Citation Nr: 1010100 Decision Date: 03/17/10 Archive Date: 03/24/10 DOCKET NO. 08-17 221 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California THE ISSUES 1. Entitlement to service connection for a chronic acquired psychiatric disability, to include depression. 2. Entitlement to service connection for residuals of a left shoulder injury. 3. Entitlement to service connection for a disability of the right wrist, to include residuals of a fracture of the right fifth metacarpal bone. 4. Entitlement to service connection for a disability manifested by stress incontinence, claimed as a bladder condition. REPRESENTATION Appellant represented by: California Department of Veterans Affairs ATTORNEY FOR THE BOARD Robert E. O'Brien, Counsel INTRODUCTION The Veteran had periods of active service from September 1985 to January 1986, from April 2002 to September 2002, and from January 2003 to October 2003. She also had many years of inactive service with the Navy Reserves. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2007 rating decision of the VARO in San Diego, California, that denied entitlement to the benefits sought. A review of the evidence of record reveals that by rating decision dated in May 2008, service connection for other disabilities, to include residuals of a right foot fracture and fractured sacrum, residuals of right scaphoid fracture with right wrist tendinitis, multiple joint osteoporosis, residuals of a cervical spine injury, residuals of a right shoulder injury, sleep apnea, scarring, postoperative status, stress incontinence, residuals of lichen simplex, disability manifested by recurrent indigestion, and hemorrhoids was denied. The Veteran was notified of the determination by communication dated June 23, 2008, by the RO in Los Angeles. Received in September 2008 was a communication from the Veteran in which she stated she had moved her permanent residence and mailing address to Arkansas, but "do not wish to have my VARO 'C' file transferred to Arkansas at this time...I request all potentially pending C&P appointments to be arranged at VAMC Little Rock, Arkansas." However, received in September 2009 was another statement from the Veteran in which she stated that "I have moved my permanent residency and mailing address to that as listed below." The address given was in Worden, Montana 59088. She asked that all "potentially pending C&P appointments to be arranged at VAMC Fort Harrison, Montana." The appeal is REMANDED to the RO by way of the Appeals Management Center in Washington, D.C. VA will notify the Veteran should further action be required. REMAND The record as it stands is currently inadequate for the purpose of rendering a fully informed decision as to the claims that have been certified for the Board's review at this time, those being service connection for depression, service connection for residuals of a left shoulder injury, service connection for disability manifested by right wrist pain, and service connection for a disability manifested by stress incontinence. 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 in developing status pertinent to the claim. Ascherl v. Brown, 4 Vet. App. 371, 377 (1993). As indicated above, the Veteran has moved her residence from California to Arkansas to Montana in the last few years. Her claims file remains in the custody of the Los Angeles RO. She did not indicate in her August 2009 communication whether she wanted the claims file transferred to the Fort Harrison RO or to be maintained at the Los Angeles RO. This needs to be clarified. The Veteran has had three separate periods of active service, with a number of years of Reserve service with the Naval Reserves. However, the dates of her Naval Reserve service are not reflected by the evidence of record. The medical evidence of record reflects that with regard to the left shoulder, she injured the shoulder in June 2004 when she fell backward and jammed the left shoulder into its socket. She was treated and evaluated periodically thereafter and in July 2005 underwent status post type II Slap repair of the left shoulder and adhesive capsulitis of the shoulder. However, she claims that she was having left shoulder difficulties prior to the post service injury in June 2004 and she argues the RO has not considered the question of aggravation with regard to this matter. The Board notes that a review of the service treatment records shows that the veteran was seen on periodic occasions for complaints with regard to her psychiatric status, stress incontinence, and right wrist difficulties. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in service connection claims, VA must provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease incurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; and (3) an indication that the disability or persistent or recurrent symptoms of a disability maybe associated with the Veteran's service; but (4) there is insufficient competent medical evidence on file for VA to make a decision on the claim. The veteran herself argues that she has not been accorded rating examinations with regard to the disabilities at issue and she asks that these be accomplished. In order to adequately address the onset of her current disabilities, the Board believes further development is in order and the case is REMANDED for the following: 1. The Veteran should be contacted and asked to provide to the best of her recollection the dates of her military service, both active duty and inactive duty. She should be asked to identify the Naval Reserve units to which she was assigned during her years of Reserve duty. The Department of the Navy should then be contacted and asked to provide records confirming her active service and inactive service dates. Any records obtained should be associated with the claims file. 2. The Veteran should be asked to identify any health care professionals from whom she has received treatment for the disabilities at issue during the years of her active and inactive service and since 2003. Attempts should be made to obtain records from any sources identified and any records, or a detailed summary thereof, should be obtained and associated with the claims file. 3. The Veteran should be accorded an examination by a physician knowledgeable in psychiatry for the purpose of determining whether it is at least as likely as not (that is, probability greater than 50 percent) that any current psychiatric disorder had its origin in service or is in any way related to the Veteran's active service. The complete rationale for any opinion expressed should be provided. If the examiner is unable to provide the requested opinion without resorting to speculation, it should be so stated and he or she must discuss why such an opinion is not possible. 4. The Veteran should also be accorded an examination by a physician knowledgeable in orthopedic disorders for the purpose of determining the current nature and etiology of any left shoulder disability and/or right wrist disorder. The examiner should review the entire record and provide an opinion to the best of his or her ability as to whether it is at least as likely as not that any current left shoulder disorder and/or right wrist disability had its origin in service or is in any way related to the Veteran's active service, to include by way of aggravation. With regard to the left shoulder, specific attention is called to the fact that the Veteran injured the shoulder in June 2004, but claims that the shoulder was giving her problems before that time. All appropriate tests should be conducted, and all pertinent disabilities associated with the left shoulder and right wrist should be diagnosed. Any opinion expressed by the examiner as to etiology of the left shoulder or right wrist disorder must be submitted by complete rationale. Again, if the examiner is not able to provide the requested opinion without resort to speculation, it should be so stated and he or she must discuss why an opinion is not possible. 5. The Veteran should also be accorded an examination by a physician knowledgeable in bladder disorders for the purpose of determining the nature and etiology of any disability involving the bladder, to include stress incontinence. Following review of the record, the examiner should provide an opinion as to whether it is more likely than not, at least as likely as not, or less likely than not that any current bladder disorder, to include stress incontinence, had its origin in service or is in any way related to the Veteran's service. Any opinion expressed must be supported by complete rationale. If the examiner is not able to provide the requested opinion without resort to speculation, it should be so stated and he or she must discuss why such an opinion is not possible. 6. Thereafter, the issues on appeal should be readjudicated. If the benefits sought on appeal are not granted, the Veteran and her representative should be provided with a Supplemental Statement of the Case and be afforded the appropriate period of time within which to respond. Then, the case should be returned to the Board for further appellate consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required of the Veteran unless notified by the VA, but she is apprised of the importance of appearing for any scheduled examination. Failure to do so without good cause may result in the denial of her claims. 38 C.F.R. § 3.655 (2009). 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 The Veterans Benefits Act of 2003, Pub. L. No. 108-183, § 707(a), (b), 117 Stat. 2651 (2003) (to be codified at 38 U.S.C. §§ 5109B, 7112). _________________________________________________ V. L. JORDAN 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) (2009).