Citation Nr: 1319198 Decision Date: 06/12/13 Archive Date: 06/21/13 DOCKET NO. 09-07 722 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Salt Lake City, Utah THE ISSUES 1. Entitlement to service connection for a skin disorder, to include as a result of exposure to herbicides. 2. Entitlement to service connection for a lung disorder, to include as a result of exposure to herbicides. REPRESENTATION Appellant represented by: James M. McElfresh II, Agent WITNESSES AT HEARING ON APPEAL Appellant, Appellant's Spouse, and T.M. ATTORNEY FOR THE BOARD Robert J. Burriesci, Counsel INTRODUCTION The Veteran served on active duty from September 1968 to May 1970, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2008 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2011, the Veteran testified at a videoconference Board hearing before the undersigned Veterans Law Judge. A transcript of this hearing is associated with the claims folder. This case was previously before the Board in March 2013 when it was remanded for additional development. In a statement dated in March 2013 the Veteran's representative raised the issue of whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a bilateral knee disability. This issue is not on appeal before the Board; therefore, the proper course of action is to refer it to the RO for appropriate action. Under 38 C.F.R. § 19.37 (2012) a supplemental statement of the case (SSOC) should be issued where relevant, non-duplicative evidence is received prior to the transfer of the claim to the Board. Subsequent to the issuance of the November 2012 SSOC and prior to transfer of the claim to the Board in May 2013, additional treatment records from Dixie Regional Medical Center, VA treatment records, an article on hammertoes, and a statement from the Veteran's representative were associated with the claims file. However, the Board finds that the records from Dixie Regional Medical Center are duplicative of evidence already in the claims file in that they reiterate that the Veteran is diagnosed with COPD, identify medication previously noted upon VA examination, and provide a statement regarding the Veteran's breathing. The VA treatment records are duplicative of the records already in the claims file. The statements provide additional argument and the article is not relevant to the claim on appeal. As such, the Board finds that an additional SSOC is not necessary. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). The issue of entitlement to service connection for a skin disorder, to include as a result of exposure to herbicides, is addressed in the REMAND portion of the decision below and is REMANDED to the Department of Veterans Affairs Regional Office. FINDING OF FACT A chronic lung disorder was not shown during service and the competent evidence does not establish a chronic lung disorder is etiologically related to in-service disease or injury or otherwise related to active service. CONCLUSION OF LAW A lung disorder was not incurred or aggravated in active service and may not be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1137 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309 (2012). REASONS AND BASES FOR FINDING AND CONCLUSION I. Duties to Notify and Assist As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2012). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice from VA must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide in accordance with 38 C.F.R. § 3.159. This notice must be provided prior to an initial unfavorable decision on a claim by the agency of original jurisdiction (AOJ). Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006); Pelegrini v. Principi, 18 Vet. App. 112 (2004). In Dingess v. Nicholson, 19 Vet. App. 473 (2006), the U.S. Court of Appeals for Veterans Claims (Court) held that, upon receipt of an application for a service-connection claim, 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) require VA to review the information and the evidence presented with the claim and to provide the claimant with notice of what information and evidence not previously provided, if any, will assist in substantiating, or is necessary to substantiate, each of the five elements of the claim, including notice of what is required to establish service connection and that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. Here, the VCAA duty to notify was satisfied by way of a letter sent to the appellant in November 2007 that fully addressed all notice elements and was sent prior to the initial AOJ decision in this matter. The letter informed the appellant of what evidence was required to substantiate the claim and of the appellant's and VA's respective duties for obtaining evidence. In addition, the letter informed the Veteran that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded VA has a duty to assist the Veteran in the development of the claim. This duty includes assisting the Veteran in the procurement of service treatment records and pertinent treatment records and providing an examination when necessary. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. The Board finds that all necessary development has been accomplished, and therefore appellate review may proceed without prejudice to the appellant. See Bernard v. Brown, 4 Vet. App. 384 (1993). The RO has obtained VA treatment records. The Veteran submitted private treatment records from Doctor's Free Clinic, Dixie Medical Center, Snow Canyon Clinic, and Drs. G.C., A.J.M., and B.R., and was provided an opportunity to set forth his contentions during the hearing before the undersigned Veterans Law Judge. The appellant was afforded a VA medical examination in May 2012. In March 2012 the Board remanded the claim of entitlement to service connection for a lung disorder, to include as a result of exposure to herbicides, for additional VA treatment record to be obtained and associated with the claims file, and for the Veteran to be afforded a VA medical examination. Subsequent to the Board's remand, additional VA treatment records were obtained and associated with the claims file and the Veteran was afforded a VA medical examination in May 2012. As such, the Board is satisfied that the AOJ has substantially complied with the orders of the March 2012 remand. See Dyment v. West, 13 Vet. App. 141, 146- 47 (1999) (regarding substantial compliance). Significantly, neither the appellant nor his representative has identified, and the record does not otherwise indicate, any additional existing evidence that is necessary for a fair adjudication of the claim that has not been obtained. Hence, no further notice or assistance to the appellant is required to fulfill VA's duty to assist the appellant in the development of the claim. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd 281 F.3d 1384 (Fed. Cir. 2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); see also Quartuccio v. Principi, 16 Vet. App. 183 (2002). The Court held in Bryant v. Shinseki, 23 Vet. App. 488, 493-94 (2010) that there are two duties imposed by 38 C.F.R. 3.103(c)(2), (1) the duty to fully explain the issues and (2) the duty to suggest the submission of evidence that may have been overlooked-are not impacted by the Veteran's receipt of a VCAA-compliant notice letter. Here, during the hearing the Veterans Law Judge informed the Veteran: Really, to establish service connection what we need to show is a current disability and we need to show that it is somehow related to service. It can be related to an injury in service, a disease . . . or some incident that occurred. That's really the relationship that needs to be demonstrated. In addition, the Veteran's representative demonstrated actual knowledge of this information as his questions specifically elicited responses designed to show that the Veteran had a lung disorder related to his service. See Dalton v. Nicholson, 21 Vet. App. 23, 30-31 (2007) (explaining that actual knowledge is established by statements or actions by the claimant or the claimant's representative that demonstrate an awareness of what was necessary to substantiate his or her claim.) Accordingly, the Veteran is not shown to be prejudiced on this basis. In addition, the Veterans Law Judge sought to identify any pertinent, outstanding evidence that might have been overlooked. The Veterans Law Judge specifically asked the Veteran where he received his treatment. Accordingly, the Veteran is not shown to be prejudiced on this basis. Moreover, neither the Veteran nor his representative has asserted that VA failed to comply with 38 C.F.R. § 3.103(c)(2), nor has he identified any prejudice in the conduct of the Board hearing. By contrast, the hearing focused on the elements necessary to substantiate the claims, and the Veteran, through his testimony, demonstrated that he had actual knowledge of the elements necessary to substantiate his claims. As such, the Board finds that, consistent with Bryant, the AVLJ complied with the duties set forth in 38 C.F.R. § 3.103(c)(2). II. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. § 3.303(a) (2010). Establishing service connection generally requires medical evidence or, in certain circumstances, lay evidence of the following: (1) A current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) nexus between the claimed in-service disease and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Hickson v. West, 12 Vet. App. 247 (1999); Caluza v. Brown, 7 Vet. App. 498 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table). A Veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era (beginning in January 1962 and ending in May 1975) shall be presumed to have been exposed during such service to herbicide agents, including an herbicide commonly referred to as Agent Orange. 38 U.S.C.A. § 1116(a)(3) (West 2002); 38 C.F.R. §§ 3.307, 3.309. Whenever VA's Secretary determines, on the basis of sound medical and scientific evidence, that a positive association exists between the exposure of humans to an herbicide agent and the occurrence of a disease in humans, the Secretary shall prescribe regulations providing that a presumption of service connection is warranted for that disease. 38 U.S.C.A. § 1116(b)(1). If a Veteran was exposed to an herbicide agent during active military service, the following diseases will be presumed to have been incurred in service if manifest to a compensable degree within specified periods, even if there is no record of such disease during service: AL amyloidosis, chloracne or other acneform disease consistent with chloracne, Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes), Hodgkin's disease, ischemic heart disease, all chronic B-cell leukemias, multiple myeloma, non-Hodgkin's lymphoma, Parkinson's disease, acute and subacute peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers (cancer of the lung, bronchus, larynx, or trachea), and soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma). 38 U.S.C.A. § 1116(a)(2); 38 C.F.R. §§ 3.307(a)(6), 3.309(e). VA's Secretary has determined that a presumption of service connection based on exposure to herbicides to include Agent Orange used in the Republic of Vietnam during the Vietnam era is not warranted for any condition for which the Secretary has not specifically determined a presumption of service connection is warranted. See Notice, 72 Fed. Reg. 32,395 (2007). The availability of presumptive service connection for a disability based on exposure to herbicides does not preclude a Veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of his current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence is competent the Board must determine, on a case by case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d at 1376-77. The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C.A. § 7104(a) (West 2002). Moreover, the Court has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996). The Veteran seeks entitlement to service connection for a lung disorder. The Veteran contends that his lung disability is related to his pneumonia in service as well as his exposure to herbicides in the Republic of Vietnam. The Board notes that service treatment records reveal that the Veteran was found to have a rare growth of diplococcus pneumonia. In April 1970 the Veteran was noted to be exposed to malaria and taking Chlor-quine-primaquine tablets weekly. In May 1970 the Veteran indicated in his Report of Medical History upon separation that he had nose or throat trouble, hay fever, and chronic cough. In January 2011 the Veteran was noted to be diagnosed with chronic obstructive pulmonary disease (COPD) with exacerbation. The impression included rule out asbestosis. Pulmonary function testing performed in January 2011 revealed moderate obstructive lung disease. In February 2011 Dr. B.R. reported a history of lung disease. The Veteran was diagnosed with emphysema in February 2011. In April 2011 the Veteran was diagnosed with COPD with some emphysematous changes on computed tomography of thorax but predominant chronic bronchitis. At the hearing before the undersigned Veteran's Law Judge in October 2011 the Veteran reported that he was told that his lung condition came from the water in the Saigon River and in the rice paddies in Vietnam. He indicated that the water caused his pneumonia which resulted in his current lung disorder. He also reported that his condition was related to exposure to herbicides. In September 2011 the Veteran was noted to have a history of chronic obstructive pulmonary disease and centrilobular emphysematous changes/multiple blebs on computed tomography performed in February 2011. In September 2011 the Veteran was assessed with COPD with moderate obstructive airway disease on spirometry and normal DLCOsb early 2011. The results of a pulmonary function test were noted. The Veteran was afforded a VA medical examination in May 2012. The Veteran was noted to be diagnosed with COPD with a diagnosis date of February 2011. The Veteran was noted to be treated with inhalational anti-inflammatory therapy and bronchodilator medications. The Veteran was reported to have been diagnosed with COPD centrilobular emphysematous changes/multiple blebs by computed tomography in February 2011. Pulmonary function tests were performed and reported. It was reiterated in the examination report that the examiner should consider the Veteran's exposure to herbicides while in service and that there is a notation in the service treatment records of a rare growth of diplococcus pneumonia. The examiner rendered the opinion that the Veteran's respiratory disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The rationale provided was: The claims regarding skin and respiratory conditions are not considered presumptively connected as the current physical manifestations and diagnoses of skin conditions [do] not fall under the conditions considered presumptive connections. The claim of respiratory conditions as proven by the [V]eteran do not fall under presumptive conditions and is more likely than not a consequence of the [V]eteran's 50+ year smoking history. The Board finds that entitlement to service connection for a lung disorder is not warranted. The Board notes that the Veteran's lung disorder, diagnosed as COPD and emphysema, is not a disability for which service connection is afforded on a presumptive basis due to exposure to herbicides. In addition, although service treatment records reveal a rare growth of diplococcus pneumonia and post service treatment records reveal that the Veteran has been diagnosed with COPD and emphysema, the evidence is against a finding that the Veteran's lung disorder is related to his active service. A report of a VA medical examination dated in May 2012 reveals that the examiner noted that the Veteran had a rare growth of diplococcus pneumonia in service and rendered the opinion that the Veteran's lung disorder was less likely than not related to his active service. The examiner included the rationale that the Veteran's lung disorder was most likely related to his long history of smoking. Lastly, initially the Veteran contended that his lung disorder was related to exposure to asbestos in service and this was contemplated in the March 2008 RO rating decision. However, subsequently, as discussed at the October 2011 Board hearing, the Veteran did not indicate that his lung disorder was related to asbestos exposure but argued that it was related to his exposure to herbicides in service. Thus the Board finds that the Veteran clarified his claim at the hearing as entitlement to service connection for a lung disorder, to include as a result of herbicide exposure. To the extent that the Veteran has claimed that lung disorder is related to exposure to asbestos in service, other than the Veteran's statements there is no evidence that the Veteran was exposed to asbestos in service and there is no evidence that the Veteran's current lung disease may be related to exposure to asbestos. As such, entitlement to service connection for a lung disorder, to include as a result of herbicide exposure, is denied. ORDER Service connection for a lung disorder, to include as a result of exposure to herbicides, is denied. REMAND The Veteran seeks entitlement to service connection for a skin disorder. The Veteran contends that his skin disorder is related to his exposure to humidity and monsoons as well as herbicides in the Republic of Vietnam. The Veteran further contends that he has had a skin disorder since service. The Board notes that the service treatment records do not reveal any complaint, diagnosis, or treatment for any skin disorder. In March 2008 the Veteran was noted to have nicotine stains on the right fingers and seborrheic keratoses on the back. In a January 2011 treatment note the impression provided was rash from Agent Orange. In another treatment note dated in January 2011 the Veteran was noted to have a probable fungal infection in the left great toe. At a hearing before the undersigned Veterans Law Judge the Veteran's representative stated that "[r]easonable minds can further deduce the combat features and elements of his U.S. Army MOS along with . . . Vietnam's humidity and monsoons would have provided the proper environment for his foot and lung disorders." In March 2011 it was note that "previous rash attributed to agent orange not apparent at this time." In May 2012 the Veteran was noted to have no skin lesions, rashes, ulcers, scars, or tattoos. He had very dry skin. The Veteran was prescribed a lubricant cream for dry skin. In March 2012 the Board remanded this issue, in part, for the Veteran to be afforded a VA medical examination and for an opinion to be rendered regarding whether it is at least as likely as not that his skin disorder had its onset during service, including exposure to herbicides while in Vietnam. The Veteran was afforded a VA medical examination in May 2012. The Veteran was noted to be diagnosed with dermatitis and tinea in March 2007 and a keratinization skin disorder. The Veteran complained of a skin breakout described as a rash on the legs, arms, and chin that bleeds. He reported that the breakouts occurred frequently and that he had them ever since he came home from Vietnam. The Veteran was noted to have been seen by a private provider a year prior and to have been treated by VA. The examiner noted that no specific diagnoses had been given regarding the skin conditions per review of the claims file and VA medical records. The Veteran had been prescribed different creams and was using hydrocerin daily. The Veteran's skin conditions were noted to not cause any scarring or disfigurement of the head, face, or neck. He had no benign or malignant skin neoplasms. He had no systemic manifestations due to any skin disease. He was treated nearly constantly with topical medications. The Veteran had no debilitating or non-debilitating episodes due to his skin condition. Physical examination revealed dermatitis affecting less than five percent of the total body area. His infection of the skin affected less than five percent of the total body area. The dermatitis was noted to affect the bilateral lower extremities and the chin. He had tinea cruris affecting the groin. It was reiterated in the examination report that the examiner should consider the Veteran's exposure to herbicides while in service. The examiner rendered the opinion that the Veteran's skin disorder was less likely as not incurred in or caused by the claimed in-service injury, event, or illness. The relevant rationale provided was: The claims regarding skin and respiratory conditions are not considered presumptively connected as the current physical manifestations and diagnoses of skin conditions [do] not fall under the conditions considered presumptive connections. The examiner continued to provide the list of health outcomes not associated with exposure to certain herbicide agents. The Board notes that once VA undertakes the effort to provide an examination when developing a service-connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). In addition, the Board notes that as discussed above, remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand order. Stegall v.West, 11 Vet. App. 268, 271 (1998). Here, although the examiner rendered an opinion regarding the etiology of the Veteran's skin disorder, the examiner did not provide adequate rationale. The examiner's rationale rely upon the lack of the Veteran's skin disorder being included as a disorder for which a presumption of service connection is afforded based upon exposure to herbicides. The availability of presumptive service connection for a disability based on exposure to herbicides does not preclude a Veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); see also Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Court has also held that a medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion ... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions."). As the examiner did not provide complete rationale for the opinion rendered, the examination is inadequate and the claim must be remanded for the Veteran to be afforded another VA medical examination. Review of the VA treatment records reveals a notation that the Veteran was treated by a podiatrist, Dr. G.C., in February 2011. Review of the claims file reveals a letter from Dr. G.C. dated in January 2011 but do not reveal the treatment record from February 2011. VA is required to make reasonable efforts to help a claimant obtain records relevant to his claim, whether or not the records are in Federal custody. See 38 U.S.C.A. § 5103A(b)(1); 38 C.F.R. § 3.159(c)(1). Accordingly, attempts must be made to obtain complete treatment records from Dr. G.C. Since the claims file is being returned it should be updated to include VA treatment records compiled since May 2012. See 38 C.F.R. § 3.159(c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). 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) (2012). Expedited handling is requested.) 1. Attempt to obtain VA medical records pertaining to the Veteran that are dated since May 2012. 2. After obtaining necessary authorization, attempt to obtain and associate with the claims file treatment records from Dr. G.C. Any additional pertinent records identified by the Veteran during the course of the remand should also be obtained, following the receipt of any necessary authorizations from the Veteran, and associated with the claims file. 3. Thereafter, arrange for the Veteran to undergo an appropriate VA examination to determine the nature, extent, onset and etiology of any skin disorder found to be present. The claims file should be made available to and reviewed by the examiner. All indicated studies and all findings should be reported in detail. The examiner should comment on the Veteran's report regarding the onset and symptomatology since service and opine as to whether it is at least as likely as not (a 50 percent or greater probability) that any skin disorder found to be present is related to or had its onset during service, including exposure to herbicides while in Vietnam. The examiner should also comment upon the Veteran's reports of exposure to humidity and monsoons. The rationale for all opinions expressed should be provided in a legible report. 4. Thereafter, readjudicate the Veteran's claim. If the benefit sought on appeal is not granted, issue the Veteran and his representative a supplemental statement of the case and provide the Veteran an opportunity to respond. 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. 2012). ______________________________________________ MILO H. HAWLEY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs