Opinion

Ivan R. Sellers v. Eric K. Shinseki

  • 25 Vet. App. 265
  • 2012 U.S. Vet. App. LEXIS 1282
  • 2012 WL 2380247
Court
United States Court of Appeals for Veterans Claims
Filed
Jun 26, 2012
Status
Published
On the bench
Kasold, Hagel, Schoelen
Cited by
5 cases
Authority
More cited than 25.4%

explaining that the issue of how notice was received by the parties is moot where actual receipt serves to establish finality for purposes of appeal to this Court

How later courts described this case

  • explaining that the issue of how notice was received by the parties is moot where actual receipt serves to establish finality for purposes of appeal to this Court
  • “[0]ur caselaw makes clear that defects of deci-sional notice are cured when the record demonstrates that the claimant and his representative actually received notice of the decision.”

Written by the judges who cited it.

The opinion

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

NO. 08-1758

IVAN R. SELLERS, APPELLANT,

V.

ERIC K. SHINSEKI,

SECRETARY OF VETERANS AFFAIRS, APPELLEE.

On Appeal from the Board of Veterans' Appeals

(Argued November 9, 2011 Decided June 26, 2012)

Douglas J. Rosinski, of Columbia, South Carolina, with whom James E. Swiger, of

Centreville, Virginia, was on the brief for the appellant.

James B. Cowden, with whom Will A. Gunn, General Counsel; R. Randall Campbell,

Assistant General Counsel; and Richard Mayerick, Deputy Assistant General Counsel, all of

Washington, D.C., were on the brief for the appellee.

Before KASOLD, Chief Judge, and HAGEL and SCHOELEN, Judges.

SCHOELEN, Judge, filed the opinion of the Court. KASOLD, Chief Judge, filed an opinion

concurring in the result.

SCHOELEN, Judge: The appellant, Ivan R. Sellers, through counsel, appeals an April 2,

2008, Board of Veterans' Appeals (Board or BVA) decision in which the Board determined that a

July 14, 1988, rating decision did not contain clear and unmistakable error (CUE). Record (R.) at

18. The Board also confirmed that the appellant was not entitled to an effective date earlier than

February 5, 2004, for service connection for retinitis pigmentosa (RP),1 as found by the January 31,

2005, Houston VA regional office (RO) decision. Id. Both parties filed briefs, and the appellant

filed a reply brief. It was later revealed that a June 1, 2004, rating decision had found CUE in the

July 1988 rating decision and awarded a March 25, 1988, effective date for service connection for

1

"Retinitis Pigmentosa" is "a group of diseases, frequently hereditary, marked by

progressive loss of retinal response . . . , retinal atrophy, attenuation of the retinal vessels, and

clumping of the pigment, with contraction of the field of vision." DORLAND'S ILLUSTRATED

MEDICAL DICTIONARY 1634 (32d ed. 2012) [hereinafter DORLAND'S].

RP. R. at 287-93. A limited remand from this Court to the Board resulted in a June 29, 2011,

supplemental Board decision in which the Board determined that the June 2004 rating decision was

authentic, but only a draft decision. See Ivan Sellers, BVA 08-1758, at 10, 12 (June 29, 2011).

Thereafter, the parties filed supplemental briefs. This appeal is timely, and the Court has jurisdiction

to review the Board's decision pursuant to 38 U.S.C. §§ 7252(a) and 7266(a). Because the Court

finds that the June 2004 RO decision binds VA and the January 2005 RO decision is void ab initio,

the Court will set aside the Board's April 2008 decision and reverse in part and affirm in part the

Board's June 29, 2011, supplemental decision.

I. FACTS

A. Claim for Entitlement to Service Connection for RP

The appellant served on active duty in the U.S. Army from January 1966 to October 1973.

R. at 304. In his November 1965 medical history report, the appellant attested that he had a history

of eye trouble and that he wore eyeglasses. R. at 466-67, 481. The enlistment examination report

observed that the appellant's visual acuity, refraction, pupil equality and reaction, and ocular motility

all appeared in normal condition. R. at 484. These impressions were confirmed in the appellant's

September 1973 separation examination, which concluded that all visual functions were normal.

R. at 454.

Nine days after the appellant's separation examination, an ophthalmology examination was

conducted because he complained of flashing lights in his left temporal field and a restricted field

of vision. R. at 456. The examiner observed that the appellant had suffered visual field contraction

and retinal pigment epithelium (RPE) "defects."2 Id. The examiner concluded, however, that "no

pathology" existed. R. at 456.

In June 1982, a private physician diagnosed the appellant with RP. R. at 500. The physician

described the condition as "a collection of disorders which are characterized by night blindness,

peripheral visual loss, and, in the later stages of the disease, central vision problems, color vision

problems, and reading difficulties." Id. The physician advised that the condition is almost always

2

RPE is the outer pigmented layer of the optical part of the retina that extends from the

entrance of the optic nerve to the pupillary margins of the iris. See DORLAND'S at 1781.

2

hereditary, but that the appellant had "no specific evidence of similar problems in other members of

[his] family." Id.

In March 1988, the appellant filed a claim for entitlement to disability compensation for RP

with cataracts. R. at 488-94. In July 1988, the RO issued a rating decision denying the claim. R.

at 451-52. The RO explained the relevant facts as follows:

On separation exam[ination], [the veteran] complained of decreased peripheral vision

and decreased night vision, and op[h]thalmological evaluation also showed

complaints of flashing lights in the left temporal field. No definite pathology was

found. [Private physician] reports show [the veteran] has progressive bilateral

retinitis pigm[e]ntosa and has undergone bilateral catara[c]t extraction. There is no

evidence of eye trauma in service.

R. at 452. The RO concluded that the appellant's condition was a constitutional or developmental

abnormality (CDA) and that it was not aggravated in service. Id. The September 1988 Statement

of the Case (SOC) explained that the appellant's RP was a CDA, and CDAs "can only be service-

connected by aggravation."3 R. at 447. To establish service connection by aggravation, the RO

continued,

[i]t must be actively shown that the condition was made worse by some specific

portion of the veteran's military service and made worse at a rate faster than the

normal progression of the condition. There is no evidence that the veteran's

condition was in any way aggravated by his military service or caused to progress

faster than his normal progression by that military service.

Id. The appellant failed to perfect an appeal and the decision thus became final.

In February 2004, the appellant filed a statement arguing that the July 1988 RO decision was

premised upon CUE. R. at 410-11. VA construed the appellant's filing as both a request to reopen

his claim and a request to revise the July 1988 RO decision because of CUE. R. at 15, 346.

B. The Houston RO's Claim Processing: February 2004 to September 2004

The appellant states that on June 14, 2004, he received a phone call from RO official Cynthia

Canady, who told him that (1) the RO had made a decision on his request to revise the July 1988 RO

3

Our concurring colleague briefly questions whether the VA determination that RP is a

congenital condition, and thus not compensable via in-service incurrence, may stand against the

congressionally mandated presumption of soundness. We do not address this question as it was

not raised by the parties and is not necessary to our decision.

3

decision based on CUE; (2) CUE was found in the July 1988 RO decision; (3) he would receive a

July 1988 effective date with a "one time car allowance"; and (4) he would receive "a letter in about

a week to ten days stating this award."4 R. at 320. A week later, on June 21, 2004, Ms. Canady e-

mailed the appellant's representative and advised him that "VA has made a decision on Mr.

Sellers['s] claim." R. at 540. She asked for an address to which to send "a copy of the rating

decision and notification letter." Id.

That same day, according to a VA report of contact prepared by Ms. Canady, she spoke with

the appellant's wife to "verify dependent information in [the] claim folders." R. at 390. On June 23,

2004, the appellant's representative responded to Ms. Canady's June 21, 2004, e-mail and provided

a Denver, Colorado, street address for the Blinded Veterans Association. R. at 540.

About a week later, the appellant phoned Ms. Canady to ask why he hadn't yet received his

notification letter. R. at 320. She responded that it might take a month to receive the letter, but that

she had completed the payment tabulation. Id. She quoted the appellant a total award figure of

$495,963.03, but she stated that the figure could change because it needed to be reviewed by two

other officials. Id.

In late July 2004, the appellant called Ms. Canady again to check on the status of the

notification letter, but she said that she could not explain why it had been delayed since her

tabulations had been "corrected and verified." Id. Ms. Canady advised that his total award would

be $534,233.33 plus an $11,000 one-time car allowance. Id.

During the second week of September 2004, the appellant again called Ms. Canady to inquire

into the status of the notification letter. Id. Upon investigation, Ms. Canady found that the file had

been with "the rating board" since August 23, 2004, despite the fact that it bore two of the three

signatures needed for disbursement. Id. Ms. Canady said that she could not explain why

transmission had been delayed and that she could not help the appellant any further. Id.

After again inquiring about the status of the letter that same week, the appellant was directed

4

This account comes from a January 11, 2005, letter submitted to VA on behalf of the

appellant by U.S. Senator John Cornyn's office (January 2005 Cornyn Inquiry Letter), which

contains the appellant's typewritten account of his interactions with the Houston RO from June

14, 2004, through December 2004. R. at 319-21.

4

to the Visual Impairment Services Team (VIST) coordinator at the Houston RO. R. at 320-21. The

appellant phoned the VIST coordinator who advised that an issue had arisen regarding the appellant's

effective date and that he would look into it. R. at 321. There is no evidence that any followup was

conducted.

C. The Houston RO's Claim Processing: October 2004 to February 2005

On October 28, 2004, RO Decision Review Officer (DRO) Beverly Cole sought advice from

the VA regional counsel, based in New Orleans, Louisiana, regarding the July 1988 RO decision.

R. at 294-95. In particular, Ms. Cole sought guidance on whether a March 1985 unpublished

General Counsel (GC) opinion was binding and whether it would require the July 1988 RO decision

to be revised based on a finding of CUE. R. at 294.

A regional counsel staff attorney responded to Ms. Cole's request on December 7, 2004,

prefacing her response with the statement that she could not opine on whether the GC opinion would

determine whether the July 1988 RO opinion contained CUE, but explaining that she could "advise

on portions" of the request. R. at 295. The staff attorney also noted that the "claims folder contains

a rating decision dated June 1, 2004." R. at 296. The staff attorney did not, however, comment on

the significance of the June 2004 RO decision's presence in the claims file.

On November 14, 2004, the appellant submitted a letter to the RO in which he stated:

Please allow me to explain some concerns I have about my claim. Having my initial

claim and its appeal denied in 1988 and now having been told my recent appeal was

approved, you can imagine the excitement my family and I have felt . . . . I must

admit my excitement is waning as the months pass by and my phone calls to [the

Houston RO VIST coordinator] haven't been returned.

* * * *

I have been informed that my claim is with the Rating Board. I also understand it's

with the Decision Review Offices. What I don't understand is why my claim received

two of the three necessary signatures and yet it is back to more review . . . . Why the

long delay?

* * * *

I want you to please write me a letter detailing where my claim actually is and how

much longer I should expect [to wait] before my claim is finalized.

R. at 386. There is no record evidence showing that any RO official responded to the appellant's

letter. During the first week of December 2004, the appellant again contacted the RO and, several

5

days later, an RO official advised the appellant that his file had been sent to New Orleans for a legal

opinion. R. at 321. The official explained that there was a legal question whether the effective date

would be 1988 or 1989, and that legal counsel recommended "us[ing] the earlier date," but that VA

nevertheless owed the appellant money and that they would pay him. Id. In the second week of

December 2004, the appellant visited the RO in person and was advised that the effective date for

his evaluation would be February 5, 2004, the date of his CUE request to revise the July 1988 RO

decision. Id.

On December 14, 2004, an RO rating specialist solicited an eye examination from the VA

medical center as to the "[e]tiology/onset" of the appellant's RP. R. at 293, 377-79. At the January

14, 2005, examination, the examiner concluded that the appellant suffered from advanced RP "with

very significant loss of peripheral vision [in] both eyes and small islands of vision remaining [in]

both eyes." R. at 325. The physician concluded that it was

at least as likely as not that the retinitis pigmentosa began to manifest while the

patient was in military service. This is based not only on his own anecdotal

experiences of reduced peripheral and night vision while actively engaged in his

military duties but also based on viewing records of eye exams when he was

separated from military service in September of 1973 during which time he made

similar complaints . . . . As for whether the retinitis pigmentosa was aggravated by

the patient[']s military service, I cannot resolve that issue without resort to mere

speculation.

Id.

On January 31, 2005, the RO issued a decision granting service connection for RP effective

February 5, 2004, but denying the appellant's request to find that the July 1988 RO decision

contained CUE. R. at 352-71. The decision also awarded the appellant entitlement to special

monthly compensation, adapted housing, and automobile and adaptive equipment. R. at 366, 371.

The January 2005 RO decision was signed by two officials: (1) Susan Durkin, and (2) Beverly Cole,

the DRO who had sought an opinion from the VA regional counsel in October 2004. R. at 294, 371.

D. The Appellant's Notice of Disagreement and Subsequent RO Actions

On March 11, 2005, the appellant, through his representative, filed his NOD with the January

2005 RO decision. R. at 332. On May 3, 2005, the appellant filed a statement setting forth more

fully the reasons he disagreed with the RO's denial of his request to revise the July 1988 RO decision

6

based on CUE.5 R. at 286. In particular, the appellant stated:

I am [] submitting a copy of [an] undated VARO letter with rating decision dated

June 1, 2004, as evidence that my effective date should be March 25, 1988, as this

previous decision established. I contend this effective date is based on a Clear and

Unmistakable Error (CUE) . . . .

Id. The June 2004 RO decision that the appellant attached to his correspondence found CUE in the

July 1988 RO decision and granted entitlement to service connection for RP at a 100% evaluation,

effective March 25, 1988. R. at 289, 292. The June 2004 RO decision set forth the reasons for the

decision and a summary of the evidence. R. at 290-91. The June 2004 RO decision also granted

special monthly compensation and entitlement to automobile and adaptive equipment. R. at 292-93.

That decision contained the signatures of three officials: (1) Susan Durkin, who also signed the

January 2005 decision; (2) "L. Spurlock"; and (3) the illegible signature of an official purporting to

sign "for" Paul Black, Chief of the Houston RO.6 R. at 293.

The cover letter that the appellant submitted with the June 2004 RO decision was addressed

to the appellant's representative in Denver, Colorado. R. at 287. The letter is undated, but contains

the stamped signature of Houston RO Chief Paul Black. R. at 287-88. Unlike the June 2004 RO

decision, the cover letter refers only to the appellant's entitlement to automobile and adaptive

equipment.7 R. at 287-88.

However, the letter's "Enclosure(s)" line contains three entries: (1) "VA Form 4107"; (2) "VA

Form 21-4502;" and (3) "Rating Decision." R. at 288 (emphasis added). The letter further explains

"[t]he enclosed VA Form 4107, 'Your Rights to Appeal Our Decision,' explains your right to appeal."

Id. The letter also notes that VA Form 21-4502 is the "Application for Automobile or Other

Conveyance and Adaptive Equipment." R. at 287. The record is not clear as to when or how the

appellant obtained the notification letter or the June 2004 RO decision.

5

The May 2005 statement was received by the RO on June 6, 2005. R. at 286.

6

In its June 29, 2011, supplemental decision, the Board found that the third signer was a

"coach," who "sign[ed] on behalf of the Chief, Veteran's Service Center." See Ivan Sellers, BVA

08-1758, at 5.

7

The record does not contain any rating decision decided prior to the June 2004 RO

decision that granted entitlement to automobile and adaptive equipment.

7

On August 22, 2005, the RO issued an SOC in response to the appellant's March 2005 NOD,

reiterating its January 2005 finding that the July 1988 RO decision did not contain CUE. R. at 200-

25, 249-76. The August 2005 SOC neither mentioned nor acknowledged receipt of the appellant's

May 2005 statement discussing the attached June 2004 RO decision.

On October 14, 2005, the appellant, through his representative, submitted his Substantive

Appeal to the Board. R. at 177-88. This document appealed the August 2005 SOC. The Substantive

Appeal does not mention the May 2005 statement or the June 2004 RO decision. In response to the

appellant's Substantive Appeal, the RO issued a Supplemental Statement of the Case (SSOC) on

April 10, 2006. R. at 173-76. The April 2006 SSOC does not mention the May 2005 statement or

the June 2004 RO decision. R. at 173.

On June 22, 2006, the appellant requested a hearing in connection with his "pending appeal

for effective date and Clear and Unmistakable Error (CUE) for retinitis pigmentosa." R. at 154. At

the December 18, 2006, hearing held at the RO by DRO Marian Peters, the appellant testified that

he had received a call on June 14, 2004, advising him that his request to revise the July 1988 RO

decision based on CUE had been granted and that he would receive a check "for the retroactive

payback of [sic] March 1988." R. at 81. The appellant explained that subsequent attempts to obtain

the retroactive payment based upon the June 2004 RO decision were unfruitful. R. at 81-82. In

response, DRO Peters stated that

we've had the person in our front office [] look at this case; like you were saying you

were called [and told] that it had been approved; that is true. We tried to grant the

benefit from our perspective, but the front office said No! This is an incorrect

decision. As a DRO I cannot overrule what the front office says; however, I am

going to wait until I get your transcript back with everything that you have said in this

hearing today. When I get that transcript back, I'm going to go and see if I can talk

to some people that are in the front office to see if they will listen and see . . . if they

will listen and read what you have told me concerning the law that we should apply

. . . but I as a Decision Review Officer cannot overrule what the front office says

because a decision review officer prior to me was the one that signed off on the rating

granting, saying it was a clear and unmistakable error . . . . I cannot promise you

anything.

R. at 83 (emphasis added).

On June 21, 2007, the RO issued a second SSOC, signed by DRO Dexter Leavitt, in which

it reaffirmed its January 2005 finding that the July 1988 RO decision did not contain CUE. R. at 66-

8

72. The appellant appealed this RO decision. R. at 57.

E. Proceedings Before the Board

On December 17, 2007, the Board conducted a hearing at which the appellant testified as to

his failed attempts to obtain the disability compensation award dictated by the June 2004 RO

decision. R. at 29-30. With respect to the June 2004 RO decision, the appellant stated: "I have a

copy of it, I have the signed signatures and when I showed it to someone [] in the regional office they

were surprised that I had signatures because I'm not supposed to have . . . [the] decision . . . ." R. at

29. The appellant continued that he "was never told why [the June 2004 RO decision] was not

allowed," and that was why he had a "bad taste in [his] mouth." R. at 29-30.

On April 2, 2008, the Board issued a decision denying the appellant's motion to revise the

July 1988 RO decision based on CUE, but failed to acknowledge or discuss the June 2004 RO

decision. R. at 2-18. Instead, the decision focused on the merits of the appellant's motion for

revision based on CUE and earlier-effective-date argument. R. at 4-16.

F. Procedural History on Appeal: The June 2004 RO Decision Revelation

On June 9, 2008, the appellant filed his Notice of Appeal to this Court. The appellant's initial

and reply briefs, prepared by his attorney at the time, failed to mention the June 2004 RO decision.

The record did not include the June 2004 RO decision or any related documents, and it lacked

several documents critical to the appeal, including the August 2005 SOC and the complete January

2005 RO decision.

On January 25, 2011, the Court issued a memorandum decision affirming the Board's April

2, 2008, decision that the July 1988 RO decision did not contain CUE. See Sellers v. Shinseki, No.

08-1758, 2011 WL 219905 (Jan. 25, 2011). On February 10, 2011, the appellant's counsel moved

to withdraw citing the appellant's instruction, and the Court granted his motion 15 days later. The

next day, the appellant filed a motion for panel review pro se, attaching the June 2004 RO decision

as evidence that he was entitled to a March 1988 effective date pursuant to MacKlem v. Shinseki,

24 Vet.App. 63 (2010). See Motion for Panel Review at 3-5, 8-12.

On May 27, 2011, the Court granted the appellant's motion for panel review, withdrew the

January 25, 2011, memorandum decision, and remanded the matter to the Board for the limited

purpose of determining (1) whether the June 2004 RO decision was an authentic document; and (2)

9

whether it was the subject of the Extraordinary Award Procedure (EAP), invalidated by the U.S.

Court of Appeals for the Federal Circuit (Federal Circuit) in Military Order of the Purple Heart v.

Secretary of Veterans Affairs, 580 F.3d 1293 (Fed. Cir. 2009) (Purple Heart).

On remand, the same Board member who presided over the appellant's December 2007 Board

hearing and who produced the April 2008 Board decision began by making the following

observations:

[T]he Board notes that the June 2004 document was not of record at the time of the

Board's April 2008 decision. This document was first submitted by the Veteran in

June 2005. This document appears to be a document created by the RO, and shows

that it was signed by three RO personnel (a rating specialist, a decision review

officer, and a "coach" (signing on behalf of the Chief, Veteran's Service Center)),

who determined that the July 1988 decision, which denied service connection for

retinitis pigmentosa, was CUE.

Ivan Sellers, BVA 08-1758, at 5. The Board ultimately concluded that the June 2004 RO decision

was authentic. Id. at 6.

The Board next found that the June 2004 RO decision was not promulgated pursuant to the

EAP. Id. at 9. The Board first explained that the EAP at issue in MacKlem and Purple Heart was

not in effect at the time the June 2004 RO decision was revised. Id. at 10. The Board also found that

nothing indicated that the June 2004 RO decision was subject to an "EAP-like" process. Id. The

Board further observed that there was no basis to show that the RO sought and obtained a

determination from the Compensation and Pension Service or other decisionmaker outside the RO.

Id. at 11. On the contrary, according to the Board:

The evidence shows that the Veteran's claim was adjudicated only by RO personnel,

specifically, the January 2005 grant of his claim was signed by two RO personnel.

He is therefore not shown to have been denied "in person" interaction with the

deciding officials, as required by 38 C.F.R. § 3.103(c)(2).

Id.

The Board also found that the June 2004 RO decision was not received "in the regular course

of business" by the appellant:

This document does not bear a date stamp, or any other indication, to show that it

was ever mailed to the Veteran, nor does the Veteran contend[] that he received this

document in the regular course of business as a decisional document. See 38

U.S.C.A. § 5104. This document is not accompanied by a cover letter, nor does it

10

contain any indication that it notified the Veteran of his appellate rights. See 38

C.F.R. § 19.25 (2010). In short, there is nothing to show that this document was

provided to the appellant in the regular course of business as a decisional document.

In this regard, the Veteran has stated that he was advised that his claim had been

granted during telephone conversations with RO personnel in June 2004. See

Veteran's letters, received in January 2005 and August 2010. In his January 2005

letter to his Congressman, he clearly expressed frustration that an award letter had

not been received. The fact that VA did not transmit the June 2004 provisional

document to the Veteran in the normal course of business is a clear indication that

VA did not intend the June 2004 document to be a final decision.

Id. at 10.

The Board ultimately concluded that the June 2004 RO decision "was apparently written up

as a . . . draft decisional document," and was subject to further review, including review informed

by advisory legal and medical opinions. Id. at 11 (emphasis in original). The Board also noted that

receipt of incorrect information from RO personnel alone is not a basis upon which to award

benefits. Id. at 12.

G. Procedural History on Appeal: Supplemental Briefing on the June 2004 RO Decision

In September 2011, the Court required the parties to submit supplemental briefing on two

jurisdictional questions raised by the supplemental Board decision. First, the parties were required

to articulate what transmission from VA to a claimant is considered a "decision" that binds VA field

offices and to discuss whether the June 2004 RO decision constitutes such a decision. September

2011 Briefing Order at 1. Second, the parties were ordered to address whether the presumption of

regularity attached to the manner in which the June 2004 RO decision was approved and transmitted

to the appellant. Id. The parties were also ordered to be prepared to discuss at oral argument

whether an August 2011 revision to 38 C.F.R. § 3.103(c)(1) (2010) would have an impermissible

retroactive effect as applied in this case. Id. at 2.

II. ANALYSIS

A. A Binding RO Decision as Jurisdictional Prerequisite

1. Introduction

This Court's ability to hear and decide cases is predicated upon the parties' timely adherence

to procedural requirements imposed by statute and regulation. See Best v. Brown, 10 Vet.App. 322,

11

325 (1997); see also Henderson ex rel. Henderson v. Shinseki, 131 S. Ct. 1197, 1201-06 (2011). The

requirement that the Court may only review Board decisions over which the Board had jurisdiction,

is the touchstone of the Court's own jurisdiction. See 38 U.S.C. §§ 7104(a) (jurisdiction of the

Board), 7252(a) (jurisdiction of the Court), 7266(a) (Notice of Appeal); see also Jarrell v.

Nicholson, 20 Vet.App. 326, 334 (2006) (en banc). In this vein, the Board is unable to act on a

"matter" absent an appealable, binding RO decision that is adverse to the claimant. 38 U.S.C.

§§ 511(a) (decisions of the Secretary), 7104(a); see also Godfrey v. Brown, 7 Vet.App. 398, 409-10

(1995); Bernard v. Brown, 4 Vet.App. 384, 391 (1993).

For an RO decision to be effective, the RO must provide notice in accordance with section

5104(a). See 38 C.F.R. § 3.104(a) (2011) ("A decision of a duly constituted rating agency . . . shall

be final and binding on all field offices of the Department of Veterans Affairs as to conclusions

based on the evidence on file at the time VA issues written notification in accordance with 38 U.S.C.

[§] 5104." (emphasis added)). Such notice must, among other things,8 be "provide[d]" to the

claimant and the claimant's representative and include "an explanation of the procedure for obtaining

review of the decision." 38 U.S.C. § 5104(a).

Once notice has been issued pursuant to section 5104(a), the RO may not effect any revisions

to its decision, sua sponte, on the same factual basis,9 without a finding of CUE. 38 U.S.C.

§ 5109A(a); 38 C.F.R. §§ 3.104(a), 3.105(a) (revision of decisions) (2011). Binding the RO at the

time section 5104(a) notice is issued serves to "preclude repetitive and belated readjudication of

veterans' benefit[s] claims." Cook v. Principi, 318 F.3d 1334, 1339 (Fed. Cir. 2002). Binding the

RO at such time also activates a claimant's ability to accept its decision or appeal the decision to the

Board. 38 U.S.C. § 7105(a)-(c).

Exercise of this Court's jurisdiction is thus dictated by the RO issuing a binding decision, in

accordance with section 5104(a), which a claimant may appeal. See 38 U.S.C. §§ 7104(a), (b), (c),

8

See section II.A.3, infra, for a full discussion of these requirements.

9

Revisions to final decisions made on different facts must be made pursuant to a finding

of new and material evidence, and because the adjudication is based on a new set of facts it is, in

effect, an adjudication of a new claim. 38 U.S.C. § 5108. There is no dispute that no such

finding was made at any point in this case.

12

7252(a), 7266(a). Any question, therefore, whether the Board improperly acted upon a nonbinding,

unappealable RO decision invokes the Court's independent obligation to police its own jurisdiction:

[J]urisdiction[al] [questions] alter[] the normal operation of our adversarial system.

Under that system, Courts are generally limited to addressing the claims and

arguments advanced by the parties. Courts do not usually raise claims or arguments

on their own. But federal courts have an independent obligation to ensure that they

do not exceed the scope of their jurisdiction, and therefore they must raise and decide

jurisdictional questions that the parties either overlook or elect not to press.

Henderson, 131 S. Ct. at 1202 (citation omitted); see also Barnett v. Brown, 83 F.3d 1380, 1383

(Fed. Cir. 1996) (stating that it is a "well-established judicial doctrine that any statutory tribunal must

ensure that it has jurisdiction over each case before adjudicating the merits, that a potential

jurisdictional defect may be raised by the court or tribunal, sua sponte or by any party, at any stage

in the proceedings, and, once apparent, must be adjudicated" (emphasis added)). The Court is

therefore compelled to resolve all jurisdictional questions before proceeding to the merits of an

appeal.

2. The Jurisdictional Issue Before the Court

This appeal began as a dispute over whether the Board erred in finding that there was no

CUE in the July 1988 RO decision (a determination first made by the RO in a January 2005

decision), but the introduction of the June 2004 RO decision calls into question whether the January

2005 RO decision itself was improperly promulgated. If the June 2004 RO decision is the operative

RO decision, then the Board lacked jurisdiction to entertain the appeal of the January 2005 RO

decision, and, in turn, this Court lacks jurisdiction to review the merits of the April 2008 Board

decision. Cf. Jarrell, 20 Vet.App. at 334; see also Bernard, 4 Vet.App. at 391.

There is no dispute that the January 2005 RO decision did not find, pursuant to § 3.105(a),

that the June 2004 RO decision contained CUE. There is also no dispute that the June 2004 RO

decision is authentic, Ivan Sellers, BVA 08-1758, at 6, and there is no allegation of fraud.

However, the Secretary argues that the June 2004 RO decision is merely provisional because

it lacks indicia of a binding RO decision, including clear evidence that the RO provided the appellant

notice of the decision in accordance with 38 U.S.C. § 5104(a). Secretary's Supplemental (Supp.)

Brief (Br.) at 5-7. The appellant responds that the June 2004 RO decision is binding upon VA

because the record evidence requires the Court to presume that the Houston RO transmitted the

13

decision to the appellant and his representative. Appellant's Supp. Br. at 7-8. The Secretary

maintains, however, that, irrespective of how the appellant received the June 2004 RO decision, an

additional layer of review and authorization was required before it could be released so as to bind

VA. Secretary's Supp. Br. at 10-11.

The Court must determine whether the RO provided section 5104(a) notice of the June 2004

RO decision to the appellant and his representative such that it became a final, binding decision

pursuant to § 3.104(a). The Court will also examine whether the June 2004 RO decision was

promulgated and authorized consistent with RO procedure set forth in VA Adjudication Procedures

Manual M21-1 (M21-1) and whether the June 2004 RO decision retains features of a typical RO

decision.10 In so doing, the Court is empowered to make any finding of fact "crucial to the proper

determination of whether this Court has jurisdiction." Stokes v. Derwinski, 1 Vet.App. 201, 203-04

(1991); see also Evans v. Shinseki, 25 Vet.App. 7, 10 (2011).

3. The Provision of Notice

On remand, the Board found that, although the June 2004 RO decision was authentic, it was

a "draft" decision. Ivan Sellers, BVA 08-1758, at 6, 11. First, the Board explained that the June

2004 RO decision was not accompanied by a cover letter or notice of appellate rights. Id. at 10. The

Board further observed that "VA did not transmit the June 2004 provisional document to the Veteran

in the normal course of business" and this fact "is a clear indication that VA did not intend the June

2004 document to be a final decision." Id. The Secretary echoes the Board's conclusion,

emphasizing that, "[t]o the extent [the] [a]ppellant came into possession of [the June 2004 RO

decision and notification letter] by means other than direct receipt from VA, they would not be in

conformance with the requirements of [section 5104(a)]." Secretary's Supp. Br. at 5-6 (emphasis

added).

The Board and the Secretary misunderstand the facts of this case and the minimum

10

For purposes of this matter, it is unnecessary to determine whether M21-1 provisions

serve as nonbinding guidance for VA adjudicators, see Guerra v. Shinseki, 642 F.3d 1046, 1050-

51 (Fed. Cir. 2011), or whether they have the force and effect of law. See Cohen v. Brown, 10

Vet.App. 128, 139 (1997); Fugere v. Derwinski, 1 Vet.App. 103, 107 (1990); see also Morton v.

Ruiz, 415 U.S. 199, 235 (1974); 38 C.F.R. § 19.5 (2011). Therefore, the Court will not reach this

issue.

14

requirements for the content and effective transmission of decisional notice. First, the notice

requirements codified in section 5104(a) and enumerated in 38 C.F.R. § 3.103(b)(1), (f) dictate that

notice of an RO decision shall be "provide[d] to the claimant and to the claimant's representative"

and such notification shall be "in writing." Section 3.103(f) elaborates that

[a]ll notifications will advise the claimant of the reason for the decision; the date the

decision will be effective; the right to a hearing subject to paragraph (c) of this

section; the right to initiate an appeal by filing a Notice of Disagreement which will

entitle the individual to a Statement of the Case for assistance in perfecting an appeal;

and the periods in which an appeal must be initiated and perfected (See part 20 of this

chapter, on appeals).

38 C.F.R. § 3.103(f) (2011); see also 38 C.F.R. § 3.103(b)(1) (adding that notice shall include advice

of the right to representation).

Second, the Board fails to appreciate that the June 2004 RO decision, as submitted with the

appellant's May 2005 statement, was "[e]nclos[ed]" with a notification letter. R. at 287-92. The

notification letter also provided that VA's "Form 4107" was enclosed with the letter, which indicates

that the appellant received notice of his appellate rights as required by § 3.103(b)(1), (f).11 R. at 288;

see, e.g., Butler v. Principi, 244 F.3d 1337, 1340 (Fed. Cir. 2001) (holding that the Court did not err

"by applying the presumption of regularity to the mailing of a copy of a notice of appeal rights . . .

particularly in light of the [notification letter] which was present in the record"). Thus, the Board's

finding that there was "[no] indication" that the appellant was notified of his appellate rights was

erroneous. Ivan Sellers, BVA 08-1758, at 10; see Pentecost v. Principi, 16 Vet.App. 124, 129

(2002) ("Reversal is the appropriate remedy when there is absolutely no plausible basis for the

BVA's decision and where that decision is clearly erroneous in light of the uncontroverted evidence

in appellant's favor" (citation omitted)).12

11

The notification letter's effectiveness is not undermined because it only mentions the

appellant's entitlement to automobile and adaptive equipment. See R. at 287-88. There is no RO

practice to list all findings in a notification letter where, as here, the rating decision is provided

with the notification letter. See R. at 288-93; M21-1, pt. III, ch. 11, para. 11.09(a)(1). There is

also no evidence of an RO decision prior to June 2004 granting the appellant's entitlement to

automobile and adaptive equipment.

12

The appellant maintains that a written notice of appellate rights is unnecessary where,

as here, a claimant receives a favorable decision. Appellant's Supp. Br. at 12. The inclusion of

15

In addition, our caselaw makes clear that defects of decisional notice are cured when the

record demonstrates that the claimant and his representative actually received notice of the

decision.13 See Clark v. Principi, 15 Vet.App. 61, 62-64 (2001) (holding that Board's "mailing defect

was cured by the appellant's actual receipt of a copy of the June 1999 Board decision in January

2000"); cf. Hauck v. Brown, 6 Vet.App. 518, 519 (1994) (stating that notice defects are not overcome

where there is no evidence of actual receipt). Contrary to the Secretary's view, the issue whether VA

directly transmitted decisional notice to the claimant is moot where actual receipt is established. See

Ashley v. Derwinski, 2 Vet.App. 62, 65-67 (1992). Indeed, actual receipt serves to establish finality

for purposes of appeal to this Court. See id. at 67 (holding that the date of actual receipt was the date

on which the 120-day period of section 7266(a) began to run); cf. Tablazon v. Brown, 8 Vet.App.

359, 361 (1995) (holding that, "where VA has failed to procedurally comply with statutorily

mandated requirements, a claim does not become final for purposes of appeal to the Court" and thus,

"there is no final Board decision before us for review").

In Ashley, the Board mailed its decision to the claimant consistent with section 7104(e), but

the Board failed to mail its decision to the appellant's representative. Ashley, 2 Vet.App. at 67.

Rather, a third party – a "State Veterans Claims Agent" – relayed to the representative a copy of the

decision previously mailed to the claimant. Id. at 65. The Court in Ashley held that the defective

transmission of the Board decision to the representative via a third party was irrelevant because the

record established that the representative in fact received the decision. Id. at 67 ("There is no need

for us to decide what the result would have been had [the claimant's representative] never received

the decision."). Similarly, where a claimant demonstrates actual receipt of an RO decision and notice

from either the RO or his representative, there is no question whether such notice is effective and

binding on VA pursuant to section 5104(a) and § 3.104(a).

VA's written notice of appellate rights form with the notification letter moots the appellant's

argument; therefore, the Court need not resolve this issue.

13

The Secretary argues that the notification letter bears inconsistencies with RO

procedures for the dating and filing of final correspondence. Secretary's Supp. Br. at 5; see also

M21-1, pt. III, ch. 11, para. 11.06. As explained above, however, these inconsistencies are

irrelevant where it is established that the claimant and his representative have received notice.

16

In this case, the record at bar provides ample evidence that the appellant and his

representative received the June 2004 RO decision and notification letter, as submitted with the

appellant's May 2005 statement.14 On June 14, 2004, an RO official advised the appellant that a

decision had been rendered and that written notice was forthcoming. R. at 320. In an email to the

appellant's representative on June 21, 2004, an RO official confirmed that a decision had been

rendered and asked that the representative provide a mailing address to which to send a copy of the

"rating decision and notification letter." R. at 540. In response, the representative provided the

Denver, Colorado, street address for his service organization. Id. RO officials prepared a

notification letter, secured the RO Chief's signature, and affixed the Denver, Colorado, street address

to the notification letter. R. at 287-88. In his May 2005 statement to the RO, the appellant

"[e]nclos[ed]" the June 2004 RO decision with the notification letter bearing the Denver, Colorado,

street address provided by the representative. R. at 286-92. The appellant asserted that the June

2004 RO decision and accompanying notification letter demonstrated that the July 1988 RO decision

was "based on a Clear and Unmistakable Error." R. at 286.

Thus, we need not decide how the appellant received the June 2004 RO decision directly

from the RO or from his representative because the facts of this case establish that VA provided

14

The Secretary also speculates that the appellant's representative obtained possession of

these documents during a period of review sanctioned by M21-1, pt. VI, ch. 2, para. 2.05.

Secretary's Supp. Br. at 6. However, the record provides no basis for this theory. As the

Secretary posits, RO procedure permits a claimant's representative to review a rating decision and

discuss any outstanding issues with a rating official at the RO or, with permission from the Chief

of the RO, outside the RO. See M21-1, pt. VI, ch. 2, para. 2.05. The Secretary ignores, however,

the RO's practice, consistent with regulation, of preparing notification letters only at the time of

issuing binding decisions, not when providing for a representative's review of a draft rating

decision. See M21-1, pt. III, ch. 11, para. 11.09(a); 38 C.F.R. §§ 3.103(b)(1), (f), 3.104(a); cf.

M21-1, pt. VI, ch. 2, para. 2.05. Thus, the fact that the RO expressed its intent to send a

notification letter to the appellant's representative 20 days after the rating decision was approved

(R. at 289, 540), and that the notification letter is addressed to the representative (R. at 540), is

clear evidence that he did not obtain the June 2004 RO decision during a period of

prepromulgation review. Moreover, there is no record evidence suggesting that the appellant's

representative traveled from his location in Denver, Colorado, to the RO in Houston, Texas, to

conduct the in-person review contemplated by RO procedure or that the representative was

granted an exemption from the Chief of the RO for offsite review. See M21-1, pt. VI, ch. 2, para.

2.05. The Secretary's speculation must, therefore, be rejected.

17

notice of the June 2004 RO decision in accordance with section 5104(a) and § 3.103(b)(1), (f).

Accordingly, the Secretary's arguments must be rejected and the Board's findings on this issue must

be reversed.

4. The Adjudicative Process and Rating Decision Content

The Secretary also argues that the June 2004 RO decision is not a final, binding decision

because it was not promulgated consistent with RO decision-authorization procedure. The Secretary

repeatedly refers to an additional layer of review, which should have occurred after the designee of

the Chief of the RO signed the June 2004 RO decision, which was required to render the decision

binding, rather than merely "provisional[]." Secretary's Supp. Br. at 10. Specifically, citing to M21-

1 provisions, the Secretary maintains that a "post-determination team" was required to review the

June 2004 RO decision and calculate an "award" (a schedule of payments) before it could be released

to the appellant and bind VA. Secretary's Supp. Br. at 9. In other words, the Secretary asserts that

the appellant and his representative could not be notified until after postdetermination review.

However, even assuming that the M21-1 provisions cited by the Secretary dictated the RO's

conduct here, such provisions do not explicitly establish the sequence in which RO adjudicative tasks

are performed, nor do they demonstrate that an "award" letter must be generated before a "rating

decision" can be transmitted to a claimant and bind VA. Rather, the cited M21-1 provisions merely

(1) describe the organization of RO adjudicative functions; (2) identify the procedures to approve

"rating decisions" granting entitlement to large retroactive awards; (3) discuss the procedures to

authorize "awards" generally; and (4) list requirements for notifying claimants of RO decisions,

including those provided by § 3.103(b), (f).15 These provisions fail to establish that rating decisions

must be delayed at the behest of producing RO "award" letters.

By contrast, the record demonstrates that the decisional content stipulations set forth in M21-

1, pt. VI, ch. 3, paras. 3.08-3.30 are met by the June 2004 RO decision, including the following:

(1) The organization of the decision into "narrative" and "codesheet" sections; (2) inclusion of

"Introduction," "Decision," "Evidence," "Reasons for Decision," and "References" subsections; and

(3) specific evaluation and effective date. R. at 287-93. Moreover, consistent with M21-1, pt. VI,

15

See M21-1, pt. I, ch. 2, paras. 2.01-2.03; M21-1, pt. III, ch. 11, para. 11.09(a); M21-1,

pt. V, ch. 9, para. 9.01; M21-1, pt. VI, ch. 3, para. 3.07.

18

ch. 3, para. 2.04(c), the June 2004 RO decision itself contains two signatures from rating specialists,

and a third from the designee of the Chief of the Veterans Service Center, in accordance with M21-1,

pt. VI, ch. 3, para. 3.07. R. at 293.

5. The Binding June 2004 RO Decision and 38 C.F.R. § 3.105(a)

As discussed above, the June 2004 RO decision is an authentic product of the RO

adjudicative process, it contains content typical of RO rating decisions, and the RO provided notice

of the June 2004 RO decision to the appellant and his representative consistent with section 5104(a)

and § 3.103(b)(1), (f). In light of these facts, the Court must hold that VA is bound by the June 2004

RO decision. See 38 C.F.R. § 3.104(a).

It follows, therefore, that the January 2005 RO decision is void ab initio.16 The January 2005

RO decision is not based on a finding of new and material evidence, see 38 U.S.C. § 5108, nor is it

predicated on a finding of CUE in the June 2004 RO decision, see 38 C.F.R. § 3.105(a), nor did the

RO follow the established procedures for revoking a prior decision. See 38 C.F.R. § 3.105(e). The

RO thus lacked authority to render a decision on the same factual basis as the June 2004 RO

decision, see 38 C.F.R. § 3.104(a), and the Board's exercise of jurisdiction over the January 2005 RO

decision was likewise in excess of statutory authority. 38 U.S.C. §§ 7104(a), (b), (c); see also

Jarrell, 20 Vet.App. at 334; Bernard, 4 Vet.App. at 391.

B. The Applicability of Purple Heart

1. Introduction

The peculiar facts of this case raise an issue that provides an alternative basis upon which to

hold that the Board lacked jurisdiction to entertain the merits of the January 2005 RO decision:

Namely, whether the process by which the RO revised its June 2004 RO decision violates the

appellant's procedural rights, thus rendering the January 2005 RO decision void ab initio. See

MacKlem, 24 Vet.App. at 71 (finding that where an RO decision was revised pursuant to the invalid

EAP, the resulting decision was void ab initio); Purple Heart, 580 F.3d at 1297-98.

The principle announced in Purple Heart and enforced in MacKlem holds that policies that

impinge upon the "veteran's right to participate and respond" while VA revises a decision on the

16

The Secretary's attempt to apply the presumption of regularity to the January 2005

decision must, therefore, fail. Secretary's Supp. Br. at 8.

19

veteran's claims violate 38 C.F.R. § 3.103(c), among other regulations. Purple Heart, 580 F.3d at

1297. To be sure, as the Board determined, the EAP at issue in Purple Heart is not implicated in

this case – the EAP was first instituted in August 2007, more than two years after review of the June

2004 RO decision. Ivan Sellers, BVA 08-1758, at 10. However, the question before the Court, as

the Board recognized, is whether the RO engaged in an "EAP-like" procedure in its review of the

June 2004 RO decision, which, too, would run afoul of the principle announced in Purple Heart.

Ivan Sellers, BVA 08-1758, at 10. Such a question of law is one the Court reviews de novo, without

deference to the Board's conclusions of law. See Butts v. Brown, 5 Vet.App. 532, 539 (1993) (en

banc).

2. Law

At the time of the Purple Heart decision, a claimant's "right to participate and respond" was

principally protected by provisions of § 3.103, which stated:

§ 3.103(a) Statement of policy. Every claimant has the right to written notice of the

decision made on his or her claim, the right to a hearing, and the right to

representation . . . and it is the obligation of the VA to assist a claimant in developing

the facts pertinent to the claim . . . . The provisions of this section apply to all claims

for benefits and relief, and decision thereon, within the purview of this part 3.

* * * *

§ 3.103(c)(1). Upon request, a claimant is entitled to a hearing at any time on any

issue involved in a claim . . . . VA will provide one or more employees who have

original determinative authority of such issues to conduct the hearing and be

responsible for establishment and preservation of the hearing record.

* * * *

§ 3.103(c)(2). The purpose of a hearing is to permit the claimant to introduce into the

record, in person, any available evidence which he or she considers material and any

arguments or contentions with respect to the facts and applicable law which he or she

may consider pertinent . . . . It is the responsibility of the employee or employees

conducting the hearings to explain fully the issues and suggest the submission of

evidence which the claimant may have overlooked and which would be of advantage

to the claimant's position.

Purple Heart, 580 F.3d at 1296-97 (citing 38 C.F.R. § 3.103(a), (c)). The Federal Circuit in Purple

Heart also cited § 3.105, under which, in the event of a proposed reduction in granted benefits, the

RO must give the beneficiary "60 days for the presentation of additional evidence to show that [the]

benefits should be continued at their present level." Id. (citing 38 C.F.R. § 3.105(e), (f), (g)). The

Federal Circuit observed that these procedural protections were threatened by the EAP:

20

[B]y the new procedure the veteran does not have a hearing in the presence of the

persons who now have final decisional authority for [RO] decisions. It is not disputed

that there is no opportunity to provide additional evidence "which would be of

advantage," § 3.103(c)(2), and that the veteran is not told when the [RO] makes an

award that meets the criteria of this new C & P procedure. The [EAP] instructs the

[RO]: "Do not offer these [large award] rating decisions to any veteran's

representative for review until the C & P Service makes a final determination

regarding the propriety of the decision."

The new procedure does not provide the "in person" interaction provided by §

3.103(c)(2), and no opportunity to respond to the concerns of the deciding official,

whose decisional authority is removed from the [RO]. See Fast Letter 07-19, at 2 ("If

the C & P determines the decision is improper, it will provide specific corrective

action."); Fast Letter 08-24, at 3 ("C & P instructions are considered part of the

pre-decisional process and are not to be included in the permanent record . . . .

[R]epresentatives will be permitted the opportunity to review the draft rating

decision, but only after the file is returned from C & P Service and corrections, if

necessary, are made to it."). The C & P Service's determination is then issued in the

name of the [RO], and the veteran has no way of knowing what persuaded an

unidentified decision-maker to reduce the award that was made by the persons before

whom the hearing was held.

Purple Heart, 580 F.3d at 1297. The Federal Circuit, accordingly, held the EAP invalid. Id. at

1297-98.

3. The Retroactive Effect of 38 C.F.R. § 3.103(c)(1) (2011)

Since Purple Heart and MacKlem were decided, § 3.103(c)(1) was amended. Effective

August 23, 2011, § 3.103(c)(1) no longer guaranteed a hearing before "one or more employees who

have original determinative authority" over the issues to be decided at the hearing. Instead, claimants

were only entitled to a hearing before "one or more employees of the VA office having original

jurisdiction over the claim to conduct the hearing and to be responsible for establishment and

preservation of the hearing record." Compare 38 C.F.R. § 3.103(c)(1) (2011), with 38 C.F.R.

§ 3.103(c)(1) (2010).17 The regulatory provision was amended while the appellant's claim was

17

VA claimed that "[t]his language [was] consistent with other portions of §

3.103(c)(1)." Rules Governing Hearings Before the Agency of Original Jurisdiction, 76 Fed.

Reg. 52,572-01, 52,573 (Aug. 23, 2011) (to be codified at 38 C.F.R. pts. 3, 20). VA undertook

this amendment as part of a host of amendments to "reflect VA's intent" to "clearly distinguish

hearings before [agencies of original jurisdiction] from hearings before the Board, including the

duties of the respective VA personnel conducting the hearing." Id.

21

pending before this Court. See Rules Governing Hearings Before the Agency of Original

Jurisdiction, 76 Fed. Reg. at 52,572-73.

At oral argument, the Secretary conceded that the amendment did not alter the RO's

responsibilities with respect to the conduct of hearings. Given this concession, the Court need not

inquire into whether VA's amendment "would impair rights a party possessed when he acted," thus

having "an impermissible retroactive effect."18 Ervin v. Shinseki, 24 Vet.App. 318, 322 (2011)

(citing Landgraf v. USI Film Prods., 511 U.S. 244, 272 (1994)).

4. The Purple Heart Doctrine Applied to this Case

The Board found that the January 2005 RO decision was not produced pursuant to an EAP-

like procedure. Ivan Sellers, BVA 08-1758, at 11. The Board explained that the RO did not abdicate

decisionmaking authority to an outside decisionmaker and that the appellant's claim was adjudicated

by RO personnel. Id. As such, the Board reasoned that the appellant was not denied "in[-] person

interaction with the deciding officials, as required by 38 C.F.R. § 3.103(c)(2)." Id. At oral

argument, the Secretary echoed the Board's position.

However, both the Board and the Secretary neglect key facts that demonstrate that the

appellant's rights to participate and respond were violated here. As in MacKlem, 24 Vet.App. at 66,

71, the appellant was advised of a decision on his claim authorized by RO officials, but, unlike

MacKlem, this case involves an RO that surreptitiously commenced review and revision of that

decision despite the fact that it had issued final and binding decisional notice to the appellant and

his representative pursuant to section 5104(a) and § 3.103(b)(1), (f). Cf. id. at 67, 71 (referring to

decision as a "proposal"); see also R. at 320-21.

Furthermore, between June 2004 and December 2004, the appellant attempted at least seven

times to learn of the status of his decision – including sending a letter to the Chief of the RO – but

18

Effective June 18, 2012, VA's August 23, 2011, revision to § 3.103(c)(1) is rescinded.

VA took this action because the prior amendment failed to adhere to notice-and-comment

procedures required by the Administrative Procedure Act (APA). See Rules Governing Hearings

Before the Agency of Original Jurisdiction and the Board of Veterans' Appeals; Repeal of Prior

Rule Change, 77 Fed. Reg. 23,128-01 (Apr. 18, 2012) (codified at 38 C.F.R. pt. 3, 20).

22

was given neither an adequate explanation, nor an audience by a final decisionmaker. R. at 320-21,

386. Even more peculiarly, after the appellant formally requested a hearing in June 2006, DRO

Marian Peters confessed that (1) the hearing would not be held by persons with final decisionmaking

authority; (2) even though she did not initially approve the June 2004 RO decision (R. at 293), she

worked to prevent revision of it; and (3) an unidentified entity known as "the front office" exercised

final decisional authority and secured revision of the June 2004 RO decision without the appellant's

knowledge or participation. R. at 82-83, 154.

Contrary to the Board and the Secretary's position, the fact that the revision of the June 2004

RO decision never left the RO is of no moment. The Federal Circuit in Purple Heart noted that the

EAP removed decisional authority from the RO, but central to the court's ruling was the undisputed

fact that the EAP prevented "a hearing in the presence of the persons who . . . have final decisional

authority for [RO] decisions," refused an "opportunity to respond to the concerns of the deciding

official," and resulted in a diminution of benefits that would have otherwise been conferred upon the

veteran. 580 F.3d at 1297. That final decisional authority was removed from the RO was merely

incidental to the dictates of the EAP, and its relevance to this matter is limited in light of the fact that

the RO bound itself to the dictates of the June 2004 RO decision pursuant to § 3.104(a).19

The Court cannot tolerate a similarly opaque, obfuscatory revision process in this case merely

because VA saw fit to confine its conduct to the agency of original jurisdiction. Indeed, the right to

a hearing before persons with "original determinative authority" guaranteed in § 3.103(c)(1), a right

on which the Federal Circuit in Purple Heart explicitly relied, 580 F.3d at 1296, is not limited to

cases in which the decisionmaker operates outside the RO. To read § 3.103(c)(1) as the Board and

Secretary insist would invite subversion.

As the Court in MacKlem observed, 24 Vet.App. at 72, VA is encouraged to implement

efficiency and efficacy measures in the adjudication process, such as supervisory review of front-line

adjudicators. The Court's holding today is no impediment to such innovations. Indeed, the record

19

The EAP was challenged pursuant to 38 U.S.C. § 502, which provides for direct

review of actions of the Secretary. Purple Heart, 580 F.3d at 1294 n.1 ("An action of the

Secretary to which section 552(a)(1) or 553 of title 5 (or both) refers is subject to judicial review.

Such review shall be in accordance with chapter 7 of title 5 and may be sought only in the United

States Court of Appeals for the Federal Circuit.").

23

demonstrates that the June 2004 RO decision was authorized by rating specialist "Durkin," DRO

"Spurlock," and, consistent with the review procedures for rating decisions granting entitlement to

large retroactive awards, a designee of the Chief of the RO. R. at 293; see also M21-1, pt. VI, ch.

3, para. 3.07. If further review was required, the RO was empowered to undertake such review

pursuant to § 3.105(a), but it was not permitted to introduce "a secret adjudication [in]to a non-

adversarial system." MacKlem, 24 Vet.App. at 72.

This case presents a disturbing encroachment upon the appellant's rights to participate and

respond codified at 38 C.F.R. § 3.103(c)(1) and vindicated in Purple Heart. Accordingly, consistent

with MacKlem, 24 Vet.App. at 71-72, the January 2005 RO decision is void ab initio and the April

2008 Board decision relying on the January 2005 RO decision must be set aside as "not in

accordance with law." Id. (citing Brown v. Brown, 5 Vet.App. 413, 422 (1993)); cf. Schafrath v.

Derwinski, 1 Vet.App. 589, 595-96 (1991) (An "ultra vires action of [the Board] Chairman 'must

be treated as though it had never been taken.'" (emphasis in original) (citing In Re Fee Agreement

of Smith, 1 Vet.App. 492, 496 (1991) (per curiam))). On remand, the appellant must therefore be

placed in receipt of the favorable and effective June 2004 RO decision. See MacKlem, 24 Vet.App.

at 71 ("[T]he proper remedy is to place the appellant in the position he was in before the EAP, in

receipt of a favorable decision, even if that position is erroneous."). The Board must proceed

expeditiously, in accordance with 38 U.S.C. § 7112 (requiring Secretary to provide for "expeditious

treatment" of claims remanded by the Court).

III. CONCLUSION

After consideration of the appellant's and the Secretary's pleadings, and a review of the

record, the Court holds that (1) the June 2004 RO decision is binding upon VA; and (2) the April

2, 2008, Board decision is set aside. The Court also reverses the findings of the Board's June 29,

2011, supplemental decision relating to the draft status of the June 2004 RO decision and whether

that decision was accompanied by a notice of appellate rights. Accordingly, the Board's April 2,

2008, decision is SET ASIDE and the Board's June 29, 2011, supplemental decision is REVERSED

IN PART and AFFIRMED IN PART, and the matter is REMANDED for action consistent with this

opinion.

24

KASOLD, Chief Judge, concurring in the result: I agree with my colleagues that Mr. Sellers

is entitled to an effective date for benefits for his RP disease earlier than February 5, 2004, albeit for

different reasons.

Specifically, I cannot agree with the majority's holding that the Board clearly erred in its

supplemental 2011 finding20 that the June 2004 RO decision was not binding because it was not

issued to Mr. Sellers in the normal course of business. The majority hold that, because Mr. Sellers

and his representative actually received the June 2004 RO decision and a notification letter, that

decision was binding regardless of how he received it. But, the "notification letter" cited by the

majority is not addressed to Mr. Sellers, is undated, purportedly awards Mr. Sellers financial

assistance in purchasing an automobile, and does not mention an award of benefits based on CUE.

Moreover, the claims file only contains the copy sent by Mr. Sellers. There is no indication that this

notification was ever issued by the Secretary or that it related to the June 2004 RO decision denying

CUE.

Succinctly stated, the Board's finding that the June 2004 RO decision was not final because

it was not issued in the normal course of business is plausible based on the record of proceedings and

I do not have a "firm conviction" that the Board erred in that finding. See 38 U.S.C. § 7261(a)(4);

Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990) ("'A finding is "clearly erroneous" when . . . the

reviewing court on the entire evidence is left with the definite and firm conviction that a mistake has

been committed.'" (quoting United States v. U.S. Gypsum Co., 333 U.S. 364, 395 (1948))).

I also disagree with the majority's views that only actual receipt – no matter how transmitted

or obtained – matters in determining whether a decision has been issued and is binding. Not only

does this view open a pandora's box of mistakenly released or fraudulently acquired drafts, especially

under the Secretary's current provision that representatives may review decisions before their release,

see M21-1, pt. VI, ch. 2, para. 2.05, but the cases cited in support of the majority's view are

inapposite. More specifically, Ashley and Clark found defects in transmission irrelevant to veterans'

assertions that their Notices of Appeal were untimely; they do not find that a decision never

transmitted in the normal course of business is binding. See Ashley v. Derwinski, 2 Vet.App. 62, 65

20

The Board's 2011 supplemental decision was rendered at the request of the Court and

focuses on the processing of Mr. Sellers's request for revision.

25

(1992) (claimant arguing that "the 120-day filing period . . . did not begin to run . . . , because the

B[oard] failed to meet its statutory obligation to mail a copy of the decision to her representative");

see also Clark v. Principi, 15 Vet.App. 61, 63 (2001) (claimant arguing that his Notice of Appeal

was timely because the Board decision was sent to the wrong address).

Accordingly, I would affirm the 2011 supplemental finding of the Board that the 2004 RO

decision was not issued in the normal course of business and therefore is not binding on the

Secretary.

On the other hand, because the facts found by the Board do not support its 2008 decision that

the 1988 RO decision did not contain CUE, I would reverse the 2008 Board decision. Specifically,

the Board found that Mr. Sellers entered service with no indication that he had RP. Although Mr.

Sellers's separation examination also did not reflect that he had RP, the Board noted that he was

referred for an optometry consultation examination because of complaints of decreased vision. As

the Board found, that in-service eye examination report reflects that (1) Mr. Sellers complained of

flashing lights and constricted field of vision, (2) Mr. Sellers had retinal pigment epithelial (RPE)

defects, and (3) no pathology was found.21 The 2008 Board also noted that a 1982 medical report

diagnosed Mr. Sellers with RP and explained that RP is characterized by, inter alia, peripheral visual

loss and changes in the back wall of the eye. Despite recognizing this record evidence, the Board

inexplicably and summarily concluded that the evidence at the time of the 1988 RO decision

reflected no competent evidence that RP manifested during service.

The Board further found no evidence of a specific, in-service diagnosis of RP, but it failed

to recognize that there is no requirement that a veteran be diagnosed in service for a disease to be

service connected. Indeed, the Board's focus on the timing of the diagnosis – rather than the

manifestation of the symptoms – contravenes precedent. See DeLisio v. Shinseki, 25 Vet.App. 45,

56 (2011) ("[E]ntitlement to benefits for a disability or disease does not arise with a medical

diagnosis of the condition, but with the manifestation of the condition . . . .").

21

As the majority note, RPE defects are defects of "a layer of pigmented epithelium that is

the outer of the two parts of the optic part of the retina . . . extending from the entrance of the optic

nerve to the pupillary margin of the iris," and RP is "a group of diseases, frequently hereditary,

marked by progressive loss of retinal response . . . , retinal atrophy, attenuation of the retinal vessels,

and clumping of the pigment, with contraction of the field of vision." DORLAND'S at 1781, 1634.

26

Moreover, the record reflects that the 1988 RO did not deny benefits because Mr. Sellers did

not have RP. Rather, the RO denied benefits because Mr. Sellers's RP was considered a

constitutional or developmental abnormality (CDA) that was inherited and not aggravated in service.

See R. at 452 (1988 RO decision stating: "Vet's [RP] is a CDA, not aggravated in service."). This

view – that Mr. Sellers's RP was a CDA – was consistent with the Secretary's view at the time that

RP was presumed to be hereditary if there was no evidence otherwise. See R. at 107 (VA Office of

General Counsel Opinion 1-85 (Mar. 5, 1985) (reissued as VA Gen. Coun. Prec. 82-90 (July 18,

1990)), stating that "VA adjudicators ordinarily are justified in finding that [a congenital,

developmental or familial in origin] disease, by its very nature, preexisted the claimant's military

service"), 122 (VA Gen. Coun. Prec. 11-1999 (Sept. 2, 1999), noting that the M21-1, ch. 50, para.

50.09(d) (Jan. 3, 1986), instructed that "[i]f no other cause is shown for [RP], consider it to be

hereditary, and determine service connection on whether or not there has been aggravation of this

preexisting condition during service."); cf. 38 U.S.C. § 7104(c) (Board is bound by General Counsel

opinions).

However, although the Secretary's presumption that RP is hereditary might be appropriate

for many purposes, it cannot be used to defeat the congressionally mandated presumption of

soundness. See 38 U.S.C. § 1111. Otherwise stated, because Mr. Sellers entered service without

any notation that he had RP, his in-service manifestation of RP is presumed service connected unless

it is shown by clear and unmistakable evidence that RP existed prior to service and was not

aggravated by service. Id. Here, the Board found no evidence, and the record of proceedings reflects

no clear and unmistakable evidence, that RP manifested prior to service, and the only medical

evidence before the 1988 RO on whether Mr. Sellers had a family history of RP found "no specific

evidence of similar problems in other members of your family." R. at 500 (1982 medical report).

In sum, Mr. Sellers would have been awarded service connection in 1988 but for the RO's

presumption that RP was hereditary. Accordingly, I find the Board's 2008 determination that the

1988 RO decision did not contain CUE to be arbitrary, capricious, an abuse of discretion, or

otherwise not in accordance with law, and I would reverse it – which is the basis for my concurring

in the result of the majority's decision. See Joyce v. Nicholson, 19 Vet.App. 36, 42-43 (2005) (Board

decisions on CUE motions are reviewed under the "arbitrary, capricious, an abuse of discretion, or

27

otherwise not in accordance with law" standard); Fugo v. Brown, 6 Vet.App. 40, 43-44 (1993)

(demonstrating CUE requires showing that the outcome would have been manifestly different but

for the error); see also Gutierrez v. Principi, 19 Vet.App. 1, 10 (2004) ("[R]eversal is the appropriate

remedy when the only permissible view of the evidence is contrary to the Board's decision.").22

22

One differentiating effect of a Board reversal and remand based on CUE in the 1988

RO decision as opposed to a Board reversal and reinstatement of the 2004 RO decision is that

reversal by the Court predicated on CUE in an earlier decision does not permit further revision of

that earlier decision by the Secretary. Compare Winsett v. Principi, 341 F.3d 1329, 1331

(Fed.Cir.2003) (holding that CUE may not be brought after an underlying issue has been

adjudicated by a court and noting that permitting such action "would allow a lower tribunal to

review the decision of a higher tribunal") with 38 C.F.R. §§ 3.104(a), 3.105(a) (permitting

revision of final RO decisions based on CUE).

28

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

A word about cookies

We need a few to keep you signed in and the library working. The rest help us see which pages people use and where they get stuck. They stay off unless you say yes.