A recent case from the Federal Circuit on VA disability benefits has held that pain alone can be the basis for a veteran’s disability rating nullifying a long-standing Veterans’ Appeal Court precedent. See Saunders v. Wilkie, Case No. 2017-1466 (US Fed. Cir. April 3, 2018) (“Saunders”).
Prior to Saunders,the VA and the Veterans’ Court of Appeal had held to the position that pain alone, without a diagnosed or identifiable underlying malady or condition, could not, in and of itself, constitute a disability for which service-connected disability rating might be granted. The primary case was Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999) In Sanchez-Benitez,the veteran reported severe, debilitating pain and claimed the pain was attributed to neck trauma he experienced while in service. However, the veteran was unable to provide a medical nexus between the pain and the neck trauma. As such, the VA and various appeals denied the veteran a disability rating based on pain alone. Since 1999, the Sanchez-Benitezdecision had been relied on by the Veterans’ Court of Appeal more than 100 times and had been used a legal guidance by the Veterans’ Board of Appeal at least 83 times.
Thus, the nullification of Sanchez-Benitez is important news for veterans. If you are a New Orleans veteran with pain only disability from a service-related medical condition, then call Ascend Disability Lawyers, LLC. We might be able to help you apply for VA disability benefits. Here is a quick discussion.
New Orleans VA Disability Benefits Attorneys: Facts of Saunders v. Wilke
In Saunders, the veteran — Melba Saunders — served in the Army from 1987 until 1994. During her service, Saunders sought treatment for knee pain and was diagnosed with patellofemoral pain syndrome (“PFPS”). At the end of her service, Saunders filed a claim for disability compensation for knee pain and other conditions. Her claim was denied because she failed to report for a required medical examination.
As an aside, this is why we, here at Ascend Disability Lawyers, LLC, constantly emphasize the importance of following through with ALL of the steps and procedures for obtaining VA disability benefits. Failing to show up for your medical examinations is one of the most common procedural reasons for denial.
In any event, Ms. Saunders did not appeal her denial in 1994. In 2008, Saunders filed a new claim which was denied in 2010. The VA regional office denied the claim based on a lack of evidence of treatment for a knee condition. Saunders timely appealed.
As part of the appeal and review process, Saunders underwent a VA medical examination in 2011. The medical examiner found the following:
- Saunders reported bilateral knee pain while running, squatting, bending, etc.
- Saunders had no anatomic abnormality, weakness, or reduced range of motion
- Saunders had functional limitations on walking
- Saunders was unable to stand for more than a few minutes
- Saunders sometimes required use of a cane or brace
The medical examiner diagnosed Saunders with subjective bilateral knee pain. With respect to occupational functioning, the medical examiner found that the pain resulted in (1) increased absenteeism and (2) reduced ability of Saunders to complete daily activities. The examiner also concluded that Saunders’s knee condition was at least as likely as not caused by, or a result of, Saunders’s military service. Upon request for supplementation, the medical examiner further reported that there was no pathology to render a diagnosis on Saunders’s condition.
Once again, the VA regional office denied Saunders claim with respect to knee pain on the grounds that Saunders had not demonstrated a currently diagnosed bilateral knee condition linked to military service. Pain was not alone sufficient for a finding of disability.
Saunders timely appealed this denial to the Board of Veterans’ Appeals which affirmed. Saunders then timely appealed the Board’s decision to the US Court of Appeals For Veterans’ Claims which also affirmed the denial. Finally, Saunders appealed to the Federal Circuit Court which, as discussed below, reversed and remanded back to the Board further findings including whether Saunders satisfied her burden to show her bilateral knee condition qualifies as a “disability” and/or whether Saunders’s pain impaired her functionality.
New Orleans Veterans’ Disability Attorneys — Court Of Appeals Reasoning
In nullifying Sanchez-Benitez v. West, the Federal Circuit Court of Appeals basically held that, even though a specific pathology or underlying condition cannot be medically identified, pain alone can be sufficiently debilitating to constitute a “disability” under the relevant statutes. The court began by discussing the VA disability statute, 38 U.S.C. § 1110, which states in part:
For disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, the United States will pay to any veteran thus disabled … compensation as provided in this subchapter …
The court focused on the second and third words — “disability resulting…” In the court’s reasoning, compensation is paid for the disability, NOT the medical condition. Further, the idea of “disability” is about functional impairment — that is, “disability” refers to a condition that impairs normal functioning and reduces earning capacity. Thus, in the court’s view, the factual focus should be on the disability, not the pain or the underlying medical condition. If the service-related pain is sufficiently severe and debilitating to cause functional impairment, then pain alone CAN be a disability.
According to the court, this is consistent with long-established precedent. The court noted, for example, that, in general, a veteran seeking compensation must establish three elements:
(1) the existence of a present disability
(2) in-service occurrence or aggravation of a disease or injury and
(3) a causal link between the present disability and the disease or injury incurred or aggravated during service
The court noted that Saunders potentially satisfied these three prongs even without a pathology to explain her knee pain. First, Saunders was/is currently asserting the existence of a disability — functional limitations — some evidence of which was provided by the 2011 VA medical examiner’s report. Second, as noted above, Saunders reported knee pain while in-service and was diagnosed — while in-service — with PFPS. Third, again as noted, the 2011 VA medical examiner’s report stated that it was “at least as likely as not” that Saunders knee pain was caused by, or a result of, Saunders’s military service. The court did not hold that Saunders was entitled to VA disability benefits. Rather, Saunders had presented sufficient evidence and that the Board should fully review and consider the evidence. For these reasons, the court returned the case to the Board for further proceedings.
Contact New Orleans VA Disability Benefits Law Firm Ascend Disability Lawyers, LLC Today
For more information, contact the experienced New Orleans VA disability benefits attorneys here at Ascend Disability Lawyers, LLC. Your debilitating service-related pain might entitle you to disability benefits. We have extensive experience helping New Orleans and Louisiana veterans apply for VA disability. Contact us today via email or by calling directly.