Simon v. Derwinski — Board must explain rejection of favorable medical evidence

The veteran sought a total disability rating based on individual unemployability for a service-connected low back disability. The record included several medical opinions—one from a private physician and one from a VA physician—stating that the veteran was completely disabled or incapable of gainful employment. The Board nevertheless denied the claim, relying instead on older evidence suggesting greater functional ability and without explaining why it found the later medical opinions less persuasive.

The Court held that the Board failed to provide adequate reasons or bases for its decision. The Court emphasized that while the Board is not required to accept every medical opinion, it must explain any rejection of favorable medical evidence and point to medical support in the record rather than relying on its own judgment. Because the Board did not address the key favorable opinions or explain its preference for earlier evidence, the Court reversed and remanded for readjudication.

The Board must provide adequate reasons or bases when rejecting favorable medical opinions, especially where those opinions address employability; it may not substitute its own medical judgment for competent medical evidence.

A Board decision denying TDIU must confront favorable medical opinions head-on. If the Board discounts such opinions, it must explain why in a medically grounded way.

Simon is a classic reasons-and-bases case in the TDIU context. It shows that favorable disability opinions cannot be ignored or implicitly rejected without explanation, and it remains useful when the Board relies on stale evidence or fails to address recent, favorable medical assessments.

The Board failed to address favorable medical opinions and implicitly substituted its own medical judgment for competent evidence.

A veteran submits two recent physician statements saying he cannot maintain substantially gainful employment due to a service-connected disability, but the Board denies TDIU by citing older records showing some physical capacity without explaining the conflict.

Cite Simon when the Board overlooks favorable employability opinions, fails to explain why it discounts them, or appears to rely on its own interpretation of medical evidence rather than a medical basis.

Gilbert v. Derwinski, Colvin v. Derwinski, Fletcher v. Derwinski