Howell v. Nicholson

Robert Howell (plaintiff) was a Korean War veteran. In 1982, the Department of Veterans Affairs (VA) (defendant) determined that Howell’s paranoid schizophrenia was a service-connected disability and that Howell was 100 percent disabled. In 2000, Howell sought special monthly compensation (SMC) benefits for housebound and aid-and-attendance care. In support of his application, Howell submitted a handwritten note from Dr. Jose Duque stating that Howell was unable to care for himself because of his physical and mental disabilities. At that time, Howell also suffered from spinal disease and hypertension, neither of which was connected to his military service. Howell underwent a VA medical examination in connection with his claim. Based on reports of Howell’s condition given by Howell and Howell’s wife, the VA physician, Dr. Padma Raghavan, issued a report that Howell was unable to handle his daily living needs independently because of his physical and mental disabilities. Neither Dr. Duque’s report nor Dr. Raghavan’s report contained medical commentary or supporting medical evidence for the stated conclusion. Further, neither medical report distinguished between the difficulties Howell faced because of his service-connected paranoid schizophrenia versus his non-service-connected physical disabilities. The VA denied Howell’s SMC claim. Howell appealed. The Board of Veterans’ Appeals affirmed, holding that (1) Howell’s service-connected paranoid schizophrenia did not alone render him in need of either housebound care or aid-and-attendance care; and (2) Howell’s ability to attend the VA medical examination proved he was not housebound. Howell appealed.