evidence VA found lacking). On remand, the appellant

is free to submit additional evidence and to raise his arguments to the Board, and the Board is

required to consider them. See Kay v. Principi, 16 Vet.App. 529, 534 (2002).

III. CONCLUSION

Based on the foregoing analysis and a review of the record on appeal, the Board's April 7,

2004, decision is VACATED and the appellant's claim for presumptive service connection for an

undiagnosed chronic condition alleged to be the result of service in the Persian Gulf under 38 U.S.C.

§ 1117 is REMANDED for further proceedings consistent with this decision. The appellant's appeal

as to matters finally decided in the September 1998 Board decision is DISMISSED for lack of

jurisdiction.

KASOLD, Judge, concurring: I fully concur in the well-reasoned opinion of the Court and

I write separately only to highlight the following three points:

1. The Court's Opinion Is Consistent With Our Precedent and Jurisdictional Statute.

Any suggestion that the opinion today is in some way a shift from our prior caselaw

regarding finality of Board decisions – based on one theory of service connection while another

theory is remanded for further adjudication – is without merit. Specifically, the Court historically

has considered that a Board decision denying benefits for a disability based on one particular theory,
25

while another theory is still being developed below, to be final for purposes of appeal and the Court's

jurisdiction over an appeal. See, e.g., Rice v. Shinseki, 22 Vet.App. 447 (2009) (exercising

jurisdiction over an appeal of a Board decision that denied an earlier effective date for TDIU even

though Board remanded the matter of an initial rating for PTSD; Court exercised its discretion to

decline review of the merits and vacated the Board's decision as to TDIU because the matter was

not fully developed, and remanded the matter for readjudication subsequent to adjudication of the

initial rating for PTSD); D'Aries v. Peake, 22 Vet.App. 97 (2008) (exercising jurisdiction over

appeal of Board decision that denied service connection for cause of veteran's death even while

claim for DIC was denied in a separate Board decision and remanded in a separate Court decision);

Andrews v. West, 16 Vet.App. 384 (1999) (table) (exercising jurisdiction over appeal of Board

decision denying benefits based on direct service connection while benefits based on secondary

service connection were still being adjudicated). 

The Court also has bifurcated a claim, affirming parts of a Board decision related to a claim

for benefits while remanding for further adjudication other matters stemming from the same

decision. See, e.g., Barringer v. Peake, 22 Vet.App. 242 (2008) (affirming Board decision with

regard to schedular ratings and effective date and remanding for adjudication of extraschedular

consideration); Palczewski v. Nicholson, 21 Vet.App. 174 (2007) (affirming denial of service

connection for hearing loss while remanding for readjudication with regard to tinnitus); Harder v.

Brown, 5 Vet.App. 183 (1993) (affirming Board decision denying the reopening of a claim based

on right-knee disability based on direct service connection, and reversing denial based on secondary

service connection and remanding for further adjudication). 

There are only two exceptions to our having jurisdiction over Board decisions that are final

with regard to a matter, and for which notice how and when to appeal has been provided: Harris v.

Derwinski, 1 Vet.App. 180 (1991), and Roebuck v. Nicholson, 20 Vet.App. 307 (2006). In Harris,

the Court held that when the matters remanded are inextricably intertwined with another matter for

which the Board denied benefits and stated its decision was final, the Court lacked jurisdiction to

hear an appeal over the matter declared final by the Board. 1 Vet.App. at 183. Today, we correctly

overturn that part of Harris and hold that we do indeed have jurisdiction over a Board decision that

denies benefits when the Board states its decision is final and that decision is timely appealed.

However, the Court may, for reasons of judicial economy, nevertheless remand such a decision for
26

adjudication with the matter still under administrative adjudication if the matters are inextricably

intertwined. Id.; see also Gurley v. Nicholson, 20 Vet.App. 573, 576 n.3 (2007) (recognizing the

dilemma a claimant faces with the question whether to timely appeal a Board decision, or risk

having his right to appeal vitiated for failure to timely appeal).

The other exception is implicitly raised by Roebuck, which, as noted ante at 16, involved a

unique set of circumstances such that the Court concluded that the Board decision denying a matter

was not final despite the Board's decision stating it was final and the fact the claimant had been

provided notice how and when to appeal. Although I concur that Roebuck can be distinguished from

our precedential cases where the Court had jurisdiction over final Board decisions for which notice

of appellate rights has been provided, it must be recognized that Roebuck is indeed an exception

thereto. Any characterization that today's opinion establishes a new concept of finality elevates the

recent single panel decision in Roebuck, rendered on exceptional circumstances, above the consistent

understanding of this Court's jurisdiction in the nonexceptional circumstances where the Board

renders a final decision on one theory supporting a claim for benefits and remands for further

adjudication that part of the claim that is based on another theory that could support an award of

benefits.

2. Assertions that Evidence on Direct Service Connection Was Not Fully Developed at the

Time of the 1998 Board Decision Are Speculative.

One of the concurring opinions suggests that the September 1998 Board decision that denied

Mr. Tyrues's direct service-connection claim for lung disability could have been based on evidence

that was not properly and fully developed; however, readers should note that this allegation is

unsupported by reference to any facts; it is pure speculation. Moreover, the very suggestion of

inadequate development reinforces the fact that Mr. Tyrues should have appealed the 1998 decision

in a timely manner if he was not satisfied with it, so that effective appellate review could be

conducted. Review of a decision rendered over 10 years ago certainly ignores the mandate from

Congress that an appeal of a final Board decision be taken within 120 days of that decision.

38 U.S.C. § 7266.

3. Our Jurisdiction Is Predicated on Final Board Decisions Adversely Affecting a Claimant.

Although the Court has tried to define a "claim" for all purposes, see Rice, 22 Vet.App. at

451, any such effort is fruitless. Our jurisdiction is over final Board decisions affecting benefits.
27

38 U.S.C. §§ 7252, 7266; see, e.g., Maggitt v. West, 202 F.3d 1370, 1376 (Fed. Cir. 2000). Nothing

in statute or caselaw limits our jurisdiction to final decisions on claims, or otherwise defines the

context of our jurisdiction over final Board decisions on all aspects of a claim. Can it reasonably

be argued that the denial of benefits for a disability based on one theory is not a final Board decision

affecting benefits? A veteran might very well be entitled to benefits based on the theory denied by

the Board, and to require him to wait 10 or more years to appeal that decision is wholly contrary to

our statutory jurisdiction, which is the "exclusive jurisdiction to review decisions of the Board of

Veterans' Appeals" when a final decision is appealed by "a person adversely affected by such

decision" within 120 days of the mailing of the decision. 38 U.S.C. §§ 7252 and 7266.

Moreover, as we recently held in Clemons v. Shinseki, claimants seek benefits for disabilities

as they perceive them based upon particular symptoms, not based upon a particular medical term

causing the perceived disability. 23 Vet.App. 1, 4 (2009). The requirement to liberally construe a

claim, and the recognition that claimants generally are not competent to provide opinions as to

diagnoses that require medical training, compel the Secretary to view and develop a claim for

benefits based on the reported symptoms and not just a particular, unconfirmed "diagnosis," On the

other hand, the requirement to liberally construe a claim for benefits in no way constrains the

Secretary from processing the claim based on different theories or diagnoses. Indeed, the Federal

Circuit has held that a claim for benefits finally denied as to one medical cause, is to be treated

separately from a subsequent claim for benefits based on a different medical cause, even when the

disability as perceived by the veteran is the same, such as a hearing loss that is sensorineural as

opposed to conductive. Boggs v. Peake, 520 F.3d 1330, 1337 (Fed. Cir. 2008). 

Thus, a "claim" seeking benefits – i.e., a claim for benefits for whatever a veteran suffers

from – is different from a "claim" denied – i.e., the denial of benefits based on one specific medical

diagnosis differs from a later submitted "claim" for benefits based on a different medical diagnosis.

Otherwise stated, what constitutes a "claim" differs depending on what stage in the administrative

process one is attempting to define a claim – at the stage when a "claim" is filed, or at the final stage

when a "claim" is denied. With regard to our jurisdiction, however, it should not be overlooked that

it is premised on a final Board decision affecting benefits, and not on what constitutes a claim at any

given time in the adjudication process below.
28

As succinctly stated in the Court's opinion, when the Board renders a final decision on a

matter affecting benefits, and a claimant is provided a copy of that decision and notice how and

when to appeal it, the failure to timely file an NOA precludes this Court from having jurisdiction

over that decision. This is what the law states, and it is the basic holding of the Court's decision

today.

HAGEL, Judge, concurring in the result, dissenting in part: I concur in the majority's

ultimate conclusion that we do not have jurisdiction to review the September 1998 Board decision.

However, I write separately because I believe that our lack of jurisdiction stems from entitlement

to service connection for a chronic lung disorder being a separate and distinct claim for VA

compensation from entitlement to service connection for Persian Gulf Syndrome under 38 U.S.C.

§ 1117. The majority chooses not to decide this issue and in doing so further confuses this Court's

caselaw with the interchangeable use of the terms "issue," "matter," and "claim" without a clear

definition of those terms.

Although the majority states that it is unnecessary to decide whether Mr. Tyrues has

presented one claim or two, its analysis stems from the proposition that Mr. Tyrues has presented

a single claim for benefits based on a lung condition. The majority regards Mr. Tyrues's joint pain,

stomach pain, and memory loss symptoms as only ancillary to the lung condition. Such analysis is

facilitated by the mostly interchangeable use of the terms "issue," "matter," and "claim" without

specifically stating to what each terms refers. This lack of precision will, in my view, result in fuzzy

decisions in the future, especially when used in an opinion by the full Court.

The majority's decision includes language such as, "a Board decision denying VA disability

compensation on one issue, while another issue is still under adjudication." and "the Board denies

benefits based on a particularissue with distinct criteria and remands for further adjudication another

issue of establishing entitlement to benefits" without explaining what an "issue" is–namely whether

it is a claim for benefits or theory of entitlement to benefits. Ante at 13 (emphasis added). The

majority later refers to a potential situation where "the Board decides one matter and remands

another matter," again without explaining the meaning of "matter." Id. at 14 (emphasis added). By

using the terms interchangeably, the majority is able to avoid using the more appropriate terms

"claim" and "theory," and, thus, is able to avoid deciding the central issue raised by Mr. Tyrues on
29

appeal and briefed by the parties–that is, whether the facts in this case define one claim or two and,

if two, the effect of this Court's decision in Roebuck.

"Claim" has been defined by VA in 38 C.F.R. § 3.1(p) (2009), as "a formal or informal

communication in writing requesting a determination of entitlement or evidencing a belief in

entitlement, to a benefit." Further, in Roebuck v. Nicholson, the Court adopted the definition of

"claim" applied by the Federal Circuit in Schroeder v. West, and determined that a claim is an

application for entitlement to a VA benefit based on a current disability. Roebuck v. Nicholson,

20 Vet.App. 307, 312-13 (2006); see Schroeder v. West, 212 F.3d 1265, 1269 (Fed. Cir. 2000). The

Roebuck Court also recognized, in line with the Court's holding in Bingham v. Principi, that

although there may be multiple theories or means of establishing entitlement to a benefit for a

disability, if the theories all pertain to the same benefit for the same disability, they constitute the

same claim. Id. at 313; see Bingham v. Principi, 18 Vet.App. 470, 474 (2004) aff'd sub nom.

Bingham v. Nicholson, 421 F.3d 1346 (Fed. Cir. 2005). The Court should therefore apply this

definition of "claim" to the facts in the instant appeal. Applying that definition to the facts in this

case, Mr. Tyrues has two separate claims for VA benefits. To fully explain my reasoning, it is

necessary to provide a more extensive recitation of the relevant facts than is provided by the

majority.

In March 1995, shortly after being hospitalized for pneumonia, Mr. Tyrues amended a prior

claim for VA benefits to include entitlement to benefits for a lung disability. In support of his claim

he submitted medical records that refer to both pneumonia and bronchitis. His claim for benefits

for a lung disorder was initially denied. Mr. Tyrues appealed that denial to the Board. 

In December 1996, Mr. Tyrues appeared at a hearing before a Board member. At this

hearing, he discussed his lung condition, including coughing and congestion, which he stated was

incurred in service based on his exposure to dust, fumes, and kerosene. Mr. Tyrues stated that, since

returning from the Persian Gulf, he has been diagnosed with pneumonia three or more times as well

as a lung infection or a growth on his lung. After the Board member stated that he had no further

questions, Mr. Tyrues's representative asked Mr. Tyrues whether he had anything to add before

concluding the hearing. In response, Mr. Tyrues stated that he had been reading about symptoms

that were being experienced by other soldiers who had served in the Persian Gulf and that he had
30

noticed that he too was developing these symptoms, including soreness and aching in his joints. In

response to Mr. Tyrues's description, the Board member stated:

That's not really relevant now. I would advise you, there is what we call a Persian

Gulf syndrome, things, now I, I would, if I were you get a hold of Mr. Weatherly here

and you guys could work up a claim because that's an area right now which the law

is changing rather rapidly and there is a distinct possibility you can get service

connected for some of these things because, like I said, it, it is in the process right

now of developing and I would certainly file a claim for it.

R. at 147 (emphasis added.) The Board member further stated that Mr. Tyrues did not currently

have such a claim, but that he should file a claim based on the symptoms that he was describing.

The Board member again stated: "[T]he whole process starts with you filing a claim and identifying

what you feel are the symptoms related to this and [what] the Persian Gulf syndrome symptoms are,

there's a wide variety of them . . . ." Id. Six days later, in apparent response to the suggestion from

the Board member, Mr. Tyrues submitted a statement in support of claim, stating that he wanted to

amend his claim "to include aching joints, memory loss, and stomach condition caused from [his]

Persian Gulf service." R. at 159.

In March 1997, the Board remanded his claim for benefits for a lung disorder back to the

regional office, which sent Mr. Tyrues a letter, on March 19, 1997, notifying him that he could

submit additional evidence with respect to that claim. In April 1997, VA sent Mr. Tyrues a notice

letter regarding his newly filed "claim for disability benefits based on Persian Gulf War service."

R. at 163 (emphasis added). The letter requested that Mr. Tyrues submit medical and non-medical

evidence to support his claim. In response, Mr. Tyrues submitted lay statements from his wife, a

coworker, and a fellow soldier who served with him in the Persian Gulf and who, at that time,

worked with him at home. The letter from his coworker referred to Mr. Tyrues experiencing flu and

cold symptoms upon returning from service. Mr. Tyrues's fellow soldier and current coworker also

stated that after returning from duty, Mr. Tyrues missed work "because of flu, colds, complaints of

aching joints, and soreness in his body." R. at 172. He further stated that Mr. Tyrues could not

work as a result of the pain in his body. Mr. Tyrues's wife stated that her husband experienced

constant joint pain, numbness, inability to move after sleeping, flu-like symptoms, and a propensity

to experience colds. 
31

An April 4, 1997, VA Compensation and Pension Examination worksheet mentions two

claims, one claim for benefits for a lung disorder being remanded from the Board and another claim

for benefits for aching joints, memory loss, and a stomach condition, but notes that both claims are

related to service in the Persian Gulf. In May 1997, Mr. Tyrues underwent a VA examination,

which appears to relate his lung condition to his service in the Persian Gulf. The examiner also

diagnosed him with "possible Gulf War Syndrome with shortness of breath, joint pain, [and]

memory loss." R. at 191. Following a request by VA for authorization to obtain records, VA

received records from Dr. Arnold, which stated that Mr. Tyrues experienced significant lower back

pain, manifested as "a dull aching pain with intermittent sharp component on movement." R. at 212.

Later records show Mr. Tyrues sought treatment for joint pain in his right shoulder, lumbar strain,

flu-like symptoms, morning stiffness in his joints, generalized joint pain, coughing, and a sore

throat. VA also received medical records from Dr. Mitchum, which also revealed that Mr. Tyrues

experienced chronic back pain, pneumonia, and bronchitis. 

On April 20, 1998, the regional office issued a Supplemental Statement of the Case, stating

that it was continuing to deny entitlement to VA benefits for a lung disorder. On the same day, the

regional office issued a decision that addressed four issues: A denial of entitlement to service

connection for a lung condition (noted as a remanded issue) and denial of the three other conditions,

including joint pain, memory loss, and a stomach condition (noted to be new issues and all attributed

to an "undiagnosed illness"). R. at 241. Mr. Tyrues, referencing the April 1998 Supplemental

Statement of the Case, which denied only entitlement to VA benefits for a lung condition, appealed

to the Board. Indeed, the brief submitted by his representative to the Board on appeal clearly stated

that the "question at issue" on appeal was "entitlement to service connection for a lung disorder."

R. at 261. In this brief, Mr. Tyrues's representative referred only to Mr. Tyrues's claim for benefits

for a lung disorder and that claim's previous procedural history.

In September 1998, the Board denied service connection for a lung disorder. The Board,

referring to the April 1998 rating decision, also remanded the "issue of entitlement to service

connection [] for a chronic disorder manifested by shortness of breath, due to an undiagnosed illness,

claimed as secondary to Persian Gulf War service." R. at 266. Although the Board discussed some

of the same evidence, it referred to two claims, a claim for entitlement to service connection for a

lung disorder on a direct basis and a claim for entitlement to service connection for a chronic
32

disorder, due to an undiagnosed illness. With regard to the chronic disorder, the Board ordered VA

to provide Mr. Tyrues with a new medical examination, which was provided in December 1998.

In February 2000, the Board denied Mr. Tyrues's claim for benefits for "shortness of breath

as a chronic disability resulting from an undiagnosed illness." R. at 313. The decision was

subsequently remanded by the Court pursuant to the parties' joint motion for a remand for VA to

provide Mr. Tyrues with a new medical examination. In December 2001, Mr. Tyrues underwent

another VA examination, at which the examiner stated that Mr. Tyrues's shortness of breath due to

an undiagnosed illness is at least as likely as not due to the Gulf War service." R. at 350. That

examiner also diagnosed Mr. Tyrues with "mild chronic bronchitis." Id. In July 2002, the Board's

Case Development Unit found that these two diagnoses appeared to be inconsistent and ordered

another examination, requesting the examiner diagnose Mr. Tyrues with a particular disorder or

indicate that his symptoms were the result of an undiagnosed illness. In October 2002, a VA

examiner found that Mr. Tyrues did not have any respiratory problems at that time and that any

previous problems are related to allergies and not related to his Gulf War service. In April 2004,

the Board denied his claim for benefits for a respiratory/ lung disorder as a chronic disability

resulting from an undiagnosed illness.

These facts reveal that Mr. Tyrues was advised by a member of the Board, to file a claim

for benefits for Persian Gulf Syndrome. Although the majority’s description of this person as a

"hearing officer" is not incorrect, such a description does not convey the authority with which this

statement was made. See 38 C.F.R. § 3.103(c)(2)(2009). Certainly a Board member understands the

difference between additional symptoms of a disability for which benefits have already been claimed

and a claim for benefits based upon a separate disability. The Board member specifically advised

Mr. Tyrues to submit a "claim" to the agency of original jurisdiction. R. at 147. The use of such

terminology by the Board serves to illustrate the problems associated with the majority's undefined

use of "issue," "claim," and "matter." Further, from the time that Mr. Tyrues amended his claim in

1996 to include entitlement to VA benefits for aching joints, memory loss, and stomach condition

caused by his Persian Gulf service until the Board issued its September 1998 decision remanding

that claim, VA had considered, developed, and adjudicated his claims for benefits for a lung

condition and for a chronic disability resulting from service in the Persian Gulf separately. Although

the majority states that it need not decide the issue of whether Mr. Tyrues presented one claim or
33

two, it must consider the claims as one in order to proceed to its discussion of Harris and Roebuck,

the two issues the majority appears bound to reach. In so doing, the majority treats Mr. Tyrues as

having filed a single claim for a lung disorder based on two theories of entitlement to service

connection, a direct basis under 38 U.S.C. § 1110 and a presumptive basis under 38 U.S.C. § 1117.

However, in doing so, the majority fails to explain why Mr. Tyrues's claim for VA benefits for a

chronic disorder, characterized by a collection of symptoms described as aching joints, memory loss,

a stomach condition, and shortness of breath caused by an undiagnosed illness is part of a claim for

benefits for a single lung disorder. 

As stated above, when Mr. Tyrues initially described his symptoms at the December 1996

Board hearing, the Board member informed him that he needed to file a new claim for benefits for

Persian Gulf syndrome, which he subsequently did. Upon receipt of his new claim, the regional

office developed this claim as separate and distinct from his claim for benefits for a lung condition.

The record contains a notice letter requesting that he submit evidence to support his newly filed

"claim for disability benefits based on Persian Gulf War service." R. at 163. Indeed, he submitted

lay statements from his wife, his coworker, and a fellow soldier and coworker, which indicated that

he experienced joint and overall body pain as a result of an undiagnosed illness. Medical reports

from Drs. Arnold and Mitchum confirm these symptoms. Although the September 1998 Board

decision referred only to shortness of breath, it still noted that Mr. Tyrues's claim was for service

connection for a chronic disorder due to an undiagnosed illness. 

"A claim is an application for entitlement to a VA benefit based on a current disability."

Roebuck, 20 Vet.App. at 312-13; see Schroeder, 212 F.3d at 1269. In Roebuck, the Court held that

"although there may be multiple theories or means of establishing entitlement to a benefit for a

disability, if the theories all pertain to the same benefit for the same disability, they constitute the

same claim." 20 Vet.App. at 313. In this case, Mr. Tyrues has sought benefits for two separate

disabilities: A diagnosed lung disorder, described as both pneumonia and bronchitis, and an

undiagnosed chronic condition manifested by joint pain, body ache, memory loss, and stomach

conditions alleged to be the result of his service in the Persian Gulf. Compare Boggs v. Peake, 520

F.3d 1330, 1336 (rejecting this Court's holding that two claims based on separate and distinct
See Clemons v. Shinseki, 23 Vet.App. 1 (2009) for this Court's application of Boggs v. Peake, 520 F.3d at 8

1336.

34

diagnosed injuries can be considered the same claim if they involve the same symptomatology),8

with Kelly v. Nicholson, 463 F.3d 1349, 1353 (Fed. Cir. 2006) (holding that multiple diagnoses for

a single disability "were not separate claims, [but were] merely two means of establishing the same

end–the service connection claim"). Here, Mr. Tyrues could establish entitlement to service

connection based on either of his disabilities. 

The law clearly commands the determination that Mr. Tyrues has two separate claims.

Section 1117 of title 38 of the U.S. Code provides entitlement to compensation on a presumptive

basis to a Persian Gulf War veteran who complains of having an undiagnosed illness or illnesses that

are 10% or more disabling during the presumption period established by the Secretary. 38 U.S.C.

§ 1117(a)(1)(A) and (B). Pursuant to section 1117(d)(2), the Secretary has promulgated 38 C.F.R.

§ 3.317, which provides, in pertinent part:

(a)(1) Except as provided in paragraph (c) of this section, VA will pay compensation

in accordance with chapter 11 of title 38, United States Code, to a Persian Gulf

veteran who exhibits objective indications of a qualifying chronic disability,

provided that such disability:

(I) Became manifest either during active military, naval or air service in the Southwest

Asia theater of operations during the Persian Gulf War, or to a degree of 10[%] or more

not later than December 31, 2006; and 

(ii) By history, physical examination, and laboratory tests cannot be attributed

to any known clinical diagnosis. 

. . . .

(b) For the purposes of paragraph (a)(1) of this section, signs or symptoms which

may be manifestations of undiagnosed illness or medically unexplained chronic multi

symptom illness include, but are not limited to: 

 

(1) Fatigue

(2) Signs or symptoms involving skin 

(3) Headache 

(4) Muscle pain 

(5) Joint pain 

(6) Neurologic signs or symptoms 

(7) Neuropsychological signs or symptoms 
35

(8) Signs or symptoms involving the respiratory system(upper or lower)

(9) Sleep disturbances 

(10) Gastrointestinal signs or symptoms 

(11) Cardiovascular signs or symptoms 

(12) Abnormal weight loss 

(13) Menstrual disorders. 

38 C.F.R. § 3.317 (2008) (emphases added); see also 38 U.S.C. § 1117(g). 

As noted by the Secretary in his brief, 38 U.S.C. § 1117 provides a unique presumption of

service connection for undiagnosed illnesses incurred in, or manifested during a presumptive period

following, service in the Persian Gulf. By their very nature, these claims involve undiagnosed

illnesses. In this case, however, Mr. Tyrues's lung condition has been diagnosed as both pneumonia

and bronchitis. He filed his original claim for a lung condition shortly after he was hospitalized for

pneumonia. At the December 1998 Board hearing, Mr. Tyrues discussed his lung condition in terms

of previous diagnoses of pneumonia and a lung infection. The medical records submitted with his

claim reflect these diagnoses. On the contrary, at the December 1998 Board hearing, Mr. Tyrues

described symptoms including aching joints, memory loss, and stomach problems. The May 1997

medical examination specifically noted these symptoms and diagnosed him with possible Persian

Gulf Syndrome with shortness of breath, joint pain, and memory loss, which could be compensable

under section 1117. 

Mr. Tyrues's private and VA medical records reveal that, at various times, he has sought

treatment for several of the symptoms noted in § 3.317, including muscle pain, joint pain, symptoms

involving the respiratory system, and gastrointestinal symptoms. These symptoms formed a basis

for entitlement to service connection under 38 U.S.C. § 1117 that is distinct from Mr. Tyrues's claim

for entitlement to benefits for a lung condition under 38 U.S.C. § 1110. In support of his argument

that he has submitted two theories of entitlement to service connection instead of two separate

claims, Mr. Tyrues cites Schroeder, 212 F.3d at 1270. However, in Schroeder, the veteran had a

single diagnosed disability, an eye condition, and sought service connection for that condition on

a direct basis and as a result of exposure to Agent Orange. Unlike Schroeder, which involved

separate theories for establishing a single claim, this case involves two separate factual bases for

establishing entitlement to service connection for two different disabilities. In this case, any claim

for service connection for a diagnosed lung disorder, whether bronchitis or pneumonia, falls outside
 Because I would find that Mr. Tyrues has two separate claims, I believe that the discussion in the majority's 9

opinion regarding whether theories of service connection may be treated separately, including its consideration of Harris,

Roebuck, and Joyce, all ante , is unnecessary and, even if it was properly included in the opinion, would be obiter

dictum. However, I note that the Federal Circuit's order remanding this case would have the Court consider Roebuck

and Joyce. 

36

entitlement to service connection under section 1117. Indeed, under the statute and implementing

regulation, such disability "by history, physical examination, and laboratory tests cannot be

attributed to any known clinical diagnosis." 38 C.F.R. § 3.317(a)(1)(ii). 

The facts in this case reveal that Mr. Tyrues filed two claims for VA benefits based on

separate disabilities. If there are two claims and not one, then this case is easily resolved. The claim

for VA benefits for a lung condition was resolved by the Board in its 1998 decision, from which

Mr. Tyrues sought no appeal. This claim has, therefore, been finally resolved. Consequently, I

agree with the majority that the Court does not have jurisdiction to review that claim now.

38 U.S.C. § 7266(a). However, I cannot agree with the majority's implied determination that in this

case Mr. Tyrues's conditions constitute a single claim for VA benefits. With respect to that matter, 9

I respectfully dissent.

LANCE, Judge, with whom SCHOELEN, Judge, joins, concurring in part and dissenting in

part: While I agree with the outcome on the theory that was addressed by the majority, I cannot

agree that we lack jurisdiction over the entire claim. The majority opinion effectively overrules our

decision in Roebuck v. Nicholson, 20 Vet.App. 307 (2006), by limiting the case to its facts. The

majority does so in the name of administrative efficiency. However, I cannot agree that

administrative efficiency trumps a veteran's interest in receiving the full amount of benefits that he

is entitled to by virtue of his service to a grateful nation.

"An epigram widely attributed to Abraham Lincoln is appropriate in this case: How many

legs does a dog have if you count his tail as a leg? Four. You can call a tail a leg if you want to, but

it doesn't make it a leg." Kuzma v. Principi, 16 Vet.App. 140, 145 (2002) (en banc per curiam order)

(Ivers, J. dissenting); see also Arteaga v. Mukasey, 511 F.3d 940, 946 (9th Cir. 2007) (using

Lincoln's wisdom to conclude that "calling a street gang a 'social group' as meant by our humane and

accommodating [asylum] law does not make it so"); First Liberty Inv. Group v. Nicholsberg,

145 F.3d 647, 652 (3d Cir. 1998) (applying the epigram to conclude that an employer could not

escape an arbitration clause by labeling an employee as an "independent contractor"). The majority
37

opinion holds that a Board decision is final because the Board says it is. I disagree. I believe that

a Board decision does not become final until it is ripe for judicial review, regardless of the Board's

desire to wash its hands of a particular theory before the claim has been fully developed and

adjudicated. See DiCarlo v. Nicholson, 20 Vet.App. 52, 57 (2006) (stating that finality is "a measure

of procedural maturity"); Mokal v. Derwinski, 1 Vet.App. 12, 15 (1990) (adopting "as a matter of

policy the jurisdictional restrictions of the Article III case or controversy rubric"). The practical

effect of the majority's holding is that a claim can be finally denied on one theory before the

evidence is fully developed and VA is fully informed as to the nature of the veteran's current

condition and its etiology. 

It is quite reasonable to expect that, after full development of the claim, a Board decision

denying a claim on one theory will be contradicted by new evidence developed on remand of a

different theory. For example, a Board decision could—as happened here—deny a claim on theory

A because the evidence is against it, but remand the claim for further development on theory B. If

the denial of theory A is a separate decision that must be appealed immediately, then an appellant

may be prejudiced if this partial denial is final. It is easy to imagine a scenario where the remand

as to theory B produces a new medical opinion that actually supports theory A instead because new

facts come to light, there is an advance in medical knowledge, or there is simply a disagreement of

opinion by a new expert reviewing the claim. However, if theory A has already been finally

denied—either because the Board decision was not appealed or because the Court affirmed that

decision based on the record as it existed at the time of the Board decision—then the appellant is

now in the position of being finally denied as to both theories even though the evidence supports

granting the claim as to a theory that was denied based upon an underdeveloped record. Even if the

appellant realizes that the new evidence is material as to the theory that was originally denied, the

effective date awarded upon reopening will be based upon the new claim rather than the original

claim—potentially costing the appellant years of benefits. While such a process is administratively

convenient, it is also deeply unfair.

There might be ways in which a claimant who is savvy or advised by counsel could avoid

this prejudice. Perhaps the appellant could appeal the final decision as to theory A and argue that

appellate review is premature until theory B is fully developed and decided because they are

inextricably intertwined. However, the majority opinion holds, in essence, that alternative theories
38

of entitlement are not presumed to be inextricably intertwined, see ante at 18, and the evidence

showing that the theories are intertwined may not be before the Court because it is not developed

until after the remand of theory B.

However, most claimants do not have attorneys at the Board level or when they file their

NOAs to Board decisions. The majority decision purports to save claimants from the burden of

determining whether a Board decision should be appealed by adopting a bright-line rule that Board

decisions that purport to be final must always be appealed. Ante at 18. However, this "benefit" to

claimants is actually a mirage because it assumes that unrepresented claimants will know that the

Court has adopted this bright-line rule. It is much more likely that a pro se appellant will (1) not

understand that a Board decision that remands a claim as to some theories is still final as to the

others; (2) accept the decision without knowledge of the evidence that will be developed on remand;

or (3) appeal the denied theory on the merits even though the full record for the claim has yet to be

developed. Under any framework, a premature NOA can never hurt a claimant. Only under the

majority decision is a claimant penalized for not filing an NOA each time an individual theory is

rejected.

The majority opinion also fails to reconcile its notion of theory-by-theory finality with the

plain language of 38 U.S.C. § 5108. Section 5108 permits a claimant to reopen "a claim which has

been disallowed" by submitting new and material evidence. What happens when a claimant obtains

evidence that is new and material to a theory that has been finally denied before the whole claim has

been denied? Would the appellant file a separate claim to reopen a claim that is still pending and

being adjudicated? Similarly, 38 U.S.C. § 5110 limits the effective date for an award of benefits to

the date of "the original claim" or "a claim reopened after final adjudication" to no earlier than the

"date of the receipt of the application therefor." What is the effective date if theory B never becomes

final before theory A is reopened and results in the grant of the claim? Section 5103(a)(1) of title

38 requires the Secretary to provide notice of "the evidence necessary to substantiate the claim"

whenever a person applies for benefits. If theory A is still being processed and a claimant wants to

reopen theory B, is any notice required given that no new claim is being filed? If notice is required,

does it actually apply to the whole claim, or just to the theories that were previously denied? See

Kent v. Nicholson, 20 Vet.App. 1 (2006) (section 5103(a) notice as to an application to reopen a

claim must be tailored to the basis of the prior, final denial).
39

The Secretary's duty to assist has also been defined by Congress in terms of claims. See

38 U.S.C. § 5103A. Suppose a remand of theory B for a new medical opinion produces one that

"indicates" that theory A may have merit, but theory A has already been finally denied. Is 38 U.S.C.

§ 5103A(d) triggered? See McLendon v. Nicholson, 20 Vet.App. 79 (2006). On its face, the duty

applies to the claim, not to the theory. If section 5103A(d) revives the previously final theory A

without an application (or even any intent) to reopen, what would be the effective date and what date

would be relevant for determining what law was in effect at the time the claim was filed?

Although the majority opinion fails to address any of these issues, it puts the Court on course

to simply mark out every instance of the word "claim" in title 38 and pencil in "theory" in order to

make the statute functional. The alternative would be for the Court to pick and choose when

Congress meant "theory" when it actually wrote "claim." I find either solution wholly unacceptable.

See Tropf v. Nicholson, 20 Vet.App. 317, 321 n.1 (2006) ("Without standard word meanings and

rules of construction, neither Congress nor the Secretary can know how to write authorities in a way

that conveys their intent and no practitioner or—more importantly—veteran can rely on a statute or

regulation to mean what it appears to say."); THE FEDERALIST NO. 62 (James Madison) ("It will be

of little avail to the people that the laws are made by men of their own choice, if . . . no man who

knows what the law is today can guess what it will be tomorrow.").

The only realistic benefit to claimants cited by the majority is that claimants may receive

faster judicial review of the denied theories if claims may be denied and appealed on a piecemeal

basis. Ante at 15. However, premature judicial review is likely to harm the appellant because the

Court is prohibited from considering favorable evidence developed after the Board decision on

review and may affirm the denial without benefit of the new information. See Bonhomme

v. Nicholson, 21 Vet.App. 40, 43-45 (2007). More importantly, once the Court has gone down the

track of allowing some types of interlocutory appeals in the name of faster justice, it is not apparent

where the train will stop. If the Board rejects an argument concerning the duty to notify or the duty

to assist, but remands for a different type of development, why should an appellant wait years before

the Court gets involved? Conversely, the majority also fails to recognize that if the RO grants

benefits on the second theory on remand, then any review of the first Board decision denying the

same benefit is moot. The potential for the Court to waste time on moot appeals is part of the central

reason why finality should be based upon principles of ripeness rather than blind deference to the
40

Board. Hence, the Court's decision effectively overrules Mokal by abandoning both ripeness and

mootness as limitations on our jurisdiction. See 1 Vet.App. at 15.

Rather than ripeness or mootness, the majority purports to manage our theory-by-theory

jurisdiction on the Board's choice to include "an 'order granting appropriate relief or denying relief.'"

Ante at 9 (quoting 38 U.S.C. § 7104(d)). However, this standard grants the Board power to

arbitrarily allow or deny claimants the ability to appeal theories by choosing whether to include such

an order. For example, a Board decision may include a discussion of why the evidence does not

support theory A, but remand for a new medical opinion addressing theory B. If the Board includes

an order line formally denying theory A, then it must be immediately appealed. However, if it does

not include such a line and remands the whole claim, then the decision is not appealable. By tying

our jurisdiction to a technicality controlled by the Board, we grant the Secretary a tool to manage

our jurisdiction as he sees fit. Cf. Ribaudo v. Nicholson, 20 Vet.App. 552 (2007) (en banc) (rejecting

the argument that the Secretary has inherent authority to stay cases pending an appeal of a Court

opinion to the Federal Circuit); Marsh v. West, 11 Vet.App. 468, 470 (1998) ("This Court has been

wary of action or inaction by the B[oard] that would have had the effect of depriving this Court of

jurisdiction to review a B[oard] decision over which the Court would have had jurisdiction but for

the B[oard]'s action or inaction."). Alternatively, the Court will get involved in the business of

determining whether a Board's discussion of a theory amounts to a formal denial regardless of the

technicality.

I would also note that the majority’s new concept of finality for Board decisions is

inconsistent with the nature of finality at the regional office level. It is well established that RO

decisions are appealed on a claim-by-claim basis by the appellant's filing a Notice of Disagreement

(NOD). So long as a timely NOD is filed, an appellant is free to raise any theory of entitlement to

the Board and the Board must consider all theories of entitlement raised by the record even if the

theories are not raised by the claimant. See Robinson v. Peake, 21 Vet.App. 545, 553 (2008).

Nonetheless, the majority concludes that a theory-by-theory concept of finality applies at the Board

level even though claim-by-claim finality applies at the RO level. Moreover, it is not apparent how

the majority opinion's concept of theory-by-theory finality can be reconciled with the Federal

Circuit's decision in Bingham v. Nicholson that "[u]nder [38 U.S.C. § 7104(b)], finality attaches once
41

a claim for benefits is disallowed, not when a particular theory is rejected." 421 F.3d1346, 1348-49

(Fed. Cir. 2005).

The majority opinion asserts that applying Roebuck as written "creates a new exception to

the rule of finality and ignores the fact that Roebuck explicitly was based on unique circumstances."

Ante at 11. Nothing could be further from the truth. I read Roebuck as an application of well

established, general principles of finality for appellate review. It has been more than 40 years since

the Supreme Court explained 

The long-established rule against piecemeal appeals in federal cases and the

overriding policy considerations upon which that rule is founded have been

repeatedly emphasized by this Court. . . . [T]he rule as to finality "requires that the

judgment to be appealable should be final not only as to all the parties, but as to the

whole subject-matter and as to all the causes of action involved."

Andrews v. United States, 373 U.S. 334, 340 (1963) (quoting Collins v. Miller, 252 U.S. 364, 370

(1920)) (citations omitted). This concept has been widely embraced by the federal appellate courts.

See, e.g., Garner v. U.S. West Disability Plan, 506 F.3d 957, 960-61 (10th Cir. 2007) (holding that

a district court's characterization of its order as "final" is not binding and that "courts do not

ordinarily treat the burden of having to participate in [additional] litigation as one that justifies

appeal from a nonfinal order"); Dieser v. Continental Cas. Co., 440 F.3d 920, 923 (8th Cir. 2006)

("A final decision . . . ends the litigation on the merits and leaves nothing for the court to do but

execute the judgment." (internal quotation omitted)); Nichols v. Cadle Co., 101 F.3d 1448, 1448-49

n.1 (1st Cir. 1996) (noting that certification of a pre-mature appeal "by a well-intentioned district

judge can create a minefield for litigants and appellate courts alike" and holding that "a judgment

is final (and, thus, appealable . . .) only if it conclusively determines all claims of all parties to the

action"). Hence, I do not advocate for the creation of any type of "finality claim," but only for the

application of the general rule defining when a claim is final. Cf. DiCarlo, 20 Vet.App. at 57

("Finality is . . . a measure of procedural maturity. It distinguishes processes that have been

completed from those that have not.").

Of course, if Congress desired to give this Court some interlocutory review power, it could

certainly do so. Such authority might be narrowly tailored to rulings of law that would be

appropriate for such review. See 38 U.S.C. § 7292(b)(1) (permitting interlocutory appeals to the

Federal Circuit where "the ultimate termination of the case may be materially advanced by the
42

immediate consideration of [the] question"). If such a change were made, then the Court might be

authorized to review issues peculiarly suited to interlocutory review without jeopardizing the

claimant's effective date by torturing the definition of "a final Board decision" on a claim.

Accordingly, I see neither the statutory authority for the Court's ruling nor the benefit to veterans

created by encouraging piecemeal litigation. Cf. Matthews v. Nicholson, 19 Vet.App. 202, 206

(2005) (per curiam order) ("The Court cautions counsel against engaging in piecemeal litigation.");

Snyder v. Principi, 16 Vet.App. 62, 69 n.3 (2002) (en banc per curiam order) (Steinberg, J.,

concurring) ("The Secretary should need no reminder of the Court's longstanding policy to

discourage piecemeal litigation."); Burton v. Principi, 15 Vet.App. 276, 277 (2001) (per curiam

order) ("We should not encourage the kind of piecemeal litigation in which the appellant here has

engaged.").

Despite my misgivings, I would be constrained to agree with the majority if its opinion of

the controlling caselaw cited compelled the outcome reached. Fortunately, it does not. Notably, the

majority cites both Maggitt v. West, 202 F.3d 1370 (Fed. Cir. 2000), and Joyce v. Nicholson, 443

F.3d 845 (Fed. Cir. 2006), and then proceeds to ignore the plain language it quotes from those

opinions. As quoted by the majority, Maggitt defines the finality of a Board decision in terms of

"'the benefit sought by the veteran.'" Ante at 9 (quoting 202 F.3d at 1376). Yet, inexplicably, the

majority does not further address or apply Maggitt. Instead of applying this clear language, the

majority relies upon language from the Federal Circuit's decision in Elkins v. Gober, 229 F.3d 1369

(Fed. Cir. 2000), while attempting to avoid acknowledging that it ruled on the finality of different

claims, not different theories. While there is much Federal Circuit caselaw noting that judicial

review of one claim may need to wait until agency adjudication of another claim is complete, it does

not logically follow that individual theories of entitlement within one claim may be reviewed

piecemeal.

The majority also relies on an overly broad reading of the Federal Circuit's decisions in

Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997), and Barrera v. Gober, 122 F.3d

1030, 1032 (Fed. Cir. 1997). They are cited for the proposition that the Federal Circuit has blessed

the concept of exercising jurisdiction over any issue where the Board purports to have rendered a

final decision. Nothing could be further from the truth. The issue in both of those cases was

whether the downstream elements of rating and effective date must be disputed through a new
43

Notice of Disagreement even though one had previously been filed disputing a denial of service

connection. See Barrera, 122 F.3d at 1031; Grantham, 114 F.3d at 1158. The actual holding of

Grantham—as relied upon in Barrera—was that the appeal of "the logically up-stream element of

service connectedness" was independent of "the logically down-stream element of compensation

level." Grantham, 114 F.3d at 1158-59. In other words, a dispute over the service-connection

element of a disability compensation claim is jurisdictionally distinct from any dispute over a

disability rating and effective date that is later awarded. This makes perfect sense. There is no

reason to assume that an appellant who obtains a remand after initially losing on the serviceconnection element will necessarily be disappointed in the disability rating or effective date after

prevailing on the service-connection element of a disability compensation claim on remand.

Accordingly, it makes sense to require such an appellant to initiate a new appeal to express

disagreement with the logically down-stream issues. Nothing in Gratham's discussion of "logically

down-stream elements" supports the proposition that alternative theories for proving the same

element may be appealed independently of each other.

I believe the ultimate flaw in the majority's use of Federal Circuit caselaw is that it traces

back to precedent outside the claimant-friendly realm of veterans law. As the majority notes, Elkins

relies upon Dewey Electronics Corp. v. United States, 803 F.2d 650 (Fed. Cir. 1986). Not only did

Dewey Electronics Corp. involve separate claims, as clearly stated in the opinion, it involved a

sophisticated corporation suing the Federal Government for a contract violation. Id. at 651-53. In

a contract suit—as with most cases in American law—the plaintiff is responsible for gathering and

presenting all the evidence to support his claim. If the plaintiff fails to do so, then he has no one to

blame but himself if appellate review of the agency contracting decision is reviewed based upon an

inadequate record. Veteran benefits claims are an exception to this general rule. In this area, VA

owes substantial duties to assist the claimant in the development of the claim. Therefore, it is

inappropriate to presume that errors that clearly prejudice the development of evidence as to one

theory of entitlement did not prejudice any other theory that may support an award of benefits.

Hence, the majority opinion's analysis importing a concept of finality suited to sophisticated

claimants before other agencies is fundamentally flawed. In addition, as the Federal Circuit

observed in Dewey Electronics Corp., "the agency's characterization of a decision is not

determinative of the finality issue and the relevant statutes outlining the required administrative
44

procedures must be examined." Id. at 654. In other words, even the caselaw relied upon by Elkins

recognized that courts may reject an agency's attempt to point to a tail and call it a leg. See also

Fagre v. Peake, 22 Vet.App. 188, 191 (2008) (per curiam order) (rejecting the Secretary's

characterization of a single Board decision as multiple separate Board decisions issued together).

In summary, I do not think that administrative convenience can justify the outcome reached

here or the concomitant confusion and delays that will be generated as a result. Rather, because the

majority opinion ignores the plain language of title 38 and controlling Federal Circuit precedent,

overrules our panel decision in Roebuck, and will prejudice veterans who will receive final Board

decisions denying benefits based upon records that are admittedly underdeveloped, I must

respectfully dissent.