Joe Whitcomb
Melba Saunders served in the U.S. Army from 1987 to 1994. During her service, she was diagnosed with patellofemoral pain syndrome (PFPS) after reporting bilateral knee pain. Although her separation exam showed normal lower extremities, it noted a history of joint pain and bone spurs.
In 1994, Saunders submitted a claim for service-connected disability based on knee pain, hip pain, and a bilateral foot condition. The VA Regional Office denied the claim due to her failure to attend a scheduled examination. In 2008, she filed a new claim for knee and foot issues. The VA reopened the prior decision, reviewed the claims on the merits, and again denied service connection. The agency stated it lacked current medical evidence for her knee condition, even though her in-service PFPS diagnosis was documented.
In response, Saunders filed a Notice of Disagreement and pursued the appeal process. A 2011 VA examination found no anatomical abnormalities but documented functional limitations due to knee pain, such as restricted walking and standing. The examiner diagnosed subjective bilateral knee pain and opined that the pain likely originated from military service. Despite this, the VA insisted that pain alone could not be a basis for service connection and denied the claim.
Veterans Court ruled pain alone insufficient for service connection
Saunders appealed to the Board of Veterans' Appeals. The Board reopened her knee claim based on new and material evidence but denied it again. It cited Veterans Court precedent in Sanchez-Benitez v. West, which held that pain without an underlying diagnosis did not constitute a compensable disability. The Board found that Saunders lacked a present diagnosis linked to her military service.
Saunders appealed to the Veterans Court, which upheld the Board's denial. The court reaffirmed its holding from Sanchez-Benitez, stating that pain without an underlying diagnosed condition does not qualify as a disability under 38 U.S.C. § 1110.
Saunders sought review by a panel of the Veterans Court, which adopted the single-judge decision in full. The Veterans Court denied en banc review, and Saunders then appealed to the U.S. Court of Appeals for the Federal Circuit.
Federal Circuit reversed Veterans Court interpretation
The Federal Circuit found that it had jurisdiction under 38 U.S.C. § 7292 to review the Veterans Court's statutory interpretation. The court concluded that the legal question of whether pain alone can constitute a disability under § 1110 was reviewable.
The court held that the term "disability" in § 1110 refers to functional impairment of earning capacity, not necessarily a diagnosed disease. It noted that the statute compensates for functional limitations caused by injury or disease incurred in service, and does not limit disability to diagnosed conditions. Dictionary definitions and VA regulations, including 38 C.F.R. §§ 4.1 and 4.10, supported the interpretation that pain can qualify as a disability if it impairs functioning.
The court also examined the VA's rating regulations, which account for pain as a component of functional loss. It found that regulations such as 38 C.F.R. § 4.40 (functional loss), § 4.45 (joint disability), and § 4.56 (muscle disability) consider pain in disability evaluations. The court concluded that the Veterans Court's prior decision to categorically exclude pain from the definition of "disability" was inconsistent with statutory and regulatory interpretations.
The court emphasized that while not every instance of pain warrants compensation, pain that causes functional impairment may qualify as a disability under § 1110. It also found no basis in statute or regulation for requiring a formal diagnosis to support claims involving functional pain.
Remand for further proceedings
The court determined that the Board had not applied the correct legal standard in evaluating Saunders's claim. It noted that the Board had not made findings regarding whether Saunders's reported knee pain functionally impaired her earning capacity. The court also stated that neither the Board nor the Veterans Court had assessed the other two prongs of the service connection test: in-service incurrence or aggravation and nexus.
The Federal Circuit reversed the Veterans Court's legal conclusion and remanded the case for further proceedings. On remand, the Board was instructed to determine whether Saunders's knee pain met the definition of a disability based on functional impairment and, if so, whether it was linked to her military service.
Help with veterans disability compensation claims
If you’ve experienced pain or functional limitations linked to your military service, Whitcomb, Selinsky PC handles veterans disability claims involving service-connected impairments, disputed ratings, and VA appeals. Reach out to schedule a consultation and learn how our team can assist with your claim.