Citation Nr: 1320898 Decision Date: 06/28/13 Archive Date: 07/05/13 DOCKET NO. 09-42 774 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to service connection for bilateral knee disabilities claimed as arthritis. 2. Entitlement to service connection for bilateral hand disabilities claimed as arthritis. 3. Entitlement to service connection for a back disability (claimed as middle back condition). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD C. Eckart, Counsel INTRODUCTION The Veteran served on active duty from March 1969 to January 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a September 2008 rating decision of the Nashville Tennessee, regional office (RO) of the Department of Veterans Affairs (VA) which denied service connection for the above claimed disabilities. The issue of entitlement to an increased rating for ischemic heart disease has been raised by the record in an informal claim of June 2012 located in the electronic record, but has not been adjudicated by the Agency of Original Jurisdiction (AOJ). Therefore, the Board does not have jurisdiction over it, and it is referred to the AOJ for appropriate action. Additional evidence was associated in the electronic record since the most recent adjudication by the AOJ, without a written waiver of AOJ review. See 38 C.F.R. § 20.1304. Based on the duplicative, irrelevant, and/or cumulative nature of each of this additionally submitted evidence, there is no prejudice to the Veteran for the Board to proceed with decisions on the merits of the Veteran's claims without initial AOJ consideration, or without obtaining a waiver of this consideration. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran's DD-214 reflects that he served as a general construction machine operator. Service treatment records show that in January 1970, he was struck in the middle of his lower back by a rock, with pain, tenderness and some swelling in that area. No laceration or bone damage was apparent. A January 1971 note described back pain as the result of an accident that recurred approximately 0100 hours. He was assessed with complaints of back pain continuing. The records are silent for any complaints of knee or hand problems. A January 1972 statement of medical condition revealed there was no change in his medical condition since his separation examination. The actual separation examination itself is not of record. On file is an April 2009 letter from B.W., NP, who noted that the Veteran's pertinent medical problems included multiple past orthopedic injuries with chronic osteoarthritis of the spine, both knees and both hands. She opined that the Veteran has extensive osteoarthritis with daily stiffness and pain in his spine and multiple other joints which may possibly be related to past operation of heavy construction equipment, his assigned duties during military service. The record shows that the Veteran has not been afforded a VA examination with respect to the disorders at issue. Under the circumstances, the Board finds that such an examination is necessary in this case. Accordingly, the case is REMANDED for the following actions: 1. Schedule the Veteran for a VA orthopedic examination to determine the nature and etiology of any right or left knee, right or left hand, and back disability. The claims file must be provided to the examiner for review in connection with the examination. With respect to each right and/or left knee disorder identified by the examiner, the examiner should provide an opinion as to whether it is at least as likely as not that such disability is etiologically related to service or was manifest within one year of service discharge. With respect to each right and/or left hand disorder identified by the examiner, the examiner should provide an opinion as to whether it is at least as likely as not that such disability is etiologically related to service or was manifest within one year of service discharge. With respect to any back disorder identified by the examiner, the examiner should provide an opinion as to whether it is at least as likely as not that such disability is etiologically related to service or was manifest within one year of service discharge. A complete rationale for each opinion offered should be provided. 2. Thereafter, and after undertaking any other development action deemed necessary, the RO/AMC should readjudicate the issues on appeal. If the benefits sought on appeal are not granted in full the RO/AMC should issue a supplemental statement of the case and should provide the Veteran and his representative an opportunity to respond. After the Veteran and his representative have been given an opportunity to respond to the supplemental statement of the case, and the period for submission of additional information or evidence set forth in 38 U.S.C.A. § 5103(b) (West 2002) has expired, if applicable, the case should be returned to the Board for further appellate consideration, if otherwise in order. By this remand, the Board intimates no opinion as to any final outcome warranted. The appellant and his representative have the right to submit additional evidence and argument on the matters the Board has remanded to the RO. Kutscherousky v. West, 12 Vet. App. 369 (1999). This case must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board 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). _________________________________________________ Thomas H. O'Shay Acting 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).