# Stephanie Ortega v. Douglas A. Collins

Aggregated by Superinsight from public-domain sources, as of 2026-09-08. Domain: va/cavc.

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## Stephanie Ortega v. Douglas A. Collins, No. 24-4799 (2026) {#10843169}

*No. 24-4799*

Official source: <http://www.uscourts.cavc.gov/documents/OrtegaS_24-4799.pdf>

_Stephanie Ortega v. Douglas A. Collins, No. 24-4799, decided 2026-04-13._

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

                                           No. 24-4799

                                 STEPHANIE ORTEGA, APPELLANT

                                                V.

                                   DOUGLAS A. COLLINS,
                         SECRETARY OF VETERANS AFFAIRS, APPELLEE.

                         On Appeal from the Board of Veterans' Appeals

(Argued December 16, 2025                                                 Decided April 13, 2026)

        Michal Leah Kanovsky, with whom Glenn R. Bergmann, both of Rockville, Maryland, was
on the brief, for the appellant.

      Kirsten S. Dowell, Appellate Attorney, with whom Danielle A. Runyan, Acting General
Counsel; David L. Quinn, Assistant Chief Counsel; and Carolyn F. Washington, Deputy Chief
Counsel, all of Washington, D.C., were on the brief for the appellee.

        Before FALVEY, LAURER, and JAQUITH, Judges.

       FALVEY, Judge, filed the opinion of the Court. JAQUITH, Judge, filed an opinion
concurring in part and dissenting in part.

        FALVEY, Judge: Army veteran Stephanie Ortega, through counsel, appeals an April 4,
2024, Board of Veterans' Appeals (Board) decision granting an initial 50% rating for cephalgia
(head pain); denying a rating above 10% for gastroesophageal reflux disease (GERD) and a
compensable rating for left knee surgical residual scars; and denying service connection for
chronic fatigue syndrome (CFS), left and right foot hallux valgus (claimed as bunions), and left
and right foot pes planus.
        We called this case to panel to address two matters: (1) did the Board violate Ms. Ortega's
due process rights when it notified her that it received her VA Form 10182 (Notice of
Disagreement or NOD) after the 90-day deadline to submit evidence had already passed; and (2)
what happens when the agency of original jurisdiction (AOJ) lists an incorrect "favorable" finding
in its decision.
        We don't answer the first question. Even if we assume a notice error, we can't see how it
prejudiced Ms. Ortega. When she appealed to the Board, she used a form that told her that she had

90 days to submit evidence. She didn't. In fact, she never tried to submit any evidence as part of
her Board appeal. Thus, we don't need to weigh in on the Board's notice obligations when nothing
suggests Ms. Ortega was impacted by evidentiary notice problems.
          At first blush, we don't need to answer the second question either. We can, and do, remand
Ms. Ortega's foot claims because VA obtained inadequate exams and the Board ignored contrary
evidence when it concluded that she had a foot disability that preexisted service. But to ensure that
she is not plagued by any potential confusion from flawed favorable findings, we clarify that only
findings that are favorable are binding on subsequent VA adjudicators. That's what Congress
required. And here, the AOJ's finding was not favorable to Ms. Ortega. Thus, it doesn't bind VA
on remand.
          After resolving these matters that require a precedential opinion, we also address three
issues that do not. See Frankel v. Derwinski, 1 Vet.App. 23, 25-26 (1990). We find that the Board
provided inadequate reasons or bases for its determinations about CFS, GERD, and left knee
scars.1
          In the end, we vacate the parts of the Board decision concerning bilateral hallux valgus,
bilateral pes planus, CFS, GERD, and left knee scars and remand those claims for readjudication
consistent with this decision and our instructions. And we affirm the part of the Board decision
regarding cephalgia.

      I. ANY BOARD ERROR CONCERNING NOTICE WAS NOT PREJUDICIAL
          When claimants appeal to the Board and choose the evidence submission docket, they can
submit evidence with their NOD or they have 90 days from when the Board receives their NOD
to submit that evidence. 38 U.S.C. § 7113(c). Ms. Ortega argues that the Board violated her due
process rights by waiting until after that 90-day period to notify her of receipt of her NOD.
Appellant's Brief (Br.) at 13. As we explain, any notice error was harmless given the facts here.
To understand why, we start with how Ms. Ortega appealed to the Board.

          1
            Much like our discussion of the foot exams or the Board's reasons or bases for finding that the foot
disabilities preexisted service, our decision on CFS, GERD, and left knee scars does not establish new, binding
precedent.

                                                       2

                                                  A. Background
         In a September 2020 decision, the AOJ granted service connection for cephalgia with a
30% rating effective October 2019; continued a 10% GERD rating and a 0% left knee scar rating;
and denied service connection for CFS, bilateral hallux valgus, and bilateral pes planus. Record
(R.) at 489-90.
         Ms. Ortega appealed the AOJ decision to the Board, choosing the evidence submission
review option. The form she used stated: "I have additional evidence in support of my appeal that
I will provide within the next 90 days." R. at 467. Ms. Ortega mailed the form, without more
evidence, on October 27, 2020. R. at 465.
         Despite what the form said, Ms. Ortega did not submit any evidence "within the next 90
days." Nor did she submit evidence after the Board received her appeal. The date stamp on the
form and the envelope show that VA received it on November 5, 2020. R. at 465-67. From this
date, Ms. Ortega had 90 days—until February 3, 2021—to submit evidence to the Board.
         The day after this period expired, the Board sent Ms. Ortega a letter stating that it had
received her appeal. Despite the time having run, the Board told her that she had "90 days from
the date of the Board's receipt of [her] Board Appeal . . . to submit new evidence." R. at 428.
Unhelpfully, the letter did not tell Ms. Ortega when the Board had received her appeal.
         Sometime in January 2023, VA associated more treatment records with Ms. Ortega's claims
file, some of which Ms. Ortega believes are important for her claims.2 In the decision on appeal,
the Board stated that its decision was "based on the evidence of record as of the date the September
2020 rating decision was issued, any evidence submitted with the Veteran's [NOD], and any
additional evidence submitted within 90 days following receipt of her NOD. . . . The Board has
not considered any evidence other than that noted." R. at 8; see R. at 5-6. In short, the Board
considered none of the records VA received in January 2023.

         2
           The exact date when VA obtained these records is unclear, but it no longer appears disputed that VA
obtained and uploaded them and that it did so in January 2023. See Appellant's Br. at 9-10 (citing evidence in the
record from January and February 2021 but not stating when it was submitted and the cited documents not containing
a VA date stamp); Secretary's Br. at 5 (asserting that approximately 2 years after the February 2021 Board letter, Ms.
Ortega submitted evidence); Appellant's Reply Br. at 1 (stating that she did not file that evidence and instead "[t]hey
were obtained by the [AOJ] on Jan. 4, 2023, accompanied by a service treatment record (STR) certification noting
'records being enclosed herein' the bulk of which were electronic"); R. at 143 (a service treatment records certification
form from the Army to VA); R. at 202, 229 (the cited medical evidence noting a Department of Defense ID and that
they were created on January 4, 2023); Oral Argument (OA) at 23:18-23:38, https://www.youtube.com/
watch?v=TZIbgLGby2E (during oral argument, the Secretary informed the Court that he had mistakenly stated in his
brief that Ms. Ortega submitted the evidence and noting that "VATRs" were associated with the file).

                                                           3

                                            B. Analysis
       The crux of Ms. Ortega's appeal is that she believes VA never gave her adequate notice
about how long she had to submit evidence. As she sees it, the Board erred by notifying her of its
receipt of her NOD after the 90-day period for submitting evidence without offering a clue that
her deadline had passed. Appellant's Br. at 13.
       This matters because, as the Board explained, the record that it can review is limited to
evidence considered by the AOJ in its decision, as well as "[e]vidence submitted by the appellant
. . . , if any, with the [NOD] . . . [or] within 90 days following receipt of the [NOD]." 38 U.S.C.
§ 7113(c) (evidence submission docket); see 38 C.F.R. § 20.303 (2025) (the implementing
regulation). Thus, it seems reasonable that a claimant would care about the date that the Board
received the NOD; after all, Congress decided that the 90-day submission deadline would start on
this date. Even so, if, when, or how VA must notify the claimant about this date is not something
we resolve today.
       This is because, even accepting that an error happened here, any such error is not
prejudicial to Ms. Ortega; she never tried to submit any evidence. When she completed her NOD,
the form told her that she had 90 days to submit evidence. She didn't. Indeed, between when she
mailed her NOD on October 27, 2020, to when the Board issued its decision nearly 4 years later
in August 2024, including after the Board sent the February 4, 2021, letter, we find no indication
that Ms. Ortega wanted to submit evidence but was stopped by inadequate notice. We are thus not
surprised that the Board did not consider if any notice gaps affected her ability to pursue this
appeal; the Board must address only those issues raised by the claimant or the record. See Robinson
v. Peake, 21 Vet.App. 545, 552-53 (2008), aff'd sub nom. Robinson v. Shinseki, 557 F.3d 1355
(Fed. Cir. 2009).
       At bottom, with nothing to suggest that Ms. Ortega even tried to submit any evidence with
or following her NOD, we see only harmless error; her notice arguments thus become
inconsequential. See 38 U.S.C. § 7261(b)(2) (providing that the Court must "take due account of
the rule of prejudicial error"); Shinseki v. Sanders, 556 U.S. 396, 409-410 (2009) (finding that "the
burden of showing that an error is harmful normally falls upon the party attacking the agency's
determination"). Our review of her circumstances and the record confirms that Ms. Ortega was not
harmed by a lack of clarity on the exact timeline to submit evidence. See Slaughter v. McDonough,

                                                  4

29 F.4th 1351, 1355 (Fed. Cir. 2022) (holding that our Court must look to the circumstances of the
case when considering prejudicial error).
         During oral argument, Ms. Ortega asserted that she did not submit evidence because, when
she received the letter, she thought it was too late to do so. OA at 16:20-17:30. But her purported
reliance on the VA letter is confusing. First, the letter didn't tell her when VA received her NOD,
so it's unclear why she'd think she already missed her chance. If anything, the letter invited her to
submit evidence by repeating the general 90-day deadline (despite that deadline having passed).
And even before this letter, Ms. Ortega filled out a form that told her to submit evidence along
with the NOD or within the next 90 days.
         We are similarly not convinced by Ms. Ortega's vague invocation of delays around the
COVID-19 pandemic and her related expectation for specific notice. She states that it was her
expectation that she would be notified when VA received her NOD and she would then submit
evidence. OA at 16:52-17:10. But we can't understand the origin of this expectation.3 Again, the
NOD stated that she would provide any additional evidence "within the next 90 days." R. at 467.
And Ms. Ortega knew when she mailed the NOD. It is true that she might not have known the
exact date that VA received it, but she was aware of the general 90-day period and submitted no
evidence.4

         3
           We understand that VA, when implementing the Veterans Appeals Improvement and Modernization Act
(AMA) and addressing 38 C.F.R. § 20.202(b)(3) (described as "Submission of Evidence in Conjunction With Notice
of Disagreement") and commenting that it would be difficult to calculate the relevant deadlines because VA did not
provide adequate notice of when it received the NOD, said that it was the Board's practice to notify veterans when an
appeal had been received and docketed at the Board. 84 Fed. Reg. 138, 152 (Jan. 18, 2019) (noting that, as the precise
procedures for providing such notice might change based on technological systems, VA would continue to address
this matter through procedural guidance). But neither Ms. Ortega's pleadings nor her oral argument make clear that
she relied on this regulatory history in forming an expectation that clear notice would come and that she would then
submit evidence.

          We note that, despite its regulatory commitment, VA appears to have done nothing to fix the issue it identified
in rulemaking. And perhaps a panel will one day soon address the evidence submission issues raised in that regulatory
history. But, as we stress throughout the opinion, we do not reach those questions today because we do not understand
how any of those notice issues impacted Ms. Ortega.
         4
            In her reply brief, Ms. Ortega attached the current NOD form, which has different language than the form
she completed in 2020. The prior form stated: "I have additional evidence in support of my appeal that I will provide
within the next 90 days." R. at 467. The current form says: "I have additional evidence in support of my appeal that I
will submit to the Board with my [NOD] or within 90 days of the Board's receipt of my [NOD]." Appellant's Reply
Br.; App. 2. She argues that the language change shows that the information in the form she completed was inaccurate.
Id. at 3. First, we're reluctant to infer error from VA's attempt to make its forms clearer; for sound policy reasons, the
law frowns on imposing liability for remedial measures. See, e.g., FED. R. EVID. 407. Second, and as we explain in
depth, this is particularly true when the NOD plainly put her on notice that there was a ticking 90-day clock for her to

                                                            5

         Her failure to submit any evidence, or even flag confusion about her time to submit
evidence to the Board, is what renders any Board error harmless. We agree with her that Congress's
choice to tie the evidence submission deadline to when VA receives a document, without then
establishing any requirement that VA notify the claimant once it receives that document, creates
gaps.5 But with no suggestion of prejudice in the record, Ms. Ortega's due process argument is the
sort of grand facial challenge that does not fare well absent a more developed argument. "We reject
that argument, although we don't foreclose the possibility that there could be a violation of . . . due
process principles in a specific case. But we don't see that here." Bilharz v. Collins, 38 Vet.App.
366, 377 (2025).
         Besides identifying nothing in the record to suggest that the lack of clarity about the
deadline to submit evidence impacted her, Ms. Ortega also fails to address the process, explained
below, that is available to those veterans who might find themselves in the evidentiary window
gaps potentially created by the AMA.
         This two-part omission ultimately makes her due process contentions underdeveloped. See
Locklear v. Nicholson, 20 Vet.App. 410, 416 (2006) (holding that the Court will not entertain
underdeveloped arguments); Evans v. West, 12 Vet.App. 22, 31 (1998) (noting that the Court will
disregard vague assertions and unsupported contentions).
         "The fundamental requirement of due process is the opportunity to be heard 'at a
meaningful time and in a meaningful manner.'" Mathews v. Eldridge, 424 U.S. 319, 333 (1976)
(quoting Armstrong v. Manzo, 380 U.S. 545, 552 (1965)). And in making her due process
challenge, Ms. Ortega does not, among other things, acknowledge the options already available to
those veterans who want to submit evidence.

submit evidence. True, we will likely have to consider the potential evidentiary windows or notice problems that could
exist in the AMA world. But we don't see how they affected Ms. Ortega. Thus, that is a matter for another panel.
         5
           Ms. Ortega suggests that such a notice requirement is found in 38 C.F.R § 3.110, which says that the period
for taking any action required of a claimant shall run from the date that VA sends a claimant notice of that required
action. That may be. As the veteran notes, Appellant's Reply Br. at 6, the Court in Rowell v. Principi, 4 Vet.App. 9,
15 (1993), said that § 3.110 clarified the time limit for filing an NOD; that is, it related challenging a rating decision
with § 3.110. However, that case, one of only two precedential cases before our Court discussing § 3.110, predates
the AMA. There are questions remaining as to whether and how § 3.110 applies to an NOD under the AMA and how
that regulation interplays with 38 CF.R. § 20.110, which provides for the computation of time for filing "any written
document" with the Board. But the panel does not reach those questions today because, again, Ms. Ortega was not
harmed by any VA notice error.

                                                            6

         She doesn't explain why, even with the right to due process, an appellant could not confirm
with VA that it had received the NOD, particularly here where Ms. Ortega states she was concerned
about delays due to the pandemic.6 Those represented by attorneys, agents, or veterans service
organizations who have electronic access to VA claims files should have an even easier time. And
even if veterans can't do that and miss the statutory deadline to submit evidence, VA may still
consider waiving that 90-day deadline. See Bolds v. McDonough, 37 Vet.App. 359, 367 (2024)
(holding that section 7113's evidence submission limitation is a claims-processing rule subject to
Secretarial waiver).
         If all that fails, Congress did not leave veterans who have new evidence but missed their
Board shot without a process. Such veterans, including Ms. Ortega, can submit supplemental
claims. This option permits review of their claim and that evidence by the AOJ (and if need be,
the Board) all without a loss of the effective date. See Andrews v. McDonough, 34 Vet.App. 151,
160 (2021) (explaining how a supplemental claim provides a process for those who want to submit
evidence under the AMA).
         Ultimately, we do not need to decide whether any of these options provide a meaningful
opportunity to be heard that is enough to prevent a due process issue. They may not be enough.
But as we've said, Ms. Ortega has not shown that she was impacted by any notice issues; she did
not submit or try to submit evidence. And at this point, there is no reason for us to explore the
matter further. See Teva Pharm. USA, Inc. v. Novartis Pharm. Corp., 482 F.3d 1330, 1337–38
(Fed. Cir. 2007) (holding that "federal courts are to decide only 'actual controversies by judgment
which can be carried into effect, and not to give opinions upon moot questions or abstract
propositions, or to declare principles or rules of law which cannot affect the matter in the case
before it'") (quoting Local No. 8-6, Oil, Chem. & Atomic Workers Int'l Union v. Missouri, 361 U.S.
363, 367 (1960)).

         6
            Although this does not impact our decision, it appears that VA provides a portal for veterans to check the
status of their claims, including to inform them when "[t]he Board . . . is holding [the] case open for new evidence for
90 days." See https://www.va.gov/resources/what-your-decision-review-or-appeal-status-means/ (last visited March
26, 2026). Without access to the portal, we do not know if it provides information about Board receipt of an NOD or
the evidence submission window. What's more, we do not decide here whether this is sufficient process. But it would
be helpful in future cases to determine whether such options do give adequate process.

                                                           7

         "[T]he cardinal principle of judicial restraint—if it is not necessary to decide more, it is
necessary not to decide more—counsels us to go no further." PDK Lab'ys Inc. v. DEA, 362 F.3d
786, 799 (D.C. Cir. 2004) (Roberts, J., concurring in part and concurring in the judgment).
         Because the unsuccessful notice argument was the only challenge Ms. Ortega raised
regarding the Board's grant of a 50% cephalgia rating, see Appellant's Br. at 20 (briefly asserting
that if it were not for the Board's deficient February 2021 letter, it was unknown whether she would
have submitted more evidence to support an extraschedular cephalgia rating),7 we will affirm that
part of the Board decision. Ms. Ortega made other arguments about her other claims. And so, we
will address those in turn, starting with the other panel question first.

                        II. ONLY FAVORABLE FINDINGS ARE BINDING
         Ms. Ortega had multiple periods of active service. Some evidence suggests her foot
disability preexisted service; other evidence—including exams that noted information about her
feet—suggests the opposite. This evidence showed no foot problems in service or between periods
of service.
         Without ever addressing why Ms. Ortega's foot disability seemingly disappeared between
these multiple medical exams, VA developed her claim with a focus on whether her disability was
aggravated by service. This led to inadequate exams and inadequate reasons or bases. Resolving
this exam issue or the Board's reasons or bases error does not create new precedent.
         The novel question is what to do about another AOJ error. In the September 2020 decision,
the AOJ went as far as labeling the conclusion that her disability preexisted service as favorable.
Everyone agrees that this is not actually a favorable finding, at least in the direct service connection
context. See Appellant's Br. at 13; Secretary's Br. at 14; OA at 33:55-34:53. But Ms. Ortega is
concerned that she is stuck with it because the AOJ called it favorable. As we explain, that is not

         7
           Unlike Ms. Ortega, the dissent argues that the Court should remand the cephalgia claim because the Board
did not address whether an extraschedular rating was warranted for that condition. But again, Ms. Ortega raised no
such argument in her pleadings or during oral argument. She mentioned an extraschedular cephalgia rating just once
and only in her opening brief. Appellant's Br. at 20 ("It is also unknown whether she would have submitted more
evidence to support increased ratings for GERD, an extraschedular rating for cephalgia, or service connection for her
foot conditions."). So the majority did not consider remanding the cephalgia claim based on that theory. See United
States v. Sineneng-Smith, 590 U.S. 371, 375-76 (2020) (finding that, "as a general rule, our system is designed around
the premise that [parties represented by competent counsel] know what is best for them, and are responsible for
advancing the facts and argument entitling them to relief") (alteration in original) (citations omitted).

                                                          8

the case; the statute makes only favorable findings binding. With this top-level overview, we can
look at the details of Ms. Ortega's foot claim.
                                          A. Background
        Ms. Ortega had active duty in the Army Reserve from February 2009 to August 2009,
December 2009 to December 2010, and November 2017 to October 2018. R. at 2977, 2978, 2514.
It appears that the Board might have overlooked the first period of service. See R. at 7 (the Board
only noting active duty service from December 2009 to December 2010 and November 2017 to
October 2018). But the Secretary acknowledges all three periods of active duty service. Secretary's
Br. at 2.
        The entrance examination for her first period of service noted mild asymptomatic bilateral
hallux valgus and pes planus. R. at 1232 (November 2008 entrance examination). But in Ms.
Ortega's November 2008 report of medical history, she denied any foot trouble. R. at 1217. There
is no separation examination for this period of service in the claims file. See Appellant's Br. at 3.
During a March 2011 VA examination for Ms. Ortega's knee, the foot disabilities seemingly
disappeared, as the examiner noted no bilateral foot symptoms or flare-ups of foot disease. R. at
3325. In July 2011, VA issued a memo stating that requested STRs were unavailable. R. at 3254.
Ms. Ortega's foot disability was not referenced during a November 2011 VA Gulf War
examination; the examiner noted no bilateral foot symptoms or flare-ups of foot disease. R. at
3194. And a September 2018 separation examination similarly noted that the veteran's feet were
normal. R. at 1569.
        In January 2020, Ms. Ortega filed a claim for service connection for bilateral pes planus
and bunions. R. at 989. She submitted a private December 2019 examination from a chiropractor,
Dr. Coley. Dr. Coley noted that the veteran began experiencing chronic foot pain during active
duty service and had bunions in service. R. at 993-94. She diagnosed bilateral pes planus
complicated by plantar fasciitis and bunions, noting that the onset was during service. Id.
        Later in January 2020, VA requested an examination, phrasing the question to the examiner
for each condition as follows: "Aggravation of a pre-existing condition. Was the Veteran's [foot
condition] (which clearly and unmistakably existed prior to service) aggravated beyond its natural
progression by preexisting on entrance exam during service?" R. at 596, 597, 598, 99.
        In August 2020, a VA examiner diagnosed bilateral hallux valgus and pes planus, R. at
569, but said there was no plantar fasciitis diagnosis as "[s]ymptoms are subjective only," R. at

                                                  9

566, 586. The examiner noted that the onset was 2009 and that Ms. Ortega reported that her boots
aggravated her feet and her condition worsened when she was deployed to Kuwait in 2018. R. at
571 (stating that she was on her feet for 12-hour shifts and experienced worsening foot pain and
cramping). The examiner opined that bunions were not clearly and unmistakably aggravated
beyond their natural progression by an in-service injury and that "[t]emporary aggravation is
plausible, but there is no evidence of permanent aggravation of the pre-existing [b]union right
foot." R. at 562-63, 588-89.
       VA then asked for an examination about the left bunion and bilateral pes planus, again
phrasing the question about each condition as follows: "Aggravation of a pre-existing condition.
Was the Veteran's [foot condition] (which clearly and unmistakably existed prior to service)
aggravated beyond its natural progression by preexisting on entrance exam during service?" R. at
558-61.
       In September 2020, a VA examiner opined that it was less than likely that her left foot
bunion and bilateral pes planus, complicated by plantar fasciitis, was aggravated beyond its natural
progression "by preexisting on entrance exam during service," explaining that the available service
treatment records showed no chronic diagnosis, complaint, evaluation, or treatment for a left foot
bunion or bilateral pes planus during active duty service. R. at 546, 550, 554 (also noting no
complaints about a left foot bunion or bilateral pes planus in her October 2018 separation exam).
       Later in September 2020, the AOJ denied service connection for hallux valgus and pes
planus. R. at 490; see R. at 489 (like the Board, also noting only her last two periods of active duty
service and not mentioning the first period from February to August 2009). This is the rating
decision that contains the flawed "favorable findings" that the claimed foot conditions existed
before service and that the November 2008 entrance examination showed a diagnosis of those
conditions. R. at 493-96. In November 2020, VA received her appeal. R. at 467.
       In the April 2024 decision on appeal, the Board found that, because the November 2008
entrance examination noted hallux valgus and pes planus, the presumption of soundness did not
apply. R. at 21. The Board stated the following:
       [N]otwithstanding the standard the AOJ asked the examiner to apply in rendering
       the requested opinion, the Board finds that the Veteran is not entitled to the standard
       of clear and unmistakable evidence, as both conditions were noted on an entrance
       examination, and the Veteran has not carried her burden of showing that the
       conditions increased in severity during her active service. The proper standard for
       the opinion was whether it is approximately at least as likely as not that the

                                                 10

        Veteran's existing disabilities increased in severity. The Board finds that the
        evidence is persuasively against a finding of increased severity of either.
R. at 22.
        The Board acknowledged the veteran's lay statements and those reported to Dr. Coley, who
noted that onset of the foot conditions began during active duty service. Id. But the Board found
that Dr. Coley did not indicate that she knew that both conditions existed before service. Id. The
Board also determined that Ms. Ortega's statements were at odds with her service treatment records
and separate claim for service connection for varicose veins. Id. The Board noted that, although
the veteran reported being on a running profile because of a foot condition, a 2017 service
treatment record showed that she was excused from running because of her left knee. Id. The Board
also highlighted that, in earlier statements, she had reported that being on her feet for 12-hour shifts
aggravated her leg pain and caused varicose veins but then, in a later statement, she said those
shifts caused feet pain and cramping. Id. The Board also looked to the lack of any complaints of
foot symptoms on her November 2018 separation exam, even as she reported that joint pain was
due solely to her knee disability. In that same report, her feet were assessed as normal. Id.
        The Board stated that, "[a]s concerns the VA examiner's initial opinion that temporary
exacerbations of the hallux valgus and pes planus was plausible, the Board interprets that statement
as meaning that it was not out of the realm of possibility, which the examiner may have based on
the Veteran's lay reported history." R. at 22-23. But the Board found that "plausible does not equate
to probable." Id. The Board concluded that the examiner opined that her review of the service
treatment records did not reveal a basis for her to state that the veteran's "current state" of hallux
valgus and pes planus was due to the rigors of her active duty service. R. at 23. Thus, the Board
denied service connection for the foot conditions.
                                             B. Analysis
        Challenging the premise that her disability preexisted service, Ms. Ortega argues that to
adopt the RO's or Board's findings, one would have to believe that she had preexisting hallux
valgus and pes planus in November 2008, which then disappeared between various VA and
military examinations. Appellant's Br. at 22. She asserts that neither the AOJ nor the Board
acknowledged these seemingly contradictory facts and based their findings of her conditions
preexisting service on only the 2008 entrance examination. Id. She also highlights that her service
treatment records were lost so there is an incomplete picture of her medical history during service.
Id. She contends that the AOJ did not consider this before determining that its findings that her
                                                  11

conditions preexisting service were "favorable" to her and that the Board blindly accepted those
findings. Id. at 22-23.
        Ms. Ortega also argues that the Board did not discuss whether the duty to assist was
satisfied when the VA examiners were told that her foot conditions "'clearly and unmistakably
existed prior to service'" and "then asked a nonsensical question of whether a preexisting condition
could be 'aggravated' by 'preexisting on entrance exam.'" Id. at 23.
        The Secretary responds that "the Board did not merely adopt the AOJ's unfavorable
findings"; instead, it independently concluded that the foot conditions clearly and unmistakably
preexisted service because those conditions were noted on the November 2008 entrance
examination. Secretary's Br. at 14 (later acknowledging that the findings that the foot conditions
preexisted service were "arguably unfavorable"). The Secretary did not address Ms. Ortega's
argument that the Board failed to discuss whether the duty to assist was met. On balance, we agree
with Ms. Ortega.
        With so much evidence against the conclusion that Ms. Ortega had a preexisting foot
disability, we'd expect some discussion from the Board on why it found otherwise. After all, the
Board is required to discuss such favorable evidence. Caluza v. Brown, 7 Vet.App. 498, 506
(1995), aff'd per curiam 78 F.3d 604 (Fed. Cir. 1996). In short, the Schrödinger-esque nature of
Ms. Ortega's potentially preexisting condition called for a response from the Board. The Board's
silence requires remand. See id.
        The inadequacy of the August and September 2020 VA examinations also requires remand.
First, recall that the Board acknowledged that the standard in the VA examination requests was
improper: "notwithstanding the standard the AOJ asked the examiner to apply in rendering the
requested opinion . . . The proper standard for the opinion was whether it is approximately at least
as likely as not that the Veteran's existing disabilities increased in severity." R. at 22. The Board
was right that this was the wrong standard.
        Under 38 U.S.C. § 1153, "[a] preexisting injury or disease will be considered to have been
aggravated by active . . . service, where there is an increase in disability during such service, unless
there is a specific finding that the increase in disability is due to the natural progress of the disease."
In other words, the veteran must show that service increased the severity of the preexisting
disability beyond its natural progression. Jensen v. Brown, 19 F.3d 1413, 1417 (Fed. Cir. 1994).

                                                    12

          Unsurprisingly, the VA examination requests that contained the incorrect standard, see R.
at 559-61, 596-99 ("Was the Veteran's [foot condition] (which clearly and unmistakably existed
prior to service) aggravated beyond its natural progression by preexisting on entrance exam during
service?"), resulted in inadequate VA examinations, see R. 563, 589 (the August 2020 examiner
opining that "[t]emporary aggravation is plausible, but there is no evidence of permanent
aggravation of the pre-existing [b]union right foot"); R. at 546, 550, 554 (the September 2020
examiner opining that it was less than likely that her left foot bunion and bilateral pes planus
complicated by plantar fasciitis was aggravated beyond its natural progression "by preexisting on
entrance exam during service").
          An adequate examination "sufficiently inform[s] the Board of a medical expert's judgment
on a medical question." Monzingo v. Shinseki, 26 Vet.App. 97, 105 (2012). If the question posed
by VA contains an incorrect, nonsensical standard and the examiner responds to that question by
reiterating the incorrect standard, then the Board was not sufficiently informed on that matter.
Here, in the September 2020 VA examination's conclusion, the examiner repeated the nonsense
contained within the examination request. R. at 546, 550, 554. And the August 2020 examination
addresses only right foot hallux valgus and provides inadequate rationale for its conclusion about
"temporary" aggravation. See Nieves-Rodriguez v. Peake, 22 Vet.App. 295, 304 (2008) (holding
that an adequate examination contains sufficient detail and rationale to permit the Board to make
a fully informed decision on a claim). Thus, remand is warranted for VA to obtain a new
examination with the proper standards for the bilateral hallux valgus and bilateral pes planus
claims.
          With reasons or bases remands and remands for new exams, we would ordinarily not
address other arguments that would not provide a greater remedy. Nor would we convene a panel
where all we're doing is applying well-settled law. But we have discretion to address additional
issues to provide guidance to VA on remand. See Quirin v. Shinseki, 22 Vet.App. 390, 395 (2009).
What's more, clarifying the status of the flawed favorable findings would provide Ms. Ortega with
additional benefits—she wouldn't be tied down by the binding nature of favorable findings. And
this is a novel issue that requires precedent. See Frankel, 1 Vet.App. at 25-26.
          In 38 U.S.C. § 5104(b)(4), Congress requires VA to identify findings that are favorable to
the claimant. Besides ensuring clarity and helping claimants decide how to structure any needed
appeal, this matters because "[a]ny finding favorable to the claimant . . . shall be binding on all

                                                  13

subsequent adjudicators within the Department, unless clear and convincing evidence is shown to
the contrary to rebut such favorable finding." 38 U.S.C. § 5104A. VA's regulation similarly makes
"[a]ny finding favorable to the claimant made by either a VA adjudicator . . . or by the Board . . .
binding on all subsequent [AOJ] and Board . . . adjudicators, unless rebutted by evidence that
identifies a clear and unmistakable error in the favorable finding." 38 C.F.R. § 3.104(c) (2025).
       Congress decided that only favorable findings would be binding on subsequent
adjudicators. The ordinary meaning of favorable would include those findings that are
advantageous or give a result in one's favor. See Food Mktg. Inst. v. Argus Leader Media, 588 U.S.
427, 436 (2019) (holding that, in statutory interpretation, a court's starting point is the ordinary
meaning and structure of the law); see also https://www.merriam-webster.com/dictionary/
favorable (last visited March 26, 2026). Thus, a finding is only binding if it is advantageous or
helps the claimant. And when that finding doesn't help, Congress did not want VA to treat it as
binding. The simple inquiry for any VA adjudicator when considering awarding a benefit is
whether a finding helps the claimant get that particular benefit; if it does, the finding is binding
absent clear error—at least with respect to that issue. If it doesn't help, the adjudicator is not bound
by that finding.
       Here, we don't know whether the Board thought it was bound by the AOJ calling the finding
about a preexisting disability favorable, because the Board didn't address this issue. If it did, such
a conclusion here would be plainly wrong. This isn't to say that finding a preexisting disability can
never be favorable. Obviously in a case focused on establishing aggravation of a preexisting
disability, getting this element checked off as favorable would help. And without exhausting all
other possibilities for how this could be favorable, such a finding could indirectly help ensure that
a claimant meets the current disability element needed for service connection. But here, the AOJ
had already favorably found that Ms. Ortega had a current disability. And so, the finding that Ms.
Ortega's foot conditions preexisted service appears to be entirely unfavorable. If a condition
preexisted service, that means that the presumption of soundness—a presumption that is generally
beneficial to veterans—does not apply. See Horn v. Shinseki, 25 Vet.App. 231, 234 (2012) ("The
burden then falls on VA to rebut the presumption of soundness."). Thus, the AOJ's finding has no
binding effect on the Board or subsequent VA adjudicators.
       Besides raising questions about the binding effect of the finding, Ms. Ortega also argued
that VA gave her inadequate notice by mislabeling the finding. We don't need to reach that

                                                  14

question, given that her case is returning to the AOJ for a new exam. The record will reopen once
the case is back with the AOJ and Ms. Ortega now knows that the finding is not favorable.
       What's more, we have already observed that 38 C.F.R. § 20.802(a) gives the Board
authority to consider remanding for correction of errors in addition to duty to assist errors. See
Gladish v. Collins, 39 Vet. App. 1, 14 (2025). Had Ms. Ortega brought up her notice confusion to
the Board, or if the error was reasonably raised as a problem by the record, our precedent already
provides a remedy. Id.
                                        C. Remand Instructions
       Where does this leave us? The Board failed to consider the records showing that Ms. Ortega
did not have a foot disability before her last period of service. Thus, we are vacating the Board's
finding that the foot conditions preexisted service. And because VA obtained medical exams using
the wrong standard, the Board must return this matter to the AOJ so that VA can obtain exams
under the proper legal standard—that is, the new VA foot examination should reflect the correct
standards regarding preexisting conditions, presumption of soundness, direct service connection,
and aggravation. When the AOJ readjudicates this claim or obtains new exams, it is not bound by
the flawed finding that Ms. Ortega's disabilities preexisted service, just as it is not bound by any
finding that is not favorable to her.

                      III. NON-PRECEDENTIAL DETERMINATIONS
       We will now address three non-precedential matters concerning the CFS, GERD, and left
knee scar claims. Much like our findings above about the foot exams or the Board's reasons or
bases, these determinations do not create precedent.
                                               A. CFS
       Ms. Ortega notes that the Board found that the September 2020 "VA examination report
does not include any findings that would trigger a work-up, to include the fact that the examiner
did not suggest that one was needed to determine if the Veteran has CFS," but argues that this is
not what the examination stated. Appellant's Br. at 27 (citing R. at 19, 532-41).
       In September 2020, the VA examiner noted that Ms. Ortega reported experiencing extreme
fatigue after deployment and that she "has made an appointment for a work-up for [CFS], but due
to C[OVID-19], veteran has been unable to get in with VA PCP." R. at 533. When asked, "Have
other clinical conditions that may produce similar symptoms been excluded by history, physical

                                                 15

examination, and/or laboratory tests to the extent possible?" the examiner marked "no" and stated
that "per veteran, lab tests have not been completed to exclude other clinical conditions." R. at 534.
       Although the Board acknowledged "the Veteran's report that the Pandemic precluded her
from undergoing a work-up for CFS," R. at 19, it still found that the examination did not include
any findings that would trigger a work-up, id. However, it does seem that a work-up was in
progress—she stated that she had made an appointment for one—but was delayed due to COVID-
19. Thus, the Board's characterization of the September 2020 examination—that it did not suggest
that a work-up was needed to determine whether Ms. Ortega had CFS—is not accurate. And so, a
remand is warranted for the Board to adequately consider the September 2020 examination. See
Tucker, 11 Vet.App. at 374; Gilbert, 1 Vet.App. at 56-57.
       Because we are remanding the CFS claim, we need not address Ms. Ortega's additional
arguments, which would not lead to a remedy greater than remand. See Best v. Principi, 15
Vet.App. 18, 19 (2001). And Ms. Ortega may make these arguments on remand. See Kay v.
Principi, 16 Vet.App. 529, 534 (2002); Kutscherousky v. West, 12 Vet.App. 369, 372–73 (1999)
(per curiam order); see also Clark v. O'Rourke, 30 Vet.App. 92, 97 (2018).
                                             B. GERD
       Ms. Ortega asserts that the Board overlooked favorable evidence about her GERD claim,
including information within Dr. Coley's opinion. Appellant's Br. at 28-29.
       The Board stated that "Dr. C[oley] had no comment on the Veteran's GERD other than that
service connection should be continued." R. at 12 (denying a GERD rating above 10%). However,
Dr. Coley noted in her December 2019 opinion that, "[s]ince service connection there has been
extension of [GERD], to include frequent heartburn, vomiting, pain in the chest and left
arm/shoulder, and at times, choking. She sleeps on an incline to manage the condition at night."
R. at 993.
       Ms. Ortega's GERD is rated by analogy under 38 C.F.R. § 4.114, Diagnostic Code (DC)
7346 (hiatal hernia). At the time of the April 2024 Board decision, DC 7346 provided a 30% rating
for "[p]ersistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation,

                                                 16

accompanied by substernal or arm or shoulder pain, productive of considerable impairment of
health" and a 10% rating for "two or more symptoms for the 30[%] evaluation of less severity."8
        The Board noted that an August 2020 VA examiner indicated that the sole symptoms the
veteran reported were reflux and regurgitation. R. at 12. But, again, Dr. Coley noted arm/shoulder
pain and the prior 30% rating criteria included arm or shoulder pain. Dr. Coley also documented
that Ms. Ortega sometimes experienced choking and the prior 30% rating criteria included
dysphagia (trouble swallowing). Thus, even if Dr. Coley's notation of heartburn and vomiting is
similar to the August 2020 examiner's notation of reflux and regurgitation, there are two other
symptoms aside from those.
        And so, although the Board noted Dr. Coley's opinion, it did not provide adequate reasons
for rejecting the favorable evidence contained within. See Caluza, 7 Vet.App. at 506. The Secretary
argues that the veteran focuses on the number of symptoms, but the 30% rating requires
"considerable impairment in health." Secretary's Br. at 22. He asserts that Dr. Coley offered no
opinion on the severity of Ms. Ortega's symptoms, other than to say that she sleeps at an incline.
It may be true that this ultimately does not show a "considerable impairment of health," but that is
for the Board to discuss, which it did not. See Caluza, 7 Vet.App. at 506; see also Washington v.
Nicholson, 19 Vet.App. 362, 369 (2005) (holding that the Board must in the first instance assess
and weigh the evidence).
        Thus, remand of the GERD claim is warranted. See Tucker, 11 Vet.App. at 374. On remand,
the Board can also fix the characterization of the appeal period to reflect January 17, 2020, rather
than July 17, 2020, as it mistakenly noted. R. at 12; see Appellant's Br. at 28.
                                            C. Left Knee Scars
        Ms. Ortega contends that the Board overlooked favorable evidence, including the reason
for her November 2018 knee surgery—which was to debride symptomatic scar tissue—and that,
in 2017, she complained of her knee being worse because of scar tissue. Appellant's Br. at 29-30
(citing R. at 2449-50, 2381). First, the Court notes that she seems to mischaracterize the 2017
report, which was contained in a VA social work note and noted: "Veteran stated she's been trying
to make sure that she doesn't do anything to make her knee worse as she has some scar tissue from

        8
          An amended version became effective May 2024, which now states that DC 7346 (hiatal hernia and
paraoesophageal hernia) is to be rated under DC 7203 (stricture of esophagus). That rating criteria focuses on
dysphagia (trouble swallowing).

                                                     17

her previous surgery but that she is going to a chiropractor . . . to work on it." R. at 2381. This does
not appear to say that her knee was worse because of scar tissue. However, the November 2018
operative note stated that the pre-operative and post-operative diagnosis was "symptomatic intra-
articular scar tissue, left knee" and that one of the procedures performed was debridement of scar
tissue. R. at 2449 (noting that the veteran had re-torn her ACL).
        The Board denied a rating above 0% for left knee residual surgical scars. The Board stated
that the criteria for a compensable rating for the scars had not been met and cited 38 C.F.R. § 4.118,
DC 7804. R. at 7. Under DC 7804, a 10% rating is warranted for "one or two scars that are unstable
or painful" and Note (1) provides that an "unstable scar is one where, for any reason, there is
frequent loss of covering of skin over the scar." The Board noted that in August 2020, a VA
examiner documented three scars and that they were healed, stable, and not painful. R. at 14-15.
The Board also mentioned Dr. Coley's private December 2019 record in which she stated that the
scars were painful, tender to touch, and itched. R. at 15. The Board then afforded greater weight
to the other evidence than to Dr. Coley's opinion. Id. The Board found that it was unclear if Dr.
Coley had examined the veteran's scars or relied on her lay statements. Id. The Board also stated
that a March 2018 service treatment record noted that the scar over the midline was well healed.
R. at 15-16. The Board then mentioned the August 2020 examination again, which said that the
scars were stable and not painful. R. at 16.
        But the Board did not discuss the November 2018 operative note, which, again, stated that
the pre-operative and post-operative diagnosis was "symptomatic intra-articular scar tissue, left
knee" and that one of the procedures performed was debridement of scar tissue. The November
2018 operative note came after the March 2018 record stating that a scar was well healed and
before the August 2020 VA examination noting that the scars were stable and not painful. The
November 2018 operative note does not state that the scars were unstable or painful, but it did say
that the scar tissue was "symptomatic." And that is seemingly favorable evidence, particularly in
light of the December 2019 private opinion stating that the scars were painful. Perhaps Ms. Ortega
would only get a staged increased rating rather than one for the entire appeal period. But it is for
the Board to discuss that evidence and weigh it against the other evidence of record. See
Washington, 19 Vet.App. at 369; Caluza, 7 Vet.App. at 506. And so, remand of the left knee scar
claim is also warranted. See Tucker, 11 Vet.App. at 374.

                                                  18

                                       IV. CONCLUSION
       Based on the above, the part of the Board decision granting a 50% cephalgia rating is
AFFIRMED. The parts of the Board decision denying service connection for left and right foot
hallux valgus and left and right foot pes planus are VACATED and those claims are REMANDED
for adjudication consistent with the instructions noted in this opinion. And the parts of the Board
decision denying a GERD rating above 10%, a compensable left knee scar rating, and service
connection for CFS are VACATED and those claims are REMANDED.

       JAQUITH, Judge, concurring in part and dissenting in part: I concur in the Court's decision
to vacate the parts of the Board decision denying service connection for left and right foot hallux
valgus, left and right foot pes planus, and CFS, and the parts of the Board decision denying a
GERD rating above 10% and a compensable left knee scar rating, and remanding all of those
claims. But I dissent from the majority's affirmance of the Board's 50% cephalgia rating, and from
the majority's determination that the obviously erroneous notice by the Board was not prejudicial—
which may affect all of the veteran's disability ratings on remand.
                            A. Remand for Extraschedular Consideration
       Before further addressing the notice issue, there is a problem that should put the Board's
cephalgia rating with the rating decisions vacated and remanded in the non-precedential portion of
the Court's opinion. In September 2020, the AOJ granted service connection for cephalgia with an
evaluation of 30%. R. at 480. The veteran's October 2020 NOD appealed her cephalgia rating,
saying that it "should be 60%." R. at 467. The Board found that the veteran's migraine headaches
are evaluated under 38 C.F.R. § 4.124a, Diagnostic Code 8100 (2025), which provides for a
maximum rating of 50%. R. at 9. The Board relied on the findings and opinions of a private
physician in concluding that, rather than the 30% rating by the AOJ, "the Veteran’s headaches are
more accurately characterized by an initial disability rating of 50%." R. at 11. However, the Board
did not even mention that the veteran sought a 60% rating, which would be extraschedular. When
a claimant "suggests that a schedular rating may be inadequate, the Board must specifically
adjudicate the issue of whether referral for an extraschedular rating is warranted." Thun v. Peake,
22 Vet.App. 111, 115 (2008), aff'd sub nom. Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). The
Court should remand the cephalgia claim for the Board to comply with Thun. Even if the majority
envisions expanding the holding in Witkowski to render referral unnecessary, the Board must

                                                19

specifically decide whether to refer the extraschedular rating issue or "hear those arguments itself
[and adjudicate the issue]—as its jurisdiction would otherwise permit." Witkowski v. Collins, 38
Vet.App. 459, 470 (2025) (en banc). But see 38 C.F.R. § 3.321(b)(1) (2025) ("To accord justice to
the exceptional case where the schedular evaluation is inadequate to rate a single service-connected
disability, the Director of Compensation Service . . . is authorized to approve . . . an extra-schedular
evaluation commensurate with the average impairment of earning capacity due exclusively to the
disability."); Bell v. McDonough, 85 F.4th 1383, 1385 (Fed. Cir. 2023) (relying on Thun's
endorsement of "the agency's long-standing interpretation of § 3.321(b)(1) as allowing agency
recommendations alongside any requests for an extra-schedular determination").
       Having followed the Board's lead in overlooking the veteran's claim for an extraschedular
rating of her cephalgia, the majority blames the veteran. Ante at 8 n.7. That fingerpointing is
misplaced, for the veteran specified that the cephalgia rating she appealed "should be 60%," R. at
467—and thus above the regulatory maximum—and then argued that the Board's notice errors
deprived her of due process and the corresponding guaranty of a meaningful opportunity to submit
evidence, especially where VA strictly applies the evidentiary record rule specified by section
7113(c). Reply Br. at 3-4. The veteran argued that, with proper notice, she could have "submitted
the favorable medical evidence of record dated January through February 2021 that rebutted many
of the Board’s findings in the decision on appeal." Appellant's Br. at 19-20; OA at 19:10-26 ("just
from the medical treatment records that we have from that 90-day period there is evidence there
that she could have submitted that would have supported her claims"); see R. at 145-367; see also
infra at 26. And she argued for remand because the effect of her lost opportunity to submit even
more evidence to support an extraschedular rating for cephalgia was unquantifiable. Appellant's
Br. at 20. Moreover, the Court's review authority is not cabined by the parties' arguments. See 38
U.S.C. § 7261; Patton v. West, 12 Vet.App. 272, 283 (1999) ("[C]ourts of appeals have the
discretion to raise legal issues not raised by a party."); Kamen v. Kemper Fin. Servs., Inc., 500 U.S.
90, 99 (1991) ("[T]he court is not limited to the particular legal theories advanced by the parties,
but rather retains the independent power to identify and apply the proper construction of governing
law."). The veteran's appeal to the Board sought an extraschedular rating for her cephalgia and her
appeal to the Court of the Board's failure to award an extraschedular rating focused on having a
meaningful opportunity to submit evidence in support of that appeal. In reviewing the Board's
decision, the Court could consider the dispositive issue of the Board's complete failure to fulfill its

                                                  20

obligation to address the veteran's pursuit of an extraschedular rating even if the parties failed to
specifically identify and brief it. See U.S. Nat. Bank of Oregon v. Indep. Ins. Agents of Am., Inc.,
508 U.S. 439, 447 (1993). The Board's failure to adjudicate the extraschedular rating issue is as
obvious as the Board's denial of due process, but the majority chooses to look the other way. See
Jonathan Swift, A TREATISE ON POLITE CONVERSATION 85 (1783) ("[T]here's none so blind, as
they that won't see.").
                                          B. Incorrect Notice
       The majority identifies only half the problem in its framing of the due process issue. The
majority asks—but decides not to answer—whether the Board violated Ms. Ortega's due process
rights when it notified her that it received her NOD after the 90-day deadline to submit evidence
had already passed. Ante at 9. The majority fails to mention that VA gave incorrect notice to begin
with, even criticizing the claimant for failing to satisfy the incorrect deadline VA specified.
       The AOJ's notice letter described VA's decision and said that, if the veteran disagreed with
the decision, she had one year to select from three review options and submit the required
application form. R. at 470. Regarding appealing to the Board, an attached form advised that the
veteran "may request a hearing with a Veterans Law Judge and/or the opportunity to submit
additional evidence." R. at 478. There was no notice of the time frame or deadline for submitting
evidence. The notice did not include the required application form, instead referring the veteran to
a website to obtain one. R. at 479.
       The veteran located an NOD (VA Form 10182) and signed and submitted it on October 27,
2020, appealing the ratings for the disabilities at issue: her cephalgia, GERD, left knee scars, CFS,
bilateral hallux valgus, and bilateral pes planus. R. at 467. The review option she chose was
"Evidence Submission Reviewed by a Veterans Law Judge." Id. The preprinted form said, "I have
additional evidence in support of my appeal that I will provide within the next 90 days, but I do
not want a Board hearing." R. at 467. That "within the next 90 days" language on the preprinted
form was the only notice of the veteran's opportunity to submit evidence. Unfortunately, that notice
was patently incorrect. The applicable statute and regulation both provide that, for cases in which
a hearing is not sought but an opportunity to submit evidence is requested, the evidentiary record
before the Board is limited to the evidence considered by the AOJ, evidence submitted by the
appellant with the NOD, and evidence submitted by the appellant "within 90 days following receipt

                                                 21

of the [NOD]." 38 U.S.C. § 7113(c); 38 C.F.R. § 20.303. Not "within the next 90 days"—within
90 days following the Board's receipt of the veteran's NOD.9
         Adequate notice is '''[a]n elementary and fundamental requirement of due process.'"
Memphis Light, Gas & Water Div. v. Craft, 436 U.S. 1, 13 (1978) (quoting Mullane v. Central
Hanover Trust Co., 339 U.S. 306, 314 (1950)). "[A]ctual notice is a minimum constitutional
precondition" when, as here, the proceedings may adversely affect a veteran's property interest in
her benefits. Mennonite Bd. of Missions v. Adams, 462 U.S. 791, 800 (1983); see Cushman v.
Shinseki, 576 F.3d 1290, 1298 (Fed. Cir. 2009) (holding that a veteran's "entitlement to [disability]
benefits is a property interest protected by the Due Process Clause of the Fifth Amendment to the
United States Constitution"). Indeed, "[t]he entire thrust of the VA's nonadversarial claims system
is predicated upon a structure which provides for notice and an opportunity to be heard at virtually
every step in the process." Thurber v. Brown, 5 Vet. App. 119, 123 (1993).
         The AOJ is required to inform claimants for whom it has determined entitlement or
nonentitlement of VA benefits, "of appellate rights provided by 38 U.S.C. chapters 71 and 72,"
which include the right guaranteed by section 7113(c) to submit evidence within 90 days following
the Board's receipt of the veteran's NOD. 38 C.F.R. § 20.200 (2025).
         Accepting incorrect notice as satisfying due process "would make the notice requirement
useless, which is not acceptable in a nonadversarial system built on notice and the opportunity to
be heard." Wiker v. McDonough, 36 Vet.App. 119, 126 (2023). Simply put, for notice to be
adequate it must be accurate. Cook v. McDonough, 36 Vet.App. 175, 189 (2023). Although the
Secretary inexplicably argues that there was no notice error, section 7113(c) says otherwise.
Comparing the statute and VA's form, it is indisputable that VA erred. See Wiker, 36 Vet.App. at
126 ("[W]hen VA says in a regulation that it intends to give a veteran notice, we assume that means
VA will give the veteran correct notice. And when it falls short of that, as it did here, VA errs.").
                                C. Misleading Notice That's Too Little Too Late
         The Board compounded VA's notice error by never telling the veteran when VA received
her NOD and by not providing correct notice until after the time for submitting evidence had

         9
           Comparing the form to the statute and regulation is all that is needed to conclusively establish error. That
VA subsequently corrected the form is a permissible consideration, given that the Federal Rules of Evidence have
been held inapplicable to Board proceedings, see, e.g., Boykin v. Derwinski, 2 Vet.App. 479, 481 (1992), but the
importance of the correction is that it diminishes the cost of VA doing the right thing to cases that arose before it fixed
the problem—assuming the other notice shortcomings are also fixed.

                                                           22

passed. R. at 428. The veteran signed and mailed her NOD on October 27, 2020. R. at 467, 465.
VA received her NOD on November 5, 2020, but never told the veteran that. R. at 465-66, 429-
30. Instead, in its letter dated February 4, 2021, the Board said that it had received the veteran's
"Board appeal request," without saying when, and that the veteran had 90 days from the
(unspecified) date of the Board's receipt of her appeal to submit new evidence. R. at 428. The
Board knew that it had received the veteran's NOD on November 5 and knew—or most certainly
should have known, by simply counting the days—that her 90-day window had already expired
when it finally and misleadingly provided accurate notice of that window.
       The majority is unconcerned about the Board's neglectful illusion and blames the veteran
for failing to make it through the misinformation. Ante at 4-5. The majority dismisses the veteran's
"expectation that she would be notified when VA received her NOD and she would then submit
evidence" because the majority "can't understand the origin of this expectation." Ante at 5. But the
origin of that expectation was explained at oral argument: "in the regulatory history for the
evidence lane, VA said this very concern was raised, and VA said, 'we will notify claimants in
accordance with our laws, like we usually do.'" OA 17:40-54. The majority is deaf to her argument,
ante at 5 n.3, but the veteran's detrimental reliance was made clear—her counsel expressly said, in
response to a question from the panel about the veteran not submitting evidence, that "she was
reasonably waiting for notice that her 10182 had arrived" . . . "her expectation was that she would
be notified and then would submit evidence once she knew that it had arrived." OA 16:50-17:10.
Moreover, the veteran's expectation was right. In promulgating 38 C.F.R. § 20.202(b)(3) following
the enactment of the AMA, VA related that "commenters expressed concern that VA does not
provide adequate notice as to when it received the [NOD] and therefore the veteran will not be
able to calculate the relevant deadlines [for the submission of evidence]." VA Claims and Appeals
Modernization, 84 Fed. Reg. 138, 152 (Jan. 18, 2019) (codified at 38 C.F.R. pts. 3, 8, 14, 19, 20,
and 21). VA said that it "carefully considered this comment" and determined that no changes were
required because "it is currently the Board's practice to notify veterans and representatives when
an appeal has been received and docketed at the Board" and that even if VA's notice procedures
changed based on technological systems and resources, "VA will continue to address this matter

                                                23

through internal procedural guidance consistent with the law and regulations." Id. In this case, the
Board did not fulfill VA's assurance.10
         The veteran also argued that 38 C.F.R. § 3.110 required VA to calculate the 90-day period
for submitting evidence from the date the Board mailed her notification of its receipt of her NOD.
OA at 2:03-28; Appellant's Br. at 13; Reply Br. at 4-6. Section 3.110 provides, in subsection (a),
that, "[i]n computing the time limit for any action required of a claimant or beneficiary, including
the filing of claims or evidence requested by VA, the first day of the specified period will be
excluded," and in subsection (b) that "[t]he first day of the specified period referred to in paragraph
(a) of this section shall be the date of mailing of notification to the claimant or beneficiary of the
action required and the time limit therefor." 38 C.F.R. § 3.110 (2025). As the veteran highlights,
VA said § 3.110(b) was added because, "If claimants or beneficiaries are not furnished notice of
the time limits within which they are required to act, it is unreasonable to penalize them for failing
to act within those time limits." Procedural Due Process, 53 Fed. Reg. 37,797, 37,799 (Sep. 28,
1988). In promulgating the final rule, VA said the amendments were necessary "because of the
need for more specificity in VA regulations on procedural due process." Procedural Due Process,
55 Fed. Reg. 13,522 (Apr. 11, 1990). VA specified that "it is the intent of VA to ensure, to the
maximum extent practicable, that notice of any time limit within which a claimant or beneficiary
must act, to perfect a claim or challenge an adverse VA decision, is effectively communicated to
that claimant or beneficiary [because i]neffective notice is tantamount to no notice." Id. at 13,526.
And VA specifically chose that "time limits established by VA regulations are computed from the
date of the letter of notification [because t]he date of the letter of notification is known by VA,
whereas the date of the postmark is not." Id. at 13,527.
         The majority apparently favors the Secretary's view that § 3.110 doesn't apply because
claimants are not required to submit evidence. Ante at 5 n.4; Secretary's Br. at 11. But the
regulation gives, as an example of actions "required" of a claimant, "the filing of claims." 38 C.F.R.

         10
           The Board also failed to follow through on its current process promise—"If the Board agrees to review
your case, you’ll get a letter telling you that the Board has added your case to the docket."—until it was too late to
submit evidence. See Board Appeals, https://www.va.gov/decision-reviews/board-appeal/ Board Appeals (last visited
Mar. 25, 2026). "If the Veteran submits an AMA NOD without selecting a Board review option, identifying the issues
the Veteran wants to appeal, or that is unsigned, a clarification letter is sent to the Veteran." BOARD OF VETERANS’
APPEALS OPERATIONS HANDBOOK, AMA Appeals Received at the Board 15 (April 2020). If no clarification is needed
and the NOD is timely, "a Docketing Letter will be sent to the Veteran confirming an appeal has been docketed by the
Board." Id. To the extent that this process was followed, it did not include meaningful notice of the actual 90-day
window within which the veteran could submit evidence.

                                                         24

§ 3.110(a). Sure, veterans must file an NOD to go to the Board, but they also must submit evidence
within the time limits set forth by section 7113 to get that evidence considered by the Board.
Neither action is mandatory in a strict sense—the veteran could choose to file a supplemental claim
or HLR request (or forgo the appeal entirely) rather than submit an NOD, just as he or she could
chose the direct review or hearing dockets at the Board rather than opt for evidence submission.
Just as an NOD is required to appeal to the Board, evidence is required to be submitted within the
specified window to be considered by the Board.
        The majority now acknowledges that the Court has held that § 3.110 sets the time limit for
appealing rating decisions, ante at 6 n.5, so filing an NOD is a "required" action under § 3.110.
See Rowell v. Principi, 4 Vet. App. 9, 15 (1993) (stating that § 3.110 clarifies the computation of
the time limit for filing NODs such that "the letter notifying the veteran of the July 21, 1988, initial
denial of his claim [wa]s dated August 3, 1988," so "under paragraphs (b) and (a), respectively, of
§ 3.110, August 3, 1988, is considered 'the first day of the specified period,' and that day is
excluded from consideration in computing the time period for filing"); see also Wells v. Peake,
No. 07-0913, 2008 WL 5111436, at *2 (Vet. App. Nov. 26, 2008) (applying § 3.110(b) to
determine the time limit to file a Substantive Appeal); Bautista v. Brown, No. 92-0268, 1993 WL
439090, at *1 (Vet. App. Oct. 25, 1993) ("In the instant case, because the letter notifying the
appellant of the October 28, 1988, rating decision denying his claim was dated November 14,
1988, the one-year period for filing the NOD began on November 15, 1988, and ended on
November 14, 1989.").
        The regulations cited at the end of § 3.110(b) are not in conflict with the regulation's
application to starting the 90-day evidentiary window clock. Sections 19.52 and 20.203 adopt §
3.110(b)'s equivalency of the date of the letter and the date of mailing in the context of AOJ
determinations that start the NOD clock, NODs, and Substantive Appeals, and § 20.110 accepts
the postmark dates of claimants' filings that precede the expiration of applicable time limits.
Reading the regulations together, see Williams v. McDonough, 37 Vet.App. 305, 310 (2024), §
3.110's computation for the time period beginning on the date the Board mails notice to the
claimant of the time limit meshes perfectly with § 20.110's provisions that the time limit must end
on a workday and that a response postmarked prior to the end of the time period must be accepted
as having been timely filed. 38 C.F.R. §§ 3.110, 20.110. Effective communication of notice of the
time limit within which the veteran must have submitted evidence to challenge the adverse VA

                                                  25

decisions is assuredly within the ambit of § 3.110, see 55 Fed. Reg. at 13,526, but was not provided
by the Board or the AOJ.
                                D. The Notice Errors Were Prejudicial
       "[P]rejudice is established by demonstrating a disruption of the essential fairness of the
adjudication, which can be shown by demonstrating that the error . . . affected or could have
affected the outcome of the determination." Simmons v. Wilkie, 30 Vet.App. 267, 279 (2018), aff'd,
964 F.3d 1381 (Fed. Cir. 2020). The claimant is required to explain how the error caused him or
her harm. Shinseki v. Sanders, 556 U.S. 396, 410 (2009). The obvious prejudice here is that the
veteran never submitted additional evidence in support of her appeal. She explained how that
happened. She expected that she would be notified, as VA promised, when VA received her NOD
and accepted her appeal, and she would submit evidence then. OA at 16:51-17:12. When she
finally received the Board's February 4, 2021, letter, she guessed that it was too late to submit
evidence. OA at 16:20-17:15; Reply Br. at 1. After all, she knew that she had sent her NOD to the
Board on October 27, 2020, and she had waited for the Board to notify her that it had received and
accepted her appeal, but that had never happened. Then she received a letter from the Board dated
February 4, 2021, that said she had 90 days from when the Board had received her NOD to have
submitted evidence—still without telling her when such receipt had happened. Although she didn't
know until much later, the Board had received her NOD on November 5, 2020—9 days after she
sent it. If it took the same 9 days for the Board's letter to arrive, it would have been 109 days since
she sent the Board her NOD. So it is not surprising that she guessed that it was too late for her to
submit evidence and her guess was a reasonable and undoubtedly correct one in light of the precise
evidentiary record requirements spelled out by statute and regulation—see, e.g., 38 U.S.C. § 7113;
Green v. McDonough, 37 Vet.App. 127, 135 (2024); and 38 C.F.R. §§ 20.301-.303 (2025)—and
the strict enforcement by VA and the Board of the veteran's requirements but not the requirements
for timely, accurate agency notice. "From VA's perspective, the closing of the evidentiary record
is one of the foundational features of the AMA, and one of its most valuable in terms of enabling
VA, over time, to process claims and appeals more efficiently." VA Claims and Appeals
Modernization, 84 Fed. Reg. 138, 140 (Jan. 18, 2019). However, the Congressional design of the
AMA to "help ensure that the process is both timely and fair,'" H. Rep. No. 115-135 at 5 (2017),
depends on clear, accurate, timely, and complete notice. Such notice was pivotal here because the
record shows that the veteran had material evidence to submit.

                                                  26

       At the time of her September 2020 VA examination, the treatment plan for the veteran's
migraines included only over-the-counter Tylenol as needed. R. at 525. Army treatment records
show that on January 10, 2021, and again on January 25, 2021, the veteran was provided 50 mg
sumatriptan succinate tablets to take at the start of migraine attacks. R. at 163, 199. On January
10, she was provided 27 tablets and told to take one tablet when an attack began and then take
another tablet in 2 hours if necessary, but not more than 2 doses in 24 hours. R. at 163. In her refill
on January 25, she was also instructed to start with one tablet and repeat in 2 hours as needed, and
up to a maximum of 200 mg (which would be 4 doses) in 24 hours. R. at 199. "According to the
American Headache Society guidelines, sumatriptan is recommended for the acute treatment of
moderate-to-severe migraines." StatPearls, Sumatriptan, https://www.ncbi.nlm.nih.gov/books/
NBK470206/ (last updated Nov. 12, 2023). See MigraineBuddy, Managing Severe Migraines:
When to Use Sumatriptan, https://migrainebuddy.com/managing-severe-migraines-when-to-use-
sumatriptan/ (Oct. 30, 2023) ("Sumatriptan is a commonly prescribed medication for managing
severe migraines.").
       Army treatment records also reflect evidence within the proper time window (through
February 3, 2021) of other disabilities at issue, including the prescription of Diclofenac gel to treat
the veteran's left knee scar pain, R. at 162, 224, and 230; the prescription of omeprazole to treat
the veteran's GERD, R. at 199, 221, 223, 225, 226, and 230; and treatment for the veteran's chronic
fatigue, R. at 223, 225, 229, and 232.
                                             E. Conclusion
       At the very least, the Board's affirmance of the cephalgia rating should be vacated and
remanded so the Board can address (1) the veteran's request for an extraschedular rating, and (2)
the notice errors—which the Board apparently did not realize VA and it had made—and then
provide proper notice, afford the veteran her heretofore lost opportunity to submit additional
evidence, and find facts to assess prejudice in the first instance. See Tadlock v. McDonough, 5
F.4th 1327, 1337-38 (Fed. Cir. 2021). "Where the effect of an error on the outcome of a proceeding
is unquantifiable, however, we will not speculate as to what the outcome might have been had the
error not occurred." Wagner v. United States, 365 F.3d 1358, 1365 (Fed. Cir. 2004) (quoted with
approval by Cowan v. McDonough, 35 Vet.App. 232, 249 (2022)).
       The majority reallocates the agency's notice obligation to the veteran, or at least leaves the
veteran to bear the burden of the notice errors by VA and the Board. Ms. Ortega did not miss her

                                                  27

shot, ante at 7; VA and the Board hid the target. "[A] party's ability to take steps to safeguard its
interests does not relieve the [agency] of its constitutional obligation." Mennonite Bd. of Missions,
462 U.S. at 800 (holding that notice by means "certain to ensure actual notice is a minimum
constitutional precondition to a proceeding which will adversely affect the liberty or property
interests of any party"). And "the availability of supplemental claims is not the panacea for all
Board procedural errors that the Secretary suggests." Bolds v. McDonough, 37 Vet.App. 359, 370
(2024). "Prejudice is established by demonstrating a disruption of the essential fairness of the
adjudication, either by showing an error that prevented the claimant from effectively participating
in the adjudicative process or that affected or could have affected the outcome of a decision." Id.,
citing Simmons, 30 Vet.App. at 279. At a minimum, it is beyond cavil that the notice errors here
could have affected the outcome.
        "Close enough for government work" may be a bureaucracy's battle cry, but it has no place
in denying one who has borne the actual battle timely, correct notice and the meaningful
opportunity to be heard that such notice enables. (Ms. Ortega earned a Combat Action Badge for
being actively engaged with the enemy in Afghanistan when a rocket hit the front of her living
quarters and she administered first aid to two roommates who suffered bleeding wounds. R. at 269,
3481.) "Are we to become just another of the cascading impediments faced by veterans seeking
the benefits conferred by Congress?" Rosinski v. Shulkin, 29 Vet.App. 183, 197 (2018) (Greenberg,
J., dissenting).
        The majority embraces the perfect trap for the unwary: in accordance with the explicit
Congressional creation of an evidentiary record restriction that begins upon VA's receipt of the
veteran's NOD and extends for 90 days, VA promulgated a regulation mimicking the statute but
then provided incorrect notice of when the 90 days started, never told the veteran when it received
her NOD, and only provided an accurate description of the event (but not the date) that started the
90 days after the 90-day deadline had expired. However, "[t]he VA disability compensation system
is not meant to be a trap for the unwary." Comer v. Peake, 552 F.3d 1362, 1369 (Fed. Cir. 2009).
        Creating confusion through inattention to notice requirements and then capitalizing on
errors to deny benefits is intolerable in a disability compensation system "so uniquely pro-
claimant, [where] the importance of systemic fairness and the appearance of fairness carries great
weight," and "the ability of the Board to render a fair, or apparently fair, decision may depend on
the veteran's ability to ensure the Board has all potentially relevant evidence before it." Hodge v.

                                                 28

West, 155 F.3d 1356, 1363 (Fed. Cir. 1998). I respectfully dissent from both the affirmance of the
denial of the veteran's cephalgia claim and the Court's finding that the clear errors in the doubly
faulty notice here were not prejudicial.

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