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Court Wins

BVA wrongly denies service connection for pseudogout due to reliance on inadequate VA medical exam

Lisa Ioannilli

February 28, 2018

Updated: November 20, 2023


History of the case

The Veteran served on active duty in the U.S. Navy from April 1972 to June 1975.  He injured his left knee when he jumped out of a rack on the boat.  Ever since, he experienced left knee symptoms, and in 1976 VA awarded disability compensation for a left knee disability.

The first evidence of pseudogout appeared in 1994, where a lab showed pyrophosphate crystals.  He applied for disability compensation for pseudogout in 2009, which VA denied in 2010.  The Veteran appealed this decision to the Board of Veterans’ Appeals.  The Board ultimately remanded the matter to obtain a VA examination and opinion.  The Board specifically instructed the examiner to opine on whether the Veteran’s pseudogout was related to service or the left knee disability.  The examiner provided a negative nexus opinion.

Board denied service connection for pseudogout

In December 2016, the Board denied entitlement to disability compensation for pseudogout, as secondary to a service-connected left knee disability.  With CCK’s help, the Veteran appealed this decision to the Court of Appeals for Veterans Claims.

Court agrees with CCK’s argument

CCK argued, and the Court agreed, that the 2015 VA medical examiner failed to provide an adequate rationale for his conclusion regarding aggravation.  This was problematic because the Board found this opinion highly probative in rendering its decision.

The examiner essentially concluded that the left knee did not aggravate pseudogout, as there was no supporting evidence.  However, the Board previously remanded the matter to obtain a medical opinion specifically because there was insufficient evidence in the file to render a decision.  Thus, the examiner’s finding that there was no other evidence in the record showing aggravation simply restated what the Board already determined when it remanded the issue in March 2015.  The Board did not discuss this part of the examiner’s opinion.  It also failed to explain what it gleaned from the examiner’s rationale.  The Court concluded that without further analysis, it could not understand the basis for the Board’s reliance on the 2015 examiner’s opinion.  The Court vacated the Board’s decision and remanded the matter for the Board to provide an adequate statement of reasons or bases for its decision.

To read a copy of the Court’s decision, click here.

About the Author

Bio photo of Lisa Ioannilli

Lisa joined CCK in March 2012. Lisa is a Senior Attorney focusing on representing disabled veterans in claims pending before the U.S. Department of Veterans Affairs and the United States Court of Appeals for Veterans Claims.

See more about Lisa