Citation Nr: 1323890 Decision Date: 07/26/13 Archive Date: 08/06/13 DOCKET NO. 07-22 040 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for hearing loss. 2. Entitlement to service connection for tinnitus. 3. Entitlement to service connection for a left hand disability. 4. Entitlement to service connection for a left elbow disability. 5. Entitlement to service connection for a low back disability. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Shamil Patel, Counsel INTRODUCTION The appellant served in the National Guard from February 1965 to February 1990. He was on active duty for training from February 10, 1965 to July 29, 1965, and from April 8, 1978 to October 14, 1978. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2006 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The appellant's claims were previously remanded by the Board in February 2011, and now return to the Board for further review. The appellant's Virtual VA file has also been reviewed as part of his appeal. The issues of entitlement to service connection for hearing loss and tinnitus are addressed in the REMAND portion of the decision below and are REMANDED to the RO via the Appeals Management Center (AMC) in Washington D.C. FINDINGS OF FACT 1. The appellant does not have a left hand condition etiologically related to service. 2. The appellant does not have a left elbow condition etiologically related to service. 3. Lumbar strain is not etiologically related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for a left hand condition have not been met. 38 U.S.C.A. §§ 101, 1110, 1131, 5103, 5103A, 5107 (West 2002 and Supp 2012); 38 C.F.R. §§ 3.6, 3.303 (2012). 2. The criteria for service connection for a left elbow condition have not been met. 38 U.S.C.A. §§ 101, 1110, 1131, 5103, 5103A, 5107 (West 2002 and Supp 2012); 38 C.F.R. §§ 3.6, 3.303 (2012). 3. The criteria for service connection for a low back condition have not been met. 38 U.S.C.A. §§ 101, 1110, 1131, 5103, 5103A, 5107 (West 2002 and Supp 2012); 38 C.F.R. §§ 3.6, 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Veterans Claims Assistance Act of 2000 A. Duty to Notify Under the Veterans Claims Assistance Act (VCAA), when VA receives a complete or substantially complete application for benefits, it must notify the claimant of the information and evidence not of record that is necessary to substantiate a claim, which information and evidence VA will obtain, and which information and evidence the claimant is expected to provide. 38 C.F.R. § 3.159 (2012). Such notice must include notice that a disability rating and an effective date for the award of benefits will be assigned if there is a favorable disposition of the claim. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006); 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107; 38 C.F.R. §§ 3.159, 3.326; see also Pelegrini v. Principi, 18 Vet. App. 112, 120-21 (2004) (Pelegrini II). Prior to the initial adjudication of the appellant's claims, letters dated in September 2005 and June 2006 were sent to the appellant in accordance with the duty to notify provisions of the VCAA. 38 U.S.C.A. § 5103; 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). The appellant was notified of the evidence that was needed to substantiate his claims; what information and evidence that VA will seek to provide and what information and evidence the appellant was expected to provide, and that VA would assist him in obtaining evidence, but that it was his responsibility to provide VA with any evidence pertaining to his claims. See Pelegrini v. Principi, 18 Vet. App. 112, 120-21 (2004) (Pelegrini II). He was also notified of the criteria for establishing an effective date and disability rating. See Dingess. Therefore, he received complete notice regarding his service connection claims. B. Duty to Assist The claim was previously remanded to obtain the appellant's complete service treatment records and identified private treatment records, and to afford him VA examinations. A review of the claims file reflects that the appellant's service treatment records, private treatment records, Social Security Administration (SSA) records, and lay statements have been associated with the claims file. The appellant was also afforded VA examinations. 38 C.F.R. § 3.159(c)(4). When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The VA examinations obtained in this case are adequate as they are collectively predicated on a review of the claims file; contain a description of the history of the disabilities at issue; document and consider the relevant medical facts and principles; and provide opinions regarding the nature and etiology of the appellant's claimed disabilities. VA's duty to assist with respect to obtaining a VA examination or opinion for the issues on appeal has been met. 38 C.F.R. § 3.159(c)(4). The directives of the February 2011 remand have been satisfied. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that a remand by the Court or the Board confers on the veteran or other claimant, as a matter of law, the right to compliance with the remand orders). No medical examination or opinion has been obtained specifically for the appellant's claim for service connection for a left elbow disorder. However, the Board finds that the evidence, which does not reflect competent evidence of current symptoms or an injury, event, or disease in service, warrants the conclusion that a remand for an examination and/or opinion is not necessary to decide the claim. See 38 C.F.R. § 3.159(c)(4). Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in service connection claims, VA must provide a VA medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the VA to make a decision on the claim. As discussed below, the evidence does not satisfy the standards of McLendon, as there is no indication of current symptoms or symptoms in service. VA has provided the appellant with the opportunity to submit evidence and argument in support of his claims. The appellant has not made the Board aware of any additional evidence that needs to be obtained prior to appellate review, and no further action must be undertaken to comply with the provisions of 38 U.S.C.A. § 5103(a), § 5103A, or 38 C.F.R. § 3.159. Service Connection A. Applicable Law In order to establish service connection for a claimed disability, the facts must demonstrate that a disease or injury resulting in current disability was incurred in active military service or, if pre-existing active service, was aggravated therein. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2012). Service connection may 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) (2012). In addition, certain chronic diseases, including hearing loss and arthritis, may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C.A. §§ 1101, 1112 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.307, 3.309 (2012). For a 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, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. If the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (2012). However, service connection based on a theory of continuity of symptomatology is applicable only for those disabilities explicitly recognized as "chronic" in 38 C.F.R. § 3.309. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may be granted for disability resulting from disease or injury incurred during active duty for training (ADT), or injuries suffered during inactive duty training (IDT) to include when a cardiac arrest or a cerebrovascular accident occurs during such training. See 38 U.S.C.A. §§ 101(24), 106. Reserve and National Guard service generally means ADT and IDT. ADT is full time duty for training purposes performed by Reservists and National Guardsmen pursuant to 32 U.S.C.A. §§ 316, 502, 503, 504, or 505. 38 U.S.C.A. § 101(22); 38 C.F.R. § 3.6(c). Basically, this refers to the two weeks of annual training, sometimes referred to as "summer camp," that each Reservist or National Guardsman must perform each year. It can also refer to the Reservist's or Guardsman's initial period of training. IDT includes duty, other than full-time duty, performed for training purposes by Reservists and National Guardsmen pursuant to 32 U.S.C.A. §§ 316, 502, 503, 504, or 505. 38 U.S.C.A. § 101(23); 38 C.F.R. § 3.6(d). Basically, this refers to the twelve four-hour weekend drills that each Reservist or National Guardsman must perform each year. These drills are deemed to be part-time training. Active military service includes active duty, any period of ADT during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in line of duty, and any period of IDT during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident which occurred during such training. 38 U.S.C.A. § 1106; 38 C.F.R. § 3.6(a). Generally, an individual who has only Reserve or National Guard service (ADT or IDT with no active duty) is not a veteran as legally defined. In the service connection context, for example, this means that the presumption of soundness upon entry into service and the presumptive service connection provisions of 38 C.F.R. § 3.307, applicable to active duty, would not apply to ADT or IDT. 38 U.S.C.A. §§ 1111, 1112, 1137; 38 C.F.R. § 3.307. Thus, service connection on a presumptive basis is not available where the only service performed is ADT or IDT. See Biggins v. Derwinski, 1 Vet. App. 474, 476-78 (1991). The evaluation of evidence generally involves a three-step inquiry. First, the Board must determine whether the evidence comes from a "competent" source. The Board must then determine if the evidence is credible, or worthy of belief. Barr v. Nicholson, 21 Vet. App. 303 (2007) (Observing that once evidence is determined to be competent, the Board must determine whether such evidence is also credible). The third step of this inquiry requires the Board to weigh the probative value of the proffered evidence in light of the entirety of the record. Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159. Lay evidence may be competent and sufficient to establish a diagnosis of a condition when: (1) a layperson is competent to identify the medical condition (i.e., when the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer); (2) the layperson is reporting a contemporaneous medical diagnosis, or; (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). In ascertaining the competency of lay evidence, the Courts have generally held that a layperson is not capable of opining on matters requiring medical knowledge. Routen v. Brown, 10 Vet. App. 183 (1997). In certain instances, however, lay evidence has been found to be competent with regard to a disease with "unique and readily identifiable features" that is "capable of lay observation." See, e.g., Barr v. Nicholson, 21 Vet. App. 303 (2007) (concerning varicose veins); see also Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007) (a dislocated shoulder); Charles v. Principi, 16 Vet. App. 370 (2002) (tinnitus); Falzone v. Brown, 8 Vet. App. 398 (1995) (flatfeet). Laypersons have also been found to not be competent to provide evidence in more complex medical situations. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (concerning rheumatic fever). Competent medical evidence is evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. Competent medical evidence may also include statements conveying sound medical principles found in medical treatises. It also includes statements contained in authoritative writings, such as medical and scientific articles and research reports or analyses. 38 C.F.R. § 3.159(a)(1). After determining the competency and credibility of evidence, the Board must then weigh its probative value. In this function, the Board may properly consider internal inconsistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza at 511-512 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curiam) (table); see Madden v. Brown, 125 F.3d 1447 (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"). B. Left Hand The appellant underwent examinations in October 1964, July 1965, September 1969 and January 1971. No relevant abnormalities were noted, and the appellant denied any history of symptoms related to an injured hand. In May 1971, the appellant was treated for a bruised hand. He was prescribed oil of wintergreen. Notably, the record does not specify which hand was injured. Nonetheless, subsequent examinations in August 1975, September 1978, November 1983 and April 1987 reflect normal findings, and the appellant repeatedly denied any symptoms of a hand injury. In March 1988, the appellant was treated for pain and throbbing in his left 4th digit. He was treated with a splint. In his August 2005 claim, the appellant stated that he injured his left wrist while lifting a ruck sack off his back. He stated he was put on light duty for two weeks. He submitted a statement from a service comrade which corroborated his account. An additional statement dated April 2006 was submitted by R.D., who stated that he had known the appellant his whole life, and that the appellant had experienced a lot of trouble with his left arm. A December 2007 statement from the appellant's private physician stated that the appellant was at least 80 percent permanently disabled in his left hand or arm, based on the standards outlined in the Guide to Evaluation of Permanent Impairment Rating published by the American Medical Association. Records dated November 2008 reflect treatment for a cervical spine condition, with pain radiating from the neck into the left hand. The appellant had reduced grip strength in the left hand. He was diagnosed with radiculopathy. The appellant underwent a VA examination in March 2011. He reported injuring his left ring finger in 1988, and it had remained weak since that time. He stated that he did not seek medical attention after the initial event. However, after a physical examination, the examiner stated that the appellant's left hand was completely normal. Based on the record, the Board finds that service connection for a left hand disability is not warranted. Although the appellant sustained an injury to the left hand in 1988, the evidence does not reflect a current left hand disability. The March 2011 VA examiner specifically concluded that the appellant's left hand was normal. Although private records reflect a diagnosis of radiculopathy, this is the result of the appellant's chronic neck condition. There are no documented residuals of an injury to the hand itself. The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997) (holding that the VA's and the Court's interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary and therefore the decision based on that interpretation must be affirmed); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). In the absence of proof of a present disability, there can be no valid claim. Rabideau v. Derwinski, 2 Vet. App. 141, 143- 44 (1992). The appellant's own statements regarding his left hand have also been considered. While he has not demonstrated any specialized medical knowledge or training, he is competent to report basic injuries to the hand and symptoms such as pain or weakness. However, a specific left hand or finger condition has not been diagnosed. Given the normal findings from the VA examination, service connection based only on the appellant's reported symptoms is not appropriate. See Sanchez-Benitez v. West, 13 Vet. App. 282, 285 (1999) (pain alone, without a diagnosed or identifiable underlying malady or condition, does not in and of itself constitute a disability for which service connection may be granted). C. Left Elbow During the appellant's October 1964 enlistment examination, he was noted to have a prior history of a fractured left elbow. Private records dated June 2005 also reflect a history of a fractured left elbow at age 7. However, the record is otherwise negative for any complaints, treatment, or diagnoses of a left elbow condition. The appellant underwent numerous examinations from October 1964 through April 1987. No left elbow conditions were noted, and he repeatedly denied any symptoms associated with the elbow. As discussed above, while the appellant has radiculopathy in the left arm, there is no indication of a current elbow condition or residuals of an elbow injury. As there is no currently diagnosed elbow disability, and no indication of an elbow disability in service, service connection for a left elbow condition is denied. D. Low Back The appellant underwent examinations in October 1964, July 1965, September 1969 and January 1971. No relevant abnormalities were noted, and the appellant denied any history of symptoms related to back injury. Records dated September 1973 show the appellant injured his back while lifting a mortar base. X-rays revealed curvature of the lumbar spine. The treating physician noted that this could represent positioning, splitting by the appellant, or possibly true scoliosis. No fracture was seen. He was diagnosed with a lumbosacral strain and prescribed 3 days of bed rest. The injury was noted to have occurred in the line of duty. Nonetheless, subsequent examinations in August 1975, September 1978, November 1983 and April 1987 reflect normal findings, and the appellant again repeatedly denied any symptoms of a back injury. In his August 2005 claim, the appellant reported injuring his back in 1971 while lifting mortar base plates into a truck. An additional statement dated April 2006 was submitted by R.D., who stated that he had known the appellant his whole life, and that the appellant had experienced a lot of trouble with his back. Private records dated February 2008 noted findings of chronic back pain, status post injury in military. The appellant underwent a VA examination in March 2011. The claims file was reviewed by the examiner, who noted the appellant's September 1973 low back injury. The appellant stated that following that injury, his back was "never the same." However, he denied seeking any medical attention for it in the 1970's or 1980's. Following a physical examination, the appellant was diagnosed with lumbosacral strain, and the examiner noted that a more precise diagnosis could not be rendered as there was no objective data to support a more definitive finding. In addition, the examiner concluded that current lumbar strain was not related to the service, including the back injury in 1973. He stated that there was no evidence of a chronic back condition during service or in the years following separation, and noted that the appellant denied recurrent back pain in 1983 and 1983. Therefore, a nexus to service cannot be made. Based on the evidence, the Board finds that service connection for a low back condition is not warranted. Although the appellant is diagnosed with lumbar strain, the overall weight of the evidence is against a finding that this condition was incurred in or otherwise related to service. The March 2011 VA examiner concluded that lumbar strain was not related to service. This opinion was based on a review of the claims file, a history provided by the appellant, and a physical examination. There is no competent medical opinion to refute this conclusion or to otherwise suggest that a lumbar spine condition was incurred in service. The Board has again considered the appellant's own statements regarding his condition. However, while lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), as to the specific issue in this case, the etiology of his current lumbar strain falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007) (lay persons not competent to diagnose cancer). Further, to the extent that the appellant's statements, and those of other lay witnesses, are offered as evidence of continuity of symptomatology, the Board acknowledges that lay evidence concerning continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). As noted, in adjudicating his claims, the Board must evaluate the appellant's credibility. See Washington v. Nicholson, 19 Vet. App. 362, 368-69 (2005). In rendering a decision on appeal, the Board must 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. While the Board acknowledges that the appellant is competent to provide evidence of his own experiences, there are no further complaints of low back symptoms in service following the 1973 injury. The appellant underwent numerous additional examinations, and no relevant abnormalities were recorded during those examinations. The appellant also repeatedly denied any recurrent low back pain. These facts weigh heavily against any claim he now makes that he has had problems ever since service. The Board is not holding that corroboration is required. Rather, the Board finds his assertions to be less credible than the negative contemporaneous records. Symptoms, not treatment, are the essence of any evidence of continuity of symptomatology. However, with respect to a merits review, the lack of evidence of treatment bears on the credibility of the evidence of continuity. As such, the Board finds that the probative evidence is against the claim based on continuity of symptomatology. The Court has indicated that the normal medical findings at the time of separation from service, as well as the absence of any medical records of a diagnosis or treatment for the pertinent chronic disability for many years after service is probative evidence against the claim. See Mense v. Derwinski, 1 Vet. App. 354, 356 (1991). ORDER Service connection for a left hand disability is denied. Service connection for a left elbow disability is denied. Service connection for a low back disability is denied. REMAND With respect to the appellant's claims for service connection for hearing loss and tinnitus, additional development is warranted. Impaired hearing will be considered a disability for VA purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000 and 4000 Hertz is 40 decibels or greater; or the auditory thresholds for at least three of these frequencies 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). A VA examination was conducted in March 2011. The examiner reviewed the claims file, and noted the audiometric findings in the appellant's service treatment records. She diagnosed bilateral sensorineural hearing loss, and concluded that it was less likely than not related to noise exposure in service. She noted that hearing tests in 1965 and 1969 revealed normal findings. Therefore, left ear hearing loss evident in January 1971 was a post-service occurrence. These levels were unchanged in 1975. A September 1978 examination revealed no threshold shift in either ear, so hearing did not worsen in 1977 or 1978. An enlistment examination was conducted in August 1975. Pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 15 15 15 15 LEFT 15 15 15 15 50 During a separation examination in September 1978, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 5 5 10 45 LEFT 10 10 0 20 50 Contrary to the statements of the VA examiner, there was a shift in pure tone thresholds in the right ear, specifically at the 4 kHz level. Notably, the appellant had a period of active duty for training in 1978. He did not satisfy the criteria for right ear hearing loss under 38 C.F.R. § 3.385 during his 1975 examination, but did satisfy them during the September 1978 examination. Therefore, a supplemental opinion addressing this threshold shift is necessary before adjudicating the claim. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). Accordingly, the case is REMANDED for the following action: 1. Forward the claims file to the audiologist that conducted the March 2011 VA examination, if available, for a supplemental opinion. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the appellant's current hearing loss and tinnitus had their clinical onset during active service or is related to any in-service disease, event, or injury, to include in-service noise exposure. The examiner must note that the appellant had a period of active duty for training from April 8, 1978 to October 14, 1978. She must specifically comment on the shift in pure tone thresholds in the right ear in the 4 kHz range between 1975 and 1978. The threshold was recorded as 15 decibels in August 1975, which is normal hearing for VA purposes, and 45 decibels in September 1978, which is considered to be hearing loss for VA purposes. The complete rationale for all opinions expressed should be set forth in the examination report. If further examination of the Veteran is deemed necessary, arrange for the appellant to undergo VA examination to obtain the above-noted opinion. The entire claims file, to include a complete copy of this remand, must be made available to the examiner designated to examine the appellant, and a notation to the effect that review of the claims file took place should be included in the report of the examiner. The examination report should include discussion of the appellant's documented medical history and assertions. All indicated tests and studies should be accomplished. All examination findings, along with the complete rationale for all opinions expressed, should be set forth in the examination report. 2. Review the claims file and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, appropriate corrective action must be implemented. If any report does not include adequate responses to the specific opinions requested, it must be returned to the providing examiner for corrective action. 3. After completing the requested actions, and any additional notification and/or development deemed warranted, readjudicate the claim on appeal in light of all pertinent evidence and legal authority. If the benefit sought on appeal remains denied, furnish the appellant and his representative an appropriate supplemental statement of the case (SSOC) that includes clear reasons and bases for all determinations, and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. 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). ____________________________________________ KELLI A. KORDICH Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs