Citation Nr: 1103602 Decision Date: 01/28/11 Archive Date: 02/08/11 DOCKET NO. 09-01 514 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Milwaukee, Wisconsin THE ISSUE Entitlement to service connection for normocytic, normochromic anemia, to include as secondary to service-connected duodenal ulcer, status post gastrectomy and vagotomy. REPRESENTATION Veteran represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD K. M. Schaefer, Associate Counsel INTRODUCTION The Veteran served on active duty from February 1953 to January 1955. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in June 2008 by the Department of Veterans Affairs (VA) Regional Office (RO) in Milwaukee, Wisconsin. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2010). 38 U.S.C.A. § 7107(a)(2) (West 2002). 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 After a careful review of the record, the Board finds that a remand is necessary in this case to allow VA to obtain additional treatment records and to schedule a VA examination. With respect to the treatment records, the Board notes that the Veteran receives regular treatment at facilities within the Milwaukee VA medical center (VAMC). The most recent VA treatment record in the claims file is dated in August 2008. Records generated by VA facilities that may have an impact on the adjudication of a claim are considered in the constructive possession of VA adjudicators during the consideration of a claim, regardless of whether those records are physically on file. Bell v. Derwinski, 2 Vet. App. 611, 613 (1992); see Dunn v. West, 11 Vet. App. 462, 466-67 (1998). Therefore, all treatment records for the Veteran dated from August 2008 onward should be obtained from the Milwaukee VAMC. In June 2010, the Board requested an opinion from a hematologist with the Veterans Health Administration (VHA). 38 U.S.C.A. § 7109 (West 2002); 38 C.F.R. § 20.901(d) (2010). The opinion was received in September 2010. The specialist reported that she reviewed the claims file, and her opinion reflects a detailed examination of its contents. As a result of her review, she opined that it is less likely than not that the Veteran's anemia is causally or etiologically due to or aggravated by his service-connected duodenal ulcer. However, she also indicated that her opinion would be different if the Veteran has a vitamin B12 deficiency, but no findings regarding vitamin B12 were of record as of the last laboratory report in February 2008. Thus, she recommended that his vitamin B12 level be checked. Accordingly, the Board is remanding the appeal so that the Veteran may be scheduled for a VA examination to assess his claimed anemia, to include laboratory testing of his vitamin B12 level, as well as any other lab work deemed necessary and appropriate to the examination. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2010). Expedited handling is requested.) 1. Request all VA treatment records from the Milwaukee VAMC dated from August 2008 onward. All requests and responses, positive and negative, should be associated with the claims file. 2. Schedule the Veteran for a VA examination in order to ascertain the existence of his claimed anemia and vitamin B12 level. The claims file should be made available for review, and the examination report should reflect that such review occurred. All tests necessary and appropriate to the examination should be conducted, including a vitamin B12 level. Upon a review of the record and examination of the Veteran, the examiner should respond to the following: Is it more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability less than 50 percent), that the Veteran has a vitamin B12 deficiency? A rationale for any opinion advanced should be provided. The examiner should also state what sources were consulted in forming the opinion. 3. After completing the above actions and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's service connection claim should be readjudicated, to include all evidence received since the January 2009 statement of the case. If the claim remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. The Veteran has the right to submit additional evidence and argument on the matter 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. 2010). _________________________________________________ MILO H. HAWLEY 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) (2010).