## Facts

- A veteran was service connected for prostate cancer and assigned a 100% rating under Diagnostic Code 7528.
- After remission following radiation therapy, VA proposed and implemented a reduction to 60% based on urinary residuals.
- During the reduction dispute, the veteran reported additional symptoms, including diarrhea and swelling in the ankles and feet, and was later diagnosed with lower-extremity lymphedema.
- A March 2016 VA examination documented the diarrhea and lymphedema and indicated further testing was needed to determine whether radiation treatment caused those conditions.
- The agency reduced the prostate-cancer rating without separately adjudicating secondary service connection for diarrhea or lymphedema.
- The veteran later filed a separate TDIU application alleging unemployability due to prostate cancer and secondary lymphedema.
- VA granted TDIU effective the date of the later TDIU application, reasoning TDIU related to lymphedema was not claimed earlier.
- The Board denied an earlier effective date, finding no pending TDIU or secondary-service-connection issues within the earlier prostate-cancer rating stream.
- The veteran appealed to the U.S. Court of Appeals for Veterans Claims.

## Issues

1. Whether, during adjudication of a formally initiated claim seeking the proper evaluation of a service-connected disability, VA must develop and adjudicate secondary service-connection issues reasonably raised by the record.
2. Whether the Board erred by not treating reasonably raised secondary conditions (and related TDIU/effective-date questions) as part of the same pending claim stream.

## Decision

- The Court held that VA must develop and adjudicate secondary service-connection issues that are reasonably raised during adjudication of a claim for the proper evaluation of a primary service-connected disability.
- The Court concluded the record reasonably raised secondary service connection for diarrhea and lymphedema as potential residuals of prostate-cancer radiation treatment.
- The Court held the Board erred by failing to adjudicate those secondary issues and by treating TDIU based on them as dependent on a later, separate application.
- The Court vacated the Board’s decision and remanded for adjudication of secondary service connection and for readjudication of TDIU/effective-date matters under the correct framework.

## Legal Principles

- The scope of a pending rating claim includes complications and residual conditions that are reasonably raised by the claimant’s statements or medical evidence during adjudication.
- VA has a duty to develop and adjudicate logically related secondary service-connection issues reasonably raised within that claim stream, without requiring a separate formal claim.
- When unemployability is reasonably raised in connection with the pending evaluation of a service-connected disability (including reasonably raised secondary conditions), entitlement to TDIU must be considered within the same claim stream.
- Effective-date analysis for TDIU and related benefits cannot be limited to the filing date of a later application if the underlying secondary conditions and unemployability were reasonably raised during the earlier pending claim.

## Conclusion

The Court required VA to treat reasonably raised secondary residuals and their TDIU implications as part of the pending prostate-cancer rating claim, vacating the Board’s denial of an earlier TDIU effective date and remanding for adjudication of secondary service connection and readjudication of TDIU and effective dates.


Bailey v. Wilkie, 33 Vet. App. 188 (2021)