Citation Nr: 1319507 Decision Date: 06/17/13 Archive Date: 06/27/13 DOCKET NO. 08-38 868 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Winston-Salem, North Carolina THE ISSUES 1. Entitlement to service connection for a right hand disability, to include degenerative joint disease and carpal tunnel syndrome. 2. Entitlement to service connection for a bilateral elbow disability, to include degenerative joint disease and cubital tunnel syndrome. 3. Entitlement to service connection for a bilateral knee disability. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD H. Yoo, Counsel INTRODUCTION The Veteran served on active duty from March 1960 to September 1960, with subsequent periods of active duty for training and inactive duty for training ending in September 2000. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2007 rating decision of the Winston-Salem, North Carolina, Regional Office (RO) of the Department of Veterans Affairs (VA). In February 2010, the Veteran testified before the undersigned Veterans Law Judge, sitting in Winston-Salem, North Carolina. A transcript of that proceeding has been prepared and incorporated into the evidence of record. The Board notes that the Veteran's initial claim was for service connection for a right hand disability and bilateral elbow disability. The medical evidence of record also indicates that the Veteran has been diagnosed with degenerative joint disease in the right hand and bilateral elbows, carpal tunnel syndrome in the right hand, and cubital tunnel syndrome in the elbows, bilaterally. The scope of a claim includes any disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record. Clemons v. Shinseki, 23 Vet. App. 1 (2009); Brokowski v. Shinseki, 23 Vet. App. 79 (2009). Given the foregoing, the Board has recharacterized the claims as reflected on the title page. A review of the Virtual VA paperless claims processing system does not reveal any additional documents pertinent to the present appeal. The issue of entitlement to service connection for a bilateral knee disability is addressed in the REMAND portion of the decision below and is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDINGS OF FACT 1. The evidence of record fails to demonstrate a causal relationship between the Veteran's right hand disability, including degenerative joint disease and carpal tunnel syndrome, and his military service. 2. The evidence of record fails to demonstrate a causal relationship between the Veteran's bilateral elbow disability, including degenerative joint disease and cubital tunnel syndrome, and his military service. CONCLUSIONS OF LAW 1. The criteria for service connection for a right hand disability, to include degenerative joint disease and carpal tunnel syndrome, have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 5103, 5103A (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2012). 2. The criteria for service connection for a bilateral elbow disability, to include degenerative joint disease and cubital tunnel syndrome, have not been met. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 5103, 5103A (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. The Veterans Claims Assistance Act of 2000 With respect to the appellant's claims decided herein, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2012). Under the VCAA, when VA receives a complete or substantially complete application for benefits, it is required to notify the claimant and his representative, if any, of any information and medical or lay evidence that is necessary to substantiate the claim. See 38 U.S.C.A. § 5103(a) (West 2002); 38 C.F.R. § 3.159(b) (2012); Quartuccio v. Principi, 16 Vet. App. 183 (2002). In Pelegrini v. Principi, 18 Vet. App. 112, 120-21 (2004) (Pelegrini II), the United States Court of Appeals for Veterans Claims (Court) held that 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. 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); 38 C.F.R. §§ 3.102, 3.56(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; (3) that the claimant is expected to provide. The notice requirements described above apply to all five elements of a service connection claim: (1) veteran status; (2) existence of disability; (3) connection between service and the disability; (4) degree of disability; and (5) effective date of benefits where a claim is granted. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). In May 2006, January 2007, and April 2007, June 2010, February 2011, July 2011, and December 2011 the agency of original jurisdiction (AOJ) provided the notice required by 38 U.S.C.A. § 5103(a) (West 2002) and 38 C.F.R. § 3.159(b) (2012). Specifically, the AOJ notified the Veteran of information and evidence necessary to substantiate the claims for service connection; information and evidence that VA would seek to provide; and information and evidence that the Veteran was expected to provide. These letters also provided the Veteran with the notice pursuant to Dingess. All the law requires is that the duty to notify is satisfied and that claimants are given the opportunity to submit information and evidence in support of their claims. Once this has been accomplished, all due process concerns have been satisfied. See Bernard v. Brown, 4 Vet. App. 384 (1993); Sutton v. Brown, 9 Vet. App. 553 (1996); see also 38 C.F.R. § 20.1102 (2012) (harmless error). In view of the foregoing, the Board finds that the Veteran was notified and aware of the evidence needed to substantiate his claims, as well as the avenues through which he might obtain such evidence, and of the allocation of responsibilities between himself and VA in obtaining such evidence. Accordingly, there is no further duty to notify. Next, VA has a duty to assist the Veteran in the development of the claims. This duty includes assisting him in the procurement of service medical 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 Veteran. See Bernard v. Brown, 4 Vet. App. 384 (1993). The VA has obtained copies of the Veteran's service treatment and personnel records, and has reviewed the evidence in the Virtual VA system. The duty to assist also includes providing a medical examination or obtaining a medical opinion when such is necessary to make a decision on a claim, as defined by law. The Veteran's service treatment records and VA medical records are in the file. Private medical records identified by the Veteran have been obtained, to the extent possible. In addition, the Veteran stated at the April 2012 VA examination that he was in receipt of Social Security Administration (SSA) Disability benefits that warranted obtaining additional records. As such, in February 2013, the Board remanded this appeal for the outstanding SSA records. Murincsak v. Derwinski, 2 Vet. App. 363 (1992). In March 2013, the SSA National Records Center stated that these records do not exist and further efforts would be futile as the records have been destroyed. The Veteran has at no time referenced additional outstanding records that he wanted VA to obtain or that he felt were relevant to these claims. The record indicates that the Veteran was also afforded VA examinations in April 2012, and the results of which have been included in the claims file for review. This examination involved review of the claims file and thorough examinations of the Veteran. Given the foregoing, the Board finds that the VA has substantially complied with the duty to obtain the requisite medical information necessary to make a decision on the Veteran's claim. Furthermore, in February 2010, the Veteran had the opportunity to testify at a Board hearing at the Winston-Salem RO over which the undersigned Veterans Law Judge presided. The provisions of 38 C.F.R. § 3.103(c)(2) impose two distinct duties on VA employees, including Board personnel, in conducting hearings: the duty to explain fully the issues and the duty to suggest the submission of evidence that may have been overlooked. Bryant v. Shinseki, 23 Vet. App. 488 (2010). During the Board hearing, the undersigned clarified the issue on appeal and inquired as to the etiology of the Veteran's asserted symptoms. The Veteran was offered an opportunity to ask the undersigned questions regarding his claims. The Board, therefore, concludes that it has fulfilled its duty under Byrant. Additionally, the Board finds there has been substantial compliance with its March 2012 and March 2013 remand directives. The Board notes that the Court has recently noted that "only substantial compliance with the terms of the Board's engagement letter would be required, not strict compliance." See D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (holding that there was no Stegall (Stegall v. West, 11 Vet. App. 268) violation when the examiner made the ultimate determination required by the Board's remand.) As stated above, the Veteran was afforded additional VA examinations and the AMC attempted to locate SSA records. Based on the foregoing, the Board finds that the AMC substantially complied with the mandates of its remands. See Stegall, supra, (finding that a remand by the Board confers on the appellant the right to compliance with its remand orders). As there is no indication that any failure on the part of VA to provide additional notice or assistance reasonably affects the outcome of this case, the Board finds that any such failure is harmless. See Newhouse v. Nicholson, 497 F.3d 1298 (Fed. Cir. 2007). Importantly, the Board notes that the Veteran is represented in this appeal. See Overton v. Nicholson, 20 Vet. App. 427, 438 (2006). The Veteran has submitted argument and evidence in support of the appeal. Based on the foregoing, the Board finds that the Veteran has had a meaningful opportunity to participate in the adjudication of his claims such that the essential fairness of the adjudication is not affected. II. Merits of the Claims Governing Laws and Regulations Under the laws administered by VA, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred during service. 38 C.F.R. § 3.303(d). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. 38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004) (citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); Caluza v. Brown, 7 Vet. App. 498, 505 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (table)). Service connection may also be granted for chronic disabilities, such as organic disease of the nervous system, if such are shown to have been manifested to a compensable degree within one year after the Veteran was separated from service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. As an alternative to the nexus requirement, service connection for these chronic disabilities may be established through a showing of continuity of symptomatology since service. 38 C.F.R. § 3.303(b)(2012). The option of establishing service connection through a demonstration of continuity of symptomatology rather than through a finding of nexus is specifically limited to the chronic disabilities listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Here, the Board notes that the Veteran's diagnosed degenerative joint disease of the right hand and bilateral elbows are subject to service connection based upon continuity of symptomatology under 38 C.F.R. § 3.309(a). In each case where a veteran is seeking service connection for any disability, due consideration shall be given to the places, types, and circumstances of such veteran's service as shown by such veteran's service record, the official history of each organization in which such veteran served, such veteran's treatment records, and all pertinent medical and lay evidence. See 38 U.S.C.A. § 1154(a) (West 2002 and Supp. 2012). The United States Court of Appeals for the Federal Circuit (Federal Circuit) has rejected the view that competent medical evidence is required when the determinative issue in a claim for benefits involves either medical etiology or a medical diagnosis. Under 38 U.S.C.A. § 1154(a), lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a 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 (Fed. Cir. 2009); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). The Board has thoroughly reviewed all the evidence in the Veteran's claims file. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the evidence submitted by the Veteran or on her behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record, but does not have to discuss each piece of evidence). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claims. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122 (2000) (the law requires only that the Board address its reasons for rejecting evidence favorable to the appellant). The Board must assess the credibility and weight of all evidence, including the medical evidence, to determine its probative value, accounting for evidence, which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the appellant. Equal weight is not accorded to each piece of evidence contained in the record; not every item of evidence has the same probative value. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Factual Background and Analysis The Veteran contends that his current arthritis in the right hand is due to an in-service injury. Specifically, in a December 2012 statement, the Veteran stated he injured his right hand when a truck door was slammed on it. He stated his fingers were severely injured and he was taken to the hospital. The Veteran stated that in the process of pulling his right hand out of the door, he hit his elbow on the side of the truck and did not realize he injured his right elbow in the process as all of his focus was on the injured right hand. The Veteran also reported in the April 2003 notice of disagreement that arthritis was contributed to by the many times he had to sleep on the ground while in the field for camps throughout the years. He also discussed having to pick up many heavy items over the years in the Reserves. The Board notes that a May 1978 service treatment record reflect a right hand injury as the Veteran has described. The record indicates he was treated for contusion to the 3rd and 4th fingers. The x-rays taken at this time were negative. The Board conceded in the March 2012 decision to reopen and remand these issues that this injury occurred in the line of duty. Numerous in-service examination reports from February 1960 through September 1996 do not show any complaints or clinical abnormalities for the right hand and do not demonstrate that the Veteran reported past or current elbow disabilities. Reports of the May 1978 right hand injury do not reflect that he injured his elbows or reported elbow symptomatology during that time. A September 1996 periodic non-flying examination report notes that the Veteran's upper extremities were clinically normal but had normal range of elbow motion. This record also notes "[e]lbow arthralgia mild, plays tennis without notable discomfort." In the April 2003 notice of disagreement, the Veteran reported that took pain medication before and after tennis. The Veteran underwent a general VA examination in February 2002 where no complaints or diagnosis of a right hand disability was made. Regarding the bilateral elbows, the February 2002 VA examination report reflects an impression of limited motion of the bilateral elbows with x-ray evidence of degenerative joint disease. This record notes that the Veteran reported having had limitation of motion of the bilateral elbows for the past two years. He reported having had no specific treatment or x-rays. It notes that "He recalls no injury and says that the condition developed gradually." The Veteran submitted an undated letter from a private physician, Dr. J. S., noting that he suffers from osteoarthritis of the right hand and elbow that "is the result of trauma that took place while the patient was in the military." In April 2012, the Veteran was afforded a VA examination for the right hand and fingers where he was diagnosed with right hand degenerative joint disease with carpal tunnel, status post-surgical with residual scar. The Veteran reported that he experienced tingling and numbness in both hand and fingers in 1985 when he was diagnosed with bilateral carpal tunnel and underwent surgery. A physical examination revealed no localized tenderness over the right hand and fingers but noted limitation of the interphalangeal and metacarpophalangeal joint movements in the right hand. Arthritic nodules were noted at the interphalangeal joints in the fingers, bilaterally. X-rays of the right hand were reported as "scattered moderately severe degenerative and proliferative changes in the right hand." The examiner explained that carpal tunnel syndrome in the right hand was caused by entrapment of the median nerve in the wrist and was "not caused or permanently aggravated by the [V]eteran's right hand 3rd and 4th digit injury documented during the active duty in the year 1978." Regarding the degenerative joint disease in the right hand, the examiner concluded that it was a natural age related progression of the disease over a period of time and was not caused by the Veteran's injury to his 3rd and 4th digits in the military service. Similarly, the Veteran underwent a VA examination for both elbows and forearms in April 2012. According to the examination report, the Veteran was diagnosed with bilateral degenerative joint disease with cubital tunnel syndrome, status post-surgical transposition of the ulnar nerve with a residual scar. He stated that in 1985, he had pain in both elbows and was diagnosed with cubital tunnel syndrome in both elbows. A physical examination revealed limitation of range of motion in both elbows with no localized tenderness. Surgical scars were present. An x-ray revealed severe right elbow degenerative disease and moderate left elbow degenerative disease. The VA examiner determined that the cubital tunnel syndrome was caused by entrapment of the ulnar nerve in the cubital tunnel in the elbow and the degenerative joint disease in the elbows was a natural age related progression of the disease in the joint over a period of time. As such, the cubital tunnel syndrome and degenerative joint disease in both elbows were not caused or permanently aggravated by the injury to the right elbow in 1978, or caused or permanently aggravated by the Veteran's military service. In light of the totality of the evidence of record, the Board finds that the Veteran's claim for entitlement to service connection for a right hand disability and a bilateral elbow disability must be denied. Regarding the Veteran's right hand disability, the April 2012 VA examiner provided a negative nexus opinion that the degenerative joint disease and carpal tunnel syndrome in the right hand were not caused or permanently aggravated by the Veteran's right hand 3rd and 4th digit injury documented during his military service in 1978. The Board acknowledges Dr. J. S.'s undated statement providing a positive nexus opinion between the Veteran's osteoarthritis in the right hand and the injury sustained in service. However, it is the responsibility of the Board to assess the credibility and weight to be given the evidence. See Hayes v. Brown, 5 Vet. App. 60, 69-70 (1993) (citing Wood v. Derwinski, 1 Vet. App. 190, 192-93 (1992)). The probative value of medical evidence is based on the physician's knowledge and skill in analyzing the data, and the medical conclusion the physician reaches; as is true of any evidence, the credibility and weight to be attached to medical opinions are within the province of the Board. See Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). When reviewing such medical opinions, the Board may appropriately favor the opinion of one competent medical authority over another. See Owens v. Brown, 7 Vet. App. 429, 433 (1995). However, the Board may not reject medical opinions based on its own medical judgment. See also Obert v. Brown, 5 Vet. App. 30 (1993); Colvin v. Derwinski, 1 Vet. App. 171 (1991). In assessing medical opinions, the failure of the physician to provide a basis for his opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician's access to the claims file and the thoroughness and detail of the opinion. See Prejean v. West, 13 Vet. App. 444, 448-49 (2000). A medical opinion may not be discounted solely because the examiner did not review the claims file. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Here, despite the positive nexus opinion from Dr. J. S., the Board finds the April 2012 VA medical opinions of record to be the most probative in light of the complete evidence of record. In this regard, the VA examination reports were based on a thorough review of the claims file, to include the Veteran's contentions and complete medical history. Madden v. Brown, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (holding that the Board must assess the credibility and probative value of the medical evidence in the record); see also Owens v. Brown, 7 Vet. App. 429, 433 (1995) (holding that the Board may appropriately favor the opinion of one competent medical authority over another); Prejean v. West, 13 Vet. App. 444, 448-9 (2000) (holding that factors for assessing the probative value of a medical opinion included the physician's access to the claims file and the thoroughness and detail of the opinion); see also Guerrieri, supra (holding that the probative value of medical opinion evidence is based on the personal examination of the patient, the knowledge and skill in analyzing the data, and the medical conclusion reached). Although Dr. J. S. provided a positive nexus opinions, this conclusion does not reflect any review or discussion of the contents of the claims file, address any of the contrary evidence of record, or provide any rationale supporting the opinions. The Board further notes that Dr. J. S.'s statement is merely a conclusory statement without factual, medical rationale. See Nieves-Rodriguez, supra. In contrast, the VA examiner's opinion is the most thorough and factually supported opinions of record, given that they are consistent with other evidence of record and included review of the claims file. This medical evidence is competent, credible and persuasive, as it is based on accurate facts and supported by a rationale. Id. Regarding the bilateral elbow disability, the Board acknowledges the Veteran's contention that it was injured during service either when he injured his right hand or from repetitive use or from sleeping on the ground during service. While the Veteran currently has an elbow disability, the medical evidence of record as a whole supports the proposition that there is no etiological relationship between the origin and/or severity of any bilateral elbow disability and service. Specifically, the April 2012 examination provided a negative nexus opinion as to the question of etiology for both the Veteran's degenerative joint disease and cubital tunnel syndrome. The April 2012 opinion provide a comprehensive discussion of the evidence, lay and medical, and provided an explanation as to why it is not related to the Veteran's 1978 right hand injury or his military service in general. In addition, the Board acknowledges the Veteran's statements and his belief that his current right hand and bilateral elbow disabilities are related to his military service. The Board, however, finds that the Veteran is not competent to relate his degenerative joint disease of the right hand and bilateral elbows, cubital tunnel syndrome of the elbows, and carpal tunnel syndrome of the right hand, to his period of service despite evidence of an in-service injury of the right hand. Although it is error to categorically reject a non-expert opinion as to etiology, or nexus, not all questions of nexus are subject to non-expert opinion. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). Whether a layperson is competent to provide a nexus opinion depends on the facts of the particular case. Here, despite the Veteran's contentions and competence to report his symptomatology, given the complexity of the particular question of etiology and the fact that a nexus opinion may not be rendered based on personal observation, the Board finds that the Veteran is not competent to opine on the etiology of his right hand and bilateral elbow disabilities. Accordingly, his opinions are not probative and are outweighed by the medical evidence of record. While the Board is sympathetic to the Veteran's claims, taking into account all of the relevant evidence of record, the preponderance of the evidence is against a finding of an etiological relationship between the Veteran's right hand and bilateral elbow disabilities and his military service, the Board concludes that service connection is not warranted. Although the Veteran is entitled to the benefit of the doubt where the evidence is in approximate balance, the benefit of the doubt doctrine is inapplicable where, as here, the preponderance of the evidence are against the claims. 38 U.S.C.A. § 5107(b) (West 2002); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). ORDER Entitlement to service connection for a right hand disability, to include degenerative joint disease and carpal tunnel syndrome, is denied. Entitlement to service connection for a bilateral elbow disability, to include degenerative joint disease and cubital tunnel syndrome, is denied. REMAND Although the Board sincerely regrets the additional delay that may be caused by this remand, it is necessary to ensure that there is a complete record on which to decide the Veteran's claim. The Board notes in this regard that VA has a duty to assist claimants in obtaining evidence needed to substantiate a claim. 38 U.S.C.A. §§ 5107(a) 5103A (West 2002); 38 C.F.R. § 3.159(c) (2012). As previously stated, the Veteran's claim was remanded in February 2013 to obtain the Veteran's complete SSA records, including any administrative decision(s) on his application for SSA disability benefits and all underlying medical records. However, in March 2013, the SSA National Records Center stated these records were unavailable. In April 2013, the Veteran submitted a statement that the unavailable SSA records pertain to his right knee. The Veteran stated that there are additional records at the Police Pension Fund in Albany, New York, pertaining to the injury to his right knee. He stated he was employed at the Glen Cove Police Department and retired in 1989. As such, these records should be obtained and associated with the record for consideration. Accordingly, the case is REMANDED for the following action: 1. The RO/AMC should ask the Veteran to identify all sources of treatment or evaluation he has received for his bilateral knee disability, along with all sources of treatment or evaluation he has received and should secure copies of complete records of the treatment or evaluation from all sources appropriately identified, which are not already of record. In particular, the RO/AMC should attempt to obtain any medical records pertaining to his bilateral knee disability from the Police Pension Fund located in Albany, New York. 2. The RO/AMC should then readjudicate the claim. If it remained denied, the RO/AMC should issue an appropriate supplemental statement of the case and provide the Veteran the opportunity to respond. The case should then be returned to the Board for further appellate review, if otherwise in order. No action is required of the appellant until he is notified. 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). ______________________________________________ WAYNE M. BRAEUER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs