Citation Nr: 1305993 Decision Date: 02/21/13 Archive Date: 02/27/13 DOCKET NO. 10-44 017 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Louisville, Kentucky THE ISSUES 1. Entitlement to a compensable rating for recurrent pharyngitis. 2. Entitlement to service connection for a disability manifested by chest pain, claimed as secondary to unregulated chemicals in drinking water in service. 3. Entitlement to service connection for a heart condition, claimed as secondary to unregulated chemicals in drinking water in service. REPRESENTATION Veteran represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Megan C. Kral, Associate Counsel INTRODUCTION The appellant is a Veteran who served on active duty from March 1974 to March 1976. This matter is before the Board of Veterans' Appeals (Board) on appeal from a March 2010 rating decision of the Louisville, Kentucky Department of Veterans Affairs (VA) Regional Office (RO), that granted service connection for pharyngitis, rated 0 percent, effective April 8, 2009. In his October 2010 VA Form 9, the Veteran requested a hearing before the Board. In a statement received in October 2011, he withdrew such request. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action on his part is required. REMAND The VA examination to evaluate the veteran's pharyngitis that was the basis for the current rating was conducted in September 2009; he has not been examined by VA to assess the severity of the disability since. In claims for increased ratings VA's duty to assist includes the duty to conduct a thorough and contemporaneous examination of the Veteran (as indicated). See Green v. Derwinski, 1 Vet. App. 121 (1991). Since the September 2009 examination, the Veteran has asserted that symptoms of his pharyngitis have worsened. Specifically, while the disability was described in September 2009 as a very mild sore throat occurring every 3 months and resolving, without antibiotics, in 2-3 days, in the Veteran's May 2010 notice of disagreement (NOD) he stated that he had symptoms daily. Accordingly, a contemporaneous examination to assess the disability is necessary. A VA treatment record notes the Veteran indicated he was receiving Social Security Administration (SSA) disability benefits. Medical records considered in any SSA disability benefits determination are constructively of record and must be secured. Furthermore, the record suggests that the Veteran receives ongoing treatment. In a claim for increase, contemporaneous treatment records are pertinent evidence that must be secured. Significantly, VA treatment records are of record. Identified facilities where the Veteran has received treatment include the VA Medical Center (VAMC) in Huntington and the Prestonsburg Community Based Outpatient Clinic (CBOC). Regarding claims of service connection for a disability manifested by chest pain (claimed as secondary to unregulated chemicals in drinking water) and service connection for a heart disorder (also as secondary to unregulated chemicals in drinking water) such claims were denied by a March 2010 rating decision. In a VA Form 9 received in October 2010, the Veteran indicated he was not properly evaluated by VA for the chest pain and cardiac disability (suggesting he was seeking to pursue appeals in those matters also). The Board construes the Veteran's statement in his VA Form 9 to be a timely filed NOD with regard to the claims of service connection for a disability manifested by chest pain and service connection for a heart condition. Submission of a timely NOD triggers the appeal process and issuance of a statement of the case (SOC). As the Veteran has not been afforded a SOC addressing these issues, the claims must now be remanded for such action. Manlincon v. West, 12 Vet. App. 238, 240-41 (1999). Following such action, these issues will be before the Board only if the Veteran perfects his appeal the filing of a timely substantive appeal. Accordingly, the case is REMANDED for the following n: 1. The RO must provide the Veteran with a SOC addressing the issues of service connection for a disability manifested by chest pain, claimed as secondary to unregulated chemicals in drinking water and service connection for a heart disability, claimed as secondary to unregulated chemicals in drinking water. The Veteran should be informed that he must file a timely and adequate substantive appeal in order to perfect an appeal of these issues to the Board. If a timely substantive appeal is filed, the claims should be certified to the Board. 2. The RO should ask the Veteran to identify all providers of evaluation or treatment he has received for pharyngitis since April 2009 (records of which are not already associated with the record) and authorizations for VA to secure records of any such private evaluations or treatment. The RO should secure for the record copies of complete clinical records of the evaluations/treatment from all providers identified, to specifically include updated records of VA treatment from the Huntington VAMC and the Prestonsburg CBOC. 3. The RO should secure from SSA a copy of their determination awarding the Veteran SSA disability benefits, as well as copies of all medical records considered in connection with such determination. 4. After the development sought above is completed, the RO should arrange for the Veteran to be scheduled for an ENT examination to ascertain the current severity of his recurrent pharyngitis. The Veteran's claims file must be reviewed by the examiner in conjunction with the examination. Any tests or studies indicated should be completed. The examiner must identify all symptoms and impairment of function related to the pharyngitis, specifically noting recent medical history (of symptoms and treatment), and indicating whether or not there is hoarseness and/or inflammation of cords or mucous membrane. 5. The RO the review the record and readjudicate the veteran's claim. If the benefit sought remains denied, the RO should issue an appropriate supplemental statement of the case and afford the Veteran and his representative the opportunity to respond. Then case should then be returned to the Board for further appellate consideration, if otherwise in order. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). These claims must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ GEORGE R. SENYK Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of is appealable to the Court. 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) (2012).