## Facts

- A U.S. Army veteran (active duty 1954–1956) was service-connected for Guillain–Barré syndrome (GBS) at 10% disability.
- In the 1990s, he was diagnosed with major depressive disorder and sought service connection on a secondary basis to GBS.
- Service records noted treatment for GBS, an entry for “situational maladjustment,” and a normal psychiatric condition at separation.
- The veteran submitted favorable private medical opinions stating his major depression was secondary to service-connected GBS; one physician later acknowledged not reviewing certain neurology treatment records.
- VA obtained two psychiatric examinations (2000 and 2004) by the same VA examiner, who reviewed the claims file and opined that major depressive disorder was not caused by GBS, citing prior neurologic findings of mild residuals.
- The Board of Veterans’ Appeals denied secondary service connection, assigning greater probative weight to the VA examiner largely because the VA examiner reviewed the complete claims file and the private physicians did not.
- The veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims.

## Issues

1. Whether the Board erred by assigning greater probative weight to a VA medical opinion principally because it was based on claims-file review while discounting private opinions for lack of full claims-file review.
2. Whether the Board provided an adequate statement of reasons or bases for its weighing of conflicting medical opinions under 38 U.S.C. § 7104(d)(1).

## Decision

- The court vacated the Board’s decision and remanded for readjudication.
- The court held the Board erred in treating lack of full claims-file review as a categorical basis to find a private opinion less probative.
- The court held the Board failed to provide adequate reasons or bases for favoring the VA opinion and discounting the private opinions.

## Legal Principles

- A medical opinion’s probative value depends chiefly on whether it is factually accurate and contains fully articulated, sound reasoning, not on the mere fact of claims-file review.
- VA examiners and private physicians are evaluated as expert witnesses; the Board may not mechanically prefer VA opinions based on institutional status or routine access to the file.
- The Board must assess whether each opinion rests on sufficient facts or data, an accurate factual premise, and a reasoned explanation connecting facts to conclusions.
- A conclusory medical statement without analysis generally warrants little weight compared to a well-explained opinion supported by clinical data or other rationale.
- Under 38 U.S.C. § 7104(d)(1), the Board must provide a reasoned explanation for its weighing of conflicting medical evidence sufficient to permit judicial review, beyond stating that one examiner reviewed the claims file.

## Conclusion

The court required the Board to reassess competing medical opinions without a categorical preference for claims-file review or VA examiners and to explain, with specific reasoning, why any opinion is more persuasive in resolving secondary service connection.


Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008)