Source: https://veteranclaims.net/2009/03/21/muscle-injury-beyrle-v-brown-through-and-through/
Timestamp: 2019-04-26 04:25:41+00:00

Document:
through[-]and[-]through injury, with muscle damage, is always at least a moderate injury, for each group of muscles damaged.” Entitlement to a moderate disability rating under section 4.72 does not require a finding of muscle damage, but does necessitate a finding of muscle involvement. See Beyrle v. Brown, 9 Vet.App. 377, 383 (1996); Myler, 1 Vet.App. at 574. Pursuant to 38 C.F.R. 4.55(a) (1968), “[m]uscle injuries in the same anatomical region . . . will not be combined, but instead, the rating for the major group affected will be elevated from moderate to moderately severe, or from moderately severe to severe.” In Myler, supra, the Court held that the Board committed CUE when it failed to assign a moderately severe rating for a through-and-through wound affecting MGs XIII and XIV under extant regulations that mirrored sections 4.55(a) and 4.72 as they existed in 1968.
30% disability rating for residuals of the appellant’s right thigh wounds was CUE. The 1968 rating decision awarded the appellant service connection for a gunshot wound to MG XIV, the anterior of the thigh. That injury was rated as moderate, or 10% disabling, under DC Previous Document5314Next Hit. See R. at 109. The medical evidence of record before the ratings board in 1968 included records of the appellant’s treatment at USAF and USN hospitals.
The USAF hospital records indicate that he suffered two wounds to the right thigh. While it could not be determined at that time whether the wounds were through-and-through, one of the wounds originated at the posterior of the thigh (MG XIII) and was “relatively deep,” involving the rectus femoris muscle in the anterior of the thigh (MG XIV). R. at 61.
Upon transfer to the USN hospital for more extensive treatment, it was determined that his right thigh injury was a through- and-through wound. R. at 58. Records from the USN hospital also show that in July 1966 the appellant had skin grafts to the posterior of his right thigh. R. at 53, 59. The record in November 1968 also contained the report of the October 1968 VA special orthopedic examination. That report described the pertinent wound as “through the right thigh.” R. at 96. The examiner described a 4- inch by 1¼-inch scar on the posterior of the right thigh with tissue missing below the scar. R. at 97. X-rays showed numerous bits of shrapnel in the posterior of both thighs. R. at 98.
In the decision on appeal, the Board observed that the appellant’s medical records described scars on the right posterior thigh from a through-and-through wound and a loss of tissue beneath the scar. R. at 21. However, the Board, like the RO in 1968, failed to consider a separate rating for the posterior thigh muscles or how the rating of the appellant’s thigh injuries are affected by 38 C.F.R. 4.55(a) and 4.72 (1968). The medical evidence before the Board in 1968 clearly establishes that the appellant suffered a through-and-through wound that penetrated through the posterior of his thigh, MG XIII, and into the muscles in MG XIV in the anterior of the thigh. It is undebatable that such a wound involved the muscles in the posterior of his thigh. Thus, pursuant to section 4.72, the appellant should have been awarded a moderate rating for MG XIII, in addition to his moderate rating for MG XIV. See Beyrle, 9 Vet.App. at 383; Myler, 1 Vet.App. at 574; 38 C.F.R. 4.73, Diagnostic Code (DC) 5313 (1968).
residuals of a gunshot wound of the right upper extremity; and (5) denied an effective date prior to June 1, 1989, for the assignment of a combined 100% disability evaluation. Record (R.) at 1-27. This appeal is timely and the Court has jurisdiction pursuant to 38 U.S.C. 7252(a). The pro se appellant has filed an informal brief and a reply brief. The Secretary has filed a brief. Single-judge disposition is appropriate when, as here, the issue is of relative simplicity and the outcome is not reasonably debatable. See Frankel v. Derwinski, 1 Vet.App. 23, 25-26 (1990).
The Court will reverse and remand in part and vacate and remand in part the Board decision.
wounds to the right upper arm, right forearm, both thighs and left foot.
involving the rectus femoris muscle. R. at 61.
that the wounds to his right thigh were through- and-through. R. at 58.
performed and fusion of that joint and the distal joint was accomplished.
grafts to the posterior of his right thigh. R. at 53, 59.
duty. R. at 88-90. The veteran was medically discharged in January 1968.
scars and neuroma in lateral scar above the elbow.
compartments quadriceps, femoral vastus lateralis as described.
Numerous bits of shrapnel in the soft tissues-both thighs.
. . . . Retained bits of shrapnel big [and] 2nd toes.
proximal area of the forearm.
assigned a 100% prestabilization disability rating under 38 C.F.R. 4.
rating as of October 10, 1968. Id.
with respect to the May 1990 effective date for his 100% combined rating.
left 2nd toe, and a painful scar on the right upper arm. R. at 203-05.
next level). R. at 206-07.
pending completion of a new VA examination. R. at 212.
palsy and assigned a 20% rating for the condition effective October 1995.
280. This resulted in a combined rating of 100%, effective June 1, 1989.
90% from October 10, 1968, until June 1, 1989. R. at 280-83.
wound fracture of the right upper arm. R. at 326.
Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096. R.
10% rating for residuals of a gunshot wound of the right thigh.
claims with respect to the 1968 RO decision. Id. at 12.
Although the VCAA is not applicable to CUE claims, see Livesay v.
claimant’s possession that pertains to the claim.
Veterans Affairs, 345 F.3d 1334, 1347 (Fed. Cir. 2003) (noting that 3.
to identify “who is responsible for obtaining such evidence.” Id.
to 38 U.S.C. 7104(a) and (d)(1)).
speculation. See Wagner v. United States, 365 F.3d 1358, 1365 (Fed. Cir.
have been had the error not occurred.”); Daniels v. Brown, 9 Vet.App.
any additional factual or evidentiary development. See Valiao v.
having taken “due account of the rule of prejudicial error,” 38 U.S.C.
before the Board at the readjudication.” Best v. Principi, 15 Vet.
Fletcher v. Derwinski, 1 Vet.App. 394, 397 (1991); see also 38 U.S.C.
provide “expeditious treatment” for claims remanded by the Court).
future appeal. See Best, supra.
268 (2003) (citing Disabled Am. Veterans, 234 F.3d at 696-98); Cook v.
Principi, 318 F.3d 1334, 1338- 41 (Fed. Cir. 2002), cert. denied, 539 U.S.
the decision is supported by an adequate statement of reasons or bases.
38 U.S.C. 7261(a)(3)(A), 7104(d)(1); see Lane v. Principi, 16 Vet.
slip op. at 7 (June 29, 2004).
of muscle damage, but does necessitate a finding of muscle involvement.
See Beyrle v. Brown, 9 Vet.App. 377, 383 (1996); Myler, 1 Vet.App.
sections 4.55(a) and 4.72 as they existed in 1968.
included records of the appellant’s treatment at USAF and USN hospitals.
rectus femoris muscle in the anterior of the thigh (MG XIV). R. at 61.
determined that his right thigh injury was a through- and-through wound.
bits of shrapnel in the posterior of both thighs. R. at 98.
XIII. See 38 C.F.R. 4.56(a), (b) (1968).
manifestly different. See Grover, Russell, and Myler, all supra.
precluded from raising his claim in the future. See Brown v. West, 203 F.
party and was also not addressed by the Board’s decision.

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