United States v. Green: “Bodily Injury” in VWPA Restitution Excludes Pure Psychological Harm but Includes Physical Manifestations of Trauma

I. Introduction

Case: United States v. Anita Green (companion appeal involving Amanda Hovanec)
Court: United States Court of Appeals for the Sixth Circuit
Date: February 13, 2026

The appeals arise from a homicide committed during divorce and custody litigation. Amanda Hovanec killed her husband (T.H.) by injecting him with etorphine, a large-animal tranquilizer imported from South Africa. Anthony Theodorou shipped the drug at Hovanec’s direction. After the killing, the conspirators staged a false narrative, disposed of evidence, abandoned the victim’s car, and buried the body. Anita Green—Hovanec’s mother—drove Hovanec and Theodorou to bury the body and, according to testimony credited at sentencing, assisted in pre-offense planning.

The case presented three principal appellate clusters:

• Green’s sentence: whether she deserved a Guidelines reduction for acceptance of responsibility.
• Green’s restitution: whether psychological harm to the children qualifies as “bodily injury” under the Victim and Witness Protection Act (18 U.S.C. § 3663(b)(2)).
• Hovanec’s sentence: whether the district court erred in its handling of a defense psychological report and in applying role and obstruction enhancements.

II. Summary of the Opinion

A. Disposition

• Affirmed Green’s 121-month sentence (including denial of acceptance-of-responsibility reduction).
• Affirmed Hovanec’s 480-month sentence (including the district court’s treatment of the psychological report, the aggravating-role enhancement, and the obstruction enhancement).
• Reversed and remanded Green’s restitution order for further factual findings under the correct legal standard.

B. Key holdings

• Acceptance of responsibility: the district court did not err in denying Green a reduction where it found she falsely denied relevant conduct, including through statements made during the change-of-plea colloquy.
• VWPA restitution (“bodily injury”): “bodily injury” excludes purely mental harms, but includes physical manifestations of mental harms; the record did not conclusively establish qualifying physical manifestations caused by the offense, requiring remand.
• Hovanec’s sentencing: the district court’s skepticism about Dr. Brams’s report was not clearly erroneous; the role enhancement under U.S.S.G. § 3B1.1(c) and obstruction enhancement under U.S.S.G. § 3C1.1 were properly applied.

III. Analysis

A. Precedents Cited (and How They Shaped the Decision)

1. Acceptance of responsibility (Green)

• United States v. Jett: The court used Jett for core principles—defendant’s burden to “clearly demonstrate” acceptance, the idea that a guilty plea alone is not enough, and preservation rules triggering plain-error review. This framed Green’s appeal as largely uphill because her objections were not specifically preserved at sentencing.
• United States v. Denson: Supplied clear-error review for factual determinations, reinforcing the deference owed to the district court’s credibility-driven finding that Green was dishonest.
• United States v. Thomas and United States v. Prater: Cited for the Sixth Circuit’s unsettled standard when applying Guidelines to uncontested facts. The panel avoided resolving the split by showing Green failed under any standard and (for some arguments) could only obtain relief under plain error.
• United States v. Cabrera and United States v. Vonner: Provided the four-part plain-error test that controlled key acceptance-of-responsibility sub-issues.
• United States v. Jeter and United States v. Tilford (and United States v. Hakley): Green invoked these “temporal limitation” cases to argue that pre-plea conduct cannot defeat acceptance. The panel distinguished them: those cases involved other criminal conduct before indictment/plea, while Green’s problem was dishonesty in the plea process itself. The court’s reasoning is notable: it ties the acceptance analysis to the integrity of the plea colloquy and rejects a reading that would immunize misstatements made while entering the plea.
• United States v. Lay, United States v. Cook, United States v. Conner, and United States v. Bonds: These authorities reinforced the doctrinal line that a defendant need not volunteer relevant conduct, but if she speaks, she cannot falsely deny it; and that untruthfulness supports denial of the reduction.
• United States v. Hinojosa and United States v. Navarro-Camacho: Anchored the “two permissible views of the evidence” principle—central to upholding the district court’s reading of ambiguous plea-colloquy statements.

2. Restitution: “bodily injury” under 18 U.S.C. § 3663 (Green)

• United States v. Church and United States v. Evers: Supplied the threshold proposition that federal courts lack inherent restitution power—restitution must be statutorily authorized. This set the interpretive posture: strict adherence to statutory prerequisites.
• United States v. Scott: Offered general framing of VWPA restitution as compensation for victims’ losses, but only within statutory limits.
• United States v. Fike: Confirmed the Government bears the burden (preponderance) to establish restitution—important on remand when causation and physical manifestation must be shown.
• In re MCP No. 185, Grand Traverse Band of Ottawa & Chippewa Indians v. U.S. Att'y W. Dist. of Mich., and Williams v. Taylor: These cases supplied the interpretive method: start with statutory text, read in context, and apply ordinary meaning where Congress did not define the term.
• In re Vill. Apothecary, Inc.: Applied the anti-surplusage canon to reject the Government’s argument that because the restitution subsection references “psychiatric” and “psychological” care, “bodily injury” must include mental harm. The panel reasoned that interpreting “bodily injury” to include mental injury would make the statutory wording awkward and potentially superfluous.
• United States v. Reichow, United States v. Hicks, and United States v. Powell: These sibling-circuit decisions supported the de novo conclusion that “bodily injury” does not encompass purely psychological harms for VWPA restitution. The Sixth Circuit aligned itself with this line.
• United States v. Breshers and United States v. Dotson: Addressed contrary outcomes but were discounted because they arose under plain-error review and did not definitively resolve the issue on the merits.
• Allison Engine Co. v. United States ex rel. Sanders, Barnhart v. Sigmon Coal Co., and W. Va. Univ. Hosps., Inc. v. Casey: These cases supported the court’s comparative-statutory analysis: when Congress includes language in one statute but omits it in another, courts presume purposeful variation. The panel used this to evaluate (but not overread) Congress’s inconsistent Title 18 definitions of “bodily injury.”
• Pullman-Standard v. Swint: Supplied the remand principle: if the district court made no necessary finding because it applied an erroneous legal rule, the appropriate course is remand for factfinding.
• Doe v. Etihad Airways, P.J.S.C. and Meyers v. City of Cincinnati: Cited to show Sixth Circuit dicta has treated sleeplessness sometimes as mental harm and sometimes as physical harm—supporting the panel’s refusal to treat sleeplessness as per se bodily injury on the thin record.
• Eastern Airlines, Inc. v. Floyd (and related Warsaw Convention cases: Lloyd v. Am. Airlines (In re Air Crash at Little Rock Ark., on June 1, 1999), Carey v. United Airlines, Terrafranca v. Virgin Atl. Airways Ltd.): Used chiefly as a contrast. The panel explained these treaty-driven interpretations relied on French text/history and thus were inapposite. Importantly, Eastern Airlines, Inc. v. Floyd left open recovery where mental injury is accompanied by physical injury—consistent with the Sixth Circuit’s “physical manifestation” rule.
• Davis v. D.C.: Cited to distinguish Prison Litigation Reform Act doctrine; the PLRA’s “prior showing” language is materially different from § 3663.
• Armstrong v. Shirvell: Noted as illustrative (not controlling) that physical injury resulting from emotional distress is recognized in other legal settings, reinforcing ordinary-language meaning that physical sequelae of trauma are still “bodily” harms.

3. Sentencing reasonableness and enhancements (Hovanec)

• Gall v. United States, United States v. Mack, United States v. Fowler: Established the procedural-reasonableness framework and abuse-of-discretion review, including the “clearly erroneous facts” concept.
• United States v. Cunningham and United States v. Wilson: Provided the “important factor” test: an erroneous fact warrants reversal only if it appears important to sentencing and the sentence might have been different absent it. This controlled the analysis of the “hired advocate” comment.
• United States v. Robinson and United States v. Dalasta: Supported the proposition that the district court may weigh expert reports skeptically; disagreement with credibility/cogency assessments is not enough for clear error.
• United States v. Knight: Distinguished—misattributing testimony can be clear error, but the panel found no comparable misattribution occurred here.
• United States v. Parks: Used to reject reversal where an arguably erroneous remark (the “hired advocate” label) was not shown to be important to the sentence.
• United States v. Tristan-Madrigal, United States v. Lynde, United States v. Curry, United States v. Sexton, and again United States v. Vonner: Grounded the substantive-reasonableness review and emphasized that challenging a below-guidelines variance as “too long” is especially demanding.
• United States v. Minter, United States v. Nicolescu, United States v. Washington, United States v. Taylor, United States v. Vasquez, and United States v. Kamper: Structured the role-enhancement analysis. The court treated leadership as satisfied where the defendant directed others’ actions and recruited accomplices, even if another participant undertook independent tasks.
• United States v. Prigmore and United States v. Johnson: Reinforced appellate deference to sentencing credibility determinations.
• United States v. Histed and United States v. Thomas: Provided the obstruction enhancement standard of review discussion (fact findings clear error; legal conclusions de novo; application standard unsettled).
• United States v. Van Shutters, United States v. Waldon, and United States v. Schwartz: Demonstrated that obstruction can be found even when the attempt fails and even when the investigation ultimately proceeds quickly; “attempted obstruction” suffices.
• United States v. Glass, United States v. Epps, and again United States v. Cunningham: Rejected the “predetermination” claim; judges may have preliminary views or draft opinions if parties are heard and the record shows consideration.
• United States v. Harmon, United States v. Potts, and United States v. Grimes: Supported treating the district court’s stray citation to Minter during the obstruction ruling as a non-reversible slip of the tongue because the record showed correct legal engagement overall.
• United States v. Bostic and United States v. LeBlanc: Supplied the preservation rule; because Hovanec did not object on the “wrong case citation” theory below, review was plain error.

B. Legal Reasoning

1. Acceptance of responsibility: plea-colloquy honesty matters

The court’s acceptance-of-responsibility reasoning turned on a practical distinction:

• The Jeter/Tilford line prevents courts from denying acceptance based on unrelated pre-plea criminal activity absent federal “notice.”
• But a defendant’s statements while entering the plea go directly to whether the plea reflects genuine acceptance. The panel reasoned that it would be incoherent to treat the guilty plea as “significant evidence” of acceptance yet ignore dishonesty in the process of tendering it.

On this record, the panel found no plain error in the district court’s conclusion that Green falsely denied relevant conduct (particularly, prior knowledge of the plan), and it upheld the denial of the reduction.

2. Restitution: ordinary meaning of “bodily injury” controls, with a key refinement

The restitution analysis proceeded in three steps:

1. Statutory gatekeeping: Under United States v. Church and United States v. Evers, restitution is permitted only as Congress authorizes. The relevant authorization here was the VWPA, 18 U.S.C. § 3663 (not the MVRA).
2. Text and ordinary meaning: Because “bodily injury” is undefined in § 3663, the court used contemporary dictionary meaning and concluded “bodily” is physical/corporeal, contrasted with mental/spiritual.
3. Refinement—physical manifestations: The court accepted the Government’s narrower argument: when mental trauma produces physical symptoms, the victim has suffered an injury to the body. Thus, “bodily injury” includes physical manifestations of psychological harms, so long as causally resulting from the offense.

The district court had awarded restitution for psychological treatment on the premise that psychological injury itself is “bodily injury.” That legal premise was rejected. Because the record did not clearly establish qualifying physical manifestations caused by Green’s offense (as opposed to general trauma, uncertainty, or speculation), Pullman-Standard v. Swint compelled a remand for further factfinding.

3. Hovanec’s sentencing: deference to credibility and to sentencing factfinding

The panel rejected Hovanec’s claim that the district court sentenced on “clearly erroneous facts” by discounting Dr. Brams’s report. The opinion emphasized (i) the Government’s specific critiques about lack of objective testing and possible inaccuracies in self-reported history, and (ii) the absence of proof that any disputed characterization was an “important factor” in the final sentence under United States v. Cunningham/United States v. Wilson.

The leadership enhancement was sustained because the district court found multiple application-note factors (decision-making, recruitment, control/authority), and the record showed Hovanec directed key steps (hitman search, import/shipping concealment). The obstruction enhancement was sustained because attempted destruction and deception qualifies even if investigators quickly solved the case, and pre-investigation acts qualify if purposefully calculated and likely to thwart investigation (Guidelines commentary applied by analogy to United States v. Van Shutters and related cases).

C. Impact

1. VWPA restitution: a clarified threshold with practical consequences

The decision will likely matter most in restitution litigation under 18 U.S.C. § 3663(b)(2) (and the parallel MVRA language where applicable), especially in cases involving:

• child victims and other vulnerable victims whose primary harms are psychological;
• witness intimidation, stalking, threats, or violent crime “spillover” effects on family members;
• trauma-related treatment claims where the victim experiences headaches, abdominal pain, insomnia, panic symptoms, exacerbation of preexisting conditions, or other somatic effects.

The rule draws a firm line against restitution based solely on emotional injury, but invites careful evidentiary development on somatic consequences and causation. The Government’s burden under United States v. Fike becomes pivotal: on remand and in future cases, prosecutors should expect to present medical/therapeutic documentation linking symptoms to the offense and describing the physical manifestation with more than “may or may not” language.

2. Sentencing practice: plea-colloquy statements as acceptance-of-responsibility evidence

For defendants seeking U.S.S.G. § 3E1.1 reductions, the opinion underscores that careful parsing or minimization during the change-of-plea colloquy can have Guidelines consequences. District courts in the Sixth Circuit now have explicit appellate support for using colloquy statements to evaluate whether the defendant “truthfully admitted” the offense and did not falsely deny relevant conduct.

3. Expert mitigation evidence: reliability scrutiny is affirmed

The court’s treatment of the Brams report signals that mitigation experts should anticipate rigorous reliability challenges: objective testing, collateral records, and clear sourcing matter, particularly when the report is built substantially on self-report.

IV. Complex Concepts Simplified

• VWPA vs. MVRA: The VWPA (18 U.S.C. § 3663) permits discretionary restitution in certain cases; the MVRA (18 U.S.C. § 3663A) mandates restitution for enumerated offenses. Here, the parties agreed VWPA applied, but the “bodily injury” language relevant to psychological-care restitution is the same for present purposes.
• “Bodily injury”: Under this opinion, it means physical injury. Emotional distress alone is not enough. But emotional distress that causes physical symptoms (somatic manifestations) can qualify.
• Acceptance of responsibility (U.S.S.G. § 3E1.1): A guilty plea helps but does not guarantee the reduction. If a defendant falsely denies relevant conduct, the reduction may be denied.
• Plain error review: If an argument was not properly raised below, the appellant must show a clear/obvious error that affected substantial rights and the fairness/integrity of proceedings—an intentionally demanding standard.
• Role enhancement (U.S.S.G. § 3B1.1(c)): Adds levels if the defendant organized/led/managed/supervised at least one other participant. Directing another person’s actions can be enough.
• Obstruction enhancement (U.S.S.G. § 3C1.1): Covers willful obstruction or attempted obstruction. The attempt need not succeed; pre-investigation acts can count if designed and likely to thwart investigation.

V. Conclusion

United States v. Anita Green is most significant for its restitution holding: in the Sixth Circuit, “bodily injury” in 18 U.S.C. § 3663(b)(2) does not include purely psychological harms, yet does include physical manifestations of psychological trauma. The decision both constrains and preserves restitution: it bars awards resting only on mental anguish, but permits restitution where the Government can prove trauma-related physical symptoms and causal linkage to the offense.

The opinion also reinforces two sentencing lessons: (1) statements made during the plea process can defeat acceptance-of-responsibility reductions when they falsely deny relevant conduct; and (2) district courts retain wide discretion to assess mitigation experts’ reliability and to apply role/obstruction enhancements when the record supports purposeful planning, direction of others, and evidence-destruction efforts.