## Facts

- Patrick D. MacPhee, a Vietnam-era veteran, was service-connected for PTSD effective 1982.
- The VA initially rated his PTSD at 30% and later reduced it to 10% effective February 1, 1986.
- In August–September 1988, MacPhee was hospitalized at a VA facility for excessive drinking and anxiety.
- A treating psychologist opined that the most likely diagnosis was PTSD related to Vietnam, noted severe PTSD-related problems, and indicated MacPhee was unlikely to maintain sobriety without addressing PTSD symptoms.
- The discharge summary listed diagnoses including PTSD and continuous alcohol dependence.
- In 1989, the VA continued the 10% PTSD rating despite the 1988 hospitalization records.
- Years later, MacPhee obtained higher PTSD ratings, eventually reaching 100%, but disputed the effective date of increased compensation.
- MacPhee argued that the 1988 VA medical records constituted an informal claim for increased benefits and/or for benefits related to alcohol dependence.
- The Board denied an earlier effective date; the Court of Appeals for Veterans Claims affirmed; MacPhee appealed to the Federal Circuit.

## Issues

1. Whether VA medical records can constitute an informal claim under 38 C.F.R. § 3.157(b)(1) when they identify a condition not previously claimed by the veteran and not previously determined to be service connected.
2. Whether the 1988 VA hospitalization records required the VA to treat them as an informal claim for an increased PTSD rating under § 3.157(b)(1).

## Decision

- The Federal Circuit affirmed the judgment of the Court of Appeals for Veterans Claims.
- The court held that the 1988 VA medical records did not constitute an informal claim under 38 C.F.R. § 3.157(b)(1) for alcohol dependence (or related benefits) because that condition had not previously been claimed or adjudicated as service connected.
- The court upheld the Veterans Court’s acceptance of the Board’s determination that the 1988 records did not function as an informal claim for an increased PTSD rating under § 3.157(b)(1).

## Legal Principles

- Under 38 C.F.R. § 3.157(b)(1), VA medical reports may be accepted as an informal claim for increased benefits or to reopen only after a formal claim has been allowed, or a compensation claim has been disallowed solely because the service-connected disability was not compensable in degree.
- VA treatment records do not, by themselves, constitute an informal claim for benefits for a condition that has not previously been claimed and has not been previously recognized as service connected.
- Medical evidence of diagnosis, treatment, or causal relationship is distinct from a claim for benefits; an informal-claim theory under § 3.157(b)(1) depends on the regulation’s preconditions and does not convert newly noted conditions into claims.
- On appeal, the Federal Circuit’s review is limited to questions of law, including interpretation of statutes and regulations, and does not permit reweighing factual findings.

## Conclusion

The Federal Circuit held that § 3.157(b)(1) does not treat VA medical records as an informal claim for a newly identified, unadjudicated condition; the regulation applies only when the records relate to a disability already the subject of an allowed claim (or a limited compensability-based disallowance), so MacPhee was not entitled to an earlier effective date based on the 1988 hospitalization records.


MacPhee v. Nicholson, 459 F.3d 1323 (Fed. Cir. 2006)