[00:00:00] Speaker 02: And that leads us to our final case this morning, number 23, 1465, Love versus McDonough, Mr. Eyler. [00:00:10] Speaker ?: Go ahead. [00:00:11] Speaker 03: Good morning, Your Honor. [00:00:11] Speaker 03: Attorney Ken Eyler, appearing here on behalf for 1465 for Mr. Love with me at counsel's table is attorney John Niles. [00:00:19] Speaker 03: We will, of course, be in this appeal getting into the merits of Mr. Love's appeal and why the Veterans Court erred [00:00:26] Speaker 03: in affirming the board's decision denying Mr. Love's entitlement to compensation for his prostate cancer at the correct sum as opposed to the reduced sum. [00:00:37] Speaker 03: As the court is aware, obviously he's been dealing with this condition for 20 years, as we briefly encapsulated, on the virtue of one examination that occurred in 2018. [00:00:48] Speaker 03: uh... essentially his rating that had been placed for over a decade uh... is reduced and he's been without those benefits now since december two thousand nineteen for over four years uh... and as we explained in our brief basically first reason that's the uh... reduction by the agency was improper was based on misinterpretation of the notes in that that note uh... person to the secretary's authority under thirty u s c eleven fifty-five the secretary's reputation of the no issue [00:01:18] Speaker 01: implicates when you say they misinterpreted the note, that gets us into the question of whether Foster was correctly decided, correct? [00:01:26] Speaker 03: Yes, your honor. [00:01:27] Speaker 01: OK. [00:01:27] Speaker 01: Yes, correct. [00:01:28] Speaker 01: And whether the agency exceeded its authority under 1155 is a separate question. [00:01:35] Speaker 01: Yes. [00:01:36] Speaker 01: OK. [00:01:36] Speaker 01: That's correct. [00:01:37] Speaker 01: Basically, you're saying we have those two questions to look at. [00:01:40] Speaker 01: Yes. [00:01:41] Speaker 03: OK. [00:01:41] Speaker 03: Yes. [00:01:41] Speaker 03: And with the court's leave, I'll actually address the second issue. [00:01:45] Speaker 03: first, which is not the May question, which is may the Secretary promulgate a note that somehow exempts a condition from the Secretary's schedule from the protections found at Chapter 3 of Title 38 of the CFR. [00:02:00] Speaker 03: And I'll address the second question first, which is [00:02:03] Speaker 03: that it did not do so. [00:02:04] Speaker 03: The note doesn't exclude those protections contrary to the secretary's argument. [00:02:09] Speaker 02: OK, but I think you've got a bit of a problem there. [00:02:11] Speaker 02: And this is a point that neither party has raised. [00:02:17] Speaker 02: My law clerk found in the rating schedule that there are ratings that specifically say that a discontinuance is subject to 3.344. [00:02:30] Speaker 02: For example, if you look, that's true of Rating 7713. [00:02:36] Speaker 02: And yet that language doesn't appear in the rating provision that we're dealing with here. [00:02:45] Speaker 02: Doesn't that sort of suggest that the rating provision that we're dealing with here is not subject to 3.344? [00:02:54] Speaker 03: We would submit no, Your Honor, if only because, as we argued, as we explained in our brief, the silence of the note, because there's still the question of what has to be done with respect to this exam. [00:03:06] Speaker 02: But I don't think you're addressing the question. [00:03:08] Speaker 02: If some of the notes say this is subject to 3.344 and others don't, doesn't that suggest that the ones that don't were not intended to require analysis under 3.344? [00:03:22] Speaker 03: Our position is, Your Honor, no. [00:03:23] Speaker 03: That the fact that it wasn't specifically explicitly mentioned, the 3.344 applies, would not necessarily mean that the rule isn't still applicable here. [00:03:38] Speaker 03: Because essentially, the position would be that, as the Secretary suggests, [00:03:45] Speaker 03: two theories, right, as to how it is the case that somehow the diagnostic code in question is more specific or that it fully complies with 3.344. [00:03:56] Speaker 03: Well, if it fully complies, Your Honor, with 3.344... I'm sorry. [00:04:00] Speaker 02: I don't think you really... You haven't addressed my concern that if some provisions have the reference and others don't, [00:04:08] Speaker 02: doesn't that suggest that the ones that don't, including this one, it's deliberate? [00:04:13] Speaker 03: It would suggest it, Your Honor, but we would simply argue that while that may be suggested, right, that 3.344 does not apply, we would maintain that that's still not the case for the purposes of our argument, that it does apply, because we submit that the Secretary's argument [00:04:32] Speaker 03: that it somehow is more specific and complies with 3.344 is mistaken as to an exam's adequacy because if it somehow is more specific [00:04:46] Speaker 03: and it somehow encompasses 3.344, then how is it that we're here? [00:04:52] Speaker 03: Why are we here? [00:04:53] Speaker 03: Because the only issue, of course, that is before this court, and the only issue that Mr. Love raised before the Veterans Court was to the adequacy of his exam. [00:05:05] Speaker 03: And the board said, hey, you don't get that. [00:05:08] Speaker 03: This is just simply a mechanism. [00:05:10] Speaker 03: There's a temporal element here. [00:05:12] Speaker 03: And so when he said, look, that's wrong, [00:05:16] Speaker 03: and appeal that to the veterans court. [00:05:17] Speaker 03: The veterans court said, hey, the single judge panel in Mr. Love's case said, well, yeah, I'm foreclosed under the veterans court's holding in Foster from addressing it. [00:05:29] Speaker 03: So they didn't even consider it. [00:05:31] Speaker 01: Are you saying that the exam, the 75-28 exam, you're saying that that is inferior or not as satisfactory as an exam under 3.343 or 3.344? [00:05:45] Speaker 03: cracker yes that was his argument that was the argument that he wanted the board of course we couldn't decide that that's a fact issue well but the the the reasons why the exam or inadequate you're right around that would simply be the application of law of the facts which would be on this court's scope but the the inability to even raise [00:06:04] Speaker 03: 3.344 is an issue of interpretation of the note because the secretary, of course, is saying prostate cancer is somehow unique from every other condition that the secretary rates pursuant to the secretary's schedule. [00:06:18] Speaker 01: What's wrong with that? [00:06:19] Speaker 01: I mean, there might be different types of cancers, have different conditions with different implications, different [00:06:25] Speaker 01: periods of remission, recurrences, and here one of the things that struck me was in the factual part of it that, and correct me if I'm wrong, but Mr. Love had this rating, then it was taken away, then it came back again, [00:06:41] Speaker 01: And then it was eventually taken away. [00:06:43] Speaker 01: So I mean, it's on the face of it. [00:06:45] Speaker 01: And I grant, we can't make a factual determination. [00:06:49] Speaker 01: But that would suggest a careful, pinpointing examination as to the progress of his condition. [00:07:00] Speaker 03: Well, one of the secretary's arguments goes to this, which is to say, well, 3.344, this court should give full effect to the last two sentences of 3.344C. [00:07:13] Speaker 03: But the point being is, as we explained in our reply brief to the secretary, the board didn't make any factual findings to that point because it didn't even consider the operation of the adequacy of the exam in the first place. [00:07:27] Speaker 03: uh... and so essentially the secretary's position is not just mister love and and and his prostate cancer but any veteran with any type of prostate cancer condition doesn't have the protections afforded to them under three point three four four and indeed your honor the basic argument that that's appropriate because uh... rating provision here contemplates [00:07:54] Speaker 02: that the 100 percent rating is a temporary rating, and that when there's treatment, the whole thing will be reevaluated. [00:08:05] Speaker 03: Correct, Your Honor. [00:08:05] Speaker 03: I guess that the issue our position would be, because under just the language of the note in the diagnostic code, right, there's really two elements. [00:08:15] Speaker 03: There's the temporal element that the Veterans Court focused on in Foster, right, and then there's the examination element. [00:08:22] Speaker 03: So for the examination element though, so if those two conditions are met, ostensibly your honor, the secretary's position would be even though you or I don't have the necessary medical qualifications to conduct an exam of a veteran's prostate cancer condition. [00:08:36] Speaker 03: uh... secretary says hey if if attorney ken eilert did your prostate cancer exam i guess you just through the short straw because there's been an exam stand with us all the way back well i'm just saying because because it it goes to the adequacy issue your honor so what we're what i'm trying to point out the why on its face mister is that why on his face is what's contemplated in seventy five twenty eight uh... why on his face is there any [00:09:04] Speaker 03: inadequacy there inherent inadequacy i mean well because there there are several protections your honor afforded under three point three four four in the requirement well i'm talking about why on his face there in inadequacy inherent inadequacy in seventy five twenty eight which is what you seem to be suggested well what we are what we uh... respectfully i think what we argued in our brief right is that it's it's science as to the protections of three point three four four [00:09:31] Speaker 03: And obviously, as your honor pointed out, there are other diagnostic codes. [00:09:35] Speaker 02: When the Veterans Administration talks about giving an exam, they're not talking about giving a medical exam by a lawyer. [00:09:41] Speaker 02: So I don't quite understand what your point is. [00:09:45] Speaker 03: But the adequacy of medical exams, your honor, is something that the secretary also wants to ensure in a separate part of the CFR. [00:09:54] Speaker 03: It's just simply that the exam be adequate. [00:09:57] Speaker 03: since veterans are relying on this income, and that there's substantial improvement shown, as opposed to, as we pointed to, there was some improvement shown in Mr. Love's condition. [00:10:11] Speaker 03: So each of those, there are various protections. [00:10:13] Speaker 03: It's not just the competency of the examiner, and that a competent examiner would be the one to make the determination. [00:10:21] Speaker 02: I understand your argument. [00:10:22] Speaker 02: You're saying [00:10:22] Speaker 02: is that the exam that's provided in the rating schedule is not necessarily as thorough as the one required by 3.344. [00:10:31] Speaker 02: I understand that. [00:10:34] Speaker 03: Yes, Your Honor. [00:10:36] Speaker 03: So I would just briefly then turn to the first issue, having discussed that it does not exclude 3.344. [00:10:45] Speaker 03: Our first argument being that the scope of USC 1155 is finite. [00:10:51] Speaker 03: and essentially it's limited to the secretary adopting and applying on the one hand a disability symptoms with on the other hand [00:10:59] Speaker 03: the average resultant decrease that they cause in civilian earning capacity. [00:11:03] Speaker 01: You're saying even if 7528 stands alone, it was improper for the secretary to promulgate that. [00:11:13] Speaker 01: Right. [00:11:13] Speaker 01: Because essentially, 1155. [00:11:17] Speaker 01: How can we review that? [00:11:19] Speaker 01: Isn't that something as to the substance of the rating schedule? [00:11:24] Speaker 03: No, Your Honor, because... 7252B? [00:11:28] Speaker 03: No, Your Honor. [00:11:29] Speaker 03: We explain, or we argue in our brief, that this isn't an issue, and the secretary characterized this in the secretary's brief, as it doesn't conflict, that the diagnostic code doesn't conflict. [00:11:43] Speaker 03: But rather, the issue is one of that it exceeds 1155's scope, because we point to the example that it would be improper for the secretary to say, okay, within this schedule, [00:11:59] Speaker 03: you cannot rate conditions that are secondary, because 3.310 requires, excuse me, Your Honor, I believe that's the correct regulation, essentially conditions that are secondary, residual, also have to be rated. [00:12:15] Speaker 03: So if the secondary said, no, you just rate this condition, you can't rate this other condition, that would be an improper diagnostic code in excess of the authority to say, you just have to focus on what's the impact, [00:12:28] Speaker 03: Right? [00:12:29] Speaker 03: And what is the resultant rate? [00:12:31] Speaker 01: But if the secretary exceeds his or her authority, the secretary is acting contrary to 1155, right? [00:12:41] Speaker 03: Correct. [00:12:43] Speaker 03: In excess of, and then thus, you have an unhinged executive. [00:12:47] Speaker 01: The secretary could err in two ways. [00:12:50] Speaker 01: One, do something wrong or go beyond his or her authority, right? [00:12:55] Speaker 01: And you're saying the latter happened here. [00:12:57] Speaker 03: Correct. [00:12:58] Speaker 03: But because of the secretary's crafting a diagnostic code unique to prostate cancer that basically says, this condition, it doesn't matter if a veteran has an exam by an adequate competent examiner if they've had the condition for more than five years. [00:13:19] Speaker 03: Your Honor. [00:13:20] Speaker 02: I just don't see that it says that. [00:13:24] Speaker 02: You can have an exam by an examiner who's not competent? [00:13:28] Speaker 02: It doesn't say that. [00:13:29] Speaker 03: But that's Mr. Love's argument, your honor. [00:13:31] Speaker 03: That was his argument to the board. [00:13:32] Speaker 03: That's what happened to me, had I had a competence exam, because I've had many exams in the 20 years that I've had my prostate cancer. [00:13:39] Speaker 02: That's a fact question. [00:13:42] Speaker 02: He's entitled to a competent exam, but that's not before us. [00:13:46] Speaker 02: And the provision on its face doesn't say you're not entitled to a competent exam. [00:13:54] Speaker 03: Well, the 3.344 does. [00:13:55] Speaker 03: And that's our argument, Your Honor, which is that's the protection that 3.344 gives that the Veterans Court says does not apply to this diagnostic code. [00:14:05] Speaker 03: Your Honor, I see that unless the Court has any additional questions, I reserve the balance of my time for a while. [00:14:10] Speaker 02: I'll give you two minutes. [00:14:18] Speaker 02: Thank you. [00:14:18] Speaker 02: Okay. [00:14:19] Speaker 02: Is that correct? [00:14:21] Speaker 02: Bezak, you're on. [00:14:23] Speaker ?: Bezak, okay. [00:14:23] Speaker 01: Mr. Bezak, let me ask you, is it your, before you launch into what you were going to say, just to pick up the last point we were discussing with Mr. Eyler, on this question, [00:14:43] Speaker 01: He contends that the VA exceeded its authority in 1155 in promulgating 7528, correct? [00:14:54] Speaker 00: I believe that's true, Your Honor, yes. [00:14:56] Speaker 01: That's as we understand it. [00:14:58] Speaker 01: I think that's correct. [00:14:59] Speaker 01: That's what he says. [00:15:01] Speaker 01: And you say, and there's a footnote in your brief, that a good argument can be made for the proposition. [00:15:07] Speaker 01: We can't review that. [00:15:09] Speaker 01: Yes, Your Honor. [00:15:10] Speaker 01: Because of Warner and Wingard. [00:15:12] Speaker 01: and the language of 7252B. [00:15:15] Speaker 01: So do you stand by that position? [00:15:17] Speaker 00: Yes, Your Honor. [00:15:18] Speaker 00: So to the extent that Mr. Love's argument is that the diagnostic code and or its note was improperly promulgated, that would be an argument that speaks to the content [00:15:34] Speaker 00: of that rating schedule and uh... thirty eight u s c seventy two fifty two be specifically precludes the veterans court from reviewing the content of the ratings schedule and thereby that would also be an improper review of a direct appeal of that issue in this court so if they can't review it we can't use it yes yes your honor not in the context of of this case i think you have to be a five oh two yes your honor exactly uh... i think to the extent that that the argument is that there is something wrong with that rating code that [00:16:04] Speaker 00: And I think that the illustration of that is the effect of that argument would presumably be striking or modifying that code in some way. [00:16:13] Speaker 00: That has to be done through a 502 petition. [00:16:15] Speaker 01: Now, one other question. [00:16:16] Speaker 01: We haven't, when Foster was decided, this is the second point on appeal. [00:16:21] Speaker 01: When Foster was decided, it resolved the 75-28 issue. [00:16:26] Speaker 01: But then the rest of the case was sent back [00:16:30] Speaker 01: because of the determination that the board had erred with respect to residuals, I think what it was. [00:16:37] Speaker 01: And I assume that Foster is still somewhere in the process, because it hasn't come up here, as far as I know. [00:16:47] Speaker 01: So we're going to have to, I would think in this case, say Foster was right or wrong, correct? [00:16:56] Speaker 00: I believe so, Your Honor. [00:16:57] Speaker 01: We're still on the second point. [00:16:59] Speaker 00: Yes, at least in part. [00:17:03] Speaker 01: Foster's not come up here yet. [00:17:05] Speaker 00: It's still at the VA. [00:17:06] Speaker 00: I looked up whether or not Foster had made it up here. [00:17:08] Speaker 00: I did not follow up on where it may be in the lower process. [00:17:11] Speaker 00: So I assume it is still somewhere in the process of the residual determination being reevaluated. [00:17:20] Speaker 00: But yes, no, Foster has not come up to this court yet. [00:17:22] Speaker 00: And this case is effectively [00:17:24] Speaker 00: reliant on the Foster decision, at least parts of it. [00:17:30] Speaker 00: To the merits, unless the court has any further questions on the 1135 authority question, I'll move on to how 38 CFR 3.344 applies or does not in this case. [00:17:54] Speaker 00: Primarily, I'd like to set the context of this particular rating for the court just a bit. [00:18:00] Speaker 00: The prostate cancer rating, like many cancer ratings that are found in the schedule, is essentially a binary rating. [00:18:09] Speaker 00: It's a 100% rating. [00:18:10] Speaker 00: If there is an active cancer, it is a 100% rating. [00:18:13] Speaker 00: When cancer goes into remission, that rating ends. [00:18:15] Speaker 00: I did not look up every single one, but all the cancers I found had something similar, where there is a 100% rating. [00:18:20] Speaker 00: There is a note that describes the process. [00:18:22] Speaker 00: by which that rating ends and how residuals are to be rated once the cancer is in remission. [00:18:32] Speaker 02: Those types of ratings, as the Veterans Court noted in Foster and... I don't think that's actually quite true because the rating I was referring to earlier is for a form of leukemia and the rating says it is subject [00:18:50] Speaker 00: Yes, Your Honor, and I wasn't about to say that they effectively are, that there is some overarching regulation related to cancers in particular. [00:19:07] Speaker 00: But I think that the recognition is that the terms of 3.344 are really intended to speak to decisions to lower a particular rating [00:19:18] Speaker 00: based on severity, based on quality of life, based on employability. [00:19:21] Speaker 00: That is simply not a question that comes into play when you're talking about the specific 75-28 prostate cancer rating. [00:19:30] Speaker 00: There's a determination that needs to be made whether the cancer is active, whether the cancer is in remission, and that is the basis for the discontinuation of the rating. [00:19:39] Speaker 00: And the note specifically lays out all of the processes that are required for that. [00:19:44] Speaker 00: provides a six-month window after treatment. [00:19:47] Speaker 00: This is a recognition on the part of VA that this is a treatable, in many cases, disease, and the six months is based on VA's learned experience, the medical and scientific knowledge of how treatment goes, about the period in which recovery is commonly seen, and that rating reflects [00:20:13] Speaker 00: those understandings, and then once there is, that finding permission directs the rater to look at residuals which fall under a different diagnostic code for follow-up ratings. [00:20:25] Speaker 00: All of this is to say that we believe that because of the specific procedures that are laid out in the rating, that code [00:20:38] Speaker 00: applies the procedures specifically that are more generally laid out in 3.344 to this particular disease. [00:20:53] Speaker 00: I will touch briefly on, unless the court has questions about that particular argument, the language in [00:21:07] Speaker 00: 3.344C. [00:21:10] Speaker 00: I don't think the court needs to reach this point, but there was a question certainly left over in the Hanser case about whether... You haven't discussed in the briefing below, right? [00:21:26] Speaker 00: I think it was discussed in Foster. [00:21:29] Speaker 00: I'm sorry, it wasn't discussed in Foster. [00:21:31] Speaker 00: Sorry, I missed the question. [00:21:33] Speaker 02: The Houser issue, if you recall that, was not briefed before the Veterans Court. [00:21:38] Speaker 00: No, it was not. [00:21:40] Speaker 00: So perhaps, and I said the court doesn't need to reach that. [00:21:44] Speaker 00: So frankly, I think I can move on. [00:21:53] Speaker 00: I don't have too much more to say to the court unless there are questions. [00:21:58] Speaker 00: I think our briefing lays out fairly clearly that this is intended to be a specific procedural application and that the... Oh my goodness, I'm sorry. [00:22:13] Speaker 00: The analysis of the regulatory language first is clear on its face as to the language [00:22:21] Speaker 00: in DC 7528, and then also to the extent that 4.344 is the general procedure for, to the extent there is a reduction, that 7528 is the specific application in the unique instance of prostate cancer, and that this specific should trump the general application. [00:22:43] Speaker 00: Unless the court has further questions, we can certainly rest on our briefs. [00:22:47] Speaker 02: Okay. [00:22:47] Speaker 02: Thank you, Ms. [00:22:47] Speaker 02: Bissat. [00:22:48] Speaker 00: Thank you, Your Honor. [00:22:52] Speaker 01: I just have two questions. [00:23:00] Speaker 01: One, do you agree with Ms. [00:23:03] Speaker 01: Bizak as to her recitation with respect to Foster, that namely Foster is still at the Veterans Court level? [00:23:12] Speaker 01: It hasn't been decided yet. [00:23:17] Speaker 01: In other words, it hasn't come up here. [00:23:21] Speaker 01: Because as we know, it decided the 75-28 issue, but sent the residual issues back. [00:23:27] Speaker 01: And so it's still there somewhere. [00:23:29] Speaker 03: Is that correct? [00:23:31] Speaker 03: As far as I'm aware, Your Honor, that is the case. [00:23:34] Speaker 03: I'm not aware that that is not the current posture in Foster, but I'm not certain. [00:23:42] Speaker 01: view with respect to Ms. [00:23:43] Speaker 01: Bczak's contention that we can't look at the question of whether the VA exceeded its authority in promulgating 1155. [00:23:57] Speaker 01: She says we're barred from doing that. [00:24:00] Speaker 03: We disagree, Your Honor. [00:24:01] Speaker 01: Why do you disagree? [00:24:02] Speaker 03: Well, we disagree because Wingard embraces only those provisions of the secretaries that are within the secretary's authority to promulgate. [00:24:10] Speaker 03: The note here is if it's beyond that authority to promulgate, then contrary to the Secretary's position, Wingard does not apply. [00:24:19] Speaker 03: How about Warner? [00:24:21] Speaker 03: Same. [00:24:24] Speaker 03: Same. [00:24:26] Speaker 03: And basically, Your Honor, to just briefly again address, if as the Secretary just argued, [00:24:33] Speaker 03: If the protections are somehow more specific in 725 and or are encompassed in the note to resolve the concern about the adequacy of examinations, it begs the questions, Your Honor, what exactly was Mr. Love supposed to do? [00:24:49] Speaker 03: Because that's all he did. [00:24:50] Speaker 03: I mean, what he did was say, I didn't get those protections that are afforded in 3.344. [00:24:56] Speaker 03: And he raised that to the board. [00:24:58] Speaker 03: board didn't consider it, the Veterans Court says, we can't. [00:25:01] Speaker 03: We can't. [00:25:02] Speaker 03: And we would submit that the court should find, of course, first that the secretary, unless the court has any additional questions. [00:25:08] Speaker 01: Is he saying there was no problem with my 75-28 exam as far as it went, but I should have had something more? [00:25:19] Speaker 03: No. [00:25:19] Speaker 03: He's simply saying his argument, Your Honor, was that the exam was inadequate, which the board and the Veterans Court never even reached. [00:25:26] Speaker 03: That's the issue. [00:25:29] Speaker 03: Your Honor, if there are no further questions, we respectfully ask that this Court would reverse the Veterans Court's decision and foster a law with Mr. Love's rating on the ancillary benefit of special monthly compensation. [00:25:39] Speaker 02: Okay. [00:25:39] Speaker 02: Thank you. [00:25:40] Speaker 02: Thank Health Council. [00:25:41] Speaker 02: The case is submitted. [00:25:41] Speaker 02: That concludes our session for this month.