Citation Nr: 1323209 Decision Date: 07/19/13 Archive Date: 07/24/13 DOCKET NO. 08-36 163 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Honolulu, Hawaii THE ISSUES 1. Entitlement to service connection for hypertension. 2. Entitlement to service connection for the residuals of a shell fragment wound. 3. Entitlement to service connection for a lumbar spine disability. REPRESENTATION Veteran represented by: Vietnam Veterans of America ATTORNEY FOR THE BOARD Terrence T. Griffin, Counsel INTRODUCTION The Veteran, who is the appellant, served on active duty from May 1964 to May 1966. These matters are before the Board of Veterans' Appeals (Board) on appeal of a rating decision in November 2007 of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2010, the Board remanded the claims, but further development is needed. VA records show that in August 2007 a CT scan showed coronary and aortic atherosclerosis, raising the claim of service connection under 38 C.F.R. § 3.309(e), which is referred to the RO for appropriate action. The appeal is REMANDED to the RO via the Appeals Management Center in Washington, DC. REMAND A decision on the claim of service connection for hypertension is deferred until the other claims on appeal are finally adjudicated. On the claim of service connection for residuals of a shell fragment wound, in March 2011 on VA examination, the VA examiner described a scar on the left upper chest wall, but the examiner was unable to state that the scar was due to a fragment wound without resort to speculation, because there was insufficient evidence in the record. On the claim of service connection for a lumbar spine disability, in March 2011 on VA examination, the diagnosis was degenerative joint disease. The VA examiner expressed the opinion that the disability was less likely than not the result of service, because there was no medical evidence in the service treatment records to support the claim. As the Board must consider all reasonably raised theories of service connection and as the VA examinations are insufficient to decide the claims, further development under the duty to assist is needed. Accordingly, the case is REMANDED for the following action: 1. Afford the Veteran an examination by a VA examiner, who has not previously examined the Veteran, to determine: Whether it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability of less than 50 percent) that a scar on the left upper chest wall is related to an injury in service? In formulating the opinion, the VA examiner is asked to comment on the following: In service, the Veteran served in Vietnam for seven months as an infantryman. The Veteran is competent to describe an injury even though there is no record of an injury in the service treatment records. The Board finds that the history provided by the Veteran is credible and consistent with the circumstances of his service. The Veteran's file must be made available to the VA examiner for review. 2. Afford the Veteran an examination by a VA examiner, who has not previously examined the Veteran, to determine: Whether it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability of less than 50 percent) that degenerative joint disease of the lumbar spine is related to an injury in service? In formulating the opinion, the VA examiner is asked to comment on the following: In service, the Veteran had airborne training and he served in Vietnam for seven months as an infantryman. The Veteran is competent to describe symptoms of an injury even though there is no record of an injury in the service treatment records. The Board finds that the history provided by the Veteran is credible and consistent with the circumstances of his service. After service, chronic back pain was first documented by VA in June 2007. The Veteran's file must be made available to the VA examiner for review. 3. After the requested development is completed adjudicate the claims of service connection for residuals of a shell fragment wound and for a lumbar spine disability on the merits. If additional evidence is received on the claim of service connection for hypertension, the claim should also be adjudicated. If any benefit is denied, then provide the Veteran and his representative a supplemental statement of the case and return the case to the Board. 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). The claims 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). _________________________________________________ George E. Guido Jr. 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).