Citation Nr: 1306272 Decision Date: 02/22/13 Archive Date: 02/27/13 DOCKET NO. 05-41 563 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUES 1. Whether new and material evidence has been received to reopen a claim of entitlement to service connection for a bilateral foot disorder. 2. Entitlement to service connection for a psychiatric disorder. REPRESENTATION Veteran represented by: Georgia Department of Veterans Services ATTORNEY FOR THE BOARD S. Becker, Associate Counsel INTRODUCTION The Veteran served on active duty from July 1964 to July 1968. This matter comes before the Board of Veterans' Appeals (Board) from a July 1998 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. Among other things, no new and material evidence was found therein to reopen previously denied service connection claims for a bilateral foot condition and for a nervous disorder. The Veteran appealed each of these determinations. Pursuant to the Veteran's request, a hearing was scheduled regarding this matter for June 2006. The Veteran waived his right to this hearing in May 2006. See 38 C.F.R. § 20.704(e) (2012) (a hearing request may be withdrawn by the Veteran at any time before the day of the hearing). The Board remanded the issues of whether new and material evidence was received to reopen the claim of service connection for a chronic disability of the feet and for a chronic mental disorder for additional development in April 2008 and July 2010. In June 2012, new and material evidence was found by the Board with respect to service connection for a chronic mental disorder. The previously denied claim therefore was reopened. The issue of entitlement to service connection for a chronic mental disorder was remanded for additional development, as was the issue of whether new and material evidence was received to reopen the claim of service connection for a chronic disability of the feet. Each of the issues on appeal has been recharacterized, as listed on the title page, consistent with Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that a claimant without medical expertise cannot be expected to precisely delineate the diagnosis of his mental condition, so VA must construe the claim to include currently diagnosed psychiatric conditions in addition to those claimed). All additional development fully or at least substantially has been completed. Adjudication of this issue accordingly may proceed, if otherwise in order. See Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall v. West, 11 Vet. App. 268 (1998), where the Board's remand instructions were substantially complied with); aff'd, Dyment v. Principi, 287 F.3d 1377 (2002). Based on review of the Veteran's claims file and his Virtual VA "eFolder," adjudication now is in order regarding the issue of entitlement to service connection for a psychiatric disorder. The following determination accordingly is made on that issue. The issue of whether new and material evidence has been received to reopen a claim of entitlement to service connection for a bilateral foot disorder is not yet ripe for adjudication. It is addressed in the REMAND portion of the decision below. As such, it once again is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDING OF FACT The credible and competent evidence establishes that the Veteran's current psychiatric disorder, for which a diagnosis of depressive disorder, not otherwise specified, is assigned, is related to his service. CONCLUSION OF LAW The criteria for establishing service connection for an acquired psychiatric disorder, for which a diagnosis of depressive disorder, not otherwise specified, is assigned, have been met. 38 U.S.C.A. §§ 101, 1101, 1110, 1112, 1113, 1131, 1153, 5107 (West 2002); 38 C.F.R. §§ 3.2, 3.102, 3.303, 3.307, 3.309, 3.384, 4.125, 4.130, Diagnostic Codes 9201-9211 (2012). (CONTINUED ON NEXT PAGE) REASONS AND BASES FOR FINDING AND CONCLUSION I. Duties to Notify and Assist Before addressing the merits, the Board notes that VA has a duty to notify and a duty to assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5103, 5103A; 38 C.F.R. §§ 3.159. These duties stem from the Veterans Claims Assistance Act (VCAA) of 2000. The Veteran's instant request for service connection for a psychiatric disorder, as it was made in February 1998, predates the VCAA. The VCAA was enacted and became effective during the pendency of this matter, in other words. Notwithstanding their applicability, discussion of the duties to notify and assist is not necessary. Service connection for a psychiatric disorder is awarded herein. This constitutes a full allowance or grant of the benefit sought for that issue. Any errors committed regarding the duty to notify or the duty to assist pertaining to it accordingly were harmless. II. Service Connection Service connection "basically means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service . . . or if preexisting such service, was aggravated therein." 38 C.F.R. § 3.303(a); see also 38 U.S.C.A. §§ 1110, 1131. To establish service connection, there generally must be (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus between the current disability and the in-service disease or injury. See Hickson v. West, 12 Vet. App. 247 (1999); Barr, 21 Vet. App. at 303. Disabilities that are psychiatric disorders must be diagnosed in accordance with the Diagnostic and Statistical Manual (DSM) of Mental Disorders. 38 C.F.R. § 4.125(a). Service connection also may be established if the evidence of record reveals chronicity or continuity. 38 C.F.R. § 3.303(b). If a chronic disease is shown in service, subsequent manifestations of the same chronic disease at any later date, however remote, may be service connected, unless clearly attributable to intercurrent causes. Id.; Barr, 21 Vet. App. at 303. Continuity of symptomatology post-service is required where a condition in service is noted but is not, in fact, chronic or where a diagnosis of chronicity legitimately may be questioned. Id.; Savage v. Gober, 10 Vet. App. 488 (1997). Further, service connection may be established for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection is presumed when there is no record of a disease during service if certain circumstances exist. 38 U.S.C.A. § 1112; 38 C.F.R. §§ 3.307, 3.309. Applicable here are those for presumptive service connection for chronic diseases. 38 U.S.C.A. § 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). First, the Veteran must have served 90 days or more during a period of war or after December 31, 1946. 38 U.S.C.A. § 1112(a); 38 C.F.R. § 3.307(a)(1). Second, the Veteran must have manifested a chronic disease such as an organic disease of the nervous system like a psychosis to a compensable degree within one year from the date of separation from service. 38 U.S.C.A. § 1101(3), 1112(a)(1); 38 C.F.R. §§ 3.307(a)(2), (3), 3.309(a). Psychosis includes brief psychotic disorder, delusional disorder, psychotic disorder due to general medical condition, psychotic disorder not otherwise specified, schizoaffective disorder, schizophrenia, schizophreniform disorder, shared psychotic disorder, and substance-induced psychotic disorder. 38 C.F.R. § 3.384; see also 38 C.F.R. § 4.130, Diagnostic Codes 9201-9211. Affirmative evidence rebutting in-service incurrence or aggravation of the disease must be taken into consideration even if the two aforementioned circumstances are met. 38 U.S.C.A. §§ 1113, 1153; 38 C.F.R. §§ 3.307(d), 3.309(a). The Board must account for evidence that it finds to be persuasive or unpersuasive and provide reasons for rejecting any material evidence favorable to the Veteran. Gabrielson v. Brown, 7 Vet. App. 36 (1994), Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, an assessment of the probative value of the lay evidence in addition to the medical evidence must be undertaken. Lay evidence indeed may be sufficient by itself to support a claim of service connection. Barr, 21 Vet. App. at 307. This is the case where the evidence is both competent and credible. Competency is "a legal concept determining whether testimony may be heard and considered" whereas credibility is "a factual determination going to the probative value of the evidence to be made after the evidence has been admitted." Layno v. Brown, 6. Vet. App. 465 (1994). A lay person is competent to provide testimony or statements relating to facts of events that the lay person observed or that is within the realm of his/her personal knowledge. Id. In weighing credibility, discounting of competent testimony or statements from a lay person may occur "in the light of its own inherent characteristics and its relationship to other items of evidence." Madden v. Gober, 125 F.3d 1477 (Fed. Cir. 1997). Factors for consideration therefore include a showing of interest, self-interest, bias, inconsistent statements, inconsistency with other evidence of record, facial implausibility, bad character, malingering, desire for monetary gain, and witness demeanor. See Pond v. West, 12 Vet. App. 341 (1999); Macarubbo v. Gober, 10 Vet. App. 388 (1997); Caluza v. Brown, 7 Vet. App. 498 (1995); Cartright v. Derwinski, 2 Vet. App. 24 (1991). "[T]he Board cannot determine that lay testimony or a lay statement lacks credibility merely because it is unaccompanied by contemporaneous medical evidence." Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). However, the lack of such evidence in combination with other factors may lead to the determination the lay testimony or statement is not credible. The benefit of the doubt shall be given to the Veteran when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert, 1 Vet. App. at 49. As such, the Veteran prevails when the evidence supports his claim or is in relative equipoise but does not prevail when the preponderance of the evidence is against the claim. Id. While all the evidence has been reviewed, only the most salient and relevant evidence is set forth. See Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). This evidence leads the Board to conclude that service connection for a psychiatric disorder is warranted. All necessary requirements for establishing entitlement to this benefit have been met. It is undisputed that the Veteran has a current disability. A current disability exists when there is a disability when a claim for it is filed or at any time during the pendency of such claim. McClain v. Nicholson, 21 Vet. App. 319 (2007). The Veteran filed this claim in February 1998, as noted above. Since then, psychiatric disorders have been diagnosed. VA treatment records reflect that dysthymia provisionally was diagnosed and depression was diagnosed in August 1998. Records from the Social Security Administration (SSA) reveal that rule out malingering and personality disorder not otherwise specified (NOS) were diagnosed in May 1999 while somatoform disorder NOS was diagnosed in October 1999. Upon VA examination in July 2012, depressive disorder NOS was diagnosed. It additionally was indicated that recent documentation showed diagnoses of dysthymia, mood disorder in conditions classified elsewhere, and depressive disorder not elsewhere classified. Also undisputed is that the Veteran served more than 90 days during a period of war after December 31, 1946. Indeed, almost all of his service from July 1964 to July 1968 was during the Vietnam era. See 38 U.S.C.A. § 101(29); 38 C.F.R. § 3.2(f) (both defining the Vietnam era as the period beginning on August 5, 1964, and ending on May 7, 1975, for Veterans who did not serve in the Republic of Vietnam). Yet none of his aforementioned diagnoses constitutes a psychosis. Further, neither the Veteran nor his representative has contended that he has a psychosis which initially manifest during the first post-service year. Service connection accordingly cannot be presumed, but, rather, must be established. With respect to the in-service incurrence or aggravation of an injury or disease, service treatment records reveal the following. The Veteran complained that he did not like his duties and had not been off base in a few months in June 1965. Depression secondary to duty incompatibility was diagnosed. In June 1968, the Veteran complained of psychiatric symptoms to include depression and excessive worry, nervous trouble, being nervous, loss of weight, and frequent trouble sleeping at the time of his separation examination in June 1968. He was found to be psychiatrically normal, however. These in-service manifestations necessitate consideration of the presumption of soundness. Gilbert v. Shinseki, 26 Vet. App. 48 (2012) (presumption of soundness applies only when there is manifestation of a disease or injury during service). A Veteran will be presumed to have been in sound condition when examined, accepted, and enrolled for service except as to defects, infirmities, or disorders noted at that time. 38 U.S.C.A. § 1111; 38 C.F.R. § 3.304(b); Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004). Noted means only such conditions as are recorded in examination reports. 38 C.F.R. § 3.304(b). Here, the Veteran was found to be psychiatrically normal at his May 1964 entrance examination. He therefore is presumed to have been psychiatrically sound then. The presumption of soundness is rebutted where clear and unmistakable (obvious and manifest) evidence demonstrates that an injury or disease existed prior to examination, acceptance, and enrollment for service and was not aggravated by service. 38 U.S.C.A. § 1111 (West 2002); 38 C.F.R. § 3.304(b) (2012); Wagner v. Principi, 370 F.3d 1089 (Fed. Cir. 2004). Clear and unmistakable evidence is an onerous evidentiary standard requiring that the conclusion be undebatable. Cotant v. Principi, 17 Vet. App. 116 (2003); Vanerson v. West, 12 Vet. App. 254 (1999). Such evidence does not exist that the Veteran had a psychiatric disorder or even psychiatric symptoms prior to his service. No treatment records or other medical documentation concerning this period exist. It follows that there is no need to consider whether there exists clear and unmistakable evidence that there was no aggravation by service. In sum, the Veteran's in-service manifestations represent incurrence rather than aggravation. The only remaining question is whether there is a nexus between his current psychiatric disorder and the psychiatric manifestations he incurred during service. Acknowledgement is given at the outset to the Veteran's belief that such a nexus exists. He is a lay person because there is no indication that he possesses medical expertise. A lay belief sometimes is sufficient to prove nexus. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (quoting Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007), as follows: "explicitly rejected [is] the view ... that 'competent medical evidence is required ... [when] the determinative issue involves ... etiology'"). It indeed is error to suggest that lay evidence can never be sufficient to satisfy the nexus requirement. See Colantonio v. Shinseki, 606 F.3d 1378 (Fed. Cir. 2010); Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). Yet the question of whether there exists a nexus in this particular case falls outside the province of a lay person. It instead is a medical question. Of note in this regard are the numerous potential causes of psychiatric disorders and the number of years that have passed since the Veteran's separation from service. Only those with specialized medical knowledge, training, and/or experience are competent where the determinative issue is one of medical causation. See Jones v. West, 12 Vet. App. 460 (1999). The Veteran, as a lay person without such knowledge, training, and/or experience, thus is not competent to render an opinion that there exists a nexus between his current psychiatric disorder and his service. See Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau, 492 F.3d at 1372. One medical opinion concerning nexus is of record. Specifically, the examiner who conducted the July 2012 VA examination addressed the issue of nexus. The examiner who conducted the July 2012 examination opined that it is at least as likely as not that "an acquired psychiatric disorder," for which a diagnosis of depressive disorder, not otherwise specified, was assigned, had its onset during the Veteran's service. At least as likely as not, the standard required to establish service connection, conveys that the probability is 50 percent or greater. The examiner determined that the evidence is equally balanced for and against the onset of the Veteran's psychiatric disorder during his service. In other words, the probability here is precisely the minimum 50 percent required. It was noted on the one hand that the Veteran likely had situational depressive symptoms during service in 1965 that were not severe enough for a DSM diagnosis, as no treatment was provided then and he did not complain of psychiatric symptoms again until a few years later. It was noted on the other hand that the Veteran complained of psychiatric symptoms during service in June 1968 and again six months post-service in December 1968. December 1968 VA treatment records indeed document his complaints of anxiety, nervousness, and depression that had become worse. Lithium was prescribed. The examiner indicated that this suggests a diagnosis even though no DSM diagnosis was provided at the time. In addition to lay evidence, the probative value of medical evidence may be discounted "in the light of its own inherent characteristics and its relationship to other items of evidence." Madden, 125 F.3d at 1477. Factors that may be considered in assessing the probative value of a medical opinion include a physician's access to the claims file or other pertinent evidence, the thoroughness and detail of the opinion, the accuracy of the factual premise underlying the opinion, the scope of examination, the rationale for the opinion offered, the degree of certainty provided, and the qualifications and expertise of the examiner. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Prejean v. West, 13 Vet. App. 444 (2000); Black v. Brown, 10 Vet. App. 297 (1997); Ardison v. Brown, 6 Vet. App. 405 (1994); Sklar v. Brown, 5 Vet. App. 140 (1993); Reonal v. Brown, 5 Vet. App. 458 (1993); Guerrieri v. Brown, 4 Vet. App. 467 (1993). The qualifications and expertise of the VA examiner are undisputed. The claims file was reviewed by the examiner. Examination of the Veteran, although considerably limited due to his aphasia, was as thorough as possible. Both this review and examination helps ensure the accuracy of the factual premises underlying the opinion. Here, no inaccuracy is detected. The examiner's opinion was supported by a rationale. It is sufficiently thorough and detailed, as the rationale referenced and discussed pertinent evidence. Finally, no hesitation or uncertainty was expressed by the examiner in rendering the opinion. The opinion therefore is entitled to substantial probative value. Acknowledgement is given to the fact that the examiner who conducted the VA examination also opined that it is less likely than not that the Veteran's acquired psychiatric disorder has been chronic and continuous since his service. Noted in this regard was the following. The Veteran reported psychiatric and/or substance abuse treatment in 1969, 1981, and 1985 but treatment records were not available. A VA treatment record dated in August 1998, at which time dysthymia provisionally was diagnosed and depression was diagnosed, contains his report of psychiatric symptoms without treatment for the previous 20 years. May and June 1991 private treatment records diagnose depression, dysthymia, posttraumatic stress disorder (from childhood abuse), alcohol dependence, and rule out schizoid personality disorder. "A lot of social anxiety" was mentioned. In February 2001, the Veteran contended his mental health was aggravated by improper VA care. The examiner indicated that the available medical evidence did not support a continuous psychiatric disorder from 1968 to 1991, from 1991 to 1998, from 1998 to 2001, or from 2001 to the present. The examiner further considered it significant that the Veteran's psychiatric symptoms were attributed to VA care on one occasion and to numerous stressors on another occasion. Considered together, the examiner's opinions convey that an acquired psychiatric disorder but not the Veteran's current psychiatric disorder had its onset during his service since there was no continuity. Unlike the examiner's first opinion concerning an acquired psychiatric disorder, the second opinion concerning the Veteran's current psychiatric disorder is entitled to very little probative value. The analysis of the factors to be considered with respect to probative value is essentially the same for both opinions with the exception of review of the claims file and the accuracy of the factual premises underlying the opinion. There was no indication with the first opinion that the review of the claims file was anything other than thorough. For the second opinion, the review was incomplete. The May and October 1999 SSA records diagnosing psychiatric disorders were not mentioned. Neither were April and May 1985 VA treatment records supplied by the SSA reflecting the Veteran's treatment for substance abuse. The first opinion more importantly was factually accurate, but the second opinion is not. This opinion is predicated on the lack of continuous medical evidence concerning a psychiatric disorder since service. Yet continuity of treatment, as opposed to continuity of symptoms, is not required. Savage, 10 Vet. App. at 488. The Veteran's assertions that he has had psychiatric symptoms continuously since his service therefore must be considered in and of themselves. As a lay person, he is competent to so assert because such symptoms would have been within his personal experience. He also is credible to so assert because there is no significant reason for doubt. It is true that the Veteran has a self-interest in gaining financially by asserting that he has had psychiatric symptoms continuously since his service. Such an assertion, especially if found competent and credible, makes it more likely that service connection will be granted. A grant potentially could result in his receipt of VA compensation benefits (as his only service-connected disability thus far is evaluated as noncompensable). Malingering further has been noted. However, it was not conclusively confirmed. It there is nothing facially implausible about the Veteran manifesting psychiatric symptoms persistently since his service. The Veteran's assertions in this regard are consistent with one another. At no point has he ever waivered. His assertions also are not inconsistent with the other evidence. This evidence confirms intermittent treatment for psychiatric symptoms and disorders. It is reiterated that the Board cannot determine the Veteran is not credible merely because his assertions regarding continuity are unaccompanied by medical evidence. In sum, the Veteran is awarded the benefit of the doubt that he manifested an acquired psychiatric disorder during service since the examiner's opinion to that effect is worth substantial probative value. The examiner's opinion that the Veteran's current psychiatric disorder is unrelated to this in-service acquired psychiatric disorder given a lack of continuity is worth very little probative value. He rather is found to be competent and credible in asserting such continuity. A nexus thus exists between his current psychiatric disorder and the psychiatric manifestations signifying an acquired psychiatric disorder he exhibited during service. This is the last of the necessary requirements for awarding service connection. Accordingly, service connection for a psychiatric disorder is granted. ORDER Service connection for an acquired psychiatric disorder for which a diagnosis of depressive disorder, not otherwise specified, is assigned, is granted. REMAND The issue of whether new and material evidence has been received to reopen a claim of entitlement to service connection for a bilateral foot disorder unfortunately must be remanded for a fourth time. Although the Board sincerely regrets the delay this will cause, the Veteran should be afforded another opportunity to identify or submit relevant records. In particular, the Board notes that, at his 2012 examination, the Veteran appeared confused. He had aphasia. He struggled to say his name. The Veteran was hemiplegic and his right hand was contracted. It is clear that the Veteran requires considerable assistance if he is to have any chance to respond to VA's Remand of this claim. For this reason, the Board has directed attention, in the Remand below, to obtaining the assistance for the Veteran of his representative or any individual authorized to assist the Veteran, such as a guardian, relative, representative payee, social worker or administrator at the nursing home where he resides, or other authorized individual. In the June 2012 remand, the Board directed that the Veteran be afforded "an opportunity to identify ANY evidence, clinical or non-clinical, regarding treatment of or symptoms of hallux valgus after 1969." He thus was sent a letter later in June 2012 requesting that he authorize the release of treatment records to VA from each private physician who treated his hallux valgus after 1969, informing him that he alternatively could obtain such records and submit them to VA himself, and lastly requesting that he identify any VA facility that provided hallux valgus treatment after 1969. No response was received. The Veteran brought "paperwork" to his July 2012 VA examination, according to the examiner. Per the examiner, it reflected that he had been a resident of a particular nursing home in Cincinnati, Ohio, since February 2012, and prior thereto had been a resident of a nursing home in Georgia. It additionally reflected that he had numerous diagnoses, to include bunions. This paperwork was not attached to the examination report. The aforementioned "paperwork" is pertinent because it appears that the Veteran attempted to provide additional relevant information. However, the examiner was unable to accept the "paperwork," as it concerned issues which were not related to the VA examination. The Veteran should be afforded another opportunity to submit this evidence. It further appears, based on the examiner's report, that the information is relevant to the Veteran's claim for service connection for a bilateral foot disorder. The examiner's report suggests that he may have received treatment recently for this disorder. Although the Veteran has been given an opportunity to identify pertinent records concerning this disorder, to date he has not been requested specifically to provide authorization for the release of paperwork to include treatment records other records from his nursing homes in Cincinnati, Ohio, and Georgia to VA or to supply them to VA himself. These requests must be made. The Veteran, and the representative or individual who assists him, is hereby notified, given the June 2012 remand, that the issue being remanded has been pending since February 1998, and that this is the fourth remand, that another remand for additional records development in the future is unlikely. Should the Veteran opt to authorize the release of paperwork to include treatment records other records from his nursing homes in Cincinnati, Ohio, and Georgia to VA, reasonable efforts to obtain them consist of making an initial request and, if necessary, at least one follow-up request. 38 C.F.R. § 3.159(c)(1). The Veteran shall be notified of the inability to obtain any records requested on remand if necessary. 38 U.S.C.A. § 5103A(b)(2); 38 C.F.R. § 3.159(e)(1). Such notification shall identify the records at issue, explain the efforts made to obtain them, describe any further efforts that will be made to obtain them, and inform the Veteran that he ultimately is responsible for providing the records. 38 C.F.R. § 3.159(e)(1). For non-Federal records, it may be provided at the same time the follow-up request is made. Id. Finally, it is noted that correspondence issued to the Cincinnati, Ohio, nursing home at which the Veteran was apparently residing at the time of the July 2012 VA examination has been returned in December 2012 and January 2013 as "not deliverable as addressed" and "unable to forward." All appropriate attempts therefore should be made to verify the Veteran's current address prior to undertaking records development. The Board also notes that, at the time of the July 2012 VA examination, the Veteran was residing in Ohio but he has a Georgia representative. Accordingly, the case is REMANDED for the following action: 1. Make all appropriate attempts to verify the Veteran's current address. In particular, if written correspondence to the Veteran from the agency of original jurisdiction (AOJ) is returned as undeliverable, the AOJ must consult VHA to determine where the Veteran is receiving health care and what address VA has for the Veteran's health care purposes. If a new address is verified, send the Veteran a copy of this decision and remand. Document the claims file or "eFolder" as appropriate regarding this paragraph. 2. The nursing home or other facility at which the Veteran resides should be asked to provide VA with the name of the Veteran's guardian, fiduciary, representative payee, relative, or any other individual who assists him. This individual should be asked to assist the Veteran to respond to this Remand. The Veteran's representative is requested to contact the Veteran and an individual authorized to assist the Veteran, after verifying the authorization of the assisting individual. The current representative should advise the Veteran about whether the Veteran should seek a representative in the state where the Veteran currently resides, if he resides outside Georgia. 3. Request that the Veteran, with the assistance of a representative, relative, or other individual, authorize the release of any relevant clinical records which can be identified, to include treatment records other records from his nursing homes in Cincinnati, Ohio, and Georgia, to VA. The Veteran's representative, either the current representative or newly-selected representative, should assist the Veteran and the individual designated to assist the Veteran to respond to this Remand and the development following this Remand. 4. Request identified records. Send a follow-up request as necessary. Any records obtained shall be associated with the claims file or "eFolder." Notice shall be provided to the Veteran if the records are not obtained. Document the claims file or "eFolder" as appropriate regarding this paragraph. 5. Obtain complete VA outpatient and inpatient records for the Veteran, including a search for any available VA records prior to his 1998 claim. 6. After completion of the above development, readjudicate whether new and material evidence has been received to reopen a claim of entitlement to service connection for a bilateral foot disorder. The proper standard, specifically the version of 3.156(a) prior to the amendment made thereto in 2001, shall be used. a. If it is determined that new and material evidence has been received, conduct any development necessary to adjudicate the issue of service connection. This includes, at a minimum, seeking medical review of the record to obtain opinion, and, if necessary, scheduling the Veteran for an appropriate medical examination complete with an opinion as to service etiology. Then adjudicate the service connection issue. If service connection is granted, issue a rating decision. If service connection is denied, issue a supplemental statement of the case (SSOC) to the Veteran and his representative and afford them the requisite time period to respond. A copy of the rating decision or SSOC shall be placed in the claims file or "eFolder." b. If it is determined that new and material evidence has not been received, the Veteran and his representative shall be provided with a SSOC and afforded the requisite time period to respond. A copy of the SSOC shall be placed in the claims file or "eFolder." The Veteran has the right to submit additional evidence and argument on the issue 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. 2012). ______________________________________________ Tresa M. Schlecht Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs