Citation Nr: 0813598 Decision Date: 04/24/08 Archive Date: 05/01/08 DOCKET NO. 04-33 535 ) DATE ) ) On appeal from the Department of Veterans Affairs Medical and Regional Office Center in Fargo, North Dakota THE ISSUES 1. Entitlement to an increased (compensable) evaluation for the residuals of grenade fragmentation wounds to the left upper arm. 2. Entitlement to an evaluation in excess of 10 percent for the residuals of grenade fragmentation wounds to the left hand. 3. Entitlement to an evaluation in excess of 10 percent for the residuals of grenade fragmentation wounds to the left wrist. 4. Entitlement to an evaluation in excess of 20 percent for degenerative changes of the lumbar spine as the residual of grenade fragmentation wounds. 5. Entitlement to an effective date prior to April 4, 1997 for an award of service connection for the residuals of grenade fragmentation wounds to the left hand. 6. Entitlement to an effective date prior to April 4, 1997 for an award of service connection for degenerative changes of the lumbar spine as the residual of grenade fragmentation wounds. 7. Entitlement to an effective date prior to April 4, 1997 for the award of a total disability rating based upon individual unemployability due to service-connected disability. 8. Entitlement to an effective date prior to April 4, 1997 for an award of Dependents' Educational Assistance pursuant to the provisions of 38 U.S.C.A. Chapter 35. ATTORNEY FOR THE BOARD Stephen F. Sylvester, Counsel INTRODUCTION The veteran served on active duty from March 1951 to March 1953. This case comes before the Board of Veterans' Appeals (Board) on appeal of rating decisions by Department of Veterans Affairs (VA) Regional Offices (RO). In a decision of November 2000, the Board granted a separate and distinct 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand. This left the veteran in receipt of a separate 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand, a separate 10 percent evaluation for the residuals of grenade fragmentation wounds to the left wrist, and a separate noncompensable evaluation for the residuals of grenade fragmentation wounds to the left upper arm. In a subsequent Order of March 2001, the United States Court of Appeals for Veterans Claims (Court) vacated only that part of the Board's November 2000 decision which denied an evaluation in excess of 10 percent for the residuals of grenade fragmentation wounds to the left wrist and a compensable evaluation for the residuals of grenade fragmentation wounds to the left upper arm, thereby leaving in effect the previous Board-assigned 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand. In a decision of January 2002, the Board "restated" the aforementioned assignment of a 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand, and once again denied entitlement to an evaluation in excess of 10 percent for the residuals of grenade fragmentation wounds to the left wrist, and a compensable evaluation for the residuals of grenade fragmentation wounds to the left upper arm. In a subsequent Order of October 2002, the United States Court of Appeals for Veterans Claims (Court) vacated the Board's entire January 2002 decision regarding the issues of increased evaluations for the veteran's service-connected residuals of fragmentation wounds to the left hand, the left wrist, and the left upper arm. In a rating decision of December 2003, the RO granted service connection and a 20 percent evaluation for degenerative changes of the lumbar spine. In that same decision, the RO effectuated the Board's November 2000 decision granting a separate and distinct 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand, and additionally granted entitlement to a total disability rating based upon individual unemployability and Dependents' Educational Assistance. All of the aforementioned benefits were made effective from April 4, 1997, the date of receipt of the veteran's claim for a total disability rating based upon individual unemployability. This case was most recently before the Board in September 2006, at which time it was remanded for additional development. The case is now, once more, before the Board for appellate review. Finally, for reasons which will become apparent, the appeal as to the issues of increased evaluations for the service- connected residuals of grenade fragmentation wounds to the left upper arm, the left hand, and the left wrist, as well as that of an increased evaluation for service-connected degenerative changes of the lumbar spine is being REMANDED to the RO via the Appeals Management Center (AMC) in Washington, D.C. VA will notify you if further action is required on your part. FINDINGS OF FACT 1. On April 4, 1997, the RO received the veteran's claim for a total disability rating based upon individual unemployability, a claim which was additionally construed as a request for increased evaluations for the veteran's service-connected residuals of grenade fragmentation wounds. 2. In a rating decision of June 1997, the RO denied entitlement to a total disability rating based upon individual unemployability, essentially on the basis that the veteran's unemployability was in large part the result of his nonservice-connected arthritis of the lumbar spine. 3. In a rating decision of October 1997, the RO denied increased evaluations for the veteran's service-connected residuals of grenade fragmentation wounds to the right and left buttocks, the right and left lower legs, and the left arm, as well as an increased evaluation for service-connected malaria, and a total disability rating based upon individual unemployability. Once again, denial of the veteran's claim for a total disability rating based upon individual unemployability was in large part premised upon the fact that his unemployability was due primarily to his nonservice- connected arthritis of the lumbar spine. 4. In a rating decision of December 2004, the RO effectuated the Board's November 2000 grant of service connection for the residuals of grenade fragmentation wounds to the left hand, and assigned a 10 percent evaluation. That same rating decision also granted service connection for degenerative changes of the lumbar spine, assigned a 10 percent evaluation, and additionally granted entitlement to a total disability rating based upon individual unemployability and Dependents' Educational Assistance under the provisions of 38 U.S.C.A. Chapter 35. All of the aforementioned benefits were made effective from April 4, 1997, the date of receipt of the veteran's claim for a total disability rating based upon individual unemployability (and inferred claim for increased ratings). 5. The claim which led to the ultimate award of the benefits currently under consideration was received no earlier than April 4, 1997. CONCLUSIONS OF LAW 1. An effective date earlier than April 4, 1997 for an award of service connection for the residuals of grenade fragmentation wounds to the left hand is not warranted. 38 U.S.C.A. §§ 1110, 5110 (West 2002); 38 C.F.R. § 3.400 (2007). 2. An effective date earlier than April 4, 1997 for an award of service connection for degenerative changes of the lumbar spine is not warranted. 38 U.S.C.A. §§ 1110, 5110 (West 2002); 38 C.F.R. § 3.400 (2007). 3. An effective date earlier than April 4, 1997 for the award of a total disability rating based upon individual unemployability is not warranted. 38 U.S.C.A. §§ 1155, 5110 (West 2002); 38 C.F.R. §§ 3.321, 3.340, 3.341, 3.400, 4.16 (2007). 4. An effective date earlier than April 4, 1997 for an award of Dependents' Educational Assistance pursuant to the provisions of 38 U.S.C.A. Chapter 35 is not warranted. 38 U.S.C.A. §§ 3501, 5110 (West 2002); 38 C.F.R. §§ 3.400, 3.807, 21.3020, 21.3021 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In reaching this determination, the Board wishes to make it clear that it has reviewed all the evidence in the veteran's claims file, which includes: his multiple contentions; in addition to pertinent RO, Board, and Court decisions, and both VA and private treatment records and examination reports. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the veteran's claims, and what the evidence in the claims file shows, or fails to show, with respect to each claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000), and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). The veteran in this case seeks an effective date earlier than April 4, 1997 for awards of service connection for the residuals of grenade fragmentation wounds to the left hand and lumbar spine, as well as for a total disability rating based upon individual unemployability and an award of Dependents' Educational Assistance. In that regard, service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303. Service connection may also be granted for any disease diagnosed after discharge, when all the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (2007). Total disability ratings based upon individual unemployability may be assigned where the schedular rating is less than total when it is found that the service-connected disability or disabilities are sufficient to produce unemployability without regard to advancing age. 38 C.F.R. §§ 3.321, 3.340, 3.341, 4.16 (2007). Total disability ratings for compensation may also be assigned where the schedular rating is less than total when it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of a single service-connected disability ratable at 60 percent or more, or as a result of two or more disabilities, provided at least one disability is ratable at 40 percent and there is sufficient additional disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 4.16 (2007). Finally, for the purpose of Dependents' Educational Assistance under 38 U.S.C.A. Chapter 35, a child, spouse, or surviving spouse of a veteran or serviceperson will have basic eligibility where the veteran was discharged from service under conditions other than dishonorable, and has a permanent and total service-connected disability. 38 U.S.C.A. § 3501 (West 2002); 38 C.F.R. §§ 3.807, 21.3020, 21.3021 (2007). As regards the assignment of effective dates, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase is the date of receipt of claim, or the date entitlement arose, whichever is later. The effective date of an evaluation and award of compensation is generally the day following separation from service, or the date entitlement arose, if the claim is received within one year after separation from service; otherwise, the date of receipt of claim, or the date entitlement arose, whichever is later. 38 U.S.C.A. § 5110(a) (West 2002); 38 C.F.R. § 3.400 (2007). Unless specifically provided otherwise, a claim for increased compensation is to be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C.A. § 5110(a) (West 2002). Section 5110 (b)(2) "specifically provides otherwise" by stating that an effective date of an award of increased compensation is to be the earliest date as of which it is ascertainable that an increase in disability has occurred, if the application is received within one year from such date. 38 U.S.C.A. § 5110(b); see also 38 C.F.R. § 3.400(o)(1)(2) (effective date of award of increased rating is the earliest date as of which it is factually ascertainable that an increase in disability has occurred if the claim is received within one year from such date; otherwise, date of receipt of claim); Swanson v. West, 12 Vet. App. 442, 447 (1999); Hazan v. Gober, 10 Vet. App. 511, 520 (1997). Put somewhat more simply, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase is the date of receipt of claim, or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400 (2007). In the present case, a review of the record discloses that, in a decision of August 1996, the Board specifically denied entitlement to service connection for arthritis of the lumbar spine. The veteran was next heard from on April 4, 1997, at the time of the filing of his claim for a total disability rating based upon individual unemployability. At that time, the veteran indicated that he had an eighth grade education, as well as occupational experience as a maintenance man, and in the area of lumber sales. Apparently, the veteran last worked in 1993. In a rating decision of June 1997, the RO denied entitlement to a total disability rating based upon individual unemployability. At that time, it was noted that private medical records beginning in 1996 showed evidence of increased low back pain. Magnetic resonance imaging confirmed the presence of spinal stenosis in the area of the 4th and 5th lumbar vertebrae, with accompanying neurogenic claudication. A May 1997 surgical report was significant for the presence of a partial laminectomy with bilateral foraminotomies and mesial facetectomies. Based on such findings, it was concluded that the veteran's unemployability was due primarily to his nonservice-connected arthritis of the lumbar spine, and not to his other service-connected disabilities. In a subsequent rating decision of October 1997, and in apparent response to the veteran's previous claim for a total disability rating based upon individual unemployability, the RO denied entitlement to increased evaluations for the service-connected residuals of grenade fragmentation wounds to the right and left buttocks, the right and left lower legs, and the left arm. The RO additionally denied entitlement to an increased evaluation for the service- connected residuals of malaria, and it continued its denial of a total disability rating based upon individual unemployability. Once again, the denial of the veteran's claim for a total disability rating based upon individual unemployability was based in large part on the fact that his unemployability was due primarily to a nonservice-connected low back condition. In a decision of November 2000, the Board granted a separate 10 percent evaluation for the residuals of a grenade fragmentation wound to the left hand. In so doing, the Board concluded that, while the veteran's service-connected disability had been described in terms of his left arm, based on the evidence of record, and, in particular, a June 1999 VA examination, three separate ratings were warranted, since the evidence showed three separate and not overlapping areas of the veteran's left upper extremity which were affected by grenade fragmentation. The Board concluded that, based on the June 1999 VA examination findings, the veteran had three separate disabilities which should be described separately for rating purposes, since three separate and distinct areas of the left upper extremity were affected. More specifically, there were two retained metallic objects in the veteran's left hand, as well as scars as the residuals of metallic objects which had been removed from the left wrist, and a scar of the left upper arm. As noted above, in an Order of March 2001, the Court vacated that portion of the Board's November 2000 decision which denied increased evaluations for the service-connected residuals of grenade fragment wounds to the left wrist and left upper arm. However, the Court specifically left in effect the Board's assignment of a separate and distinct 10 percent evaluation for the service-connected residuals of grenade fragmentation wounds to the left hand. The Board notes that, following a VA orthopedic examination in September 2003, the examiner offered his impression that the veteran suffered from the residuals of shell fragment wounds to the left hand, wrist, and upper arm, characterized by slight weakness of left grip strength, a loss of range of motion of the left wrist, and slight loss of range of motion of the left elbow. Also noted were certain residuals of fragmentation wounds to both the right and left buttocks, and to both lower legs. According to the examiner, the inservice grenade explosion had caused the veteran to be blown to the ground, at which time he suffered from a loss of consciousness, and, also, a likely lower back injury. Based on his physical examination of the veteran and a review of available records, the examiner offered his opinion that it was at least as likely as not the case that the veteran's osteoarthritis of the back was the result of his inservice traumatic injury. According to the examiner, a grenade blast close enough to cause multiple shell fragment injuries would likely be severe enough to cause the veteran to be blown off his feet, resulting in injury. As regards certain employability issues, the examiner was of the opinion that the veteran 's service-connected conditions, including his lower back disability, would prohibit him from most any labor-intensive task requiring lifting, bending, or carrying objects. Further noted was that the veteran's lower back and left arm conditions would most likely inhibit any task such as sitting at a desk or typing on a keyboard, which would be included in the great majority of sedentary-type employment situations. Based in large part on the aforementioned VA examination, the RO, in a rating decision of December 2003, granted service connection (and a 20 percent evaluation) for degenerative changes of the lumbar spine as the residual of grenade fragmentation wounds. In that same rating decision, the RO effectuated the Board's November 2000 award of a separate and distinct 10 percent evaluation for the residuals of grenade fragmentation wounds to the left hand. Based upon a review of all pertinent evidence of record, and given that service connection was now in effect for the veteran's predominantly- disabling lower back condition, the RO awarded a total disability rating based upon individual unemployability, as well as Dependents' Educational Assistance under the provisions of 38 U.S.C.A. Chapter 35. All of the aforementioned benefits were made effective from April 4, 1997, the date of receipt of the veteran's claim for a total disability rating based upon individual unemployability which precipitated not only the Board's award of a separate 10 percent evaluation for the service-connected residuals of grenade fragmentation wounds to the left hand, but also the grant of service connection for degenerative changes of the lumbar spine, and a total disability rating based upon individual unemployability leading to the award of Dependents' Educational Assistance. As noted above, the effective date of an evaluation and award of compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase is the date of receipt of claim, or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400 (2007). In the case at hand, it is clear that the "claim" which ultimately led to the award of benefits for which the effective date is now in dispute was the veteran's claim for a total disability rating based upon individual unemployability, which was received on April 4, 1997. While some might argue that the veteran's "entitlement" to service connection for the residuals of grenade fragmentation wounds to the left hand arose no earlier than the time of the aforementioned VA examination in June 1999, while "entitlement" to service connection for degenerative changes of the lumbar spine, a total disability rating, and Dependents' Educational Assistance arose no earlier than the VA examination of September 2003, what is clear is that the RO has, in fact, awarded benefits effective the date of receipt of the veteran's claim, which is to say, April 4, 1997, a point in time significantly earlier than the aforementioned examinations in June 1999 and September 2003. In any case, it is clear that the veteran's "claim" for the benefits in question was received no earlier than April 4, 1997. In point of fact, a review of the record reveals no other communication or action prior to that date which could be considered as a claim for the benefits which have now been awarded, the vast majority of which hinge upon the aforementioned award of service connection for degenerative changes of the lumbar spine. Significantly, and as noted above, the Board, in a decision of August 1996, specifically denied entitlement to service connection for just that disability. Under the circumstances, an effective date earlier than April 4, 1997 for awards of service connection for the residuals of grenade fragmentation wounds to the left hand and lumbar spine, as well as awards of a total disability rating based upon individual unemployability and Dependents' Educational Assistance must be denied. The Veterans Claims Assistance Act of 2000 (VCAA) imposes obligations on VA in terms of its duty to notify and assist claimants. When VA receives a complete or substantially complete application for benefits, it is required to notify the veteran and his representative, if any, of any information and medical or lay evidence that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a) (West 2002 & Supp. 2007); 38 C.F.R. § 3.159(b) (2007); Quartuccio v. Principi, 16 Vet. App. 183 (2002). In Pelegrini v. Principi, 18 Vet. App. 112, 120-21 (2004), the Court held that VA must (1) inform the claimant about the information and evidence not of record that is necessary to substantiate the claim; (2) inform the claimant about the information and evidence that VA will seek to provide; (3) inform the claimant about the information and evidence the claimant is expected to provide; and (4) request that the claimant provide any evidence in his possession which pertains to the claim. The Board finds that the VCAA notice requirements have been satisfied by correspondence dated in October 2006. In that letter, VA informed the veteran of the necessary prerequisites to establishing an effective date for any benefits awarded. See Dingess/Harman v. Nicholson, 19 Vet. App. 473 (2006). As to informing the veteran of which information and evidence he was to provide to VA, and which information and evidence VA would attempt to obtain on his behalf, VA informed him that it had a duty to obtain any records held by any federal agency. It also informed him that, on his behalf, VA would make reasonable efforts to obtain records which were not held by a federal agency, such as records from private doctors and hospitals. The RO told the veteran that he could obtain private records himself and submit them to VA. Finally, he was told to submit any evidence in his possession which pertained to his claims. VA must also make reasonable efforts to assist the veteran in obtaining evidence necessary to substantiate the claim for the benefits sought, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. In connection with the current appeal, VA has obtained the veteran's service medical records, as well as VA and private inpatient and outpatient treatment records and examination reports. Also of record are numerous pertinent RO, Board, and Court decisions. For the foregoing reasons, the Board concludes that all reasonable efforts were made by VA to obtain evidence necessary to substantiate the veteran's current claims for earlier effective dates. The evidence of record provides sufficient information to adequately evaluate the claims, and the Board is not aware of the existence of any additional relevant evidence which has not been obtained. Therefore, no further assistance to the veteran with the development of evidence is required. 38 U.S.C.A. § 5103A(a)(2); 38 C.F.R. § 3.159(d); see Mayfield v. Nicholson, 19 Vet. App. 103 (2005), rev'd on other grounds, 444 F.3d 1328 (Fed. Cir. 2006). ORDER An effective date earlier than April 4, 1997 for the award of service connection for the residuals of grenade fragmentation wounds to the left hand is denied. An effective date earlier than April 4, 1997 for the award of service connection for degenerative changes of the lumbar spine as the residual of grenade fragmentation wounds is denied. An effective date earlier than April 4,1997 for the award of a total disability rating based upon individual unemployability due to service-connected disability is denied. An effective date earlier than April 4, 1997 for the award of Dependents' Educational Assistance pursuant to the provisions of 38 U.S.C.A. Chapter 35 is denied. REMAND In addition to the above, the veteran in this case seeks increased evaluations for the service-connected residuals of grenade fragmentation wounds to the left upper arm, the left hand, and left wrist, as well as an increased evaluation for service-connected degenerative changes of the lumbar spine as the residual of inservice grenade fragmentation wounds. In pertinent part, it is contended that all of the aforementioned disabilities are more severe than presently evaluated, and productive of a greater degree of impairment than is reflected by the respective schedular evaluations now assigned. In that regard, the Board notes that, for an increased compensation claim, Section 5103(a) requires, at a minimum, that the Secretary notify the claimant that, to substantiate the claim, the claimant must provide, or ask the Secretary to obtain, medical or lay evidence demonstrating a worsening or increase in severity of the disability and the effect that worsening has on the claimant's employment and daily life. Vazquez-Flores v. Peake, 22 Vet. App. 37 (2008). Further, if the Diagnostic Code or Codes under which the claimant is rated contain criteria necessary for entitlement to a higher disability rating that would not be satisfied by the veteran demonstrating a noticeable worsening or increase in severity of the disability and the effect that worsening has on the claimant's employment and daily life (such as a specific measurement or test result), the Secretary must provide at least general notice of that requirement to the claimant. Additionally, the claimant must be notified that, should an increase in disability be found, a disability rating will be determined by applying relevant Diagnostic Codes, which typically provide for a percent (depending on the disability involved), based on the nature of the symptoms of the condition for which disability compensation is being sought, their severity and duration, and their impact upon employment and daily life. Consistent with the statutory and regulatory history, the notice must also provide examples of the types of medical and lay evidence that the claimant may submit (or ask the Secretary to obtain) which are relevant to establishing entitlement to increased compensation, e.g., competent lay statements describing symptoms, medical and hospitalization records, medical statements, employers' statements, job application rejections, and any other evidence showing an increase in the disability or exceptional circumstances relating to the disability. Vazquez-Flores, supra. In the present case, a review of the record fails to reveal that the veteran was ever provided with VCAA-complying notice with respect to his claims for increased ratings. More specifically, correspondence dated in September 2003 and October 2006 failed to adequately advise the veteran that he could submit evidence showing the effects of the worsening or increase in severity of his service-connected disabilities upon his "employment and daily life." Moreover, that correspondence failed to furnish the veteran with the appropriate Diagnostic Code or Codes which might potentially remain unsatisfied despite a showing of increasing symptomatology on the part of the veteran. Under the circumstances, the case must be remanded for proper notice under 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b), to include an explanation as to the type of evidence needed to establish both a disability rating and an effective date. See Vazquez-Flores v. Peake, 22 Vet. App. 37 (2008); see also Dingess, supra; Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006) (while the VCAA notice need not be contained in a single communication, post-decisional documents (e.g., Statements or Supplemental Statements of the Case) cannot satisfy the duty to notify). Accordingly, in light of the aforementioned, the case is REMANDED to the RO for the following actions: 1. Any pertinent VA or other inpatient or outpatient treatment records, subsequent to November 2006, the date of the most recent VA examination of record, should be obtained and incorporated in the claims folder. The veteran should be requested to sign the necessary authorization for release of any private medical records to the VA. All attempts to procure records should be documented in the file. If the records identified by the veteran cannot be obtained, a notation to that effect should be inserted in the file. In addition, the veteran should be informed of any such problem. 2. The veteran should then be specifically advised that he may submit any and all evidence showing the effects of the worsening or increase in severity of his service-connected disabilities on his "employment and daily life." All such evidence, when obtained, should be made a part of the veteran's claims folder. 3. The veteran should then be furnished copies of all of the potentially applicable Diagnostic Codes governing the award of increased benefits for his service-connected left hand, left wrist, or left upper arm disability, as well as for his service-connected degenerative changes of the lumbar spine. As to the veteran's service-connected left upper extremity disabilities, he should be given copies of 38 C.F.R. Part 4, Diagnostic Codes 5215, 5306, and 5309, as well as Diagnostic Codes 7804 and 7805 in effect prior to August 30, 2002, and Diagnostic Codes 7801 through 7805 which became effective August 30, 2002. As to the veteran's service-connected degenerative changes of the lumbar spine, he should be provided with copies of Diagnostic Codes 5292, 5293, and 5295 in effect prior to September 26, 2003, as well as Diagnostic Codes 5242 and 5243 which became effective on September 26, 2003. 4. Thereafter, review the claims file, and ensure that all notification and development action required by 38 U.S.C.A. §§ 5102, 5103, and 5103A are fully complied with and satisfied with respect to the veteran's claims for increased ratings. The notice should include an explanation as to the information or evidence needed to establish a disability rating and effective date of any increase for the claims on appeal, as outlined by the Court in Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). 5. Finally, review the veteran's claims for increased evaluations for the service-connected residuals of grenade fragment wounds to the left upper arm, the left hand, and left wrist, as well as his claim for an increased evaluation for degenerative changes of the lumbar spine as the residual of grenade fragmentation wounds. Should the benefits sought on appeal remain denied, the veteran should be provided with a Supplemental Statement of the Case (SSOC). The SSOC must contain notice of all relevant actions taken on the claims for benefits since the issuance of the most recent SSOC in August 2007. An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome in this case. The veteran need take no action unless otherwise notified. 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. §§ 5109B, 7112 (West Supp. 2007). ______________________________________________ C. CRAWFORD Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs