Citation Nr: 1320601	
Decision Date: 06/26/13    Archive Date: 07/05/13

DOCKET NO.  12-15 572	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs (VA) Regional Office (RO) 
in Roanoke, Virginia


THE ISSUES

1. Entitlement to an effective date earlier than February 2, 2012 for the assignment of a 30 percent rating for the service-connected degenerative joint disease of the right knee. 

2. Entitlement to an effective date earlier than February 2, 2012 for the assignment of a 30 percent rating for the service-connected degenerative joint disease of the left knee. 

3. Entitlement to a total disability rating based on individual unemployability by reason of service-connected disability (TDIU).


REPRESENTATION

Veteran represented by:	Carl B. Bedell, Attorney at Law



WITNESS AT HEARING ON APPEAL

The Veteran


ATTORNEY FOR THE BOARD

M. Donohue, Counsel


INTRODUCTION

The Veteran had active service from June 1972 to October 1982. 

These matters come before the Board of Veterans' Appeals (Board) on appeal of May 2010 and February 2012 rating decisions by the RO. 

In May 2010, the RO denied the Veteran's claim for increased ratings for his service-connected right and left knee disabilities.  The Veteran perfected an appeal of this decision. 

Before the Veteran's appeal was certified to the Board, in the above-mentioned February 2012 rating decision, the RO increased the disability ratings assigned to the service-connected right and left knee disabilities; a 30 percent rating was assigned effective on February 2, 2012.  While the Veteran has indicated his satisfaction with the 30 percent disability rating, he has perfected an appeal of the assigned effective date. 

As the Veteran has indicated his satisfaction with the assigned disability rating, his increased rating claim is no longer on appeal.  C.f. AB v. Brown, 6 Vet.App. 35, 38 (1993).  However, during the pendency of his appeal, the Veteran had stated that his bilateral knee disabilities prevented him from performing "normal work."  See the April 2010 VA examination. 

In Rice v. Shinseki, 22 Vet.App. 447 (2009), the Court held that a TDIU claim is part of an increased rating claim when such claim is raised by the record.  As the Veteran has submitted evidence indicating that he has been unable to work while seeking an increased rating, the issue of a TDIU rating remains on appeal.  See Locklear v. Shinseki, 24 Vet.App. 311 (2011) (although a TDIU and increased rating issues are best analyzed as part of the same claim, bifurcation of the TDIU and increased rating aspects of the claim is generally within the Secretary's discretion).

The Veteran testified at a hearing held before the undersigned Veterans Law Judge at the Board's offices in Washington D.C. in January 2013.  A transcript of the hearing has been associated with the Veteran's electronic claims file.

During the hearing, the Veteran submitted additional evidence and written argument.  The RO has not considered this evidence; however, the Veteran has waived consideration of such evidence by the agency of original jurisdiction.  See 38 C.F.R. § 20.1304 (2012).

The issue of entitlement to a TDIU rating is being remanded to the RO.


FINDINGS OF FACT

1.  For the one-year period prior to the filing of the Veteran's claim for increase, beginning on March 30, 2009, the service-connected degenerative joint disease of the left knee is shown to have been productive of a disability picture manifested by a functional loss due to pain and episodes of effusion that more closely resembled that of extension restricted to 20 degrees.     

2.  For the one-year period prior to the filing of the Veteran's claim for increase, beginning on March 30, 2009, the service-connected degenerative joint disease of the right knee is shown to have been productive of a disability picture manifested by a functional loss due to pain and episodes of effusion that more closely resembled that of extension restricted to 20 degrees.     


CONCLUSIONS OF LAW

1. The criteria for the assignment of an effective date of March 30, 2009, for the assignment of a 30 percent rating for the service-connected degenerative joint disease of the right knee are met. 38 U.S.C.A. §§ 1155, 5107, 5110 (West 2002); 38 C.F.R. §§ 3.102, 3.400, 4.7, 4.71a including Diagnostic Code 5261 (2012).

2. The criteria for the assignment of an effective date of March 30, 2009, for the assignment of a 30 percent rating for the service-connected degenerative joint disease of the left knee are met. 38 U.S.C.A. §§ 1155, 5107, 5110 (West 2002); 38 C.F.R. §§ 3.102, 3.400, 4.7, 4.71a including Diagnostic Code 5261 (2012).


REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

After the evidence has been assembled, the Board is responsible for evaluating the entire record.  38 U.S.C.A. § 7104(a) (West 2002).  When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant.  See 38 U.S.C.A. § 5107 (West 2002); 38 C.F.R. § 3.102 (2012).  

Indeed, in Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims (Court) stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail."  

To deny a claim on its merits, the preponderance of the evidence must be against the claim.  See Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54.

Furthermore, the Board notes that it has reviewed all of the evidence in the claims file.  Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail.  Rather, the Board's analysis will focus specifically on what evidence is needed to substantiate the issues adjudicated herein and what the evidence in the claims file shows, or fails to show, with respect to these claims.  See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000).  


I.  The Veterans Claims Assistance Act of 2000 (VCAA)

The Veterans Claims Assistance Act of 2000 (VCAA), codified in pertinent part at 38 U.S.C.A. §§ 5103, 5103A (West 2002), and the pertinent implementing regulation, codified at 38 C.F.R. § 3.159 (2012), provide that VA will assist a claimant in obtaining evidence necessary to substantiate a claim but is not required to provide assistance to a claimant if there is no reasonable possibility that such assistance would aid in substantiating the claim.  

The law and regulations also require VA to notify the claimant and the claimant's representative, if any, of any information and any medical or lay evidence not previously provided to VA that is necessary to substantiate the claim.  

As part of the notice, VA is to specifically inform the claimant and the claimant's representative, if any, of which portion, if any, of the evidence is to be provided by the claimant and which part, if any, VA will attempt to obtain on behalf of the claimant. 

In March 2006, the Court issued its decision in the consolidated appeal of Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006) and held that the notice requirements of 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a "service connection" claim.  As previously defined by the courts, those five elements include: (1) veteran status; (2) existence of a disability; (3) a connection between the veteran's service and the disability; (4) degree of disability; and (5) effective date of the disability.  

Upon receipt of an application for "service connection," therefore, VA is required 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 the elements of the claim as reasonably contemplated by the application.  This includes notice that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded.

The Board also notes that the Court has held that the plain language of 38 U.S.C.A. § 5103(a) requires that notice to a claimant pursuant to VCAA be provided "at the time" that, or "immediately after," VA receives a complete or substantially complete application for VA-administered benefits.  Pelegrini v. Principi, 18 Vet. App. 112, 119 (2004). 

The timing requirement enunciated in Pelegrini applies equally to the initial-disability-rating and effective-date elements of a service-connection claim.  Dingess, supra.

In the present case, VA issued a VCAA notice letter to the Veteran in April 2010.  This letter informed the Veteran as to the law pertaining to the assignment of a disability rating and effective date.  The letter also informed the Veteran of his and VA's respective duties for obtaining evidence.  

Moreover, the Veteran demonstrated actual knowledge of what was necessary to substantiate his earlier effective date claim in a March 2012 letter when he argued that his effective date should be the date of his claim.  The Veteran also argued that the evidence demonstrated that his disabilities were 30 percent disabling prior to February 2012.

In short, the record indicates that the Veteran received appropriate notice pursuant to VCAA.

VCAA also provides that VA shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate a claim for VA benefits, unless no reasonable possibility exists that such assistance would aid in substantiating the claim.  

In the present appeal, the Board finds that reasonable efforts have been made to assist the Veteran in obtaining evidence necessary to substantiate his claims, and that there is no reasonable possibility that further assistance would aid in substantiating such claims.  

In particular, the record contains the Veteran's service treatment records, private treatment records, excerpts from a medical treatise, a VA examination report and the January 2013 hearing transcript.  

The Board has carefully reviewed the Veteran's statements and concludes that he has not identified further evidence not already of record.  The Board has also reviewed the medical records for references to additional treatment reports not of record, but has found nothing to suggest that there is any outstanding evidence with respect to the Veteran's claims. 

The Board additionally observes that all appropriate due process concerns have been satisfied.  See 38 C.F.R. § 3.103 (2012).  The Veteran has been accorded the opportunity to present evidence and argument in support of his claims.  He exercised the option of a personal hearing and was afforded one in January 2013. 

Based on the foregoing, the Board finds that all relevant facts have been properly and sufficiently developed in this appeal and that no further development is required to comply with the duty to assist the Veteran in developing the facts pertinent to his claim.  Essentially, all available evidence that could substantiate the claim has been obtained. There is no indication in the file that there are additional relevant records that have not yet been obtained.  


II.  Law and Regulations

Disability ratings are assigned in accordance with the VA's Schedule for Rating Disabilities and are intended to represent the average impairment of earning capacity resulting from disability.  See 38 U.S.C.A. § 1155 (West 2002); 38 C.F.R. §§ 3.321(a), 4.1 (2012).  Separate diagnostic codes identify the various disabilities.  See 38 C.F.R. Part 4.  

The Court has held that "staged" ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. See Hart v. Mansfield, 21 Vet.App. 505 (2007).

The evaluation of a service-connected disability involving a joint rated on limitation of motion requires adequate consideration of functional loss due to pain under 38 C.F.R. § 4.40 and functional loss due to weakness, fatigability, incoordination or pain on movement of a joint under 38 C.F.R. § 4.45. See DeLuca v. Brown, 8 Vet.App. 202 (1995).

The basis of disability evaluations is the ability of the body as a whole to function under the ordinary conditions of daily life, including employment.  38 C.F.R. § 4.10 (2012).  Disability of the musculoskeletal system is primarily the inability to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. 38 C.F.R. § 4.40 (2012).

Consideration is to be given to whether there is less movement than normal, more movement than normal, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity, atrophy of disuse, instability of station, or interference with standing, sitting, or weight bearing. 38 C.F.R. § 4.45 (2012).

The Veteran's service-connected right and left knee disabilities are each rated under Diagnostic Code 5261 (limitation of leg extension). 

Under Diagnostic Code 5261, limitation of extension of the leg provides a non-compensable rating if extension is limited to five degrees, a 10 percent rating if limited to 10 degrees, a 20 percent rating if limited to 15 degrees, a 30 percent rating if limited to 20 degrees, a 40 percent rating if limited to 30 degrees, and a 50 percent rating if limited to 45 degrees.  

The Board observes that normal range of motion for the knee is defined as follows: flexion, zero degrees to 140 degrees; and extension, 140 degrees to zero degrees.  38 C.F.R. § 4.71, Plate II (2012).

The provisions governing the assignment of the effective date of an increased rating are set forth in 38 U.S.C.A. § 5110(a) and (b)(2) (West 2002) and 38 C.F.R. § 3.400(o) (2012).  

The general rule as to the effective date of an award of increased compensation is that the effective date of the award "shall not be earlier than the date of receipt of the application thereof." 38 U.S.C.A. § 5110(a).  This statutory provision is implemented by regulation that provides that the effective date for an award of increased compensation will be the date of receipt of claim or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400(o)(1).

An exception to that rule regarding increased ratings applies, however, under circumstances where the evidence demonstrates that a factually ascertainable increase in disability occurred within the one-year period preceding the date of receipt of a claim for increased compensation.  If an increase in disability occurred within one-year prior to the claim, the increase is effective as of the date the increase was "factually ascertainable."  

If the increase occurred more than one year prior to the claim, the increase is effective the date of claim.  If the increase occurred after the date of claim, the effective date is the date of increase. 38 U.S.C.A. § 5110(b)(2); Dalton v. Nicholson, 21 Vet.App. at 31-32; Harper v. Brown, 10 Vet.App. 125 (1997); 38 C.F.R. § 3.400 (o)(1)(2); VAOPGCPREC 12-98 (1998).

Any communication or action, indicating an intent to apply for VA benefits from a claimant, his duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. 38 C.F.R. § 3.155(a) (2012).  

The date of receipt of evidence from a private physician or a lay person will be accepted when the evidence furnished by or in behalf of the claimant is within the competence of the physician or lay person and shows a reasonable possibility of entitlement to benefits. 38 C.F.R. § 3.157(b)(2) (2012). 

Also, the date of VA outpatient or hospital examination, or the date of admission to a VA or uniformed services hospital, will be accepted as the date of receipt of a claim when the report of such treatment or examination relates to a disability for which increased compensation is sought. 38 C.F.R. § 3.157(b)(1) (2012).   


III. Analysis

The Veteran in this case seeks an effective date earlier than February 2, 2012 for the award of a 30 percent disability rating for his service-connected degenerative joint disease for each of his knees. 

In determining an appropriate effective date for an increased rating, the Board must first identify the date of filing of the increased rating claim.  The Board then determines when it was "factually ascertainable" that an increase in disability occurred.  Such date may be before or after the date the claim was filed, but may be no more than one year prior to the date of claim.  See 38 C.F.R. § 3.400(o) (2012).

Here, the Veteran was granted service connection bilateral knee disabilities in a January 1985 rating decision.  A 10 percent disability rating was assigned effective on April 17, 1984.  

In an April 1994 rating decision, the RO assigned separate 10 percent disability rating to the service-connected right and left knee disabilities.  The Veteran was notified of this decision and his appellate rights in a May 1994 letter.  No appeal was taken from that determination, and it became final.  38 U.S.C.A. § 7105 (West 2002); 38 C.F.R. §§ 20.300, 20.302 (2012).  

The applicable statutory and regulatory provisions require that VA look to all communications from a claimant that may be interpreted as applications or claims, formal and informal, for benefits.  In particular, VA is required to identify and act on informal claims for benefits.  See 38 U.S.C. § 5110(b)(2); 38 C.F.R. §§ 3.1(p), 3.400(o)(2), 3.155(a); see also Servello v. Derwinski, 3 Vet.App. 196, 198-200 (1992).

A review of the record shows  that there are no communication from the Veteran or a representative of the Veteran to VA that can be interpreted as a claim for increase after the April 1994 rating decision, and prior to the March 2010 claim for an increased rating.  Neither the Veteran nor his attorney has identified such a claim.  

Accordingly, the Board concludes that the date of receipt of the Veteran's claim for an increased rating for his service-connected right and left knee disabilities is March 30, 2010.

The Board's inquiry now shifts to the date entitlement to an increased rating arose, that is when it was factually ascertainable that an increase in disability occurred. The time frame in question starts a year before the March 30, 2010 date of receipt of the claim, i.e., from March 30, 2009.

As noted, the service-connected right and left knee disabilities were each rated as 10 percent disabling at the time of his claim. 

Significantly, for the period prior to receipt of the claim for increase, in a February 2010 letter, the Veteran's private physician stated that the Veteran's knees had continued to deteriorate and to experience recurrent effusions "which [had] been present for many years."  It was noted that he had been experiencing problems with work and that his knee disabilities limit[ed] his "stooping, bending, prolonged walking, carrying heavy equipment and . . . prevent[ed] him from long runs or carrying equipment over [a] prolonged period of time."  The private physician documented that the Veteran had been advised to have surgery on both knees. 

Thus, there is probative evidence that tends to show that the Veteran was experiencing increased knee manifestation productive of substantial functional limitations for some time prior to his filing for compensation benefits higher than 10 percent.  

During an April 2010 VA examination, the Veteran also complained of having "weakness, swelling, giving way, lack of endurance, locking subluxation and pain" involving his knees.  He also reported that, during flare-ups, he could not "kneel, bend, walk, climb stairs" and was unable to bend his knees.  

On examination in April 2010, the VA examiner did note that the Veteran walked with an altered gait and limp.  It was reported that the Veteran demonstrated a full range of motion for each knee and that his joint function was not "additionally limited by pain, fatigue, weakness, lack of endurance or incoordination after repetitive use."  The Veteran also was noted to have no effusion of either knee.  However, each knee was noted to have crepitus.  The examiner added that the Veteran's medial/lateral ligaments and menisci were within normal limits for both knees. 

The Veteran has consistently asserted that the VA examiner's findings were not adequate for rating purposes.  See, e.g., a June 2010 statement.  After reviewing the evidence of record, the Board agrees with his assessment. 

For example, while the April 2010 VA examiner found that the Veteran's ligament and meniscus testing were normal, the February 2010 statement from the Veteran's private physician noted that the Veteran had a "complex tear of the medial meniscus" and "possibly a partial tear of his anterior cruciate ligament of his left knee."  This was based on an MRI performed in February 2010 prior to the filing of the Veteran's claim for increase and performance of the VA examination.  

An MRI performed in November 2011 also showed that the Veteran's right knee had a complex tear of the posterior horn of the medial meniscus and tricompartmental osteoarthritic changes.  The nature of these objective findings, in the Board's opinion, would also serve to document the recorded history of his having chronic right knee manifestations including flare ups and episodes of effusion over a period of time.  

With respect to the range of motion noted at the time of the April 2010 VA examination, the record included a self-report of medical history that the Veteran completed several weeks before the examination.  In this report, the Veteran once again identified his disability picture as including an inability to bend his knees and symptoms of weakness, swelling, pain, giving way, lack of endurance, locking and subluxation. 

In a December 2011 letter, E.L., M.D., first documented that the Veteran's right knee extension was limited to 20 degrees and his left knee extension was limited to 25 degrees.  It was also noted that the Veteran "ha[d] a great deal of discomfort" in doing minimal tasks. 

A private treatment record from February 2012 stated that the Veteran's bilateral knee extension was limited to 20 degrees.  It was also reported that the Veteran was extremely uncomfortable and that his knees "limited . . . his function."  It was noted that there was effusion involving both knees. 

To the extent that the April 2010 VA examination did not identify any actual limitation of motion or effusion referable to either knee, the private treatment records clearly indicated that the Veteran has recurrently demonstrated a significant decrease in extension of both knees prior to the assigned effective date of February 2, 2012.  

Further, for the period prior to the filing of his claim, the private treatment records and the Veteran's recorded VA examination history tend to establish that the Veteran experienced difficulty rising from a seated position, was limited in his ability to stoop or bend, and walked with an altered gait.  He reported not being able to walk up stairs, stand for periods of time, or carry weights. 

The Veteran is competent to report persistent pain, limitation of motion, and the functional impact of his bilateral knee disability.  See Falzone v. Brown, 8 Vet.App. 398, 405 (1995)(lay person competent to testify to pain and visible flatness of his feet).  It is the Board's fundamental responsibility to evaluate the probative value of all evidence. Owens v. Brown, 7 Vet.App. 429 (1995); Gabrielson v. Brown, 7 Vet.App. 36 (1994).  

In the evaluation of evidence, VA adjudicators may properly consider internal inconsistency, facial plausibility and consistency with other evidence submitted on behalf of the veteran. Caluza v. Brown, 7 Vet.App. 498 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curiam) (table); see Madden v. Brown, 125 F.3d 1447, 1481 (Fed. Cir. 1997) (holding that the Board has the "authority to discount the weight and probative value of evidence in light of its inherent characteristics in its relationship to other items of evidence."). 

Accordingly, based on this record, the Board's review of the evidence shows that the service-connected bilateral knee disability picture manifested by a functional loss due to pain and episodes of effusion more nearly approximated that of extension restricted to 20 degrees for the period prior to filing of claim for increase, beginning on March 30, 2009.  

The Veteran's reports as to having both pain and a limitation of function related to effusion or other flare ups involving each knee are found to be credible and generally consistent throughout the period of the appeal and for some time prior to the filing of the Veteran's claim for increase.  

In considering the Veteran's statements concerning physical limitations due to pain and effusion in his knees, and given the objective finding recorded over the course of the appeal, the Board finds it to be factually ascertainable that an increase in disability had occurred no earlier than March 30, 2009, even though the bilateral knee problems were noted to have "been present for many years." 

Hence, an effective date of March 30, 2009, for the assignment of the 30 percent disability rating for the service-connected degenerative joint disease of each knees is granted.


ORDER

An earlier effective date of March 30, 2009, for the assignment of a 30 percent disability rating for the service-connected degenerative joint disease of the right knee is granted. 

An earlier effective date of March 30, 2009, for the assignment of a 30 percent disability rating for the service-connected degenerative joint disease of the left knee is granted. 


REMAND

After having carefully considered the matter, and for reasons expressed hereinbelow, the Board finds that the issue of entitlement to a TDIU rating must be remanded for further development.  

As an initial matter, the Board observes that the Veteran has not received notice pursuant to VCAA as it pertains to this issue.  If, as here, the record has a procedural defect with respect to the notice required under VCAA, this may not be cured by the Board.  Disabled American Veterans v. Secretary of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003). The Board must remand this claim to the agency of original jurisdiction to provide the Veteran with adequate VCAA notice.  Dingess v. Nicholson, 19 Vet. App. 473 (2006); 38 U.S.C.A. §§ 5103, 5103A (West 2002); and 38 C.F.R. § 3.159 (2010).  

Further, as the RO has not addressed the claim for a TDIU rating, this issue must be remanded for initial consideration by the RO. See Bernard v. Brown, 4 Vet.App. 384 (1993).

Accordingly, this remaining matter is REMANDED for the following action:

1. The RO should issue to the Veteran and his attorney a VCAA notice letter pertaining to the issue of entitlement to a TDIU rating in accordance with applicable legal precedent, including 38 U.S.C.A. §§ 5102, 5103, and 5103A (West 2002) & 38 C.F.R. § 3.159 (2012).  

2.  Then, the RO should have the Veteran scheduled a VA examination to evaluate the severity of his service-connected disabilities.  The claims folder, including a copy of this decision, should be made available to, and should be reviewed by, the examiner in conjunction with the examination.  All indicated studies or testing should be conducted.  In this capacity, the examiner is advised that the Veteran is currently service connected for degenerative joint disease of the right and left knees (each evaluated as 30 percent disabling), degenerative disc disease of the lumbar spine (evaluated as 20 percent disabling), and a residual scar of the sternum (evaluated at noncompensable level).

After reviewing the entire record and examining the Veteran, the VA examiner should opine as to whether, without regard to age or the impact of any nonservice-connected disabilities, there is a 50 percent probability or greater that the service-connected disabilities, either alone or in the aggregate, preclude him securing and following substantially gainful employment (more than marginal) consistent with his educational background and employment experience.

A complete rationale for any opinion expressed and conclusion reached should be set forth in a legible report.

3. After completing all indicated development, the RO should readjudicate the claim remaining on appeal in light of all the evidence of record.  If any benefit sought on appeal remains denied, the Veteran and his attorney should be furnish a fully responsive Supplemental Statement of the Case and afforded a reasonable opportunity for response.  

Thereafter, if indicated, the case should be returned to the Board for the purpose of appellate disposition.  

The Veteran has the right to submit additional evidence and argument on the matter 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 or by the Court 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).



______________________________________________
STEPHEN L. WILKINS
Veterans Law Judge, 
Board of Veterans' Appeals

Department of Veterans Affairs