Crawford v. Brown, 5 Vet. App. 33 (1993) — Informal claims require intent to seek the specific benefit; inadequate examinations require remand

James L. Crawford appealed a Board decision denying an increased rating for schizo-affective disorder and an effective date earlier than July 7, 1989, for the grant of service connection. The Court first addressed the effective-date issue and held that the veteran’s July 1966 request for outpatient treatment did not satisfy the regulatory requirements for an informal claim because it did not identify a claim for compensation benefits. The Court also concluded that 38 C.F.R. § 3.157 did not apply because there had not been a prior allowance or disallowance of a formal claim for compensation or pension that would allow a hospitalization report to function as an informal claim to reopen or for increased benefits. On that basis, the Court found a plausible factual basis for the Board’s denial of an earlier effective date and affirmed that part of the decision.

On the rating issue, the Court concluded that the evidence before the Board was inadequate to support review of whether the disability produced “definite” or “considerable” social and industrial impairment under Diagnostic Code 9205. Because the most recent examination did not provide a sufficiently informed basis for rating the disability, the Court vacated and remanded for a contemporaneous and thorough psychiatric examination that considered prior medical treatment records. The Court also directed the Board to provide adequate reasons or bases on readjudication.

A communication is an informal claim only if it expresses intent to seek the specific benefit at issue, and VA may not rate a disability on an inadequate record when a contemporaneous, thorough examination informed by prior treatment history is required.

Advocates should separate treatment requests from compensation claims when challenging effective dates, and should attack ratings supported by stale or incomplete examinations by demanding a fully informed, contemporaneous exam.

The case is useful in both effective-date and rating appeals. It limits informal-claim arguments where the veteran sought treatment rather than compensation, while also reinforcing VA’s obligation to base disability ratings on an adequate medical record.

Treating a treatment request as a compensation claim or relying on an examination that does not adequately address the severity of the disability in light of prior records.

A veteran files for VA treatment soon after service but does not mention compensation, then later receives service connection with a later effective date. Separately, the veteran’s most recent psychiatric exam is too cursory to distinguish between moderate and severe impairment, yet the Board uses it to deny a higher rating.

Use the effective-date portion to resist informal-claim theories based solely on treatment-seeking communications. Use the remand portion to argue that an exam is inadequate when it does not provide a current, history-informed assessment of severity.

Gilbert v. Derwinski, Wells v. Principi, Wilson v. Derwinski, Green v. Derwinski, Littke v. Derwinski