Viegas v. Shinseki

• Decision Date: 31 January 2013
• Docket Number: No. 2012–7075.,2012–7075.
• Citation: 705 F.3d 1374
• Parties: John L. VIEGAS, Claimant–Appellant, v. Eric K. SHINSEKI, Secretary of Veterans Affairs, Respondent–Appellee.
• Court: U.S. Court of Appeals — Federal Circuit

705 F.3d 1374

John L. VIEGAS, Claimant–Appellant,

v.Eric K. SHINSEKI, Secretary of Veterans Affairs, Respondent–Appellee.

No. 2012–7075.

United States Court of Appeals, Federal Circuit.

Jan. 31, 2013.

Linda E. Blauhut, Paralyzed Veterans of America, of Washington, DC, argued for claimant-appellant. With her on the brief was Jennifer A. Zajac.

Scott D. Austin, Assistant Director, Commercial Litigation Branch, Civil Division, United States Department of Justice, of Washington, DC, argued for respondent-appellee. On the brief were Stuart F. Delery, Acting Assistant Attorney General, Jeanne E. Davidson, Director, Todd M. Hughes, Deputy Director, and Elizabeth M. Hosford, Senior Trial Counsel. Of counsel on the brief were Michael J. Timinski, Deputy Assistant General Counsel, and Christa A. Shriber, Attorney, United States Department of Veterans Affairs, of Washington, DC.

Before RADER, Chief Judge, NEWMAN and MAYER, Circuit Judges.

MAYER, Circuit Judge.

John L. Viegas appeals the final judgment of the United States Court of Appeals for Veterans Claims (“Veterans Court”) affirming a decision of the Board of Veterans' Appeals (“board”) that denied his claim for disability compensation under 38 U.S.C. § 1151. See Viegas v. Shinseki, No. 10–568, 2011 WL 5865451, 2011 U.S.App. Vet. Claims LEXIS 2554 (Nov. 23, 2011) (“Veterans Court Decision ”). Because we conclude that the Veterans Court misinterpreted the causation requirement set forth in section 1151(a)(1), we reverse and remand.

I. Background

The relevant facts are not in dispute. Viegas served in the United States Army from November 1965 to November 1967. After he left the service, he was injured in a diving accident. As a result, Viegas now suffers from “incomplete” quadriplegia.

In May 2004, Viegas participated in a prescribed aquatic therapy session at a Department of Veterans Affairs (“VA”) medical center in Palo Alto, California. Afterward, he stopped to use a restroom located in the VA facility. While he was in the restroom, the grab bar he was using to lift himself into his wheelchair came loose from the wall and he fell to the ground. As a result of the fall, Viegas sustained injuries to both his upper and lower extremities. Viegas' medical condition deteriorated after his fall. Prior to his fall, Viegas could sometimes walk with a walker, but since the accident he can only stand with assistance.

In July 2004, Viegas filed a claim for section 1151 benefits. He asserted that as a result of the fall in the VA restroom he had “incurred severe injury to his shoulder and neck resulting in loss of use of his lower extremities and impairment of his upper extremities.” A VA regional office denied Viegas' claim, concluding that he was not entitled to benefits under section 1151 because he was “not in direct VA care at the time of [his] fall.” On appeal, the board affirmed, stating that benefits are available under section 1151 only if a veteran's “additional disability [is] the result of injury that was part of the natural sequence of cause and effect flowing directly from the actual provision of hospital care, medical or surgical treatment, or examination furnished by [the] VA and ... such additional disability was directly caused by that VA activity.”

Viegas then appealed to the Veterans Court. The court held that although Viegas' injury occurred in a VA facility, it was not caused directly by “hospital care, medical or surgical treatment, or examination furnished by [the] VA.” Veterans Court Decision, 2011 WL 5865451, at *1, 2011 U.S.App. Vet. Claims LEXIS 2554, at *2 (citations and internal quotation marks omitted). In the court's view, while Viegas might potentially be able to seek compensation for his injuries under the Federal Tort Claims Act, 28 U.S.C. § 1346(b), the additional disability incurred as a result of his fall was “simply not covered by section 1151.” Veterans Court Decision, 2011 WL 5865451, at *1, 2011 U.S.App. Vet. Claims LEXIS 2554, at *3. Viegas then filed a timely notice of appeal with this court.

II. Discussion

We have jurisdiction over appeals from the Veterans Court under 38 U.S.C. § 7292. Questions of statutory interpretation are questions of law, subject to de novo review. Chandler v. Shinseki, 676 F.3d 1045, 1047 (Fed.Cir.2012); Boggs v. Peake, 520 F.3d 1330, 1334 (Fed.Cir.2008).

Pursuant to section 1151, a veteran who sustains a “qualifying additional disability” as a result of VA medical treatment or hospital care is entitled to benefits “in the same manner as if such additional disability ... were service-connected.” 38 U.S.C. § 1151(a); see Roberson v. Shinseki, 607 F.3d 809, 813 (Fed.Cir.2010). In relevant part, section 1151 provides:

(a) Compensation under this chapter and dependency and indemnity compensation under chapter 13 of this title shall be awarded for a qualifying additional disability or a qualifying death of a veteran in the same manner as if such additional disability or death were service–connected. For purposes of this section, a disability or death is a qualifying additional disability or qualifying death if the disability or death was not the result of the veteran's willful misconduct and—

(1) the disability or death was caused by hospital care, medical or surgical treatment, or examination furnished the veteran under any law administered by the Secretary, either by a Department employee or in a Department facility as defined in section 1701(3)(A) of this title, and the proximate cause of the disability or death was—

(A) carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the Department in furnishing the hospital care, medical or surgical treatment, or examination; or

(B) an event not reasonably foreseeable[.]

38 U.S.C. § 1151 (emphasis added).

Section 1151 delineates three prerequisites for obtaining disability compensation. First, a putative claimant must incur a “qualifying additional disability” that was not the result of his own “willful misconduct.” Id. § 1151(a).¹ Second, that disability must have been “caused by hospital care, medical or surgical treatment, or examination furnished the veteran” by the VA or in a VA facility. Id. § 1151(a)(1). Finally, the “proximate cause” of the veteran's disability must be “carelessness, negligence, lack of proper skill, error in judgment, or similar instance of fault on the part of the [VA],” or “an event not reasonably foreseeable.” Id. §§ 1151(a)(1)(A), 1151(a)(1)(B).

Section 1151 thus contains two causation elements-a veteran's disability must not only be “caused by” the hospital care or medical treatment he received from the VA, but also must be “proximate[ly] cause[d]” by the VA's “fault” or an unforeseen “event.” Id. § 1151(a). There is no question that Viegas' injury meets section 1151's second causation element since it was proximately caused by the VA's failure to properly install and maintain the grab bar in a restroom at its Palo Alto Medical Center. The sole issue presented on appeal is whether his injury was “caused by” the medical treatment or hospital care he received from the VA.

The government argues that Viegas' injury falls outside the ambit of section 1151 because the statute encompasses only those injuries that are “directly caused by the provision of medical care.” In the government's view, section 1151 applies “to disabilities that are caused by actual care or treatment, rather than injuries that coincidentally occur in VA facilities.” Viegas disagrees. He asserts that his injury was “caused by” the hospital care he received at the VA's Palo Alto Medical Center because it occurred while he “was receiving care and treatment” at the facility. According to Viegas, section 1151's causation requirement is satisfied whenever a veteran comes to a VA facility for medical treatment and, as a result of the VA's negligence, sustains an injury while on VA premises.

We do not find either the government's or Viegas' interpretation of the phrase “caused by” in section 1151(a)(1) wholly satisfactory. Contrary to the government's assertions, nothing in the statutory text requires that a veteran's injury must be “directly” caused by the “actual” medical care provided by VA personnel. On the other hand, however, section 1151 does not extend to the “remote consequences” of VA medical treatment, Brown v. Gardner, 513 U.S. 115, 119, 115 S.Ct. 552, 130 L.Ed.2d 462 (1994) ( “Gardner ”), and a veteran is not entitled to obtain section 1151 disability benefits simply because he was in a VA medical facility at the time he sustained an injury.

A. The Statutory Text

“As is true in every case involving the construction of a statute, our starting point must be the language employed by Congress.” Reiter v. Sonotone Corp., 442 U.S. 330, 337, 99 S.Ct. 2326, 60 L.Ed.2d 931 (1979). Nothing in the plain language of section 1151 requires that a veteran's injury must be “directly” caused by the “actual” provision of medical care by VA personnel. To the contrary, the statute is framed disjunctively, stating that a disability must be “caused by” hospital care or medical treatment that is provided to a veteran “ either by a [VA] employee or in a [VA] facility.” 38 U.S.C. § 1151(a)(1) (emphases added). In other words, the causation element is satisfied not only when an injury is directly caused by the actions of VA employees, but also when that injury occurs “in a [VA] facility” as a result of the VA's negligence. By use of the disjunctive, Congress intended to encompass not simply the actual care provided by VA medical personnel, but also treatment-related incidents that occur in the physical premises controlled and maintained by the VA. See Reiter, 442 U.S. at 338, 99 S.Ct. 2326 (eschewing a “strained construction” of a statute that “would ... ignore the disjunctive ‘or’ ” contained in the statutory text); Fed. Commc'ns Comm'n v. Pacifica Found., 438 U.S. 726, 739–40, 98 S.Ct. 3026, 57 L.Ed.2d 1073 (1978) (ex...