Hart v. Mansfield — Staged ratings apply to increased-rating claims when disability severity changes over time

The case extended staged ratings to increased-rating claims, not just original ratings. In Hart v. Mansfield, the Court extended the concept of staged ratings beyond initial-rating appeals and held that staged ratings also apply in traditional increased-rating claims when the evidence shows distinct periods of different disability severity during the appeal period.

The veteran sought an increased rating for a service-connected left-knee disability rated under Diagnostic Code 5257 for instability. During the appeal period, conflicting medical evidence emerged regarding the severity of the knee condition. A private physician documented anterior cruciate ligament laxity and instability in 2001 and 2002, while later VA examinations in 2005 found no instability.

The Board denied an increased rating by focusing primarily on the most recent VA examination findings and concluding that no current instability existed. The Court held that the Board failed to adequately consider whether the earlier medical evidence supported a higher staged rating during part of the appeal period.

The Court explained that increased-rating claims may involve multiple distinct levels of disability over time and that VA must evaluate the disability throughout the entire relevant appeal period — generally from one year before the claim was filed until final adjudication.

The Court also emphasized that resolving conflicting medical evidence and determining whether the disability actually improved or merely fluctuated are factual determinations that must be adequately addressed by the Board with proper reasons or bases.

Hart became the foundational staged-rating case for increased-rating claims and significantly expanded the practical impact of Fenderson v. West.

Staged ratings are appropriate in increased-rating claims when the factual findings show distinct periods during the appeal period where the service-connected disability exhibits symptoms warranting different ratings.

• VA must consider staged ratings whenever the evidence shows changes in severity.
• A higher rating may be warranted for only part of the appeal period.

VA cannot focus only on the most recent examination in an increased-rating claim. Different ratings may be warranted for different periods of time based on how the disability changed during the appeal period. Extended staged ratings to increased-rating claims, not just original ratings.

Hart v. Mansfield is one of the most important rating-period cases in veterans law because it expanded staged ratings into traditional increased-rating claims.

Before Hart, staged ratings were primarily associated with initial-rating appeals under Fenderson v. West. Hart clarified that fluctuating disability severity matters equally in increased-rating claims and that veterans may be entitled to higher ratings for temporary or earlier periods of worsening even if the condition later improves.

The decision is especially important in:

• orthopedic claims,
• mental health claims,
• migraine claims,
• cyclical illnesses,
• fluctuating neurological conditions,
• postoperative recovery periods,
• and long-pending appeals involving changing symptom severity.

Hart also strongly reinforces the Board’s obligation to reconcile conflicting medical evidence and explain why certain evidence is accepted or rejected during different portions of the appeal period.

The VA frequently denies increased-rating claims by focusing only on the most recent examination findings while ignoring earlier evidence showing periods of greater impairment during the appeal period. Adjudicators also often fail to reconcile conflicting medical evidence or improperly assume that later improvement eliminates entitlement to higher staged ratings for earlier periods.

A veteran files an increased-rating claim for PTSD in 2020. Treatment records from 2020 through 2022 show severe panic attacks, suicidal ideation, and occupational impairment supporting a 70% rating. By 2024, the veteran’s symptoms partially improve with treatment, and a later VA examination supports only a 50% rating.

The VA denies a rating higher than 50% by relying primarily on the most recent examination.

Under Hart v. Mansfield, VA must evaluate the entire appeal period and determine whether staged ratings are warranted for earlier periods where the evidence demonstrated more severe impairment.

Hart is one of the strongest cases available for maximizing retroactive benefits in increased-rating claims involving fluctuating symptom severity.

Strategically, the case is especially useful whenever:

• symptoms worsened temporarily,
• surgery or flare-ups caused periods of greater impairment,
• earlier examinations supported higher ratings,
• conflicting medical opinions exist,
• or the disability improved before final adjudication.

Hart is particularly powerful in claims involving:

• knee instability,
• mental health fluctuations,
• migraines,
• spinal conditions,
• cyclical diseases,
• and orthopedic disabilities where symptoms vary over time.

The case also supports challenging Board decisions that selectively rely on later examinations while failing to adequately address favorable earlier evidence.

Hart pairs especially well with:

• Fenderson v. West,
• Francisco v. Brown,
• McClain v. Nicholson,
• Ardison v. Brown,
• and Owens v. Brown.

Commonly tied to 38 U.S.C. § 1155 and 38 C.F.R. Part 4, including the diagnostic code and functional-loss provisions relevant to the disability.