Citation Nr: 0208759 Decision Date: 07/31/02 Archive Date: 08/02/02 DOCKET NO. 97-04 660 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Pittsburgh, Pennsylvania THE ISSUES 1. Entitlement to service connection for a bilateral hip disability, including an undiagnosed illness (UI) manifested by hip pain. 2. Entitlement to service connection for a bilateral knee disability, including an UI manifested by knee pain. 3. Entitlement to service connection for a bilateral ankle disability, including an UI manifested by ankle pain. 4. Entitlement to service connection for headaches, including an UI manifested by headaches. 5. Entitlement to service connection for memory loss, including an UI manifested by memory loss. 6. Entitlement to service connection for hypertension, including an UI manifested by cardiovascular symptoms. 7. Entitlement to service connection for defective vision, including an UI manifested by defective vision. 8. Entitlement to service connection for a skin condition, including an UI manifested by skin problems. 9. Entitlement to service connection for chronic fatigue syndrome (CFS), including an UI manifested by fatigue. 10. Entitlement to service connection for a disability manifested by loss of libido, including an UI manifested by loss of libido. 11. Entitlement to service connection for a disability manifested by loss of sleep, including an UI manifested by loss of sleep. ATTORNEY FOR THE BOARD Richard V. Chamberlain, Counsel INTRODUCTION The veteran had active service from June 1966 to May 1970, and from December 1990 to May 1991. The veteran served in the Southwest Asia theater of operations from January 11 to April 18, 1991, during the Persian Gulf War (PGW). This appeal came to the Board of Veterans' Appeals (Board) from December 1995 and later RO rating decisions that denied service connection for the conditions listed on the first 2 pages of this remand. In April 1999 and December 1999, the Board remanded the case to the RO for additional action. REMAND The April 1999 and December 1999 Board remands instructed the RO to send the veteran an appropriate supplemental statement of the case. That action has not been performed. The Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (Nov. 9, 2000) (codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, and 5126 (West Supp. 2001) eliminated the concept of a well-grounded claim and redefined VA's duty to assist the veteran in the development of a claim. VA regulations for the implementation of the VCAA were published in August 2001. 66 Fed. Reg. 45620 (Aug. 29, 2001) (to be codified as amended at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, and 3.326(a)). In this case, there is additional VA duty to assist the veteran in the development of his claims. In view of the above, the case is REMANDED to the RO for the following actions: 1. The RO should advise the veteran of the evidence needed to substantiate his claims and offer to assist him in obtaining any relevant evidence. 2. The veteran should be scheduled for a VA general medical examination under the current guidelines for PGW veterans in order to determine the nature and extent of any hip disability, including an UI manifested by hip pain; knee disability, including an UI manifested by knee pain; ankle disability, including an UI manifested by ankle pain; headaches, including an UI manifested by headaches; memory loss, including an UI manifested by memory loss; hypertension, including UI manifested by cardiovascular symptoms; defective vision, including an UI manifested by defective vision; skin condition, including an UI manifested by skin problems; CFS, including an UI manifested by fatigue; disability manifested by loss of libido, including an UI manifested by loss of libido; and disability manifested by loss of sleep, including an UI manifested by loss of sleep. The examiner should list all diagnosed conditions and state which symptoms, abnormal physical findings, and abnormal laboratory test results are associated with each. If the veteran has symptoms, abnormal findings, and abnormal laboratory test results that have not been associated with a known clinical diagnosis, the general medical examiner should arrange for further specialist examination(s) as indicated, to address those unassociated signs and symptoms. Each examiner should also express an opinion as to the etiology of any chronic disability found and any UI manifested by objective indicators or signs or symptoms found, including whether it is at least as likely as not that such disorders and UI's are related to incidents during the PGW. The examiners should support the opinions by discussing medical principles as applied to the specific evidence in the veteran's case. In order to assist the examiners in providing the requested information, the claims folder must be made available to them and reviewed prior to the examinations. 3. The RO must review the claims file and ensure that all notification and development action required by the VCAA is completed. In particular, the RO should ensure that the new notification requirements and development procedures contained in the VCAA and the regulatory revisions in 66 Fed. Reg. 45620 (Aug. 29, 2001) (to be codified as amended at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, and 3.326(a)) are completed. 4. After the above, the RO should review the veteran's claims for service connection for the various disabilities based on the merits. If action remains adverse to the veteran, an appropriate supplemental statement of the case should be sent to him. He should be afforded the opportunity to respond to the supplemental statement of the case before the file is returned to the Board. The veteran has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West Supp. 2002) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44- 8.45 and 38.02-38.03. J. E. Day Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2001).