Citation Nr: 0121435 Decision Date: 08/23/01 Archive Date: 08/29/01 DOCKET NO. 94-23 692 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim of service connection for post-traumatic stress disorder (PTSD). 2. Whether new and material evidence has been submitted to reopen a claim of service connection for an acquired psychiatric disorder other than PTSD. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARINGS ON APPEAL Appellant ATTORNEY FOR THE BOARD Neil T. Werner, Counsel INTRODUCTION The veteran served on active duty from September 1970 to June 1972. The question of entitlement to service connection for a psychiatric disorder-to include PTSD--previously has been considered and denied. In August 1978, the RO denied a claim of service connection for an acquired psychiatric disorder. Thereafter, in March the RO denied a claim for service connection for an acquired psychiatric disorder and, in December 1981, denied service connection for PTSD. And, in September 1984, the Board denied the veteran's appeal of a January 1982 RO decision that had denied service connection for an acquired psychiatric disorder. This appeal comes before the Board of Veterans' Appeals (Board) from a December 1993 decision that denied the veteran's application to reopen a claim of service connection for an acquired psychiatric disorder, to include PTSD. In August 1996 and May 1998, the Board remanded the issue. For reasons explained below, the Board has recharacterized the appeal as involving the two separate issues listed on the cover page of the decision. The Board notes that, most recently, in May 2001, the RO characterized the claim simply as "service connection for post-traumatic stress disorder," which indicates that the claim was reopened. The Board emphasizes, however, that the question of whether a previously denied claim should be reopened is a jurisdictional matter that must be addressed before the Board may consider the underlying claims. See Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). Hence, regardless of the RO's actions, the Board must initially address the question of whether "new and material" evidence has been presented. Once the Board finds that no such evidence has been offered, that is where the analysis must end, and what the RO may have determined in this regard is irrelevant. Barnett, 83 F.3d at 1383. The Board's decision on the issue petition to reopen the claim for service connection for PTSD is set forth below, whereas the issue of whether new and material evidence has been submitted to reopen a claim for service connection for an acquired psychiatric disorder other than PTSD is addressed in the remand following the decision. FINDINGS OF FACT 1. In December 1981, the RO denied service connection for PTSD, and the Board most recently denied service connection for an acquired psychiatric disorder in September 1984; there was then no evidence of a diagnosis of PTSD of record. 2. New evidence submitted since the RO's December 1981 denial and the Board's September 1984 denial-specifically, which reflects diagnoses of PTSD relating to military service-is so significant that it must be considered in order to fairly decide the merits of the claim of service connection for PTSD. 3. Although the evidence demonstrates that the veteran served in the infantry in service, and that his unit performed combat support functions in Vietnam, there is no evidence that he "engaged in combat with the enemy." 4. None of the veteran's claimed in-service stressful experiences in Vietnam have been corroborated by supporting evidence. CONCLUSIONS OF LAW 1. The RO's December 1981 denial of service connection for PTSD, and the Board's September 1984 decision denying service connection for an acquired psychiatric disorder are final. 38 U.S.C.A. §§ 7104, 7105 (West 1991); 38 C.F.R. §§ 3.104, 20.302, 20.1100, 20.1103 (2000). 2. Since the last prior final denials of the claim, new and material evidence to reopen the claim for service connection for PTSD has been submitted. 38 U.S.C.A. §§ 5108, 7105 (West 1991& Supp. 2000); 38 C.F.R. § 3.156 (2000). 3. The criteria for service connection for PTSD have not been met. 38 U.S.C.A. §§ 1110, 5107 (West 1991 & Supp. 2001); 38 C.F.R. §§ 3.303, 3.304(f) (2000). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS A. New and Material Evidence A grant of service connection for PTSD requires a diagnosis of the condition, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f) (2000). In connection with the current appeal, the veteran now contends that he has PTSD as a result of his service in the Republic of Vietnam. However, service connection for an acquired psychiatric disorder-to specifically include PTSD- previously has been considered and denied. In August 1978, the RO denied a claim of service connection for an acquired psychiatric disorder. Thereafter, in March the RO denied a claim for service connection for an acquired psychiatric disorder and, in December 1981, denied service connection for PTSD. And, in September 1984, the Board denied the veteran's appeal of a January 1982 RO decision that had denied service connection for an acquired psychiatric disorder. The veteran did not appeal the December 1981 denial of service connection for PTSD. Hence, that decision is final. See 38 U.S.C.A. § 7105; 38 C.F.R. §§ 3.104, 20.302, 20.1103. Likewise, the veteran has not requested reconsideration of the Board's September 1984 denial of service connection for any acquired psychiatric disorder (which, would appear to include, by implication, PTSD), and no other exception to finality applies. Hence, that decision is also final. See 38 U.S.C.A. § 7104; 38 C.F.R. § 20.1100. Given the prior final denials, the veteran's current claim for service connection for PTSD may now be considered only if new and material evidence has been associated with the claims file since those denials. See 38 U.S.C.A. §§ 5108, 7104; 38 C.F.R. § 3.156; Hodge v. West, 155 F.3d 1356 (Fed.Cir. 1998). "New and material evidence" is defined, by regulation as follows: New and material evidence means evidence not previously submitted to agency decision makers which 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) (2000) (Emphasis added). For the purpose of determining whether new and material evidence has been submitted, the credibility of the evidence is to be presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). Moreover, the evidence to be considered is that added to the record since the last final denial on any basis. Evans v. Brown, 9 Vet. App. 273 (1996). Using these guidelines, the Board has compared the evidence of record at the time of the RO's December 1981 decision and the Board's September 1984 denial. Board decision, and the additional evidence subsequently associated with the claims file. Evidence previously included service medical records, private medical records and letters, dated from March 1978 to November 1981, VA examination reports, dated in August 1980 and November 1981, eight lay statements dated in July 1982, one lay statement dated in March 1983, numerous written statements from the veteran, and testimony at a November 1983 personal hearing. While the medical records show the veteran's complaints and/or treatment for a number of psychiatric disorders variously diagnosed (including schizophrenia, psychoses, and drug and alcohol addiction) they were negative for complaints or treatment for a psychiatric disorder diagnosed as PTSD or an opinion relating a PTSD to military service. The Board notes that, while the record at that time included a July 1981 letter from the Mental Health Clinic in Flint, Michigan (hereinafter "Flint MHC"), that reported that the veteran ". . . is suffering from chronic anguish related to Post Traumatic Stress Disorder," it did not provide VA with a clear diagnosis of PTSD; it only reported that the veteran had PTSD like symptoms. Likewise, the letter did not provide a clear opinion that the veteran's current psychiatric disorder was related to his in-service experiences. Evidence subsequently associated with the claims file includes medical records that show, for the first time, complaints and/or treatment for adverse symptomology specifically diagnosed as PTSD, beginning in January 1991. See private treatment records from Genesee County Community Mental Health Services dated in January 1991, November 1992, September 1993, and October 1993; psychiatric evaluation from Dr. R. Kilaru, Psychiatrist, dated in March 1994; letter from David W. K. Lee, M.D., dated in June 1994; private treatment records from the Psychiatric Consultation Center, dated in February 1995; letter from Richard L. Weiss, Ph.D., L.P.C., dated in November 1995; private psychiatric evaluation dated in July 1996; VA examination dated in June 1997; Social Security Administration (SSA) examinations dated in May 1991, May 2000, and July 2000; and records from Ability Management Association dated in January and February 2001. The record also contains, for the first time, medical opinions that appear to relate the veteran's PTSD to some of the experiences the veteran claim took place while in military service. See June 1994 letter from Dr. Lee; February 1995 treatment record from the Psychiatric Consultation Center, November 1995 letter from Dr. Weiss; July 1996 private psychiatric evaluation; June 1997 VA examination report; July 2000 SSA examination; and January and February 2001 records from Ability Management Association. In short, the evidence previously of record did not contain a confirmed diagnosis of PTSD or any medical opinion relating the veteran's PTSD to some of the experiences the veteran claimed took place while in military service. Since the prior denials referred to above, additional medical records have been received reflecting both diagnoses of PTSD and medical evidence suggesting a relationship between such condition and the veteran's military service. The Board finds that the newly received medical evidence is new and material as defined by regulation. See 38 C.F.R. § 3.156(a). In other words, such evidence bears directly and substantially upon the issue at hand, and is neither duplicative nor cumulative. Moreover, as the evidence demonstrates post-service complaints and treatment for a psychiatric disorder diagnosed as PTSD that were not previously shown, as well as a nexus opinion, this newly received evidence is so significant that it must be considered in order to decide fairly the merits of the underlying claim. Id. The Board concludes that the veteran has submitted new and material evidence to reopen the claim of service connection for PTSD, and the claim is hereby reopened. Hence, the claim for service connection must be considered on the merits. B. Merits Consideration At the outset, the Board notes that, because the RO has adjudicated the claim for service connection for PTSD on a de novo basis, there is no prejudice to the veteran in proceeding to a merits consideration of that claim. As a further preliminary matter, the Board finds that a remand of the claim for service connection for PTSD for additional development is not warranted. In this regard, the Board acknowledges that, on November 9, 2000 (during the pendency of this appeal), the President signed into law the Veterans Claims Assistance Act of 2000, which contains revised notice provisions, and additional requirements pertaining to VA's duty to assist. See Pub. L. No. 106-475, §§ 3-4, 114 Stat. 2096, 2096-2099 (2000) (codified, as amended, at 38 U.S.C. §§ 5102, 5103, 5103A, and 5107 (West Supp. 2001). The new law applies to all claims filed on or after the date of the law's enactment, as well as to claims filed before the date of the law's enactment, and not yet finally adjudicated as of that date. See Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475, § 7, subpart (a), 114 Stat. 2096, 2099-2100 (2000); VAOPGCPREC 11-2000 (Nov. 27, 2000). However, the Board concludes that the new law does not preclude it from proceeding to an adjudication of the veteran's claim for service connection because the requirements of the new law have been satisfied. By the RO rating decision on appeal, the Statement of the Case (SOC), and the Supplemental Statements of the Case (SSOC) furnished the veteran and his representative, the RO has provided notice of the information and evidence necessary to substantiate his claim. Significantly, in the May 2001 SSOC, the RO cited specific provisions of the new law, and invited the veteran to inform it of any additional evidence or information that he wanted the RO to obtain for him; the veteran indicated that he had nothing further to add about the issue. In connection with the issue on appeal, pertinent medical evidence (to including diagnoses of PTSD and medical opinion that appears to relate PTSD to the veteran's military service) has been associated with the claims file, and there is no indication that there is any outstanding evidence that is necessary for an equitable adjudication of the issue on appeal. Finally, the veteran has had an opportunity to testify at a hearing on appeal, and, as addressed below, the RO has undertaken appropriate development in an attempt to verify the veteran's alleged combat service and/or the occurrence of specific in-service stressful experiences that he claims have culminated in a diagnosis of PTSD. Under these circumstances, the Board finds that the claim is ready to be considered on the merits. The veteran contends that he has PTSD that is attributable to stressful events he experienced while stationed off the waters of the Republic of Vietnam on the USS Iwo Jima and USS New Orleans during 1971. In support of his claim that he experienced such events, he provided written statements, a history at VA examinations and in private medical records, and his testimony at personal hearings. Specifically, the veteran reported that during 1971, he was assigned to a Battalion Landing Team aboard Helicopter Landing Ships off of the coast of the Republic of Vietnam. Next, he reported that he participated in either two or three helicopter assaults from his ship into the Republic of Vietnam and that during those times he and his fellow Marines were armed and were charged with security for the helicopter landing areas. Moreover, the veteran reported that on one occasion, he and a friend named "[redacted]" (a/k/a " [redacted] [redacted]," a/k/a " [redacted]") were getting water when "[redacted]" stepped on a land mine approximately 60 yards from where he was standing, was blown-up, and either badly wounded of killed. On another occasion, the veteran reported that he remembered being splashed with blood and bone when a soldier he was with was struck by enemy gunfire while they were running to get on board a helicopter. On yet other occasions, the veteran reported being out on patrols and entering villages where he would hear children crying. The veteran also reported another incident, possible while in training in the Philippines, when he saw a soldier accidentally shot in the chest while changing the barrel of a M50 machine gun. While the actual time the veteran spent in the Republic of Vietnam varied (10 minutes (see November 1983 personal hearing) and three months (see October 1994 personal hearing)) and the number of helicopter assaults he participated in also varied (either three (see VA Form 9) or 2 (see April 2001 personal hearing)), nonetheless he indicated that he participated in several helicopter assaults which took place from May 1, 1971, to May 2, 1971, May 20, 1971, to May 22, 1971, and from June 24, 1971, to June 26, 1971. As indicated above, a grant of service connection for PTSD requires a diagnosis of the condition, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f) (2000). The Board acknowledges that the record includes diagnoses of PTSD which appear to be medically related to the veteran's military service (see June 1994 letter from Dr. Lee; February 1995 treatment record from the Psychiatric Consultation Center, November 1995 letter from Dr. Weiss, a July 1996 private psychiatric evaluation; June 1997 VA examination report; July 2000 SSA examination; and January and February 2001 records from Ability Management Association). Assuming, for the sake of analysis, that this evidence satisfies the first criterion of section 3.304(f), the question remains as to as to whether there is credible evidence that the claimed in-service stressor(s) (which, by implication, underlie(s) the diagnosis of PTSD) actually occurred, the second criterion under section 3.304(f). The evidence necessary to establish the occurrence of a recognizable stressor during service to support a diagnosis of PTSD will vary depending upon whether the veteran engaged in "combat with the enemy." The Court has repeatedly instructed that VA must make a specific finding as to whether the veteran engaged in combat. See Gaines v. West, 11 Vet. App. 353, 359 (1998); Cohen, 10 Vet. App. at 145; Zarycki, 6 Vet. App. at 98. Participation in combat, a determination that is to be made on a case by case basis, requires that the veteran have personally participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality. See VAOPGCPREC 12-99 (October 18, 1999). If VA determines that the veteran engaged in combat with the enemy and his alleged stressor is combat-related, then the veteran's lay testimony or statement is accepted as conclusive evidence of the stressor's occurrence and no further development or corroborative evidence is required, providing that such testimony is found to be "satisfactory," i.e., credible, and "consistent with the circumstances, conditions, or hardships of service." See 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. 3.304(f) (1995); Cohen v. Brown, 10 Vet. App. 128, 146-47 (1997); Zarycki v. Brown, 6 Vet. App. 91, 98 (1993). If, however, VA determines either that the veteran did not engage in combat with the enemy or that the veteran did engage in combat, but that the alleged stressor is not combat related, the veteran's lay testimony, by itself, is not sufficient to establish the occurrence of the alleged stressor. Instead, the record must contain service records that corroborate the veteran's testimony or statements. See Cohen, 10 Vet. App. at 147; Zarycki, 6 Vet. App. at 98. The veteran's DD Form 214 and copies of some of his personnel records reveal that his military occupational specialty (MOS) was infantryman. Such an MOS is, traditionally, associated with combat service. In this case, however, the evidence indicates that, while the veteran's unit performed combat support, there is no indication that either the veteran's unit (or the veteran, himself), actually engaged in combat with the enemy. While the veteran has asserted that "Combat Service Code 9" in his service personnel records demonstrate his combat service, these records show only that he was assigned to a Battalion Landing Team aboard Helicopter Landing Ships in 1971. Moreover, despite the veteran's assertions that he was awarded the Combat Action Ribbon, he has not provided any evidence to support such assertions, and the only citations reflected in his military records-the Vietnam Service Medal, National Defense Service Medal, and the Good Conduct Medal-are not indicative of any combat service. Furthermore, there is no evidence establishing the occurrence of any of the veteran's specifically claimed in- service stressful experiences, to include coming under enemy assault, or the deaths of either of the veteran's former service comrades. A NAVMC 118(11) (Administrative Remarks), contains an entry of "Combat Service Code 9." A partial copy of the Marine Corps Manpower Systems Code Manual reported that the above entry indicated that the recipient served less than a six- month tour in the Republic of Vietnam. A NAVMC 118(3) shows that the veteran was assigned to Company D, BLT, 1st Battalion, 9th Marine, 3rd Marine Division from March 1971 to June 1971, to Company D, 1st Battalion, 9th Marine, 3rd Marine Division from July 1971 to September 1971, to "Sub-Unit, One H&S Co[mpany], 1/9" from October 1971 to November 1971, to "H&S Co[mpany], SU 1, 1/9" in early November 1991, and to Company D, 1st Battalion, 9th Marine, 3rd Marine Division, from November 1971 to February 1972. A NAVMC 118(9) (Combat History-Expeditions-Awards Record) reflects the presence of the veteran in the contingent waters of the Republic of Vietnam for four days in May 1971 and for three days in June 1971. Specifically, it shows that the ship the veteran was aboard at these times participated in combat support operations in the contingent waters of the Republic of Vietnam from May 1, 1971, to May 2, 1971, May 20, 1971, to May 22, 1971, and from June 24, 1971, to June 26, 1971. A NAVMC 118(17) (Sea and Air Travel-Embarkation Slips) shows that the veteran embarked on board the USS Iwo Jima in Okinawa on March 11, 1971. He thereafter arrived and disembarked in the Philippines on March 15, 1971. Subsequently, he was aboard the USS Iwo Jima from March 24, 1971, to April 17, 1971. At this time, the veteran both boarded and departed the ship while it was in the Philippines. Similarly, a NAVMC 118(17) shows that the veteran embarked on board the USS New Orleans in Okinawa on May 16, 1971, and thereafter arrived and disembarked in the Philippines on June 1, 1971. He thereafter boarded the USS New Orleans on June 24, 1971, while in the Philippines and departed on June 29, 1971, while in Okinawa. In November 1998, in reply to a request for information to verify the veteran's alleged combat service or specific in- service stressful experiences, 's stressors, the Headquarters United States Marine Corps forwarded battalion command chronologies for the 1st Battalion, 9th Marines (1/9) for May to June 1971. The Board notes that command chronologies reported, among other things, that on May 1, 1971, ships carrying the 1st Battalion, 9th Marines passed through the contiguous waters of the Republic of Vietnam, on May 21, 1971, they conducted training exercises in the waters contiguous to Danang, Republic of Vietnam, and on June 24, 1971, ships carrying the 1st Battalion, 9th Marines passed through the contiguous waters of the Republic of Vietnam. They also report that, from June 3 to June 21, 1971, the 1st Battalion, 9th Marines were engaged in training exercises in the Philippines. These records contain no information to corroborate any of the veteran's claimed in-service stressful experiences. In August 1999, in reply to a requests for information to verify the veteran's claim that a friend named "[redacted]," a/k/a " [redacted]," and a/k/a " [redacted]" had been killed or wounded in action, the Headquarters United States Marine Corps conducted a search of Marine Corps casualty reports from Southeast Asia as well as the Directory of Names on the Vietnam War Memorial and were "unable to identify a [redacted] [redacted], or derivations of than name. . ." as a United States Marine Corps casualty. In July 2000, in reply to a request for ship logs for the USS Iwo Jima for April 30 to May 3, 1971, and for the USS New Orleans for May 19 to May 23, 1971, and from June 23 to June 27, 1991, the Naval Historical Center forwarded copies of the requested deck logs to the RO. Deck logs for the USS Iwo Jima show that from April 30 to May 31, 1971, show, among other things, that from May 1 to May 2, 1971, the ship conducted tactical maneuvers and/or flight operations; on May 20, 1971, the ship was in Danang Harbor, Republic of Vietnam; on May 21, 1971, the ship steamed for the Philippines; on May 22, 1971, the ship was docked in the Philippines; and on May 23, 1971, the ship steamed for Hawaii. Deck logs for the USS New Orleans, dated from May 19 to May 31, 1971, show, among other things, that on May 19, 1971, elements of battalion landing team 1/9 embarked at Okinawa, the ship's destination was the Philippines; from May 20 to May 24, 1971, the shipped steamed from the Philippines to Taiwan with elements of the 1/9 and during that time carried out flight training; from May 24, to May 29, 1971, the ship was moored in a Taiwan harbor; and on May 29, 1971, the ship steamed towards the Philippines with elements of the 1/9 aboard. Moreover, deck logs for that ship dated from June 1 to June 27, 1971, show, among other things, that from June 1 to June 14, 1971, the ship was moored in the Philippines and elements of battalion landing team 1/9 were aboard; from June 14 to June 19, 1971, the ship steamed too and conducted training in a Philippines training area; from June 19, to June 24 1971, the ship was moored in the Philippines; and on June 24, 1971, ship steamed from the Philippines to Okinawa with elements of battalion landing team 1/9 on board. In short, these records confirm that the veteran was on board the USS Iwo Jima from March 11, 1971, to March 15, 1971, and from March 24, 1971, to April 17, 1971, and was aboard the USS New Orleans from May 16, 1971, to June 1, 1971, and from June 24, 1971, to June 29, 1971. Moreover, the RO, using the veteran's description of his stressors, contacted the Headquarters United States Marine Corps and the Naval Historical Center. The records obtained from the Headquarters United States Marine Corps and the Naval Historical Center show that elements of the 1st Battalion, 9th Marines were aboard the USS Iwo Jima in May 1971 and the USS New Orleans during June 1971. The records also show that ships carrying member of the 1st Battalion, 9th Marines were in the waters off the coast of the Republic of Vietnam during May and June 1971 and elements of the 1st Battalion, 9th Marines conducted training in the waters off the coast of the Republic of Vietnam and in the Philippines during May and June 1971. However, while the veteran claimed that he participated in at least two helicopter assaults into the Republic of Vietnam, on one occasion had a friend wounded or killed after stepping on a land mine, on another occasion was splashed with blood when a fellow solder was shot while they were under fire and running to get on board a helicopter, and on yet another occasions saw a soldier shot by accident while in training in the Philippines, nothing in any of the service records, the command chronologies for the 1st Battalion, 9th Marines, the deck logs for the USS Iwo Jima, or the deck logs for the USS New Orleans supports these assertions. Under these circumstances, and despite the RO's efforts to assist the veteran in the development of the claim, and notification of what was needed to support the claim, the Board finds that the record does not support the veteran's assertions that he engaged in combat with the enemy (to which a claimed stressor is related), or establish the occurrence of any of the specifically claimed in-service stressful experiences. There is, thus, no credible evidence to established that the veteran's claimed stressors occurred, a necessary requirement for a grant of service connection for PTSD. See 38 C.F.R. § 3.304(f). Thus, notwithstanding the fact that at least one VA physician and multiple private health professionals have accepted the veteran's description of his in-service experiences as credible and as providing a basis for diagnosing PTSD, VA is not bound by those opinions. See Wood v. Derwinski, 1 Vet. App. 190, 192 (1991). The fact remains that, aside from the question of diagnosis, the explicit regulatory criteria for a grant of service connection are not met, and, on that basis, the claim must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the- doubt doctrine. However, as the preponderance of the evidence is against the veteran's claim, that doctrine is not applicable in the instant appeal. See 38 U.S.C.A § 5107(b) (West Supp. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55- 57 (1991). ORDER New and material evidence has been submitted to reopen the veteran's claim of service connection for PTSD, and, to this extent, the appeal is granted. Service connection for PTSD is denied. REMAND As regards the matters of service connection for an acquired psychiatric disorder other than PTSD, in August 1996, the Board remanded this matter to the RO, in part, so that the RO could obtain the name of the veteran's pre-service family physician as well copies of his relevant treatment records. However, neither the name of the physician nor his treatment records were obtained and associated with the claims file. A remand by the Board confers on the veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). As the RO has not fully complied with the terms of an earlier remand, another remand is warranted. The Board also finds, as explained below, that further development with respect to this issue is warranted. , particularly given the need for further development as indicated below. In view of the changes in the law brought about by the Veterans Claims Assistance Act of 2000, VA must ensure compliance with the notice and duty to assist provisions contained in the new law. This should include consideration of whether any additional notification or development action is required under the Act. VA is required to notify the claimant of the evidence necessary to complete the application for the benefit sought, as well as of its efforts to procure relevant evidence. Moreover, required development action may include requesting information as described in 38 U.S.C.A. § 5106. Service medical records do not document any complaints, findings, diagnoses, or treatment of any psychiatric disorder, other than an August 1970 enlistment examination noting a history of anxiety. Moreover, post-service medical records are negative for complaints, diagnoses, or treatment for a psychiatric disorder until 1977. However, post-1977, they reflect several psychiatric diagnoses including schizophrenia. See VA examinations dated in August 1980, November 1981, November 1993, and June 1997; private treatment records from Flint MHC dated in April 1979 and February 1981; March 1980 letter from Dixie Moore, Ph.D.; March 1981 letter from Dr. Ucer, November 1981 letter from Dr. Finkelstein; treatment records from Genesee County Community Mental Health Services dated in August and October 1993; SSA examinations dated in May 1979, July 1979, September 1980, and December 1981; and records from Ypsilanti State Hospital dated in October 1979 and February 1980. Moreover, at least one physician reported that he had treated the veteran for psychiatric problems since September 1975 and, if fact, the veteran had had psychiatric problems since his graduation from high school. See March 1981 letter from Dr. Ucer. Likewise, except as reported below, none of the medical records currently found in the record contain an opinion as to the origins or etiology of the veteran's current psychiatric disorders (other than PTSD). Specifically, an October 1979 record from Ypsilanti State Hospital reported, as to the veteran's current mental problems (i.e., psychosis, probably schizophrenia), that "[t]here may be some relationship to his time in service, but no information is currently available about that period." In a May 1980 letter from the Flint MHC, it was opined that they "feel strongly that his psychiatric problems occurred while in the military." And, a November 1981 letter from Lionel Finkelstein, M.D., included the following opinion, ". . . it is likely that his experiences in the service may have served to precipitate his mental illness or to add to a preexisting predisposition to schizophrenia." However, a review of the record on appeal shows that, while the RO obtained some records from Ypsilanti State Hospital, dated in 1979 and 1980, and some Flint MHC treatment records, numerous other records from the time period directly after the veteran's separation from military service, which records may shed some light as to the origins or etiology of the veteran's current psychiatric disorder, have not been obtained and associated with the record. Specifically, a review of the record on appeal shows that the veteran obtained psychiatric treatment at Hurley Medical Center in 1976 and McLaren General Hospital in 1977. The record thereafter shows that he received psychiatric treated from a Dr. Ucer from September 1975 to May 1979. Additionally, the records shows that he obtained pre-1980 treatment from a Dr. Hafez with the Fifth Avenue Community Mental Health Clinic and underwent psychiatric testing at the Forensic Center in March 1980. In addition, the record shows that he received treatment at the Flint MHC from 1977 to 1994 and was hospitalization at Ypsilanti State Hospital from October 1979 to February 1980. The veteran also testified that he had had therapy for approximately two and a haft years (from approximately 1977 to 1978) with a Bill Payne. Moreover, records obtained from the SSA show the veteran received help from the TEP - Rainbow Connection as well as the Michigan Rehabilitation Services. Furthermore, personal hearing testimony and other evidence found in the claims file reveals that the veteran claimed to had been treated for psychiatric disorders by Drs. Joglacer, Rofez, Vergough, Lee, Kim, and Elaine Trippi. Therefore, on remand, the Board finds that the RO should obtain and associate with the record all of the veteran's records from all of the above sources. 38 C.F.R. § 19.9 (2000). Furthermore, if the RO determines that new and material evidence sufficient to reopen the claim has been obtained (see 38 C.F.R. § 3.156), the RO should arrange for the veteran to undergo a VA examination to obtain a medical opinion as to the relationship, if any, between any current acquired psychiatric disorder (other than PTSD) and his active military service. The veteran is hereby advised that failure to report to any such scheduled examination, without good cause, may well result in a denial of the claim. See 38 C.F.R. § 3.655 (2000). Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant and death of an immediate family member. Id. If the veteran does not report to the scheduled examination, the RO should obtain and associate with the record any notice(s) sent to him concerning such examination. While the matter is in remand status, and to ensure compliance with the Veterans Claims Assistance Act of 2000, the RO should also undertake any other indicated development and/or notification prior to readjudicating the claim. Accordingly, this matter is hereby REMANDED to the RO for the following action: 1. The RO should contact Erol Ucer, M.D., and the veteran and obtain the name and address of the veteran's pre- service family physician. The RO should thereafter obtain and associate with the claims file all outstanding pertinent medical records from that physician. 2. The RO should undertake all necessary development to obtain and associate with the claims file all outstanding pertinent medical records, to specifically include 1976 treatment records from Hurley Medical Center, 1977 treatment records from McLaren General Hospital, 1975 to 1979 treatment records from Dr. Ucer, 1977 to 1994 treatment records from Flint MHC, all treatment records held by Dr. Hafez (Fifth Avenue Community Mental Health Clinic), March 1980 records from the Forensic Center, October 1979 to February 1980 hospitalization records for Ypsilanti State Hospital, all therapy records held by Bill Payne (dated from approximately 1977 to 1978), all records held by TEP - Rainbow Connection, all records held by the Michigan Rehabilitation Services, and any other treatment records held by Drs. Joglacer, Rofez, Vergough, Lee, Kim, and Elaine Trippi. The RO should also obtain all outstanding pertinent medical records from any VA facility(ies) and any other source(s) or facility(ies) identified by the veteran. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact should be noted in the veteran's claims file, and he and his representative so notified. The veteran is also free to submit any pertinent medical or other records to support his claim, and the RO should afford him the opportunity to do so. 3. If the RO determines that new and material evidence to reopen the claim has been presented, the RO should arrange for the veteran to undergo a comprehensive VA examination by an appropriate VA specialist to determine the current nature and etiology of any current psychiatric disability other than PTSD (to comply with Veterans Claims Assistance Act of 2000). The entire claims file, to include a complete copy of this REMAND, must be furnished to, and be reviewed by, the physician designated to examine the veteran. All indicated tests and studies, to include psychological testing, should be accomplished, and all clinical findings should be reported in detail. After examination of the veteran and consideration of his pertinent history, the physician should identify all current psychiatric disability other than PTSD, and provide an opinion as to whether, with respect to each diagnosed disability, it is at least as likely as not that any such disability is the result of injury or disease incurred in or aggravated during the veteran's active military service. The typewritten report of examination must include all examination findings, along with the complete rationale for each opinion expressed and conclusion reached. 4. If the veteran fails to report to the scheduled examination, the RO should obtain and associate with the record any notice(s) of the examination sent to the veteran. 5. To help avoid future remand, the RO must ensure that all requested development has been completed (to the extent possible) in compliance with this REMAND. If any action is not undertaken, or is taken in a deficient manner, appropriate corrective action should be undertaken. See Stegall v. West, 11 Vet. App. 268 (1998). 6. The RO must also review the claims file and ensure that all notification and development action required by the Veterans Claims Assistance Act of 2000, Pub. L. No. 106-475 is completed. In particular, the RO should ensure that the new notification requirements and development procedures contained in sections 3 and 4 of the Act (to be codified as amended at 38 U.S.C. §§ 5102, 5103, 5103A, and 5107) are fully complied with and satisfied. 7. After completion of the above requested development, and any other indicated development and/or notification action, the RO should adjudicate the claim on appeal in light of all pertinent evidence and legal authority. The RO must provide adequate reasons and bases for its determination. 8. If the benefit sought on appeal continues to be denied, the RO should furnish to the veteran and his representative an appropriate supplemental statement of the case, and afford them the opportunity to provide written or other argument in response thereto before the claims file is returned to the Board for further appellate consideration. The purpose of this REMAND is to afford due process and to accomplish additional development and adjudication, and it is not the Board's intent to imply whether the benefits requested should be granted or denied. The veteran need take no action until otherwise notified, but he may furnish additional evidence and/or argument during the appropriate time frame. See Kutscherousky v. West, 12 Vet. App. 369 (1999); Colon v. Brown, 9 Vet. App. 104, 108 (1996); Booth v. Brown, 8 Vet. App. 109 (1995); Quarles v. Derwinski, 3 Vet. App. 129, 141 (1992). This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board or by the Court 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. 2001) (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. JACQUELINE E. MONROE Member, Board of Veterans' Appeals