Judges Moorman, Lance, Davis, and Schoelen, all of whom began regular active service on the Court after

*

full-Court deliberations on this matter, did not participate in consideration of the appeal. See Court's Internal Operating

Procedures at V(b)(1)(C).

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

NO. 02-2259

BARNEY O. PADGETT, APPELLANT,

V.

R. JAMES NICHOLSON,

SECRETARY OF VETERANS AFFAIRS, APPELLEE.

On Appeal from the Board of Veterans' Appeals

(Decided April 19, 2005 )

Barton F. Stichman and James W. Stewart (non-attorney practitioner), both of Washington,

D.C., were on the pleadings for the appellant.

Tim S. McClain, General Counsel; R. Randall Campbell, Assistant General Counsel; John

D. McNamee, Acting Deputy Assistant General Counsel; Cristine D. Senseman; and Edward V.

Cassidy, Jr., all of Washington, D.C., were on the pleadings for the appellee.

Before IVERS, Chief Judge, and STEINBERG, GREENE, KASOLD, and HAGEL, Judges.

*

KASOLD, Judge, filed the opinion of the Court. HAGEL, Judge, filed an opinion

concurring in part and dissenting in part. IVERS, Chief Judge, filed a dissenting opinion.

KASOLD, Judge: World War II veteran Barney O. Padgett appeals through counsel an

August 8, 2002, Board of Veterans' Appeals (Board) decision that denied his claim for VA disability

compensation for service-connected osteoarthritis of the right hip on direct, presumptive, and

secondary bases. Record (R.) at 1-20. In a July 9, 2004, panel decision of this Court issued after

oral argument, the Board's decision was vacated and the matter remanded for readjudication. On

September 14, the Court granted motions by both parties for a full-Court decision and withdrew the

panel decision. Padgett v. Principi, 18 Vet.App. 404 (2004) (en banc order). For the reasons stated
2

below, the Board's decision will be reversed in part and set aside in part, and the matter will be

remanded for further proceedings consistent with this opinion.

I. FACTS

Mr. Padgett served on active duty in the U.S. Army from January 1943 to July 1945. He is

a combat veteran who served in Europe, Africa, and the Middle East. R. at 22-23. In March 1943,

he injured his left knee as a result of slipping on ice in Plattsburgh, New York. R. at 43. In July

1944, he reinjured hisleft knee during combat when he jumped into a ditch seeking cover from shell

fire. R. at 54, 71. His service medical records indicate that he was diagnosed with having a sprained

left knee, chronic, severe, and synovitis of the left knee, chronic, severe, secondary to the left-knee

sprain. Id. In August 1945, a VA regional office (RO) awarded him service connection for residuals

of a left-knee injury, rated at 30% disabling. R. at 92. That rating was reduced later to 10%. R. at

149.

In September 1975, Mr. Padgett filed claims seeking service connection for arthritis-related

pain in his left leg, left hip, and the left side of his back. R. at 149. In a June 1976 decision, the RO

assigned a 30% rating for traumatic arthritis of his left knee and for a residual sprain of the left knee

with favorable ankylosis. R. at 185. The RO denied service connection for a lumbar-spine disorder

and further determined that the evidence did not indicate the existence of a current left-hip disorder.

R. at 185-87. Mr. Padgett appealed to the Board, claiming that all his arthritis had been caused by

his service-connected left-knee injury. R. at 189-92, 201. In an April 1977 decision, the Board

found that his multiple-joint arthritis, other than that of his left knee, was not incurred while in

service, aggravated by service, or caused by an in-service disease or injury, and the Board denied

his appeal. R. at 211-15.

In March 1993, Mr. Padgett filed a claim for service connection for a right-hip disorder on

the basis that the need for a right-hip replacement was caused by his left-knee disability. R. at 218.

The RO obtained treatment records from Dr. Charles H. Shaw, Mr. Padgett's private orthopedic

surgeon. In those records, Dr. Shaw noted that in 1982 Mr. Padgett was "morbidly obese" and

suffered from degenerative arthritis in the neck, spine, and knees. R. at 226. In 1988, Dr. Shaw

wrote that x-rays taken after an October 1988 automobile accident depicted, inter alia, severe

degenerative arthritis of the left knee with lesser changes in the right knee and severe degenerative
3

arthritis of the right hip with lesser changes in the left hip. R. at 230. Mr. Padgett underwent a

right-total-hip arthroplasty in 1989. R. at 233-37. In 1991, Dr. Shaw also recommended a

left-total-knee arthroplasty. R. at 237.

In May 1993, the RO found that there was no evidence that his right-hip condition had been

caused by his left-knee disability and denied Mr. Padgett's claim. R. at 240, 242. Mr. Padgett

appealed to the Board. R. at 246, 260. In support of his appeal, he submitted the following

additional medical statements from his private physicians indicating that the degenerative disease

that he was experiencing in his right hip was related to his left-knee injury. In a December 1993

letter, Dr. Shaw stated: 

Mr. Padgett historically sustained an injury to his left knee while in the [s]ervice.

This injury has resulted in severe endstage traumatic osteoarthritis of his knee. He

also states that he thinks he sustained an injury to his hip as a result of that same

incident. Over the years he has developed progressively increasing degenerative

disease of both his left knee and right hip.

It is my feeling that the gait abnormalities associated with the severity of the disease

involving hisleft knee ha[ve] adversely impacted the progression of the degenerative

disease of his right hip and have in fact aggravated his symptoms with it. It is my

feeling that the degenerative disease that he has experienced in his right hip is related

to his original injury.

R. at 262. 

In a January 1994 letter, Dr. Robert Thoburn, a private specialist in internal medicine and

rheumatology, stated: 

[Mr. Padgett] had an injury to the left knee while in the service. This has progressed

to severe osteoarthritis of the left knee secondary to trauma. He thinks he sustained

an injury to the right hip and has progressive pain and stiffness of the right hip.

He has an endstage left knee that has resulted in weight shifting to the right side. It

is likely that this has resulted in progression of osteoarthritis of the right hip. It is

consistent that the osteoarthritis of the right hip and left knee are related to the

original injury.

R. at 261.

Mr. Padgett also submitted an October 1993 letter from Dr. James A. Rawls, in which Dr.

Rawls stated that he had treated Mr. Padgett for almost 30 years and noted that "a major problem

most of this time has been osteoarthritis involving the weight-bearing joints, knees, hips, and low

back." R. at 263. Mr. Padgett also submitted a June 1979 letter from Dr. Rawls that noted Mr.
4

Padgett's left-knee pain, but Dr. Rawls did not comment specifically on Mr. Padgett's gait or righthip disability. R. at 265-67. In March 1994, after reviewing this newly submitted evidence, the RO

continued to deny the claim. R. at 272-74.

In May 1994, Mr. Padgett filed a Notice of Disagreement with respect to the March 1994 RO

decision and, in December 1994, he was afforded a hearing before the RO. At the hearing, Mr.

Padgett testified under oath that he had injured his right hip while in service at the same time that

he had reinjured his left knee in 1944. R. at 296-97. In January 1995, after finding that the evidence

did not provide a sufficient basisfor service connection on either a direct or secondary basis, the RO

again denied Mr. Padgett's claim R. at 303-04.

Mr. Padgett appealed that January 1995 RO decision to the Board (R. at 319) and submitted

additional statements from Dr. Thoburn and Dr. Shaw (R. at 325, 340). In a November 1995 letter,

Dr. Thoburn opined: "It is my feeling that a shift in weight [because of his altered gait] plus his size

and obesity contributed to accelerated osteoarthritis of his right hip," thereby leading to a total

right-hip replacement. R. at 325. In an October 1996 statement, Dr. Shaw opined that Mr. Padgett's

irregular gait pattern resulting from his left-knee injury increased symptoms in his right hip, which

ultimately required right-hip replacement. R. at 340. Dr. Shaw concluded that "[Mr. Padgett's]

war-related injury directly aggravated his symptoms with respect to his hip." Id.

In April 1997, the Board remanded the case to the RO to (1) adjudicate Mr. Padgett's claim

for compensation based on direct service connection, (2) reconsider his claim for compensation

based on a secondary basis as a result of the Court's decision in Allen v. Brown, 7 Vet.App. 439

(1995) (en banc) (holding that veteran may be awarded compensation for aggravation of

non-service-connected condition by service-connected disability), and (3) afford him a hearing

before a traveling section of the Board. R. at 354-57.

In June 1997, Mr. Padgett underwent a VA examination by Dr. F. Henderson. R. at 360-63.

Dr. Henderson concluded that Mr. Padgett suffered from multijoint "degenerative joint disease" that

was "a consequence of the aging process" rather than any one specific injury. Id. at 363. However,

he also stated that Mr. Padgett's left-knee injury may have "played a part in the damage that later

required a left-knee replacement, but not necessarily a hip replacement." Id. In addition, Dr.

Henderson noted that he had not reviewed the claims file and that a certified orthopedist should

review the case "for a more definitive opinion." R. at 361, 363.
5

During a February 1999 Board hearing, Mr. Padgett again testified under oath that he had

injured his right hip at the same time he had reinjured his left knee in 1944. R. at 393-410. In a July

1999 letter, the Board requested an expert medical opinion from the chief of staff of the Columbia,

South Carolina, VA Medical Center (VAMC). R. at 413-15. As its authority for requesting the

opinion, the Board's letter cites Veterans Health Administration Directive 10-95-040 (April 17,

1995), 38 C.F.R. § 20.901 (1999), and 38 U.S.C. § 7109. R. at 413. Dr. John K. Blincow, a VA

employee, was tasked by the Chief of Staff of the VAMC to review Mr. Padgett's claims file and

provide to the Board the requested advisory medical opinion. See R. at 413-20. After examining

Mr. Padgett's claims file, Dr. Blincow concluded that (1) Mr. Padgett's right-hip disorder was caused

by age-related degenerative arthritis and was not related to his in-service left-knee injury or a gait

abnormality and (2) his left-knee disability did not aggravate or cause an increase in severity of his

right-hip arthritis. R. at 418-20. 

On August 8, 2002, the Board issued the decision on appeal. R. at 1-19. In its decision, the

Board accorded the VA medical opinions more weight than the opinions rendered by Mr. Padgett's

private physicians. R. at 14-18. The Board found that the opinions of the private physicians were

"equivocal and apparently unsubstantiated [in] nature." R. at 16. In contrast, the Board stated that

"both of [the VA opinions] have tremendous probative value as both were based on a thorough

review of the claims file, which is essential [to] formulating a sound opinion." Id. The Board found

that the medical evidence of record did not indicate a nexus between an in-service injury to Mr.

Padgett's right hip and his current right-hip disability or that his right-hip disability manifested

within one year after his discharge, and thus denied service connection on direct and presumptive

bases. R. at 14-17. The Board also denied Mr. Padgett's claim for secondary service connection,

after finding that Mr. Padgett's right-hip injury was not related to his service-connected left-knee

disability. R. at 17-18.

On appeal, Mr. Padgett argues, inter alia, that (1) the Board erred in relying on the June 1997

VA medical opinion rendered by Dr. Henderson because he did not review Mr. Padgett's claims file,

did not discuss the positive medical evidence in the claims file, and did not consider the fact that Mr.

Padgett had injured his right hip in combat (Appellant's Brief (Br.) at 17-18); (2) the Board did not

have the authority under the then-existing regulation, 38 C.F.R. § 20.901, to secure the 1999 VA

expert medical opinion of Dr. Blincow, and even if the Board had the authority to obtain such an
6

opinion, under section 7104(a), title 38, U.S. Code, and Disabled American Veterans v. Secretary

of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003) [hereinafter DAV v. Sec'y], the Board could not

consider that opinion without first remanding the matter to the agency of original jurisdiction or

obtaining Mr. Padgett's waiver (Appellant's Br. at 20-24); (3) the Board's finding that Mr. Padgett's

right-hip condition is not related to an in-service injury or his service-connected left-knee disability

is clearly erroneous because the private medical opinions of record provide the required etiological

relationship for service connection to be awarded (Appellant's Br. at 15-16); and (4) because the

Board could not properly rely on either of the VA medical opinions, the only medical opinions

properly before the Board or the Court are those that support Mr. Padgett's claim and therefore the

Court should reverse the Board's decision denying his claim (Appellant's Br. at 25). In the

alternative, Mr. Padgett argues that the Court should remand the case for the Board to correct the

errors that he identified and to ensure compliance with the notice and assistance requirements of

sections 5103(a) and 5103A, title 38, U.S. Code. Appellant's Br. at 26 n.2.

The Secretary filed an initial brief in which he argued primarily for a remand, based on his

failure to comply with notice duties under section 5103(a). Secretary's (Sec'y) Br. at 7-13.

However, Mr. Padgett "waive[d] this Court's consideration [of] the errors relating to the . . . duty to

notify discussed in . . . the Secretary's brief." Appellant's Reply Br. at 1-2. The Secretary, with

leave of the Court, then filed a sur-reply brief in order to address Mr. Padgett's other arguments.

Although the Secretary agrees with Mr. Padgett that the Board erred in relying on the 1997 VA

medical opinion of Dr. Henderson (Sec'y Br. at 10), the Secretary argues that the Board had the

authority under section 7109(a) and § 20.901 (2002) to obtain the 1999 VA medical opinion of Dr.

Blincow, and that opinions obtained pursuant thereto do not require remand to the RO for initial

consideration (Sec'y Sur-Reply Br. at 3-7).

In Mr. Padgett's response to the Secretary's sur-reply brief, he argues, inter alia, that Dr.

Blincow's medical opinion did not fit under any exception to section 7104(a) that would allow the

Board initially to consider additional evidence. Appellant's Response to Sec'y Sur-Reply Br. at 2-6.

In his motion for a full-Court decision, the Secretary argues that section 7109(a) is a clear exception

to section 7104(a) and that the United States Court of Appeals for the Federal Circuit (Federal

Circuit) found in DAV v. Sec'y that the exception exists, thereby precluding this Court from holding

otherwise. Sec'y Motion (Mot.) at 3. Mr. Padgett argues in his cross-motion for a full-Court
7

decision that the Court has full authority to review the Board's factual findings for clear error.

Appellant's Mot. at 3.

II. ANALYSIS

Mr. Padgett raises two issues concerning the Board's consideration of Dr. Blincow's 1999

expert medical opinion. First, he argues that the Board failed to follow applicable regulatory

procedures in obtaining this medical opinion, thereby rendering its use invalid. Second, he argues

that even if the Board had the statutory and regulatory authority to "secure" the opinion, it did not

have the statutory authority to "consider" it in the first instance, absent a waiver from Mr. Padgett.

We will address each of these contentions in turn.

A. Regulatory Authority to Secure and Consider 1999 Expert

Medical Opinion of Dr. Blincow

Before rendering its decision, the Board requested an expert medical opinion from the Chief

of Staff of the VAMC in Columbia, South Carolina. Mr. Padgett argues that the Board lacked the

authority under the law in effect at the time to ask the Chief of Staff to provide a medical opinion

because the regulations provided only that such an opinion could be solicited from VA's Chief

Medical Director (also known as the Under Secretary for Health), and made no reference to any

other person, including a Chief of Staff of a VAMC. See Appellant's Br. at 20; see also 38 C.F.R.

§ 20.901(a).

After obtaining the expert medical opinion but during the pendency of the Board decision,

the Secretary amended § 20.901(a) to authorize the Board to obtain a medical opinion from any

appropriate health-care professional within VA, not just the Chief Medical Director. See Rules of

Practice: Medical Opinions From the Veterans Health Administration, 66 Fed. Reg. 38,158, 38,159

(July 23, 2001); compare 38 C.F.R. § 20.901(a) (1999) with 38 C.F.R. § 20.901(a) (2002). Given

this modification of the regulation, the Court cannot and does not find that Mr. Padgett was

prejudiced by the Board's solicitation in 1999 of Dr. Blincow's expert medical opinion because the

Board had clear regulatory authority to take such action and consider Dr. Blincow's opinion in 2002,

when it ultimately relied upon it and rendered the decision here on appeal. See 38 U.S.C.

§ 7261(b)(2) (Court shall take due account of rule of prejudicial error).
8

B. Statutory Authority to Secure and Consider

Expert Medical Opinion

Mr. Padgett also argues that, even if obtaining or securing Dr. Blincow's opinion was

permissible by regulation, the Board could not rely upon Dr. Blincow's medical opinion in the first

instance, absent the claimant's waiver, because it would deny Mr. Padgett his right to "one review

on appeal to the Secretary" as provided for by 38 U.S.C. § 7104(a); see also DAV v. Sec'y, supra.

Although Mr. Padgett focuses on the Board's authority – or lack thereof – to "consider" Dr.

Blincow's opinion in the first instance, it is essential that we first examine the statutory authority of

the Board to "secure" the opinion. For the reasons set forth below, we conclude that in section

7109(a) the United States Congress statutorily recognized and sanctioned the practice of the Board

to secure expert medical opinions from VA employees and thereby provided statutory authority for

that practice. We also find that the authority of the Board to secure a medical opinion includes the

authority for the Board to consider that opinion.

1. Board May Secure Expert Medical Opinions

At the outset, we note that the Court already has addressed on several occasions the Board's

use of medical opinions it obtained, and concluded, either directly or implicitly, that the Board had

the authority to secure medical expert opinions from both VA and non-VA employees. See, e.g.,

Winsett v. West, 11 Vet.App. 420, 426 (1998) (holding that section 7109(a) does not preclude Board

from obtaining medical opinions not rendered from outside VA); Perry v. Brown, 9 Vet.App. 2, 6

(1996) (stating that, in event that medical-nexus opinion was needed on remand, "Board may seek

to obtain that development itself through a [VA] or non-VA [medical expert] opinion"); Thurber v.

Brown, 5 Vet.App. 119, 120-21 (1993) (commenting that section 7109 assumes, although does not

specificallyauthorize, Board's obtaining opinions of VA medical experts, and holding that 38 C.F.R.

§ 20.901(a) authorizing such action is a valid promulgation pursuant to statutory sections 7109 and

5107(a)); see also Chevron U.S.A., Inc. v. Natural Res. Def. Council, Inc., 467 U.S. 837, 843-45

(1984) (Court gives deference to executive department's regulation making reasonable interpretation

of statutory scheme). In light of the subsequent issuance of the Federal Circuit's opinion in DAV v.

Sec'y, however, we feel constrained to examine this question anew and thus proceed to do so.

In DAV v. Sec'y, the Federal Circuit held that a regulation authorizing the Board to obtain

additional evidence without remand to an RO for initial consideration of that evidence violated the
9

statutory requirement in section 7104(a) that there be one appellate review of the Secretary's

decisions. See DAV v. Sec'y, 327 F.3d at 1353 (invalidating 38 C.F.R. § 19.9(a)(2) (2000)).

Although the Federal Circuit concluded that section 7104(a) generally precluded the Board from

considering new evidence in the first instance, absent waiver by the claimant, that court recognized

that Congress could make exceptions, and further noted that Congress had explicitly done so with

regard to expert medical opinions in at least two statutory provisions as implemented by regulation.

Specifically, the Federal Circuit stated:

[W]hen Congress intended to authorize the Board to obtain additional evidence

without "one review on appeal to the Secretary," it knew how to do so. Congress has

provided express statutory authority to permit the Board to obtain additional

evidence, such as expert medical opinions in specific cases. See, e.g., 38 U.S.C.

§ 5107(a) (2000) (authorizing Board to obtain medical opinions from VA's Under

Secretary for Health (formerly the Chief Medical Director)); 38 U.S.C. § 7109

(2000) (authorizing Board to obtain independent medical opinions from outside the

VA); 38 C.F.R. § 20.901(a) (2002) (authorizing Board to obtain opinions from the

Veterans Health Administration); 38 C.F.R. § 20.901(b) (authorizing Board to obtain

medical opinions from the Armed Forces Institute of Pathology).

DAV v. Sec'y, 327 F.3d at 1347-48. Although we note that former section 5107(a) (now 38 U.S.C.

§ 5103A(d)) did not expressly authorize the Board to obtain or secure medical opinions, the import

of the Federal Circuit's analysis, at least as it relates to this case, is that court's recognition that

Congress may provide an exception to the one-appellate-review requirement of section 7104(a), and

that Congress did so in section 7109. We agree.

"The starting point in interpreting a statute is its language, for 'if the intent of Congress is

clear, that is the end of the matter.'" Gardner v. Brown, 5 F.3d 1456, 1456 (Fed. Cir. 1993)

[hereinafter Gardner II], aff'd, 513 U.S. 115 (1994). "Determining a statute's plain meaning requires

examining the specific language at issue and the overall structure of the statute." Gardner v.

Derwinski, 1 Vet.App. 584, 586 (1991) [hereinafter Gardner I], aff'd sub nom. Gardner II, 5 F.3d

1456 (Fed. Cir. 1993), aff'd, 513 U.S. 115 (1994); see also Splane v. West, 216 F.3d 1058, 1068-69

(Fed. Cir. 2000) ("canons of construction . . . require us to give effect to the clear language of a

statute and avoid rendering any portions meaningless or superfluous"); Gardner I, 1 Vet.App. at

587-88 ("Where a statute's language is plain, and its meaning clear, no room exists for construction.

There is nothing to construe."). Where the plain meaning of a statute is discernible, that "plain

meaning must be given effect unless a 'literal application of [the] statute will produce a result
10

demonstrably at odds with the intention of its drafters.'" Gardner I, 1 Vet.App. at 587 (quoting

Griffin v. Oceanic Contractors, Inc., 458 U.S. 564, 571 (1982)).

Section 7109(a) authorizes the Board to secure expert medical opinions when deemed

necessary. Although this section authorizes the Board to secure these opinions from experts who

are not employees of VA, it also recognizes and sanctions the Board's practice to secure such

opinions from medical experts employed by VA. Section 7109(a) states in relevant part:

When, in the judgment of the Board, expert medical opinion, in addition to that

available within the Department [of Veterans Affairs], is warranted by the medical

complexity or controversy involved in an appeal case, the Board may secure an

advisory medial opinion from one or more independent medical experts who are not

employees of the Department.

38 U.S.C. § 7109(a) (emphasis added).

Although section 7109(a) does not explicitly authorize the Board to secure expert medical

opinions from experts within VA, the phrase "in addition to that available within the Department

[of Veterans Affairs]" is an express sanctioning of the practice of the Board to use such experts.

The inclusion of this reference to the Board's existing practice within the statutory authority for the

Board to use experts outside VA, creates a strong implication that Congress was recognizing and

approving the existing practice of the Board to secure medical opinions from experts within VA. 

Moreover, to the extent that there is any doubt, the legislative history of section 7109(a)

demonstrates that this recognition of the Board's practice of using VA medical experts in addition

to outside medical experts was a deliberate action by Congress. See Steadman v. SEC, 450 U.S. 91,

101 (1981) (Court may look to legislative history to reveal Congress' intent). The principal purpose

of the section that eventually became section 7109 was to provide the Board with the authority to

secure an advisory medical opinion from independent medical experts who were not employees of

VA. See Pub. L. No. 87-671, 76 Stat. 557 (1962); 38 U.S.C. § 4009 (1962) (redesignated as section

7109 by Pub. L. No. 12-40, § 402(b)(1), 105 Stat. 238 (1991)). The House-passed version of the bill

would have required the VA chief medical director to "render an opinion to the Board on the

medical aspects of the case" in every case in which (1) an RO had denied a service-connection

claim, (2) medical evidence had been submitted that tended to support the claim, and (3) the case

was appealed and such an opinion was requested. In such cases, the opinion would have to "be

considered by the Board." H.R. REP. NO. 87-1453, at 2 (1962) (to accompany H.R. 852); see also
11

H.R. 852, 87th Cong. (2d Sess.), § 1 (adding new section 4009 to title 38, U.S. Code) (as reported

Mar. 19, 1962); 108 CONG.REC. 5519 (Apr. 2, 1962) (House passage of reported bill). In addition,

after a claim had been disallowed, reopened, and again denied, the House-passed bill also would

have required the Chief Medical Director, upon request after appeal to the Board, to refer the case

to an independent medical-expert advisory panel for review, and it would have made the opinion of

that panel "binding upon the Board." Id. 

The United States Senate committee considering the bill amended it by dropping the mandate

to the Chief Medical Director and the Board, thereby leaving "the use of independent medical

experts permissive with the Board rather than mandatory as would have been required by the bill

as passed by the House of Representatives." S. REP. NO. 87-1844 (1962), reprinted in

1962 U.S.C.C.A.N. 2585, 2586. It explained its action by noting that the bill it was reporting made

"no reference to the Board of Veterans' Appeals securing an advisory opinion from the Chief

Medical Director of the Veterans' Administration since this is a matter within Agency discretion

and ample authority for this practice now exists." Id. (emphasis added); see H.R. 852, 87th Cong.

(2d Sess.), § 1 (amending proposed section 4009 in House-passed bill) (reported Aug. 6, 1962). The

Senate version of the bill authorizing the Board to seek expert medical opinions "in addition to that

available within the Department," was concurred in by the United States House of Representatives,

108 Cong. Rec. 18406 (Sept. 4, 1962), and thereafter was enacted. By adding this language, instead

of the House mandatory language, Congress recognized and approved the continuing authority of

the Board to seek expert medical opinions from medical experts employed by VA in addition to the

newly granted authority to secure such opinions from medical experts outside VA. This recognition

is demonstrated by the Explanatory Statement on Compromise Agreement on Division A,

accompanying the enactment of the Veterans Judicial Review Act, Pub. L. 100-687, § 103(a)(1),

102 Stat. 4105 (1988), which, inter alia, modified then-section 4009 and stated that "[t]he

Committees . . . note with approval the current practice of obtaining [expert medical] opinions" from

within VA. 134 Cong. Rec. S16653 (1988), reprinted in 1988 U.S.C.C.A.N. 5834, 5842. Thus, we

hold that section 7109 provides statutory authority for the Board to secure medical opinions from

both VA and other medical experts.

We now address Mr. Padgett's argument that the plain wording of section 7109(a) authorizes

the Board only to secure, not to consider in the first instance, an expert medical opinion, and that
12

this means that the Board is required to return a case to the RO for initial consideration of any expert

medical opinion that the Board might secure. For the reasons stated below, we reject this

interpretation.

2. Board Initially May Consider Expert Medical Opinions It Secures

Although Mr. Padgett correctly notes that section 7109(a) authorizes the Board to "secure"

expert medical opinions and does not explicitly state that the Board may "consider" those opinions

in the first instance, his interpretation of the statute to mean that the Board is precluded from so

considering them is inconsistent with the analysis of DAV v. Sec'y, supra, as well as the discussion

in Perry and Thurber, both supra. Mr. Padgett's interpretation is also inconsistent with the statutory

scheme and the legislative purpose behind section 7109 and it would produce absurd results.

a. DAV v. Sec'y, Perry, and Thurber: In DAV v. Sec'y, the Federal Circuit stated: "[W]hen

Congress intended to authorize the Board to obtain additional evidence without 'one review on

appeal to the Secretary,' it knew how to do so." 327 F.3d at 1347-48. If the Federal Circuit was

addressing only the obtaining (or securing) of evidence in its narrowest sense, as Mr. Padgett would

have us construe those terms, then there would have been no need for the Federal Circuit to note that

Congress knew how to authorize the Board to obtain such evidence "without 'one review on appeal

to the Secretary'" because the mere obtaining of evidence by the Board (without review) could not

violate the one-appellate-review requirement of section 7104(a); only the Board's consideration of

such evidence could possibly do so. We view the Federal Circuit's conclusion in this respect as

integral to its analysis ofsection 7104(a) and therefore not dictum. See generally Co-Steel Raritan,

Inc. v. Int'l Trade Comm'n, 357 F.3d 1294, 1307-08 (Fed. Cir. 2004) (defining dictum as language

that is unnecessary to decision in case) (citingBLACK'S LAW DICTIONARY 1100 (7th ed. 1999)); see

also DaimlerChrysler Corp. v. United States, 361 F.3d 1378, 1385 n.3 (Fed. Cir. 2004) (noting that,

even if dictum, court "would feel obligated to follow the Supreme Court's explicit and carefully

considered statements"); Ins. Co. of the West v. United States, 243 F.3d 1367, 1372 (Fed. Cir. 2001)

(same); Stone Container Corp. v. United States, 229 F.3d 1345, 1349-50 (Fed. Cir. 2000) (same).

Moreover, consistent with DAV v. Sec'y, this Court has implicitly recognized the propriety of the

Board's consideration of medical opinions it obtains. See Perry, 9 Vet.App. at 6 (stating that on

remand the Board could develop a case itself through use of a VA medical expert opinion); Thurber,
13

5 Vet.App. at 126, (noting that notice to a claimant and opportunity to respond were required before

Board could rely on a VA medical expert opinion that it obtained).

Even if the language in DAV v. Sec'y was not binding upon us, based on the following

analysis we agree with the Federal Circuit's conclusion as to section 7109.

b. Statutory Scheme: Although the plain language of the statute – here authorizing the Board

to "secure" an expert medical opinion from both VA and non-VA medical experts – is the starting

point of an analysis of that statute, see Gardner II, Splane, and Gardner I, all supra, it is not the

totality of analysis. When interpreting the meaning of a statute, "each part or section of a statute

should be construed in connection with every other part or section so as to produce a harmonious

whole" and "it is not proper to confine interpretation to the one section to be construed." 2A N.

SINGER, SUTHERLAND ON STATUTORY CONSTRUCTION § 46:05 (6th ed. 2000) [hereinafter

SUTHERLAND]. That is, "the court will not only consider the particular statute in question, but also

the entire legislative scheme of which it is a part." SUTHERLAND, § 46:05; see also King v. St.

Vincent's Hosp., 502 U.S. 215, 221 (1991) (when interpreting statute, court is required to look at

context and provisions of law as a whole); Imazio Nursery, Inc. v. Dania Greenhouses, 69 F.3d

1560, 1564 (Fed. Cir. 1995) (all parts of a statute must be construed together without according

undue importance to single or isolated portion). Moreover, a "statute should be construed so that

effect is given to all its provisions, so that no part will be inoperative or superfluous, void or

insignificant, and so that one section will not destroy another unless the provision is the result of

obvious mistake or error." SUTHERLAND, § 46:06; see also Splane, supra.

The statutory scheme pertinent to our review in this case includes separate authorities for the

Secretary to obtain medical opinions at the RO level. See 38 U.S.C. §§ 5103A(d), 5109. Those

medical opinions are first considered by an RO, whose decisions can be appealed to the Board. See

38 U.S.C. §§ 7104(a), 7105. Section 7109(a) gives the Board separate and independent authority

to secure advisory medical opinions when, "in the judgment of the Board, expert medical opinion,

in addition to that available within the Department, is warranted by the medical complexity or

controversy involved in an appeal case". 38 U.S.C. § 7109(a). Considering these provisions in

concert, the Court concludes that it would have been incongruous for Congress to have given

discretionary authority to the Board to obtain a medical opinion but require initial review of that

opinion by the RO, which already had an opportunity to seek and review medical opinions obtained
14

under its own separate authority in 38 U.S.C. § 5109. Unlike DAV v. Sec'y, this is not a case

involving regulatory authority for the Board to consider evidence that conflicts with a statutory right

to one review on appeal. Rather, the authority issue here involves the statutory scheme itself.

Requiring the Board to send information that it is statutorily permitted to secure back to the RO for

initial consideration is inconsistent with the overall statutory scheme and the intent of Congress

(described below in part II.B.1.c) that the Board resolve conflicts in evidence.

Our conclusion that Congress intended for the Board to consider the expert opinions that it

obtained under section 7109(a) is further supported by the fact that Congress also provided dueprocess protections. Subsection (c) of section 7109 requires the Board to furnish notice and a copy

of the opinion to the claimant. See Winsett, 11 Vet.App. at 426 ("subsection (c) of section

7109[, by] requir[ing] notice and provision of a copy of the [VA] opinion to a claimant (as does

section 5109[(c)]), merely restates the procedural process due a claimant under higher law before

a decision is made"); 38 C.F.R. § 20.903(a) (2004) (Board to give claimant notice and opportunity

to respond to evidence obtained under § 20.901, the regulation implementing section 7109(a)); see

also Thurber, 5 Vet.App. at 122 (concluding that 38 C.F.R. § 20.903, which requires notification

to claimant of use by Board of expert medical opinion and opportunity to respond, "applies to both

independent and VA opinions"). If an expert opinion obtained by the Board had to be sent to the

RO before it could be considered by the Board, there would be no need for the Board to provide

notice and a copy to the claimant because the RO is otherwise required to do so. See 38 U.S.C.

§ 5109(c); 38 C.F.R. § 3.328(d) (2004).

c. Legislative Purpose: The express purpose for enacting the provision that is now codified

as section 7109 was "to improve the appellate procedures applicable to veterans' claims by

authorizing the referral ofsuch claimsto independent medical experts" in order to "resolve conflicts

of evidence in questions involving service connection of disabilities or deaths." S. REP. NO. 1844

(1962), reprinted in 1962 U.S.C.C.A.N. 2585, 2585-86. The interpretation of the scheme urged by

Mr. Padgett, i.e., remanding to the RO for initial consideration of expert medical opinions requested

and obtained by the Board pursuant to section 7109(a), does nothing to improve the referenced

appellate procedures. We believe that it is difficult, if not impossible, to escape the conclusion that

Congress, by specifically referencing appellate procedures and by vesting in the Board (VA's
15

appellate body) the authority to procure such expert medical opinions, intended that the Board be

able both to procure and to review the medical opinions obtained under section 7109(a).

d. Avoiding Absurd Results: Finally, Mr. Padgett's interpretation of section 7109(a) would

lead to absurd results. See United States v. X-Citement Video, Inc., 513 U.S. 64, 68-69 (1994)

("Some applications of respondent's position would produce results that were not merely odd, but

positively absurd . . . . We do not assume that Congress, in passing laws, intended such results.");

Timex V.I., Inc. v. United States, 157 F.3d 879, 886 (Fed. Cir. 1998) ("statutory construction that

causes absurd results is to be avoided if at all possible"). It would be absurd to conclude that

Congress authorized the Board to "secure" but not "consider" VA expert medical opinions, when

the Board was already authorized to remand matters to the RO for consideration, and the RO was

authorized to obtain and consider VA expert medical opinions. See 38 U.S.C. §§ 5103A(d), 5109.

The incongruity of a conclusion that the Board is authorized to obtain, but not consider in the first

instance, an expert medical opinion is further illustrated by the application of that conclusion to

another section of the statutory scheme, section 7107, title 38, U.S. Code. Under section 7107, if

Mr. Padgett's position that the Board can do only what is explicitly authorized is correct, then the

Board could hold a hearing and record Mr. Padgett's testimony but, because section 7107 fails to

state explicitly that the Board can consider his testimony in the first instance, the hearing transcript

would have to be sent to the RO for initial consideration (where Mr. Padgett may already have had

a hearing, see, e.g., 38 U.S.C. § 7105(a) (stating that, after the filing of a Notice of Disagreement,

"[e]ach appellant will be accorded hearing . . . rights"); 38 C.F.R. §§ 3.103(a) (requiring notice of

right to hearing and citing 38 U.S.C. § 501(a) as statutory authority for this right); 3.105(i)

(affording claimant opportunity for hearing prior to severance of service connection, reduction in

compensation or pension, and other reductions and discontinuances) (2004)). This would mean that

the Board could no longer assess in the first instance the credibility of the hearing testimony of a

claimant, a well-recognized role of the Board. See Cuevas v. Principi, 3 Vet.App. 542, 547 (1992)

(noting that Board is required to "address the credibility of appellant's sworn testimony or provide

reasons for discounting that testimony"); Wilson v. Derwinski, 2 Vet.App. 16, 20 (1991) (same);

Smith v. Derwinski, 1 Vet.App. 235, 237-38 (1991) ("[d]etermination of credibility is a function for

the [Board]"). Because Mr. Padgett's interpretation would lead to the above absurd results, it should

be avoided.
16

3. Summary

In summary, we conclude that section 7109(a) gives the Board the authority to secure expert

medical opinions from both VA and non-VA medical experts, and that such authority includes the

authority to consider in the first instance the information so obtained and does not conflict with the

section 7104(a) right to one appellate review, particularly given the fact that due-process protections

are provided in the statute and regulation, 38 U.S.C. § 7109(a); 38 C.F.R. § 20.903(a). This

conclusion, in effect, reaffirms Thurber, supra, and is consistent with DAV v. Sec'y, supra.

Accordingly, the Court holds that the Board's consideration of Dr. Blincow's expert medical opinion

was fully consistent with the statutory scheme as an exception to, and not in conflict with, the "one

review on appeal to the Secretary" provision of section 7104(a).

III. REMEDY

Mr. Padgett seeks reversal of the Board decision based on his argument that the Board could

not properly rely on either VA medical opinion, leaving the opinions of Drs. Shaw and Thoburn as

the only medical opinions properly before the Board. Although the Court rejects the contention that

the Board could not consider the VA medical opinions for any purpose, we nevertheless find

reversal appropriate as to the denial of Mr. Padgett's secondary-service-connected right-hipdisability claim. Additionally, remand is appropriate with regard to his claims for presumptive and

direct service connection for his right-hip disability.

A. Board Decision as to Secondary Service Connection for

Right-Hip Disability will be Reversed

Secondary service connection may be granted for any disability that is proximately due to

or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a) (2004); see Allen,

7 Vet.App. at 448 (allowing secondary service connection for aggravation of non-service-connected

condition by service-connected disability). The Board's decision regarding the finding of secondary

service connection is a finding of fact that the Court reviews under the "clearly erroneous" standard

of review set forth in 38 U.S.C. § 7261(a)(4). See Harder v. Brown, 5 Vet.App. 183, 187 (1993).

In this regard, section 7261(a)(4) directs the Court to "reverse or set aside" any "finding of material

fact adverse to the claimant . . . if the finding is clearly erroneous." 38 U.S.C. 7261(a)(4). "'A

finding is 'clearly erroneous' when although there is evidence to support it, the reviewing court on
17

the entire evidence is left with the definite and firm conviction that a mistake has been

committed.'" Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990) (emphasis added) (quoting United

States v. U.S. Gypsum Co., 333 U.S. 364, 395 (1948)). Of course, if the Board's "'account of the

evidence is plausible in light of the record viewed in its entirety, the court of appeals may not

reverse it.'" Gilbert, 1 Vet.App. at 52 (quoting Anderson v. City of Bessemer City, 470 U.S. 564,

573-74 (1985)).

Additionally, when assessing the factual determinations of the Board, the Court is required

by 38 U.S.C. § 7261(b)(1) to "take due account" of the application of 38 U.S.C. § 5107(b), the

"benefit-of-the-doubt" rule in every case. Under this rule, the Secretary is charged with the duty to

consider all information and evidence of record and, when there is an "approximate balance of

positive and negative evidence regarding any issue material to the determination of the matter, the

Secretary shall give the benefit ofthe doubt to the claimant." 38 U.S.C. § 5107(b); see also Mariano

v. Principi, 17 Vet.App. 305, 313 (2003) (also referring inferentially to benefit-of-the-doubt rule as

"equipoise standard"); 38 C.F.R. § 3.102 (2004). Put another way, under the benefit-of-the-doubt

rule, "the preponderance of the evidence must be against the claim for benefits to be denied."

Gilbert, 1 Vet.App. at 54; see Robinette v. Brown, 8 Vet.App. 69, 76 (1995) ("the unique evidentiary

burdens in the VA adjudication system . . . permit a merits disallowance only where the evidence

preponderates against the claim"); see also Ortiz v. Principi, 274 F.3d 1361, 1365 (Fed. Cir. 2001)

("benefit of the doubt rule may be viewed as shifting the 'risk of nonpersuasion' onto the VA to

prove that the veteran is not entitled to benefits"). In application, this rule creates a preponderanceagainst-the-claim evidentiary standard that applies to every finding of material fact. See Mariano,

Robinette, and Gilbert, all supra. The Court cannot carry out its section 7261(b) responsibility to

"review the record of proceedings before the Secretary and the Board . . . and . . . take due account

of the Secretary's application of section 5107(b)", 38 U.S.C. § 7261(b), (b)(1), without referring to

the probativeness of the evidence that the Board weighed in finding that the evidence preponderated

against the claim. Indeed, that is exactly what the Court did three times in its opinion in Mariano,

17 Vet.App. at 313-17.

Although in Gilbert the Court indicated that a review of the Board's application of the

benefit-of-the-doubt rule would be under the "arbitrary, capricious, an abuse of discretion, or

otherwise not in accordance with law" standard of review pursuant to 38 U.S.C. § 7261(a)(3)(A),
18

Gilbert, 1 Vet.App. at 58 (dictum), such a review was not carried out there because the Court

concluded that the Board's statement of reasons or bases was inadequate, thereby warranting

remand, id. at 59. More recently, the Court held that it reviews the "outcome" of the Board's

application of the benefit-of-the-doubt rule under the "clearlyerroneous" standard ofreview set forth

in 38 U.S.C. § 7261(a)(4), and then proceeded to apply that standard of review. Mariano, supra

(quoting Roberson v. Principi, 17 Vet.App. 135, 146 (2003)). Accordingly, if the Court has "'the

definite and firm conviction that a mistake has been committed'" by the Board in finding that the

evidence preponderated against the claim on a finding of material fact, then section 7261(a)(4) and

section 7261(b)(1) require that such finding be held clearly erroneous and be reversed or set aside.

Gilbert, supra (quoting U.S. Gypsum Co., supra (reversing lower Court's finding of fact under

"clearly erroneous" standard of review));see also Veterans Benefits Act of 2002 (VBA), Pub. L. No.

107-330, § 401, 116 Stat. 2820, 2832 (enacting section 7261(b)(1) and revising section 7261(a)(4));

Mariano, supra (noting "clearly erroneous" standard of review applies to assessment of "outcome

of the Board's application" of benefit-of-doubt rule, thrice holding Board's application of section

5107(b) clearly erroneous, and twice reversing it and once setting it aside); Roberson, 17 Vet.App.

at 147 (noting no change to "clearly erroneous" standard of review). But see Wells v. Principi,

18 Vet.App. 33, 39 (2004) (en banc order) (Steinberg, J., dissenting to denial of full-Court decision)

(opining that VBA brought "about a major expansion of the Court's responsibilities as to review of

BVA factfinding").

The Secretary argues that the Court cannot hold clearly erroneous a Board finding unless the

evidence is uncontroverted against the Board's finding; specifically, the Secretary states: 

Reversal by the Court is warranted only when there is absolutely no plausible

basis for the [Board's] decision and where the [Board's] decision is clearly erroneous

in light of the uncontroverted evidence in [the a]ppellant's favor. Hicks v. Brown,

8 Vet.App. 417, 422 (1995). The medical evidence regarding nexus or aggravation

in this case is controverted, so reversal is not appropriate.

Sec'y Sur-Reply at 3. The Hicks language cited by the Secretary as authority for not finding clear

error unless the evidence is uncontroverted was derived from Hersey v. Derwinski, 2 Vet.App. 91,

95 (1992), where it was used to describe how strong the claimant's evidence was – it was

"uncontroverted". This characterization of the evidence in Hersey was not presented as a new or

different criterion for "clearly erroneous" review. See Hicks, supra; see also Wells v. Principi,
19

18 Vet.App. 33, 47-48 (en banc order) (Steinberg, J., dissenting to denial of full-Court decision)

(analyzing Hicks and Hersey in relation to Anderson, U.S. Gypsum Co., and Gilbert); id at 49-51

(Kasold, J., dissenting to denial of full-Court decision) (same). 

It is clear from U.S. Gypsum Co., Mariano, and Gilbert that the existence of some

controverting evidence (that is, evidence that is not in the appellant's favor) does not preclude this

Court from carrying out the mandates in section 7261(a)(4) and (b)(1) to "review the record of

proceedings before the Secretary and the Board" and then to "take due account of the Secretary's

application of [the] section 5107(b)" benefit-of-the-doubt rule (i.e., "the preponderance of the

evidence must be against the claim for benefits to be denied," Gilbert, supra), 38 U.S.C.

§ 7261(b)(1), that governs the Board's decisionmaking as to every finding of material fact, and to

"set aside or reverse" that application when it is "clearly erroneous," 38 U.S.C. § 7261(a)(4). See

Mariano, 17 Vet.App. at 313-17 (twice holding Board's findings clearly erroneous even though

evidence was not uncontroverted); see also U.S. Gypsum Co., 333 U.S. at 395-96 (finding lower

court's finding clearly erroneous where evidence was not uncontroverted). To the extent that Hicks

and other precedent relying on Hersey can be read to support the proposition that a Board finding

cannot be clearly erroneous unless the evidence against that finding is uncontroverted, that precedent

is overruled unanimously.

In reviewing the Board's decision to deny secondary service connection for the right-hip

disability in light of the entire record in this case, we note that there are two doctors with intimate

knowledge of Mr. Padgett and his medical status who opine that his left-knee injury "directly

aggravated," "adversely impacted," or otherwise "contributed to" or "resulted in" his right-hip

problems. R. at 261-62, 325, 340. Dr. Thoburn, a rheumatologist, was aware of Mr. Padgett's knee

condition since at least 1975, when Dr. Thoburn was consulted by another doctor who believed that

Mr. Padgett had severe degenerative arthritis and a possible torn medial meniscus of the left knee.

R. at 162. In 1976, Dr. Thoburn treated Mr. Padgett for, inter alia, degenerative arthritis of the left

knee. R. at 189-91. Dr. Shaw, an orthopaedic surgeon, began treating Mr. Padgett in 1982,

performed his right-total-hip arthroplasty in 1989, and evaluated his medical condition in follow-up

medical evaluations through 1991. R. at 226-37. Dr. Shaw provided copies of his periodic

evaluations to Dr. Thoburn throughout his treatment of Mr. Padgett. R. at 226-37.
20

The Board noted Dr. Shaw's opinion that Mr. Padgett's "in service left knee injury resulted

in severe traumatic osteoarthritis of the left knee which adversely impacted the progression of

degenerative disease of the right hip and aggravated his symptoms" and that his "in service left knee

injury resulted in an irregular gait pattern which directly aggravated his right hip symptoms." R. at

17. Further, the Board noted Dr. Thoburn's opinion that Mr. Padgett's "left knee condition resulted

in his weight shifting to the right side, which resulted in the progression of osteoarthritis of the right

hip." Id.

In contrast to the opinions of Drs. Shaw and Thoburn, which are based on personal

examinations and knowledge of Mr. Padgett's pertinent medical and physical history, including

direct observation of the alteration of his gait, are the opinions of Drs. Henderson and Blincow, the

VA doctors. Dr. Henderson examined Mr. Padgett but, contrary to what the Board stated in its

decision, he did not review the claims file. R. at 16, 361 (Dr. Henderson's report stating, "C file was

not available for review"). Dr. Henderson's report also made no mention of Mr. Padgett's in-service

right-hip injury. R. at 360-63. These factors render Dr. Henderson's report of "questionable

probative value." Mariano, 17 Vet.App. at 317 (flawed methodology in creating medical report

rendersreport of "questionable probative value"); Bielby v. Brown, 7 Vet.App. 260, 268 (1994) ("In

order for an expert's opinion to be based upon the facts or data of a case, those facts or data must be

disclosed to or perceived by the expert prior to rendering an opinion[;] otherwise the opinion is

merely conjecture and of no assistance to the trier of fact.") (emphasis in original); Green v.

Derwinski, 1 Vet.App. 121, 124 (1991) (duty to assist requires providing claimant with "thorough

and contemporaneous" medical examination that "takes into account the records of prior medical

treatment"); 38 C.F.R. § 4.1 (2004) ("It is . . . essential both in the examination and in the evaluation

of a disability, that each disability be viewed in relation to its history.").

Moreover, Dr. Henderson's diagnosis was not definitive, stating that the "fact that both hips

and knees are affected by this problem [(i.e., degenerative joint disease)] suggest[s] that it is a

consequence of the aging process," further stating that the "fact that he did injure the left knee . . .

50 years ago suggest[s] that this may have played a part in the damage that required a knee

replacement, but not necessarily a hip replacement," and further noting that "[f]or a more definitive

opinion, it is suggested that a certified orthopedist review this case." R. at 363 (emphasis added).

The latter statement diminishes further the value of this report as probative medical evidence. See
21

Espiritu v. Derwinski, 2 Vet.App. 492, 494-95 (1992) (question involving special knowledge

requires witness skilled in that area); see also Sklar v. Brown, 5 Vet.App. 140, 146 (1993)

(specialist's opinion on medical matter outside his or her specialty to be given little weight);

Guerrieri v. Brown, 4 Vet.App. 467, 470-71 (1993) ("probative value of medical opinion evidence

is based on the medical expert's personal examination of the patient, the physician's knowledge and

skill in analyzing the data, and the medical conclusion that the physician reaches"); cf. Bloom v.

West, 12 Vet.App. 185, 187 (1999) (speculative medical opinion cannot establish in-service medical

nexus to service). 

Dr. Blincow's report fares not much better. Although direct examination of Mr. Padgett by

a medical expert is not necessary to make the expert's medical report competent, see Black v. Brown,

10 Vet.App. 279, 286 (1997) (Kramer, J., dissenting) ("medical opinions obtained from . . . medical

experts provide sufficient bases for awarding a claim . . . and those physicians, by definition,

examine only records, not patients" (citing 38 C.F.R. § 20.901(a), (d)), the lack of a complete and

accurate record, at least as to material and relevant facts, certainly undercuts an expert medical

opinion's probative value. See Bielby, supra.

Dr. Blincow makes no reference to the in-service incurrence of Mr. Padgett's combat-related

right-hip injury, which the Board accepted as having occurred as Mr. Padgett had asserted. R. at 16;

see 38 U.S.C. § 1154(b); 38 C.F.R. § 3.304(d) (2004) ("[s]atisfactory lay or other evidence that an

injury or disease was incurred or aggravated in combat will be accepted as sufficient proof of service

connection if the evidence is consistent with the circumstances, conditions or hardships of such

service"); cf. Caluza v. Brown, 7 Vet.App. 498, 508 (1994) (lay evidence of veteran's combat-related

injury must be accepted by Board as sufficient proof of in-service incurrence or aggravation of

injury absent clear and convincing proof to contrary), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (table).

Indeed, Dr. Blincow notes in hisreport that there "is no recorded record of any injury to the patient's

right hip at the time of the [1944 left-knee injury]" (R. at 418) and that "[t]here is no mention of any

injury to the right hip in the medical records" (R. at 419). It is not the province of the Court to

speculate on the extent to which knowledge of Mr. Padgett's right-hip injury in service would have

affected Dr. Blincow's medical conclusions; indeed, the materiality and relevance of that knowledge

is itself a medical question. It is, however, axiomatic that without knowledge of Mr. Padgett's righthip injury, Dr. Blincow's conclusions with regard to the etiology of Mr. Padgett's current right-hip
22

disability are necessarily based on incomplete information and rendered suspect. Accordingly, Dr.

Blincow's conclusions with regard to Mr. Padgett's right-hip disability, having been made in the

absence of a potentially material and relevant fact, are also of "questionable probative value."

Mariano, 17 Vet.App. at 317; see also Bielby, supra; Reonal v. Brown, 5 Vet.App. 458, 461 (1993)

("opinion based upon an inaccurate factual premise has no probative value").

Despite the infirmities in the reports of Drs. Henderson and Blincow, and the lack of such

infirmities regarding the opinions of Drs. Shaw and Thoburn, the Board found that the probative

value of the opinions of Drs. Henderson and Blincow "far outweighed" the value of the opinions of

Drs. Shaw and Thoburn. Based on this weighing of the evidence, the Board found that Mr. Padgett's

right-hip injury was not secondarily service connected because the preponderance of the evidence

was against that claim. R. at 18. However, given the little probative weight, if any, that can legally

and reasonably be accorded the opinions of Drs. Henderson and Blincow, as opposed to the opinions

of Drs. Shaw and Thoburn that strongly support secondary service connection for the right-hip

injury, the finding of the Board that the evidence preponderated against this claim is simply not

"plausible in light of the record viewed in its entirety," Gilbert, 1 Vet.App. at 52 (quoting Anderson,

470 U.S. at 574); see also 38 C.F.R. § 3.303(a) (2004) ("[d]eterminations as to service connection

will be based on review of the entire evidence of record"), and the Court has "'the definite and firm

conviction that a mistake has been committed.'" Gilbert, supra (quoting U.S. Gypsum Co., supra);

see Mariano, 17 Vet.App. at 314-17.

The only plausible resolution of the key factual issue on the record in this case is that Mr.

Padgett's right-hip disability was aggravated by his service-connected left-knee disability, and the

Board's decision that the evidence preponderated against this claim must therefore be, and will be,

reversed. See 38 U.S.C. § 7261(a)(4) (Court must "reverse or set aside" clearly erroneous finding

of material fact); Pullman-Standard v. Swint, 456 U.S. 273, 292 (1982) (reversal is appropriate

where "the record permits only one resolution of the factual issue"); Mariano, supra; see also Ortiz,

274 F.3d at 1365 ("benefit of the doubt rule may be viewed as shifting the 'risk of nonpersuasion'

onto the VA to prove that the veteran is not entitled to benefits"); Robinette, 8 Vet.App. at 76 ("a

merits disallowance [is permitted] only where the evidence preponderates against the claim");

Gilbert, 1 Vet.App. at 54 ("the preponderance of the evidence must be against the claim for benefits

to be denied"). Accordingly, Mr. Padgett's claim for disability benefits on the basis of a right-hip
23

disability secondary to his service-connected left-knee disability will be remanded for assignment

of a disability rating and the effective date thereof. See Fenderson v. Principi, 12 Vet.App. 119, 127

(1999) (remanding for consideration of staged ratings in connection with initial award of service

connection).

Finally, the Court notes that it would be an anomalous use of 38 U.S.C. § 7104(a), a

provision designed to provide to VA claimants the benefit and protection of an administrative appeal

process within VA, to deny meaningful judicial review in this Court. Such an aberrant shield-tosword transformation, which was embraced bythe now-withdrawn panel opinion that this full-Court

opinion replaces, was addressed earlier in the consideration of this case, as follows: 

The right to "one review on appeal to the Secretary" provided in

section 7104(a) is a process right guaranteed to VA claimants, not the

Secretary who clearly has no right of appeal to this Court. To permit

the appellant's process right to operate as a shield from the Court's

review of the Board's arguably clearly erroneous denial of a claim is

to stand the statute and common sense on their heads.

Padgett v. Principi, 18 Vet.App. 223, 226 (2004) (per curiam order) (Steinberg, J., dissenting to

denial of full-Court decision) (citations omitted).

B. Board Decision as to Direct and Presumptive Service Connection for

Right-Hip Disability will be Remanded

The Board also denied Mr. Padgett's claims for disability benefits for a right-hip disability

on direct and presumptive bases. In so doing, the Board discounted the favorable opinions of Drs.

Shaw and Thoburn because they "appear[ed] to be largely based on Mr. Padgett's self-reported

history of having sustained a right-hip injury in service." The Board relied upon, inter alia, its

finding that "the most probative medical evidence on file" – the previously discussed faulty reports

of Drs. Henderson and Blincow – failed to demonstrate that the right-hip injury was incurred in or

aggravated by service or that the injury was manifested within one year after discharge from service.

R. at 16-17. 

At the outset, we note a serious incongruity in that the Board correctly accepts as true that

Mr. Padgett injured his right hip during combat in World War II, see 38 U.S.C. § 1154(b); 38 C.F.R.

§ 3.304(d) (2004); cf. Caluza, supra, but then rejects as not probative the opinions of Drs. Shaw and

Thorburn, in part, because they relied on Mr. Padgett's report that he had injured his right hip in

service. R. at 16. Having accepted as true that Mr. Padgett injured his right hip during war, it was
24

error then to reject the reports of Drs. Shaw and Thorburn because they relied on that fact. Cf.

Bailey v. Derwinski, 1 Vet.App. 441, 447 (1991) (reversing as clearly erroneous 1990 Board finding

that arthritis of shoulder was due to aging process rather than trauma when 1988 Board had found

that "almost identical evidence" as to arthritis of wrist showed arthritis to be posttraumatic in

nature); see also Otero-Castro v. Principi, 16 Vet.App. 375, 382 (2002) (relying on Bailey, supra);

Thomas v. Principi, 16 Vet.App. 197, 200 (2002) (citing Bailey, supra, for proposition that Board

"must be reversed because inconsistent VA factfinding was reached in 'arbitrary and capricious'

manner in violation of 38 U.S.C. § 7261(a)(3)(A)"). On remand, the Board may not assign

diminished probative value to these reports on the basis that they relied upon Mr. Padgett's report

of a hip injury during combat.

Moreover, as noted above, neither Dr. Blincow nor Dr. Henderson knew or understood that

Mr. Padgett had actually or presumably injured his right hip during combat in World War II, as was

accepted as true by the Board. See R. at 16. Without this information, these doctors could not (and

did not) form an opinion regarding a nexus between the in-service incurrence of that injury and his

current right-hip disability. See Caluza, 7 Vet.App. at 506 (service connection requires medical

nexus between in-service incurrence or aggravation of injury and appellant's current disability).

Accordingly, insofar as these reports relate to a direct- or presumptive-service-connection

assessment, they have no probative value. See Mariano and Reonal, both supra.

Whereas with the secondary service-connection issue the record contains substantial

evidence that Mr. Padgett's right-hip disability was secondary to his service-connected left-knee

injury and the Board's decision that the evidence preponderated against that claim was clearly

erroneous, warranting reversal, the record is silent as to a medical nexus between Mr. Padgett's

current right-hip disability and the incurrence, either on direct or presumptive bases, of his right-hip

injury in service. See Caluza, supra. Moreover, the necessary factual determinations cannot be

made by this Court in the first instance. See Hensley v. West, 212 F.3d 1255, 1263 (Fed. Cir. 2000)

(appellate tribunals are not appropriate fora for initial factfinding); see also 38 U.S.C. § 7261(c).

Accordingly, the decision of the Board as to Mr. Padgett's claim for disability benefits for

his right-hip disability on direct or presumptive bases will be set aside and the matter remanded for

readjudication and any additional development necessary. See Bucklinger v. Brown, 5 Vet.App. 435,

440 (1993) (remand is the appropriate remedy when the Board has failed to make necessary findings
25

of fact); 38 C.F.R. § 19.9 (2004) (requiring Board, when additional development is necessary, to

remand to RO for further development or to direct Board personnel to undertake appropriate action).

C. Remand Proceedings

On remand, Mr. Padgett will have the opportunity to present any additional evidence and

argument in support of his claim, and the Board must consider any evidence and argument so

presented. See Kay v. Principi, 16 Vet.App. 529, 534 (2002). The Court notes that Mr. Padgett is

a combat veteran who is now 83 years old and has already waited over twelve years to have his

claim finally decided. In light of this, judgment will be entered and mandate will issue 10 days after

the date on which this opinion is issued. See U.S. VET. APP. R. 2 (suspension of rules), 35 (motion

for reconsideration), 36 (entry of judgment), 41(a) (issuance of mandate); see also Mariano,

17 Vet.App. at 318 (same order regarding judgment and mandate). The Court expects that the

Secretary will provide expeditious treatment of this matter on remand. See 38 U.S.C. §§ 5109B,

7112; see also Vargas-Gonzalez v. Principi, 15 Vet.App. 222 (2001).

IV. CONCLUSION

On consideration of the foregoing, the August 8, 2002, decision of the Board with regard to

Mr. Padgett's secondary-service-connection right-hip disability claim is REVERSED; the decision

with regard to Mr. Padgett's presumptive and direct service-connection right-hip disability claims

is SET ASIDE; and the entire matter is REMANDED for further proceedings consistent with this

opinion.

REVERSED IN PART; SET ASIDE IN PART; and REMANDED.

HAGEL, Judge, concurring in part and dissenting in part: I join in the Court's opinion to the

extent that it overrules the Court's precedents that "can be read to support the proposition that a

Board finding [of fact] cannot be clearly erroneous unless the evidence against that finding is

uncontroverted." Ante at 18. Reversal is not limited to instances where the evidence is

uncontroverted in an appellant's favor – that limitation sets the bar prohibitively high. Rather, this

Court can reverse a Board finding of fact when the Court possesses "a definite and firm conviction

that a mistake has been committed." Hersey v. Derwinski, 2 Vet.App. 91, 94 (1992) (quoting United

States v. U. S. Gypsum Co., 333 U.S. 364, 395 (1948)). It is unfortunate that the uncontroverted-
26

evidence standard has crept into our jurisprudence, and I am pleased that the Court today

emphatically eradicates that errant standard. That said, for the reasons provided below, I dissent

from the Court's conclusion that VA medical opinions ordered by the Board pursuant to VA

regulation 38 C.F.R. § 20.901(a) (2004) are exempt from an appellant's statutory right to "one

review on appeal to the Secretary" provided for in 38 U.S.C. § 7104(a). 

In Disabled American Veterans v. Secretary of Veterans Affairs, the Federal Circuit

invalidated VA regulation 38 C.F.R. § 19.9(a)(2) (2002) because that regulation would have allowed

the Board, "the only appellate tribunal under the Secretary," "to gather and consider evidence that

had not been before the regional office without having to remand the case to the regional office "for

initial consideration and without having to obtain the appellant's waiver." 327 F.3d 1339, 1347 (Fed.

Cir. 2003) [hereinafter DAV v. Sec'y]. The Federal Circuit based its finding on section 7104(a),

which provides that "all questions in a matter which . . . is subject to decision by the Secretary shall

be subject to one review on appeal to the Secretary" and because, in its view, "[w]hen the Board

obtains evidence that was not considered by the [regional office] and does not obtain the appellant's

waiver, . . . an appellant has no means to obtain 'one review on appeal to the Secretary' because the

Board is the only appellate tribunal under the Secretary." Id. In reaching this decision , the Federal

Circuit then stated, in what can be characterized fairly as dicta, as follows:

Furthermore, we note that when Congress intended to authorize the Board to obtain

additional evidence without "one review on appeal to the Secretary," it knew how to

do so. Congress has provided express statutory authority to permit the Board to

obtain additional evidence, such as expert medical opinions in specific cases. See,

e.g., 38 U.S.C. § 5107(a) (2000) (authorizing Board to obtain medical opinions from

the VA's Under Secretary for Health (formerly the Chief Medical Director));

38 U.S.C. § 7109 (2000) (authorizing Board to obtain independent medical opinions

from outside the VA); 38 C.F.R. § 20.901(a) (2002) (authorizing Board to obtain

opinions from the Veterans Health Administration); 38 C.F.R. § 20.901(b)

(authorizing Board to obtain medical opinions from the Armed Forces Institute of

Pathology).

Id. at 1347-48 (emphasis added). In other words, the Federal Circuit in DAV v. Sec'y instructed us

that the Board is prohibited from considering in the first instance evidence without either obtaining

an appellant's waiver of regional office consideration of that evidence or express statutory authority

to consider such evidence in the absence of a such a waiver.
27

First, I note that 38 U.S.C. § 5107(a) (2000) did not expressly authorize the Board to obtain

medical opinions from VA's Under Secretary for Health and that the majority appears to concede

as much. See 38 U.S.C. § 5107(a) (2000) (providing, prior to the enactment of the Veterans Claims

Assistance Act of 2000, Pub. L. No. 106-475, 114 Stat. 2096, that "[t]he Secretary shall assist such

a claimant in developing the facts pertinent to the claim"); ante at 9 ("[W]e note that section 5107(a)

does not expressly authorize the Board to obtain or secure medical opinions."). I also note that VA

is not Congress and that the regulation cited to by the Federal Circuit, 38 C.F.R. § 20.901 (a)

and (b), cannot support the proposition for which they are cited, namely that "Congress has provided

express statutory authority to permit the Board to obtain additional evidence, such as expert medical

opinions in specific cases." DAV v. Sec'y, 327 F.3d at 1347; see William Jameson & Co. v.

Morgenthau, 307 U.S. 171, 173-174(1939)(noting that an administrative regulation does not equate

to an Act of Congress). 

 As for section 7109, it appears that that statute is the only authority cited to by the Federal

Circuit that can even arguably support the proposition that Congress permitted the Board to obtain

expert medical opinions and to consider such evidence in the first instance without entitling an

appellant to "one review on appeal to the Secretary." 38 U.S.C. § 7104(a). Nevertheless, even

assuming for the sake of argument that Congress, in enacting section 7109, carved out an exception

to the right of an appellant to one review on appeal to the Secretary, in my view Mr. Padgett's case

does not implicate section 7109. The only way the majority can conclude that § 20.901 establishes

an exception to section 7104 is to conclude that section 7109 provides adequate congressional

authority for this regulation. Because the majority's decision is premised on the conclusion that

section 7109 provides authority for the Board to obtain and consider VA medical opinions in

addition to independent medical opinions, I cannot concur in that portion of the Court's opinion.

Further, whether section 7109 establishes an exception to the principle expounded in DAV v. Sec'y

in cases where independent medical opinions are requested and, if so, the parameters of such an

exception would be more appropriately examined in a case where those issues are squarely

presented. This is not such a case.

The majority's conclusion to the contrary turns solely on the existence in section 7109(a) of

the nonessential phrase "in addition to that available within the Department." Ante at 10. In my

view, the majority, in its rush to analyze the evidence and reach a conclusion with which I am in
28

sympathy, has adopted an interpretation ofsection 7109 that stretches the phrase "in addition to that

available within the Department" too far. Congress, in section 7109 itself and in the legislative

history underlying that statute, merely recognized that there existed, at the time that that statute was

enacted, preexisting authority for the Board's practice of obtaining VA medical opinions – such

authority was not vested in the Board by section 7109. The Senate committee's statement makes

clear that "ample authority" for the Board's practice of securing a medical opinion from within VA

already existed at the time of section 7109's enactment and that the Senate version of the bill, which

ultimately became what is now section 7109, was therefore making "no reference to the Board

securing an advisory opinion from the Chief Medical Director of VA." S.REP.NO. 87-1844 (1962),

reprinted in U.S.C.C.A.N. 2585, 2586. In that regard, I note the existence of 38 U.S.C. § 212

(1962), which provided the Administrator (now the Secretary) with the authority "to assign

duties . . . to such . . . employees as he may find necessary." It is beyond my comprehension that

Congress would pass a statute whose purpose was to authorize that which was already authorized

and to provide authority for a practice already supported by ample authority. 

Artfully casting Congress as having "approved" of a preexisting practice or as having

"sanctioned" such a practice does not transform what is in essence a recognition of then-preexisting

authority into an instrument that grants such authority. See Ante at 10. As I read section 7109 and

its legislative history, that section did one thing and one thing only; it authorized the Board to obtain

medical opinions from experts who were independent of VA. The initiation of the legislative

process that culminated in the passage of what is now section 7109 was motivated by a desire to

combat a perception of VA bias and to "inspire, in the veteran, the confidence that his claim is

receiving objective consideration." 108 CONG.REC. H5518 (Apr. 2, 1962) (statement of Rep. Lane).

For that reason, in addition to those stated above, it strikes me as improvident to cite the very statute

that authorized the Board to procure non-VA medical opinions as the authority for the Board to

obtain VA medical opinions. That said, I do not question whether the Board is permitted to obtain

VA medical opinions; I simply express my opinion that the authority vested in the Board by

§ 20.901(a) is not rooted in section 7109 but elsewhere, for instance § 20.901 cites as authority 38

U.S.C. § 5103A(d) in addition to section 7109. Because I do not believe that section 7109 is the

authority that permits the Board to obtain VA medical opinions, because I see no reason to believe

that section 5103A(d) establishes an exception to section 7104(a), and because no other statutory
29

authority has been advanced that would permit the Board to consider in the first instance Boardordered VA medical opinions, an exception to section 7104(a)'s grant of "one review on appeal to

the Secretary" is not implicated in the instant case. Absent such an exception, the Federal Circuit's

decision in DAV v. Sec'y compels me to conclude that before the Board can consider a VA medical

opinion that it orders pursuant to § 20.901, it must either obtain the claimant's waiver of regional

office consideration of that evidence or remand the matter for regional office adjudication. DAV v.

Sec'y, 327 F.3d at 1347. 

The foregoing discussion leaves open the question of whether reversal is the appropriate

remedy in this case. Reluctantly, I am compelled to conclude that it is not. Although I would tend

to agree with the majority's evaluation of the evidence, because the Board was not permitted to

consider Dr. Blincow's report without (1) Mr. Padgett's waiver of regional office consideration of

that evidence or (2) remanding the matter for regional office adjudication, the Board's findings with

respect to that report are void. It follows then that by evaluating Dr. Blincow's opinion, the majority

is engaged in factfinding in the first instance, which it is prohibited by law from doing. See

38 U.S.C. § 7261(c); Hensley v. West, 212 F.3d 1255, 1263 (Fed. Cir. 2000) (stating that "appellate

tribunals are not appropriate fora for initial factfinding"). If Mr. Padgett had wanted us to review

the Board's factual conclusions with respect to Dr. Blincow's opinion, he could have so argued and

could have waived regional office consideration of Dr. Blincow's opinion. If he had done so before

us, it would not be inappropriate for us to review the Board's findings of fact with respect to that

piece of evidence. However, he has not advanced such an argument nor made such a request.

Specifically, he does not seek reversal based on a review of all of the evidence considered by the

Board, but only a portion thereof – his argument for reversal is premised on his contention that the

Court should exclude from consideration due to various alleged inadequacies or procedural defects

VA medical opinions, including that of Dr. Blincow. Appellant's Brief (Br.) at 16-26; Reply Br.

at 6-7. He has never argued for reversal based on a review of all the evidence of record, i.e., the

totality of the evidence relied upon by the Board in rendering its decision. Regarding waiver, he was

well aware of his ability to waive his right to a remand in order to have the Court reach the merits

of his claim. In fact, he specifically waived consideration of any potential error with respect to

deficient notice under the Veterans Claims Assistance Act (Reply Br. at 1-2) and his representative

reaffirmed the limited scope of that waiver when questioned on the subject during oral argument.
30

Accordingly, this matter should be remanded to the Board and, in turn and absent a waiver by Mr.

Padgett, by the Board to the regional office for initial adjudication based on the full record and after

appropriate regional office action the opportunity for "one review on appeal to the Secretary," if Mr.

Padgett should invoke that right in a timely fashion. 38 U.S.C. § 7104(a).

IVERS, Chief Judge, dissenting: Because Judge Hagel finds that the majority errs in its

analysis regarding the applicability of Disabled Am. Veterans v. Sec'y Veterans Affairs, 327 F.3d

1339 (Fed. Cir. 2003), to this matter, while engaging in impermissible factfinding to reach its

conclusion that reversal, rather than remand is the appropriate remedy, I join in his separate

statement. However, I write separately to address my own concerns that, in its effort to reach a

clearly sympathetic outcome, the majority ignores this Court's role as an appellate body, and parses

the medical evidence of record to arrive at that outcome. 

As Judge Hagel correctly states in his dissent, this Court, as an appellate body, is prohibited

both by statute and longstanding precedent, from making initial findings of fact. See 38 U.S.C.

§ 7261(c); Andre v. Principi, 301 F.3d 1354 (Fed. Cir. 2002); Elkins v. Gober, 229 F.3d 1369 (Fed.

Cir. 2000); Hensley v. West, 212 F.3d 1255 (Fed. Cir. 2000). The Federal Circuit has stated, with

uncompromising clarity, that lest this Court become a factfinder, rather than a court of appellate

review, "fact-finding is to be performed by the expert BVA", not by the judges of this Court. Elkins,

229 F.3d at 1377. Here, however, the majority determines that a mistake has been made, then goes

well beyond the bounds of appellate jurisprudence, and engages in factfinding to support the

credibility of its own findings in support of that determination. Rather than reviewing the Board's

application of the law and arriving at its decision to reverse the Board's finding that the evidence

preponderates against Mr. Padgett's claim for entitlement to service connection for osteoarthritis of

the right hip on a secondary basis, and because "[it] is left with a definite and firm conviction that

a mistake has been committed", Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990), the majority appears

not only to review the evidence de novo, but also parses the evidence, substituting its judgment for

that of the Board. Ante at 18-21. In order to reach its conclusion that reversal rather than remand

is proper here, the majoritymust know with certainty that, but for the flaws in the VA examinations,

the Board would have found in the appellant's favor. By weighing and discounting some of
31

evidence, the majority leaves only medical evidence favoring the appellant's claim. That evidence,

by the Court's action, then becomes uncontroverted.

While I do not disagree with the majority's statement that "the existence of some

controverting evidence . . . does not preclude this Court from carrying out the mandates in section

7261(a)(4) and (b)(1)", I must strongly disagree with the majority's treatment of our jurisprudence

in both Hersey v. Derwinski, 2 Vet.App. 91 (1992), and Hicks v. Brown, 8 Vet.App. 417 (1995). The

language in Hicks that reversal is the appropriate remedy when there is absolutely no plausible basis

for the BVA's decision and where that decision is clearly erroneous in light of the uncontroverted

evidence in the appellant's favor derives from our decision in Hersey, which had characterized the

evidence in the appellant's favor as "uncontroverted" and did not add that criterion to the standards

for a finding of "clearly erroneous." Hersey and Hicks were thereafter followed in a number of

opinions requiring that the evidence in favor of the appellant be uncontroverted for reversal, an

unanticipated result. See, e.g., Pentecost v. Principi, 16 Vet.App. 124, 129 (2002); Ardison v.

Brown, 6 Vet.App. 405, 409 (1994).

I agree with Judge Hagel that correcting the course of our jurisprudence where it appears to

veer from its intended course is a welcome outcome of this matter and I concur in that correction,

even though this is not an appropriate case in which to overrule Hersey or Hicks. The majority here

eliminates the VA evidence against the claim on the bases that one opinion was based on an

inaccurate premise and that the other was rendered without the appellant's claims file without regard

to the entirety of the evidence of record. By parsing the evidence in this manner and ignoring the

extenuating factors of the appellant's weight (described as variously as "obese" and "morbidly

obese") (R. at 226-27, 325), medical and family history of degenerative arthritis (R. at 226, 230, 325,

340, 363, 418-20), the only remaining medical evidence favors of the appellant's claim, and, unlike

both Hersey and Hicks, where the evidence was, indeed, uncontroverted, the evidence here truly

becomes uncontroverted as a result of the Court's action. Because it would decide the case

differently than the Board below, the majority, feeling that a mistake has been made, does not

merely consider and weigh all of the evidence, it discriminates among the evidence and then reaches

its result. 

The majority's desire to elevate the concurrence in Gilbert, without expressly overruling

Gilbert's holding, is palpable, but this is not the case in which to do so. Even if we agree that the
32

concurrence in Gilbert should be given more weight, to do so by slighting our responsibility as an

appellate court is wrong. In Gilbert, this Court adopted the definition of "clearly erroneous" put

forward by the Supreme Court in United States v. U.S. Gypsum Co., 333 U.S. 364 (1948), and in

Anderson v. City of Bessemer City, 470 U.S. 564 (1985). Since Gilbert, the Court has continued to

apply this definition. See Duenas v. Principi, 18 Vet.App. 512, 519 (2004); Burris v. Principi,

15 Vet.App. 348, 353 (2001); Bowling v. Principi, 15 Vet.App. 1, 15-16 (2001); Pond v. West,

12 Vet.App. 341, 345 (1999); Villano v. Brown, 10 Vet.App. 248, 249-50 (1997); Slater v. Principi,

4 Vet.App. 43, 44 (1993) (per curiam order); Hersey, 2 Vet.App. at 94. While it may be appropriate

and timely to reexamine Gilbert, the facts of this case do not lend themselves to doing so. Here

again, the extenuating factors of the appellant's weight, medical and family history of degenerative

arthritis complicate the evidence confronting both the Board below and this Court on appeal. 

The majority's approach throughout this matter is illustrative of the danger inherent in

applying the arguably subjective standard that, when "the reviewing court . . . is left with a definite

and firm conviction that a mistake has been made," (Gilbert, 1 Vet.App. at 52) without the

tempering effect of a review of the "entire" evidence and a recognition of the rarity of fact-finding

in the appellate process.

Lastly, I note that the majority, without addressing the Court's longstanding rejection of the

"Treating Physician Rule" (see Winsett v. West, 11 Vet.App. 420 (1998); Guerrieri v. Brown,

4 Vet.App. 467, 473 (1993); Chisem v. Brown, 4 Vet.App. 169, 176 (1993)), comes perilously close

to its adoption by its approach to the appellant's private treating physicians. By failing to address

the nonapplicability of the Treating Physician Rule, while appearing to apply it, the majority leaves

in question the status of this Court's long-held position on this matter, and may, in fact, sub silentio,

appear to overturn our previous holdings on this matter.