Source: https://veteranclaims.net/2009/04/15/new-and-material-claims-require-specific-vcaa-notification-kent-v-nicholson-no-04-181-decided-march-31-2006/
Timestamp: 2019-04-26 04:29:30+00:00

Document:
constitute “material” evidence to reopen the psychogenic disorder claim.
The terms “new” and “material” have specific, technical meanings that are not commonly known to VA claimants. Because these requirements define particular types of evidence, when providing the notice required by the VCAA, it is necessary, in most cases, for VA to inform claimants seeking to reopen a previously and finally disallowed claim of the unique character of evidence that must be presented.
section 5103(a) and 3.159(b) require VA to review the information and the evidence presented with the claim and to provide the claimant with notice of what information and evidence not previously provided, if any, will assist in substantiating or is necessary to substantiate each of the five elements of the claim, including notice of what is required to establish service connection and that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. Dingess v. Nicholdson, __Vet.App.__, No.01-1917 (Mar. 3, 2006); see also Collaro v. West, 136 F.3d 1304, 1308 (Fed. Cir. 1998) (stating that a service-connection claim that provides for disability-compensation benefits consists of the following five elements: “(1) Veteran status; (2) existence of a disability; (3) a connection between the veteran’s service and the disability; (4) degree of disability; and (5) effective date of the disability”); Fenderson v. West, 12 Vet.App. 119, 125 (1999) (stating same).
General Counsel; Richard Mayerick, Deputy Assistant General Counsel; and Barbara J. Finsness, all of Washington, D.C., were on the brief for the appellee.
Before HAGEL, LANCE, and SCHOELEN, Judges.
SCHOELEN, Judge: The appellant, Benjamin F. Kent, through counsel, appeals an October 8, 2003, Board of Veterans’ Appeals (Board or BVA) decision that determined that he had not presented new and material evidence to reopen his previously and finally denied claims for service connection for psychogenic gastrointestinal reaction and psoriasis. Record (R.) at 1-13. The appellant and the Secretary each filed a brief.
pursuant to 38 U.S.C. 7252(a) and 7266. For the reasons that follow, the Court will vacate the October 8, 2003, Board decision and remand the matters for further proceedings consistent with this opinion.
September 16, 1950, to January 20, 1951, when he received a medical discharge as a result of a disability. R. at 17. The report from his entrance medical examination reflects no mental or physical abnormalities. Id. On October 30, 1950, he visited sick bay with complaints of stomach pain and vomiting of blood. R. at 21. At that time, he reported that three years before he entered service he had had an “ulcer” with pain, nausea, and vomiting of blood. R at 21. He stated that he was treated by his midwife-grandmother. R. at 22. He reported that he had done well on a diet of soft food, and had experienced no further symptoms until four days prior to his visit to sick bay. R. at 21. He was diagnosed with acute gastroenteritis, and he was transferred to a naval hospital for treatment.Id. After a series of medical tests were performed, the appellant was diagnosed with “hematemesis, cause unknown.” R. at 23-24. In December 1950, after a second hospitalization for the same symptoms, the medical diagnosis was changed to “psychogenic gastrointestinal reaction.” R. at 25, 33. The appellant was also diagnosed as having “symmetrical acne” on his face and back. R. at 28. In January 1951, the Board of Medical Survey determined that the appellant was not medically fit for duty because of his psychogenic gastrointestinal reaction, and that the disability preexisted service and was not aggravated by service. R. at 33.
attempted unsuccessfully to reopen his claim. R. at 52-60.
not filed within the one-year appeal period. R. at 74.
The appellant attempted to reopen the service-connection claims for psoriasis and psychogenic gastrointestinal reaction in July 1999. R. at 95. In support of his claims, he submitted copies of his service medical records. R. at 97. On August 4, 1999, the RO determined that no new and material evidence had been submitted. Id.
concluded that the appellant had not submitted new and material evidence to reopen his claims for service connection for psoriasis and gastrointestinal psychogenic reaction. R. at 1-13.
interpretation of law pertaining to the presumption of soundness entitled him to a de novo readjudication of his claim for service connection for psychogenic gastrointestinal reaction. Appellant’s Brief (Br.) at 6-10.
Alternatively, he argues that changes in the interpretation of the law surrounding the presumption of soundness constituted new and material evidence to reopen his claim for psychogenic gastrointestinal reaction. Id. at 10-11. He also argues that VA violated 38 U.S.C. 5103(a) when it failed to give him adequate notice of the information or evidence necessary to substantiate his claims. Id. at 11-14. The appellant asks the Court to vacate the Board decision and remand the matter. Id. at 14.
for the Board’s finding that there was no new and material evidence to reopen the appellant’s service-connection claims, that the Board provided an adequate statement of reasons or bases for its decision, and that VA complied with its duty to notify pursuant to 38 U.S.C. 5103(a).
Board’s decision. Id. at 21-22.
changes in the interpretation of law” surrounding the presumption of sound condition came about after the RO in April 1951 denied his claim for service connection for psychogenic gastrointestinal reaction in 1951, ” the Secretary is required to conduct a de novo review of the previously denied claim” irrespective of whether the appellant has submitted new and material evidence to reopen his claim. Appellant’s Br. at 7.
administrative issue.” This statutory provision presupposes the right to a de novo adjudication of a previously and finally denied claim because of an intervening change in law that creates a new basis of entitlement to a benefit. Spencer, 4 Vet.App. at 288.
Harmonizing the provisions of section 5110(g) and the prohibition in section 7104(b) against reopening a finally denied claim in the absence of new and material evidence, the Court in Spencer found that when a “provision of law or regulation creates a new basis of entitlement to benefits, an applicant’s claim of entitlement under such law or regulation is a claim separate and distinct from a claim previously and finally denied prior to the liberalizing law or regulation.” Spencer, 4 Vet.App. at 289. In such a case, there is no attempt to reopen the finally denied claim; rather, a different claim is presented for adjudication. Id.
1094-96 (Fed. Cir. 2004) (discussing legislative history of 38 U.S.C.
1111); Jordan v. Principi, 17 Vet.App. 261, 276-77 (2003) (Steinberg, J., separate views) (discussing same), aff’d sub. nom Jordan v. Nicholson, 401 F.3d 1296 (Fed. Cir. 2005); Cotant v. Principi, 17 Vet.App. 116, 123-26 (2003) (discussing same). In short, the law as it currently exists was in effect at the time that the RO denied the appellant’s service-connection claim in 1951.
preexisted service and was not aggravated by service.
supra; see also VA Gen. Coun. Prec. 3-2003 (July 16, 2003). Prior to the Court’s holding in Wagner, VA was required to show only clear and unmistakable evidence of a preexisting condition to overcome the presumption of soundness. See Crowe, 7 Vet.App at 245; 38 C.F.R. 3.304(b)(2004); cf. Presumption of Sound Condition: Aggravation of a Disability by Active Service, 70 Fed. Reg. 23,027, 23,029 (May 4, 2005) (amending 3.304(b) to conform to Wagner holding). Thus, the effect of the Federal Circuit’s decision in Wagner was to increase VA’s burden to rebut the presumption of soundness for wartime veterans.
procedural does not create new rights to VA benefits. See Spencer, 4 Vet.
App. at 289. In Routen v. West, 142 F.3d 1434, 1439-41 (Fed. Cir. 1988), the Federal Circuit held that a change in the law that raised the evidentiary burden required of VA to rebut the statutory presumption of aggravation available to peacetime veterans from “competent” evidence to ” clear and unmistakable” evidence was procedural, and not substantive in nature. Id. The Federal Circuit stated that the change in the evidentiary standard did not create a new cause of action since no new basis of entitlement to the underlying VA benefit was created. Id. At 1442.
Circuit’s opinion in Wagner is procedural, and not substantive, in nature.
any disposition of the appeal other than affirmance of the Board decision, the case should not be remanded for development that could not possibly change the outcome of the decision”).
themselves considered evidence. Id. Accordingly, a change that raises the government’s evidentiary burden to rebut the presumption of sound condition may not constitute new and material evidence to reopen a finally decided claim.
the VCAA apply to claims to reopen. See Quartuccio v. Principi, 16 Vet.App. 183, 186 (2002). Failure to comply with any of the four VCAA requirements may constitute remandable error. See Pelegrini, 18 Vet.App. at 121-22; Quartuccio, 16 Vet.App. at 188. In addition, a Board failure to provide an adequate statement of reasons or bases as to VCAA compliance may also constitute remandable error. See 38 U.S.C. 7104(a), (d)(1); Charles v.
Principi, 16 Vet.App. 370, 374 (2002).
Court finds error, it must “take due account of the rule of prejudicial error.” 38 U.S.C. 7261(b)(2); see Mayfield, 19 Vet.App. at 112-21 (explaining how the Court “take[s] due account of the rule of prejudicial error” both in general, and in the context of VCAA notice).
evidence of a current disability; medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. See Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996). Upon receipt of an application for a service-connection claim, section 5103(a) and 3.159(b) require VA to review the information and the evidence presented with the claim and to provide the claimant with notice of what information and evidence not previously provided, if any, will assist in substantiating or is necessary to substantiate each of the five elements of the claim, including notice of what is required to establish service connection and that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. Dingess v. Nicholdson, __Vet.App.__, No.01-1917 (Mar. 3, 2006); see also Collaro v. West, 136 F.3d 1304, 1308 (Fed. Cir. 1998) (stating that a service-connection claim that provides for disability-compensation benefits consists of the following five elements: “(1) Veteran status; (2) existence of a disability; (3) a connection between the veteran’s service and the disability; (4) degree of disability; and (5) effective date of the disability”); Fenderson v. West, 12 Vet.App. 119, 125 (1999) (stating same).
the underlying claim for the benefit sought by the claimant.
connection or insufficient evidence on one or more of these elements.
variation of the above three situations.
assist claimants in the development of their claims); Quartuccio, 16 Vet.
depends on the basis on which the prior claim was denied. See Evans v.
last final disallowance), overruled, in part, on other grounds by Hodge v.
needed to reopen his claim.
fairness of the proceedings. See Mayfield, 19 Vet.App. at 115.
to the underlying compensation benefits.
under the VCAA to notify the appellant of any “information and . . .
preexist service and was incurred therein.
the information or evidence needed to substantiate the claim to reopen.
to Assist, 66 Fed. Reg. 45,620, 45,630 (Aug. 29, 2001) (codified at 38 C.F.
not preexist service and was incurred therein.
disorder claim. In this regard, the April 2001 letter is inadequate.
cumulative nor redundant” of evidence already in the record. 38 C.F.R.
evidence he had submitted to reopen his claim satisfied the “new evidence” requirement. R. at 481-82, 483-84, 491-92. Thus, these documents contained information that was incomplete and confusing, thereby rendering the VCAA notice inadequate. See Mayfield, 19 Vet.App. at 125 (stating that confusing notice about what information and evidence had not been previously provided may amount to a notice deficiency); Pelea v. Nicholson, 19 Vet.App. 296 (2005) (noting that incomplete or affirmatively misleading correspondence might discourage a reasonable person from otherwise submitting evidence to substantiate a claim), appeal dismissed, No.06-7019, 2005 U.S. App. LEXIS 28138 (Federal Circuit Dec. 1, 2005).
satisfy the first VCAA requirement necessarily subsumes a conclusion that the Secretary also failed to satisfy the second and third VCAA elements (that is who would be responsible for seeking to obtain the information and evidence required by the first notice requirement).
him was inadequate under the first, second, and third VCAA requirements.
complied with the VCAA, we turn to the notice that VA provided the appellant with regard to reopening his psoriasis claim.
April 2001 letter does not use the statutory language that such evidence would constitute material evidence to reopen the psoriasis claim, the letter’s discussion of the evidence required to reopen a claim was sufficiently broad so as to encompass both bases upon which the appellant could reopen his claim. The letter conveyed to the appellant the essence of what would be material evidence in the context of his claim to reopen. See Mayfield, 19 Vet.App. at 126-27 (stating that “a complying [VCAA] notice need not necessarily use the exact language of the regulation so long as that notice properly conveys to a claimant the essence of a regulation”).
determine what further evidence was needed. Although the April 2001 letter provided the appellant notice of the evidence or information that was needed to substantiate the “material” element of a claim to reopen, the notice is insufficient in light of the letter’s failure to notify the appellant of what information and evidence was needed to substantiate the “new” element of the claim to reopen. For this reason, the Court holds that the April 2001 letter did not inform the appellant adequately of the information and evidence not of record that is necessary to substantiate the claim to reopen the service-connection claim for psoriasis.
that the evidence that he had submitted satisfied the “new” requirement. Because these notice documents provided the appellant with information that was incomplete and confusing, the notice was insufficient. Mayfield, supra. Therefore, the Court holds that the appellant was not provided adequate notice of the first VCAA requirement.
The Secretary’s failure to satisfy the first VCAA requirement necessarily subsumes a conclusion that he also failed to satisfy the second and third VCAA elements.
failure to explain the concept of new evidence is not prejudicial because any nexus evidence would necessarily be new evidence.
what evidence he must submit in support of his psoriasis claim. As a claim for service connection includes all theories under which service connection may be granted, see Bingham v. Principi, 18 Vet.App. 470, 474 (2004), the Court notes that this remand does not limit the appellant to pursuing a theory of service connection under 3.303(b) on remand even though the VCAA letter was prejudicially erroneous only as to that theory.
VACATED and the matters are REMANDED to the Board for further proceedings consistent with this decision.

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