"It is the duty of the people to care for him who shall have borne the battle, his widow, and orphan."
-Abraham Lincoln

Tuesday, March 20, 2018

Porriello: CUE and Res Judicata


Porriello v. Shulkin, Case Number 16-2880, decided March 12, 2018 considers a request to revise a previous rating decision based on clear and unmistakable error in the context of a case that had previously been ruled upon by the Court and the Federal Circuit.

The veteran was discharged in 1961 after a medical board and a 1961 application for benefits was denied based on the condition being pre-existing service and not being aggravated during service and subsequently denied again after new evidence was submitted.

Ultimately, a 2005 decision granted service connection for the condition with a 100% rating.  The veteran then submitted a statement stating he believed the claim had been denied in error years before and that he was owed an earlier effective date.  A letter from a veterans service organization then asserted CUE in the 1968 denial without referencing the first 1961 decision or describing any particular theory of CUE.  The CUE claim was denied in 2006, appealed to the Board and a VSO argued a specific theory of CUE.  The Board denied in 2008 and the claim was appealed to the Court.  The veteran argued the 1961 decision improperly applied the presumption of soundness and presumption of aggravation.  A single judge decision stated even assuming a factual error, “whether a different result would have ensued was not absolutely clear.” Id. at *5.  Additionally, “[a]s to the presumption of aggravation, the Court found that the evidence of record in 1961 did not clearly establish that Mr. Porriello's … [condition] worsened.  Id. at *5.  The decision was affirmed by the Federal Circuit without comment.

Subsequently, the veteran filed “ a request for revision of the March 1961 rating decision on the basis of CUE.  The request generally argued that the rating decision improperly applied the presumption of soundness.”  The request was denied by the RO and Board and in his NOD noted this NOD was the first time he had specifically alleged CUE in the 1961 decision and the 2005 statement did not present a specific allegation of CUE and thus should have been dismissed.

“Mr. Porriello argues that the May 2008 Board lacked subject matter jurisdiction to consider any allegation of CUE in the 1961 and 1968 rating decisions because he never presented any specific allegation of CUE at the outset of proceedings leading to that decision.”  Id. at *6.  He further argued “the May 2008 Board should have dismissed the appeal and, having failed to do so, its decision is "a nullity at law."  He concludes that the May 2008 Board decision could not have subsumed the 1961 and 1968 rating decisions because the Board lacked jurisdiction.”  Id. at *6.  “The Secretary's counterarguments assume the validity of the court decisions, which Mr. Porriello disputes on the basis the Board lacked jurisdiction to render its 2008 decision.”  Id. at *7.

The Court began by stating “As an original matter, Mr. Porriello's jurisdictional arguments might have force and weight.  Not only was there no specific allegation of CUE in Mr. Porriello's February 2005 statement, but the May 2008 Board's jurisdiction over the 1961 rating decisions is also murky at best.” Id. at *8.  However, the Court then stated

The time for raising such jurisdictional objections, however, has passed. "A litigant . . .
may raise a court's lack of subject-matter jurisdiction at any time in the same civil action, even initially at the highest appellate instance." "Even subject matter jurisdiction, however, may not be attacked collaterally." "[T]he need for finality forbids a court called upon to enforce a final order to 'tunnel back . . . for the purpose of reassessing prior jurisdiction de novo.'"

Id. at *8 (internal citations omitted).

The Court then found:

Mr. Porriello had the opportunity to raise the jurisdictional issue in his appeal of the May
2008 Board decision, both to this Court and to the Federal Circuit. He did not raise any such jurisdictional challenge, either in his briefs to this Court or in his briefs to the Federal Circuit.  Caselaw uniformly provides that he may not attack the jurisdiction of the 2008 Board, or of this Court, or of the Federal Circuit, collaterally. The Court concludes that the 2008 Board decision and the decisions of this Court and the Federal Circuit are valid as well as final.

Id. at *9.

The Court then determined the requirements of res judicata had been met in this case and stated

Whether, based on the facts of the case, a claim is barred by the doctrine of res judicata is
a question of law that [appellate courts] review de novo."  Here, all the requirements for the application of res judicata are met. As discussed above, Mr. Porriello's failure to raise any jurisdictional challenge on direct appeal means that the decisions of the Board, this Court, and the Federal Circuit are both final and valid.
***
Clearly, the 2008 Board decision, which this Court and the Federal Circuit upheld, was on the merits and the parties are the same. Thus, the doctrine of res judicata precludes raising the same CUE theory again. Consequently, the Board was correct in dismissing the appeal of the CUE motion.

Id. at *10. 

While the case shows the Court is willing to end an appeal on res judicata grounds (something I don’t remember happening before), this is a narrow decision addressing CUE and a history of the case before the Court. 

Decision by Chief Judge Davis and joined by Judges Bartley and Meredith.

Monday, March 19, 2018

Golden: PTSD and GAF Scores


Golden v. Shulkin, Case Number 16-1208, decided February 23, 2018 considers the Board’s reference to GAF scores when setting a PTSD rating.  The Court strictly determines GAF scores should not be considered. 

As said by the Court:

The "Global Assessment of Functioning" scale was a scale ranging from 0 to 100, that was created to reflect "psychological, social, and occupational functioning on a hypothetical continuum of mental health illness." See DSM-IV at 32. In other words, a GAF score was a numerical summary on a standardized scale reflecting the presence and severity of psychological symptoms and their effects.

Id. at *4.

GAF scores were long considered by the VA in setting a PTSD rating.  However, in August 2014 the VA amended its regulations to replace references to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) with references to DSM-V.  The DSM-V had done away with references to GAF scores because the American Psychiatric Association found them lacking in clarity and usefulness.  Id. at *5.

In this case, the Board did discuss the veteran’s GAF scores and stated: “While the Veteran's GAF scores have fluctuated over time, his lowest score assigned – 40 in May 2010 – is consistent with no greater impairment than that contemplated by the assigned 70 percent rating. In fact, the Veteran has also received GAF scores that would indicate only serious or moderate symptomatology.”  Id. at *3. 

The Appellant argued the Board erred in but argued the GAF scores were relevant, but the scores must be addressed within a context of noting they were methodologically flawed and particularly unreliable when applied to PTSD.  Id. at *3.  The Secretary also argued reference to GAF scores was required because the Board had to consider all pertinent evidence and any error was non-prejudicial.  Id. at *3-4.

The Court rejected both arguments, stating: “Given that the DSM-5 abandoned the GAF scale and that VA has formally adopted the DSM-5, the Court holds that the Board errs when it uses GAF scores to assign a psychiatric rating in cases where the DSM-5 applies.”  Id. at *5.  The Court also stated

The Board's rating analysis for psychiatric disorders has always been "symptom driven,"
meaning that "symptom[s] should be the fact finder's primary focus when deciding entitlement to a given disability rating." The Court simply clarifies that, to the extent that the Board may have been tempted to use numerical GAF scores as a shortcut for gauging psychiatric impairment, such use would be error. 

Id. at *6 (internal citations omitted).

The Court further addressed the Secretary’s argument that reference to the GAF scores was non-prejudicial error.  It stated:

Although it is possible that the Board may have analyzed the appellant's GAF scores in response to his argument that his low GAF score of 40 entitled him to a higher rating the Board did not provide this explanation, and the Court is unable to conclude that the Board's decision would have been the same had the discussion of GAF scores been removed. The Court does not hold that the Board commits prejudicial error every time the Board references GAF scores in a decision, but in this case, it is unclear whether the Board's discussion of the GAF scores was prejudicial.

Id. at *7.

While the GAF score was an easy shorthand way of generating a rating, it was unreliable and it is probably better the Court simply forbade reference to it than preserving it as a piece of evidence to be analyzed.  This case will be grounds for many appeals dealing with mental health issues as the Board and some advocates have continued to reference GAF scores in their arguments.

Decision by Judge Greenberg, joined in by Judges Pietsch and Allen.