Joseph Spellers v. Robert L. Wilkie

CourtUnited States Court of Appeals for Veterans Claims
DecidedSeptember 7, 2018
Docket16-4053
StatusPublished

This text of Joseph Spellers v. Robert L. Wilkie (Joseph Spellers v. Robert L. Wilkie) is published on Counsel Stack Legal Research, covering United States Court of Appeals for Veterans Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Joseph Spellers v. Robert L. Wilkie, (Cal. 2018).

Opinion

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

No. 16-4053

JOSEPH SPELLERS, APPELLANT,

V.

ROBERT L. WILKIE, SECRETARY OF VETERANS AFFAIRS, APPELLEE.

On Appeal from the Board of Veterans' Appeals

(Argued April 19, 2018 Decided September 7, 2018)

Dana N. Weiner and Alyse E. Galoski, with whom Lauren E. Robbins was on the brief, all of Providence, Rhode Island, for the appellant.

Anthony D. Ortiz and Carolyn F. Washington, with whom James M. Byrne, General Counsel; and Mary Ann Flynn, Chief Counsel, were on the brief, all of Washington, D.C., for the appellee.

Before BARTLEY, ALLEN, and MEREDITH, Judges.

ALLEN, Judge: The appellant, Joseph Spellers, is a veteran of the U.S. Army with honorable service. He is service connected for bilateral lower extremity sciatica. He also uses a cane and walker as a result (at least in part) of this condition. He timely appeals a November 17, 2016, Board of Veterans' Appeals (Board) decision denying referral for consideration of an extraschedular rating under 38 C.F.R. § 3.321(b)(1). This matter was submitted to a panel of the Court principally to address whether the Board must consider the appellant's use of assistive devices, such as a cane or walker, in its extraschedular analysis of his sciatica. As we will further explain, because of the nature of the criteria contained in 38 C.F.R. § 4.124a, Diagnostic Code (DC) 8520 and 38 C.F.R. § 4.120, we hold that the schedular rating criteria contemplate the symptoms necessitating the use of assistive devices, as well as the severity of those symptoms, and thus referral for extraschedular consideration on that basis was not warranted. But, remand is nonetheless warranted because the Board gave an inadequate statement of reasons or bases for finding the appellant's report of side effects from his pain medications not credible. Therefore, the Court will set aside the November 2016 Board decision on appeal and remand this matter for further proceedings. I. FACTS AND PROCEDURAL HISTORY In January 2006, VA granted service connection to the appellant for a low back strain and eventually awarded a 20% disability rating. Following VA examinations, VA also awarded 10% disability ratings for sciatica of each of his legs in November 2009. The appellant appealed these ratings to the Board, which denied an increase (including on an extraschedular basis) in a May 2015 decision. He appealed the Board decision only to the extent that he had been denied referral for consideration of an extraschedular rating. In March 2016, the Court granted a joint motion for partial remand on that issue. In the November 17, 2016, decision on appeal, the Board declined to refer the appellant's claim for consideration of a disability rating higher than 10% for right and left lower extremity sciatica on an extraschedular basis. The Board considered the appellant's use of a cane and walker and concluded that, although they are "not specifically listed in the rating criteria for evaluating neurologic disabilities, assistive devices are provided to alleviate the presence of symptoms and/or functional limitations caused by an individual's disability." Record (R.) at 11. The Board found that the appellant's symptoms that required the use of assistive devices "are fully contemplated by the rating criteria and associated regulations" and "the use of such assistive device directly addresses a veteran's functional limitations." R. at 12. Therefore, the Board concluded, "the use of such devices does not create an exceptional disability picture such that the rating criteria is inadequate." Id. The Board also considered the appellant's use of pain medication and its associated side effects in connection with its extraschedular analysis but found that his reports were not credible. The Board based its credibility determination in large measure on the appellant's failure to report certain side effects during treatment at various times, as purportedly required under a patient agreement he signed. Finally, the Board considered the collective impact of the appellant's service-connected disabilities and concluded that referral for extraschedular consideration was not warranted on this basis because all his symptoms are contemplated by the rating criteria for each disability individually.

II. ANALYSIS Our analysis begins with a discussion of the caselaw governing extraschedular analysis and the framework provided for the schedular criteria for sciatica. We then address the appellant's argument that the Board failed to properly consider his use of assistive devices in this context.

2 Next, we discuss the Board's credibility determination relating to the side effects of the appellant's pain medication and, in that context, the appellant's argument that the Board failed to address the second part of an extraschedular analysis. Finally, we briefly address the appellant's argument that the Board erred in assessing whether an extraschedular referral was warranted based on his combined service-connected disabilities. A. Use of Assistive Devices and Diagnostic Code 8520 1. Extraschedular Framework Service-connected disabilities are assigned ratings to adequately compensate veterans. 38 C.F.R. § 3.321(a) (2018); King v. Shulkin, 29 Vet.App. 174, 178-79 (2017). When the corresponding or analogous DC for evaluating a disability is insufficient to compensate a veteran for a service-connected disability, see 38 C.F.R. §§ 4.20, 4.27 (2018), extraschedular evaluation may be appropriate. For these exceptional cases, 38 C.F.R. § 3.321(b)(1) provided, in relevant part: To accord justice . . . to the exceptional case where the schedular evaluations are found to be inadequate, the Under Secretary for Benefits or the Director, Compensation Service, upon field station submission, is authorized to approve on the basis of the criteria set forth in this paragraph an extra-schedular evaluation commensurate with the average earning capacity impairment due exclusively to the service-connected disability or disabilities. The governing norm in these exceptional cases is: A finding that the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards.[1]

In Thun v. Peake, this Court held that determining whether a veteran is entitled to a referral for consideration of extraschedular rating under § 3.321(b) requires a three-part inquiry. 22 Vet.App. 111, 115 (2008), aff'd sub nom. Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). The first element requires the Board to determine whether the "evidence before VA presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate." Id. This requires the Board to compare a veteran's specific symptoms

1 This version of § 3.321(b)(1) was in effect until January 8, 2018, when an amended version took effect.

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Joseph Spellers v. Robert L. Wilkie, Counsel Stack Legal Research, https://law.counselstack.com/opinion/joseph-spellers-v-robert-l-wilkie-cavc-2018.