Citation Nr: 0328076 Decision Date: 10/20/03 Archive Date: 10/28/03 DOCKET NO. 02-00 616 ) DATE ) ) ) On appeal from the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder (PTSD). 2. Entitlement to service connection for a low back disorder. 3. Entitlement to service connection for a mid back disorder. REPRESENTATION Appellant represented by: James Valentin, Attorney ATTORNEY FOR THE BOARD C. Dillon, Associate Counsel INTRODUCTION The veteran served on active duty from September 12 to October 27, 1976. This matter arises before the Board of Veterans' Appeals (Board) on appeal from January 2000 and December 2001 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey. In January 2000, the RO denied service connection for degenerative joint disease of the lumbosacral spine and residuals of an injury to the thoracic spine. In December 2001, the RO denied service connection for PTSD. VA's duty to assist extends to a liberal reading of the record for issues raised in all documents or oral testimony submitted prior to a BVA decision. EF v. Derwinski, 1 Vet. App. 324, 326 (1991); see also Douglas v. Derwinski, 2 Vet. App. 435 (1992). In a statement received by the RO in January 2002, the veteran reported that during active service his "entire back was injured which includes the lower, middle and upper back." Although the mid and low back disorder claims are currently in appellate status, the issue of entitlement to service connection for an upper back disorder has not been adjudicated. The Board is referring that issue to the RO for appropriate action. See Godfrey v. Brown, 7 Vet. App. 398 (1995). The issues of entitlement to service connection for PTSD and a mid back disorder are the subjects of the REMAND herein. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. A low back disorder, to include arthritis, did not have its onset during active service or within one year following the veteran's separation from service and did not result from disease or injury in service. CONCLUSION OF LAW The veteran is not entitled to service connection for a low back disorder. 38 U.S.C.A. §§ 1112, 1131, 1137 (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2003). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Duty to notify and assist The Veterans Claims Assistance Act of 2000 (VCAA) provides that VA has a duty to notify a claimant of any information and evidence needed to substantiate and complete a claim, and of what part of that evidence is to be provided by the claimant and what part VA will attempt to obtain for the claimant. 38 U.S.C.A. § 5103(a) (West 2002); 38 C.F.R. § 3.159(b)(1) (2002); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). In this case, in an March 2001 letter, the RO notified the veteran of the evidence on which the proposed retroactive reduction in his pension benefits was based. The veteran was also notified of the applicable legal provisions in a December 2001 Statement of the Case. Given the facts of this case, and the nature of the issue on appeal, the Board finds that VA has satisfied its notification duties to the veteran under the VCAA. See Quartuccio v. Principi, 16 Vet. App. 183 (2002). The Board is aware of the recent judicial decision in Paralyzed Veterans of America v. Secretary of Veterans Affairs, ___ F.3d ___, No. 02-7007 (Fed. Cir. Sept. 22, 2003), which held that the new regulation codified at 38 C.F.R.§ 3.159(b)(1) is invalid because it permits VA to render a decision in a claim if a response to a request for information from the veteran is not received within 30 days, instead of waiting a full year for such response. In this case, however, the RO's March 2001 letter, although requesting the information within 60 days, further provided, "If the information or evidence is received within one year from the date of this letter, and we decide that you are entitled to VA benefits, we may be able to pay you from the date we received your claim." Although it appears that the RO relied in part on the invalidated regulation, the veteran was provided more than two years ultimately to submit evidence. Indeed, evidence was received as late as August 2002; thus the veteran certainly was not dissuaded from providing additional evidence or statements. The notice provided to the veteran over one year ago has accorded him ample time for response. No useful purpose would be served by further delaying appellate review to provide additional notice; it is clear from communications from the veteran and his representative that they seek appellate review without further delay. Assistance shall also include providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim. 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.159(c)(4) (2003). VA conducted spine examinations in April 1999 and April 2001, and the reports from these examinations include diagnoses consistent with low back disability. Notwithstanding this, there is no competent evidence tending to show that the veteran had a low back disorder, including arthritis of the lumbar spine, during service. Even taking into account the veteran's statements, these criteria have not been met. Arthritis, for example, is not the type of condition where the veteran's statements alone could provide a link to active service. This is because he lacks the education, training, or experience to offer medical diagnoses or opinions. See Espiritu v. Derwinski, 2 Vet. App. 492 (1992). VA must also make reasonable efforts to assist the claimant in obtaining evidence necessary to substantiate the claim for the benefit sought, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. 38 U.S.C.A. § 5103A(a) (West 2002); 38 C.F.R. § 3.159(c), (d) (2003). The claims file contains the veteran's service medical records, VA treatment records, and a wealth of non-VA medical records. All records identified by the veteran have been obtained, and submissions by the veteran and his private attorney since the RO's March 2001 letter have not provided information or evidence not previously of record. II. Service Connection Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated during service. 38 U.S.C.A. § 1131 (West 2002); 38 C.F.R. § 3.303 (2003). To prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in- service occurrence or aggravation of a disease or injury; and medical evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Pond v. West, 12 Vet App. 341, 346 (1999). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence that it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the appellant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). The medical evidence establishes the veteran currently suffers from a low back disorder variously diagnosed as spondylolisthesis, retrolisthesis, degenerative joint disease of the lumbar spine, back sprain, diffuse low back pain, and lumbar myofascitis; however, the record does not contain lay evidence of in-service occurrence or aggravation of a disease or injury, and there is no medical evidence of a nexus between an in-service injury or disease and the current disability. The veteran contends that his service medical records document a back injury. Review of the service medical records indeed show complaints of back pain during the veteran's brief tenure of active service. Although the veteran denied any back problems on entrance examination in September 1976 and clinical evaluation of the spine was normal at that time, two treatment entries the following month in October 1976 specifically document complaints and diagnosis of middle back pain from T5 to T12; the veteran made no complaints of low back pain, and no low back symptomatology was found. There are no records suggesting he received medical attention of any kind in the remaining three weeks prior to discharge from service. In statements to VA, the veteran has reported that he "was seen in sick call for seven months" as a result of falling against a concrete wall when a drill instructor allegedly pushed him into a "grenade pit." The Board has considered the veteran's assertions, but the service medical records and his statements made contemporaneous with service raise significant concern as to the veracity of his more recent account of events. See Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (holding that interest in the outcome of a proceeding may affect the credibility of testimony). The veteran served less than two months before service separation and thus could not have received seven months of in-service treatment. Additionally, the October 1976 service medical records document the veteran's report that he experienced a motor vehicle accident prior to enlistment; this was the only reported source of spinal injury at that time. The veteran's statements in favor of the claim are therefore of little weight and probative value. See Quiamco v. Brown, 6 Vet. App. 304, 308 (1994). Evidence of low back symptomatology dates back to no earlier than 1993, approximately 17 years post-service, when the veteran underwent chiropractic evaluation at Hamilton Chiropractic Center. Although several treating physicians have reported the veteran's medical history to include an in- service back injury and tend to suggest a belief that the veteran's current low back disorder is the result of that in- service incident, such medical statements are afforded no probative value, as they are based on a history supplied by the veteran where that history is unsupported by the medical evidence. See Black v. Brown, 5 Vet. App. 177 (1993); Swann v. Brown, 5 Vet. App. 229 (1993); Pound v. West, 12 Vet. App. 341 (1999). In addition to the lack of findings of low back pathology in the service medical records, the post-service medical evidence affirmatively shows the incurrence of spinal injury many years after service. October 1997 neurodiagnostic testing requiring subsequent chiropractic treatment was reportedly for a slip and fall injury that occurred in July 1997. It is also noteworthy that at the October 1997 neurodiagnostic testing, the veteran indicated no history of trauma to the low back and no significant past medical history. Morrisville Chiropractic Center certified in April 2000 that the veteran began treatment in February 2000 for injuries to the neck and back from a work-related accident in January 2000. In an October 1998 statement, the veteran indicated that 15 years ago he filed a claim of entitlement to service connection for a back condition. There is no record of such a claim in the file, and there is no reason to believe the evidentiary record is incomplete, particularly in light of the veteran's demonstrated lack of credibility. The Board has considered the statements of the veteran, as well as those from his friends and family reporting that the veteran experienced injuries as a result of in-service grenade training. Despite such statements, neither a layperson nor the Board is competent to supplement the record with unsubstantiated medical conclusions. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). Health professionals, however, are experts and are presumed to know the requirements applicable to their practice and to have taken them into account in providing a diagnosis. Cohen v. Brown, 10 Vet. App. 128 (1997). In this case, the competent medical evidence does not establish the presence of an in- service lumbar spine disease or injury, and the Board attaches greater probative weight to such evidence. For veterans who service for 90 days or more, service connection for arthritis may be established based on a legal "presumption" by showing that the disability manifested itself to a degree of 10 percent or more within one year from the date of separation from active military service. 38 U.S.C.A. § 1112 (West 2002); 38 C.F.R. §§ 3.307, 3.309 (2003). As noted above, the veteran had only 46 days of service. The preponderance of the evidence is against the veteran's claim of entitlement to service connection. The evidence in this case is not so evenly balanced so as to allow application of the benefit of the doubt rule as required by law and VA regulations. 38 U.S.C.A. § 5107(b) (West 2002); 38 C.F.R. §§ 3.102, 4.3 (2003). ORDER Entitlement to service connection for a low back disorder is denied. REMAND Following a review of the record, the Board finds that remand is required for compliance with the duty to assist, to ensure that there is a complete record upon which to decide the veteran's claims. Additionally, in a decision promulgated on September 22, 2003, Paralyzed Veterans of America v. Secretary of Veterans Affairs, No. 02-7007, -7008, -7009, -7010 (Fed. Cir. Sept. 22, 2003), the United States Court of Appeals for the Federal Circuit invalidated the 30-day response period contained in 38 C.F.R. § 3.159(b)(1) as inconsistent with 38 U.S.C.A. § 5103(b)(1). Because this case is being remanded for additional development, the RO should take this opportunity to inform the veteran of the requisite time allowed to respond to an RO request for additional information or evidence. I. PTSD The veteran alleges that the stressful events that have caused his PTSD include incidents of verbal and physical abuse he received during basic training from a drill instructor named "Alford" and a sergeant named "Donahue." Aside from the veteran's statements, there is no evidence of these stressful events. The United States Court of Appeals for Veterans Claims (Court) has stressed the necessity of complete development of the evidence if a PTSD claim is based on an alleged personal assault. See Patton v. West, 12 Vet. App. 272, 276 (1999). In Patton, the Court pointed out that there are special evidentiary development procedures for PTSD claims based on personal assault contained in VA ADJUDICATION PROCEDURE MANUAL M21-1, Part III, 5.14(c) (Feb. 20, 1996), and former MANUAL M21-1, Part III, 7.46(c)(2) (Oct. 11, 1995). The general M21-1 provisions on PTSD claims in 5.14 require that in cases where available records do not provide objective or supportive evidence of the alleged in-service stressor, it is necessary to develop for this evidence. MANUAL M21-1, Part III, 5.14(b)(2). As to personal-assault PTSD claims, more particularized requirements are established regarding the development of "alternative sources" of information as service records may be devoid of evidence because many victims of personal assault, especially sexual assault and domestic violence, do not file official reports either with military or civilian authorities. MANUAL M21-1, Part III, 5.14(c). Further, the provisions of subparagraphs (7) and (8) indicate that "[b]ehavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor", and that "secondary evidence may need interpretation by a clinician, especially if it involves behavior changes" and that "[e]vidence that documents such behavior changes may require interpretation in relationship to the medical diagnosis by a VA neuropsychiatric physician." When read together, the Court states that the subparagraphs show that in personal-assault cases the Secretary has undertaken a special obligation to assist a claimant in producing corroborating evidence of an in-service stressor. II. Mid back disorder The veteran currently suffers from degenerative joint disease of the thoracic spine. The service medical records contain an unremarkable entrance examination, but treatment records one month after enlistment show complaints of mid back pain and a diagnosis of middle back pain from T5 to T12. The veteran reported at that time that his mid back pain was a result of a motor vehicle accident that occurred prior to service. These facts raise the possibility the veteran had a mid back disorder that pre-existed service, which may have increased in severity during such service. See 38 U.S.C.A. § 1153 (West 2002); 38 C.F.R. §§ 3.304(b), 3.306 (2003). Temporary or intermittent flare-ups of a preexisting injury or disease are not sufficient to be considered "aggravation in service" unless the underlying condition, as contrasted with symptoms, has worsened. This means the base line against which the Board is to measure any worsening of a disability is the veteran's disability as shown in all of his medical records, not on the happenstance of whether he was symptom-free when he enlisted. Hunt v. Derwinski, 1 Vet. App. 292, 297 (1991); Green v. Derwinski, 1 Vet. App. 320, 323 (1991); Jensen v. Brown, 4 Vet. App. 304, 306-307 (1993). For this reason, VA should attempt to obtain the veteran's pre-service medical records, particularly those related to his 1976 motor vehicle accident. Accordingly, this case is REMANDED to the RO for the following actions: 1. The RO must review the claims file and ensure that all duty to notify obligations have been satisfied in accordance with the recent decision in Paralyzed Veterans of America v. Secretary of Veterans Affairs, as well as 38 U.S.C.A. §§ 5102, 5103, and 5103A (West 2002), and any other applicable legal precedent. 2. The RO must ask the veteran to identify all health care providers that treated him for a mid back disorder or spinal injury prior to active service. Obtain records from each health care provider the veteran identifies. Specifically inquire about medical records of treatment and evaluation following his reported 1976 motor vehicle accident. 3. After associating any additional records obtained as a result of this remand, the RO should schedule the veteran for a VA examination for the purpose of determining the nature and etiology of the veteran's current mid back disability. Any indicated tests should be accomplished. The claims file must be made available to the examiner; the clinician should indicate in the examination report that the claims file was reviewed. Following a review of the claims file and the clinical evaluation, the clinician should opine whether it is at least as likely as not that any current mid back disorder is related to the veteran's active service. A rationale for any opinion expressed should be provided. 4. Regarding the PTSD claim, the veteran should be asked to provide specific details of the occurrence of any in- service stressful events, to include those incidents involving Drill Instructor Alford and Sergeant Donahue. He should provide the full names of witnesses, actual dates of occurrence, unit assignment information, and other relevant information. Advise the veteran that he must be as specific as possible for verification purposes. 5. The RO should review any PTSD-stressor information that may be submitted by the veteran and prepare a summary, which should then be submitted, with all supporting documentation, to the U.S. Armed Services Center for Research of Unit Records (USASCRUR), to corroborate the occurrence of the incident(s) and any indication of the veteran's involvement therein. 6. If the record contains credible supporting evidence to establish the existence of a claimed stressor, based on USASCRUR's response, the RO must arrange for a VA PTSD examination. Any indicated tests should be accomplished. The claims file must be made available to the examiner; the clinician should indicate in the examination report that the claims file was reviewed. If the examiner diagnoses PTSD, he/she must identify the specific stressor(s) on which the diagnosis is based. A rationale for any opinion expressed should be provided. 7. Thereafter, the RO should review the claims file and ensure that no other notification or development action, in addition to that directed above, is required. If further action is required, the RO should undertake it before further adjudication of the claims. 8. The RO should then readjudicate the veteran's claims, with application of all appropriate laws and regulations, including consideration of any additional information obtained as a result of this remand. If the decision with respect to any of the claims remains adverse to the veteran, he and his attorney should be furnished a supplemental statement of the case and afforded a reasonable period of time within which to respond thereto. The appellant 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. 8.43 and 38.02. ______________________________________________ JAMES L. MARCH Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs YOUR RIGHTS TO APPEAL OUR DECISION The attached decision by the Board of Veterans' Appeals (BVA or Board) is the final decision for all issues addressed in the "Order" section of the decision. The Board may also choose to remand an issue or issues to the local VA office for additional development. If the Board did this in your case, then a "Remand" section follows the "Order." However, you cannot appeal an issue remanded to the local VA office because a remand is not a final decision. The advice below on how to appeal a claim applies only to issues that were allowed, denied, or dismissed in the "Order." If you are satisfied with the outcome of your appeal, you do not need to do anything. We will return your file to your local VA office to implement the BVA's decision. However, if you are not satisfied with the Board's decision on any or all of the issues allowed, denied, or dismissed, you have the following options, which are listed in no particular order of importance: ? Appeal to the United States Court of Appeals for Veterans Claims (Court) ? File with the Board a motion for reconsideration of this decision ? File with the Board a motion to vacate this decision ? File with the Board a motion for revision of this decision based on clear and unmistakable error. Although it would not affect this BVA decision, you may choose to also: ? Reopen your claim at the local VA office by submitting new and material evidence. There is no time limit for filing a motion for reconsideration, a motion to vacate, or a motion for revision based on clear and unmistakable error with the Board, or a claim to reopen at the local VA office. None of these things is mutually exclusive - you can do all five things at the same time if you wish. However, if you file a Notice of Appeal with the Court and a motion with the Board at the same time, this may delay your case because of jurisdictional conflicts. If you file a Notice of Appeal with the Court before you file a motion with the BVA, the BVA will not be able to consider your motion without the Court's permission. How long do I have to start my appeal to the Court? You have 120 days from the date this decision was mailed to you (as shown on the first page of this decision) to file a Notice of Appeal with the United States Court of Appeals for Veterans Claims. If you also want to file a motion for reconsideration or a motion to vacate, you will still have time to appeal to the Court. As long as you file your motion(s) with the Board within 120 days of the date this decision was mailed to you, you will then have another 120 days from the date the BVA decides the motion for reconsideration or the motion to vacate to appeal to the Court. You should know that even if you have a representative, as discussed below, it is your responsibility to make sure that your appeal to Court is filed on time. How do I appeal to the United States Court of Appeals for Veterans Claims? Send your Notice of Appeal to the Court at: Clerk, U.S. Court of Appeals for Veterans Claims 625 Indiana Avenue, NW, Suite 900 Washington, DC 20004-2950 You can get information about the Notice of Appeal, the procedure for filing a Notice of Appeal, the filing fee (or a motion to waive the filing fee if payment would cause financial hardship), and other matters covered by the Court's rules directly from the Court. You can also get this information from the Court's web site on the Internet at www.vetapp.uscourts.gov, and you can download forms directly from that website. The Court's facsimile number is (202) 501-5848. To ensure full protection of your right of appeal to the Court, you must file your Notice of Appeal with the Court, not with the Board, or any other VA office. How do I file a motion for reconsideration? You can file a motion asking the BVA to reconsider any part of this decision by writing a letter to the BVA stating why you believe that the BVA committed an obvious error of fact or law in this decision, or stating that new and material military service records have been discovered that apply to your appeal. If the BVA has decided more than one issue, be sure to tell us which issue(s) you want reconsidered. Send your letter to: Director, Management and Administration (014) Board of Veterans' Appeals 810 Vermont Avenue, NW Washington, DC 20420 VA FORM JUN 2003 (RS) 4597 Page 1 CONTINUED Remember, the Board places no time limit on filing a motion for reconsideration, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to vacate? You can file a motion asking the BVA to vacate any part of this decision by writing a letter to the BVA stating why you believe you were denied due process of law during your appeal. For example, you were denied your right to representation through action or inaction by VA personnel, you were not provided a Statement of the Case or Supplemental Statement of the Case, or you did not get a personal hearing that you requested. You can also file a motion to vacate any part of this decision on the basis that the Board allowed benefits based on false or fraudulent evidence. Send this motion to the address above for the Director, Management and Administration, at the Board. Remember, the Board places no time limit on filing a motion to vacate, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to revise the Board's decision on the basis of clear and unmistakable error? You can file a motion asking that the Board revise this decision if you believe that the decision is based on "clear and unmistakable error" (CUE). Send this motion to the address above for the Director, Management and Administration, at the Board. You should be careful when preparing such a motion because it must meet specific requirements, and the Board will not review a final decision on this basis more than once. You should carefully review the Board's Rules of Practice on CUE, 38 C.F.R. 20.1400 -- 20.1411, and seek help from a qualified representative before filing such a motion. See discussion on representation below. Remember, the Board places no time limit on filing a CUE review motion, and you can do this at any time. How do I reopen my claim? You can ask your local VA office to reopen your claim by simply sending them a statement indicating that you want to reopen your claim. However, to be successful in reopening your claim, you must submit new and material evidence to that office. See 38 C.F.R. 3.156(a). Can someone represent me in my appeal? Yes. You can always represent yourself in any claim before VA, including the BVA, but you can also appoint someone to represent you. An accredited representative of a recognized service organization may represent you free of charge. VA approves these organizations to help veterans, service members, and dependents prepare their claims and present them to VA. An accredited representative works for the service organization and knows how to prepare and present claims. You can find a listing of these organizations on the Internet at: www.va.gov/vso. You can also choose to be represented by a private attorney or by an "agent." (An agent is a person who is not a lawyer, but is specially accredited by VA.) If you want someone to represent you before the Court, rather than before VA, then you can get information on how to do so by writing directly to the Court. Upon request, the Court will provide you with a state-by-state listing of persons admitted to practice before the Court who have indicated their availability to represent appellants. This information is also provided on the Court's website at www.vetapp.uscourts.gov. Do I have to pay an attorney or agent to represent me? Except for a claim involving a home or small business VA loan under Chapter 37 of title 38, United States Code, attorneys or agents cannot charge you a fee or accept payment for services they provide before the date BVA makes a final decision on your appeal. If you hire an attorney or accredited agent within 1 year of a final BVA decision, then the attorney or agent is allowed to charge you a fee for representing you before VA in most situations. An attorney can also charge you for representing you before the Court. VA cannot pay fees of attorneys or agents. Fee for VA home and small business loan cases: An attorney or agent may charge you a reasonable fee for services involving a VA home loan or small business loan. For more information, read section 5904, title 38, United States Code. In all cases, a copy of any fee agreement between you and an attorney or accredited agent must be sent to: Office of the Senior Deputy Vice Chairman (012) Board of Veterans' Appeals 810 Vermont Avenue, NW Washington, DC 20420 The Board may decide, on its own, to review a fee agreement for reasonableness, or you or your attorney or agent can file a motion asking the Board to do so. Send such a motion to the address above for the Office of the Senior Deputy Vice Chairman at the Board. VA FORM JUN 2003 (RS) 4597 Page 2