Citation Nr: 1320569 Decision Date: 06/26/13 Archive Date: 07/05/13 DOCKET NO. 09-50 902 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Pittsburgh, Pennsylvania THE ISSUES 1. Entitlement to service connection for chronic sinusitis. 2. Entitlement to service connection for plantar warts. REPRESENTATION Veteran represented by: Disabled American Veterans ATTORNEY FOR THE BOARD C. Fields, Counsel INTRODUCTION The Veteran served on active duty from May 1988 to May 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2009 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Pittsburgh, Pennsylvania (Foreign Cases). In his December 2009 substantive appeal (VA Form 9), the Veteran requested a Board hearing at a local VA office. As the Veteran lives in Germany, the RO notified the Veteran that the Board does not hold hearings there, and described the options for a hearing or other ways to present evidence. In March 2010, the Veteran's representative indicated that he no longer desired a Board hearing. As such, the hearing request has been withdrawn. See 38 C.F.R. § 20.704(e) (2012). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND The Veteran contends that he has chronic sinus problems and foot problems of warts that began during service and have existed continuously since that time. He asserts that the warts on his foot are due to physical training or pressure on the feet. The Veteran's parents have each submitted a statement indicating that he was treated for sinus problems for 10 days in 1989 and for 18 days in 1991. Service treatment records showed multiple episodes of treatment for sinus problems or respiratory infections, including pneumonia, including in 1989 and 1991. The Veteran was also treated for problems with both feet during service. For example, he was noted to have pain in the left great toe after being stepped on in November 1989, sore feet after physical training in February 1990, pain due to falling arches on the right on several occasions, and pain in the right foot due to improper footwear in May 1991. The Veteran also states that he was treated for foot warts in January 1992. No pertinent symptoms or clinical abnormalities were noted on his entrance examination, and no separation examination is of record. The evidence includes treatment records from the Veteran's private providers in Germany dated from November 1991 to January 1992, and from July 1995 to February 2010. A summary of treatment from Dr. M-W from July 1995 through May 2009 showed treatment for sinus conditions on several occasions. See notations in June 1998, June 1999, October 1999, September 2000, October 2004, March 2005, February 2009, May 2009. There were also several episodes of bronchitis or respiratory infections that did not specifically reference the sinuses. A July 1998 record from Dr. H indicates that the Veteran reported headaches for about 15 years treated by analgesics, as well as frequent tonsillitis in the past. Dr. H diagnosed chronic tonsillitis and "suspicion of chronic recurrent sinusitis." Concerning plantar warts, the treatment summary from Dr. M-W showed a diagnosis of plantar wart on the foot with 3 months of conservative treatment for warts in March 2000, as well as unspecified referral to a surgeon in March 2000. An April 2005 record from Joint Surgical Practice indicates treatment for plantar wart recurrence on the left foot. The Veteran had previously had two warts removed from the same site, most recently in May 2004. The providers explained the "underlying pressure problem" and prescribed inserts and a keratolytic. Considering all lay and medical evidence, there is an indication that the Veteran's claimed disabilities may be related to his treatment for sinus and foot problems during service, as he has reported continuing symptoms and there is some evidence of treatment after service and a current disability. However, the evidence is insufficient to establish the nature of the current disability or a link to service. As such, VA has a duty to provide an examination to help substantiate the claims. See 38 C.F.R. § 3.159(c); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The RO adjudicated the claim for a foot disorder as service connection for plantar warts, left foot. Nevertheless, in a May 2009 letter, the Veteran indicated that although medical records during and after service show treatment for the left foot, it is actually the right foot that bothered (and still bothers) him. As such, it is unclear which foot is at issue. This should be clarified during the examination. Accordingly, the case is REMANDED for the following action: 1. Arrange for him to be examined to determine the whether sinus problems or plantar warts began in service or are related to a disease or injury in service. Ensure that the examiner has all pertinent lay and medical evidence and information available for review, including a copy of this remand. Review of such evidence should be noted in the examination report. The examiner should respond to the following: (a) Does the Veteran have a chronic sinus disorder (i.e. a disorder demonstrated at any time since 2008? If so, was the disorder at least as likely as not (probability of 50 percent or more) present in service or the result of a disease or injury in military service? (b) Does the Veteran have recurrent warts on the right or left foot (i.e. warts at any time since 2008)? If so, was the disorder at least as likely as not (probability of 50 percent or more) present in service or the result of a disease or injury in military service? The examiner should provide reasons for each opinion based on all evidence of record. The examiner must consider the Veteran's reports of continuing symptoms since service in addition to the medical evidence of record. If any requested opinion cannot be offered without resorting to speculation, the examiner should explain why a non-speculative opinion cannot be offered; and whether the inability to provide the needed opinion is due to the absence of any evidence or is due to the limits of scientific or medical knowledge. 2. If any benefit sought on appeal remains denied, issue a supplemental statement of the case. Then, return the case to the Board, if otherwise in order. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. All claims 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). _________________________________________________ Mark D. Hindin Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).