Opinion ID: 815698
Heading Depth: 3
Heading Rank: 2

Heading: The Elements of Standing in this Case

Text: Petitioners’ strongest theory of standing is that Krawitz, a veteran of the United States Air Force, is harmed by the 14 DEA’s continued classification of marijuana as a Schedule I drug because it deprives him of services that he is entitled to receive free of charge from the VA. The record indicates that, as a condition of his pain management treatment, Krawitz was asked by VA officials to sign a “Contract for Controlled Substance Prescription” that would prohibit him from, inter alia, using medical marijuana. See Supp. Krawitz Aff. ¶ 7; see also Krawitz Aff. Ex.1. Krawitz claims that, because he refused to sign this contract, he is now required to seek pain treatment outside the VA system. See Supp. Krawitz Aff. ¶¶ 8-10. Petitioners also contend that Krawitz suffers injury because a separate VA policy forces him to pay for a non-VA physician in Oregon to obtain the referral forms required to participate in that state’s medical marijuana program. See id. ¶¶ 11-15. Petitioners argue that both of these injuries are caused by the DEA’s continued decision to classify marijuana as a Schedule I drug and would be redressed by a favorable decision from this court. In response, the Government argues that Petitioners cannot prove redressability because their conclusion that rescheduling will result in any relief from the VA is too speculative. The first element of the “irreducible constitutional minimum of standing” is injury in fact, meaning “an invasion of a legally protected interest which is (a) concrete and particularized, and (b) actual or imminent, not conjectural or hypothetical.” Defenders of Wildlife, 504 U.S. at 560 (citations omitted) (internal quotation marks omitted). Petitioners clearly establish injury in fact here and Respondents do not seriously question it. As a veteran, Krawitz is entitled to free medical care from the VA system. This care normally includes the “[c]ompletion of forms . . . by healthcare professionals based on an examination or knowledge of the veteran’s condition.” 38 C.F.R. § 17.38(a)(1)(xv) (2012). This policy is implemented by VHA 15 Directive 2008-071, which states that “clinicians must honor all requests by patients for completion of non-VHA medical forms.” Supp. Krawitz Aff. Ex. 2. However, pursuant to VHA Directive 2011-004: “It is VHA policy to prohibit VA providers from completing forms seeking recommendations or opinions regarding a Veteran’s participation in a State marijuana program.” Supp. Krawitz Aff. Ex. 1. Thus, to participate in Oregon’s medical marijuana program, Krawitz consults with a non-VA physician in Oregon at an annual cost of approximately $140.00. See Supp. Krawitz Aff. ¶ 15. In being forced to pay out-of-pocket for care that he could otherwise receive freely from the VA system, Krawitz clearly suffers an “actual” and “concrete” injury to his “legally protected interest.” Defenders of Wildlife, 504 U.S. at 560; cf. Peacock, 682 F.3d at 83 (holding that “procedural violations that threaten an individual’s ability to obtain Medicaid coverage of prescription medications” constitute injury in fact). Beyond injury in fact, we must determine whether Krawitz’s injuries have been caused by the DEA’s decision to continue listing marijuana as a Schedule I drug and whether there is a “substantial probability” that the relief requested would redress the injury. See Nat’l Wrestling Coaches Ass’n, 366 F.3d at 944. The modest complexity of these questions arises from the fact that the agency action challenged by Petitioners – i.e. the DEA’s continued classification of marijuana as a Schedule I drug – is not the direct cause of Krawitz’s injury. Rather, his injury is caused by the actions of the VA system, which has decided as a matter of policy not to assist patients in obtaining substances illegal under federal law. This court has addressed standing under analogous circumstances in at least four previous decisions. In those cases, we looked for whether “the record presented substantial evidence of a causal relationship between the government 16 policy and the third-party conduct, leaving little doubt as to causation and the likelihood of redress.” Id. at 941. In two of those decisions, we found standing. In the other two, we denied standing. This case more strongly resembles the former two. In Block v. Meese, 793 F.2d 1303, 1308 (D.C. Cir. 1986), the plaintiff’s company owned exclusive distribution rights to a film that the Justice Department classified as “political propaganda.” The plaintiff alleged injury to his economic interests because the classification deterred potential customers. Id. To support this assertion, the plaintiff submitted declarations and affidavits from potential customers who were dissuaded from purchasing the film because of its status as “propaganda.” Id. We held that there was sufficient factual evidence on the record to establish that the harm was “attributable to the classification.” Id. In Tozzi v. U.S. Department of Health and Human Services, 271 F.3d 301 (D.C. Cir. 2001), a manufacturer of PVC plastic challenged a decision by the Secretary of Health and Human Services to list dioxin, a chemical released through the incineration of PVC plastic, as a “known” carcinogen. Though this triggered no new federal regulation, the manufacturer sued on the theory that the classification had prompted state and local entities to regulate to the detriment of the manufacturer. Id. at 309. Looking carefully at the record, we found several reasons to conclude that the government action was “at least a substantial factor motivating the third parties’ actions.” Id. at 308. We noted that Congress intended the Secretary’s determination “to serve as the federal government’s authoritative statement on the current state of knowledge regarding the carcinogenicity of various chemicals.” Id. at 309 (citing H.R. REP. NO. 951192, at 28 (1978) (describing the Secretary’s list as a 17 “comprehensive document” containing “all known or suspected carcinogenic agents”)). We also noted that the Secretary’s list of carcinogens “is widely disseminated and highly influential,” and we pointed to several local government restrictions on the use of PVC plastic that explicitly cited the Secretary’s determination that dioxin is a “known” carcinogen. Id. We also found it significant that the term “carcinogen” is “inherently pejorative and damaging,” noting that this increased the probability of an economically harmful third party response. Id. In at least two other cases, we have denied standing when a non-party’s conduct was the most direct cause of the alleged injury. In National Wrestling Coaches Ass’n, 366 F.3d at 933, “several membership organizations that represent[ed] the interests of collegiate men’s wrestling coaches, athletes, and alumni” challenged the government’s Title IX enforcement policy, alleging that it had caused several schools to cancel their men’s wrestling programs. We denied standing, reasoning that the plaintiffs “offer[ed] nothing but speculation to substantiate their claim that a favorable decision from this court [would] redress their injuries by altering these schools’ independent decisions.” Id. at 937. And in Renal Physicians Ass’n v. U.S. Department of Health & Human Services, 489 F.3d 1267 (D.C. Cir. 2007), a medical association challenged a government regulation that allegedly depressed their compensation for in-house patient referrals. Once again, this court denied standing, concluding it was “speculative,” not “likely,” that rescinding the regulation would increase the rate of compensation. Id. at 1277. Turning to the facts of this case, the causation element is satisfied because Krawitz’s injury is fairly traceable to the Government’s decision to continue listing marijuana as a Schedule I drug. As with the statute in Tozzi, Congress made 18 clear when it passed the CSA that the agency’s scheduling decisions should serve as the federal government’s “authoritative statement” on the legitimacy of particular narcotics and dangerous drugs. 271 F.3d at 309. The House Report for the CSA explains that Congress had already enacted “more than 50 pieces of legislation” relating to the regulation of dangerous drugs. H.R. REP. NO. 91-1444, reprinted in 1970 U.S.C.C.A.N. 4566, 4571. Congress intended the CSA and its scheduling program to “collect[] and conform[] these diverse laws in one piece of legislation.” Id. Furthermore, the Government’s classification of marijuana under Schedule I is “inherently pejorative.” Tozzi, 271 F.3d at 309. Under the terms of the Act, a Schedule I drug “has a high potential for abuse,” “has no currently accepted medical use,” and has “a lack of accepted safety for use.” 21 U.S.C. § 812(b)(1). When the DEA classified marijuana as a Schedule I drug, pursuant to its delegated authority under the CSA, it announced an authoritative value judgment that surely was meant to affect the policies of third-party federal agencies. Unsurprisingly, the VA has heeded the DEA’s judgment regarding marijuana, thus making the question of causation relatively easy in this case. The record before the court clearly shows that the VA’s refusal to complete Krawitz’s medical marijuana forms is traceable to the DEA’s continued decision to classify marijuana as Schedule I. VHA Directive 2011-004, which prohibits VA providers from completing state medical marijuana forms, cites three times to marijuana’s Schedule I status. See Supp. Krawitz Aff. Ex. 1. Indeed, compliance with the CSA is the only justification the Directive cites for this policy. See id. (“[VA] providers must comply with all Federal laws, including the Controlled Substances Act. Marijuana is classified as a Schedule I drug under the Controlled Substances Act.”). In light of this evidence, the Government, 19 in its brief to the court, offers nothing more than a perfunctory challenge to causation. This case is nothing like the situations in National Wrestling and Renal Physicians, where the records contained only weak evidence of causal links between the claimants’ injuries and the contested actions of third-party defendants. The Government focuses most on redressability in contesting Krawitz’s standing in this case. The Government argues that rescheduling marijuana would not “generate a significant increase in the likelihood” that the VA would authorize its physicians to recommend marijuana in Oregon. See Town of Barnstable v. FAA, 659 F.3d 28, 32 (D.C. Cir. 2011). In support of this argument, the Government suggests that, based on the current scientific evidence, there would be no approval by the Food & Drug Administration of medical marijuana, and, absent such approval, VA physicians would be unlikely to recommend a substance that could not be prescribed or readily subjected to supervised use. The Government’s argument against redressability fails. The issue is not whether VA physicians would recommend marijuana usage to patients. The issue is only whether rescheduling marijuana would “generate a significant increase in the likelihood” that Krawitz could obtain completed state medical marijuana forms from the VA. See id. Under existing regulations and VHA Directive 2008-071, VA clinicians are subject to a non-discretionary duty to “honor all requests by patients for completion of non-VHA medical forms.” See 38 C.F.R. § 17.38(a)(1)(xv) (2012); Supp. Krawitz Aff. Ex. 2. The only thing stopping VA clinicians from performing this duty with respect to Krawitz’s request is VHA Directive 2011-004. See Supp. Krawitz Aff. Ex. 1. The only reason the VA cites for implementing VHA Directive 2011-004 is the classification of marijuana as a Schedule I drug. Id. Therefore, 20 were marijuana rescheduled to reflect its potential for medical use, the VA would have no expressed reason to retain VHA Directive 2011-004 and VA clinicians would likely be subject to a non-discretionary duty to complete Krawitz’s state medical marijuana forms. This case is fully distinguishable from National Wrestling and Renal Physicians, where we found redressability lacking. In both those cases, in addition to a tenuous showing of causation, there were reasons beyond the challenged government action for the third parties to continue the conduct that caused injury to the plaintiffs. In National Wrestling there were many factors that led each school to cancel its men’s wrestling program, such as “the absence of league sponsorship for wrestling, budgetary concerns, and the need to balance the athletic program with other University priorities.” 366 F.3d at 942. Furthermore, Title IX and its accompanying regulations would have remained in force regardless of the case’s outcome. See id. at 943. Indeed the plaintiffs in National Wrestling did not even contest the legality of the Title IX regulations. Id. In Renal Physicians the court found that the plaintiffs had failed to demonstrate redressability in part because, even if the challenged regulation were struck down, market forces might drive the injurious conduct to continue. See 489 F.3d at 1277. In contrast, this case is more like Tozzi. There we found it significant for redressability that the Secretary’s listing of dioxin as a “known” carcinogen was the only such pronouncement by the federal government. See 271 F.3d at 309-10. Therefore, if we had set aside that listing, “dioxin activists could no longer point to an authoritative determination by the United States government that dioxin is ‘known’ to cause cancer in humans. . . . State and local governments would be less likely to regulate dioxin, and 21 healthcare companies would in turn be less likely to stop using PVC plastic.” Id. at 310. Here, the Schedule I listing is the authoritative federal declaration of marijuana’s illegality and unfitness for medical use. The VA is a federal agency and thus surely inclined to subscribe to such a federal declaration. Were the substance rescheduled, the VA would lose the only express justification for its policy against completing state medical marijuana forms. Therefore, it is “likely” instead of merely “speculative” that Krawitz’s injury would be redressed. Because Krawitz has Article III standing due to his inability to have the VA system complete his state medical marijuana forms, we need not consider whether his alleged inability to obtain pain management services from the VA in Virginia warrants standing. We also need not consider whether the other Petitioners have standing as well. See Watt v. Energy Action Educ. Found., 454 U.S. 151, 160 (1981) (“Because we find [one plaintiff] has standing, we do not consider the standing of the other plaintiffs.”); see also Tozzi, 271 F.3d at 310 (same).