The claimant sought DIC under former 38 U.S.C. § 1151, arguing that VA physicians failed to diagnose her husband’s metastatic cancer and that the delayed diagnosis hastened his death. The Board denied the claim, and the Veterans Court affirmed. On appeal, the Federal Circuit focused on the legal standard governing omission-based § 1151 claims. The court explained that Gardner rejected a fault requirement for commission-type injuries under the former statute, but that omission cases present a different causation problem because a claimant must identify when VA should have diagnosed or acted. The court held that requiring proof that VA should have diagnosed the condition is not an additional negligence element; instead, it is how proximate causation is established in a failure-to-diagnose claim. Because the Veterans Court applied that standard and the Federal Circuit lacked jurisdiction to revisit the Board’s factual finding that the evidence did not show VA treatment hastened death, the denial was affirmed. For advocacy, the case means a former § 1151 omission theory must be built around evidence that the condition was reasonably diagnosable during VA treatment and that failure to diagnose was the causal bridge to additional disability or death.

In a former 38 U.S.C. § 1151 claim based on VA’s failure to diagnose, the claimant must establish that VA should have diagnosed or acted but did not; that showing is the proximate-cause requirement for omission claims.

Missed-diagnosis § 1151 claims are not won by alleging a delayed diagnosis alone; the record must show that VA reasonably should have identified the condition during treatment and that the omission caused the additional disability or death.

Roberson clarifies the proof structure for former § 1151 omission claims and prevents claimants from treating every delayed diagnosis as compensable. It is a key citation when arguing that a missed diagnosis theory lives or dies on whether the condition was reasonably diagnosable in time to change the outcome.

Improper interpretation of former § 1151 by either demanding a separate negligence element or ignoring the need to prove that VA should have diagnosed the condition.

A veteran’s cancer is first diagnosed at an advanced stage after repeated VA visits for related symptoms. To pursue a former § 1151 theory, the claimant must show the disease should have been identified earlier based on the symptoms and care provided, not just that diagnosis occurred late.

Use this case to frame omission-based § 1151 arguments around diagnosability, not hindsight. It is especially useful to defend or attack whether VA had enough clinical indicators during the treatment period to trigger diagnosis and whether the alleged omission caused additional harm.

Brown v. Gardner, Gardner v. Derwinski