holding that the Board must 4 VHA Directive 2000-049 has been superseded by directive 2006-019, which remains substantively the same. See Medical Review Assistance to Board of Veterans Appeals Cases, VHA Directive 2006-019 (Apr. 3, 2006). 16 consider whether a medical opinion contains "such sufficient information that it does not require the Board to exercise independent medical judgment"
How later courts described this case
- holding that the Board must 4 VHA Directive 2000-049 has been superseded by directive 2006-019, which remains substantively the same. See Medical Review Assistance to Board of Veterans Appeals Cases, VHA Directive 2006-019 (Apr. 3, 2006). 16 consider whether a medical opinion contains "such sufficient information that it does not require the Board to exercise independent medical judgment"
- holding that a medical opinion is considered “adequate where it is based upon consideration of the veteran’s prior medical history and examinations and also describes the disability, if any, in sufficient *119 detail so that the Board’s ‘evaluation of the claimed disability will be a fully informed one.’ ” (quoting Ardison v. Brown, 6 Vet.App. 405, 407 (1994))
- explaining that, to be adequate, a medical examination or opinion must "describe[] the disability . . . in sufficient detail so that the Board's 'evaluation of the claimed disability will be a fully informed one'" (quoting Ardison, 6 Vet.App. at 407 ) (internal quotation marks omitted)
- holding a medical opinion is considered adequate when it is based on consideration of the appellant's prior medical history and examinations and also describes the disability in sufficient detail so that the Board's evaluation of the disability will be a fully informed one
Written by the judges who cited it.
The opinion
GREENE, Chief Judge,
dissenting:
I respectfully dissent from the majority’s view that the Board’s reliance on the examiner’s statement to deny direct service connection was clearly erroneous. See 38 U.S.C. § 7261 (a)(4); Forcier v. Nicholson, 19 Vet.App. 414, 421 (2006) (Board’s assessment of credibility and weight to be given to medical evidence is finding of fact reviewed under “clearly erroneous” standard); Wood v. Derwinski, 1 Vet.App. 190, 193 (1991). The March 2003 VA examiner stated that he had reviewed the claims file, examined Mr. Stefl, performed a fiberoptic endoscopic examination, and concluded that Mr. Stefl’s “nasal and sinus polyp disease is not related to service or exposure to Agent Orange.” R. at 337-38 (emphasis added). I believe the first part of this statement reflects the examiner’s opinion regarding direct service connection, while the second part relates to presumptive service connection. The examiner further noted that Mr. Stefl’s condition is not similar to respiratory cancers, which are presumed to be caused by herbicide agents and that his condition is usually caused by “recurring sinus infections and/or respiratory tract allergies.” R. at 338. These medical findings provided the Board with a plausible basis for relying on the May 2003 VA medical examination to determine whether there was direct service connection. See Gilbert v. Derwinski, 1 Vet.App. 49, 52-53 (1990) (holding that when applying “clearly erroneous” standard, Board’s finding supported by plausible basis may not be reversed even if Court would have weighed evidence differently). Further, the majority’s attempt to dictate to the medical examiner how a medical opinion should be formulated stretches the boundaries of our review. The Court has jurisdiction to review the reasons or bases contained in decisions of the Board, not the medical analysis proffered in VA medical opinions.
The Board denied direct service connection after finding that Mr. Stefl had no *126 complaints or diagnosis of nasal problems during service and because there is no medical evidence of record of a nexus between his in-service exposure to Agent Orange and his current nasal disease. R. at 10-11. Based on the Board’s factual findings and the medical conclusions of the May 2003 VA examination, I would affirm the Board’s decision to deny Mr. Stefl service connection for a nasal sinus disease on a direct basis.