Voyles v. Brown — Board must address functional loss due to pain under §§ 4.40 and 4.45

The appellant sought increased ratings for residuals of a left femur fracture and a lumbar spine disability. The record included VA and private examinations noting pain, limp, muscle spasm, and some limitation of motion, as well as sworn testimony describing constant low back pain and radiating symptoms. The Board denied higher ratings based primarily on measured range of motion and did not meaningfully address the effect of pain on functional loss.

The Court held that the Board was required to consider 38 C.F.R. §§ 4.40 and 4.45(f), even though the veteran had not expressly raised those provisions, because the record repeatedly referenced pain. The Court explained that examinations on which ratings are based must adequately portray functional loss due to pain and discuss whether pain is supported by adequate pathology and visible behavior. Because the Board failed to analyze pain-related functional loss and relied on examinations that did not fully address that issue, the Court vacated and remanded for readjudication. The Court also directed that if the record lacked adequate pathology, the Board should obtain an examination before deciding entitlement to increased ratings.

For musculoskeletal ratings, the Board must consider functional loss due to pain under 38 C.F.R. §§ 4.40 and 4.45 when the record raises that issue, and it may not rely on an examination that fails to adequately portray pain-related impairment.

Voyles is a strong remand case when the Board focuses on goniometer measurements but ignores pain, flare-like symptom descriptions, or functional limits in ordinary use. It also supports arguing that VA must obtain an examination that meaningfully addresses pain-related functional loss.

This case remains a practical tool for challenging musculoskeletal decisions that treat pain as secondary to range of motion. It reinforces that functional impairment, not just degrees of motion, drives the rating analysis and that the Board must explain how pain affects the disability picture.

The Board denies a higher rating by citing range-of-motion findings while omitting any analysis of functional loss due to pain.

A veteran with a service-connected lumbar spine disability has near-normal measured flexion, but repeated treatment notes and hearing testimony describe severe pain with sitting, standing, and lifting. The Board denies an increase without discussing whether pain causes additional functional loss under §§ 4.40 and 4.45.

Use Voyles to argue that the Board committed reversible error by failing to discuss pain-based functional loss in a musculoskeletal rating case. Pair it with testimony, treatment notes, or examination findings showing pain, spasm, guarding, or difficulty with ordinary movements.

Schafrath v. Derwinski, Quarles v. Derwinski, Green v. Derwinski, Douglas v. Derwinski, Moyer v. Derwinski, Ferraro v. Derwinski, Hatlestad v. Derwinski