Citation Nr: 0812982 Decision Date: 04/18/08 Archive Date: 05/01/08 DOCKET NO. 01-00 153A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUE Entitlement to special monthly compensation. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Clifford R. Olson, Counsel INTRODUCTION The veteran served on active duty from August 1943 to January 1946, and from January 1951 to August 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2000 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA), which adjudicated various ratings and denied entitlement to special monthly compensation based on the need for aid and attendance and/or being housebound. The veteran appealed and, in August 2001, the Board remanded the case for additional development. As a result of the requested development, the RO increased some ratings and continued to deny special monthly compensation based on the need for aid and attendance and/or being housebound. In November 2004, the Board remanded the case for examination of the veteran and medical opinions. In December 2006, the Board found it necessary to remand the special monthly compensation claim for clarification. 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 Unfortunately, the requested clarification did not fully respond to the Board's remand request and, so, the case must be returned. See Stegall v. West, 11 Vet. App. 268 (1998). In December 2006, the Board specified, The examiner should provide a complete explanation of his opinion as to whether it is at least as likely as not that the service-connected disabilities, by themselves, without contribution from the non-service- connected conditions, require the regular aid and attendance of another person, or render the veteran housebound. The doctor wrote that, the service-connected "disabilities are as least as likely as not by themselves without the contribution from the NSC (non-service-connected) conditions require the regular aid and attendance of another person or render the veteran housebound." However, he did not provide any explanation. The examiner then went on to list the service-connected disabilities and non-service-connected disabilities, in a contradictory manner. He indicated that the back pain was episodic and the varicose veins and hemorrhoids were symptom free. As to the non-service- connected conditions, he listed serious impairments including fracture of the right hip, noting the veteran was unable to bear weight on that side and was confined to bed. Non- service-connected disabilities included being legally blind in both eyes, chronic pain in the left ankle, and 2nd stage bed sores on both hips. The claim is further complicated by an intercurrent injury; a fractured hip in August 2005. The examiner has expressed an opinion to the effect that the veteran cannot bear weight on his right leg due to the fracture, and that it confines him to bed and a wheel chair. In as much as the veteran has extensive service-connected back and lower extremity disabilities, the question arises as to their role in the hip fracture and the resultant disability. This intertwined issue must be adjudicated before the special monthly compensation claim can be addressed. Accordingly, the case is REMANDED for the following action: 1. The agency of original jurisdiction (AOJ) should ask the veteran how the hip fracture happened. He should be asked to identify all care givers involved and complete the appropriate releases. Thereafter, the AOJ should obtain all available medical records from the caregivers identified by the veteran. 2. The veteran should be scheduled for an orthopedic examination. The claims folder should be made available to the examiner in conjunction with the examination. Any indicated tests or studies should be accomplished. The veteran is currently service- connected for varicose veins of the left lower extremity rated as 60 percent disabling; varicose veins of the right lower extremity, rated as 60 percent disabling; degenerative joint disease of the lumbar spine, rated as 40 percent disabling; peripheral neuropathy of the right lower extremity, rated as 10 percent disabling; peripheral neuropathy of the left lower extremity, rated as 10 percent disabling; and hemorrhoids, rated as noncompensable. The examiner should express an opinion as to the following: a. Is it at least as likely as not (a 50 percent or greater probability) that the service-connected disabilities caused or contributed to cause the veteran's right hip fracture? Please provide an explanation. b. Is it at least as likely as not (a 50 percent or greater probability) that the service-connected disabilities render the veteran permanently bedridden or so helpless to be in need of the regular aid and attendance of another person? [For this part of the question, the examiner should include the effects of the fractured hip if, and only if, he is of the opinion that the service-connected disabilities caused or contributed to cause the hip fracture.] Please provide an explanation. 3. Thereafter, the AOJ should adjudicate whether the right hip fracture is service-connected. If the claim is denied, the veteran should be advised of his appellate rights. The veteran is notified that unless he submits a timely notice of disagreement, the Board will not have jurisdiction of this issue. 4. The AOJ should subsequently adjudicate the claim for special monthly compensation. If special monthly compensation remains denied, the appellant and his representative should be provided a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. 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).