John W. Webb served in the United States Army from 1968 to 1970 and received an honorable discharge. After service, Webb developed prostate cancer that was determined to be service connected. Treatment for that condition resulted in erectile dysfunction. At the time Webb sought disability compensation for erectile dysfunction, the Department of Veterans Affairs Schedule for Rating Disabilities did not contain a diagnostic code specifically addressing that condition.
In 2015, a VA Regional Office reopened Webb’s claim and evaluated his erectile dysfunction by analogy under Diagnostic Code 7522. That code provided a compensable rating for penile deformity with loss of erectile power. The Regional Office assigned a noncompensable rating, concluding that Webb did not meet the criteria for a compensable evaluation under the analogous code.
Webb appealed the decision to the Board of Veterans’ Appeals. The Board acknowledged that the condition was unlisted and had been rated by analogy. It nonetheless determined that Webb was not entitled to a compensable rating because the record did not show a penile deformity. The Board treated the criteria of Diagnostic Code 7522 as requirements that had to be met in full.
Webb appealed to the United States Court of Appeals for Veterans Claims. That court affirmed the Board’s decision. It relied on prior precedent and concluded that when erectile dysfunction is rated by analogy under Diagnostic Code 7522, a claimant must establish the presence of a penile deformity to receive a compensable rating.
The Veterans Court did not analyze the text of the regulation governing ratings by analogy or address whether the functions affected, anatomical location, and symptomatology of Webb’s condition were closely analogous to the listed diagnostic code.
Webb appealed to the United States Court of Appeals for the Federal Circuit. The Federal Circuit reviewed the Veterans Court’s interpretation of 38 C.F.R. § 4.20, the regulation governing disability ratings by analogy.
Section 4.20 permits the VA to rate an unlisted condition under a closely related disease or injury when the functions affected, anatomical localization, and symptomatology are closely analogous. The Federal Circuit emphasized that the regulation does not require an unlisted condition to be identical to the listed condition used for comparison.
The court explained that requiring a veteran to meet every criterion of a listed diagnostic code defeats the purpose of rating by analogy. If an unlisted condition fully satisfied a listed diagnostic code, rating by analogy would be unnecessary. The court also noted that prior Veterans Court decisions had rejected strict application of diagnostic criteria when a condition was rated by analogy.
The Federal Circuit determined that the Veterans Court erred by requiring Webb to demonstrate a penile deformity as a prerequisite for a compensable rating. By doing so, the Veterans Court imposed a requirement not found in the text of section 4.20.
The court held that once the VA determines a listed condition is closely analogous to an unlisted condition, the regulation does not direct the VA to withhold compensation solely because the veteran does not meet every criterion associated with the listed diagnostic code. The proper analysis requires examining whether the conditions are closely analogous, not whether they are identical.
The Federal Circuit vacated the decision of the Court of Appeals for Veterans Claims and remanded the case for further proceedings. The court directed that Webb’s claim be reconsidered under a correct interpretation of section 4.20, without imposing requirements not contained in the regulation.
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