Citation Nr: 0325281 Decision Date: 09/26/03 Archive Date: 10/02/03 DOCKET NO. 00-23 178 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a right ankle disability, claimed as arthritis of the right ankle, as secondary to a stingray sting. 2. Entitlement to service connection for a right ankle disability, diagnosed as traumatic arthritis to the medial malleolus with tenosynovitis, as secondary to a stingray sting. 3. Entitlement to service connection for residuals of dental trauma. 4. Entitlement to an increased evaluation for a residual scarring of the right ankle, currently rated as 10 percent disabling. REPRESENTATION Appellant represented by: American Red Cross WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. L. Wight, Counsel INTRODUCTION The veteran served on active duty from July 1959 to July 1963. This case initially came before the Board of Veterans' Appeals (Board) by means of an October 2000 rating decision rendered by the Jackson, Mississippi, Regional Office (RO) of the Department of Veterans Affairs (VA). In July 2002, the Board remanded the case to the RO so that a personal hearing could be scheduled. However, the veteran had indicated that he did not desire a personal hearing. FINDINGS OF FACT 1. VA has made all reasonable efforts to assist the veteran in the development of his claim and has notified him of the information and evidence necessary to substantiate his claim. 2. The veteran's claim of entitlement to service connection for right ankle arthritis was denied by a March 1980 Board decision. 3. Evidence submitted since March 1980 bears directly and substantially upon the claim of service connection for a right ankle disability, is not cumulative or redundant, and is so significant that it must be considered in order to fairly decide the merits of the claim. 4. The veteran is diagnosed with traumatic arthritis to the medial malleolus with tenosynovitis of the right ankle which has been medically attributed to his in-service stingray sting. 5. The veteran's stingray sting resulted in two residual scars, an entrance wound scar and an exit wound scar approximately 11/2 inches above the entrance wound scar on the medial aspect of the right ankle. 6. The veteran's residual scars do not result in limitation of function of the body part affected by the scars. CONCLUSIONS OF LAW 1. The Board decision in March 1980 denying the veteran's claim for service connection for arthritis of the right ankle is final. 38 U.S.C.A. § 7104 (West 2002); 38 C.F.R. § 20.1104 (2002). 2. Evidence received since the March 1980 denial of service connection for arthritis of the right ankle is new and material, and the veteran's claim is reopened. 38 U.S.C.A. § 5108 (West 2002); 38 C.F.R. § 3.156(a) (2002). 3. Traumatic arthritis to the right medial malleolus with tenosynovitis of the right ankle was incurred during active military service. 38 U.S.C.A. §§ 1110, 1112, 1113, 1153 (West 2002); 38 C.F.R. §§ 3.303, 3.304, (2002). 4. A disability rating in excess of 10 percent for scarring of the right ankle is not warranted. 38 U.S.C.A. §§ 1155, 5107 (West 2002); 38 C.F.R. Part 4, § 4.118 Diagnostic Codes 7804, 7805 (2002); 67 Fed. Reg. 49590, 49596 (July 31, 2002). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS At the outset, the Board must consider the impact of the Veterans Claims Assistance Act of 2000 (VCAA) on the veteran's claims. 38 U.S.C.A. §§ 5100, 5102-5103A, 5106, 5126 (West 2002). The law provides that VA has a duty to assist veterans and other claimants in developing their claims for VA benefits. The Board notes that the veteran's application for the benefit at issue is complete. The VCAA provides that upon receipt of an application for VA benefits, VA shall notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, not previously provided that is necessary to substantiate the claim. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159(b). VA must inform the veteran whether he or VA bears the burden of producing or obtaining that evidence or information. 38 U.S.C.A. § 5103(a) (West Supp. 2002); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). By various correspondence from the RO as well as Statements of the Case issued during the course of the appeal, the veteran was informed of the provisions of the VCAA including VA's duty to notify him about his claim and its duty to assist him in obtaining evidence for his claim. He was also informed of the evidence necessary to establish entitlement to benefits sought, what VA had done to help him with his claim, what evidence was still needed from the veteran, and what the veteran could do to help with his claim. In particular, by letter dated in November 2001, the veteran was informed of what specific evidence was needed to substantiate his claim, he was told what information was needed to reopen his claim, and where to submit the information. He was also informed of what VA had done to assist him with his claim. Accordingly, the Board finds that the duty to inform the veteran of required evidence to substantiate his claim has been satisfied. 38 U.S.C.A. § 5103(a). The duty to assist requires VA to make "reasonable efforts to obtain relevant records (including private records)." 38 U.S.C.A. § 5103A. The veteran's service medical records and post service VA medical records are presently associated with the claims folder. The record does not show, nor has the veteran identified, the existence of any pertinent evidence that has not been associated with the claims folder. Accordingly, the Board finds that VA's duty to assist the claimant in obtaining pertinent medical records is satisfied. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159 (2002). The duty to assist also requires a medical examination or opinion when necessary to make a decision on the claim. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159(c)(4). In this regard, the veteran was afforded examinations for compensation and pension purposes during the course of his appeal. These examination reports along with the other evidence of record are sufficient to decide the veteran's claim. Accordingly, the Board finds that further remand of this matter for a medical opinion or examination is not warranted. 38 U.S.C.A. § 5103A(d)(1). VA has completed all development of this claim that is possible without further input by the appellant. The appellant has been duly notified of what is needed to establish entitlement to the benefits sought, what the VA has done and/or was unable to accomplish, and what evidence/information he can obtain/submit himself. Accordingly, the Board finds that the requirements set forth in the VCAA with regard to notice and development of the appellant's claim, have been satisfied, and that returning the case to the RO to consider the requirements of VCAA would serve no useful purpose, but would needlessly delay appellate review. Evidentiary Background: Service medical records dated in July 1962 show that the veteran was stung by a stingray while swimming. The stinger was removed and the resulting wound was cleaned. By rating action dated in October 1978, the RO denied service connection for a right ankle condition and residuals of a stingray bite as these conditions were not noted at the time of the veteran's discharge from active duty. The veteran was notified of this decision by letter dated in October 1978. Thereafter, the veteran filed a notice of disagreement of the denial of service connection for residuals of a sting from a stingray. The veteran reported that the stingray's stinger entered into the soft tissue of his ankle and moved upward before chipping bone causing a hairline fracture before exiting. He indicated that his scars were appropriately one half inch in diameter. A Statement of the Case (SOC) was subsequently issued and the veteran filed a substantive appeal to the Board. At a hearing in February 1979, the veteran reported that the sting from the stingray resulted in residual disability and that the stinger went through his boot. He reported that x- rays showed residuals of a fracture to the ankle bone. He received treatment at the aid station one time with no subsequent treatment. He reported that the area of the sting remained painful. The veteran acknowledged that no physician had diagnosed him with arthritis. The veteran was afforded an examination in June 1979. He reported a history of a hairline fracture of the right medial malleolus due to a through and through puncture caused by the stinger of a stingray. He reported pain in the area. The examiner noted a 1/4 inch entry scar and a 1/4 inch exit scar approximately 11/2 inch apart. The wounds were noted to be well healed. X-ray findings of the right ankle were negative for residuals of his stingray injury. By rating action dated in August 1979, the RO awarded service connection for residual scarring of the right ankle secondary to a stingray sting. A noncompensable evaluation was assigned. In March 1980, the Board denied service connection for various disabilities. Service connection was denied for traumatic arthritis of the right ankle as the evidence did not show that the veteran had the claimed disability. At a VA compensation and pension examination in June 1979, the examiner noted that the veteran had a 1/8 inch by 1/4 inch well healed circular entrance wound scar on the medial aspect of the right ankle. There was also a 1/4 inch by 1/2 inch exit wound scar. The scars were slightly discolored with small areas of reddish speckled discoloration. There was no drainage. The scars were slightly tender to direct palpation, but there was no inflammation or edema. There was no deformity of the ankle and no pain on weight bearing. Assessment was normal ankle examination. By rating action dated in January 1981, an increased rating of 10 percent was assigned for the veteran's scarring of he right ankle. The veteran was afforded a July 1982 VA examination. He complained of nonhealing painful scars of his right ankle. The examiner noted two scars posterior to the medial malleolus measuring .25 and .37cm respectively. They were slightly tender with slight depression on the larger scar. The scarring was not inflamed. The veteran reported that the scars ulcerated five to six times per year lasting two to three weeks. In July 2000, the veteran sought to reopen his claim for traumatic arthritis of the right ankle secondary to an in- service stingray sting. He also sought service connection for his teeth being knocked out during service. The veteran was afforded an August 2000 VA examination. He reported increased sensitivity over both the entrance and exit scars as well as chronic dermatitis associated with both areas with some numbness to the skin over these areas and pain over the medial malleolus posteriorly with inversion of the ankle. On examination, there were two small flat scars posterior to the right medial malleolus. There were some abrasions to the skin over both areas secondary to the veteran scratching the area. There was tenderness beneath the scar area in both the penetration as well as the exit area. There was complaint of pain to the posterior aspect of the medial malleolus. Range of motion of the foot was 15 degrees of dorsal flexion and 30 degrees of ventral flexion. The ankle was stable. While the examiner noted an impression of tender scars to the left ankle with associated chronic tenosynovitis to the medial aspect of the left ankle, it appears that the impression contains a typographic error as the stated clinical findings in the examination report show examination and complaint of the right ankle rather than the left ankle. Similarly, X-ray examination of the right ankle revealed no soft tissue swelling. There was a small corticated ossific density projecting adjacent to the lateral malleolus. Most likely, this finding was related to an old fracture or normal variation. The ankle joint was well maintained and no definite acute abnormalities were seen. In October 2000, the RO issued a rating action which denied an increased rating for the veteran's service-connected scars of the right ankle and service connection for residuals of dental trauma. Additionally, the RO held that new and material evidence had not been submitted to reopen a previously disallowed claim of service connection for traumatic arthritis of the right ankle secondary to a stingray sting. The veteran perfected an appeal of the issues of an increased rating for his service connection right ankle scarring and the determination that new and material evidence had not been submitted to reopen a claim of service connection for traumatic arthritis of the right ankle. In a statement dated in October 2001, the veteran expressed a belief that each of his scars of the right ankle should be afforded a 10 percent disability rating. The veteran testified at a hearing before a RO hearing officer in November 2002. He reiterated his contentions that he sustained a right ankle injury that he identified as arthritis. He also felt that separation disability evaluation were warranted for each of his right ankle scars. The veteran was afforded a VA examination in December 2002. He reported his present residual symptoms of the stingray sting as tenderness to both scars with easy irritation from socks with continual ambulation, and pain in the medial aspect of the right ankle with persistent walking or jogging. Physical examination revealed two circular scars on the medial aspect of the ankle. One was approximately 1/4 inch in diameter and the other was approximately 3/8 inch in diameter. The scars were red with no scabbing or ulceration. They were sensitive to touch. There was very slight depression to both scars, but no adherence to underlying tissues. There was some deformity to the posterior aspect of the medial malleolus with tenderness to palpation. X-ray evidence revealed evidence of old traumatic changes. These radiographic findings were consistent with the veteran's in- service injury. There was slight swelling to the posterior aspect of the malleolus with tenderness. Range of motion of the right ankle was 10 degrees of dorsal flexion; 25 degrees of plantar flexion; and 30 degrees of pronation. There was pain with manipulation of the ankle in all ranges of motion. The pain was more pronounced with the veteran trying to stand on the forefoot. An impression of residuals of stingray injury to the left ankle with tender scars and traumatic arthritis to the medial malleolus. However, the impression appears to contain a typographic error as the stated history and clinical findings in the examination report show examination and complaint of the right ankle. Claim for Service Connection for a Right Ankle Disability: Prior decisions of the Board and unappealed decisions of the RO are final and may be reopened only upon receipt of additional evidence which, under applicable statutory and regulatory provisions, is both new and material so as to warrant revision of the previous decision. 38 U.S.C.A. §§ 5108, 7104, 7105 (West 2002); 38 C.F.R. §§ 20.302, 20.1103 (2002). When presented with a claim to reopen a previously finally denied claim, first it must be determined whether the evidence submitted by the claimant is new and material and, if so, the VA will then evaluate the merits of the claim after ensuring that the duty to assist has been fulfilled. Elkins v. West, 12 Vet. App. 209 (1999). "New" evidence means more than evidence that has not previously been included in the claims folder, and must be more than merely cumulative, in that it presents new information. Colvin v. Derwinski, 1 Vet. App. 171 (1990); Evans v. Brown, 9 Vet. App. 273, 284 (1996) (the question of what constitutes new and material evidence requires referral only to the most recent final disallowance of a claim). In addition, the evidence, even if new, must be material, in that it is evidence not previously of record that bears "directly and substantially upon the specific matter under consideration, which is neither cumulative nor redundant, and which by itself or in connection with evidence previously assembled is so significant that it must be considered in order to fairly decide the merits of the claim." 38 C.F.R. § 3.156(a); see Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). In determining whether evidence is new and material, the credibility of the evidence is generally presumed. Justus v. Principi, 3 Vet. App. 510, 512-513 (1992). However, this presumption of credibility is not unlimited. The Court has subsequently held that the Justus credibility rule is not "boundless or blind;" if the newly submitted evidence is "inherently false or untrue," the Justus credibility rule does not apply. Duran v. Brown, 7 Vet. App. 216 (1994). The Board notes that new VA regulations have been promulgated pertaining to the adjudication of claims to reopen finally denied claims by the submission of new and material evidence. See 38 U.S.C.A. § 5108; 66 Fed. Reg. 45,630 (Aug. 29, 2001) (to be codified as amended at 38 C.F.R. § 3.156(a)). These changes are prospective for claims filed on or after August 29, 2001, and are, accordingly, not applicable in the present case. Service connection may be established for a current disability in several ways including on a "direct" basis. 38 U.S.C.A. §§ 101(16), 1110 (West 2002); 38 C.F.R. §§ 3.303(a), 3.304 (2002). Direct service connection may be established for a disability resulting from diseases or injuries which are clearly present in service or for a disease diagnosed after discharge from service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(a), (b), (d) (2002). In addition, service connection may be established on secondary basis if the claimed disability is due to or the result of a service connected disease or injury. 38 C.F.R. § 3.310 (2002). In the instant case, the Board finds that new and material evidence has been submitted to reopen the veteran's claim of entitlement to service connection for a right ankle disability, other than scarring, as a residual of a stingray sting. In particular, the Board notes that the prior Board decision denied service connection for a right ankle disability, specifically arthritis, as the evidence did not show that the veteran had the claimed disability. Since the prior denial of service connection, a VA physician has diagnosed the veteran with residuals of stingray injury to the ankle with tender scars and traumatic arthritis to the medial malleolus. This information is "new" as it was not on file at the time of the last prior denial. This new evidence is also material as this testimony specifically addresses the question of whether the veteran has a present right ankle disability as a result of the in- service stingray sting. This evidence bears directly and substantially upon the specific matter under consideration, is not cumulative or redundant of information previously considered, and is so significant that it must be considered in order to fairly decide the merits of the claim. Consequently, the Board finds that new and material evidence to reopen the veteran's claim has been submitted. 38 C.F.R. § 3.156(a). Having reopened the appellant's claim of entitlement to service connection for a right ankle disability, it is now incumbent upon VA to consider his claim on the merits. As indicated above, the veteran claims that he has a present right ankle disability as a result of his in-service stingray sting. This contention is supported by the clinical evidence. In this regard, the Board notes that a VA examiner diagnosed him with chronic tenosynovitis of the right ankle in August 2000. Similarly, in December 2002, a VA examiner diagnosed residuals a stingray injury to the right ankle with tender scars and traumatic arthritis to the medial malleolus. Based on the foregoing, the Board finds that the evidence shows that the veteran's has a residual right ankle disability, other than scars, as a result of his in-service stingray sting. Accordingly, a grant of service connection for traumatic arthritis to the right medial malleolus with tenosynovitis of the right ankle secondary to a sting from a stingray is in order. Increased Rating for Right Ankle Scars: Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155; 38 C.F.R. Part 4 (2002). The percentage ratings in the Schedule for Rating Disabilities represent, as far as can practicably be determined, the average impairment in earning capacity resulting from such disabilities and their residual conditions in civil occupations. 38 C.F.R. § 4.1 (2002). Moreover, each disability must be considered from the point of view of the veteran working or seeking work. 38 C.F.R. § 4.2 (2002). Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2002). The terms "mild," "moderate," and "severe" are not defined in the Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are "equitable and just." 38 C.F.R. § 4.6 (2002). It should also be noted that use of terminology such as "mild" or "moderate" by VA examiners and others, although an element of evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6 (2002). The veteran's residual scarring from the stingray injury is presently evaluated as 10 percent disabling under Diagnostic Code 7804. 38 C.F.R. § 4.118. Under the current version of these diagnostic criteria, a 10 percent disability evaluation is warranted for superficial scars that are painful on examination. A superficial scar is defined as a scar that is not associated with underlying soft tissue damage. The veteran filed his claim for an increased rating in July 2000. The criteria for evaluation of skin disorders were amended during the pendency of the veteran's appeal, effective August 30, 2002. See 67 Fed. Reg. 49590, 49596 (July 31, 2002). Those rating criteria are substantially different from the previous criteria. Pursuant to the criteria in effect prior to August 30, 2002, the Schedule provided for a 10 percent disability rating for scars that are superficial, tender and painful on objective demonstration. A rating in excess of 10 percent is not provided for under these criteria. Under Diagnostic Code 7805, scars are to be rated as limitation of function of part affected. This diagnostic code has not been amended during this appeal. The United States Court of Appeals for Veterans Claims, formerly the United States Court of Veterans Appeals, (Court) has held that for the purpose of appeals, where the law or regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the version most favorable to the appellant should be applied unless provided otherwise by statute. Karnas v. Derwinski, 1 Vet. App. 308, 312-313 (1991). Similarly, VA General Counsel has held that when a provision of the Rating Schedule is amended while a claim for an increased rating under that provision is pending, VA should first determine whether the amended regulation is more favorable to the claimant. VAOPGCPREC 3-00 (April 10, 2000). It may be necessary to separately apply the pre-amendment and post-amendment version of the regulation to the facts of the case in order to determine which provision is more favorable to the appellant, unless it is clear from a facial comparison of both versions that one version is more favorable. Id. With respect to the veteran's claim for an increased rating for his service-connected scarring of the right ankle, it is unclear from a facial comparison of both versions of the regulation, that one version is more favorable to the veteran. Therefore, the Board will evaluate the veteran's symptomatology pursuant to both the criteria in effect prior to August 30, 2002, and the criteria in effect subsequent to that date, to determine which may be more favorable to the veteran. The objective medical evidence, set forth above, shows that the veteran's in-service stingray sting resulted in residual scarring that is shown to be painful and sensitive to touch on objective examination. In light of the forgoing, the Board finds that the 10 percent disability evaluations presently assigned for scarring is appropriate under either the current or former version of Diagnostic Code 7804. A rating in excess of 10 percent is not warranted for this residual scarring as the evidence does not show that either the entrance or exit scar results in limitation of the function of his right ankle. While the veteran is shown to have painful motion of his ankle with slight swelling and tenderness of the malleolus, the most recent VA examination report dated in December 2002 indicates that this was attributable to his traumatic arthritis of the medial malleolus rather than his scars. Similarly, the August 2000 examination report indicates that the veteran had chronic tenosynovitis of the right ankle. The Board notes the veteran's contention that separate disability ratings are warranted for each scar. In this regard, the Board notes that the rating schedule provides that scars in widely separated areas, as on two or more extremities or on anterior and posterior surfaces of extremities or trunk, will be separately rated and combined. See 38 C.F.R. § 4.118, Diagnostic Code 7801, Note (1), and Diagnostic Code 7802, Note (1) (effective August 20, 2002); cf. 38 C.F.R. § 4.118, Diagnostic Code 7801, Note (2), and Diagnostic Code 7802, Note (as in effect prior to August 30, 2002). The Board finds that the veteran's entrance and exit wound scars are not located in "widely separated areas" as they are located less than two inches apart on the right ankle. Additionally, these scars are not located on opposite sides of the veteran's ankle; rather, both scars are located on the medial aspect of the ankle. Accordingly, the Board finds that separate disabilities ratings are not warranted for each residual scar. Accordingly, the Board finds that a rating in excess of 10 percent is not warranted for the veteran's residual scarring of the right ankle as a result of his in-service stingray sting. 38 U.S.C.A. §§ 1155, 5107 (West 2002); 38 C.F.R. Part 4, § 4.118 Diagnostic Codes 7804, 7805 (2002); 67 Fed. Reg. 49590, 49596 (July 31, 2002). ORDER New and material evidence has been submitted to reopen a claim of entitlement to service connection for traumatic arthritis of the right ankle. Service connection for traumatic arthritis of the right medial malleolus with tenosynovitis of the right ankle is granted. A rating in excess of 10 percent for residual scarring of the right ankle as a result of the in-service stingray sting is denied. REMAND In July 2001, the veteran submitted a statement wherein he requested service connection for dental trauma. He reported that he had two teeth knocked out during training while on active duty. According to the veteran, he was hit with a fighting stick and two teeth were knocked out. In September 2001, the RO denied service connection for dental trauma for treatment purposes. In a statement received dated in July 2002, the veteran expressed disagreement with the denial of service connection for dental trauma. He stated that he wished an explanation for the denial of service connection contending that his medical records clearly showed the injury. Under pertinent VA regulations, a written communication from a claimant or his or her representative expressing dissatisfaction or disagreement with an adjudicative determination by the agency of original jurisdiction and a desire to contest the result will constitute a Notice of Disagreement (NOD). While special wording is not required, the NOD must be in terms which can be reasonably construed as disagreement with that determination and a desire for appellate review. 38 C.F.R. § 20.201 (2002). The Board finds that the veteran's July 2002 statement constitutes a NOD to the September 2001 rating which denied the service connection for dental trauma. Under the Court's holding in Manlincon v. West, 12 Vet. App. 238 (1999), the aforementioned initiates review by the Board of the RO's September 2001 decision. Accordingly, this issue must be remanded to have the RO issue a Statement of the Case regarding this claim. Based on the foregoing discussion, this case is REMANDED for the following development: The RO should furnish to the veteran and his representative a Statement of the Case addressing the issue of entitlement to service connection for dental trauma. This Statement of the Case should summarize the law and evidence relied on in the determination of his claim. The RO should also inform the appellant of his appellate rights with respect to his claim. The purpose of this REMAND is to satisfy due process concerns. No inference should be drawn regarding the final disposition of this claim. 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 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. ______________________________________________ GARY L. GICK Veterans Law Judge, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.