Dependency and Indemnity Compensation: Surviving Spouse's Rate; Payments Based on Veteran's Entitlement to Compensation for Service-Connected Disability Rated Totally Disabling for Specified Periods Prior to Death, 72211-72221 [05-23541]
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Federal Register / Vol. 70, No. 231 / Friday, December 2, 2005 / Rules and Regulations
TABLE 5.—MORTALITY TABLE FOR SOCIAL SECURITY DISABLED MALE
PARTICIPANTS—Continued
Age x
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TABLE 6.—MORTALITY TABLE FOR SOCIAL SECURITY DISABLED FEMALE
PARTICIPANTS
Age x
qX
0.043033
0.044007
0.044993
0.045989
0.046993
0.048004
0.049021
0.050042
0.051067
0.052093
0.053120
0.054144
0.055089
0.056068
0.057080
0.058118
0.059172
0.060232
0.061303
0.062429
0.063669
0.065082
0.066724
0.068642
0.070834
0.073284
0.075979
0.078903
0.082070
0.085606
0.088918
0.092208
0.095625
0.099216
0.103030
0.107113
0.111515
0.116283
0.121464
0.127108
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0.139974
0.147292
0.155265
0.163939
0.173363
0.183585
0.194653
0.206615
0.219519
0.234086
0.248436
0.263954
0.280803
0.299154
0.319185
0.341086
0.365052
0.393102
0.427255
0.469531
0.521945
0.586518
0.665268
0.760215
1.000000
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TABLE 6.—MORTALITY TABLE FOR SOCIAL SECURITY DISABLED FEMALE
PARTICIPANTS—Continued
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0.010521
0.010984
0.011468
0.011974
0.012502
0.013057
0.013632
0.014229
0.014843
0.015473
0.016103
0.016604
0.017121
0.017654
0.018204
0.018770
0.019355
0.019957
0.020579
0.021219
0.021880
0.022561
0.023263
0.023988
0.024734
0.025504
0.026298
0.027117
0.027961
0.028832
0.029730
0.030655
0.031609
0.032594
0.033608
0.034655
0.035733
0.036846
0.037993
0.039176
0.040395
0.041653
0.042950
0.044287
0.045666
0.046828
0.048070
0.049584
0.051331
0.053268
0.055356
0.057573
0.059979
0.062574
0.065480
0.068690
0.072237
0.076156
0.080480
0.085243
0.090480
0.096224
0.102508
72211
Age x
85 ..............................................
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0.109368
0.116837
0.124948
0.133736
0.143234
0.153477
0.164498
0.176332
0.189011
0.202571
0.217045
0.232467
0.248870
0.266289
0.284758
0.303433
0.327385
0.359020
0.395842
0.438360
0.487816
0.545886
0.614309
0.694884
0.789474
1.000000
Issued in Washington, DC, this 29 day of
November, 2005.
Elaine L. Chao,
Chairman, Board of Directors, Pension Benefit
Guaranty Corporation.
Issued on the date set forth above pursuant
to a resolution of the Board of Directors
authorizing its Chairman to issue this final
rule.
Judith R. Starr,
Secretary, Board of Directors, Pension Benefit
Guaranty Corporation.
[FR Doc. 05–23554 Filed 12–1–05; 8:45 am]
BILLING CODE 7708–01–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Parts 3 and 20
RIN 2900–AL86
Dependency and Indemnity
Compensation: Surviving Spouse’s
Rate; Payments Based on Veteran’s
Entitlement to Compensation for
Service-Connected Disability Rated
Totally Disabling for Specified Periods
Prior to Death
Department of Veterans Affairs.
Final rule.
AGENCY:
ACTION:
SUMMARY: The Department of Veterans
Affairs (VA) is amending its
adjudication regulations concerning
payment of dependency and indemnity
compensation (DIC) for certain non-
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service-connected deaths and the rate of
DIC payable to a surviving spouse for
either service-connected or non-serviceconnected deaths. The purpose of this
final rule is to clarify VA’s
interpretation of two similar statutes
that provide for payments to the
survivors of veterans who were, at the
time of death, in receipt of or entitled
to receive disability compensation for
service-connected disability that was
rated totally disabling for a specified
period prior to death. This rule also
reorganizes and revises the regulations
governing surviving spouses’ DIC rates
and revises the Board of Veterans’
Appeals rule concerning the effect of
unfavorable decisions during a veteran’s
lifetime on claims for death benefits by
the veteran’s survivors.
DATES: Effective Date: This rule is
effective December 2, 2005.
Applicability Date: VA will apply this
rule to claims pending before VA on the
effective date of this rule, as well as to
claims filed after that date.
FOR FURTHER INFORMATION CONTACT:
Maya Ferrandino, Consultant,
Compensation and Pension Service,
Policy and Regulations Staff, Veterans
Benefits Administration, 810 Vermont
Avenue, NW., Washington, DC 20420
(202) 273–7211.
SUPPLEMENTARY INFORMATION:
Background
In the Federal Register of October 25,
2004 (69 FR 62229), VA proposed to
revise its DIC regulations to clarify and
harmonize VA’s interpretation of two
statutory provisions. We further
proposed to reorganize and restate
existing regulations to make them easier
to understand and apply.
DIC is a benefit paid to survivors of
veterans in cases of death due to
service-connected disability or certain
cases of death due to non-serviceconnected disability. Section 1318(b) of
title 38, United States Code, provides in
effect that, if the veteran’s death is not
caused by a service-connected
disability, DIC is payable only if the
veteran was in receipt of or ‘‘entitled to
receive’’ compensation at the time of
death for a service-connected disability
that was continuously rated totally
disabling for a period of 10 or more
years immediately preceding death, or
for a period of not less than five years
from the date of the veteran’s discharge
or release from active duty, or for a
period of not less than one year
immediately preceding death if the
veteran was a former prisoner of war.
VA has implemented this provision
through regulations at 38 CFR 3.22,
paragraph (b) of which explains that the
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phrase ‘‘entitled to receive’’ refers to
circumstances in which the veteran, at
the time of his or her death, had serviceconnected disability that was rated
totally disabling by VA, but was not
receiving compensation for one of seven
specified reasons, including the fact that
the veteran had applied for
compensation during his or her lifetime
but had not received total disability
compensation due to a clear and
unmistakable error (CUE) in a VA
decision.
We proposed to revise § 3.22(b) in two
respects. First, we proposed to revise
ambiguous language in § 3.22(b) to
clarify that the correction of CUE may
establish that a veteran was ‘‘entitled to
receive’’ benefits ‘‘at the time of death’’
irrespective of whether the CUE is
corrected before or after the veteran’s
death. We explained that the statutory
requirement that the veteran have been
entitled to benefits ‘‘at the time of
death’’ would be satisfied in such cases
because 38 U.S.C. 5109A and 7111
mandate that decisions correcting CUE
must be given full retroactive effect as
a matter of law.
Second, we proposed to add an eighth
circumstance in which a veteran may be
found to have been ‘‘entitled to receive’’
compensation at the time of death for a
disability that was continuously rated
totally disabling for the specified period
preceding death. We proposed to state
that service department records that
existed at the time of a prior final VA
decision but were not previously
considered by VA (hereinafter
referenced as ‘‘newly identified service
department records’’) may support a
finding that the veteran was ‘‘entitled to
receive’’ compensation at the time of
death for a disability that was rated
totally disabling for the specified
period. We explained that the proposed
rule would apply to such service
department records received by VA
before or after a veteran’s death, if the
records established a basis for assigning
a total disability rating for the
retroactive period specified in 38 U.S.C.
1318(b). We stated that, similar to
awards based on correction of CUE,
awards based on such newly identified
service department records may be
made retroactive as a matter of law, as
provided in long-standing VA
regulations at 38 CFR 3.156(c) and
3.400(q)(2).
Under section 1311(a)(2) of title 38,
United States Code, if a veteran’s
survivor is entitled to DIC based on
either service-connected or non-serviceconnected death, the basic monthly rate
of DIC payable to the survivor may be
increased by a specified amount if the
veteran at the time of death was in
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receipt of or was ‘‘entitled to receive’’
compensation for a service-connected
disability that was rated totally
disabling for a continuous period of at
least eight years immediately preceding
death. VA previously implemented this
provision through regulations in 38 CFR
3.5(e)(1). Unlike § 3.22, however,
§ 3.5(e)(1) did not define or elaborate
upon the phrase ‘‘entitled to receive.’’
In view of the substantially similar
language and common derivation of 38
U.S.C. 1311(a)(2) and 1318(b), VA has
concluded that the statutes should be
given a similar construction, and the
United States Court of Appeals for the
Federal Circuit (Federal Circuit) upheld
that determination in National
Organization of Veterans’ Advocates,
Inc. v. Secretary of Veterans Affairs, 314
F.3d 1373, 1378 (Fed. Cir. 2003)
(‘‘NOVA’’). In its NOVA decision,
however, the Federal Circuit criticized
VA for not elaborating the meaning of
the phrase ‘‘entitled to receive’’ in
§ 3.5(e)(1), as VA had done in § 3.22.
NOVA at 1381. The court ordered VA to
undertake further rulemaking to
harmonize those regulations.
In our October 2004 proposed rule,
we proposed to remove the provisions
in 38 CFR 3.5(e) and to replace them
with new 38 CFR 3.10. We proposed to
reorganize and restate more clearly in
new § 3.10 several provisions specifying
the amounts of DIC payable to surviving
spouses of veterans. We also proposed
to include in new § 3.10(f)(3) a
definition of the phrase ‘‘entitled to
receive’’ that would parallel the
definition set forth in § 3.22(b), as
revised by this rule.
VA also proposed to revise 38 CFR
20.1106, which provides generally that
claims for death benefits by a veteran’s
survivor will be decided without regard
to decisions rendered during the
veteran’s lifetime. The rule historically
has contained an express exception for
claims under section 1318, but not for
claims under section 1311. To ensure
that those two statutes are applied
consistently, we proposed to revise
§ 20.1106 to exempt claims under either
section 1311 or 1318.
Finally, the Federal Circuit’s order in
NOVA directed VA to address, in this
rule, whether a survivor may establish
entitlement to DIC under 38 U.S.C.
1311(a)(2) and 1318 by submitting new
and material evidence after a veteran’s
death in order to reopen a claim filed by
the veteran during his or her lifetime.
NOVA at 1380–1381. The Federal
Circuit stated that VA’s current
regulation at 38 CFR 3.22 reasonably
recognizes the correction of CUE as a
basis for revisiting final decisions made
during a veteran’s lifetime and
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satisfying the durational disability
requirement in 38 U.S.C. 1318(b).
NOVA at 1380–1381. However, the
court stated that the correction of CUE
is only one of the two statutory bases for
revisiting final decisions, and that VA
had failed to explain whether the
durational disability requirements could
be met under the other exception, which
involves the submission of new and
material evidence to reopen a
previously denied claim. NOVA at
1380–1381.
Our notice of proposed rulemaking
explained that the submission of new
and material evidence (other than newly
identified service department records)
after a veteran’s death could not
establish that the veteran was ‘‘entitled
to receive’’ benefits for any past period.
We explained that there were
fundamental differences between the
two statutory exceptions to finality and
that those distinctions were significant
in the context of claims under 38 U.S.C.
1311(a)(2) and 1318(b), which depend
upon whether a veteran was ‘‘entitled to
receive’’ benefits for past periods. The
correction of CUE is a remedy for error
committed by VA in a prior final
decision. By statute, a decision
correcting CUE has full retroactive effect
irrespective of when the CUE claim is
brought. Accordingly, a CUE claim
brought after a veteran’s death may
establish that the veteran was entitled as
a matter of law to have received benefits
during his or her lifetime.
In contrast, a reopening based on new
and material evidence (other than newly
identified service department records) is
not a retroactive correction of a prior
final decision, but is instead a means for
establishing prospective entitlement to
benefits despite a prior final denial.
Pursuant to 38 U.S.C. 5110(a), the
effective date of an award based on a
reopened claim ‘‘shall not be earlier
than the date of receipt of application
therefore.’’ Accordingly, the Federal
Circuit has held that VA regulations
reasonably provide that reopening with
new and material evidence of a
previously denied claim generally may
not operate retroactively. See Sears v.
Principi, 349 F.3d 1326, 1330 (Fed. Cir.
2003), cert. denied, 124 S. Ct. 1723
(2004). The United States Court of
Appeals for Veterans Claims (CAVC) has
explained that a reopening ‘‘is not a
reactivation of the previous claim, based
upon the original application for
benefits’’ and that ‘‘even upon a
reopening, the prior claim is still ‘final’
in a sense’’ because any award based on
the reopening can be effective no earlier
than the date of the application to
reopen. Spencer v. Brown, 4 Vet. App.
283, 293 (1993), aff’d, 17 F.3d 368 (Fed.
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Jkt 208001
Cir. 1994). Accordingly, even if new and
material evidence could show as a
factual matter that any veteran was
totally disabled due to serviceconnected disability during prior
periods, such evidence could not
establish that the veteran was entitled to
receive benefits from VA for such past
periods.
We concluded that, because awards
based on new and material evidence
generally cannot establish retroactive
entitlement to benefits, a survivor
seeking DIC under section 1311(a)(2) or
1318(b) generally cannot rely upon new
and material evidence for the purpose of
showing that a veteran was ‘‘entitled to
receive’’ VA compensation for past
periods. As noted above, the only
exception to this general principle
relates to circumstances in which newly
identified service department records
are submitted after a claim was finally
denied. Because long-standing VA
regulations authorize retroactive benefit
entitlement based on such service
department records, the proposed rule
explained that new service department
records submitted after a veteran’s death
may show that the veteran was ‘‘entitled
to receive’’ total disability compensation
for periods prior to death.
Although the Federal Circuit’s NOVA
decision refers to the possibility of a DIC
claimant ‘‘reopening’’ a deceased
veteran’s claim based on either CUE or
new and material evidence, we note that
a survivor’s DIC claim is not actually a
‘‘reopening’’ of the decedent’s claim for
disability compensation because a
veteran’s claim does not survive his or
her death. See Richard v. West, 161 F.3d
719, 721–22 (Fed. Cir. 1998). Rather, the
survivor’s claim is a new and distinct
claim that the survivor is entitled to DIC
in his or her own right based on a
showing that the veteran was ‘‘entitled
to receive’’ certain benefits during the
veteran’s lifetime. Thus the fact that
CUE and new and material evidence
both provide grounds on which the
veteran could have ‘‘reopened’’ or
otherwise revisited a previously denied
claim during his or her lifetime does
not, in itself, provide any basis for
applying those remedies to a survivor’s
DIC claim. Rather, the conclusion that a
showing of CUE could establish a
survivor’s entitlement to DIC is based on
factors unique to CUE. First, because
CUE may be corrected retroactively, a
showing of CUE may bear directly upon
the issue of whether a veteran was truly
‘‘entitled to receive’’ benefits that were
wrongly denied due to VA error during
his or her lifetime. Second, the
legislative history of 38 U.S.C. 1318
clearly expressed Congress’ intent that
‘‘the existence of clear and unmistakable
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72213
VA administrative error would be a
basis for entitlement to DIC benefits
when such administrative error is the
only bar to entitlement otherwise.’’ S.
Rep. No. 97–550, at 17 (1982), reprinted
in 1982 U.S.C.C.A.N. 2877, 2880.
Neither of those considerations applies
to the submission of new and material
evidence.
Analysis of Public Comments
We received comments from the
Paralyzed Veterans of America (PVA)
and the National Organization of
Veterans’ Advocates, Inc. (NOVA), both
of which were parties to the abovereferenced NOVA litigation. NOVA
suggested a change to the terminology
used in proposed 38 CFR 3.10(c)–(f) to
describe the benefits authorized by 38
U.S.C. 1311(a)(2). The remaining
comments from PVA and NOVA all
relate to the issue of whether DIC
claimants may rely on new and material
evidence other than newly identified
service department records to show that
the veteran was ‘‘entitled to receive’’
total disability compensation for the
specified statutory period. We address
these comments below.
I. Terminology in § 3.10(c)–(f)
We proposed to state in 38 CFR
3.10(a) that the rate of DIC payable to a
surviving spouse would consist of a
basic monthly rate and any applicable
increases specified in § 3.10(c) and (e).
We proposed, in § 3.10(c), (d), (e), and
(f), to describe the additional DIC
amount payable under 38 U.S.C.
1311(a)(2) as the ‘‘veteran’s
compensation increase’’ because the
survivor’s eligibility for that increase
was conditioned upon the veteran’s
entitlement to compensation during his
or her lifetime. NOVA states that the
term ‘‘veteran’s compensation increase’’
is misleading because the increase is
payable to the surviving spouse rather
than the veteran and suggests that we
change the term to ‘‘surviving spouse’s
compensation increase.’’ We note that
the provisions of proposed § 3.10(a) and
(c) make clear that the increase pertains
solely to the rate of DIC payable to a
surviving spouse and does not authorize
any payment to a deceased veteran.
Nevertheless, we are changing the
proposed term ‘‘veteran’s compensation
increase’’ to the more specific term
‘‘section 1311(a)(2) increase.’’ We do not
believe that the term suggested by
NOVA (‘‘surviving spouse’s
compensation increase’’) is sufficiently
specific, because § 3.10(e) refers to other
increases that are also payable to
surviving spouses as dependency and
indemnity compensation.
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II. New and Material Evidence
NOVA and PVA both assert that
survivors seeking DIC under sections
1311(a)(2) and 1318(b) should be
allowed to submit new and material
evidence after a veteran’s death for the
purpose of establishing that the veteran
was, at the time of death, ‘‘entitled to
receive’’ disability compensation for a
disability that was rated totally
disabling for the specified statutory
period immediately preceding the
veteran’s death. NOVA and PVA both
argue that the proposed rules are
arbitrary insofar as they allow claimants
to rely upon newly identified service
department records but not on other
types of new evidence submitted after a
veteran’s death. The organizations
present a number of specific arguments
in support of this assertion, which we
address below.
A. Interpretation of ‘‘Entitled To
Receive’’
Although not expressly stated in the
comments, it appears that each of the
comments from PVA and NOVA rest
upon a disagreement with VA
concerning the meaning of the phrase
‘‘entitled to receive’’ as it is used in 38
U.S.C. 1311(a)(2) and 1318(b). Because
we believe the interpretation of that
statutory phrase is relevant to all of the
comments, we address that issue as a
preliminary matter, even though it is not
expressly discussed in the comments.
The statutory requirement that the
veteran have been ‘‘entitled to receive’’
certain benefits at the time of death is
ambiguous, and two possible
interpretations of that language have
been suggested. It may be construed to
mean that the veteran had a legal right
to the specified benefits and that VA
had authority to grant such benefits to
the veteran under the statutes and
regulations giving VA authority to
award benefits for the period required
by sections 1311(a)(2) and 1318(b). This
has been VA’s consistent interpretation
of the statute. However, in a series of
decisions finding ambiguity in prior VA
regulations implementing section
1318(b), the CAVC suggested that the
phrase ‘‘entitled to receive’’ may also be
construed to mean that the veteran was
‘‘hypothetically’’ entitled to have
received total disability compensation
for the period required by sections
1311(a)(2) and 1318(b), irrespective of
whether the claimant had satisfied the
statutory requirements necessary to
actually obtain such benefits, such as
the requirements pertaining to the filing
of applications and those specifying the
effective dates of awards based on such
applications. See Wingo v. West, 11 Vet.
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App. 307, 311 (1998). Under this
interpretation, a survivor would be
required to submit evidence showing
that the veteran was totally disabled due
to a service-connected disease for the
period specified in section 1311(a)(2) or
section 1318(b), but would not need to
establish that the veteran had any legal
right to compensation for the disability
for that period or that VA had any legal
authority to pay such benefits to the
claimant under the statutes governing
VA’s authority to pay benefits. The two
commenters have advocated the latter
interpretation in the NOVA litigation
and their comments on this rule appear
to be predicated upon that
interpretation.
The distinction between the two
interpretations is significant because,
with the exception of newly identified
service department records, new and
material evidence submitted after a
veteran’s death could not establish that
the veteran had a legal right to receive
total disability compensation for a
retroactive period preceding the
veteran’s death or that VA had authority
to pay such benefits to the veteran for
that retroactive period. This is a
function of the finality of VA decisions,
the limited nature of reopenings based
on new and material evidence, and the
corresponding limitations on VA’s
authority to grant benefits in such
reopened claims. As a general matter,
once VA denies a claim, the decision is
final and VA cannot thereafter consider
the claim or award benefits except as
otherwise provided by law. See 38
U.S.C. 7104(b), 7105(c). Congress has
established two exceptions to this
finality. One exception permits VA to
correct CUE in a prior final decision and
to award benefits retroactive to the date
of the prior claim. See 38 U.S.C. 5109A,
7111. The other exception permits VA
to reopen a previously denied claim
when new and material evidence is
received. See 38 U.S.C. 5108. However,
Congress has provided that an award
based on a reopened claim may be
effective no earlier than the date VA
received the claim for reopening. See 38
U.S.C. 5110(a). Accordingly, except
with respect to newly identified service
department records, new and material
evidence submitted after a veteran’s
death could not show that a veteran had
any legal right to benefits for periods
prior to death. The commenters’
assertion that DIC claimants may rely
upon new and material evidence to
establish that a veteran was ‘‘entitled to
receive’’ benefits for past periods
necessarily reflects the view that the
phrase ‘‘entitled to receive’’ means
hypothetical entitlement rather than
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entitlement under applicable statutory
and regulatory provisions.
As stated in the notice of proposed
rulemaking, as well as in several prior
rulemaking documents published in the
Federal Register (67 FR 16309 (2002);
66 FR 65861 (2001); 65 FR 3388 (2000)),
the phrase ‘‘entitled to receive’’ is most
reasonably construed to mean that the
veteran had a legal right to total
disability compensation for the
specified period under the statutes
governing entitlement to such benefits
and that VA had authority to grant such
benefits to the veteran under the statutes
giving VA authority to award such
benefits. There are several reasons why
this interpretation best effectuates
congressional intent.
First, VA’s interpretation comports
logically with the language of sections
1311(a)(2) and 1318(b) viewed in their
entirety. Although the statutory
language alone evinces no clear
meaning, it may provide evidence of
congressional intent for consideration in
connection with other interpretive tools.
Section 1311(a)(2) requires that the
veteran, ‘‘at the time of death,’’ have
been ‘‘entitled to receive’’ compensation
for a service-connected disability ‘‘that
was rated totally disabling for a
continuous period of at least eight years
immediately preceding death.’’ Section
1318(b) similarly requires that the
veteran, ‘‘at the time of death,’’ have
been ‘‘entitled to receive’’ compensation
for a service-connected disability that
‘‘was continuously rated totally
disabling’’ for a specified period
immediately preceding death. The
requirement that the disability have
been ‘‘rated totally disabling’’ for a
specified period is consistent with an
intent to require that the veteran have
held a total disability rating assigned by
VA under the statutes and regulations
governing disability ratings for the
specified period. By statute, a veteran is
entitled to receive total disability
compensation only during periods in
which the disability is rated totally
disabling by VA. See 38 U.S.C. 1114(j).
If Congress intended to authorize
benefits without regard to whether the
veteran had obtained, or taken the steps
necessary to obtain, a total disability
rating from VA, it would have been
more logical to require only that the
veteran ‘‘was totally disabled’’ for the
specified period, rather than requiring
that the veteran was ‘‘rated totally
disabled’’ for such period.
Second, VA’s interpretation comports
with the purposes indicated by the
legislative history of sections 1311(a)(2)
and 1318(b). In providing for payment
of DIC based on the veteran’s
entitlement to total disability
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compensation during his or her lifetime,
Congress explained that its purpose was
to replace the source of income the
veteran’s family would otherwise lose
when the veteran died and his or her
compensation payments ceased. The
Senate Committee on Veterans’ Affairs
explained this purpose by stating:
The appropriate Federal obligation to these
survivors should, in the Committee’s view,
be the replacement of the support lost when
the veteran dies. For example, assume that a
veteran who is totally blind from serviceconnected causes dies at the age of 55 from
a heart attack, having been so disabled from
the age of 22—a period of 33 years. During
that period, his wife and he depended upon
his disability compensation for income
support, but, because his death is not service
connected, she would not receive DIC.
S. Rep. No. 95–1054 at 28 (1978),
reprinted in, 1978 U.S.C.C.A.N. 3465,
3486. Permitting survivors to rely on
new and material evidence or on CUE
to establish a veteran’s entitlement to
benefits that were not actually awarded
during the veteran’s lifetime would be
contrary to the stated purpose to replace
income that veterans and their families
had come to depend on by virtue of
having received total disability
payments for a prolonged period prior
to death. While Congress subsequently
explicitly amended the 1978 legislation
in 1982 to allow for recovery of DIC
benefits in cases of CUE, as indicated
below, significantly, it made no similar
express provision for recovery in cases
where new and material evidence is
presented to establish a veteran’s
entitlement to benefits that were not
actually awarded during the veteran’s
lifetime and could not have been
awarded to the veteran retroactively if
he or she had survived.
In 1982, Congress expanded the
criteria for DIC eligibility under what is
now 38 U.S.C. 1318, by authorizing DIC
in cases where the veteran would have
received total disability compensation
for the specified period prior to death
but for CUE committed by VA in a
decision on a claim submitted during
the veteran’s lifetime. The stated
purpose of that change was ‘‘to provide
that the existence of a clear and
unmistakable error should not defeat
entitlement to the survivors’ benefits.’’
S. Rep. No. 97–550, at 35 (1982),
reprinted in 1982 U.S.C.C.A.N. 2877,
2898. The legislative history further
explained that, ‘‘[u]nder the
amendment, a veteran would not need
actually to have been ‘in receipt’ of total
disability benefits for the requisite
period of time in order to provide
eligibility to the survivors if a clear and
unmistakable error had been made that
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resulted in a shorter period of receipt
than should have been provided.’’ Id.
Permitting survivors to rely on new
and material evidence to establish a
veteran’s entitlement to benefits that
were not actually awarded during the
veteran’s lifetime would go well beyond
the stated purpose to provide DIC in
cases where CUE resulted in a shorter
period of entitlement than should have
been provided. As noted above, new
and material evidence generally does
not have retroactive effect and could not
establish a longer period of
compensation entitlement for any
veteran, as correction of CUE may do.
The legislative history of the 1982
statute reasonably reflects the principle
that veterans and their families should
not be penalized in cases where the
veteran did everything necessary to
establish entitlement to a total disability
rating for the required period, but VA’s
error prevented the timely assignment of
such rating. The purpose of that
amendment was clearly remedial, in the
same way that the general authority to
correct CUE retroactively is remedial. In
contrast, the authority to reopen and
grant claims upon receipt of new and
material evidence (other than service
department records that were previously
in the government’s possession) is not
remedial, in that it does not correct any
past error, but merely permits a new
adjudication informed by new evidence.
In view of the stated congressional
purpose, we believe it is appropriate to
recognize the distinction between
statutory procedures that may result in
the retroactive assignment of a total
disability rating for periods prior to
death (i.e., correction of CUE;
readjudication based on newly
identified service department records)
and those that may not (i.e., reopening
based on new and material evidence
other than service department records).
It is, further, appropriate to recognize a
distinction between procedures
designed to remedy governmental error
(i.e., correction of CUE; readjudication
based on newly identified service
department records) and those that are
not (i.e., reopening based on new and
material evidence). Newly identified
service department records are
considered ‘‘lost or mislaid,’’ 38 CFR
3.400(q)(2), presumably by the
government, and therefore belong
conceptually with CUE, rather than with
new and material evidence. In view of
Congress’s stated purpose to allow DIC
where VA’s error was the only obstacle
to the veteran’s receipt of benefits, we
find no basis for extending DIC to
circumstances where there was no VA
error and, moreover, where VA would
have no statutory authority to award
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72215
retroactive entitlement to the veteran if
the veteran were still alive.
A third basis for our interpretation of
the statutory language is our conclusion
that, when Congress conditioned a
survivor’s DIC eligibility on the extent
and duration of a veteran’s entitlement
to benefits, it intended that VA would
apply the existing statutory provisions
governing the extent and duration of the
veteran’s entitlement, including those
prohibiting VA from according
retroactive effect to decisions based on
new and material evidence. As a general
rule, new statutes enacted as part of an
established statutory scheme must be
construed to fit logically within the
statutory scheme. See United States v.
Jefferson Electric Mfg. Co., 291 U.S. 386,
396 (1934) (‘‘As a general rule, where
the legislation dealing with a particular
subject consists of a system of related
general provisions indicative of a settled
policy, new enactments of a fragmentary
nature on that subject are to be taken as
intended to fit into the existing system
and to be carried into effect conformably
to it, excepting as a different purpose is
plainly shown.’’) When Congress
enacted statutes authorizing DIC in
cases where a veteran was ‘‘entitled to
receive’’ a specific type of benefit at a
specific level for a specific time period,
it is reasonable to assume that Congress
intended VA to apply the established
statutory and regulatory scheme then in
place governing entitlement to benefits,
including those statutes and regulations
that delimit the duration and level of
entitlement. As discussed above and in
the notice of proposed rulemaking,
those provisions permit retroactive
determinations of entitlement only in
limited circumstances, involving CUE or
newly identified service department
records.
Finally, we note that an alternate
interpretation—i.e., requiring VA to
ignore the statutory and regulatory
provisions governing a veteran’s
entitlement to benefits and the level and
duration of such entitlement—would
result in a process fraught with
uncertainty. Under the effective date
provisions of 38 U.S.C. 5110 and
corresponding VA regulations, the
duration of any veteran’s entitlement to
benefits may be determined with
relative ease and certainty, most often
by reference to the date of the claim that
resulted in the award of benefits.
Although the effective date of
entitlement may not correspond to the
date the veteran actually became
disabled or attained a particular level of
disability, the statutory procedure
promotes certainty and administrative
efficiency. However, if determinations
regarding a veteran’s entitlement to
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benefits are to be made without regard
to the statutes expressly governing the
effective dates of entitlement, there
would be no clear basis for determining
when a veteran’s entitlement to a total
disability rating began. Even assuming
that the veteran’s ‘‘hypothetical’’
entitlement would begin on the date he
or she became totally disabled due to a
service-connected disability, such a
determination ordinarily would be
exceedingly difficult, highly
speculative, and would lend itself to
prolonged evidentiary disputes,
potentially involving medical opinions
or lay testimony rendered many years
after the events in question. The
difficulty of such determinations would
be compounded by the need to evaluate
the decedent’s condition over a
prolonged continuous period of many
years prior to death. In view of
Congress’ practice of imposing clear and
definite effective-date rules for VA
benefit awards and limiting retroactive
awards and the complex issues they
involve, we believe it is reasonable to
conclude that Congress did not intend
to impose a much more complex and
uncertain process for determining a
veteran’s entitlement to benefits for
purposes of sections 1311(a)(2) and
1318. This conclusion is underscored by
the stated purposes of those statutes to
authorize benefits in cases where the
veteran’s entitlement can be simply and
readily established—i.e., where the
veteran was actually receiving total
disability compensation at the time of
death or would have received such
benefits but for a VA error that is clearly
and unmistakably shown by the record
created during the veteran’s lifetime.
NOVA presents three comments
regarding the foregoing analysis. First, it
asserts that the congressional purpose to
replace income lost when a totallydisabled veteran dies would apply
equally in circumstances in which the
veteran held a total-disability rating for
less than the specified statutory period.
We do not dispute nor diminish the
hardship that any family may face
following the death of a veteran family
member and the resulting termination of
VA benefit payments. However,
Congress has specified by statute the
period of a veteran’s entitlement to total
disability compensation that is
necessary to vest survivors with DIC
entitlement under section 1311(a)(2)
and 1318(b). The difficult task of
drawing lines governing benefit
entitlement is a policy matter entrusted
to Congress and VA is not at liberty to
alter the statutory standards Congress
has adopted. See Mathews v. Diaz, 426
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U.S. 67, 83–84 (1976). Accordingly, we
make no change based on this comment.
Second, NOVA asserts that allowing
survivors to rely upon any type of new
and material evidence submitted after a
veteran’s death would serve a ‘‘remedial
purpose’’ similar to the correction of
CUE and would be consistent with the
congressional intent to authorize DIC
where VA error prevented the veteran
from receiving benefits during his or her
lifetime. We do not agree. The statutory
and regulatory provisions relating to
CUE and newly obtained service
department records are unique not
merely because they can fairly be
described as having a ‘‘remedial’’
purpose, but also because they
effectuate that purpose by expressly
authorizing retroactive awards of
entitlement to benefits. There is no
similar authority for retroactive awards
based on new and material evidence,
and the mere assertion that the
reopening of claims serves a remedial
function cannot provide such authority
in view of the effective-date rules in 38
U.S.C. 5110(a). Moreover, it is not
accurate to say that a reopening based
on new and material evidence provides
a remedy for VA error. As the Federal
Circuit stated in Sears v. Principi, VA’s
effective-date regulations reasonably
differentiate between reopening based
on previously unobtained service
department records, which provides a
remedy for ‘‘government errors or
inattention,’’ and reopening based on
other evidence, which encompasses
‘‘situations outside the control of the
government,’’ such as where the new
evidence was not provided earlier
‘‘either due to inattention by the veteran
or his representatives or subsequent
advances in medicine and science.’’
Sears, 349 F.3d at 1331. Accordingly,
we make no change based on this
comment.
Third, NOVA asserts that interpreting
sections 1311 and 1318 to permit
reopening based on new and material
evidence would have no significant
practical effects on VA claim
processing. NOVA asserts that DIC
claimants alone would be responsible
for developing evidence relevant to their
claim and that VA would have no need
to conduct any evidentiary development
unless it were for the improper purpose
of trying to refute the survivor’s DIC
claim. VA does not agree with this
comment. If new and material evidence
submitted after a veteran’s death could
potentially establish a survivor’s
entitlement to DIC under section
1311(a)(2) and 1318(b), VA would be
required by statute and regulation, to
assist the claimant in obtaining
evidence necessary to substantiate the
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claim. 38 U.S.C. 5103A; 38 CFR
3.159(c). Such assistance would be
necessary if the claimant needed help
obtaining allegedly new and material
evidence or if evidence submitted by the
claimant was insufficient to permit fair
adjudication of the claim. The assertion
that VA’s assistance could serve no
purpose other than to refute the claim
is factually incorrect and is contrary to
law and to longstanding VA policy.
Further, the practical concerns we
discussed were not based merely on the
fact that VA would need to assist
claimants in developing evidence, as
VA routinely does. Rather, the burdens
unique to NOVA’s suggested
interpretation of sections 1311(a)(2) and
1318(b) would involve the difficulty of
resolving medical issues regarding the
duration and degree of a veteran’s
disability many years after the events in
question and the difficulty of
ascertaining a specific period of the
veteran’s ‘‘entitlement’’ to total
disability benefits in the absence of an
applicable statutory standard defining
the period of entitlement. As noted
above, 38 U.S.C. 5110(a) provides a
definite and specific mechanism for
measuring the beginning date of any
individual’s entitlement to benefits. If,
as NOVA suggests, that provision is
inapplicable in determining the period
of a veteran’s entitlement to total
disability benefits for purposes of
section 1311(a)(2) and 1318(b), there
would be no clear basis for defining the
period of a veteran’s entitlement.
Assuming the matter involved a purely
factual determination as to when the
veteran’s total disability began,
resolution of that question would often
be a matter of significant uncertainty
and speculation, compounded by the
remoteness of the events and the
unavailability of the veteran. There
potentially would be equal difficulty in
determining whether the veteran was
totally disabled throughout the specified
statutory period, as sections 1311(a)(2)
and 1318(b) require, in the absence of
clear and contemporaneous disability
evaluations throughout that period. See
38 CFR 4.1, 4.2 (discussing the need for
thorough medical reports to support
disability evaluations).
We do not suggest that these problems
are entirely insurmountable. Rather, as
stated in the notice of proposed
rulemaking, the extent of the burdens
and uncertainty that would be
associated with this interpretation of
sections 1311(a)(2) and 1318(b) lends
support to our conclusion that Congress
did not intend that interpretation. The
legislative history reflects that Congress
intended to authorize these DIC benefits
in at least two circumstances in which
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the extent and duration of the veteran’s
entitlement to benefits can be readily
established by the record of proceedings
during the veteran’s lifetime, i.e., where
the veteran actually received total
disability benefits for the specified
period or would have received such
benefits but for a VA error that is clear
and unmistakable on the existing
record. Viewed against these definite
and efficient standards, it is unlikely
that Congress intended to impose the
much more complex, uncertain, and
hypothetical adjudicative actions that
would be necessary in determinations
based on new and material evidence.
For the foregoing reasons, we make no
change based upon this comment.
B. Comments Based on 38 U.S.C.
5110(a)
As explained above, VA concluded
that the submission of new and material
evidence following a veteran’s death
could generally not retroactively
establish that the veteran was ‘‘entitled
to receive’’ compensation for periods
prior to the veteran’s death, because 38
U.S.C. 5110(a) prohibits retroactive
awards based on new and material
evidence. NOVA asserts that this
statutory limit on retroactivity is
irrelevant because section 1311(a)(2) or
1318(b) would not require VA to pay
any retroactive benefits to a veteran.
Rather, NOVA asserts, VA would be
required only to pay prospective DIC
benefits to survivors in a manner
consistent with section 5110(a).
VA does not agree with this comment.
NOVA is correct that VA would not be
required to pay retroactive benefits to a
deceased veteran or to the DIC claimant.
However, a survivor’s claim for benefits
under section 1311(a)(2) or section
1318(b) is predicated on the veteran’s
entitlement to benefits insofar as the
statutes authorize benefits only if the
veteran was ‘‘entitled to receive’’ total
disability compensation for a specified
period prior to death. In order to
determine whether a veteran was
‘‘entitled to receive’’ benefits for past
periods, VA necessarily must consider
section 5110(a), which imposes limits
on a veteran’s entitlement to receive,
and VA’s authority to award, benefits
for specific periods. If a veteran whose
claim was denied ten years ago were to
submit new evidence establishing that
he was totally disabled due to serviceconnected disability, section 5110(a)
would permit VA to award
compensation only from the date the
claim was reopened, even if the total
disability may have arisen at an earlier
date. The veteran’s reopened claim
could not establish a right to receive
benefits for any prior periods. New and
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material evidence submitted after a
veteran’s death could no more establish
the veteran’s retroactive entitlement to
benefits than could evidence submitted
by the veteran himself during his
lifetime. Although an adjudication
under section 1311(a)(2) or section
1318(b) based on new and material
evidence would not require VA to
actually release payment to a deceased
veteran, such a claim could prevail only
if VA were to find that the veteran was
entitled to receive payment from VA for
periods prior to the date VA received
the new and material evidence
establishing such entitlement. Such a
finding would be contrary to the
requirements of section 5110(a).
Accordingly, we make no change based
on this comment.
NOVA also states that, although
section 5110(a) limits the effective date
of awards based on claims reopened
after a final adjudication, the statute
refers separately to the effective date of
claims for DIC and provides that the
effective date of such awards ‘‘shall be
fixed in accordance with the facts
found.’’ NOVA asserts that it is
improper for VA to rely on the statute’s
reference to reopened claims because
effective-date issues in claims under
section 1311(a)(2) and 1318(b) are
governed by section 5110(a)’s reference
to DIC claims.
VA does not agree with this comment.
Section 5110(a) states a single effectivedate rule applicable to ‘‘an original
claim, a claim reopened after final
adjudication, or a claim for increase, of
compensation, [or] dependency and
indemnity compensation’’ and provides
that the effective date of any such award
‘‘shall be in accordance with the facts
found but shall not be earlier than the
date of receipt of application therefor.’’
In the context of a claim for DIC benefits
under section 1311(a)(2) or 1318(b),
there are potentially two effective-date
issues to which section 5110(a) may
apply. First, as explained above, section
5110(a) would govern the effective date
of any compensation award to the
veteran and thus would determine the
date, if any, on which a veteran became
‘‘entitled to receive’’ total disability
compensation. The duration of the
veteran’s total disability compensation,
if any, would determine whether the
survivor was entitled to DIC under
section 1311(a)(2) or 1318(b). Second, if
the survivor is entitled to DIC, section
5110(a) would again operate to
determine the effective date of the
survivor’s entitlement. The issue of the
effective date of a survivor’s DIC award,
if one is made, is both logically and
sequentially distinct from the issue of
the effective date of any benefits the
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72217
veteran was entitled to receive during
his or her lifetime. Accordingly, the fact
that section 5110(a) would govern the
effective date of a survivor’s DIC award
does not conflict with our conclusion
that section 5110(a) also applies in
determining whether and to what extent
the veteran was ‘‘entitled to receive’’
benefits from VA. We therefore make no
change based on this comment.
C. Comments Based on 38 U.S.C. 5108
PVA asserts that the proposed rules
are inconsistent with 38 U.S.C. 5108
insofar as they provide that newly
identified service department records
may provide a basis for establishing that
a veteran was ‘‘entitled to receive’’
benefits for past periods but that other
types of new evidence submitted after a
veteran’s death may not establish that
fact. Section 5108 provides that, ‘‘[i]f
new and material evidence is presented
or secured with respect to a claim which
has been disallowed, the Secretary shall
reopen the claim and review the former
disposition of the claim.’’ PVA asserts
that this statute unambiguously requires
VA to reopen a previously denied claim
when new and material evidence is
received. PVA further asserts that,
because this statute does not limit the
form of acceptable new and material
evidence, there is no basis for VA’s
conclusion that newly identified service
department records, but not other types
of records, submitted after a veteran’s
death, may establish that a veteran was
‘‘entitled to receive’’ benefits for periods
prior to death. NOVA similarly asserts
that there is no rational basis for
distinguishing between newly identified
service department records and other
types of new evidence.
VA does not agree with these
comments. Section 5108 allows
claimants to reopen their benefit claims
after a final denial. It is well established,
however, that a veteran’s claim for
disability compensation does not
survive the veteran’s death. See Richard
v. West, 161 F.3d 719, 721–22 (Fed. Cir.
1998). Section 5108 thus provides no
general authority for survivors to
‘‘reopen’’ a deceased veteran’s claim
with new and material evidence. A
survivor’s claim for DIC under section
1311(a)(2) or section 1318(b) is not a
‘‘reopening’’ of the deceased veteran’s
compensation claim within the meaning
of 38 U.S.C. 5108, but instead is a
distinct claim for DIC benefits by the
survivor.
Insofar as the proposed rule allows
survivors to submit newly identified
service department records after a
veteran’s death, the rule is not based
upon 38 U.S.C. 5108, but upon the
provisions of 38 U.S.C. 1311(a)(2) and
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1318(b), viewed in the context of the
overall statutory scheme in title 38,
United States Code. Although a
veteran’s claim does not survive his or
her death, sections 1311(a)(2) and
1318(b) are most reasonably construed
to permit examination of decisions on a
veteran’s claim to the extent necessary
to determine the survivor’s entitlement
to DIC. Because a survivor’s entitlement
to DIC under section 1311(a)(2) and
1318(b) may depend upon whether the
veteran was ‘‘entitled to receive’’ total
disability benefits for a specified
number of years prior to death, it is
reasonable to conclude that Congress
intended to permit VA to examine prior
claims or decisions under limited
circumstances to determine whether the
veteran was ‘‘entitled to receive’’ total
disability benefits for the specified
statutory period. This congressional
intent is made clear by the legislative
history stating an intent to allow DIC
under sections 1311(a)(2) and 1318(b) if
it is shown that the veteran would have
received the specified compensation
benefits but for CUE in a decision on a
claim during the veteran’s lifetime. As
explained above, a veteran’s retroactive
entitlement to benefits may be
established by a showing that prior
decisions contained CUE or by newly
identified service department records
that establish entitlement to benefits.
However, new and material evidence, if
submitted after a veteran’s death, could
not establish such retroactive
entitlement. Accordingly, the
distinction in the proposed rule
between newly identified service
department records and new evidence
submitted after death merely reflects the
distinction between circumstances that
may satisfy the eligibility requirements
of section 1311(a)(2) and 1318(b) and
circumstances that could not as a matter
of law satisfy those eligibility
requirements.
PVA and NOVA are correct that 38
U.S.C. 5108 does not distinguish
between newly obtained service
department records and other types of
new evidence. However, the other
statutory and regulatory provisions
upon which the proposed rule was
based do reflect a material distinction
between the retroactive effect of awards
based on newly obtained service
department records and awards based
on other types of new evidence. As
explained above, 38 U.S.C. 5110(a)
makes clear that entitlement to benefits
based on a claim reopened with new
and material evidence generally may be
effective no earlier than the date VA
received the reopened claim, and thus
cannot establish retroactive entitlement
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Jkt 208001
for periods prior to the reopening. See
also 38 CFR 3.400(q)(1). VA regulations
recognize an exception to this general
rule in cases where a previously denied
claim is reopened with newly obtained
service department records. In such
cases, VA’s regulations state that the
effective date of entitlement to benefits
will ‘‘agree with evaluation (since it is
considered that these records were lost
or mislaid) or date of receipt of claim on
which prior evaluation was made,
whichever is later.’’ 38 CFR 3.400(q)(2);
see also 38 CFR 3.156(c).
The Federal Circuit has acknowledged
and upheld the distinction between the
retroactivity of awards based on newly
obtained service department records
and awards based on other types of new
evidence. In Sears, the court stated:
[A] claim that is reopened for new and
material evidence in the form of missing
service medical records dates back to the
filing of the veteran’s original claim for
benefits. 38 CFR 3.400(q)(2) (2003).
Section 3.400(q)(1)(ii) applies to other
instances of new and material evidence,
situations in which the new evidence was
not presented earlier, either due to
inattention by the veteran or his
representative or subsequent advances in
medicine and science. We conclude that
section 3.400, which differentiates between
government errors or inattention, and
situations outside the control of the
government, is not unreasonable.
349 F.3d at 1331. As the Court noted,
the rules permitting retroactive awards
based on newly identified service
department records reflect the judgment
that the failure to establish benefit
entitlement at an earlier date would, in
such cases, be a result of ‘‘government
errors or inattention.’’ In this respect,
the rules governing awards based on
such service department records serve a
remedial function similar to the rules
governing the correction of CUE in prior
decisions. In contrast, as the Federal
Circuit noted, awards based on other
types of new evidence do not remedy
past government error, but merely
permit consideration of new evidence
that was not previously submitted for
reasons outside the government’s
control. This distinction is also
supported by the CAVC’s decision in
Spencer, 4 Vet. App. at 293, which
stated that, generally, ‘‘even upon a
reopening, the prior claim is still ‘final’
in a sense,’’ because ‘‘[a]ny award of
benefits made upon a claim reopened
under section 5108 on other than
service department reports will have an
effective date no earlier than the date of
the filing of the claim to reopen.’’ The
CAVC noted that VA’s regulations
according retroactive effect to awards
based on service department records
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were rooted in VA regulations dating
back to the 1930s and were consistent
with prior statutory provisions.
For the reasons stated above, the
distinction in the proposed rules
between awards based on newly
identified service department records
and awards based on other types of new
evidence is reasonable and is not
inconsistent with 38 U.S.C. 5108.
Accordingly, we make no change based
upon the referenced comments.
D. Other Comments
NOVA asserts that VA should not
distinguish between claims involving
newly obtained service department
records and claims involving other new
evidence submitted after a veteran’s
death, because the function of either
type of evidence would be the same, i.e.,
to provide a factual basis for
determining that the veteran met the
criteria for a total disability rating for
the specified period prior to death. This
comment is based on the assumption
that a survivor is entitled to DIC under
section 1311(a)(2) and 1318(b) whenever
current evidence shows that the veteran
was totally disabled due to serviceconnected disability for the specified
period, irrespective of whether the
veteran was entitled to receive any
payments from VA for that period under
the statutes and regulations governing
awards of VA benefits. That assumption
is incorrect, for the reasons set forth
above. Because new evidence other than
newly identified service department
records cannot retroactively establish
that a veteran was ‘‘entitled to receive’’
benefits for past periods, we make no
change based on this comment.
NOVA also asserts that the regulation
is arbitrary insofar as it permits new
evidence only in the form of newly
identified service department records
because, in NOVA’s view, service
department records could not provide
any information supporting the claim.
VA does not agree. Service department
records may be highly relevant in some
circumstances, such as where the fact of
the veteran’s total disability was
established, but VA had previously
denied service connection for the
disability due to the absence of evidence
that the disability arose in service.
Moreover, the reference in the proposed
rules to service department records is
not arbitrary, but properly reflects the
existing statutory and regulatory
scheme, which makes clear that service
department records are the only form of
new evidence that potentially may
establish that a veteran was ‘‘entitled to
receive’’ total disability compensation
for past periods.
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Federal Register / Vol. 70, No. 231 / Friday, December 2, 2005 / Rules and Regulations
III. Section 20.1106
We proposed to revise 38 CFR
20.1106 in two respects. First, we
proposed to add a reference in that rule
to 38 U.S.C. 1311(a)(2), to clarify that
claims under that statute are exempt
from the general rule that issues in a
survivor’s claim for death benefits will
be decided without regard to any
disposition of the same issues during
the veteran’s lifetime. Second, we
proposed to revise the regulation to state
that VA would disregard only
‘‘unfavorable’’ dispositions during the
veteran’s lifetime. We explained that the
second change would reflect VA’s
traditional practice of disregarding only
unfavorable decisions and would
resolve an ambiguity existing by virtue
of differing language in the caption of
§ 20.1106, which refers to ‘‘unfavorable’’
decisions during a veteran’s lifetime,
and the text of § 20.1106, which more
broadly states that VA will decide a
survivor’s claims without regard to ‘‘any
prior disposition.’’
We received no comments on the
proposed revisions to § 20.1106. Upon
further consideration, however, we have
concluded that the second change
discussed above would be misleading
and potentially inconsistent with
statutory requirements in some
instances. In a precedential opinion
designated as VAOPGCPREC 11–96,
VA’s General Counsel noted that VA’s
traditional practice under § 20.1106 had
been to disregard only unfavorable
dispositions on a veteran’s claim and,
correspondingly, to accept favorable
findings of service connection made
during a veteran’s lifetime. The General
Counsel concluded that this practice
was inconsistent with the requirements
of a statute limiting VA’s authority to
grant service connection for a veteran’s
death for purposes of a survivor’s DIC
claim, even if VA had correctly granted
service connection to the veteran during
his or her lifetime for the condition that
eventually caused the veteran’s death.
The General Counsel noted that
Congress had enacted a statute that
prospectively prohibited VA from
granting service connection for
disability or death due to an injury or
disease caused by the veteran’s abuse of
alcohol or drugs. 38 U.S.C. 105. The
General Counsel concluded that, even if
VA had properly granted service
connection to a veteran prior to the
enactment of this statute, the statute
precluded VA from granting service
connection for the veteran’s death if the
death was caused by an injury or
disease resulting from the veteran’s
abuse of alcohol or drugs. The General
Counsel concluded that VA’s traditional
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Jkt 208001
practice under § 20.1106 must yield in
the face of statutory provisions requiring
a different result.
A similar concern exists with respect
to 38 U.S.C. 1103(a), which prohibits
VA from establishing service connection
for disability or death on the basis that
it resulted from injury or disease
attributable to the veteran’s use of
tobacco products during the veteran’s
service. In Kane v. Principi, 17 Vet.
App. 97 (2003), the CAVC held that
section 1103(a) prohibits VA from
establishing service connection for a
veteran’s death due to an injury or
disease related to the veteran’s tobacco
use even if VA had properly granted
service connection for that injury or
disease during the veteran’s lifetime
based on then-existing law.
Although there may be relatively few
instances in which the Board would be
required by statute to disregard a
favorable decision during a veteran’s
lifetime, the proposed unqualified
reference to disregarding only
‘‘unfavorable’’ decisions would be
misleading and inaccurate with respect
to such cases. Accordingly, we are not
adopting that proposed change to
§ 20.1106. We recognize that § 20.1106
currently is ambiguous as to whether it
requires the Board to disregard only
unfavorable decisions. However, the
revision we proposed would not be
legally accurate or sufficiently
informative with respect to all potential
applications of that rule. A clarification
of the applicable law and VA policy
with respect to this matter would
require consideration of matters beyond
the scope of the proposed rule and,
therefore, would more properly be the
subject of a separate rule making.
We are, however, adopting as final the
proposal to revise § 20.1106 to specify
that claims under 38 U.S.C. 1311(a)(2)
are among the types of claims exempt
from the general rule that issues in a
decision on a survivor’s claim for death
benefits will be decided without regard
to any prior disposition of those issues
during the veteran’s lifetime. That
proposed change is consistent with our
determination that claims under
sections 1311(a)(2) and 1318(b) should
be addressed in the same manner. As
noted above, we received no comments
on that proposed change, which we now
adopt as final.
For the reasons stated above and in
the notice of proposed rulemaking, VA
will adopt the proposed rules as final,
with the changes discussed above.
Unfunded Mandates
The Unfunded Mandates Reform Act
of 1995 requires, at 2 U.S.C. 1532, that
agencies prepare an assessment of
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72219
anticipated costs and benefits before
developing any rule that may result in
an expenditure by State, local, or tribal
governments, in the aggregate, or by the
private sector, of $100 million or more
(adjusted annually for inflation) in any
given year. This proposed amendment
would have no such effect on State,
local, or tribal governments, or the
private sector.
Executive Order 12866
The Office of Management and Budget
has reviewed this document under
Executive Order 12866.
Paperwork Reduction Act
This document contains no provisions
constituting a collection of information
under the Paperwork Reduction Act (44
U.S.C. 3501–3521).
Regulatory Flexibility Act
The Secretary hereby certifies that
this regulatory amendment will not
have a significant economic impact on
a substantial number of small entities as
they are defined in the Regulatory
Flexibility Act, 5 U.S.C. 601–612. The
reason for this certification is that these
amendments would not directly affect
any small entities. Only VA
beneficiaries and their survivors could
be directly affected. Therefore, pursuant
to 5 U.S.C. 605(b), these amendments
are exempt from the initial and final
regulatory flexibility analysis
requirements of sections 603 and 604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic
Assistance program numbers and titles
are 64.109, Veterans Compensation for
Service-Connected Disability; and
64.110, Veterans Dependency and
Indemnity Compensation for ServiceConnected Death.
List of Subjects
38 CFR Part 3
Administrative practice and
procedure, Claims, Disability benefits,
Health care, Pensions, Radioactive
materials, Veterans, Vietnam.
38 CFR Part 20
Administrative practice and
procedure, Claims, Veterans.
Approved: August 1, 2005.
R. James Nicholson,
Secretary of Veterans Affairs.
For the reasons set forth in the
preamble, 38 CFR parts 3 and 20 are
amended as follows:
I
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Federal Register / Vol. 70, No. 231 / Friday, December 2, 2005 / Rules and Regulations
PART 3—ADJUDICATION
Subpart A—Pension, Compensation,
and Dependency and Indemnity
Compensation
1. The authority citation for part 3,
subpart A continues to read as follows:
I
Authority: 38 U.S.C. 501(a), unless
otherwise noted.
§ 3.5
[Amended]
2. Section 3.5 is amended by
removing paragraph (e).
I 3. Section 3.10 is added to read as
follows:
I
§ 3.10 Dependency and indemnity
compensation rate for a surviving spouse.
(a) General determination of rate.
When VA grants a surviving spouse
entitlement to DIC, VA will determine
the rate of the benefit it will award. The
rate of the benefit will be the total of the
basic monthly rate specified in
paragraph (b) or (d) of this section and
any applicable increases specified in
paragraph (c) or (e) of this section.
(b) Basic monthly rate. Except as
provided in paragraph (d) of this
section, the basic monthly rate of DIC
for a surviving spouse will be the
amount set forth in 38 U.S.C. 1311(a)(1).
(c) Section 1311(a)(2) increase. The
basic monthly rate under paragraph (b)
of this section shall be increased by the
amount specified in 38 U.S.C. 1311(a)(2)
if the veteran, at the time of death, was
receiving, or was entitled to receive,
compensation for service-connected
disability that was rated by VA as totally
disabling for a continuous period of at
least eight years immediately preceding
death. Determinations of entitlement to
this increase shall be made in
accordance with paragraph (f) of this
section.
(d) Alternative basic monthly rate for
death occurring prior to January 1,
1993. The basic monthly rate of DIC for
a surviving spouse when the death of
the veteran occurred prior to January 1,
1993, will be the amount specified in 38
U.S.C. 1311(a)(3) corresponding to the
veteran’s pay grade in service, but only
if such rate is greater than the total of
the basic monthly rate and the section
1311(a)(2) increase (if applicable) the
surviving spouse is entitled to receive
under paragraphs (b) and (c) of this
section. The Secretary of the concerned
service department will certify the
veteran’s pay grade and the certification
will be binding on VA. DIC paid
pursuant to this paragraph may not be
increased by the section 1311(a)(2)
increase under paragraph (c) of this
section.
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14:17 Dec 01, 2005
Jkt 208001
(e) Additional increases. One or more
of the following increases may be paid
in addition to the basic monthly rate
and the section 1311(a)(2) increase.
(1) Increase for children. If the
surviving spouse has one or more
children under the age of 18 of the
deceased veteran (including a child not
in the surviving spouse’s actual or
constructive custody, or a child who is
in active military service), the monthly
DIC rate will be increased by the
amount set forth in 38 U.S.C. 1311(b) for
each child.
(2) Increase for regular aid and
attendance. If the surviving spouse is
determined to be in need of regular aid
and attendance under the criteria in
§ 3.352 or is a patient in a nursing home,
the monthly DIC rate will be increased
by the amount set forth in 38 U.S.C.
1311(c).
(3) Increase for housebound status. If
the surviving spouse does not qualify
for the regular aid and attendance
allowance but is housebound under the
criteria in § 3.351(f), the monthly DIC
rate will be increased by the amount set
forth in 38 U.S.C. 1311(d).
(f) Criteria governing section
1311(a)(2) increase. In determining
whether a surviving spouse qualifies for
the section 1311(a)(2) increase under
paragraph (c) of this section, the
following standards shall apply.
(1) Marriage requirement. The
surviving spouse must have been
married to the veteran for the entire
eight-year period referenced in
paragraph (c) of this section in order to
qualify for the section 1311(a)(2)
increase.
(2) Determination of total disability.
As used in paragraph (c) of this section,
the phrase ‘‘rated by VA as totally
disabling’’ includes total disability
ratings based on unemployability (§ 4.16
of this chapter).
(3) Definition of ‘‘entitled to receive’’.
As used in paragraph (c) of this section,
the phrase ‘‘entitled to receive’’ means
that the veteran filed a claim for
disability compensation during his or
her lifetime and one of the following
circumstances is satisfied:
(i) The veteran would have received
total disability compensation for the
period specified in paragraph (c) of this
section but for clear and unmistakable
error committed by VA in a decision on
a claim filed during the veteran’s
lifetime; or
(ii) Additional evidence submitted to
VA before or after the veteran’s death,
consisting solely of service department
records that existed at the time of a prior
VA decision but were not previously
considered by VA, provides a basis for
reopening a claim finally decided
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Sfmt 4700
during the veteran’s lifetime and for
awarding a total service-connected
disability rating retroactively in
accordance with §§ 3.156(c) and
3.400(q)(2) of this part for the period
specified in paragraph (c) of this
section; or
(iii) At the time of death, the veteran
had a service-connected disability that
was continuously rated totally disabling
by VA for the period specified in
paragraph (c) of this section, but was not
receiving compensation because:
(A) VA was paying the compensation
to the veteran’s dependents;
(B) VA was withholding the
compensation under the authority of 38
U.S.C. 5314 to offset an indebtedness of
the veteran;
(C) The veteran had not waived
retired or retirement pay in order to
receive compensation;
(D) VA was withholding payments
under the provisions of 10 U.S.C.
1174(h)(2);
(E) VA was withholding payments
because the veteran’s whereabouts were
unknown, but the veteran was otherwise
entitled to continued payments based
on a total service-connected disability
rating; or
(F) VA was withholding payments
under 38 U.S.C. 5308 but determines
that benefits were payable under 38
U.S.C. 5309.
(Authority: 38 U.S.C. 501(a), 1311, 1314, and
1321).
4. Section 3.22 is amended by revising
paragraph (b) to read as follows:
I
§ 3.22 DIC benefits for survivors of certain
veterans rated totally disabled at time of
death.
*
*
*
*
*
(b) For purposes of this section,
‘‘entitled to receive’’ means that the
veteran filed a claim for disability
compensation during his or her lifetime
and one of the following circumstances
is satisfied:
(1) The veteran would have received
total disability compensation at the time
of death for a service-connected
disability rated totally disabling for the
period specified in paragraph (a)(2) of
this section but for clear and
unmistakable error committed by VA in
a decision on a claim filed during the
veteran’s lifetime; or
(2) Additional evidence submitted to
VA before or after the veteran’s death,
consisting solely of service department
records that existed at the time of a prior
VA decision but were not previously
considered by VA, provides a basis for
reopening a claim finally decided
during the veteran’s lifetime and for
awarding a total service-connected
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Federal Register / Vol. 70, No. 231 / Friday, December 2, 2005 / Rules and Regulations
disability rating retroactively in
accordance with §§ 3.156(c) and
3.400(q)(2) of this part for the relevant
period specified in paragraph (a)(2) of
this section; or
(3) At the time of death, the veteran
had a service-connected disability that
was continuously rated totally disabling
by VA for the period specified in
paragraph (a)(2), but was not receiving
compensation because:
(i) VA was paying the compensation
to the veteran’s dependents;
(ii) VA was withholding the
compensation under authority of 38
U.S.C. 5314 to offset an indebtedness of
the veteran;
(iii) The veteran had not waived
retired or retirement pay in order to
receive compensation;
(iv) VA was withholding payments
under the provisions of 10 U.S.C.
1174(h)(2);
(v) VA was withholding payments
because the veteran’s whereabouts were
unknown, but the veteran was otherwise
entitled to continued payments based
on a total service-connected disability
rating; or
(vi) VA was withholding payments
under 38 U.S.C. 5308 but determines
that benefits were payable under 38
U.S.C. 5309.
*
*
*
*
*
PART 20—BOARD OF VETERANS’
APPEALS: RULES OF PRACTICE
5. The authority citation for part 20
continues to read as follows:
I
Authority: 38 U.S.C. 501(a) and as noted in
specific sections.
Subpart L—Finality
6. Section 20.1106 is revised to read
as follows:
I
§ 20.1106 Rule 1106. Claim for death
benefits by survivor—prior unfavorable
decisions during veteran’s lifetime.
Except with respect to benefits under
the provisions of 38 U.S.C. 1311(a)(2),
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14:17 Dec 01, 2005
Jkt 208001
1318, and certain cases involving
individuals whose Department of
Veterans Affairs benefits have been
forfeited for treason or for subversive
activities under the provisions of 38
U.S.C. 6104 and 6105, issues involved
in a survivor’s claim for death benefits
will be decided without regard to any
prior disposition of those issues during
the veteran’s lifetime.
*
*
*
*
*
(Authority: 38 U.S.C. 7104(b)).
[FR Doc. 05–23541 Filed 12–1–05; 8:45 am]
BILLING CODE 8320–01–P
POSTAL SERVICE
39 CFR Part 111
Domestic Mail: New Postal Rates and
Fees
Postal Service.
Notice of implementation of
new domestic rates and fees.
AGENCY:
ACTION:
SUMMARY: The Governors of the U.S.
Postal Service accepted the Postal Rate
Commission’s recommendation to
increase most postal rates and fees by
approximately 5.4 percent. The Board of
Governors set 12:01 a.m. Sunday,
January 8, 2006, as the effective date for
the new prices.
EFFECTIVE DATE: 12:01 a.m., Sunday,
January 8, 2006.
FOR FURTHER INFORMATION CONTACT:
Sherry Suggs, 202–268–7261.
SUPPLEMENTARY INFORMATION: On April
8, 2005, the Postal Service filed with the
Postal Rate Commission a Request for a
Recommended Decision on Changes in
Rates of Postage and Fees. The
Commission designated the filing as
Docket No. R2005–1. On November 1,
2005, the Commission issued its
Opinion and Recommended Decision.
The Governors approved all of the
Commission’s recommendations on
November 14, 2005. Based on the
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72221
decision of the Governors and
Resolution No. 05–9 of the Board of
Governors, the Postal Service adopts the
new rates and fees and sets an effective
date of 12:01 a.m., January 8, 2006.
This price increase is the first since
2002. It is needed to fulfill a Federal law
passed in 2003 that requires the Postal
Service to place $3.1 billion in escrow
by September 30, 2006.
Customers can find resources and
additional information about the price
change at usps.com/ratecase. A special
issue of the Postal Bulletin with detailed
information, new rate and fee tables,
and revised ‘‘EZ’’ (simplified) postage
statements will be available online
December 1, 2005. The Postage Rate
Calculators at pe.usps.com will reflect
new rates and fees beginning January 8,
2006.
The Postal Service adopts the
following new rates and fees.
Conforming changes will be made
throughout Mailing Standards of the
United States Postal Service, Domestic
Mail Manual (DMM), incorporated by
reference in the Code of Federal
Regulations. See 39 CFR 111.1.
List of Subjects in 39 CFR Part 111
Administrative practice and
procedure, Postal Service.
PART 111—[AMENDED]
1. The authority citation for 39 CFR
part 111 continues to read as follows:
I
Authority: 5 U.S.C. 552(a); 39 U.S.C. 101,
401, 403, 404, 414, 3001–3011, 3201–3219,
3403–3406, 3621, 3626, 5001.
2. Revise Mailing Standards of the
United States Postal Service, Domestic
Mail Manual (DMM), to adopt the
following new rates and fees.
I
Stanley F. Mires,
Chief Counsel, Legislative.
BILLING CODE 7710–12–P
E:\FR\FM\02DER1.SGM
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Agencies
[Federal Register Volume 70, Number 231 (Friday, December 2, 2005)]
[Rules and Regulations]
[Pages 72211-72221]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-23541]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Parts 3 and 20
RIN 2900-AL86
Dependency and Indemnity Compensation: Surviving Spouse's Rate;
Payments Based on Veteran's Entitlement to Compensation for Service-
Connected Disability Rated Totally Disabling for Specified Periods
Prior to Death
AGENCY: Department of Veterans Affairs.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Department of Veterans Affairs (VA) is amending its
adjudication regulations concerning payment of dependency and indemnity
compensation (DIC) for certain non-
[[Page 72212]]
service-connected deaths and the rate of DIC payable to a surviving
spouse for either service-connected or non-service-connected deaths.
The purpose of this final rule is to clarify VA's interpretation of two
similar statutes that provide for payments to the survivors of veterans
who were, at the time of death, in receipt of or entitled to receive
disability compensation for service-connected disability that was rated
totally disabling for a specified period prior to death. This rule also
reorganizes and revises the regulations governing surviving spouses'
DIC rates and revises the Board of Veterans' Appeals rule concerning
the effect of unfavorable decisions during a veteran's lifetime on
claims for death benefits by the veteran's survivors.
DATES: Effective Date: This rule is effective December 2, 2005.
Applicability Date: VA will apply this rule to claims pending
before VA on the effective date of this rule, as well as to claims
filed after that date.
FOR FURTHER INFORMATION CONTACT: Maya Ferrandino, Consultant,
Compensation and Pension Service, Policy and Regulations Staff,
Veterans Benefits Administration, 810 Vermont Avenue, NW., Washington,
DC 20420 (202) 273-7211.
SUPPLEMENTARY INFORMATION:
Background
In the Federal Register of October 25, 2004 (69 FR 62229), VA
proposed to revise its DIC regulations to clarify and harmonize VA's
interpretation of two statutory provisions. We further proposed to
reorganize and restate existing regulations to make them easier to
understand and apply.
DIC is a benefit paid to survivors of veterans in cases of death
due to service-connected disability or certain cases of death due to
non-service-connected disability. Section 1318(b) of title 38, United
States Code, provides in effect that, if the veteran's death is not
caused by a service-connected disability, DIC is payable only if the
veteran was in receipt of or ``entitled to receive'' compensation at
the time of death for a service-connected disability that was
continuously rated totally disabling for a period of 10 or more years
immediately preceding death, or for a period of not less than five
years from the date of the veteran's discharge or release from active
duty, or for a period of not less than one year immediately preceding
death if the veteran was a former prisoner of war. VA has implemented
this provision through regulations at 38 CFR 3.22, paragraph (b) of
which explains that the phrase ``entitled to receive'' refers to
circumstances in which the veteran, at the time of his or her death,
had service-connected disability that was rated totally disabling by
VA, but was not receiving compensation for one of seven specified
reasons, including the fact that the veteran had applied for
compensation during his or her lifetime but had not received total
disability compensation due to a clear and unmistakable error (CUE) in
a VA decision.
We proposed to revise Sec. 3.22(b) in two respects. First, we
proposed to revise ambiguous language in Sec. 3.22(b) to clarify that
the correction of CUE may establish that a veteran was ``entitled to
receive'' benefits ``at the time of death'' irrespective of whether the
CUE is corrected before or after the veteran's death. We explained that
the statutory requirement that the veteran have been entitled to
benefits ``at the time of death'' would be satisfied in such cases
because 38 U.S.C. 5109A and 7111 mandate that decisions correcting CUE
must be given full retroactive effect as a matter of law.
Second, we proposed to add an eighth circumstance in which a
veteran may be found to have been ``entitled to receive'' compensation
at the time of death for a disability that was continuously rated
totally disabling for the specified period preceding death. We proposed
to state that service department records that existed at the time of a
prior final VA decision but were not previously considered by VA
(hereinafter referenced as ``newly identified service department
records'') may support a finding that the veteran was ``entitled to
receive'' compensation at the time of death for a disability that was
rated totally disabling for the specified period. We explained that the
proposed rule would apply to such service department records received
by VA before or after a veteran's death, if the records established a
basis for assigning a total disability rating for the retroactive
period specified in 38 U.S.C. 1318(b). We stated that, similar to
awards based on correction of CUE, awards based on such newly
identified service department records may be made retroactive as a
matter of law, as provided in long-standing VA regulations at 38 CFR
3.156(c) and 3.400(q)(2).
Under section 1311(a)(2) of title 38, United States Code, if a
veteran's survivor is entitled to DIC based on either service-connected
or non-service-connected death, the basic monthly rate of DIC payable
to the survivor may be increased by a specified amount if the veteran
at the time of death was in receipt of or was ``entitled to receive''
compensation for a service-connected disability that was rated totally
disabling for a continuous period of at least eight years immediately
preceding death. VA previously implemented this provision through
regulations in 38 CFR 3.5(e)(1). Unlike Sec. 3.22, however, Sec.
3.5(e)(1) did not define or elaborate upon the phrase ``entitled to
receive.''
In view of the substantially similar language and common derivation
of 38 U.S.C. 1311(a)(2) and 1318(b), VA has concluded that the statutes
should be given a similar construction, and the United States Court of
Appeals for the Federal Circuit (Federal Circuit) upheld that
determination in National Organization of Veterans' Advocates, Inc. v.
Secretary of Veterans Affairs, 314 F.3d 1373, 1378 (Fed. Cir. 2003)
(``NOVA''). In its NOVA decision, however, the Federal Circuit
criticized VA for not elaborating the meaning of the phrase ``entitled
to receive'' in Sec. 3.5(e)(1), as VA had done in Sec. 3.22. NOVA at
1381. The court ordered VA to undertake further rulemaking to harmonize
those regulations.
In our October 2004 proposed rule, we proposed to remove the
provisions in 38 CFR 3.5(e) and to replace them with new 38 CFR 3.10.
We proposed to reorganize and restate more clearly in new Sec. 3.10
several provisions specifying the amounts of DIC payable to surviving
spouses of veterans. We also proposed to include in new Sec.
3.10(f)(3) a definition of the phrase ``entitled to receive'' that
would parallel the definition set forth in Sec. 3.22(b), as revised by
this rule.
VA also proposed to revise 38 CFR 20.1106, which provides generally
that claims for death benefits by a veteran's survivor will be decided
without regard to decisions rendered during the veteran's lifetime. The
rule historically has contained an express exception for claims under
section 1318, but not for claims under section 1311. To ensure that
those two statutes are applied consistently, we proposed to revise
Sec. 20.1106 to exempt claims under either section 1311 or 1318.
Finally, the Federal Circuit's order in NOVA directed VA to
address, in this rule, whether a survivor may establish entitlement to
DIC under 38 U.S.C. 1311(a)(2) and 1318 by submitting new and material
evidence after a veteran's death in order to reopen a claim filed by
the veteran during his or her lifetime. NOVA at 1380-1381. The Federal
Circuit stated that VA's current regulation at 38 CFR 3.22 reasonably
recognizes the correction of CUE as a basis for revisiting final
decisions made during a veteran's lifetime and
[[Page 72213]]
satisfying the durational disability requirement in 38 U.S.C. 1318(b).
NOVA at 1380-1381. However, the court stated that the correction of CUE
is only one of the two statutory bases for revisiting final decisions,
and that VA had failed to explain whether the durational disability
requirements could be met under the other exception, which involves the
submission of new and material evidence to reopen a previously denied
claim. NOVA at 1380-1381.
Our notice of proposed rulemaking explained that the submission of
new and material evidence (other than newly identified service
department records) after a veteran's death could not establish that
the veteran was ``entitled to receive'' benefits for any past period.
We explained that there were fundamental differences between the two
statutory exceptions to finality and that those distinctions were
significant in the context of claims under 38 U.S.C. 1311(a)(2) and
1318(b), which depend upon whether a veteran was ``entitled to
receive'' benefits for past periods. The correction of CUE is a remedy
for error committed by VA in a prior final decision. By statute, a
decision correcting CUE has full retroactive effect irrespective of
when the CUE claim is brought. Accordingly, a CUE claim brought after a
veteran's death may establish that the veteran was entitled as a matter
of law to have received benefits during his or her lifetime.
In contrast, a reopening based on new and material evidence (other
than newly identified service department records) is not a retroactive
correction of a prior final decision, but is instead a means for
establishing prospective entitlement to benefits despite a prior final
denial. Pursuant to 38 U.S.C. 5110(a), the effective date of an award
based on a reopened claim ``shall not be earlier than the date of
receipt of application therefore.'' Accordingly, the Federal Circuit
has held that VA regulations reasonably provide that reopening with new
and material evidence of a previously denied claim generally may not
operate retroactively. See Sears v. Principi, 349 F.3d 1326, 1330 (Fed.
Cir. 2003), cert. denied, 124 S. Ct. 1723 (2004). The United States
Court of Appeals for Veterans Claims (CAVC) has explained that a
reopening ``is not a reactivation of the previous claim, based upon the
original application for benefits'' and that ``even upon a reopening,
the prior claim is still `final' in a sense'' because any award based
on the reopening can be effective no earlier than the date of the
application to reopen. Spencer v. Brown, 4 Vet. App. 283, 293 (1993),
aff'd, 17 F.3d 368 (Fed. Cir. 1994). Accordingly, even if new and
material evidence could show as a factual matter that any veteran was
totally disabled due to service-connected disability during prior
periods, such evidence could not establish that the veteran was
entitled to receive benefits from VA for such past periods.
We concluded that, because awards based on new and material
evidence generally cannot establish retroactive entitlement to
benefits, a survivor seeking DIC under section 1311(a)(2) or 1318(b)
generally cannot rely upon new and material evidence for the purpose of
showing that a veteran was ``entitled to receive'' VA compensation for
past periods. As noted above, the only exception to this general
principle relates to circumstances in which newly identified service
department records are submitted after a claim was finally denied.
Because long-standing VA regulations authorize retroactive benefit
entitlement based on such service department records, the proposed rule
explained that new service department records submitted after a
veteran's death may show that the veteran was ``entitled to receive''
total disability compensation for periods prior to death.
Although the Federal Circuit's NOVA decision refers to the
possibility of a DIC claimant ``reopening'' a deceased veteran's claim
based on either CUE or new and material evidence, we note that a
survivor's DIC claim is not actually a ``reopening'' of the decedent's
claim for disability compensation because a veteran's claim does not
survive his or her death. See Richard v. West, 161 F.3d 719, 721-22
(Fed. Cir. 1998). Rather, the survivor's claim is a new and distinct
claim that the survivor is entitled to DIC in his or her own right
based on a showing that the veteran was ``entitled to receive'' certain
benefits during the veteran's lifetime. Thus the fact that CUE and new
and material evidence both provide grounds on which the veteran could
have ``reopened'' or otherwise revisited a previously denied claim
during his or her lifetime does not, in itself, provide any basis for
applying those remedies to a survivor's DIC claim. Rather, the
conclusion that a showing of CUE could establish a survivor's
entitlement to DIC is based on factors unique to CUE. First, because
CUE may be corrected retroactively, a showing of CUE may bear directly
upon the issue of whether a veteran was truly ``entitled to receive''
benefits that were wrongly denied due to VA error during his or her
lifetime. Second, the legislative history of 38 U.S.C. 1318 clearly
expressed Congress' intent that ``the existence of clear and
unmistakable VA administrative error would be a basis for entitlement
to DIC benefits when such administrative error is the only bar to
entitlement otherwise.'' S. Rep. No. 97-550, at 17 (1982), reprinted in
1982 U.S.C.C.A.N. 2877, 2880. Neither of those considerations applies
to the submission of new and material evidence.
Analysis of Public Comments
We received comments from the Paralyzed Veterans of America (PVA)
and the National Organization of Veterans' Advocates, Inc. (NOVA), both
of which were parties to the above-referenced NOVA litigation. NOVA
suggested a change to the terminology used in proposed 38 CFR 3.10(c)-
(f) to describe the benefits authorized by 38 U.S.C. 1311(a)(2). The
remaining comments from PVA and NOVA all relate to the issue of whether
DIC claimants may rely on new and material evidence other than newly
identified service department records to show that the veteran was
``entitled to receive'' total disability compensation for the specified
statutory period. We address these comments below.
I. Terminology in Sec. 3.10(c)-(f)
We proposed to state in 38 CFR 3.10(a) that the rate of DIC payable
to a surviving spouse would consist of a basic monthly rate and any
applicable increases specified in Sec. 3.10(c) and (e). We proposed,
in Sec. 3.10(c), (d), (e), and (f), to describe the additional DIC
amount payable under 38 U.S.C. 1311(a)(2) as the ``veteran's
compensation increase'' because the survivor's eligibility for that
increase was conditioned upon the veteran's entitlement to compensation
during his or her lifetime. NOVA states that the term ``veteran's
compensation increase'' is misleading because the increase is payable
to the surviving spouse rather than the veteran and suggests that we
change the term to ``surviving spouse's compensation increase.'' We
note that the provisions of proposed Sec. 3.10(a) and (c) make clear
that the increase pertains solely to the rate of DIC payable to a
surviving spouse and does not authorize any payment to a deceased
veteran. Nevertheless, we are changing the proposed term ``veteran's
compensation increase'' to the more specific term ``section 1311(a)(2)
increase.'' We do not believe that the term suggested by NOVA
(``surviving spouse's compensation increase'') is sufficiently
specific, because Sec. 3.10(e) refers to other increases that are also
payable to surviving spouses as dependency and indemnity compensation.
[[Page 72214]]
II. New and Material Evidence
NOVA and PVA both assert that survivors seeking DIC under sections
1311(a)(2) and 1318(b) should be allowed to submit new and material
evidence after a veteran's death for the purpose of establishing that
the veteran was, at the time of death, ``entitled to receive''
disability compensation for a disability that was rated totally
disabling for the specified statutory period immediately preceding the
veteran's death. NOVA and PVA both argue that the proposed rules are
arbitrary insofar as they allow claimants to rely upon newly identified
service department records but not on other types of new evidence
submitted after a veteran's death. The organizations present a number
of specific arguments in support of this assertion, which we address
below.
A. Interpretation of ``Entitled To Receive''
Although not expressly stated in the comments, it appears that each
of the comments from PVA and NOVA rest upon a disagreement with VA
concerning the meaning of the phrase ``entitled to receive'' as it is
used in 38 U.S.C. 1311(a)(2) and 1318(b). Because we believe the
interpretation of that statutory phrase is relevant to all of the
comments, we address that issue as a preliminary matter, even though it
is not expressly discussed in the comments.
The statutory requirement that the veteran have been ``entitled to
receive'' certain benefits at the time of death is ambiguous, and two
possible interpretations of that language have been suggested. It may
be construed to mean that the veteran had a legal right to the
specified benefits and that VA had authority to grant such benefits to
the veteran under the statutes and regulations giving VA authority to
award benefits for the period required by sections 1311(a)(2) and
1318(b). This has been VA's consistent interpretation of the statute.
However, in a series of decisions finding ambiguity in prior VA
regulations implementing section 1318(b), the CAVC suggested that the
phrase ``entitled to receive'' may also be construed to mean that the
veteran was ``hypothetically'' entitled to have received total
disability compensation for the period required by sections 1311(a)(2)
and 1318(b), irrespective of whether the claimant had satisfied the
statutory requirements necessary to actually obtain such benefits, such
as the requirements pertaining to the filing of applications and those
specifying the effective dates of awards based on such applications.
See Wingo v. West, 11 Vet. App. 307, 311 (1998). Under this
interpretation, a survivor would be required to submit evidence showing
that the veteran was totally disabled due to a service-connected
disease for the period specified in section 1311(a)(2) or section
1318(b), but would not need to establish that the veteran had any legal
right to compensation for the disability for that period or that VA had
any legal authority to pay such benefits to the claimant under the
statutes governing VA's authority to pay benefits. The two commenters
have advocated the latter interpretation in the NOVA litigation and
their comments on this rule appear to be predicated upon that
interpretation.
The distinction between the two interpretations is significant
because, with the exception of newly identified service department
records, new and material evidence submitted after a veteran's death
could not establish that the veteran had a legal right to receive total
disability compensation for a retroactive period preceding the
veteran's death or that VA had authority to pay such benefits to the
veteran for that retroactive period. This is a function of the finality
of VA decisions, the limited nature of reopenings based on new and
material evidence, and the corresponding limitations on VA's authority
to grant benefits in such reopened claims. As a general matter, once VA
denies a claim, the decision is final and VA cannot thereafter consider
the claim or award benefits except as otherwise provided by law. See 38
U.S.C. 7104(b), 7105(c). Congress has established two exceptions to
this finality. One exception permits VA to correct CUE in a prior final
decision and to award benefits retroactive to the date of the prior
claim. See 38 U.S.C. 5109A, 7111. The other exception permits VA to
reopen a previously denied claim when new and material evidence is
received. See 38 U.S.C. 5108. However, Congress has provided that an
award based on a reopened claim may be effective no earlier than the
date VA received the claim for reopening. See 38 U.S.C. 5110(a).
Accordingly, except with respect to newly identified service department
records, new and material evidence submitted after a veteran's death
could not show that a veteran had any legal right to benefits for
periods prior to death. The commenters' assertion that DIC claimants
may rely upon new and material evidence to establish that a veteran was
``entitled to receive'' benefits for past periods necessarily reflects
the view that the phrase ``entitled to receive'' means hypothetical
entitlement rather than entitlement under applicable statutory and
regulatory provisions.
As stated in the notice of proposed rulemaking, as well as in
several prior rulemaking documents published in the Federal Register
(67 FR 16309 (2002); 66 FR 65861 (2001); 65 FR 3388 (2000)), the phrase
``entitled to receive'' is most reasonably construed to mean that the
veteran had a legal right to total disability compensation for the
specified period under the statutes governing entitlement to such
benefits and that VA had authority to grant such benefits to the
veteran under the statutes giving VA authority to award such benefits.
There are several reasons why this interpretation best effectuates
congressional intent.
First, VA's interpretation comports logically with the language of
sections 1311(a)(2) and 1318(b) viewed in their entirety. Although the
statutory language alone evinces no clear meaning, it may provide
evidence of congressional intent for consideration in connection with
other interpretive tools. Section 1311(a)(2) requires that the veteran,
``at the time of death,'' have been ``entitled to receive''
compensation for a service-connected disability ``that was rated
totally disabling for a continuous period of at least eight years
immediately preceding death.'' Section 1318(b) similarly requires that
the veteran, ``at the time of death,'' have been ``entitled to
receive'' compensation for a service-connected disability that ``was
continuously rated totally disabling'' for a specified period
immediately preceding death. The requirement that the disability have
been ``rated totally disabling'' for a specified period is consistent
with an intent to require that the veteran have held a total disability
rating assigned by VA under the statutes and regulations governing
disability ratings for the specified period. By statute, a veteran is
entitled to receive total disability compensation only during periods
in which the disability is rated totally disabling by VA. See 38 U.S.C.
1114(j). If Congress intended to authorize benefits without regard to
whether the veteran had obtained, or taken the steps necessary to
obtain, a total disability rating from VA, it would have been more
logical to require only that the veteran ``was totally disabled'' for
the specified period, rather than requiring that the veteran was
``rated totally disabled'' for such period.
Second, VA's interpretation comports with the purposes indicated by
the legislative history of sections 1311(a)(2) and 1318(b). In
providing for payment of DIC based on the veteran's entitlement to
total disability
[[Page 72215]]
compensation during his or her lifetime, Congress explained that its
purpose was to replace the source of income the veteran's family would
otherwise lose when the veteran died and his or her compensation
payments ceased. The Senate Committee on Veterans' Affairs explained
this purpose by stating:
The appropriate Federal obligation to these survivors should, in
the Committee's view, be the replacement of the support lost when
the veteran dies. For example, assume that a veteran who is totally
blind from service-connected causes dies at the age of 55 from a
heart attack, having been so disabled from the age of 22--a period
of 33 years. During that period, his wife and he depended upon his
disability compensation for income support, but, because his death
is not service connected, she would not receive DIC.
S. Rep. No. 95-1054 at 28 (1978), reprinted in, 1978 U.S.C.C.A.N. 3465,
3486. Permitting survivors to rely on new and material evidence or on
CUE to establish a veteran's entitlement to benefits that were not
actually awarded during the veteran's lifetime would be contrary to the
stated purpose to replace income that veterans and their families had
come to depend on by virtue of having received total disability
payments for a prolonged period prior to death. While Congress
subsequently explicitly amended the 1978 legislation in 1982 to allow
for recovery of DIC benefits in cases of CUE, as indicated below,
significantly, it made no similar express provision for recovery in
cases where new and material evidence is presented to establish a
veteran's entitlement to benefits that were not actually awarded during
the veteran's lifetime and could not have been awarded to the veteran
retroactively if he or she had survived.
In 1982, Congress expanded the criteria for DIC eligibility under
what is now 38 U.S.C. 1318, by authorizing DIC in cases where the
veteran would have received total disability compensation for the
specified period prior to death but for CUE committed by VA in a
decision on a claim submitted during the veteran's lifetime. The stated
purpose of that change was ``to provide that the existence of a clear
and unmistakable error should not defeat entitlement to the survivors'
benefits.'' S. Rep. No. 97-550, at 35 (1982), reprinted in 1982
U.S.C.C.A.N. 2877, 2898. The legislative history further explained
that, ``[u]nder the amendment, a veteran would not need actually to
have been `in receipt' of total disability benefits for the requisite
period of time in order to provide eligibility to the survivors if a
clear and unmistakable error had been made that resulted in a shorter
period of receipt than should have been provided.'' Id.
Permitting survivors to rely on new and material evidence to
establish a veteran's entitlement to benefits that were not actually
awarded during the veteran's lifetime would go well beyond the stated
purpose to provide DIC in cases where CUE resulted in a shorter period
of entitlement than should have been provided. As noted above, new and
material evidence generally does not have retroactive effect and could
not establish a longer period of compensation entitlement for any
veteran, as correction of CUE may do. The legislative history of the
1982 statute reasonably reflects the principle that veterans and their
families should not be penalized in cases where the veteran did
everything necessary to establish entitlement to a total disability
rating for the required period, but VA's error prevented the timely
assignment of such rating. The purpose of that amendment was clearly
remedial, in the same way that the general authority to correct CUE
retroactively is remedial. In contrast, the authority to reopen and
grant claims upon receipt of new and material evidence (other than
service department records that were previously in the government's
possession) is not remedial, in that it does not correct any past
error, but merely permits a new adjudication informed by new evidence.
In view of the stated congressional purpose, we believe it is
appropriate to recognize the distinction between statutory procedures
that may result in the retroactive assignment of a total disability
rating for periods prior to death (i.e., correction of CUE;
readjudication based on newly identified service department records)
and those that may not (i.e., reopening based on new and material
evidence other than service department records). It is, further,
appropriate to recognize a distinction between procedures designed to
remedy governmental error (i.e., correction of CUE; readjudication
based on newly identified service department records) and those that
are not (i.e., reopening based on new and material evidence). Newly
identified service department records are considered ``lost or
mislaid,'' 38 CFR 3.400(q)(2), presumably by the government, and
therefore belong conceptually with CUE, rather than with new and
material evidence. In view of Congress's stated purpose to allow DIC
where VA's error was the only obstacle to the veteran's receipt of
benefits, we find no basis for extending DIC to circumstances where
there was no VA error and, moreover, where VA would have no statutory
authority to award retroactive entitlement to the veteran if the
veteran were still alive.
A third basis for our interpretation of the statutory language is
our conclusion that, when Congress conditioned a survivor's DIC
eligibility on the extent and duration of a veteran's entitlement to
benefits, it intended that VA would apply the existing statutory
provisions governing the extent and duration of the veteran's
entitlement, including those prohibiting VA from according retroactive
effect to decisions based on new and material evidence. As a general
rule, new statutes enacted as part of an established statutory scheme
must be construed to fit logically within the statutory scheme. See
United States v. Jefferson Electric Mfg. Co., 291 U.S. 386, 396 (1934)
(``As a general rule, where the legislation dealing with a particular
subject consists of a system of related general provisions indicative
of a settled policy, new enactments of a fragmentary nature on that
subject are to be taken as intended to fit into the existing system and
to be carried into effect conformably to it, excepting as a different
purpose is plainly shown.'') When Congress enacted statutes authorizing
DIC in cases where a veteran was ``entitled to receive'' a specific
type of benefit at a specific level for a specific time period, it is
reasonable to assume that Congress intended VA to apply the established
statutory and regulatory scheme then in place governing entitlement to
benefits, including those statutes and regulations that delimit the
duration and level of entitlement. As discussed above and in the notice
of proposed rulemaking, those provisions permit retroactive
determinations of entitlement only in limited circumstances, involving
CUE or newly identified service department records.
Finally, we note that an alternate interpretation--i.e., requiring
VA to ignore the statutory and regulatory provisions governing a
veteran's entitlement to benefits and the level and duration of such
entitlement--would result in a process fraught with uncertainty. Under
the effective date provisions of 38 U.S.C. 5110 and corresponding VA
regulations, the duration of any veteran's entitlement to benefits may
be determined with relative ease and certainty, most often by reference
to the date of the claim that resulted in the award of benefits.
Although the effective date of entitlement may not correspond to the
date the veteran actually became disabled or attained a particular
level of disability, the statutory procedure promotes certainty and
administrative efficiency. However, if determinations regarding a
veteran's entitlement to
[[Page 72216]]
benefits are to be made without regard to the statutes expressly
governing the effective dates of entitlement, there would be no clear
basis for determining when a veteran's entitlement to a total
disability rating began. Even assuming that the veteran's
``hypothetical'' entitlement would begin on the date he or she became
totally disabled due to a service-connected disability, such a
determination ordinarily would be exceedingly difficult, highly
speculative, and would lend itself to prolonged evidentiary disputes,
potentially involving medical opinions or lay testimony rendered many
years after the events in question. The difficulty of such
determinations would be compounded by the need to evaluate the
decedent's condition over a prolonged continuous period of many years
prior to death. In view of Congress' practice of imposing clear and
definite effective-date rules for VA benefit awards and limiting
retroactive awards and the complex issues they involve, we believe it
is reasonable to conclude that Congress did not intend to impose a much
more complex and uncertain process for determining a veteran's
entitlement to benefits for purposes of sections 1311(a)(2) and 1318.
This conclusion is underscored by the stated purposes of those statutes
to authorize benefits in cases where the veteran's entitlement can be
simply and readily established--i.e., where the veteran was actually
receiving total disability compensation at the time of death or would
have received such benefits but for a VA error that is clearly and
unmistakably shown by the record created during the veteran's lifetime.
NOVA presents three comments regarding the foregoing analysis.
First, it asserts that the congressional purpose to replace income lost
when a totally-disabled veteran dies would apply equally in
circumstances in which the veteran held a total-disability rating for
less than the specified statutory period. We do not dispute nor
diminish the hardship that any family may face following the death of a
veteran family member and the resulting termination of VA benefit
payments. However, Congress has specified by statute the period of a
veteran's entitlement to total disability compensation that is
necessary to vest survivors with DIC entitlement under section
1311(a)(2) and 1318(b). The difficult task of drawing lines governing
benefit entitlement is a policy matter entrusted to Congress and VA is
not at liberty to alter the statutory standards Congress has adopted.
See Mathews v. Diaz, 426 U.S. 67, 83-84 (1976). Accordingly, we make no
change based on this comment.
Second, NOVA asserts that allowing survivors to rely upon any type
of new and material evidence submitted after a veteran's death would
serve a ``remedial purpose'' similar to the correction of CUE and would
be consistent with the congressional intent to authorize DIC where VA
error prevented the veteran from receiving benefits during his or her
lifetime. We do not agree. The statutory and regulatory provisions
relating to CUE and newly obtained service department records are
unique not merely because they can fairly be described as having a
``remedial'' purpose, but also because they effectuate that purpose by
expressly authorizing retroactive awards of entitlement to benefits.
There is no similar authority for retroactive awards based on new and
material evidence, and the mere assertion that the reopening of claims
serves a remedial function cannot provide such authority in view of the
effective-date rules in 38 U.S.C. 5110(a). Moreover, it is not accurate
to say that a reopening based on new and material evidence provides a
remedy for VA error. As the Federal Circuit stated in Sears v.
Principi, VA's effective-date regulations reasonably differentiate
between reopening based on previously unobtained service department
records, which provides a remedy for ``government errors or
inattention,'' and reopening based on other evidence, which encompasses
``situations outside the control of the government,'' such as where the
new evidence was not provided earlier ``either due to inattention by
the veteran or his representatives or subsequent advances in medicine
and science.'' Sears, 349 F.3d at 1331. Accordingly, we make no change
based on this comment.
Third, NOVA asserts that interpreting sections 1311 and 1318 to
permit reopening based on new and material evidence would have no
significant practical effects on VA claim processing. NOVA asserts that
DIC claimants alone would be responsible for developing evidence
relevant to their claim and that VA would have no need to conduct any
evidentiary development unless it were for the improper purpose of
trying to refute the survivor's DIC claim. VA does not agree with this
comment. If new and material evidence submitted after a veteran's death
could potentially establish a survivor's entitlement to DIC under
section 1311(a)(2) and 1318(b), VA would be required by statute and
regulation, to assist the claimant in obtaining evidence necessary to
substantiate the claim. 38 U.S.C. 5103A; 38 CFR 3.159(c). Such
assistance would be necessary if the claimant needed help obtaining
allegedly new and material evidence or if evidence submitted by the
claimant was insufficient to permit fair adjudication of the claim. The
assertion that VA's assistance could serve no purpose other than to
refute the claim is factually incorrect and is contrary to law and to
longstanding VA policy.
Further, the practical concerns we discussed were not based merely
on the fact that VA would need to assist claimants in developing
evidence, as VA routinely does. Rather, the burdens unique to NOVA's
suggested interpretation of sections 1311(a)(2) and 1318(b) would
involve the difficulty of resolving medical issues regarding the
duration and degree of a veteran's disability many years after the
events in question and the difficulty of ascertaining a specific period
of the veteran's ``entitlement'' to total disability benefits in the
absence of an applicable statutory standard defining the period of
entitlement. As noted above, 38 U.S.C. 5110(a) provides a definite and
specific mechanism for measuring the beginning date of any individual's
entitlement to benefits. If, as NOVA suggests, that provision is
inapplicable in determining the period of a veteran's entitlement to
total disability benefits for purposes of section 1311(a)(2) and
1318(b), there would be no clear basis for defining the period of a
veteran's entitlement. Assuming the matter involved a purely factual
determination as to when the veteran's total disability began,
resolution of that question would often be a matter of significant
uncertainty and speculation, compounded by the remoteness of the events
and the unavailability of the veteran. There potentially would be equal
difficulty in determining whether the veteran was totally disabled
throughout the specified statutory period, as sections 1311(a)(2) and
1318(b) require, in the absence of clear and contemporaneous disability
evaluations throughout that period. See 38 CFR 4.1, 4.2 (discussing the
need for thorough medical reports to support disability evaluations).
We do not suggest that these problems are entirely insurmountable.
Rather, as stated in the notice of proposed rulemaking, the extent of
the burdens and uncertainty that would be associated with this
interpretation of sections 1311(a)(2) and 1318(b) lends support to our
conclusion that Congress did not intend that interpretation. The
legislative history reflects that Congress intended to authorize these
DIC benefits in at least two circumstances in which
[[Page 72217]]
the extent and duration of the veteran's entitlement to benefits can be
readily established by the record of proceedings during the veteran's
lifetime, i.e., where the veteran actually received total disability
benefits for the specified period or would have received such benefits
but for a VA error that is clear and unmistakable on the existing
record. Viewed against these definite and efficient standards, it is
unlikely that Congress intended to impose the much more complex,
uncertain, and hypothetical adjudicative actions that would be
necessary in determinations based on new and material evidence. For the
foregoing reasons, we make no change based upon this comment.
B. Comments Based on 38 U.S.C. 5110(a)
As explained above, VA concluded that the submission of new and
material evidence following a veteran's death could generally not
retroactively establish that the veteran was ``entitled to receive''
compensation for periods prior to the veteran's death, because 38
U.S.C. 5110(a) prohibits retroactive awards based on new and material
evidence. NOVA asserts that this statutory limit on retroactivity is
irrelevant because section 1311(a)(2) or 1318(b) would not require VA
to pay any retroactive benefits to a veteran. Rather, NOVA asserts, VA
would be required only to pay prospective DIC benefits to survivors in
a manner consistent with section 5110(a).
VA does not agree with this comment. NOVA is correct that VA would
not be required to pay retroactive benefits to a deceased veteran or to
the DIC claimant. However, a survivor's claim for benefits under
section 1311(a)(2) or section 1318(b) is predicated on the veteran's
entitlement to benefits insofar as the statutes authorize benefits only
if the veteran was ``entitled to receive'' total disability
compensation for a specified period prior to death. In order to
determine whether a veteran was ``entitled to receive'' benefits for
past periods, VA necessarily must consider section 5110(a), which
imposes limits on a veteran's entitlement to receive, and VA's
authority to award, benefits for specific periods. If a veteran whose
claim was denied ten years ago were to submit new evidence establishing
that he was totally disabled due to service-connected disability,
section 5110(a) would permit VA to award compensation only from the
date the claim was reopened, even if the total disability may have
arisen at an earlier date. The veteran's reopened claim could not
establish a right to receive benefits for any prior periods. New and
material evidence submitted after a veteran's death could no more
establish the veteran's retroactive entitlement to benefits than could
evidence submitted by the veteran himself during his lifetime. Although
an adjudication under section 1311(a)(2) or section 1318(b) based on
new and material evidence would not require VA to actually release
payment to a deceased veteran, such a claim could prevail only if VA
were to find that the veteran was entitled to receive payment from VA
for periods prior to the date VA received the new and material evidence
establishing such entitlement. Such a finding would be contrary to the
requirements of section 5110(a). Accordingly, we make no change based
on this comment.
NOVA also states that, although section 5110(a) limits the
effective date of awards based on claims reopened after a final
adjudication, the statute refers separately to the effective date of
claims for DIC and provides that the effective date of such awards
``shall be fixed in accordance with the facts found.'' NOVA asserts
that it is improper for VA to rely on the statute's reference to
reopened claims because effective-date issues in claims under section
1311(a)(2) and 1318(b) are governed by section 5110(a)'s reference to
DIC claims.
VA does not agree with this comment. Section 5110(a) states a
single effective-date rule applicable to ``an original claim, a claim
reopened after final adjudication, or a claim for increase, of
compensation, [or] dependency and indemnity compensation'' and provides
that the effective date of any such award ``shall be in accordance with
the facts found but shall not be earlier than the date of receipt of
application therefor.'' In the context of a claim for DIC benefits
under section 1311(a)(2) or 1318(b), there are potentially two
effective-date issues to which section 5110(a) may apply. First, as
explained above, section 5110(a) would govern the effective date of any
compensation award to the veteran and thus would determine the date, if
any, on which a veteran became ``entitled to receive'' total disability
compensation. The duration of the veteran's total disability
compensation, if any, would determine whether the survivor was entitled
to DIC under section 1311(a)(2) or 1318(b). Second, if the survivor is
entitled to DIC, section 5110(a) would again operate to determine the
effective date of the survivor's entitlement. The issue of the
effective date of a survivor's DIC award, if one is made, is both
logically and sequentially distinct from the issue of the effective
date of any benefits the veteran was entitled to receive during his or
her lifetime. Accordingly, the fact that section 5110(a) would govern
the effective date of a survivor's DIC award does not conflict with our
conclusion that section 5110(a) also applies in determining whether and
to what extent the veteran was ``entitled to receive'' benefits from
VA. We therefore make no change based on this comment.
C. Comments Based on 38 U.S.C. 5108
PVA asserts that the proposed rules are inconsistent with 38 U.S.C.
5108 insofar as they provide that newly identified service department
records may provide a basis for establishing that a veteran was
``entitled to receive'' benefits for past periods but that other types
of new evidence submitted after a veteran's death may not establish
that fact. Section 5108 provides that, ``[i]f new and material evidence
is presented or secured with respect to a claim which has been
disallowed, the Secretary shall reopen the claim and review the former
disposition of the claim.'' PVA asserts that this statute unambiguously
requires VA to reopen a previously denied claim when new and material
evidence is received. PVA further asserts that, because this statute
does not limit the form of acceptable new and material evidence, there
is no basis for VA's conclusion that newly identified service
department records, but not other types of records, submitted after a
veteran's death, may establish that a veteran was ``entitled to
receive'' benefits for periods prior to death. NOVA similarly asserts
that there is no rational basis for distinguishing between newly
identified service department records and other types of new evidence.
VA does not agree with these comments. Section 5108 allows
claimants to reopen their benefit claims after a final denial. It is
well established, however, that a veteran's claim for disability
compensation does not survive the veteran's death. See Richard v. West,
161 F.3d 719, 721-22 (Fed. Cir. 1998). Section 5108 thus provides no
general authority for survivors to ``reopen'' a deceased veteran's
claim with new and material evidence. A survivor's claim for DIC under
section 1311(a)(2) or section 1318(b) is not a ``reopening'' of the
deceased veteran's compensation claim within the meaning of 38 U.S.C.
5108, but instead is a distinct claim for DIC benefits by the survivor.
Insofar as the proposed rule allows survivors to submit newly
identified service department records after a veteran's death, the rule
is not based upon 38 U.S.C. 5108, but upon the provisions of 38 U.S.C.
1311(a)(2) and
[[Page 72218]]
1318(b), viewed in the context of the overall statutory scheme in title
38, United States Code. Although a veteran's claim does not survive his
or her death, sections 1311(a)(2) and 1318(b) are most reasonably
construed to permit examination of decisions on a veteran's claim to
the extent necessary to determine the survivor's entitlement to DIC.
Because a survivor's entitlement to DIC under section 1311(a)(2) and
1318(b) may depend upon whether the veteran was ``entitled to receive''
total disability benefits for a specified number of years prior to
death, it is reasonable to conclude that Congress intended to permit VA
to examine prior claims or decisions under limited circumstances to
determine whether the veteran was ``entitled to receive'' total
disability benefits for the specified statutory period. This
congressional intent is made clear by the legislative history stating
an intent to allow DIC under sections 1311(a)(2) and 1318(b) if it is
shown that the veteran would have received the specified compensation
benefits but for CUE in a decision on a claim during the veteran's
lifetime. As explained above, a veteran's retroactive entitlement to
benefits may be established by a showing that prior decisions contained
CUE or by newly identified service department records that establish
entitlement to benefits. However, new and material evidence, if
submitted after a veteran's death, could not establish such retroactive
entitlement. Accordingly, the distinction in the proposed rule between
newly identified service department records and new evidence submitted
after death merely reflects the distinction between circumstances that
may satisfy the eligibility requirements of section 1311(a)(2) and
1318(b) and circumstances that could not as a matter of law satisfy
those eligibility requirements.
PVA and NOVA are correct that 38 U.S.C. 5108 does not distinguish
between newly obtained service department records and other types of
new evidence. However, the other statutory and regulatory provisions
upon which the proposed rule was based do reflect a material
distinction between the retroactive effect of awards based on newly
obtained service department records and awards based on other types of
new evidence. As explained above, 38 U.S.C. 5110(a) makes clear that
entitlement to benefits based on a claim reopened with new and material
evidence generally may be effective no earlier than the date VA
received the reopened claim, and thus cannot establish retroactive
entitlement for periods prior to the reopening. See also 38 CFR
3.400(q)(1). VA regulations recognize an exception to this general rule
in cases where a previously denied claim is reopened with newly
obtained service department records. In such cases, VA's regulations
state that the effective date of entitlement to benefits will ``agree
with evaluation (since it is considered that these records were lost or
mislaid) or date of receipt of claim on which prior evaluation was
made, whichever is later.'' 38 CFR 3.400(q)(2); see also 38 CFR
3.156(c).
The Federal Circuit has acknowledged and upheld the distinction
between the retroactivity of awards based on newly obtained service
department records and awards based on other types of new evidence. In
Sears, the court stated:
[A] claim that is reopened for new and material evidence in the form
of missing service medical records dates back to the filing of the
veteran's original claim for benefits. 38 CFR 3.400(q)(2) (2003).
Section 3.400(q)(1)(ii) applies to other instances of new and
material evidence, situations in which the new evidence was not
presented earlier, either due to inattention by the veteran or his
representative or subsequent advances in medicine and science. We
conclude that section 3.400, which differentiates between government
errors or inattention, and situations outside the control of the
government, is not unreasonable.
349 F.3d at 1331. As the Court noted, the rules permitting retroactive
awards based on newly identified service department records reflect the
judgment that the failure to establish benefit entitlement at an
earlier date would, in such cases, be a result of ``government errors
or inattention.'' In this respect, the rules governing awards based on
such service department records serve a remedial function similar to
the rules governing the correction of CUE in prior decisions. In
contrast, as the Federal Circuit noted, awards based on other types of
new evidence do not remedy past government error, but merely permit
consideration of new evidence that was not previously submitted for
reasons outside the government's control. This distinction is also
supported by the CAVC's decision in Spencer, 4 Vet. App. at 293, which
stated that, generally, ``even upon a reopening, the prior claim is
still `final' in a sense,'' because ``[a]ny award of benefits made upon
a claim reopened under section 5108 on other than service department
reports will have an effective date no earlier than the date of the
filing of the claim to reopen.'' The CAVC noted that VA's regulations
according retroactive effect to awards based on service department
records were rooted in VA regulations dating back to the 1930s and were
consistent with prior statutory provisions.
For the reasons stated above, the distinction in the proposed rules
between awards based on newly identified service department records and
awards based on other types of new evidence is reasonable and is not
inconsistent with 38 U.S.C. 5108. Accordingly, we make no change based
upon the referenced comments.
D. Other Comments
NOVA asserts that VA should not distinguish between claims
involving newly obtained service department records and claims
involving other new evidence submitted after a veteran's death, because
the function of either type of evidence would be the same, i.e., to
provide a factual basis for determining that the veteran met the
criteria for a total disability rating for the specified period prior
to death. This comment is based on the assumption that a survivor is
entitled to DIC under section 1311(a)(2) and 1318(b) whenever current
evidence shows that the veteran was totally disabled due to service-
connected disability for the specified period, irrespective of whether
the veteran was entitled to receive any payments from VA for that
period under the statutes and regulations governing awards of VA
benefits. That assumption is incorrect, for the reasons set forth
above. Because new evidence other than newly identified service
department records cannot retroactively establish that a veteran was
``entitled to receive'' benefits for past periods, we make no change
based on this comment.
NOVA also asserts that the regulation is arbitrary insofar as it
permits new evidence only in the form of newly identified service
department records because, in NOVA's view, service department records
could not provide any information supporting the claim. VA does not
agree. Service department records may be highly relevant in some
circumstances, such as where the fact of the veteran's total disability
was established, but VA had previously denied service connection for
the disability due to the absence of evidence that the disability arose
in service. Moreover, the reference in the proposed rules to service
department records is not arbitrary, but properly reflects the existing
statutory and regulatory scheme, which makes clear that service
department records are the only form of new evidence that potentially
may establish that a veteran was ``entitled to receive'' total
disability compensation for past periods.
[[Page 72219]]
III. Section 20.1106
We proposed to revise 38 CFR 20.1106 in two respects. First, we
proposed to add a reference in that rule to 38 U.S.C. 1311(a)(2), to
clarify that claims under that statute are exempt from the general rule
that issues in a survivor's claim for death benefits will be decided
without regard to any disposition of the same issues during the
veteran's lifetime. Second, we proposed to revise the regulation to
state that VA would disregard only ``unfavorable'' dispositions during
the veteran's lifetime. We explained that the second change would
reflect VA's traditional practice of disregarding only unfavorable
decisions and would resolve an ambiguity existing by virtue of
differing language in the caption of Sec. 20.1106, which refers to
``unfavorable'' decisions during a veteran's lifetime, and the text of
Sec. 20.1106, which more broadly states that VA will decide a
survivor's claims without regard to ``any prior disposition.''
We received no comments on the proposed revisions to Sec. 20.1106.
Upon further consideration, however, we have concluded that the second
change discussed above would be misleading and potentially inconsistent
with statutory requirements in some instances. In a precedential
opinion designated as VAOPGCPREC 11-96, VA's General Counsel noted that
VA's traditional practice under Sec. 20.1106 had been to disregard
only unfavorable dispositions on a veteran's claim and,
correspondingly, to accept favorable findings of service connection
made during a veteran's lifetime. The General Counsel concluded that
this practice was inconsistent with the requirements of a statute
limiting VA's authority to grant service connection for a veteran's
death for purposes of a survivor's DIC claim, even if VA had correctly
granted service connection to the veteran during his or her lifetime
for the condition that eventually caused the veteran's death. The
General Counsel noted that Congress had enacted a statute that
prospectively prohibited VA from granting service connection for
disability or death due to an injury or disease caused by the veteran's
abuse of alcohol or drugs. 38 U.S.C. 105. The General Counsel concluded
that, even if VA had properly granted service connection to a veteran
prior to the enactment of this statute, the statute precluded VA from
granting service connection for the veteran's death if the death was
caused by an injury or disease resulting from the veteran's abuse of
alcohol or drugs. The General Counsel concluded that VA's traditional
practice under Sec. 20.1106 must yield in the face of statutory
provisions requiring a different result.
A similar concern exists with respect to 38 U.S.C. 1103(a), which
prohibits VA from establishing service connection for disability or
death on the basis that it resulted from injury or disease attributable
to the veteran's use of tobacco products during the veteran's service.
In Kane v. Principi, 17 Vet. App. 97 (2003), the CAVC held that section
1103(a) prohibits VA from establishing service connection for a
veteran's death due to an injury or disease related to the veteran's
tobacco use even if VA had properly granted service connection for that
injury or disease during the veteran's lifetime based on then-existing
law.
Although there may be relatively few instances in which the Board
would be required by statute to disregard a favorable decision during a
veteran's lifetime, the proposed unqualified reference to disregarding
only ``unfavorable'' decisions would be misleading and inaccurate with
respect to such cases. Accordingly, we are not adopting that proposed
change to Sec. 20.1106. We recognize that Sec. 20.1106 currently is
ambiguous as to whether it requires the Board to disregard only
unfavorable decisions. However, the revision we proposed would not be
legally accurate or sufficiently informative with respect to all
potential applications of that rule. A clarification of the applicable
law and VA policy with respect to this matter would require
consideration of matters beyond the scope of the proposed rule and,
therefore, would more properly be the subject of a separate rule
making.
We are, however, adopting as final the proposal to revise Sec.
20.1106 to specify that claims under 38 U.S.C. 1311(a)(2) are among the
types of claims exempt from the general rule that issues in a decision
on a survivor's claim for death benefits will be decided without regard
to any prior disposition of those issues during the veteran's lifetime.
That proposed change is consistent with our determination that claims
under sections 1311(a)(2) and 1318(b) should be addressed in the same
manner. As noted above, we received no comments on that proposed
change, which we now adopt as final.
For the reasons stated above and in the notice of proposed
rulemaking, VA will adopt the proposed rules as final, with the changes
discussed above.
Unfunded Mandates
The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C.
1532, that agencies prepare an assessment of anticipated costs and
benefits before developing any rule that may result in an expenditure
by State, local, or tribal governments, in the aggregate, or by the
private sector, of $100 million or more (adjusted annually for
inflation) in any given year. This proposed amendment would have no
such effect on State, local, or tribal governments, or the private
sector.
Executive Order 12866
The Office of Management and Budget has reviewed this document
under Executive Order 12866.
Paperwork Reduction Act
This document contains no provisions constituting a collection of
information under the Paperwork Reduction Act (44 U.S.C. 3501-3521).
Regulatory Flexibility Act
The Secretary hereby certifies that this regulatory amendment will
not have a significant economic impact on a substantial number of small
entities as they are defined in the Regulatory Flexibility Act, 5
U.S.C. 601-612. The reason for this certification is that these
amendments would not directly affect any small entities. Only VA
beneficiaries and their survivors could be directly affected.
Therefore, pursuant to 5 U.S.C. 605(b), these amendments are exempt
from the initial and final regulatory flexibility analysis requirements
of sections 603 and 604.
Catalog of Federal Domestic Assistance
The Catalog of Federal Domestic Assistance program numbers and
titles are 64.109, Veterans Compensation for Service-Connected
Disability; and 64.110, Veterans Dependency and Indemnity Compensation
for Service-Connected Death.
List of Subjects
38 CFR Part 3
Administrative practice and procedure, Claims, Disability benefits,
Health care, Pensions, Radioactive materials, Veterans, Vietnam.
38 CFR Part 20
Administrative practice and procedure, Claims, Veterans.
Approved: August 1, 2005.
R. James Nicholson,
Secretary of Veterans Affairs.
0
For the reasons set forth in the preamble, 38 CFR parts 3 and 20 are
amended as follows:
[[Page 72220]]
PART 3--ADJUDICATION
Subpart A--Pension, Compensation, and Dependency and Indemnity
Compensation
0
1. The authority citation for part 3, subpart A continues to read as
follows:
Authority: 38 U.S.C. 501(a), unless otherwise noted.
Sec. 3.5 [Amended]
0
2. Section 3.5 is amended by removing paragraph (e).
0
3. Section 3.10 is added to read as follows:
Sec. 3.10 Dependency and indemnity compensation rate for a surviving
spouse.
(a) General determination of rate. When VA grants a surviving
spouse entitlement to DIC, VA will determine the rate of the benefit it
will award. The rate of the benefit will be the total of the basic
monthly rate specified in paragraph (b) or (d) of this section and any
applicable increases specified in paragraph (c) or (e) of this section.
(b) Basic monthly rate. Except as provided in paragraph (d) of this
section, the basic monthly rate of DIC for a surviving spouse will be
the amount set forth in 38 U.S.C. 1311(a)(1).
(c) Section 1311(a)(2) increase. The basic monthly rate under
paragraph (b) of this section shall be increased by the amount
specified in 38 U.S.C. 1311(a)(2) if the veteran, at the time of death,
was receiving, or was entitled to receive, compensation for service-
connected disability that was rated by VA as totally disabling for a
continuous period of at least eight years immediately preceding death.
Determinations of entitlement to this increase shall be made in
accordance with paragraph (f) of this section.
(d) Alternative basic monthly rate for death occurring prior to
January 1, 1993. The basic monthly rate of DIC for a surviving spouse
when the death of the veteran occurred prior to January 1, 1993, will
be the amount specified in 38 U.S.C. 1311(a)(3) corresponding to the
veteran's pay grade in service, but only if such rate is greater than
the total of the basic monthly rate and the section 1311(a)(2) increase
(if applicable) the surviving spouse is entitled to receive under
paragraphs (b) and (c) of this section. The Secretary of the concerned
service department will certify the veteran's pay grade and the
certification will be binding on VA. DIC paid pursuant to this
paragraph may not be increased by the section 1311(a)(2) increase under
paragraph (c) of this section.
(e) Additional increases. One or more of the following increases
may be paid in addition to the basic monthly rate and the section
1311(a)(2) increase.
(1) Increase for children. If the surviving spouse has one or more
children under the age of 18 of the deceased veteran (including a child
not in the surviving spouse's actual or constructive custody, or a
child who is in active military service), the monthly DIC rate