Citation Nr: 0428859 Decision Date: 10/20/04 Archive Date: 10/28/04 DOCKET NO. 02-05 324 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUE 1. Whether new and material evidence has been received to reopen a previously disallowed claim of entitlement to service connection for multiple sclerosis. 2. Entitlement to service connection for multiple sclerosis. REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD J. L. Tiedeman INTRODUCTION The veteran served on active duty from December 1951 to December 1955. The case comes before the Board of Veterans' Appeals (Board) on appeal from a December 2001 rating decision of the Montgomery, Alabama, Department of Veterans Affairs (VA) Regional Office (RO). The veteran was afforded a hearing before RO personnel in December 2002. A transcript of this hearing has been associated with the claims folder. Although the RO adjudicated the issue concerning service connection for multiple sclerosis on the merits, the Board is required to determine whether new and material evidence has been presented when a claim has been previously disallowed. Barnett v. Brown, 83 F.3d 1380, 1384 (Fed. Cir. 1996). For this reason, the Board has listed whether new and material evidence has been received to reopen the claim for service connection for multiple sclerosis an issue on the title page. FINDINGS OF FACT 1. The veteran's claim of entitlement to service connection for multiple sclerosis was denied by the Board in July 1989; the veteran received timely notice of that decision, but did not complete a timely appeal. 2. The evidence received since the prior Board denial is sufficient to establish a reasonable possibility that the new evidence, when viewed in the context of all the evidence, would result in a different outcome of the claim. 3. The veteran currently has multiple sclerosis, which the medical evidence indicates was as likely as not manifested to a compensable degree within seven years of his separation of service. CONCLUSIONS OF LAW 1. The Board's July 1989 decision is final. 38 U.S.C.A. § 7104(b) (West 2003); 38 C.F.R. § 20.1100 (2003). 2. The evidence received since the Board's last final denial is new and material, and thus, serves to reopen the veteran's claim for service connection for multiple sclerosis. 38 U.S.C.A. §§ 5108, 7104 (West 2003); 38 C.F.R. § 3.156 (2003). 3. Resolving reasonable doubt in favor of the veteran, multiple sclerosis is presumed to have been incurred in active service. 38 U.S.C.A. §§ 1110, 5107 (West 2003); 38 C.F.R. §§ 3.303, 3.307, 3.309, 4.124a, Diagnostic Code 8018 (2003). REASONS AND BASES FOR FINDINGS AND CONCLUSION VCAA. There has been a significant change in the law during the pendency of this appeal. On November 9, 2000, the President signed into law the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000). This law redefines the obligations of VA with respect to the duty to assist and includes an enhanced duty to notify a claimant as to the information and evidence necessary to substantiate a claim for VA benefits. The final rule implementing the VCAA was published on August 29, 2001. 66 Fed. Reg. 45,620, et seq. (Aug. 29, 2001) (codified as amended at 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a)). In view of the favorable decisions on appeal, the Board finds that any failure on the part of VA to comply with the provisions of the VCAA has not resulted in prejudice to the veteran. Reopening the claim. In June 2001, the veteran applied to reopen the claim. In July 2001, the RO denied the claim for multiple sclerosis after determining that new and material evidence had not been presented. Applicable law provides that a claim which is the subject of a prior final decision may nevertheless be reopened upon presentation of new and material evidence. See 38 U.S.C.A. § 5108. "New and material evidence" means evidence not previously submitted to agency decision makers which bears "directly and substantially" upon the specific matter under consideration. Such evidence must be neither cumulative nor redundant, and, by itself or in connection with evidence previously assembled, such evidence must be "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 generally Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). The Board notes that 38 C.F.R. § 3.156 was recently amended and that the standard for finding new and material evidence has changed as a result. 66 Fed. Reg. 45,620, 45,630 (August 29, 2001) (codified at 38 C.F.R. § 3.156(a)). However, this change in the law is not applicable in this case because the appellant's claim was not filed on or after August 29, 2001, the effective date of the amendment. In determining whether evidence is new and material, the "credibility of the evidence is to be presumed." Justus v. Principi, 3 Vet. App. 510, 513 (1992). In July 1989, the Board held that entitlement service connection for multiple sclerosis was not warranted. The veteran did not perfect an appeal of the July 1989 decision, and it became final. 38 U.S.C.A. § 7104(b). The matter under consideration in this case is whether new and material evidence has been presented sufficient to reopen the veteran's claim of entitlement to service connection for multiple sclerosis. For the veteran's claim to be reopened, evidence must have been presented, or secured, since the July 1989 Board decision which is relevant to, and probative of, the question of whether the disorder was incurred in or aggravated during his period of active duty, or manifested to a compensable degree within the seven years following service. Relevant evidence of record at the time of the July 1989 Board decision consisted of the veteran's service medical records; private treatment records, dated in June 1963, July 1964, February 1965, February 1970, April 1974, and November 1974 to July 1987; a letter from B. L. Landers, Jr., M.D., dated in November 1963; a letter from R. G. Ford, M.D., dated in November 1964; a letter from G. H. Nungester, dated in December 1964; a report from Dr. Nungester, dated in November 1965; documents from the veteran's employer, dated from January 1965 to January 1985; a January 1966 VA examination; a statement from L. B. Boyer, M.D., dated in April 1988; a hearing before RO personnel in August 1988; a Travel Board hearing in February 1989; and various lay statements. The Board concluded that this evidence reflected that the veteran's multiple sclerosis was not present in service, and was first manifest more than seven years after service. The veteran was notified in July 1989 that his claim for entitlement to service connection for multiple sclerosis had been denied. Relevant evidence submitted since the July 198 decision includes, most importantly, a medical opinion from a private neuro-radiologist, C. N. Bash, M.D., dated in September 2004. Dr. Bash stated the following: "It is my opinion that [the veteran's] first symptoms of MS occurred and were documented shortly after service in the late 1950's and/or 1961/2." Such a nexus opinion was not previously of record. Consequently, it may be concluded that this evidence relates to an unestablished fact necessary to substantiate the claim and raises a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). Accordingly, the veteran's claim for service connection for multiple sclerosis is reopened. Adjudication of the veteran's claim for service connection does not end with the finding that the claim is reopened. In determining that the veteran's claim is reopened, the credibility of evidence has been presumed and the probative value of the evidence has not been weighed. However, once the claim is found to be reopened, the presumption that evidence is credible and entitled to full weight no longer applies. Service Connection. Service connection means that the facts 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. § 1110; 38 C.F.R. § 3.303(a). This may be shown by affirmative evidence showing inception or aggravation during service or through statutory presumptions. Id. When a disease is first diagnosed after service, service connection can still be granted for that condition if the evidence shows it was incurred in service. 38 C.F.R. § 3.303(d). In order 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). Service connection may also be established for a current disability on the basis of a presumption under the law that certain chronic diseases manifesting themselves to a certain degree within a certain time after service must have had their onset in service. 38 U.S.C.A. §§ 1112, 1131 and 1137; 38 C.F.R. §§ 3.303, 3.304, 3.307 and 3.309(a). The veteran here has been diagnosed to have multiple sclerosis. 38 U.S.C.A. § 1112(a)(4) provides for such presumptive service connection when multiple sclerosis manifests to a compensable degree within 7 years of the veteran's separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Multiple sclerosis is a disease of the central nervous system, and typical symptoms include visual loss, diplopia, nystagmus, dysarthria, weakness, paresthesias, bladder abnormalities, and mood alterations. Stedman's Medical Dictionary at 1583 (26th ed. 1995). The symptoms clinically show periods of exacerbations and remissions. Id. Diagnostic Code 8018 for multiple sclerosis provides a minimum disability rating of 30 percent. For the minimum rating, there must be ascertainable residuals. See 38 C.F.R. § 4.124a, NOTE. As to residuals not capable of objective verification (i.e., fatigue, dizziness), they will be accepted when consistent with the disease and not more likely attributable to other disease. Multiple sclerosis and its residuals may be rated up to 100 percent disabling in proportion to the impairment of motor, sensory, or mental function. 38 C.F.R. 4.124a. To establish service connection for a chronic disease on a presumptive basis, it is not required that the disease be diagnosed in the presumptive period, but only that there be then shown by acceptable medical or lay evidence characteristic manifestations of the disease to the required degree, followed without unreasonable time lapse by definite diagnosis. Symptomatology shown in the prescribed period may have no particular significance when first observed, but in light of subsequent developments it may gain considerable significance. 38 C.F.R. 3.307(c). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. Nevertheless, when, after considering all the evidence, a reasonable doubt arises regarding a determinative issue, the benefit of the doubt shall be given to the claimant. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102. Factual Background. As indicated above, the veteran served on active duty from December 1951 to December 1955. The service medical records contain no reference to any complaint, finding, diagnosis, or treatment associated with multiple sclerosis. The veteran was admitted to a private hospital in June 1963 with complaints of recurrent headaches, dizzy spells, and pain and soreness in the back of the neck. Neurological examination was essentially negative. There was no evidence of organic intracranial lesion. The final diagnosis was vascular cephalgia. In a letter dated in November 1963, B. L. Landers, Jr., M.D., related the results of his evaluation of the veteran that month. The veteran's chief complaints were dizziness, pain in his left arm and chest, and stopping up in his right ear with pressure on his neck. He denied any paralysis, lasting vocal changes, or any difficulty seeing or speaking. Neurological examination was entirely within normal limits except for a severely tender left occipital nerve. Dr. Landers could not find any neurosurgical or neurological abnormality and felt that it was a functional problem. The veteran was admitted to a private hospital in July 1964 with recurrent weak spells not characteristic of any definite neurological disorder. Medical studies were essentially negative. The final diagnosis was functional hypoglycemia. R. G. Ford, M.D., mentioned in a letter dated in November 1964 that the veteran had had a history of headache, dizziness, and weakness since October 1962. He had recently had an attack of weakness, dizziness, and headache followed by an episode of "fade out." Weakness, burning, and numbness of the left upper and lower extremities were reported. Neurologic examination was entirely normal. The impression was that the veteran's symptoms were functional and did not represent significant disease. In a letter dated in December 1964, G. H. Nungester, M.D., stated of the veteran that, "no mention has been made to him concerning the possibility of MS, I hope." In a note dated in January 1965, Dr. Nungester recommended that the veteran take at least 30 days' sick leave from his usual occupation for his unspecified condition. Various documents dated from January 1965 to January 1985 from the veteran's employer, including notes from private physicians, primarily concern advances of sick leave. The veteran was admitted to a private hospital in February 1965 for study of the possibility of angina and complaints of weakness. The final diagnoses were minimal dextroscoliosis of the upper dorsal spine, mild functional hypoglycemia, mild anxiety reaction to the possibility of heart disease, and a history compatible with paroxysmal supraventricular tachycardia. A report dated in November 1965 from Dr. Nungester primarily concerns a disorder unrelated to this claim. At a VA examination in January 1966, the veteran reported symptoms of aching in the neck, tingling in the left arm, and chest pain, which began in 1961. He also reported that he could avoid weak spells by eating between meals. The veteran was admitted to a private hospital in February 1970 for evaluation of chest pain and left arm numbness dating back to 1962, and electrocardiographic changes. The impression resulting from neurological consultation was doubt radicular syndrome causing all symptoms, but still no objective evidence of neurological deficit. The final diagnoses were Type IV hyperlipoproteinemia, rectal bleeding of unknown etiology, and chest pain due to hyperventilation syndrome and osteochondritis of the left costochondral joints. A private hospital summary dated in April 1974 indicates that the veteran was referred with a chief complaint of weakness and numbness in his lower extremities. It was reported that the veteran started experiencing numbness and weakness of his legs in 1962. Symptoms of fecal incontinence, particularly in 1972, urinary frequency for the last few years, and vague visual symptomatology such as diplopia and blurring of vision, over the past ten years were noted. The discharge diagnosis was of multiple sclerosis. Private medical records, dated from November 1974 to July 1987, show further treatment for multiple sclerosis and other medical disorders. In statements dated from May to September 1987, former co- workers of the veteran, who had known him since 1956, described problems the veteran was having, such as weight loss, constant pain, shortness of breath, hands shaking, and fatigue. In a note dated in April 1988, L. B. Boyer, M.D., related that the veteran, who had been followed for multiple sclerosis since April 1974, developed the symptoms of the disease in 1962, when he began to have numbness and weakness of his legs. A formal hearing was held before RO personnel in August 1988. The veteran described symptoms he had in service and in the years following service, and presented testimony concerning treatment he sought from various doctors. In a statement dated in August 1988, another former co-worker related that the veteran was noticeably exhausted and very shaky when they began working together in 1958. The veteran was frequently in and out of the hospital for short stays and became much worse in 1962. At a Travel Board hearing in February 1989, the veteran described symptoms that began in 1958, including weakness, numbness, spasticity, exhaustion, dizziness, tremors, and blurred vision. He testified that he first requested advanced sick leave in 1960 or 1961 and that multiple sclerosis was diagnosed in 1974. A September 2004 medical opinion from C. N. Bash, M.D., indicates that, "It is my opinion that [the veteran's] first symptoms of MS occurred and were documented shortly after service in the late 1950's and/or 1961/2." The Board will include Dr. Bash's rationale for this opinion in its entirety: 1. The [veteran's] Dr. Hames wrote, that he remembers that [the veteran] had symptoms consistent with MS occurring in 1956 or so. 2. The [veteran's] Drs. Jungesten, Boyer, Haley and Dave, D all document symptoms consistent with MS occurring in [the veteran] in the 1962-1962 time frame. 3. [The veteran] left service in Dec[ember] 1955 therefore, the above noted symptoms occurred between 1 to 7 years following service. 4. MS is known to be a slowly progressive disease therefore a lag of 1 to 7 years is well within the range of symptoms to presentation, as per Merritt's textbook of neurology. 5. It is my further opinion that [the veteran's] auditory and vision complaints during the early years following discharge from the military were also initial manifestations of MS. 6. This opinion is consistent with the opinion/exam/history of Drs. Jungesten, Boyer, Haley and Dave, D and . . . lay statements . . . 7. I can find no other plausible etiology . . . that would explain [the veteran's] waxing and waning neurological symptoms of the 1956 to 1962 time period. In the record I found the following statement by rating board members and [a VA physician:] ". . . evidence does not adequately demonstrate the manifestations of multiple sclerosis during the seven years immediately following service . . . 1964, some 9 years after active duty at least one doctor considered the possibility of multiple sclerosis . . . subjective symptoms and objective findings recorded in the medical evidence do not establish the presence of multiple sclerosis during the presumptive period . . ." I have discounted this opinion because the opinion was formulated many years ago when the medical knowledge of MS was limited[;] furthermore [the VA physician] did not have the benefit of the numerous subsequent medical opinions and lay statements that are now contained within the C-file. I note, that Dr. Dave, D stated that most probably [the veteran's] symptoms might have started while he was in service. I also note the fact that Dr. Dave, D stated that initial presentation might have started around 1964 or 1965. The comment of Dr. Dave, D concerning the initial presentation means that he (Dr. Dave, D) thinks [the veteran] presented to an MD in '64 or '65. Date of presentation has little bearing on when [the veteran] first had symptoms of MS because MS patients notoriously present late. Late presentation means that the patients often have the symptoms for years before they seek and present for medical care. I also note that the record contains several negative tests/lab results[,] such as negative nerve conduction studies, negative neurological exams, and normal CSF. The fact that many of these studies were normal throughout the years, including the comment by Dr. Nungester of 30 Dec 1964 that an ". . . ophthalmologist . . . no eye abnormality . . .", is typical for MS because these tests and laboratory values are often high falsely negative, especially when the [the veteran] is in remission or is in the early stages of the disease. [The veteran] did not have access to a sensitive low false negative MRI brain scan until recently. Analysis. The veteran contends that he currently suffers from multiple sclerosis that was incurred either during military service or within the seven year presumptive period. As noted above, the veteran's service medical records are negative for any relevant symptoms or diagnosis. However, the veteran has testified that he had weakness, numbness, spasticity, exhaustion, dizziness, tremors, and blurred vision beginning in 1958, only three years following service. Lay statements also confirm that the veteran exhibited signs of exhaustion during this period as well. Medical records from Dr. Hames indicate that the veteran exhibited symptoms consistent with multiple sclerosis as early as 1956. As such, the Board finds that the veteran has established that he experienced relevant symptomatology during the 7 year presumptive period for multiple sclerosis. Medical records associated with the claims folder have established that the veteran has a current diagnosis of multiple sclerosis. The question that must be addressed is whether competent and probative evidence, i.e., medical evidence, has been presented which provides a link between the veteran's current multiple sclerosis and either his period of active duty or the symptoms he manifested during the seven year presumptive period. In this regard, the Board notes that Dr. Bash has provided a very thorough opinion which indicates that the veteran's first symptoms of multiple sclerosis occurred and were documented during the 7 year presumptive period. The Board notes that this opinion is based upon a detailed review of the claims folder and a thorough understanding of the veteran's case. In sum, this opinion, as well as other evidence of record, raises a reasonable doubt as to whether multiple sclerosis was present prior to 1962, i.e., within the first seven years after the veteran's service discharge. Resolving that doubt in the veteran's favor and recognizing that VA's Schedule for Rating Disabilities provides for a minimal rating of 30 percent for those with multiple sclerosis, the Board concludes that the evidence satisfactorily shows the presence of multiple sclerosis to a compensable degree within the first seven years of the veteran's discharge from service. Accordingly, a basis upon which to establish service connection for multiple sclerosis has been presented and the appeal is granted. ORDER Entitlement to service connection for multiple sclerosis is granted. ____________________________________________ Gary L. Gick 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