Citation Nr: 1322322 Decision Date: 07/12/13 Archive Date: 07/18/13 DOCKET NO. 10-46 626 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for prostate cancer, to include as due to exposure to herbicides. 2. Entitlement to restoration of a 30 percent disability rating for service-connected bilateral hand eczema, claimed as a skin condition. (The issues of entitlement to service connection for the loss of two top teeth, for dental treatment purposes; entitlement to an initial disability rating greater than 30 percent for service-connected mood disorder prior to August 19, 2010, and greater than 50 percent since then; entitlement to an initial compensable disability rating for scarring on the penis shaft prior to September 9, 2010, and greater than 10 percent since then; and entitlement to a total disability rating based on individual unemployability, are the subject of a separate appellate decision.) REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. Orfanoudis, Counsel INTRODUCTION The Veteran had active service from October 1972 to October 1974. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2008 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO), in St. Petersburg, Florida, that reduced a 30 percent disability rating for service-connected bilateral hand eczema, claimed as a skin condition, to zero percent, effective as of September 1, 2008. This matter also arises from a March 2009 rating decision of the RO that denied service connection for prostate cancer, to include as due to exposure to herbicides. The Veteran expressed disagreement with the reduction and the denial of service connection, and perfected a substantive appeal. In June 2012, the Veteran testified at a personal hearing over which the undersigned Veterans Law Judge presided while at the RO. A transcript of that hearing has been associated with the claims file. 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 June 2012 hearing and at a prehearing conference, the undersigned clarified the issues on appeal and inquired as to the etiology, continuity, and severity 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 Bryant. The Board notes that during the June 2012 hearing, the Veteran also presented testimony on the issues of service connection for the loss of two top teeth, an increased disability rating for service-connected mood disorder, and an increased disability rating for service-connected scarring on the penis shaft. As testimony had previously been presented on these issues before a second Veterans Law Judge, those issues are being decided in a separate decision by a panel of three Veterans Law Judges. See 38 U.S.C. § 7107 (West 2002); 38 C.F.R. §§ 19.3, 20.707 (2012); see also Arneson v. Shinseki, 24 Vet. App. 379, 386 (2011). In addition to the paper claims file, there is a Virtual VA paperless claims file associated with the Veteran's claim. A review of the documents in such file reveals that they are either duplicative of the evidence in the paper claims file or are irrelevant to the issues on appeal. The issue of service connection for prostate cancer and entitlement to a disability rating greater than 30 percent for service-connected bilateral hand eczema, claimed as a skin condition, are addressed in the REMAND portion of the decision below and are REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDINGS OF FACT 1. Service connection for the Veteran's skin disability was granted by rating action dated in March 2006, at which time an initial 30 percent disability rating was assigned effective as of March 28, 2005. 2. Following a September 2007 VA examination, the RO proposed to reduce the rating for the service-connected skin disability from 30 percent to noncompensable. The Veteran was informed of the proposal in accordance with 38 C.F.R. § 3.105(e) by letter dated November 19, 2007. 3. Following a May 2008 VA examination, by rating action dated in June 2008, the RO implemented a reduction to zero percent for the service-connected skin disability, effective September 1, 2008. Notice of the reduction was sent to the Veteran on June 18, 2008. 4. Evidence available at the time of the rating reduction did not reflect improvement in the service-connected skin disability as the September 2007 and May 2008 findings of the VA examinations were inadequate; there was no showing that symptoms had improved such that the Veteran no longer met the criteria for a 30 percent disability rating. CONCLUSION OF LAW Reduction of the disability rating for the bilateral hand eczema, claimed as a skin condition, was improper, and the criteria for restoration of an initial 30 percent disability rating have been met. 38 U.S.C.A. §§ 1155, 5103, 5107, 5112 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.105, 4.71a, Diagnostic Code 7806 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSION VA's Duty to Notify and Assist VA has specified duties to notify a claimant as to the information and evidence necessary to substantiate a claim for VA benefits. The Board has considered whether further development and notice under the Veterans Claims Assistance Act of 2000 (VCAA) or other law should be undertaken. In the decision below, the Board restores an initial 30 percent disability rating for the Veteran's service-connected bilateral hand eczema, claimed as skin condition. Given the results favorable to the Veteran, further development under the VCAA or other law would not result in a more favorable outcome or be of assistance to this inquiry. Reduction of the Disability Rating for the Skin Disability The Veteran asserts that his skin disability had not improved since the establishment of service connection in March 2006, wherein an initial 30 percent disability rating had been assigned effective as of March 28, 2005, as he has continued to experience chronic symptoms. Specifically, he asserts that the nature of his disability is such that it is not static in nature, but rather manifested by periods of flare-ups followed by inactivity. Generally, a Veteran's disability rating shall not be reduced unless an improvement in the disability is shown to have occurred. 38 U.S.C.A. § 1155 (West 2002). Prior to reducing a Veteran's disability rating, VA is required to comply with several general VA regulations applicable to all rating-reduction cases, regardless of the rating level or the length of time that the rating has been in effect. Generally, when reduction in the rating of a service-connected disability is contemplated and the lower rating would result in a reduction or discontinuance of compensation payments, a rating proposing the reduction or discontinuance will be prepared setting forth all material facts and reasons. The beneficiary must be notified at his latest address of record of the contemplated action and furnished detailed reasons therefore. The beneficiary must be given 60 days for the presentation of additional evidence to show that compensation payments should be continued at the present level. 38 C.F.R. § 3.105(e) (2012). In the advance written notice, the beneficiary will be informed of his right for a pre-determination hearing, and if a timely request for such a hearing is received within 30 days, benefit payments shall be continued at the previously established level pending a final determination. 38 C.F.R. § 3.105(i)(1) (2012). The record reflects that in a November 2007 letter, the Veteran was notified of a proposal to reduce the disability rating assigned for his skin disability. He was additionally notified that he had 60 days for the presentation of additional evidence to show that compensation payments should be continued at the present level, and that if he did not respond within those 60 days, his disability rating would be reduced. The record reflects that the Veteran did respond and presented testimony at a pre-determination hearing in March 2008. Evaluating the chronology of the process described above, the Board finds that the RO complied with the procedures required under 38 C.F.R. § 3.105(e) for reducing the Veteran's disability rating by notifying him of his rights and giving him an opportunity for a hearing and time to respond. In certain rating reduction cases, VA benefits recipients are to be afforded greater protections. 38 C.F.R. § 3.344(a)(b) (2012). Those regulations provide that rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability ratings consistent with the laws and VA regulations governing disability compensation and pension. However, the provisions of 38 C.F.R. § 3.344(c) specify that those considerations are applicable for ratings that have continued for long periods at the same level (five years or more), and that they do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant a reduction in rating. Similar protections are afforded to Veterans who have been awarded a total rating based on unemployability. 38 C.F.R. § 3.343 (2012). Under those criteria regarding reductions, the RO must find the following: (1) based on a review of the entire record, the examination forming the basis for the reduction is full and complete, and at least as full and complete as the examination upon which the rating was originally based; (2) the record clearly reflects a finding of material improvement; and (3) it is reasonably certain that the material improvement found will be maintained under the ordinary conditions of life. 38 C.F.R. § 3.344(a),(b) (2012); Kitchens v. Brown, 7 Vet. App. 320 (1995); Brown v. Brown , 5 Vet. App. 413 (1993). In this case, however, the 30 percent disability rating for the skin disability was in effect for less than five years, from March 28, 2005, to August 31, 2008. Therefore, the provisions of 38 C.F.R. § 3.344(a) and 38 C.F.R. § 3.344(b) are not applicable. 38 C.F.R. § 3.344(c) (2012). An examination disclosing improvement will, therefore, warrant reduction in the rating. 38 C.F.R. § 3.344(c) (2012). The question is, thus, whether an examination had shown an improvement warranting reduction of the rating. Disability ratings are intended to compensate impairment in earning capacity due to a service-connected disorder. 38 U.S.C.A. § 1155. Separate diagnostic codes identify the various disabilities. Id. It is necessary to rate the disability from the point of view of the Veteran working or seeking work, 38 C.F.R. § 4.2, and to resolve any reasonable doubt regarding the extent of the disability in the Veteran's favor. 38 C.F.R. § 4.3. If there is a question as to which disability rating to apply to the Veteran's disability, the higher rating will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In considering the severity of a disability, it is essential to trace the medical history of the Veteran. 38 C.F.R. §§ 4.1, 4.2, 4.41 (2012). Consideration of the whole-recorded history is necessary so that a rating may accurately reflect the elements of disability present. 38 C.F.R. § 4.2 (2012); Peyton v. Derwinski, 1 Vet. App. 282 (1991). While the Veteran's entire history is reviewed when assigning a disability rating, 38 C.F.R. § 4.1, where service connection has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55 (1994). When, however, appealing the initial assignment of a disability rating, the severity of the disability is to be considered during the entire period from the initial assignment of the disability rating to the present time. Fenderson v. West, 12 Vet. App. 119 (1999). Additionally, in determining the present level of a disability for any increased rating claim, the Board must consider the application of staged ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007). In other words, where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibited diverse symptoms meeting the criteria for different ratings during the course of the appeal, the assignment of staged ratings would be necessary. The assignment of a particular diagnostic code is "completely dependent on the facts of a particular case." See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the current diagnosis and demonstrated symptomatology. Any change in a diagnostic code by VA must be specifically explained. Pernorio v. Derwinski, 2 Vet. App. 625 (1992). Words such as "moderate," "moderately severe," and "severe" are not defined in the Rating Schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to the end that its decisions are "equitable and just." 38 C.F.R. 4.6 (2012). Use of terminology such as "severe" by VA examiners and others, although evidence to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6 (2012). It is possible for a Veteran to have separate and distinct manifestations from the same injury that would permit rating under several diagnostic codes; however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994); 38 C.F.R. § 4.14 (2012) (precluding the assignment of separate ratings for the same manifestations of a disability under different diagnoses). At the time of the reduction, the Veteran's service-connected eczema was rated under 38 C.F.R. § 4.118, Diagnostic Code 7806, which provides the rating criteria for dermatitis or eczema. At that time, a 10 percent disability rating was assigned where at least five percent but not more than 20 percent of the entire body is affected, or at least five percent, but less than 20 percent of exposed areas are affected, or; intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs is required for a total duration of less than six weeks during the twelve month period. A 30 percent disability rating was assigned where 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas are affected, or; systemic therapy such as corticosteroids or other immunosuppressive drugs is required for a total duration of six weeks or more, but not constantly, during a twelve month period. The maximum 60 percent disability rating was assigned when more than 40 percent of the entire body or more than 40 percent of exposed areas are affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs is required during a twelve month period. 38 C.F.R. § 4.118, Diagnostic Code 7806 (effective August 30, 2002). At the time of the March 2006 rating decision, the evidence of record included a VA outpatient treatment record dated in November 2004 shows that the Veteran was treated for hand dermatitis. Physical examination revealed fissuring over hyperkeratitic plaques. The assessment was hand dermatitis. A VA skin examination report dated in December 2005 that showed that the Veteran exhibited generalized papulosquamous lesions, scaling, and plaques over both hands with right more than left. The lesions were said to affect 20 to 40 percent of the exposed area, but less than five percent of the total body. The examiner added that hand eczema can be very painful when wet or very dry, so chores involving water would aggravate the condition. Also, taking showers and baths could be painful when the eczema on the hands had many fissures (tiny cracks). In an addendum dated in December 2005, the VA examiner indicated that hand eczema often started at age 20 to 30, and would continue with periods of remissions through life. The examiner added that the current condition was the same as experienced in service. In light of the foregoing, an initial 30 percent disability rating was awarded in March 2006 as the disability encompassed 20 to 40 percent of the affected area as required by Diagnostic Code 7806. A VA outpatient treatment record dated in December 2006 shows that physical examination of the Veteran's hands showed no scale, erythema, or fissures. A VA skin examination report dated in September 2007 shows that the Veteran was said to have progressive rash on his hands, manifested by dryness, itching, scaling, flaking, peeling, and outbreaks. The duration over the preceding 12 months was said to be constant. He was being treated twice daily with a topical corticosteroid. Physical examination revealed some areas of brown patches and dryness to the bilateral hand that extended to a little above each wrist. The examiner indicated that the disability affected less than five percent of the exposed areas, and less than five percent of the total body. The diagnosis was bilateral hand eczema. The examiner noted that during periods of exacerbations, he had increased itching and discomfort, and that when shaking people's hands, he would feel uncomfortable due to the appearance of his hands and scaling. In November 2007, the RO proposed to reduce the disability rating for the service-connected skin disability from 30 percent to noncompensable. A VA outpatient treatment record dated in December 2007 shows that the physical examination of the Veteran's hands revealed xerosis and mild scaling, but no erythema or fissures. The assessment was chronic hand dermatitis. Continued treatment with topical corticosteroids was indicated. During a March 2008 personal hearing at the RO, the Veteran indicated that his skin disability had not improved since the establishment of service connection in March 2006, and that he continued to experience chronic symptoms. Specifically, he asserted that the nature of his disability was such that it was manifested by periods of flare-ups followed by inactivity. A VA outpatient treatment record dated in March 2008 shows that the Veteran reported chronic hand dermatitis with limited improvement. Physical examination revealed severe xerosis and x2 shallow erosions on the dorsal aspect. There were no fissures. There was minimal palmar involvement. The assessment was hand dermatitis. He was directed to stop using hand sanitizer; to use aquaphor ointment after every hand washing to dorsal hands; and to use triamcinolone soak and smear every night and every morning. A VA dermatology note dated in April 2008 shows that the Veteran was treated for continued hand dermatitis. He indicated that he would like to start a pill to help prevent his hand dermatitis from flaring, as he was currently using many topical corticosteroids. The examiner indicated that he spoke to the Veteran at length noted that the condition was too mild to start systemic medications (Soriatane) due to the risk of liver function abnormalities and the need for monthly monitoring. A VA skin examination report dated in May 2008 shows that the Veteran was said to have chronic dermatitis of the hands manifested by constant itching, scaling, peeling, and intermittent open excoriations. Flare-ups were said to develop with increasing frequency lasting for weeks at a time. There were no precipitating factors. Topical medication would clear the symptoms temporarily. The disorder would predominantly affect the hands. There was no scarring. The Veteran was being treated with multiple constant topical corticosteroids over the preceding 12 months. The examiner indicated that the disability affected zero percent of the exposed area, and less than five percent of the total body. The diagnosis was hand dermatitis currently in remission. In June 2008, the RO implemented the reduction to zero percent for the service-connected skin disability, effective September 1, 2008. During his June 2012 hearing, the Veteran reiterated that his skin disability had not improved since the establishment of service connection, and that he continued to experience chronic symptoms. He added that he continued to use regular corticosteroids for treatment. Having considered the evidence of record in this case, the Board finds that the reduction from 30 percent to a zero percent disability rating was not proper, and a restoration of the 30 percent rating is warranted. There are two essential bases for the Board's finding. First, the Board finds that the September 2007 and May 2008 VA examination reports are of limited probative value. In this regard, the Board finds that the September 2007 finding that the symptoms affected only five percent of the exposed area to be inconsistent with the findings that the Veteran's symptoms were progressive and manifested by dryness, itching, scaling, flaking, peeling, and outbreaks requiring constant corticosteroid treatment. Moreover, the symptoms were said to extent from the hands to each wrist. This would appear to cover at the very least more than five percent of the affected area. The Board finds that May 2008 examination report to be similarly inconsistent on its face as the examiner concluded that the disability affected zero percent of the exposed area, while also indicated that the symptoms encompassed the hands and were manifested by constant itching, scaling, peeling, and intermittent open excoriations. Second, the Board finds that a review of the evidence does not reveal that an improvement in the disability had actually occurred at the time of the reduction. While the Board recognizes that the affected areas indicated by the examiners in September 2007 and May 2008 are less than that reported by the examiner in December 2005, a review of the medical evidence taken as a whole does not support the conclusion that this was a material or sustained improvement in the underlying disability. Notably, the examiner in December 2005 indicated that the disability affected 20 to 40 percent of the exposed areas. The examiner also specifically established that the hand eczema would continue with periods of remissions throughout his life. The VA outpatient treatment records and the Veteran's testimony have exhibited chronic disability with periods of flare-ups followed by brief remission, even with the use of multiple corticosteroids. It is apparent that the September 2007 and May 2008 VA examinations were not conducted during an active period of the disability. When a claimant's medical history indicates that his condition undergoes periods of remission and recurrence, VA is required to provide a medical examination during the period of recurrence in order to provide a proper disability rating. See Ardison, v. Brown, 6 Vet. App. 405, 407 (1994). It is clear that this was not done in the Veteran's case prior to his disability rating being reduced. As such, the Board finds that the VA examinations which were the basis for reducing the disability rating were inadequate. Because the reduction determination was based on inadequate examinations that were conducted at times when the disability was not in an active stage, the Board finds that it has not been shown by a preponderance of the evidence that a reduction was warranted. See Kitchens, 7 Vet. App. at 320. Therefore, restoration of the 30 percent disability rating, effective September 1, 2008, is warranted. ORDER Restoration of an initial 30 percent disability rating for service-connected bilateral hand eczema, claimed as a skin condition, is granted. REMAND After carefully considering this matter, and for reasons expressed immediately below, the Board believes that the issues of entitlement to a disability rating greater than 30 percent for service-connected bilateral hand eczema and service connection for prostate cancer must be remanded for further development of the record. The Board regrets the delay associated with this remand, however, a remand is necessary to ensure that the Veteran is accorded full compliance with the statutory duty to assist. Although the Board has established in this decision that restoration of a 30 percent disability rating is warranted for the service-connected bilateral hand eczema, additional development is necessary with regard to whether the Veteran is entitled to an even higher disability rating. In this regard, the most recent VA skin examination for evaluation of the bilateral hand eczema was in May 2008. This examination was more than five years ago, and was not conducted during an active stage of the Veteran's disability. In light of the foregoing, the Board finds that a contemporaneous examination should be conducted during an active stage of the Veteran's disability. See Allday v. Brown, 7 Vet. App. 517, 526 (1995) (where the record does not adequately reveal current state of claimant's disability, fulfillment of statutory duty to assist requires a contemporaneous medical examination-particularly if there is no additional medical evidence that adequately addresses the level of impairment of the disability since the previous examination); Caffrey v. Brown, 6 Vet. App. 377, 381 (1994) (the Board should have ordered a contemporaneous examination of the Veteran because a 23-month old examination was too remote in time to adequately support the decision in an appeal for an increased rating). With regard to the issue of service connection for prostate cancer, the Veteran asserts that he was exposed to herbicides in Germany as certain herbicides had been used to clear fields and to create improvised air fields where he was undergoing infantry training during his period of active service. Although a VA Request For Information (VA Form 3101) dated in June 2008 suggests that the Veteran had no records of exposure to herbicides during his period of active service, it does not appear than an effort was undertaken to further verify the Veteran's assertion, to include obtaining morning reports or other documentation that may support this claimed exposure. As such, the claim must be remanded to attempt to verify whether the Veteran was exposed to herbicide agents while serving in Germany during his period of active service. In this endeavor, a detailed description of the Veteran's asserted exposure must be forwarded to the VA Compensation and Pension (C&P) Service to request a review of the Department of Defense (DOD) inventory of herbicide operations to determine whether herbicides were used as the Veteran has alleged, including at all locations at which he claims to have been exposed to herbicides. If C&P Service's review confirms that herbicides were used as alleged, then a determination must be made as to whether service connection is in order. Finally, as this matter is being remanded for the reasons set forth above, any additional VA treatment records of the Veteran for his bilateral hand eczema and prostate cancer should also be obtained. See 38 U.S.C.A. § 5103A(b), (c); 38 C.F.R. § 3.159(b); see also Bell v. Derwinski, 2 Vet. App. 611 (1992) (VA medical records are in constructive possession of the agency, and must be obtained if the material could be determinative of the claim). Accordingly, the case is REMANDED for the following action: 1. The RO/AMC shall contact the appropriate VA medical facilities and attempt to obtain medical treatment records pertaining to the Veteran that are not yet associated with the claims file, to specifically include treatment for his bilateral hand eczema and prostate cancer. All records obtained must be associated with the Veteran's claims file. 2. The RO/AMC shall ask the Veteran to provide any additional information on his alleged herbicide exposure while serving in Germany, including the date(s), location(s), and/or nature of any potential exposures. He should also be invited to submit statements from fellow service members to support his allegations of herbicide exposure. 2. The RO/AMC shall follow the procedures provided in the Veteran's Benefits Administration Manual M21-1 MR, Part IV, Subpart ii, 2.C.10.o-p, for verification of any herbicide exposure claimed by the Veteran while he was stationed in Germany during his period of active service. All herbicide (as defined by regulation) use at each location should be researched for the pertinent time periods. 3. The RO/AMC shall undertake any necessary development to independently verify the Veteran's assertion that he was exposed to herbicide agents, to include Agent Orange, during his tour of duty in Germany, including contacting the United States Army and Joint Services Records Research Center (JSRRC) or other appropriate agency to obtain morning reports or other relevant documentation. Any additional action necessary, including follow-up action requested by the contacted entity, should be accomplished. If the search for corroborating information leads to negative results, the RO/AMC must notify the Veteran and his representative of this fact, explain the efforts taken to obtain this information and describe any further action to be taken. 4. The RO/AMC shall schedule the Veteran for a VA skin disorders examination to determine the current severity of his bilateral eczema of the hands. The examination must be undertaken during an ACTIVE stage of the disability. The claims file, including a complete copy of this remand, must be made available to the designated examiner for a review of the Veteran's pertinent medical history. All necessary testing and evaluation should be completed. The examination report should set forth all objective findings regarding these service-connected disabilities. The examiner must also make specific clinical findings in assessing the Veteran's bilateral eczema of the hands: (1) the percentage of the entire body that is affected; (2) the percentage of the exposed areas of the body that is affected; and (3) whether treatment of the dermatitis requires treatment by systemic therapy, such as corticosteroids or other immunosuppressive drugs, and if so, the annual duration in weeks that is required. The examiner is also asked to comment on the impact of the claimed increase in severity of the Veteran's disability, if any, on the his employment and activities of daily life. A complete rationale for any opinion expressed shall be provided. 5. The RO/AMC will then readjudicate the Veteran's claims. If the benefits sought on appeal remain denied, the Veteran and his representative should be provided with a Supplemental Statement of the Case. An appropriate period of time should be allowed for response. Thereafter, if appropriate, the case is to be returned to the Board, following applicable appellate procedure. The Veteran need take no action until he is so informed. He 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). The purposes of this remand are to obtain additional information and comply with all due process considerations. No inference should be drawn regarding the final disposition of this claim as a result of this action. This claim must be afforded expeditious treatment. The law requires that 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). ______________________________________________ JAMES L. MARCH Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs