Judge Kramer, statisfy Prong 1&3 of a CUE claim

Judge Kramer puts forth one of the few examples of how to satisfy both Prong 1 & 3 of a CUE claim:

KRAMER, Judge, concurring:
Simply put, prong (1) means that facts so known
at the time to be correct were in the VA record, but somehow were not
actually in front of the adjudicator. For example, an appellant had
submitted three items of evidence, all indicating a date stamp of receipt
by the VA prior to the adjudication in question; however, in rendering a
decision, the adjudicator specifically stated that the record contained
two pieces of evidence submitted by the appellant. It is only in such a
case that both prongs (1) and (3) can be satisfied, certainly not the
situation here.
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. 90-1511
CAFFREY.511
Search Terms: CAFFREY UNITED STATES COURT OF VETERANS APPEALS


No. 90-1511


Thomas A. CaffreyNext Hit, Appellant,

v.

Jesse Brown,
Secretary of Veterans Affairs, Appellee.


On Appeal from the Board of Veterans' Appeals



(Decided March 31, 1994 )


Thomas A. Previous HitCaffreyNext Hit, pro se.

James A Endicott, Jr., General Counsel, David T. Landers, Acting
Assistant General Counsel, Andrew J. Mullen, Deputy Assistant General
Counsel, and Michael P. Butler were on the pleadings for the appellee.


Before KRAMER, MANKIN, and STEINBERG, Judges. MANKIN, Judge, filed
the opinion of the Court, in which KRAMER, Judge, joined, concurring.
STEINBERG, Judge, filed an opinion concurring in part and dissenting in
part.


MANKIN, Judge: Thomas A. Previous HitCaffreyNext Hit (appellant) appeals an October 9,
1990, decision of the Board of Veterans' Appeals (BVA or Board) denying
entitlement to an increased rating and an earlier effective date for
chronic undifferentiated schizophrenia, currently rated at 50% disabling.
The appellant claims that the BVA erred in determining that the severity
of his condition had not increased, and that the Board failed to address
his entitlement to a higher rating due to individual unemployability. The
appellant further contends that the Board erred in determining that he was
not entitled to an earlier effective date for service connection, because
prior determinations were the result of clear and
unmistakable error (CUE), based upon the VA's failure to obtain private
medical records requested by the appellant.
The Court finds that because the Board failed to conduct a
contemporaneous examination of the appellant and assess evidence presented
by him, it did not appropriately determine whether the appellant's
condition had become more severe. Further, although the appellant raised
the issue of entitlement to an increased rating due to individual
unemployability, the Board failed to address that claim. Last, while the
appellant has raised the issue of CUE in prior determinations, the issue
is not applicable here because CUE claims cannot be based upon a failure
in the duty to assist. Accordingly, the Court vacates in part and affirms
in part the Board's October 9, 1990 decision, and remands the matter in
part.

I. Factual Background
The appellant served in the United States Army from November 24, 1958
to February 15, 1962. In March 1964, he submitted an application for
compensation or pension seeking service connection for a psychiatric
disorder. The Regional Office (RO) apparently denied the appellant's
claim in a decision dated June 5, 1964. That determination became final
as a result of the appellant's failure to file an appeal within one year
of the decision.
The appellant attempted to reopen his claim on June 3, 1975, and
referred to treatment he had undergone at the Institute, Pennsylvania
Hospital [hereinafter Institute], in March 1962. Evidence of that
treatment was not submitted by the appellant and his claim was denied on
August 8, 1975. The appellant again attempted to reopen his claim for
service connection in December 1977 and May 1978. The RO denied his claim,
and informed the appellant that new and material evidence was required to
reopen a previous and finally disallowed claim. In June 1979 the
appellant again attempted to reopen his claim, but again reopening was
denied due to the lack of new and material evidence.
On March 24, 1988, the appellant reopened his claim, and in an August
22, 1988, letter asserted that a "crucial" report of hospitalization at
the Institute for the period from February 27, 1962, to May 31, 1962, was
not in his VA files. The appellant stated that he had authorized the
hospital to send the report to the VA, and that the report proved the
appellant was admitted one week after his discharge from service. On
October 11, 1988, the RO found that the report and the other evidence of
record established a new factual basis warranting a grant of service
connection for chronic undifferentiated schizophrenia. The RO assigned a
10% rating, effective March 24, 1988, and ordered an examination to
determine the current severity of the appellant's condition.
The examination was conducted on November 28, 1988, by George Anghel,
M.D. Dr. Anghel noted that the appellant last worked in 1975 with the
exception of a part-time job for one month in 1985. The doctor found that
reasoning and judgment were not grossly impaired and attention,
orientation, memory, and intelligence were normal. He further found the
appellant's social and industrial impairment to be "moderately severe."
Based upon this medical examination, the RO issued a decision on January 9,
1989, increasing the rating for chronic undifferentiated schizophrenia to
50% disabling, with an effective date of March 24, 1988.
In August 1989 the appellant filed a Notice of Disagreement (NOD)
with the January 1989 RO decision, stating that his disability was 100%
disabling and that his award should have an effective date prior to April
1, 1988. In his NOD, the appellant stated that an earlier effective date
was warranted because he had informed the VA about his hospitalization at
the Institute, and that he did not discover until sometime in 1988 that
the medical records had not been forwarded. The appellant also claimed
entitlement to an increased rating due to the severity of his condition
and individual unemployability. With the appellant's substantive appeal
to the BVA in October 1989, he submitted a September 1989 letter from
William Woodworth, the appellant's rehabilitation counselor from July 1987
to January 1988. Mr. Woodworth stated that the appellant was then
substantially industrially impaired and unable to function vocationally.
Mr. Woodworth also stated that although counseling and college training
were provided to the appellant, he was unable to continue with the program
because his service-connected psychiatric disability had "flared up."
The appellant also submitted a report of an evaluation conducted in
December 1989 by Robert O'Toole, M.D., which stated that the appellant "is
substantially impaired for entrance into the competitive labor market."
The RO reviewed the new evidence submitted
by the appellant, and in December 1990 confirmed the existing rating and
effective date. The Board denied entitlement to an increased rating and
an earlier effective date, and the present appeal followed.

II. Analysis
A. Claim for Increased Rating
The appellant contends that the BVA erred in finding that a
disability rating for chronic undifferentiated schizophrenia above 50% is
not warranted. The appellant's contention has two elements. First, the
appellant argues he is entitled to an increased rating for his condition
because it has become worse. Second, the appellant claims he is entitled
to an increased rating based upon individual unemployability.
The VA has a duty to assist a veteran who submits a well-grounded
claim. 38 U.S.C. ù 5107; 38 C.F.R. 3.159 (1993); Littke v. Derwinski, 1
Vet.App. 90 (1990). This duty is not discretionary, Littke, 1 Vet.App.
at 92, and it may, under appropriate circumstances, include a duty to
conduct a thorough and contemporaneous medical examination. 38 C.F.R. ù
3.326 (1993); Green v. Derwinski, 1 Vet.App. 121, 123 (1991); Lineberger
v. Brown, 5 Vet.App. 367, 369 (1993); Waddell v. Brown, 5 Vet.App. 454 (
1993). The medical examination must consider the records of prior medical
examinations and treatment in order to assure a fully informed
examination. Id.
In determining that the appellant was not entitled to an increased
rating, the Board applied the appropriate rating codes for schizophrenia.
38 C.F.R. ù 4.132, Diagnostic Codes (DC) 9201-9205 (1993). A 50%
evaluation is appropriate for undifferentiated schizophrenia with
considerable impairment of social and industrial adaptability. 38 C.F.R.
ù 4.132, DC 9201-9210 (1993). A 70% rating is warranted for severe
impairment of social and industrial adaptability. Id. A 100% rating
requires active psychotic manifestations of such extent, severity, depth,
persistence, or bizarreness as to produce total social and industrial
inadaptability. Id.
The BVA supported its determination that the appellant could be rated
as only 50% disabled, 38 C.F.R. ù 4.132, DC 9204, by relying on the
November 1988 VA medical
examination. Noting that the examination found the appellant oriented
and coherent, with memory intact and no hallucinations, the examiner
determined that the appellant did not satisfy the DC criteria for a higher
rating. The Board recognized that the appellant had required repeated
psychiatric hospitalization, treatment, and medication; however, it found
that the most recent outpatient treatment did not show more than
considerable impairment of social and industrial adaptability.
Nonetheless, the Board should have conducted a contemporaneous examination
of the appellant because the November 1988 examination is too remote from
the October 1990 BVA decision to constitute a contemporaneous examination.
A claim that a condition has become more severe is well grounded where the
condition was previously service connected and rated, and the claimant
subsequently asserts that a higher rating is justified due to an increase
in severity since the original rating. Proscelle v. Derwinski, 2 Vet.App.
629, 632 (1992). Under those circumstances, pursuant to its duty to
assist, the VA was obligated here to obtain a new medical examination to
obtain evidence necessary to adjudicate the claimant's request for an
increased rating. Id.
VA regulations specifically require the performance of a new medical
examination in instances such as the present case. "Reexaminations . . .
will be requested whenever VA determines there is a need to verify . . .
the current severity of a disability." 38 C.F.R. ù 3.327(a) (1993). In
assessing the current severity of a disability, "reexaminations will be
required if . . . evidence indicates there has been a material change in a
disability or that the current rating may be incorrect." Id. In this
case, the appellant presented the letter from the rehabilitation counselor,
Mr. Woodworth, tending to suggest that the appellant's condition had
become worse. Furthermore, the appellant presented Dr. O'Toole's
psychological examination report, prepared in December 1989, which also
tended to suggest that the appellant's condition was more severe than his
rating indicated. Thus, the appellant had presented evidence indicating
both that there had been a material change in his condition, and that his
50% rating was insufficient. Therefore, the Board failed to conduct the
reexamination of the appellant that was required in accordance with both
the holdings of this Court and VA regulations. The Board's October 9,
1990, decision with regard to this matter must be vacated and the matter
remanded for further development and findings consistent with this opinion.
The appellant also asserts that the Board erred in failing to assess
his entitlement to a higher, including total, disability rating due to
individual unemployability. The appellant claimed entitlement to an
increased rating due to individual unemployability in both his NOD and
substantive appeal to the BVA. In fact, included with the substantive
appeal was the letter by the appellant's rehabilitation counselor stating
that the appellant was substantially industrially impaired and unable to
function vocationally. The appellant also submitted Dr. O'Toole's
December 1989 report stating that the appellant was substantially impaired
for entrance into the competitive labor market.
While the appellant's request for an increased rating due to
individual unemployability is apparent from all of the appellant's
pleadings, the Board failed to address this claim and the supporting
evidence in its October 9, 1990, decision. This Court has held that where
the Board has failed to adjudicate a claim which is reasonably raised by
a liberal reading of the claimant's pleadings, the Board has committed
error. Fanning v. Brown, 4 Vet.App. 225, 228-29 (1993). Having examined
the appellant's pleadings in this matter, we find that the issue of
individual unemployability was reasonably raised. Therefore, the Board's
failure to consider the issue was error, and the matter must be remanded
for a readjudication consistent with this opinion.
Finally, 38 C.F.R. ù 4.7 (1993) directs that where there is a
question as to which of two evaluations is to be applied, the higher
evaluation will be assigned where the disability picture more nearly
approximates the criteria for that rating. The VA is instructed to give
the veteran the benefit of the doubt where the evidence in a case is in
relative equipoise. 38 U.S.C. ù 5107(b). "In a case where there is
significant evidence in support of an appellant's claim, as there is here,
the Board must provide a satisfactory explanation as to why the evidence
was not in equipoise." Williams v. Brown, 4 Vet.App. 270, 273-74 (1993).
The Board, however, has failed to explain why the appellant was assigned
his present rating rather than a higher rating. We find that there was
significant evidence in support of the appellant's claim, and that the
Board failed to provide sufficient reasons or bases for its conclusion
that the evidence was not in equipoise. Accordingly, the Board's failure
to do so was error, and the matter must be remanded for a readjudication
consistent with this opinion.

B. Entitlement to Earlier Effective Date
The appellant claims the Board erred in finding that he is not
entitled to an earlier effective date for the service connection of his
undifferentiated schizophrenia. The Board based its decision on the
finding that the June 1964 RO denial was a final decision, and that the
appropriate effective date for the appellant's present service connection
was the date the reopened claim was received following the final
disallowance. 38 C.F.R. ù 3.400 (1993). The appellant asserts that he
advised the VA in his 1975 attempt to reopen his claim that he had been
hospitalized at the Institute for a nervous breakdown in 1962, and that
the VA's duty to assist required that it obtain those records. The
appellant contends that the VA's failure to obtain these records was a
breach of the duty to assist which resulted in the denial of his claim.
Had the records been present, the appellant asserts, the record would have
been complete and service connection accordingly granted at that time.
Thus, the appellant essentially argues that all determinations regarding
service connection made after 1975 but before the March 24, 1988, decision
were the product of CUE because the decisions were based on an incomplete
record.
As an initial matter, we must determine whether the appellant has
properly pleaded CUE by specifying what the alleged error is, and by
alleging why, if the purported CUE had not been made, the result would
have been different. See Fugo v. Brown, 6 Vet.App. 40, 44 (1993). Here,
the appellant has met that burden by contending that the VA was put on
notice in 1975 that he was hospitalized at the Institute, but that the VA
did not obtain these records, and by further contending that, had the
Institute records been obtained prior to the adjudications in question,
the determinations regarding service connection would have been different.
With regard to the appellant's substantive CUE claim, the Secretary
asserts that the Board did not breach its duty to assist the appellant.
The Secretary argues that because the RO repeatedly advised the appellant
of the need to provide new and material evidence to reopen his claim, and
because the appellant failed to provide this evidence, no duty to assist
the appellant ever arose. In support, the Secretary quotes this Court:

Where the VA notifies a claimant of the need for further evidence and
the claimant fails to respond within one year of that notice, the
claim is deemed to have been abandoned. . . . [I]ndividuals applying
for benefits have a responsibility to cooperate with the agency in
the gathering of evidence necessary to establish allowance of
benefits.

Morris v. Derwinski, 1 Vet.App. 260, 264 (1991). See also 38 C.F.R. ù
3.158(a) (1993). While the Secretary is certainly correct that a claimant
has a responsibility to cooperate with the VA, his reliance on this
proposition in the present case is misplaced.
This Court has held that a claimant does not always need to make a
specific request that the VA procure private medical records. Ivey v.
Derwinski, 2 Vet.App. 320, 322 (1992); 38 U.S.C. ù 5107(a) (VA has duty
to assist); Pritchett v. Derwinski, 2 Vet.App. 116, 122 (1992) (duty to
assist includes obtaining private medical records); accord Littke, 1 Vet.
App. 90. The duty to assist may arise when a claimant simply refers to
the private medical examinations or treatments without making a specific
request. Ivey, 2 Vet.App. at 322. In this instance, the duty to assist
arose when the appellant referred to his treatment at the Institute, and
it was not nullified by the appellant's purported failure to "provide new
and material evidence," since it was the VA's duty to obtain that evidence
in view of its relevance to proper adjudication of the claim. Accordingly,
we find that the VA's failure to assist the appellant obtain his records
from the Institute was a breach of the duty to assist.
In the case of Porter v. Brown, 5 Vet.App. 233 (1993), the appellant
made a similar claim of an earlier effective date for a grant of service
connection based on an assertion of CUE resulting from the VA's failure to
perform its duty to assist. In that case, the Court found that CUE could
not be found as a result of a breach of the duty to assist where the
asserted basis of the breach was the VA's failure to obtain records that
were not developed until after the disputed adjudication took place. Id.
at 236-37. The Court left open the question of whether a claim of CUE may
ever be based upon a breach of the duty to assist. Id.
In this case, the VA's failure to assist the appellant obtain private
medical records was prior to the occurrence of the disputed adjudication.
The VA's failure resulted in the
creation of an incomplete rather than incorrect record. We have held
that "[a] determination that there was a 'clear and unmistakable error'
must be based on the record and law that existed at the time of the prior
. . . decision." Russell v. Principi, 3 Vet.App. 310, 314 (1992) (en
banc). Thus, a claim of CUE is based upon an assertion that there was an
incorrect application of the law or fact as it existed at the time of the
disputed adjudication. Id. Since an analysis of whether CUE has been
committed may only proceed on the record, id., evidence that was not part
of the record at the time of the prior determination may not form the
basis of a finding that there was an act of clear and unmistakable error.
While it is true that an incomplete record may ultimately lead to an
incorrect determination, it cannot be said that an incomplete record is
also an incorrect record. If the facts contained in the record are
correct, it is not erroneous, although not embodying all of the relevant
facts. Rather, an incomplete record is just that--incomplete. It allows
for further development of facts and law to advance the veteran's claim. "
New or recently developed facts or changes in the law subsequent to the
original adjudication may provide grounds for reopening a case or for a de
novo review but they do not provide a basis for revising a finally
decided case." Id. at 313. Thus, an incomplete record, factually correct
in all other respects, is not clearly and unmistakably erroneous. This is
true even in the present case where the cause of the record's
incompleteness is the VA's breach of the duty to assist. In short, the
VA's breach of the duty to assist cannot form a basis for a claim of CUE
because such a breach creates only an incomplete rather than an incorrect
record. As unjust as this finding may appear, it is dictated by the law
by which we are bound.

III. Conclusion
Upon consideration of the record, the appellant's informal brief, and
the Secretary's motion, the October 9, 1990, decision of the Board of
Veterans' Appeals is affirmed in part, and vacated in part, and the matter
is remanded in part for further proceedings consistent with this opinion.

KRAMER, Judge, concurring: I write separately in response to part B
of the dissent. Whatever ambiguity may have existed after the issuance
of Russell v. Principi, 3 Vet.App. 310 (1992) (en banc), regarding the
possibility of basing clear and unmistakable error (CUE) on a duty to
assist violation (the sole basis for the dissent), such possibility has
been put to rest by the Court's recent decision in Damrel v. Brown, ___
Vet.App. ___, No. 93-171 (U.S. Vet. App. Feb. 18, 1994). In short,
Damrel did nothing more than synthesize the Russell test into three prongs,
all of which must be satisfied in order to have CUE:
(1) "[e]ither the correct facts, as they were known at the time,
were not before the adjudicator (i.e., more than a simple
disagreement as to how the facts were weighed or evaluated) or
the statutory or regulatory provisions extant at the time were
incorrectly applied," (2) the error must be "undebatable" and
of the sort "which, had it not been made, would have
manifestly changed the outcome at the time it was made," and (3)
a determination that there was CUE must be based on the record
and law that existed at the time of the prior adjudication in
question.
Damrel, ___ Vet.App. at ___, slip op. at 5 (quoting Russell, 3 Vet.App.
at 313-14) (emphasis added).
The reports of treatment at the Institute, Pennsylvania Hospital,
were not in the record at the time of all adjudications between June 1975
and March 1988, in which appellant alleges CUE. The language of prong (3)
certainly eliminates any aspirations that the dissent may have in trying
to reconstruct a record that did not exist at the time of the prior
adjudications. This language, for all intents and purposes, is taken
verbatim from the language of Russell, supra, at 314, which states that "[
a] determination that there was a 'clear and unmistakable error' must be
based on the record and the law that existed at the time of the prior [
agency of original jurisdiction] or BVA decision." To the extent that the
dissent hints that there may be "wiggle room" for going outside the record
because of prong (1) (correct facts known at the time, but not before the
adjudicator), such a reading would necessitate the existence of an
inconsistency between prongs (1) and (3) in order to obtain the dissent's
hoped for, but unsustainable result. The case law of this Court clearly
indicates that constructive receipt applies only to VA records. See Bell
v. Derwinski,
2 Vet.App. 611 (1992). Simply put, prong (1) means that facts so known
at the time to be correct were in the VA record, but somehow were not
actually in front of the adjudicator. For example, an appellant had
submitted three items of evidence, all indicating a date stamp of receipt
by the VA prior to the adjudication in question; however, in rendering a
decision, the adjudicator specifically stated that the record contained
two pieces of evidence submitted by the appellant. It is only in such a
case that both prongs (1) and (3) can be satisfied, certainly not the
situation here. Not to limit prong (1) to that evidence in the possession
of the VA at the time of a particular challenged adjudication would
require this Court to resolve disputes regarding what evidence could have
been put into the record existing at the time such adjudication was made,
perhaps decades ago. Such a process would involve ill-advised speculation
by the Court, and, in my view, would provide unwise incentive to submit
newly created evidence that purports to be outcome determinative and which
bears a date prior to that of the adjudication which is the subject of the
CUE claim.

STEINBERG, Judge, concurring in part and dissenting in part: I
concur in the opinion of the Court except for part II.B and its holding
that a "breach of the duty to assist cannot form a basis for a claim of [
clear and unmistakable error]" (CUE) under 38 C.F.R. ù 3.105(a) (1993).
Ante at __, slip op. at 9. I also do not agree that there necessarily was
a breach of VA's duty to assist in either 1975, 1978, or 1979[ The
majority holds that VA's duty to assist was breached but does not specify
when that breach occurred. Ante at __, slip op. at 8.] when the veteran
sought to reopen his claim.
A. Duty to Assist
Before concluding that the duty to assist in this case was violated
by the Veterans' Administration (now Department of Veterans Affairs) (VA
or Department) Regional Office (RO) in 1975, 1978, or 1979, it must first
be determined whether such a duty to assist then existed. The current
statutory duty to assist in 38 U.S.C. ù 5107(a) was not enacted until
1988 (then as ù 3007(a)) when it was added by the Veterans' Judicial
Review Act, Pub. L. No. 100-687, ù 103(a), 102 Stat. 4105, 4106 (1988) ("[
Secretary] shall assist such a claimant
[one who has submitted well-grounded claim] in developing the facts
pertinent to the claim"). However, that enactment merely codified a
regulatory obligation in 38 C.F.R. ù 3.103(a) (1987) that had existed
since 1972 and that had provided, in terms indistinguishable from those
later enacted in section 5107(a), that "[i]t is the obligation of [VA] to
assist a claimant in developing the facts pertinent to his [or her] claim."
In concluding that the VARO in 1979 did not err in not obtaining the
March 1962 Institute report, the Board of Veterans' Appeals (BVA or Board)
stated: "It is the responsibility of the claimant to provide reports of
all private medical treatment pertinent to his claim." Thomas A. Previous HitCaffreyNext Document,
BVA 90-____ (Oct. 9, 1990), at 4. That statement is clearly wrong as a
matter of law as to today's duty to assist under Littke v. Derwinski, 1
Vet.App. 90, 92 (1990) (quoting ù 3.103(a)). However, since the Court in
Littke was construing the same regulatory and statutory words as existed
in regulation in 1979 I think it would be reasonable to conclude that
there was a comparable duty to assist since at least the 1972 promulgation
of ù 3.103(a). At a minimum, a duty to assist arose in this case in 1979 (
if not in 1975 and 1978) when the veteran specifically advised the RO
about his 1962 psychiatric hospitalization at the Institute and gave the
Institute's address (R. at 65), and that duty to assist was either for VA
to seek the report or to tell the veteran to get it. Doing neither would
clearly have been a violation in 1979 when the RO had a specific duty to
respond to the veteran's very specific 1979 communication to it. Cf.
Godwin v. Derwinski, 1 Vet.App. 419, 425 (1991) (duty to assist includes
obligation to respond "one way or the other" to request for assistance).
According to the 1989 Statement of the Case, in 1975, 1978, and 1979
the RO informed the veteran in general terms that he needed to submit new
and material evidence. R. at 106-07. Perhaps that was enough -- at least
up to 1979, but the record does not show what specific responses the RO
gave at any of those times. Hence, I would hold that the duty to assist
as described above might have been violated here and, if it was, then I
would hold further, for the reasons set forth in part B, below, that that
error constituted CUE. Accordingly, I would remand for the Board to
readjudicate the CUE claim in light of the full record, which is not
available to the Court.
B. CUE
More fundamentally, I differ from the majority's holding that a CUE
claim may never be premised on a duty-to-assist violation. I would tend
to agree that such a violation could rarely meet the CUE prerequisite that
the error must be one "which had it not been made, would have manifestly
changed the outcome at the time it was made." Russell v. Principi, 3 Vet.
App. 310, 313 (en banc) (1992). In this case, however, that CUE criterion
is clearly met since we know that as soon as the RO learned in 1989 about
the 1962 Institute record, which showed that the veteran had been treated
for schizophrenia in the month after his discharge from service, it
granted him service connection for that condition. R. at 81-82. Further,
I agree with the majority (ante at __, slip op. at 7) that the veteran
timely raised this issue with sufficient specificity in his August 1989
Notice of Disagreement. R. at 98.
For the following reasons, however, I do not agree with the majority
that even if a failure to assist is demonstrated as to the RO's actions or
inactions in 1975, 1978, or 1979 (or more than one of those years), that
is a type of error which cannot constitute CUE under ù 3.105(a). First,
the Secretary has not contended that it could not be CUE -- only that
there was no duty-to-assist violation. Mot. at 7-8. Second, the Court's
rationale for its conclusion that a duty-to-assist violation is not
cognizable as the basis for a CUE claim -- that "an incomplete record is [
not] also an incorrect record" and that "an incomplete record, factually
correct in all other respects, is not clearly and unmistakably erroneous" (
ante at __, slip op. at 9) -- seems to be circular. For example, the
Court concludes that "an analysis of whether CUE has been committed may
only proceed on the . . . record at the time of the prior determination
. . . ." Ante at __, slip op. at 9. Yet, Russell, supra, this Court's
seminal opinion on CUE, very clearly established as a basis for CUE that "[
e]ither the correct facts, as they were known at the time, were not before
the adjudicator or the statutory or regulatory provisions extant at the
time were incorrectly applied." Russell, 3 Vet.App. at 313. Here both
factors may exist. The then-regulatory duty to assist may have been
violated in 1975, 1978, or 1979 (or more than one of those times), and
there is no question that "the correct facts" (the schizophrenia diagnosis
of the veteran in the
month after service) were not before the RO when it denied service
connection in each of those adjudications.
Hence, the Court's tautological distinction between an incomplete and
an incorrect record seems manifestly at variance with a fundamental
precept of Russell. Surely, it can just as reasonably be said that a
record which causes the adjudicator to deny a claim when the "correct
facts" would manifestly have produced the opposite result was an "
incorrect" record and not just an "incomplete" one. In any event, I find
nothing in Russell to warrant the incorrect/incomplete-record distinction
which the majority attempts to make.
Moreover, the majority has taken a quotation out of context from
Russell. Ante at __, slip op. at 9. The majority relied on the third
sentence in the following quotation without any reference to the first two
sentences:
The short answer is that the claim which is reversed or amended due
to a "clear and unmistakable error" is not being reopened. It is
being revised to conform to the "true" state of the facts or the law
that existed at the time of the original adjudication. New or
recently developed facts or changes in the law subsequent to the
original adjudication may provide grounds for reopening a case or for
a de novo review but they do not provide a basis for revising a
finally decided case.
Russell, 3 Vet.App. at 313. The reference to "new or recently developed
facts" in the extracted sentence refers to evidence that did not exist at
the time of the prior adverse determination as contrasted with "the 'true'
state of the facts . . . that existed at the time of the original
adjudication". Indeed, those latter words in Russell provide full, and
fully contextual, justification for the analysis I have set forth above
since, indisputably, the prior RO adjudications were not based on the "
true state of the facts".
I concede that there is some language in Russell that could form a
basis for the majority's conclusion here. That is the statement that a
CUE determination "must be based on the record and the law that existed at
the time of the prior [RO] or BVA decision." Id. at 314. That
particular phrase in the Russell opinion, however, seems to have been
focusing on the kind of example it went on to give of an error which could
not be CUE -- "a new medical diagnosis that 'corrects' an earlier
diagnosis ruled on by previous adjudicators . . . ." Russell, 3 Vet.App.
at 314. That is not the situation before us.
Moreover, the Russell language "record . . . that existed at the time"
is not the equivalent of the majority's paraphrase "record at the time of
the prior determination". Ante at __, slip op. at 9. The Russell
reference to "the record" must be read in the context of this Court's
decisions expanding what constitutes the "record" before the Department
for purposes of determining the scope of review in this Court under 38 U.S.
C. ù 7252(b), which limits that review to "the record of proceedings
before the Secretary and the Board". See Bell v. Derwinski, 2 Vet.App.
611, 612 (1992) (holding that documents which were not actually before the
adjudicators but had been generated by VA employees or submitted to VA by
claimant were, "in contemplation of law, before the Secretary and the
Board and should be included in the record"). This concept of a "
constructive" record greater than the record actually before the
adjudicators provides a useful analogy for squaring the Russell statements
in such a way as to conclude that an outcome-determinative document which
existed at a time when fulfillment of an existing duty to assist would
have discovered it was part of "the record" that should have been before
the adjudicators if they were to adjudicate the claim on the "correct
facts" or the "true state of the facts". See also Murincsak v. Derwinski,
2 Vet.App. 363, 372-73 (1992) ("The Court cannot accept the Board being
'unaware' of certain evidence, especially [but not necessarily exclusively]
when such evidence is in possession of the VA, and the Board is on notice
as to its possible existence and relevance.").
C. Response to Concurring Opinion's Reliance on Damrel Opinion
In his concurring opinion, Judge Kramer asserts that his opinion for
the Court in Damrel v. Brown, __ Vet.App. __, __, No. 93-171, slip op. at
5 (Feb. 18, 1994), "put to rest" the possibility that a duty-to-assist
violation could constitute CUE because "Damrel did nothing more than
synthesize the Russell test into three prongs". Ante at __, slip op. at
10. I do not quarrel with Damrel's synthesis, although the third prong
would constitute a binding holding only if the Court's decision sustaining
the Board's determination that there was no CUE in the 1967 prior RO
adjudication were dependent on that prong. However, as to each of the
two evidentiary items relied upon by the appellant in Damrel, the Court
there held explicitly that even if they had been included explicitly
within the record before
the RO in 1967, they would be "not controlling for VA determinations" (a
Social Security unemployability determination) and "not controlling with
respect to ratings for compensation or pension" (a VA determination of
total disability for VA insurance purposes). Damrel, __ Vet.App. at __,
slip op. at 6. Hence, in Damrel there could not have been a valid CUE
claim as to either piece of evidence since the Russell criterion of "
manifestly chang[ing] the outcome" could not have been met.
Moreover, the Damrel opinion, in synthesizing a third Russell prong,
reiterated the exact language of Russell that a CUE determination "must
be based on the record and the law that existed at the time of the prior"
adjudication. Id. at 5; Russell, 3 Vet.App. at 314. I have analyzed that
very language in part B., above, and explained how I believe those words
should be read in Russell in the context of the particular facts of this
case where the excluded true facts are undebatably outcome determinative.
Although Damrel may lend support to the majority's view on CUE here, it
hardly "put to rest" the issue before us in the instant case.
Finally, I want to stress again, as I did at the outset of part B.,
that the CUE prerequisite of manifestly changing the outcome could rarely
be met where the CUE asserted is a duty-to-assist failure. Only where it
is indisputable that compliance with the duty to assist would have changed
the outcome of the prior merits adjudication would such a CUE claim even
have to be considered. Making such an outcome-determinative judgment
would not involve the speculation suggested by the concurring opinion, but,
rather, would eliminate the need even to consider such a CUE assertion (
was there a violation of the duty to assist as it existed, if it did, at
the time?) in the vast majority of instances in which a duty-to-assist CUE
claim might be raised. As to the concurrence's Chicken-Little cry that a
Frankenstein's monster of "newly created evidence" that "bears a date
prior to that of the [old] adjudication" and "that purports to be outcome
determinative" will stalk our CUE jurisprudence, it would be well to
remember that the sky never did fall and to leave consideration of any
such factors to the elected policy-making branches of government.
D. Conclusion
For the above reasons, I would remand the appellant's properly raised
CUE claim for readjudication by the BVA on the basis of the above
analysis.