Opinion ID: 806350
Heading Depth: 2
Heading Rank: 1

Heading: The VA Rating Decision

Text: [1] The ALJ must “ordinarily give great weight to a VA determination of disability.” Id. While a VA disability decision “does not necessarily compel the SSA to reach an identical result, . . . the ALJ must consider the VA’s finding in reaching his decision,” because of the similarities between the VA disability program and the Social Security disability program. Id. However, because the two federal programs are not HILER v. ASTRUE 9051 identical, “the ALJ may give less weight to a VA disability rating if he gives persuasive, specific, valid reasons for doing so that are supported by the record.” Id. (emphasis added). Hiler’s administrative record includes several VA decisions. First, in the 1998 decision, the VA found that Hiler was entitled to “individual unemployability,” because he was unable to secure or follow a gainful occupation due to his disabilities. However, permanency of the disability was not established at that time because the VA found that there was a reasonable chance that Hiler’s low back and right knee disabilities would improve, and that he would become employable. Second, in the 2001 decision, the VA issued a decision that proposed to decrease Hiler’s low back injury from 40 percent disabling to 20 percent, to decrease his right knee injury from 30 percent disabling to 10 percent, and to terminate his entitlement to individual unemployability. On January 24, 2002, the VA sent a copy of the 2001 decision to Hiler, and stated that it proposed to make the reductions in the decision. The letter also stated that Hiler could submit additional evidence or request a personal hearing to show why the VA should not make the changes. Hiler made the request for a hearing on February 4, 2002, and the VA issued another rating decision on April 9, 2002. In its 2002 decision, the VA rejected the changes proposed in the 2001 decision, and retained Hiler’s low back and right knee disabling percentages (at 40 percent and 30 percent, respectively) that were part of the 1998 decision, and also retained Hiler’s individual unemployability rating. [2] The ALJ erred in relying only on the 2001 decision, with its proposed rating changes, and disregarding the VA’s 1998 decision and 2002 decision. The 2001 decision only proposed changes to Hiler’s ratings, and did not officially change them. The tentative nature of the 2001 decision is further shown by the VA’s January 24, 2002 letter to Hiler, informing him of the proposed reductions and termination of his employability rating, and giving him an opportunity to submit 9052 HILER v. ASTRUE more evidence or request a hearing before the decision became final. The letter specifically stated that “reduced payments” would begin following the VA’s notice to Hiler of its final decision. [3] Thus, the ALJ’s finding that the 2001 decision “decreased the claimant’s low back injury from 40 percent to 10 percent disabling; decreased his retropatellar [right knee] pain syndrome from 30 percent to 10 percent disabling; and terminated his continued entitlement to individual unemployability based on medical improvement of his knee and back conditions” shows that she misconstrued the nature of the 2001 decision. The record clearly shows that the 2001 decision did not make any final changes as to Hiler’s disability rating, nor did it terminate his individual unemployability rating. In sum, the ALJ’s statement that the 2001 decision changed Hiler’s disability rating and terminated his individual unemployability rating is not supported by substantial evidence in the record. [4] We reject the contention that the 1998 decision, the 2001 decision, and the 2002 decision were “inconsistent” decisions from which the ALJ could make a selection. The 2001 decision was not a final decision, and its proposed changes were rejected in the 2002 decision. We also reject the idea that the ALJ could rely on the 2001 decision simply because it was more “contemporaneous” with the time period for which she was evaluating Hiler’s disability. Because the 2001 decision only proposed changes, Hiler’s actual VA disability rating and his individual unemployability rating remained unchanged from that determined by the 1998 decision, as of the time of the 2001 decision. [5] We conclude that the ALJ erred in relying on a 2001 decision that only proposed changes, while ignoring the 1998 decision and the 2002 decision that rejected the proposed changes recommended in the 2001 decision. The ALJ’s misunderstanding led her to inaccurately conclude that her findHILER v. ASTRUE 9053 ing that Hiler’s disability terminated on December 4, 1998 was consistent with the VA’s ratings. Accordingly, the ALJ’s finding of medical improvement was not consistent with Hiler’s true VA ratings, and she does not give any reasons for the deviation. See McCartey, 298 F.3d at 1076. Therefore, we remand the case to the ALJ for further proceedings consistent with this opinion. We note that, on remand, the ALJ is not compelled to adopt the conclusions of the VA’s decisions wholesale, but if she deviates from final VA decisions, she may do so based only on contrary evidence that is “persuasive, specific, valid” and supported by the record. McCartey, 298 F.3d at 1076; see also Valentine v. Comm’r of Soc. Sec. Admin., 574 F.3d 685, 695 (9th Cir. 2009).