The Supreme Court on Monday declined to issue a writ of certiorari to hear the appeal of Mathis v. Shulkin, M.D. Justices Sotomayor and Gorsuch strongly questioned whether VA is entitled to a presumption that its examiners are competent and qualified to render medical opinions, which are often used as evidence against Veterans’ claims for disability benefits.
Mr. Mathis, a U.S. Air Force Veteran, appealed a Board of Veterans’ Appeals decision that denied him entitlement to service connection for sarcoidosis to the United States Court of Appeals for Veterans Claims (CAVC). Mr. Mathis argued that the VA erred when it failed to establish the doctor who authored a medical opinion used to deny his claim for service connection was a qualified expert in the field of pulmonology. The CAVC noted that VA is presumed to have selected a qualified medical expert, and the mere fact the VA medical opinion was authored by a family practitioner, and not a pulmonologist, did not render the opinion inadequate.
Mr. Mathis appealed the CAVC’s decision to the United States Court of Appeals for the Federal Circuit. The question before that Court was whether VA is legally entitled to a presumption of competency for its medical examiners. The Federal Circuit acknowledged that the process VA uses to appoint medical examiners is unclear, and that they were unable to determine whether the procedure used to select these examiners was regular, reliable, and consistent. The Circuit, however, affirmed the CAVC decision. Mr. Mathis then appealed to the Supreme Court.
Supreme Court Won’t Hear Case
Justice Gorsuch dissented from the Supreme Court’s last day of term decision. He questioned the presumption of competency of VA examiners, and asked “how is it that an administrative agency may manufacture for itself or win from the courts a regime that has no basis in the relevant statutes and does nothing to assist, and much to impair, the interest of those the law says the agency is supposed to serve?”
Justice Sotomayor did not dissent, but also issued a statement. She agreed with Justice Gorsuch that “the Board’s presumption is questionable. But the presumption is not the only problem. A decision by the VA to deny benefits in reliance on an examiner’s opinion, while denying the veteran access to that examiner’s credentials, ensures that the presumption will work to the veteran’s disadvantage.” The agreement between the two justices that there is an inherent problem with assuming VA medical examiners are qualified to provide expert opinions, is significant for all those concerned with protecting the interests of disabled veterans.