Citation Nr: 0811409 Decision Date: 04/07/08 Archive Date: 04/23/08 DOCKET NO. 05-39 978 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUE Entitlement to service connection for residuals of in-service treatment of pilonidal cyst. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Bobby Mullins, Associate Counsel INTRODUCTION The veteran had active service from February 1957 to January 1959. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2005 rating decision of the Department of Veterans Affairs Regional Office (RO) in Detroit, Michigan. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the veteran if further action is required. REMAND At the outset of this discussion, the Board notes that the veteran's service medical and personnel records appear to have been destroyed in a fire at the National Personnel Records Center (NPRC) in 1973, and have not been located. Under such circumstances, the United States Court of Appeals for Veterans Claims (Court) has held that there is a heightened obligation on the part of VA to explain findings and conclusions and to consider carefully the benefit of the doubt rule. Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). After the RO learned that no other records for the veteran could be located, the RO requested morning reports for the veteran's unit. The RO was advised that the search for morning reports should be narrowed to a 3-month period, and the RO requested more specific information from the veteran. By a statement provided in February 2008, the veteran has identified the 3-month period during which he believes it is most likely that his treatment for the cyst near his tailbone occurred. July 2002 clinical records disclose that the veteran apparently sought treatment for a pilonidal cyst. The veteran contends that, while serving in Germany, he developed severe inflammation in his tailbone region, and as a result, doctors inserted a drainage tube near his tailbone to relieve the inflammation toward the end of his service. It is the veteran's contention that this drainage tube was left in, and remains to this day, causing chronic discomfort and inflammation in the tailbone region. His service discharge was in January 1959. The veteran submitted a statement from his wife in March 2005, in which his wife indicated that the veteran was in fact operated on in service, and has had a drainage tube in his tailbone region for over 45 years. The examiner who provided outpatient medical treatment in July 2002 did not confirm the presence of a drainage tube, but did record finding a small hole in the coccyx region. The records also indicated the presence of a pilonidal cyst in the coccyx area that had been present since the veteran's military service, but it is unclear whether this is based on medical evidence or the veteran's self-reported history. The veteran requested a VA Compensation and Pension examination. In view of the circumstances, such examination needs to be conducted to provide the veteran with an opportunity to fully develop his claim. Accordingly, the case is REMANDED for the following action: 1. Even though the veteran has previously been sent such notice, it is the Board's opinion that the veteran should again be provided with notice of VA's duties to assist and notify him, set forth in the Veterans Claims Assistance Act of 2000, codified at 38 U.S.C.A. §§ 5102, 5103, 5103A., 5107 (West 2002 & Supp. 2007), and implementing regulations, including 38 C.F.R. § 3.159 (2007). The notice should include an explanation as to the information or evidence needed to determine an effective date and a disability rating if the claim for service connection is granted. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). Each item of notice described in this paragraph should be issued prior to issuance of a supplemental statement of the case (SSOC). 2. The veteran's current VA medical records from July 2002 to the present should be obtained (to the extent there are any). 3. The AMC should obtain the morning reports for the 3-month period identified by the veteran in his February 2008 statement - November 1958 through January 1959. 4. The veteran should be afforded a Compensation and Pension examination of his tailbone area as he requested. The examiner should be provided with a copy of the Remand and the veteran's claims file. The examiner should review the relevant documents in conjunction with the examination. After completing the examination, the examiner should answer the following questions: (a) Does the veteran currently have residuals of a pilonidal cyst, to include residuals of an operation where a drainage tube was inserted into his tailbone region? (b) If so, is it at least as likely as not that these residuals are from a procedure performed during active service? The examiner should provide a written summary of the relevant medical evidence reviewed, and a rationale for all opinions expressed. 5. After completion of the above and any additional development deemed necessary, the expanded record should be reviewed and it be determined if the veteran's claim can be granted. If the claim is not granted, the veteran and his representative should be furnished an appropriate supplemental statement of the case (SSOC), and be afforded an opportunity to respond. Thereafter, the case should be returned to the Board for appellate review. 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). _________________________________________________ J. A. MARKEY 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).