The U.S. Court of Appeals for the Federal Circuit (“Fed. Cir.”) recently issued a precedental decision that involved the application of the “implicit denial rule.” Generally, when a veteran files either a formal or informal claim, the claim is pending until it is 1) finally adjudicated, and 2) the veteran is notified of the denial. There are circumstances, however, where a claim is “deemed” to have been denied and finally adjudicated even if VA did not explicitly address that claim in the denial – this is the implicit denial rule.
In Munro, the veteran argued that the implicit denial rule could not appeal to informal claims. However, the Fed. Cir. held that the rule can be applied to end any pending claim whether formal or informal. In determining whether the implicit denial rule should apply to Munro, the Fed. Cir. relied heavily on its prior consideration of the rule, particularly in Deshotel v. Nicholson, 457 F.3d 1258 (Fed. Cir. 2006). In Deshotel, the Fed. Cir. held that where a veteran files closely related claims and VA explicitly denies only one of these claims, the implicit denial rule should be applied to treat the other closely-related claims as also denied. The Fed. Cir. also reviewed other cases to conclude that the implicit denial rule requires that the denial of a claim will end the pending status of any other identical pending claims. The Fed. Cir. found that Mr. Munro’s informal claims were identical to the formal claim that VA later denied, so the implicit denial rule applied here and his informal claims were deemed to be denied. It also found that from the specifics in VA’s denial, Mr. Munro should have known that his informal claim was also being denied, as the documents he submitted as the informal claims were referenced in the decision.
The documents Mr. Munro asserted were informal claims consisted of VA medical records. The Fed. Cir. noted that veterans with service-connected conditions routinely visit VA medical centers and for VA to treat each medical record as an individual claim would be unnecessary and unreasonable.
While the Munro decision was not favorable to the veteran, it can provide some guidance for others. First, be as specific as possible when submitting a claim to VA. Rather than just sending in some medical records and later trying to sort out the nature of the claim, explain your claim and what the records show upfront. (For instance, stating something like, “This is my informal claim for an increased rating for my service-connected PTSD. The attached VA treatment records show that my condition has become more severe.”).
Also, if you receive a denial from VA that you do not agree with or understand, let them know about it immediately. Mr. Munro faced additional burdens because he did not timely appeal denials and they became final decisions. If you are not satisfied with your decision from VA, keep appealing and keep the claim alive.