Full Opinion

Case: 25-1301 Document: 51 Page: 1 Filed: 08/10/2026 United States Court of Appeals for the Federal Circuit ______________________ CHRISTOPHER MICHAEL HERNANDEZ, Claimant-Appellant v. DOUGLAS A. COLLINS, SECRETARY OF VETERANS AFFAIRS, Respondent-Appellee ______________________ 2025-1301 ______________________ Appeal from the United States Court of Appeals for Veterans Claims in No. 23-4193, Judge Joseph L. Falvey, Jr. ______________________ Decided: August 10, 2026 ______________________ TRICIA PATTEN PETEK, The MilVet Law Firm, PLLC, Tacoma, WA, argued for claimant-appellant. Also repre- sented by CASEY CLOUCHETE. BRENDAN DAVID JORDAN, Commercial Litigation Branch, Civil Division, United States Department of Jus- tice, Washington, DC, argued for respondent-appellee. Also represented by ERIC P. BRUSKIN, PATRICIA M. MCCARTHY, BRETT SHUMATE; MATTHEW ALBANESE, DEREK SCADDEN, Office of General Counsel, United States Depart- ment of Veterans Affairs, Washington, DC. Case: 25-1301 Document: 51 Page: 2 Filed: 08/10/2026 2 HERNANDEZ v. COLLINS ______________________ Before LOURIE and PROST, Circuit Judges, and SUBRAMANIAN, District Judge. 1 LOURIE, Circuit Judge. Christopher Michael Hernandez appeals from a deci- sion of the United States Court of Appeals for Veterans Claims (“Veterans Court”). The Veterans Court affirmed a decision of the Board of Veterans’ Appeals (“the Board”) denying Hernandez service connection for various injuries. Hernandez v. McDonough, No. 23-4193, 2024 WL 2977383 (Vet. App. June 13, 2024) (“Decision”); J.A. 102–116 (“Board Decision”). For the following reasons, we affirm. BACKGROUND Hernandez served in the Air Force from August 1985 to August 1989. See J.A. 183. During his service in 1987, he reported experiencing eye pain and was diagnosed with pink eye and ultraviolet keratitis (sunburn on the surface of the eye). Board Decision, J.A. 109, 111. And in 1988, Hernandez reported experiencing headaches that eventu- ally led to a diagnosis of acute gastroenteritis. Id., J.A. 111. Several decades later, in May 2018, Hernandez sought disability compensation from the Department of Veterans Affairs (“VA”) for three conditions: tinnitus, an eye disabil- ity, and migraines. J.A. 239–40. The VA Regional Office (“RO”) denied service connection for all three conditions, and Hernandez appealed to the Board. J.A. 144–51. 1 Honorable Arun Subramanian, District Judge, United States District Court for the Southern District of New York, sitting by designation. Case: 25-1301 Document: 51 Page: 3 Filed: 08/10/2026 HERNANDEZ v. COLLINS 3 The Board similarly denied all three of Hernandez’s claims, determining that service connection was not war- ranted. Board Decision, J.A. 115–16. For all three claims, the Board credited private medical records that tended to show that the onset of Hernandez’s conditions occurred well after his service over statements that Hernandez made later in the context of seeking com- pensation. Id., J.A. 106–09, 110–111, 112–15. The Board noted that “[c]ourts have recognized how medical history recounted in the course of medical evaluation and treat- ment is especially probative (trustworthy) because the de- clarant has inherent incentive to give the most accurate history to, in turn, receive the best or most appropriate medical care.” Id., J.A. 106. The Board therefore gave greater probative weight to private medical records, and denied service connection for all three claims. Hernandez appealed to the Veterans Court, which af- firmed. The Veterans Court explained that the case turned on credibility determinations, and concluded that the Board properly relied “on the well-settled idea that people have an incentive to be truthful when seeking medical care” in giving “the statements [Hernandez] made to med- ical providers more weight than the assertions he made when seeking benefits.” Decision, 2024 WL 2977383, at *1. The Veterans Court therefore determined that the Board did not err in its credibility determinations because “the Board relied on a valid and intuitive legal principle” that comes from the Federal Rules of Evidence: “when people need medical care, they have great incentive to tell the truth.” Id. at *2–3. Hernandez timely appealed. Our jurisdiction is gov- erned by 38 U.S.C. § 7292. DISCUSSION Our scope of review of Veterans Court decisions is lim- ited. We must “decide all relevant questions of law” but we Case: 25-1301 Document: 51 Page: 4 Filed: 08/10/2026 4 HERNANDEZ v. COLLINS generally “may not review (A) a challenge to a factual de- termination, or (B) a challenge to a law or regulation as ap- plied to the facts of a particular case.” 38 U.S.C. § 7292(d). “We review the Veterans Court’s legal determinations de novo.” Larson v. McDonough, 10 F.4th 1325, 1327 (Fed. Cir. 2021). Hernandez argues that the Veterans Court committed two legal errors: (1) it erroneously adopted portions of the Federal Rules of Evidence; and (2) in so doing, adopted a rule contrary to the benefit-of-the-doubt rule under 38 U.S.C. § 5107(b). Open. Br. 2, 14. We address each in turn. Hernandez first argues that the Veterans Court erred in relying on the principle that those in need of medical care are incentivized to be truthful regarding their current medical state when assigning more weight to statements that Hernandez made in seeking treatment over state- ments he made when seeking benefits. See id. at 15–16. Specifically, Hernandez contends that the Veterans Court erred in using a rationale derived from the Federal Rules of Evidence’s admissibility rules to afford certain evidence greater probative weight. See id. We disagree. The Veterans Court did not err in applying the princi- ple that “when people need medical care, they have great incentive to tell the truth.” Decision, 2024 WL 2977383, at *2. That principle comes from the advisory committee notes to Federal Rule of Evidence 803, which lists excep- tions to the rule against hearsay, including that state- ments made for medical diagnosis or treatment are generally admissible despite being hearsay, at least in part due to “the patient’s strong motivation to be truthful” which carries a “guarantee of trustworthiness.” Fed. R. Evid. 803 advisory committee note (1972). As Hernandez points out, this rationale explains why statements made for medical diagnosis or treatment are admissible, and does not necessarily indicate that such Case: 25-1301 Document: 51 Page: 5 Filed: 08/10/2026 HERNANDEZ v. COLLINS 5 statements should be given greater probative weight. But we have explained that, although the Federal Rules of Ev- idence are not binding in VA and Board proceedings, such rules may “offer useful guidance” in those proceedings, in- cluding for evaluating the probative weight of evidence. See AZ v. Shinseki, 731 F.3d 1303, 1316 (Fed. Cir. 2013). We therefore see no error in the Board’s reliance on a prin- ciple supported by the Federal Rules of Evidence that “when people need medical care, they have great incentive to tell the truth.” Decision, 2024 WL 2977383, at *2. The Board merely used that principle as guidance to give greater probative weight to certain evidence. To the extent that Hernandez takes issue with the weighing of the evi- dence itself, that is a factual dispute that is outside of our scope of review. See Deloach v. Shinseki, 704 F.3d 1370, 1380 (Fed. Cir. 2013) (“[T]he evaluation and weighing of evidence are factual determinations committed to the dis- cretion of the factfinder.”). Indeed, we have recognized the trustworthiness of medical records in determining causation in the vaccine in- jury context because they “contain information supplied to or by health professionals to facilitate diagnosis and treat- ment of medical conditions” such that “accuracy has an ex- tra premium.” Cucuras v. Sec’y of Dep’t of Health & Hum. Servs., 993 F.2d 1525, 1528 (Fed. Cir. 1993). Given that the same type of accuracy is relevant here, we see no reason why that rationale cannot apply in the veterans context as well. We therefore conclude that the Veterans Court did not err in relying on the principle that “when people need medical care, they have great incentive to tell the truth” in finding no error in the Board’s weighing of the evidence. Hernandez next argues that the Veterans Court’s adoption of that principle is contrary to the benefit-of-the- doubt rule, which is recited in 38 U.S.C. § 5107(b): The Secretary shall consider all information and lay and medical evidence of record in a case before Case: 25-1301 Document: 51 Page: 6 Filed: 08/10/2026 6 HERNANDEZ v. COLLINS the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evi- dence regarding any issue material to the determi- nation of a matter, the Secretary shall give the benefit of the doubt to the claimant. (emphasis added). According to Hernandez, the Board’s ability to rely on the trustworthiness of medical records would obviate the benefit-of-the-doubt rule, because “the weight assigned to the statements relating to medical care [is] inherently deemed of higher weight than other lay tes- timony.” Open. Br. 17. Again, we disagree. The benefit-of-the-doubt rule does not apply in every case. “The VA gives the benefit of the doubt to the veteran only after determining that the positive evidence and neg- ative evidence on a material issue are in approximate bal- ance.” Bufkin v. Collins, 604 U.S. 369, 381 (2025) (emphasis added). “[E]vidence is not in ‘approximate bal- ance’ or ‘nearly equal,’ and therefore the benefit-of-the- doubt rule does not apply, when the evidence persuasively favors one side or the other.” Lynch v. McDonough, 21 F.4th 776, 781–82 (Fed. Cir. 2021) (en banc); see also Mattox v. McDonough, 56 F.4th 1369, 1378 (Fed. Cir. 2023) (“[W]hen conducting a benefit-of-the-doubt-rule analysis, as in other settings, the Board is required to assign proba- tive value to the evidence.”). We determine that the Board’s ability to credit state- ments made for the purpose of medical diagnosis or treat- ment over other evidence is not in conflict with the benefit- of-the-doubt rule. The Board must first consider and weigh all evidence, including statements made for medical diag- nosis or treatment if offered, and then must apply the ben- efit-of-the-doubt rule only “[w]hen there is an approximate balance.” 38 U.S.C. § 5107(b); see Bufkin, 604 U.S. at 381. We do not determine that statements made for medical diagnosis or treatment are always more probative than Case: 25-1301 Document: 51 Page: 7 Filed: 08/10/2026 HERNANDEZ v. COLLINS 7 other evidence, which would, according to Hernandez, ob- viate the benefit-of-the-doubt rule whenever such state- ments are introduced. Indeed, there may be instances where, depending on the facts of a case, such statements are not particularly probative, or other evidence is more probative. That is a factual determination for the finders of fact to determine on a case-by-case basis. All we deter- mine now is that the use of the general principle that “when people need medical care, they have great incentive to tell the truth” is not contrary to law. The Board’s ability to weigh statements made for the purpose of medical diag- nosis or treatment based on the facts of a case accordingly does not conflict with the benefit-of-the-doubt rule. CONCLUSION We have considered Hernandez’s remaining argu- ments but find them unpersuasive. For the foregoing rea- sons, we affirm. AFFIRMED COSTS No costs.