Citation Nr: 0810174 Decision Date: 03/27/08 Archive Date: 04/09/08 DOCKET NO. 06-03 748A ) DATE ) ) On appeal from the Department of Veterans Affairs Medical Center in Palo Alto, California THE ISSUE Entitlement to payment or reimbursement for ambulance services provided by American Medical Response on June 5, 2005. REPRESENTATION Appellant represented by: California Department of Veterans Affairs ATTORNEY FOR THE BOARD Kristi L. Gunn, Associate Counsel INTRODUCTION The veteran served on active duty from July 1968 to July 1970. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2005 decision of the Department of Veterans Affairs (VA) Medical Center (MC) in Palo Alto, California, which denied the benefits sought on appeal. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The record as it stands is currently inadequate for the purpose of rendering a fully informed decision as to the claim for payment or reimbursement for ambulance services provided by American Medical Response on June 5, 2005. Where the record before the Board is inadequate to render a fully informed decision, a remand to the RO is required in order to fulfill its statutory duty to assist the veteran to develop the facts pertinent to the claim. Ascherl v. Brown, 4 Vet. App. 371, 377 (1993). The veteran seeks payment for ambulance services provided by American Medical Response on June 5, 2005. In a December 2005 personal statement, the veteran contends that he became severely ill. The veteran explained that since he believed that his condition was life threatening, he called 911 for an ambulance to the hospital. In the November 2005 rating decision, the RO determined that the veteran was not eligible for special mode ambulance transport on June 5, 2005. Under 38 C.F.R. § 17.143(c), reimbursement of emergency travel expenses will be authorized for: (1) a veteran traveling in connection with a scheduled compensation or pension examination; or (2) a veteran or other person traveling by a specialized mode of transportation such as an ambulance, wheelchair van, or other vehicle specially designed to transport disabled individuals provided that (i) a physician determines that the special mode of travel is medical required; (ii) the person is unable to defray the expenses of the travel; and (iii) the travel is authorized in advance or was undertaken in connection with a medical emergency such that delay to obtain authorization would be hazardous to the person's life and health. See 38 C.F.R. § 17.143(c) (2007). Review of the record indicates that the VAMC denied the veteran's claim because a VA clinician determined that the veteran's medical condition was not life threatening. However, the Board notes that the medical opinion and the associated medical reports relied upon in making its decision is not of record. Those records must be incorporated into the claims file before adjudication on the merits. The RO should also ensure that proper notice has been issued pursuant to the Veterans Claims Assistance Act of 2000 (VCAA), with regard to the veteran's pending claim. VA has a duty to notify the veteran 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); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). Proper notice, which notifies him of the evidence and information necessary to support his claim must be issued to the veteran. Along with ensuring proper VCAA notice pertaining to his claim, VA is also instructed to provide proper notice under 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b). VA should inform the veteran that an effective date for the award of benefits will be assigned if an increased disability is granted, and also include an explanation as to the type of evidence that is needed to establish an effective date. See Dingess/Hartman v. Nicholson, 19 Vet. App. 473, 486 (2006). Accordingly, the case is REMANDED for the following action: 1. Ensure compliance with all notice and assistance requirements set forth in the VCAA and its implementing regulations, to include advising the veteran of the evidence necessary to substantiate his claim, as well as what evidence he is to provide and what evidence VA will attempt to obtain in accordance with Quartuccio v. Principi, 16 Vet. App. 183 (2002). The veteran should also be advised to submit all pertinent evidence in his possession. The notice should include an explanation as to the information or evidence needed to establish an effective date, as outlined by Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). 2. Incorporate into the claims file the VA clinician's opinion that was relied upon by the VAMC in making its decision. All other pertinent medical records, including documented phone conversations and treatment records should also be included within the claims file. 3. Thereafter, readjudicate the veteran's claim for entitlement to payment or reimbursement for ambulance services provided by American Medical Response on June 5, 2005. If the claim remains denied, the veteran and his representative should be provided an appropriate Supplemental Statement of the Case, and afforded the opportunity to respond. The representative should also be presented with an opportunity to complete a VA Form 646 or written argument in lieu thereof, before the record is returned to the Board for further appellate review, if in order. By this remand, the Board intimates no opinion as to any final outcome warranted. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. 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 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2007). _________________________________________________ C. CRAWFORD Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2007).