Mary Hrvatin sought service connection for the cause of her husband’s death and DIC benefits after the veteran died from ventricular fibrillation due to coronary heart disease. She argued that the veteran’s service-connected loss of use of the right leg should be treated as the functional equivalent of an amputation, bringing his cardiovascular disease within 38 C.F.R. § 3.310(b). The Court rejected that reading, holding that the regulation’s plain language applies to actual service-connected amputation at or above the knee and does not extend to functional equivalency. The Court also noted the record contained no evidence identifying an amputation site that would satisfy the regulation, and it rejected the constitutional challenge because a rational basis supported the regulatory distinction between amputees and non-amputees. Finally, the Court declined to consider the appellant’s CUE theory because it had not been presented to the Board, and it added that any rating error would have been harmless because the amputation rule capped the combined rating at 90 percent.

38 C.F.R. § 3.310(b) is limited to cardiovascular disease developing in a veteran with a service-connected amputation of one lower extremity at or above the knee; loss of use of a leg without amputation is not enough, and a collateral CUE theory not raised below is not ripe for Court review.

Advocates cannot expand § 3.310(b) beyond its text to cover loss of use of a limb. The case also reinforces the need to preserve CUE arguments at the agency level and to assess whether any alleged rating error could actually change the outcome in light of the amputation rule.

The decision is an early example of the Court enforcing the plain language of a special statutory/regulatory DIC pathway and refusing to equate disability severity with actual amputation. It is also helpful for jurisdictional practice because it shows the Court will not reach an unpresented CUE theory and may dispose of rating arguments as harmless where the maximum schedular rating is unchanged.

Treating loss of use of a limb as if it automatically satisfies an amputation-based presumption or special DIC regulation.

A widow argues that a veteran’s service-connected leg disability caused later heart disease and seeks DIC under the amputation presumption, but the veteran never had an amputation and the record does not show the specific qualifying level required by the regulation.

Use this case to oppose attempts to extend amputation-based cardiovascular presumptions to non-amputees and to frame any CUE-based rating attack as a separate theory that must have been raised before the Board.

Ardestani v. I.N.S., Bolling v. Sharp, Schlesinger v. Ballard, Frontiero v. Richardson, Reed v. Reed, Schweiker v. Wilson, Russell v. Principi, Herzog v. Derwinski, Branham v. Derwinski