Mattox: Balancing Competing Medical Opinions

Mattox v. McDonough, Case Number 2021-2175, decided by the Federal Circuit Court of Appeals on January 9, 2023 involved what the Board should do when there are two competing medical opinions and resolved that the Board did not err in looking both at the quantity and quality of the opinions in making a decision.

The veteran argued “because the record (as it pertained to whether he had service-connected PTSD) contained one physical piece of evidence pointing each way (the contradictory opinions of his private doctor and the VA examiner), it stood numerically even on the issue of his condition. Under these circumstances, Mr. Mattox urged, the VA was required by law to give him the benefit of the doubt and concede that he suffered from service-connected PTSD.”  Id. at *7. 

The Federal Circuit reiterated that the Board should assign probative value to the evidence and stated: “In short, when conducting a benefit-of-the-doubt-rule analysis, as in other settings, the Board is required to assign probative value to the evidence.”

The Federal Circuit also considered whether the Board applied the proper standard saying “in Mr. Mattox’s case, the Board followed the proper approach of assigning probative value to the relevant evidence and determining whether “the evidence persuasively favor[ed] one side or the other.” The Board’s erroneous reference to “a preponderance of the evidence” did not affect the correctness of its overall analysis.”  Id. at *17.

Essentially the Federal Circuit rejected a theory that a benefit of the doubt analysis requires a mathematical calculation of pro versus con evidence and then a grant if they are numerically equal.  Instead, they focus on the persuasiveness or quality of the evidence.  Of course, this quality standard will only lead to more disputes over decisions, but fortunately for the Federal Circuit their refusal to consider anything but legal disputes will effectively prevent those decisions from ever being considered by the Federal Circuit.  The Veterans Court’s deferential review standard also means that whatever the VA says will likely by upheld with little recourse except filing a supplemental claim with new evidence, and thus the hamster wheel is perpetuated by the Courts.

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