Citation Nr: 1323831 Decision Date: 07/26/13 Archive Date: 08/06/13 DOCKET NO. 09-13 998 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUES 1. Entitlement to service connection for shrapnel wound residuals of the stomach. 2. Entitlement to service connection for a back condition. 3. Entitlement to service connection for hearing loss. 4. Entitlement to service connection for tinnitus. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Catherine Cykowski, Counsel INTRODUCTION The Veteran had active duty service from June 1968 to January 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. In August 2009, the Veteran testified at a hearing before a VA Decision Review Officer. A transcript of the hearing is of record. The issue of entitlement to service connection for a back condition is addressed in the REMAND portion of the decision below and is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. FINDINGS OF FACT 1. The Veteran does not have a current disability of shrapnel wound residuals of the stomach. 2. The Veteran experienced acoustic trauma in service. 3. The Veteran did not sustain a disease or injury (other than acoustic trauma) of the bilateral ears in service. 4. Symptoms of bilateral hearing loss were not chronic in service. 5. Symptoms of bilateral hearing loss did not manifest to a compensable degree within one year of separation. 6. Symptoms of bilateral hearing loss have not been continuous since service separation. 7. The weight of the evidence demonstrates that the Veteran's tinnitus is not etiologically related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for shrapnel wound residuals of the stomach have not been met. 38 U.S.C.A. §§ 1101, 1110, 1154, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2012). 2. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C.A. §§ 1110, 1154, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309, 3.385 (2012). 3. The criteria for service connection for tinnitus are not met. 38 U.S.C.A. §§ 1110, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.159, 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS VA's Duties to Notify and Assist As provided for by VCAA, VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2012). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice from VA must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide in accordance with 38 C.F.R. § 3.159(b)(1). This notice must be provided prior to an initial unfavorable decision on a claim by the AOJ, in this case the RO. Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006); Pelegrini v. Principi, 18 Vet. App. 112 (2004). In Dingess v. Nicholson, 19 Vet. App. 473 (2006), the United States Court of Appeals for Veterans Claims (Court) held that, upon receipt of an application for a service-connection claim, 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b) require VA 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, each of the five elements of the claim, including notice of what is required to establish service connection and that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. Here, the VCAA duty to notify was satisfied by way of a letter sent to the Veteran in June 2008. The letter informed the Veteran of what evidence was required to substantiate his service connection claims and of the Veteran's and VA's respective duties for obtaining evidence. The letter was provided prior to the rating decision on appeal. VA also has a duty to assist the Veteran in the development of the claim. This duty includes assisting the Veteran in the procurement of service medical records and pertinent treatment records and providing an examination when necessary. 38 U.S.C.A. § 5103A ; 38 C.F.R. § 3.159. The record indicates that the RO obtained all available information relevant to the Veteran's claim. The service treatment records have been obtained, as well as VA treatment records. In this case, the Veteran informed the RO that he was in receipt of benefit from the Social Security Administration (SSA). The RO attempted to obtain the Veteran's SSA records and was informed by SSA that the records were destroyed. In light of the response from the SSA, additional efforts to obtain the Veteran's SSA records would be futile. Moreover, the Veteran underwent adequate and probative VA medical examinations for his claims. 38 U.S.C. § 5103A(d) and 38 C.F.R. § 3.159(c)(4). The Board finds that all necessary development has been accomplished, and therefore appellate review may proceed without prejudice to the Veteran. See Bernard v. Brown, 4 Vet. App. 384 (1993). The RO has obtained relevant records, and has provided adequate examinations to the Veteran. Significantly, neither the Veteran nor his representative has identified, and the record does not otherwise indicate, any additional existing evidence that is necessary for a fair adjudication of the claims that has not been obtained. Hence, no further notice or assistance to the Veteran is required to fulfill VA's duty to assist the Veteran in the development of the claims. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd 281 F.3d 1384 (Fed. Cir. 2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); see also Quartuccio v. Principi, 16 Vet. App. 183 (2002). Service Connection Laws and Regulations Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship of nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996). Sensorineural hearing loss is a "chronic disease" listed under 38 C.F.R. § 3.309(a); therefore, the presumptive provisions of 38 C.F.R. § 3.303(b) based on chronic symptoms in service and continuous symptoms since service applies to the claim for hearing loss. Shrapnel wounds and tinnitus are not "chronic diseases" listed under § 3.309(a); therefore, 38 C.F.R. § 3.303(b) does not apply to the claims for service connection for shrapnel wound residuals and tinnitus. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease, at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303(b). Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases, such as sensorineural hearing loss, became manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 2002); 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within a presumptive period, it must be shown, by acceptable medical or lay evidence, that there were characteristic manifestations of the disease to the required degree during that time. Id. Where a veteran engaged in combat with the enemy while in active service, lay evidence shall be accepted as proof of in-service incurrence or aggravation. See 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d). See also Caluza v. Brown, 7 Vet. App. 498, 505 (1995). Furthermore, a veteran's assertions regarding an injury during combat shall be accepted if consistent with the circumstances of such service. See 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d). VA's General Counsel has interpreted that the ordinary meaning of the phrase "engaged in combat with the enemy," as used in 38 U.S.C.A. § 1154(b), requires that a veteran "have participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality." VAOPGCPREC 12-99. The VA General Counsel also indicated that the determination of whether a veteran engaged in combat with the enemy necessarily must be made on a case-by-case basis, and that absence from a veteran's service records of any ordinary indicators of combat service may, in appropriate cases, support a reasonable inference that he did not engage in combat; such absence may properly be considered "negative evidence" even though it does not affirmatively show that he did not engage in combat. Id. In rendering a decision on appeal the Board must also analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify"). Service Connection for Shrapnel Wound Residuals of the Stomach The Veteran asserts that he has residual shrapnel wounds of his stomach, which were incurred in service. The Board finds that the Veteran engaged in combat with the enemy. The DD Form 214 indicates that he served Vietnam and was awarded a Purple Heart, which is indicative of exposure to combat during his service. See 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d). The Board reiterates that, for the evidentiary presumption regarding combat to apply, injuries must be consistent with the circumstances of combat with the enemy; it is not enough to show combat exposure. Service treatment records reflect complaints for fragment wounds of the left wrist but do not reflect complaints or findings of a fragment wound of the stomach. A fragment wound of the left forearm was noted upon separation in January 1970. The separation examination did not note findings of a shrapnel wound of the stomach. In a statement in support of his claim in January 2009, the Veteran described a scar on the chest and stomach area. The Veteran indicated that the scar was caused by shrapnel when he was in Vietnam. He stated that he was treated at a hospital where they patched him up and told him that the shrapnel would work itself out. In the substantive appeal dated in April 2009, the Veteran reported that, the underlying tissue and scarring can be felt and is irritating. Upon VA examination in August 2008, the Veteran reported that his outfit came under mortar attack in 1969 in Vietnam. The Veteran reported that a shell exploded, and he was hit with shrapnel on his abdomen and left upper leg. The Veteran reported that he was driven to a field hospital, where his wounds were cleaned and debrided. The Veteran reported that he remained at the field hospital for 2 to 3 days before returning to his unit. The Veteran also reported that, in 1969, a 50-caliber gun exploded, and he sustained shrapnel to the right wrist. The Veteran reported that he was given first aid. The Veteran denied any treatment of his scars since 1969. The Veteran denied pain or discomfort from the scars. The Veteran reported that he could palpate the shrapnel in his left leg and right wrist. Upon physical examination, the VA examiner indicated that no scarring of the abdomen or chest was identified. The VA examiner noted that an x-ray of the abdomen in August 2008 showed that no metallic opacity was identified in the visualized portion. The Veteran had a VA examination in October 2010. The Veteran reported that he was hit by shrapnel when his outfit came under an enemy mortar attack. The Veteran reported that a shell exploded, and he was hit with shrapnel on his abdomen and left upper leg. The examiner indicated that scarring on the abdomen could not be identified. The VA examiner noted that there was an incidental finding of dermatitis over the entire chest and abdomen. VA outpatient treatment records do not reflect any diagnoses of residual shrapnel wounds of the stomach. In statements in support of his claim, the Veteran has asserted that there are several scars in his stomach and chest area. VA outpatient treatment records do not reflect findings of shrapnel wounds of the abdomen. Based on the evidence of record, the Board finds that service connection for shrapnel wounds of the stomach is not warranted. As noted above, the Veteran is a combat veteran, and therefore VA shall accept as sufficient proof of service connection satisfactory lay or other evidence of service incurrence. Therefore, although the Veteran's service records do not reflect shrapnel wounds of the stomach, there is no clear and convincing evidence to rebut his statements regarding such injuries. However, the weight of the evidence does not demonstrate that the Veteran has a current disability of residual shrapnel wounds of the stomach for which service connection can be granted. The Veteran is competent to report being hit by shrapnel and having shrapnel in his body. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 307 (2007) (noting that lay testimony is competent to establish observable symptomatology but not competent to establish medical etiology or render medical opinions). The Veteran's subjective complaints of scars are outweighed by the two VA examination reports, which both indicated that no scarring was identified. Therefore, the overall weight of the evidence is against finding that the Veteran has current scars on the stomach. For these reasons, the Board finds that the weight of the evidence demonstrates that the Veteran does not have a current disability of shrapnel wounds of the stomach. A present disability is a prerequisite to the granting of service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Therefore, the Board finds that the preponderance of the evidence is against the claim for service connection for shrapnel wounds of the stomach. As there is a preponderance of the evidence against the appeal for service connection for shrapnel wounds of the stomach, there remains no reasonable doubt to be resolved in the Veteran's favor. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. Service Connection for Hearing Loss In cases involving service connection for hearing loss, impaired hearing will be considered to be a disease when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385 (2012). After a review of all the evidence of record, lay and medical, the Board finds that the weight of the evidence demonstrates that, other than acoustic trauma, the Veteran did not sustain an injury or disease of the bilateral ears during active service, and that symptoms of bilateral hearing loss were not chronic during active service. While the Veteran has provided credible testimony of noise exposure in service, the service treatment records do not demonstrate complaints, findings, or a diagnosis of bilateral hearing loss. A report of medical history completed in conjunction with the January 1970 separation examination reflects that the Veteran denied hearing loss. The PUHLES profile at separation of "1," which is indicative of a high level of fitness with respect to his hearing. In Hensley v. Brown, 5 Vet. App. 155 (1993), the Court stated that 38 C.F.R. § 3.385 does not preclude service connection for a current hearing disability where hearing was within normal limits on audiometric testing at separation from service. Id. at 159. The Court explained that when audiometric test results at a veteran's separation from service do not meet the regulatory requirements for establishing a "disability" at that time, the veteran may nevertheless establish service connection for a current hearing disability by submitting competent evidence that the current disability is causally related to service. Id. at 160. The Court cited with approval a medical text, which states that the threshold for normal hearing is zero decibels to 20 decibels and higher threshold levels indicate some degree of hearing loss. Id. at 157. In this case, the Board acknowledges that the Veteran had one audiometric finding of 25 decibels at 4000 Hertz upon separation from service. On the examination, there was no diagnosis of hearing loss and the Veteran was assigned a physical profile (PULHES) value for hearing of 1. PULHES is the six categories into which a physical profile is divided. The P stands for physical capacity or stamina; the U for upper extremities; the L for lower extremities; the H for hearing and ear; the E for eyes; and the S stands for psychiatric). The number 1 indicated that an individual possessed a high level of medical fitness and, consequently, was medically fit for any military assignment. Odiorne v. Principi, 3 Vet. App. 456, 457 (1992). While audiometric testing at separation shows one pure tone threshold above 20 hertz, indicating some degree of hearing loss per the Court's decision in Hensley, the examiner did not render a diagnosis of hearing loss and the Veteran was assigned a PULHES value for hearing of 1, indicating a high level of medical fitness. The two VA audiologists who reviewed the service treatment records in conjunction with the Veteran's VA examinations concluded that the Veteran did not have hearing loss disability upon service separation. For these reasons, the Board finds that a hearing loss disability was not chronic in service. The Board finds that the weight of the evidence demonstrates that hearing loss did not manifest to a compensable degree within one year of service separation. Although the Veteran has asserts that hearing loss had its onset in service, the weight of the evidence demonstrates no hearing loss complaints or symptoms during the one year period after service, and no diagnosis or findings of hearing loss of during the one year post-service presumptive period. See 38 C.F.R. §§ 4.85, 4.86, Diagnostic Code 6100 (2012). For these reasons, the Board finds that hearing loss, did not manifest to a compensable degree within one year of service separation; therefore, the presumptive provisions for hearing loss are not applicable in this case. 38 C.F.R. §§ 3.307, 3.309. Next, the Board finds that the weight of the evidence demonstrates that symptoms of hearing loss were not continuous after service separation. An initial post-service report of hearing loss is shown in the Veteran's service connection claim dated in 2008. In his claim, the Veteran did not indicate that he had hearing loss since service. He did not provide a date for the onset of his hearing loss disability. The medical history reported by the Veteran in his 2008 and 2010 VA examinations does not support a finding of continuity since separation. The August 2008 VA examination report reflects that the Veteran reported decreased hearing for about 30 years. Such history would place the onset of his hearing loss in approximately 1978, several years after separation from service. Upon VA examination in 2010, the Veteran reported a history of hearing loss for a "long time" but did not specifically report that his hearing loss had its onset in service. In weighing the Veteran's statements of continuity of symptomatology made in conjunction with the current claim for VA compensation against the lack of continuity of symptomatology in the record from 1970 to 2008, the Board finds that the absence of contemporaneous medical evidence of continuity of symptomatology for 38 years is also one additional factor, along with other lay and medical evidence stated above, that the Board has considered in finding that the Veteran's recent statements of continuity are less probative than the other evidence of record on the question of continuity of symptomatology after service. See Buchanan, 451 F.3d at 1336 (Fed. Cir. 2006) (the lack of contemporaneous medical records is one fact the Board can consider and weigh against the other evidence, although the lack of such medical records does not, in and of itself, render the lay evidence not credible). The Board further finds that the weight of the evidence demonstrates that the Veteran's currently diagnosed bilateral hearing loss is not related to his active service, including the noise exposure during service. The Veteran had a VA examination in August 2008. The Veteran reported decreased hearing for 30 years. He reported that he did not have noise exposure before service and no occupational noise exposure. He reported that his in-service noise exposures included artillery and big guns. The August 2008 VA examiner diagnosed mild bilateral sensorineural hearing loss. The VA examiner indicated that the review of the claims file showed normal hearing during an induction physical and normal hearing upon separation in January 1970. The VA examiner opined that the Veteran's hearing loss is not caused by or due to noise exposure in the military. Upon VA examination in October 2010, the Veteran reported decreased hearing for a "long time." The Veteran reported that there was no history of noise exposure before the military and no occupational or recreational noise exposure. The VA examiner diagnosed mild to moderate sensorineural hearing loss in the right ear and mild to moderate sensorineural hearing loss in the left ear. The VA examiner noted that a review of the Veteran's claims file revealed an audiological evaluation dated in January 1970, which showed the Veteran's hearing to be within normal limits. The VA opined, therefore, that the Veteran's hearing loss is not due to or the result of noise exposure during service. Based on the evidence of record, the weight of the competent credible and probative evidence demonstrates no relationship between the Veteran's current bilateral hearing loss and his military service, including no credible evidence of continuity of symptomatology of hearing loss; therefore, the Board finds that a preponderance of the lay and medical evidence that is of record weighs against the claim for service connection for bilateral hearing loss, and outweighs the Veteran's more recent contentions regarding in-service chronic symptoms and continuous post-service symptoms. For these reasons, the Board finds that there is a preponderance of the evidence against the claims for service connection for hearing loss, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102. Service Connection for Tinnitus The Veteran contends that tinnitus is related to artillery noise in service. He asserts that he had ringing in his ears for days after these activities. The Board finds that the weight of the evidence demonstrates that the Veteran was exposed to loud noise (acoustic trauma), but that the Veteran did not have tinnitus in service. Service treatment records do not reflect complaints or findings of tinnitus. Upon separation from service, the Veteran denied ear, nose, or throat trouble. No complaints or findings of tinnitus were noted upon separation. In the service connection claim dated in 2008, the Veteran did not provide a date for the onset of tinnitus. In the substantive appeal dated in April 2009, the Veteran reported that he had ringing in his ears after artillery activities in service. Upon VA examination in October 2010, with regard to the onset of tinnitus, the Veteran reported that it was," I guess when I came back from overseas." In light of the evidence which indicates that the Veteran denied ear trouble at separation and has provided vague and differing accounts regarding the onset of tinnitus, the Board finds that tinnitus was not present in service. The Board next finds that the weight of the evidence demonstrates that the Veteran's current tinnitus is not related to service. The Veteran had a VA examination in August 2008, the Veteran reported that tinnitus began "many years ago" but did not specifically report a history of tinnitus during service. The VA examiner opined that the etiology of hearing loss is at least as likely as not due to tinnitus. Upon VA examination in October 2010, the Veteran reported recurrent tinnitus. With respect to the onset of tinnitus, the Veteran reported, "I guess back when I came from overseas." The VA examiner opined that, because the response as to the onset of tinnitus was fairly vague, the etiology of tinnitus could not be determined without resorting to mere speculation. In this case, there is no competent medical evidence of a relationship between the Veteran's current tinnitus and his active duty service. To the extent that the Veteran asserts that the current tinnitus is related to service, the record does not establish that he possesses a recognized degree of medical knowledge and he is not competent to provide evidence that requires specialized knowledge, skill, experience, training or education, such whether there is a medical nexus between current tinnitus and service. Jandreau, supra; Buchanan, supra. For these reasons, the Board finds that a preponderance of the evidence is against the Veteran's claim for service connection for tinnitus, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C.A. § 5107; 38 C.F.R. § 3.102. ORDER Service connection for shrapnel wounds, stomach, is denied. Service connection for hearing loss is denied. Service connection for tinnitus is denied. REMAND Additional development is necessary with respect to the claim for service connection for a back condition. The Veteran had a VA examination of his spine in October 2010. In the examination report, the VA examiner referred to electronic medical records pertaining to treatment of the spine dated in April and September 2000 and a report of an x-ray of the lumbar spine performed in July 2001. The records referenced in the October 2010 VA examination have not been associated with the physical claims file or the Virtual VA file. The claim must be remanded in order to obtain the records. Accordingly, the case is REMANDED for the following action: 1. Associate with the record VA treatment records dated in April and September 2000 and x-ray report dated in July 2001 and any other pertinent VA records not previously associated with the record. 2. Readjudicate the claim of service connection for a back condition with consideration of all the evidence of record. If the benefit sought remains denied, issue a SSOC. The case should then be returned to the Board, if otherwise in order. The appellant 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). This claim 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). ______________________________________________ K. J. ALIBRANDO Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs