Citation Nr: 0829124 Decision Date: 08/27/08 Archive Date: 09/04/08 DOCKET NO. 07-03 279A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Huntington, West Virginia THE ISSUES 1. Entitlement to service connection for a lung disorder, to include as due to asbestos exposure. 2. Entitlement to service connection for a heart disorder, to include coronary artery disease. 3. Entitlement to service connection for a central nervous system disorder. 4. Entitlement to service connection for post-traumatic stress disorder (PTSD). 5. Entitlement to service connection for hypertension. 6. Entitlement to service connection for a digestive disorder. 7. Entitlement to service connection for a prostate disorder. 8. Entitlement to service connection for a rash. 9. Entitlement to service connection for color blindness. REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD S. Layton, Associate Counsel INTRODUCTION The appellant is a veteran who served on active duty from April 1960 to March 1964. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2005 rating decision by the Huntington, West Virginia Regional Office (RO) of the Department of Veterans Affairs (VA). The veteran has presented personal testimony during hearings before a Decision Review Officer (DRO) at the RO and before undersigned Veterans Law Judge. Transcripts of the hearings are of record. The Board notes that the veteran submitted additional evidence after the final adjudication of his claim by the RO. In March 2008, the veteran waived RO consideration of his additional evidence. The issues of entitlement to service connection for a lung disorder, heart disorder, central nervous system disorder, PTSD, hypertension, digestive disorder, prostate disorder, and rash are addressed in the REMAND portion of the decision below and are REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDINGS OF FACT 1. All relevant evidence necessary for the equitable disposition of the issue on appeal was obtained. 2. The evidence of record demonstrates the veteran's color blindness is not a result of or was aggravated by any established event, injury, or disease during active service. CONCLUSION OF LAW Color blindness was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 2002 & Supp. 2007); 38 C.F.R. § 3.303 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION The provisions of the Veterans Claims Assistance Act of 2000 (VCAA), codified at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a), and as interpreted by the United States Court of Appeals for Veterans Claims (the Court) have been fulfilled by information provided to the veteran in correspondence from the RO dated in June 2004 and April 2005. Those letters notified the veteran of VA's responsibilities in obtaining information to assist the veteran in completing his claims and identified the veteran's duties in obtaining information and evidence to substantiate his claims. (See 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a)), Quartuccio v. Principi, 16 Vet. App. 183 (2002), Pelegrini v. Principi, 18 Vet. App. 112 (2004). See also Mayfield v. Nicholson, 19 Vet. App. 103, 110 (2005), reversed on other grounds, 444 F.3d 1328 (Fed. Cir. 2006), Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006); Mayfield v. Nicholson (Mayfield II), 20 Vet. App. 537 (2006). The veteran has been made aware of the information and evidence necessary to substantiate his claims and has been provided opportunities to submit such evidence. The RO has properly processed the appeal following the issuance of the required notice. Moreover, all pertinent development has been undertaken, examinations have been performed, and all available evidence has been obtained in this case. Thus, the content of the notice letters complied with the requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b). No further action is necessary for compliance with the VCAA. During the pendency of this appeal, the Court in Dingess/Hartman found that the VCAA notice requirements applied to all elements of a claim. An additional notice as to these matters was provided in April 2006. The notice requirements pertinent to the issue addressed in this decision have been met and all identified and authorized records relevant to the matter have been requested or obtained. The Board notes that the veteran has not been afforded a VA examination in connection with his claim for service connection for color blindness. In determining whether the duty to assist requires that a VA medical examination be provided or medical opinion obtained with respect to a veteran's claim for benefits, there are four factors for consideration. These four factors are: (1) whether there is competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) whether there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumption period; (3) whether there is an indication that the disability or symptoms may be associated with the veteran's service or with another service-connected disability; and (4) whether there otherwise is sufficient competent medical evidence of record to make a decision on the claim. 38 U.S.C. § 5103A(d) and 38 C.F.R. § 3.159(c)(4). In this case, the Board is of the opinion that an additional VA examination is not required. See 38 C.F.R. § 3.159(c)(4)(i). As will be discussed further below, the evidence of record indicates that the veteran had color blindness before he entered active duty, and examinations performed at his separation from active duty and shortly thereafter do not indicate that his disorder was aggravated. The Board finds that there is sufficient competent medical evidence of record to make a decision on the claim. Further attempts to obtain additional evidence would be futile. The Board finds the available medical evidence is sufficient for an adequate determination. There has been substantial compliance with all pertinent VA law and regulations and to move forward with the claim would not cause any prejudice to the appellant. Law and Regulations Service connection may be granted for a disability resulting from personal injury suffered or disease contracted in line of duty or for aggravation of preexisting injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2007). In addition, service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there are required a combination of manifestations sufficient to identify a disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word chronic. Continuity of symptomatology is required only where the condition noted during service is not, in fact, shown to be chronic or when the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). In order to prevail on the issue of service connection on the merits, there must be medical evidence of (1) a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. Hickson v. West, 12 Vet. App. 247, 253 (1999). The Federal Circuit has held that a veteran seeking disability benefits must establish the existence of a disability and a connection between service and the disability. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). The Court has held that where the determinative issue involves medical causation or a medical diagnosis, competent medical evidence is required. Grottveit v. Brown, 5 Vet. App. 91 (1993); see also Espiritu v. Derwinski, 2 Vet. App. 492 (1992). The Federal Circuit has also recognized the Board's "authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other items of evidence." Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). VA is free to favor one medical opinion over another provided it offers an adequate basis for doing so. See Owens v. Brown, 7 Vet. App. 429 (1995). A veteran is considered to be in sound health when examined, accepted, and enrolled for service - except as to defects, infirmities, or disorders noted at the time of his entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior to service, and was not aggravated by such service. See 38 U.S.C.A. §§ 1111, 1132. It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case with all reasonable doubt to be resolved in favor of the claimant; however, the reasonable doubt rule is not a means for reconciling actual conflict or a contradiction in the evidence. 38 C.F.R. § 3.102 (2007). Factual Background and Analysis In this case, an undated note from U.S. Naval Recruiting Station, Cincinnati, Ohio, stated that the veteran was found to be physically fit for enlistment in the Navy. It was noted that the veteran had defective color vision, but it was not considered disabling. The April 1960 entrance examination indicates that the veteran's color vision was tested by "DPIP" with a result of "15-15." A service treatment note from March 1964 shows that the veteran had defective color vision, not considered disabling. The April 1964 discharge examination report contains a notation that the veteran failed the Falant color vision test. Re- enlistment examinations for the Naval Reserves dated in December 1965 and April 1966 show that the veteran passed the Yarn color vision test. During the veteran's March 2008 hearing before the undersigned, the veteran said that when he entered the military he was not colorblind, but when he left active duty, he was colorblind. He also said that exposure to carbon tetrachloride can cause temporary color blindness. Based on the evidence of record, the Board finds that the veteran was color blind before he entered active duty, and his color blindness was not aggravated by active duty. Although the veteran said at his personal hearing that he was not color blind when he entered active duty, service records show that the veteran's color blindness was noted at the recruiting center where the veteran enlisted. In this matter, the Board finds the service records to be more persuasive than the veteran's testimony as the records were created at the time the veteran entered the military, whereas the veteran's testimony was given nearly 48 years after his entrance examination. Additionally, the Board finds that the veteran's pre-existing color blindness was not aggravated by his active duty. As noted above, colorblindness was noted on reports as the veteran entered and separated from active duty. However, as examinations performed for reserve duty in December 1965 and April 1966 show that the veteran was able to pass the Yarn color vision test, it does not appear that the veteran's colorblindness was aggravated by his active duty. The Board has considered the internet articles that the veteran submitted in support of his claim. Unfortunately, the articles are general in nature and are not specific to the veteran. They do not mention the veteran or discuss his individual situation. Therefore, the Board finds the internet articles to be of less persuasive value. The main evidence portending that the veteran's service in the military caused or aggravated his colorblindness comes from him personally. Where a determinative issue involves medical causation or a medical diagnosis, competent medical evidence is required. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). Although the appellant is competent to provide evidence of visible symptoms, he is not competent to provide evidence that requires medical knowledge. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Therefore, the Board finds entitlement to service connection is not warranted. When all the evidence is assembled VA is then responsible for determining whether the evidence supports the claims or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claims in which case the claims are denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001). The preponderance of the evidence is against the claims. ORDER Entitlement to service connection for color blindness is denied. REMAND During his June 2007 hearing before a DRO and his March 2008 hearing before the undersigned, the veteran indicated that he was in receipt of disability compensation from the State of California. He stated that the basis for his compensation was stress, and he had been receiving disability compensation since 1980. Also, the veteran testified that he had received surgery from a private doctor in 1998 in connection with his claimed rash. The claims file does not contain any records in connection with this compensation or surgery. These records should be obtained and associated with the claims file. A February 2008 letter from a VA licensed clinical social worker indicated that the veteran received individual counseling once monthly at the Lexington VA medical center. No records from VAMC Lexington have been associated with the claims file. The Board emphasizes that records generated by VA facilities that may have an impact on the adjudication of a claim are considered constructively in the possession of VA adjudicators during the consideration of a claim, regardless of whether those records are physically on file. See Dunn v. West, 11 Vet. App. 462, 466-67 (1998); Bell v. Derwinski, 2 Vet. App. 611, 613 (1992). The RO must obtain all outstanding pertinent medical records from VAMC Lexington, following the procedures prescribed in 38 C.F.R. § 3.159 (2007) as regards requesting records from Federal facilities. Lung Disorder The veteran has claimed that his work as a boiler room repairman exposed him to asbestos while on active duty. He has stated that his current lung problems are related to asbestos exposure. Service records and a lay statement from April 2006 indicate that the veteran worked as a boiler repairman aboard two ships while on active duty. One evaluation report stated that the veteran assisted in repairs of a fire room. Private and VA treatment records from 1965 through the present reveal regular diagnoses of chronic bronchitis. There are no specific statutory or regulatory criteria governing claims of entitlement to service connection for residuals of asbestos exposure. McGinty v. Brown, 4 Vet. App. 428, 432-33 (1993). Likewise, applicable criteria provide no presumption of service connection for asbestos exposure claims. See Dyment v. West, 13 Vet. App. 141, 145 (1999) (holding that M21-1 does not create a presumption of exposure to asbestos solely from shipboard service). However, VA has provided guidelines for the adjudication of asbestos exposure claims in the Adjudication Procedure Manual M21-1R (M21-1R), Part IV, Subpart ii, Chapter 1, Section H, Paragraph 29. Additional guidance is found in M21-1R, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 9. The VA General Counsel has held that these M21-1R guidelines establish claim development procedures which adjudicators are required to follow in claims involving asbestos-related diseases. VAOPGCPREC 4-2000; 65 Fed. Reg. 33422 (2000). Specifically, these guidelines provide that VA must determine whether military records demonstrate evidence of exposure to asbestos in service and whether there is pre- or post-service evidence of asbestos exposure. Then, VA must determine the relationship between the claimed diseases and such asbestos exposure, keeping in mind latency and exposure information provided in M21-1R, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 9. This information provides that the latency period varies from 10 to 45 years between first exposure and development of the disease. The exposure to asbestos may be brief (as little as a month or two) or indirect (bystander disease). VA recognizes that inhalation of asbestos fibers can produce fibrosis and tumors. The most common disease is interstitial pulmonary fibrosis (asbestosis). Asbestos fibers may also produce pleural effusions and fibrosis, pleural plaques, mesotheliomas of pleura and peritoneum, lung cancer, and cancers of the gastrointestinal tract. Veterans Benefits Administration Manual M21-1R, Part IV, Subpart ii, Section C, Paragraph 9. It does not appear that the procedures outlined in The VA Adjudication Procedure Manual M21-1R, Part IV, Subpart ii, Chapter 1, Section H, Paragraph 29, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 9 have been followed concerning development of a claim involving asbestos. Consequently, additional development must be undertaken before the claim is ready for appellate review. Additionally, the veteran should be afforded a VA examination to determine the etiology of his reported lung symptoms. Heart Disorder, Central Nervous System Disorder, Hypertension, Digestive Disorder, Prostate Disorder, Rash Essentially, the veteran has claimed that he has all of the above-listed disorders secondary to being exposed to chemicals while on active duty. Service personnel records indicate that the veteran repaired boilers while on active duty. One evaluation report states that the veteran would assist in repairs of a fire room. The veteran has stated that while on active duty, he was routinely exposed to asbestos, carbon tetrachloride, and heat-resistant paint. A lay statement submitted in April 2006 also states that the veteran was exposed to asbestos and carbon tetrachloride during his work in the military. According to the service treatment records, the veteran was treated for a rash on his chest in February 1963. A dermatology consult from December 1966 shows that the veteran was treated for a rash on his trunk. The veteran testified at his March 2008 personal hearing that he had a cancer removed from his chest in 1998, and VA treatment records from 2005 indicate that he had a skin lesion on his chest, ultimately diagnosed via biopsy as a hemangioma in December 2005. Private treatment records reveal that the veteran was treated for paralysis of his extremities and an occasional inability to speak beginning in January 1970. Further private and VA treatment records throughout the 1970s show continuing treatment for seizures and nocturnal epilepsy. Private records from October 2002 and March 2003 document additional treatment for sleep paralysis. Starting in February 1991, the veteran received treatment for reflux and heartburn from a private provider. In November 1992, a private examiner gave a diagnosis of a hiatal hernia. An additional private treatment record from November 2001 indicates that the veteran had gastroesophageal reflux disease. VA treatment notes from February, March, and May 1975 state that the veteran had chronic prostatitis. In October 1995, a private examiner documented prostatitis. A September 2002 private treatment note states that the veteran's prostate was asymmetrical. In November 2003, after prostate surgery, the veteran was diagnosed with benign prostatic hypertrophy. The veteran reported on his December 1965 Report of Medical History (RMH) that he had rheumatic fever as an infant. In May 2001, a private medical examiner diagnosed the veteran as having hypertension. In February 2004, the veteran was told by a private examiner that he had coronary artery disease. The revised VCAA duty to assist requires that VA make reasonable efforts to assist the claimant in obtaining evidence necessary to substantiate a claim and in claims for disability compensation requires that VA provide medical examinations or obtain medical opinions when necessary for an adequate decision. 38 C.F.R. § 3.159. A medical examination or medical opinion is deemed to be necessary if the record does not contain sufficient competent medical evidence to decide the claim, but includes competent lay or medical evidence of a current diagnosed disability or persistent or recurrent symptoms of disability, establishes that the veteran suffered an event, injury, or disease in service, or has a disease or symptoms of a disease manifest during an applicable presumptive period, and indicates the claimed disability or symptoms may be associated with the established event, injury, or disease. 38 C.F.R. § 3.159(c)(4). The Board notes that the veteran has not been afforded a VA examination in connection with any of the above-listed claims. The veteran should be afforded a VA examination to determine the proper diagnosis and etiology of his documented symptoms. PTSD In reviewing the veteran's outpatient records, it appears that the veteran has experienced panic attacks consistently since his time on active duty. Private medical correspondence from J.E.B., Ph.D., L.P.C.C. dated March 2006 reveals a diagnosis of PTSD with a co-existing panic disorder with agoraphobia. Dr. B. referenced the DSM-IV with his diagnoses. The letter also linked the veteran's mental disorders to an experience in the military which involved sexual impropriety. A February 2008 letter from a VA licensed clinical social worker states that the veteran's current anxiety, hallucinations, nightmares, and other psychological symptoms were directly related to traumatic experiences that involved sexual assault during active duty. The Board notes that in cases of alleged personal assault or rape, special development is required. It does not appear that the procedures outlined in The VA Adjudication Procedure Manual M21-1R, Part IV, Subpart ii, Chapter 1, Section D have been followed concerning development of a claim involving personal trauma. Consequently, additional development must be undertaken before the claim is ready for appellate review. Additionally, the Board notes that the veteran has not been afforded a VA examination in connection with his PTSD claim. In Green (Victor) v. Derwinski, 1 Vet. App. 121, 124 (1991), the Court held that the duty to assist may include "the conduct of a thorough and contemporaneous medical examination, one which takes into account the records of prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one." Therefore, after all appropriate development of records with respect to the veteran's claim of personal assault and rape, the veteran should be afforded a psychiatric examination to determine the etiology of his claimed psychological disorder. Accordingly, the case is REMANDED for the following action: 1. The AMC/RO should obtain the names and addresses of all medical care providers-VA and private-who have treated the veteran for his claimed disorders. After the veteran has signed the appropriate releases, those records not already associated with the claims file should be obtained and associated with the claims folder. Specifically, the AMC/RO should obtain all outstanding medical records for the veteran from VAMC Lexington, the treatment records for the veteran's 1998 surgery, and the records associated with his disability compensation from the state of California. All attempts to procure records should be documented in the file. If the AMC/RO cannot obtain records identified by the veteran, a notation to that effect should be inserted in the file. The veteran is to be notified of unsuccessful efforts in this regard, in order to allow him the opportunity to obtain and submit those records for VA review. 2. The veteran is requested to provide a list of his employers since his separation from service, complete with the addresses, dates of employment, his job title, and a list of all chemicals to which he was exposed during each period of employment. 3. The AMC/RO should review the claims file and ensure that all notification and development action outlined by The VA Adjudication Procedure Manual M21- 1R, Part IV, Subpart ii, Chapter 1, Section H, Paragraph 29, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 9 concerning asbestos are fully complied with and satisfied. All attempts to procure records should be documented in the file. If the AMC/RO cannot obtain records identified by the veteran, a notation to that effect should be inserted in the file. The veteran is to be notified of unsuccessful efforts in this regard, in order to allow the veteran the opportunity to obtain and submit those records for VA review. 4. Thereafter, the record should be reviewed and specific determinations provided as to whether the military records demonstrate evidence of exposure to asbestos in service and whether there is pre- or post-service evidence of asbestos exposure. 5. Then, the AMC/RO should arrange for the veteran to undergo a pulmonary examination at an appropriate VA medical facility. The entire claims file must be made available to the physician performing the examination. A notation to the effect that this record review took place should be included in the report of the examiner. The examination report should include discussion of the veteran's documented medical history and assertions. All appropriate tests and studies should be accomplished, and all clinical findings should be reported in detail. The physician is requested to provide an opinion as to the whether there is at least a 50 percent probability or greater (at least as likely as not) that a lung disorder accounting for the veteran's symptoms was incurred in or is otherwise related to his period of military service. The physician is specifically requested to determine the relationship between any claimed lung disease and any documented asbestos exposure, keeping in mind latency and exposure information provided in M21-1R, Part IV, Subpart ii, Chapter 1, Section H, Paragraph 29, Part IV, Subpart ii, Chapter 2, Section C, Paragraph 9. Any opinion should be provided based on the results of examination, a review of the medical evidence of record, and sound medical principles. All examination findings, along with the complete rationale for all opinions expressed, should be set forth in the examination report. Sustainable reasons and bases are to be provided for any opinion rendered. 6. The AMC/RO should review the claims file and ensure that all notification and development action outlined by The VA Adjudication Procedure Manual M21- 1R, Part IV, Subpart ii, Chapter 1, Section D concerning personal trauma claims are fully complied with and satisfied. All attempts to procure records should be documented in the file. If the AMC/RO cannot obtain records identified by the veteran, a notation to that effect should be inserted in the file. The veteran is to be notified of unsuccessful efforts in this regard, in order to allow the veteran the opportunity to obtain and submit those records for VA review. 7. Thereafter, the record should be reviewed and specific determinations provided as to which specific stressor events, if any, have been verified. In reaching these determinations, any credibility questions raised by the record should be addressed. The veteran should be notified of these determinations and afforded the opportunity to respond. 8. The veteran should be scheduled for examination by a psychiatrist for an opinion as to whether there is at least a 50 percent probability or greater that he has a present psychiatric disorder (under DSM-IV criteria) related to a verified event in service. The examining psychiatrist should be informed as to which of the specific claimed stressor events have been verified. Prior to the examination, the claims folder must be made available to the examiner for review of the case. A notation to the effect that this record review took place should be included in the report. Opinions should be provided based on the results of examination, a review of the medical evidence of record, and sound medical principles. All examination findings, along with the complete rationale for the opinions expressed, should be set forth in the examination report. Sustainable reasons and bases must be given for any opinion rendered. 9. The AMC/RO should arrange for the veteran to undergo appropriate examination for his heart disorder, central nervous system disorder, hypertension, digestive disorder, prostate disorder, and rash at a VA medical facility. The entire claims file must be made available to the physician(s) performing the examination(s). A notation to the effect that this record review took place should be included in the report of the examiner(s). The examination report should include discussion of the veteran's documented medical history, employment history and assertions. All appropriate tests and studies should be accomplished, and all clinical findings should be reported in detail. The physician(s) is(are) requested to provide an opinion as to the whether there is at least a 50 percent probability or greater (at least as likely as not) that a heart disorder, central nervous system disorder, hypertension, digestive disorder, prostate disorder, and rash were caused by exposure to chemicals during the veteran's period of active military service. If the physician(s) determine(s) that it is not at least as likely as not that a heart disorder, central nervous system disorder, hypertension, digestive disorder, prostate disorder, and rash were caused by exposure to chemicals during the veteran's period of active military service, then the physician is asked to opine whether it is at least as likely as not (50 percent probability or greater) that any of the claimed disorders were directly related to the veteran's military service. Any opinion should be provided based on the results of examination, a review of the medical evidence of record, and sound medical principles. All examination findings, along with the complete rationale for all opinions expressed, should be set forth in the examination report. Sustainable reasons and bases are to be provided for any opinion rendered. 10. The veteran must be given adequate notice of the date and place of any requested examination. A copy of all notifications, including the address where the notice was sent must be associated with the claims folder. The veteran is to be advised that failure to report for a scheduled VA examination without good cause shown may have adverse effects on his claim. 11. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the veteran should be furnished an appropriate supplemental statement of the case and be afforded the 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. 2005). ______________________________________________ RENÉE M. PELLETIER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs