Citation Nr: 1328268 Decision Date: 09/05/13 Archive Date: 09/16/13 DOCKET NO. 08-05 225 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas THE ISSUES 1. Entitlement to an effective date earlier than August 27, 2007 for the grant of service connection for Raynaud's disease. 2. Entitlement to service connection for a left hip disability, to include as secondary to a service-connected disability. 3. Entitlement to service connection for an acquired psychiatric disability, to include as secondary to a service-connected disability. 4. Entitlement to an initial rating for Raynaud's disease of the left foot in excess of 0 percent prior to March 11, 2009, and in excess of 40 percent thereafter. 5. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU). [The issue of entitlement to service connection for a lumbar spine disability will be addressed in a separate decision]. REPRESENTATION Appellant (the Veteran) is represented by: Lori Chism, Attorney ATTORNEY FOR THE BOARD L. Cramp, Counsel INTRODUCTION The Veteran had active service from November 1973 to November 1975. The appeal as to entitlement to service connection for a left hip disability comes to the Board of Veterans' Appeals (Board) from an April 2006 rating decision of the RO in Waco, Texas. In December 2007, the Board remanded that issue to the RO for additional evidentiary development. The issues involving the initial rating and effective date for Raynaud's disease come to the Board on appeal from an August 2009 rating decision from the RO in Waco, Texas. The issue of entitlement to TDIU comes to the Board on appeal from a March 2009 decision of the RO in Waco, Texas. The Board notes that the Veteran's original attorney in this appeal withdrew from the case in February 2013, prior to certification of the appeal to the Board. The Veteran subsequently appointed a new attorney, and specified that the appointment was without limitation of consent, delaying the case. A claimant may revoke a power of attorney at any time, and a claimant may discharge an agent or attorney at any time. Unless a claimant specifically indicates otherwise, the receipt of a new power of attorney executed by the claimant and the organization or individual providing representation shall constitute a revocation of an existing power of attorney. See 38 C.F.R. § 14.631 (2012). Thus, the April 2013 VA Form 21-22a serves to revoke the previous power of attorney and to appoint the new power of attorney with respect to all issues addressed in this decision. In adjudicating these issues the Board has not only reviewed the physical claims file, but also the file on the "Virtual VA" system to insure a total review of the evidence. The issues of entitlement to service connection for a psychiatric disability, entitlement to an increased initial rating for Raynaud's disease, and entitlement to TDIU are addressed in the REMAND below and are therein REMANDED to the Department of Veterans Affairs Regional Office. FINDINGS OF FACT 1. All notification and development action needed to fairly adjudicate the issues herein decided has been accomplished. 2. The earliest pending claim for service connection for Raynaud's disease was received on December 26, 2002, which is clearly more than one year after service separation. 3. The date entitlement to service connection for Raynaud's disease arose is prior to the date of claim. 4. There was no injury or disease of the left hip during service, and there is no current left hip disability; the Veteran's symptoms are related to lumbar radiculopathy. CONCLUSIONS OF LAW 1. The criteria for an effective date for the grant of service connection for Raynaud's disease of December 26, 2002 are met; the criteria for an effective date prior to December 26, 2002 are not met. 38 U.S.C.A. §§ 5103, 5103A, 5107, 5110, 7104 (West 2002); 38 C.F.R. §§ 3.102, 3.151, 3.156(c), 3.155, 3.159, 3.400 (2012). 2. The basic criteria for service connection for a left hip disability are not met. 38 U.S.C.A. §§ 1110, 5103, 5103A, 5107, 7104 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS 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. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). 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"). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Effective Date for Grant of Service Connection for Raynaud's Disease The Veteran is seeking an effective date earlier than August 27, 2007 for the grant of service connection for Raynaud's disease. After a review of all of the evidence, and with resolution of all reasonable doubt in the Veteran's favor, the Board finds that an earlier effective date of August 26, 2002 for the grant of service connection for Raynaud's disease is warranted. The laws and regulations governing effective dates establish that, unless specifically provided otherwise, the effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase, of compensation, dependency and indemnity compensation, or pension, shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C.A. § 5110(a). The effective date of an award of disability compensation to a veteran shall be the day following the date of discharge or release if application therefor is received within one year from such date of discharge or release. 38 U.S.C.A. § 5110(b)(1). This statutory provision is implemented by a regulation which provides that the effective date of an evaluation and award of compensation based on an original claim or a claim reopened after final disallowance will be the date of receipt of the claim or the date entitlement arose, whichever is the later. See 38 C.F.R. § 3.400. A specific claim in the form prescribed by the Secretary of VA must be filed in order for benefits to be paid to any individual under the laws administered by VA. 38 U.S.C.A. § 5101(a) (West 2002); 38 C.F.R. § 3.151(a) (2012). A claim is a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1(p) (2012). Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by VA may be considered an informal claim. Such an informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within one year from the date it was sent to the claimant, it will be considered filed as of the date of receipt of the informal claim. 38 C.F.R. § 3.155(a) (2012). In this case, the initial claim of entitlement to service connection for Raynaud's disease was received by VA on December 26, 2002. That claim was presented as an increased rating claim for cold injury residuals; however the Veteran specifically identified Raynaud's disease in the claim, and he enclosed a letter from his private physician dated December 17, 2002, which noted that the Veteran was being treated for Raynaud's disease. Although arising from the Veteran's service-connected cold injury, Raynaud's disease is treated as a separate disability in the rating schedule. The diagnostic code for cold injury residuals specifically instruct the rater to separately evaluate other disabilities that have been diagnosed, such as Raynaud's phenomenon, unless their symptoms are used to support an evaluation for cold injury residuals. See 38 C.F.R. § 4.104, Diagnostic Code 7122. Thus, a claim identifying the diagnosis of Raynaud's disease and requesting compensation for the disability should have been treated as a claim for service connection for Raynaud's disease and a separate disability rating rather than simply treating the request as a claim for an increase in the rating for cold injury residuals. The Board finds that the December 26, 2002 correspondence reasonably raises a claim for service connection for Raynaud's disease. The Veteran subsequently submitted correspondence in January 2003, which also identified Raynaud's disease as a diagnosis for which he was seeking compensation. However, a February 2003 rating decision adjudicated only entitlement to increased ratings for cold injury residuals. While the diagnosis of Raynaud's disease was acknowledged, no specific finding was made regarding entitlement to service connection for this disability, nor was it acknowledged or asserted that the symptoms of Raynaud's disease were being used to support the rating for cold injury residuals. The Veteran disagreed with the February 2003 rating decision, and in correspondence received with his notice of disagreement, he wrote, "I disagree with the decision about my Raynaud's disease." Correspondence from the Veteran and his attorney submitted in conjunction with the appeal, in August 2003, May 2004, August 2005, October 2006, and August 2007, also noted the presence of Raynaud's disease. The appeal came to the Board in December 2007, at which time the Board identified and referred the unadjudicated issue of entitlement to service connection for Raynaud's disease back to the RO, noting correspondence from the Veteran's attorney in August 2007 and October 2007. The RO addressed the referred claim in January 2009, and while it initially denied the claim, it subsequently obtained a VA medical opinion in July 2009 relating Raynaud's disease to the Veteran's cold injury residuals and granted service connection for Raynaud's disease as a separate disability in an August 2009 rating decision, effective December 20, 2007. According to the RO, the effective date assigned was the date of the Board decision which "brought up the issue of entitlement." Of course, the Board did not simply "bring up" the issue, it identified a reasonably raised claim from the record. The Veteran disagreed with the effective date assigned by the RO; and, in a June 2010 rating decision, the RO granted an earlier effective date of August 27, 2007, the date of receipt of one of the multiple submissions from the Veteran's attorney which mentioned the presence of Raynaud's "Phenomenon." As noted above, in referring the issue of entitlement to service connection for Raynaud's disease back to the RO, the Board identified correspondence from the Veteran's attorney in August 2007 and October 2007. However, the Board's reference in the Introduction of its decision did not constitute a finding of fact regarding the earliest date of a pending claim, it simply put the RO on notice that a claim was reasonably raised by the record and that the RO should determine what action, if any, should be taken, as the Board does in its efforts to address new claims raised by Veterans (or that could be raised by Veterans) while it address claims on appeal. In finding that August 27, 2007 was the earliest date of a pending claim, the RO did not address any of the prior correspondence from the Veteran or his attorney. It is notable that the August 2005 and October 2006 correspondence was similarly worded to the August 2007 correspondence. The RO's selection of the August 2007 correspondence would appear to be arbitrary. While it was the earliest of the dates mentioned by the Board, it was not the earliest date of a pending claim, and the RO did not explain why an earlier date was not chosen. In determining the earliest date of a pending claim, a VA adjudicator must not only consider the dates of correspondence from the Veteran, but must also consider the effect of intervening RO decisions on the claim. A claim for VA benefits, whether formal or informal, remains pending until it is finally adjudicated. See Adams v. Shinseki, 568 F.3d 956, 960 (Fed. Cir. 2009); 38 C.F.R. § 3.160(c) (2012). A claim will also remain pending if VA has failed to notify the claimant of the denial of the claim. Cook v. Principi, 318 F.3d 1334, 1340 (Fed. Cir. 2002). However, in certain circumstances, pursuant to the implicit denial doctrine, a claim for benefits will be deemed to have been denied, and thus finally adjudicated, even if VA did not expressly address that claim in its decision. Adams, 568 F.3d at 961. The implicit denial doctrine was first pronounced in Deshotel v. Nicholson, 457 F.3d 1258 (Fed. Cir. 2006). In that case, the Federal Circuit held that, where a claimant files more than one claim with the RO at the same time, and the RO's decision acts (favorably or unfavorably) on one of the claims, but fails to specifically address the other claim, the second claim is deemed denied, and the appeal period begins to run. Shortly after the decision in Deshotel was issued, the CAVC interpreted the application of the implicit denial doctrine. In Ingram v. Nicholson, 21 Vet. App. 232 (2007), the CAVC held that a reasonably raised claim remains pending until there is either a recognition of the substance of the claim in a RO decision from which a claimant could deduce that the claim was adjudicated or an explicit adjudication of a subsequent claim for the same disability. Ingram, 21 Vet. App. at 243. In its opinion, the CAVC emphasized that it rejected a broad, sweeping reading of Deshotel as supplanting the pending claim doctrine, and reiterated that a claimant must be able to reasonably deduce from the decision that the claim was denied. Id. at 246-47. In Munro v. Shinseki, 616 F.3d 1293 (Fed. Cir. 2010), the Federal Circuit again elaborated on the implicit denial doctrine, holding that the implicit denial rule may be applied to terminate the pending status of both formal and informal claims. Munro, 616 F.3d at 1297. The Federal Circuit reiterated that Adams clarified the notice requirements for the implicit denial doctrine and rejected the appellant's argument that a VA decision must expressly discuss a pending claim for it to be deemed denied, holding that the proper notice standard is whether a VA decision provided sufficient information for a reasonable claimant to know that he would not be awarded benefits for his asserted disability. Adams, 568 F.3d 956 at 1299. Here, in assigning an effective date later than the August 2002 claim, the RO did not address earlier correspondence from the Veteran, and did not address whether it's intervening decisions in February 2003 and July 2004, adjudicating the ratings for cold injury residuals, provided sufficient information for a reasonable claimant to know that he would not be awarded service connection for Raynaud's disease. If it were found that he was provided adequate notice by either decision, but did not timely appeal the decision, such decision would constitute a final denial of the claim such that an effective date could not be assigned on the basis of that claim. The Board finds in this case that the February 2003 and July 2004 RO decisions did not put the Veteran on notice that a claim of entitlement to service connection for Raynaud's disease had been denied. On the contrary, the RO made representations to the Veteran during this period that would lead a reasonable person to conclude that service connection had actually been granted for Raynaud's disease. While the February 2003 rating decision addressed the disability only in passing, the February 2004 statement of the case - nominally addressing the ratings for cold injury residuals - also specifically set out the rating criteria for Raynaud's disease and informed the Veteran that the evidence "does not show you have the symptoms of a characteristic attack to warrant a higher evaluation under Raynaud's." The rating guide sheets show that service connection was never actually granted for Raynaud's disease; however, based on the representations made in the statement of the case, the Board finds that a reasonable person would not have been led to believe that service connection for Raynaud's disease had been denied, and therefore, that a specific appeal of such a denial should be initiated. A reasonable person might well have been confused as to the disposition of the claim of entitlement to service connection for "Raynaud's disease". The Board finds that the Veteran reasonably concluded that his appeal of the ratings for cold injury residuals encompassed his Raynaud's disease, and that his efforts should be focused on establishing entitlement to a higher rating, not on appealing a denial of service connection of which he was never informed. As the Veteran was not notified of a denial of service connection for Raynaud's disease, the August 26, 2002 claim remained pending at the time of the January 2009 RO decision. Although the January 2009 RO decision denied service connection for Raynaud's disease, the Veteran appealed that decision in April 2009. Thus, it did not become final. The RO granted service connection for Raynaud's disease shortly thereafter in August 2009, the current appeal arose from that decision. The Board finds that there is no earlier pending claim, formal or informal, of entitlement to service connection for Raynaud's disease, prior to the December 26, 2002 correspondence. The Veteran asserts that the effective date should be November 29, 1995 (see, e.g., September 15, 2009 correspondence). This is the date of his original claim for service connection for "[fr]ost [b]itten in 1974 has caused [b]ad circulation in [j]oints." However, the Board notes that this claim for service connection was initially denied in an August 1996 rating decision. The Veteran appealed that decision and service connection for frostbite residuals was ultimately granted in a March 1998 decision, effective November 29, 1995. The Board finds that there is no pending claim for service connection for Raynaud's disease arising from the November 29, 1995 claim. The clinical evidence establishes the initial diagnosis of Raynaud's as November 12, 1997, well after the November 29, 1995 claim. A prescription slip from the Veteran's private physician, Dr. Karjeker on that date notes that he was starting the Veteran on Prazosin to treat Raynaud's phenomenon, secondary to frost bite. A December 10, 1997 letter from Dr. Karjeker to VA notes that the Veteran sustained frostbite in the Army and was now suffering from Raynaud's as a result. In Boggs v. Peake, 520 F. 3d 1330 (Fed. Cir. 2008), the United States Court of Appeals for the Federal Circuit held that a claim for one diagnosed disease or injury cannot be prejudiced by a prior claim for a different diagnosed disease or injury. Rather, the two claims must be considered independently. See Ephraim v. Brown, 82 F. 3d 399 (Fed. Cir. 1996). The Board finds that this holding is applicable, albeit indirectly, in the current appeal. "Raynaud's disease" is a separately diagnosed disease from cold injury residuals, and this distinction is reflected in the rating schedule, which specifically directs the rater to apply separate ratings for each disability. Thus, the date of diagnosis of Raynaud's disease is significant in determining whether the November 1995 claim included an inferred claim of entitlement to service connection for Raynaud's disease, which had not yet been diagnosed. The Board finds that there could have been no such inferred claim. Another crucial factor in the Board's finding that a claim of entitlement to service connection for Raynaud's disease did not arise from the November 29, 1995 correspondence is that the Veteran did not mention Raynaud's disease at the time, a fatal flaw in the Veteran's reasoning. It is well settled that an intent to apply for benefits is an essential element of any claim, whether formal or informal, and, further, the intent must be communicated in writing. See Criswell, citing MacPhee v. Nicholson, 459 F.3d 1323, 1326-27 (Fed.Cir.2006) (holding that the plain language of the regulations require a claimant to have an intent to file a claim for VA benefits); also citing Rodriguez v. West, 189 F.3d 1351, 1353 (Fed.Cir.1999) (noting that even an informal claim for benefits must be in writing); also citing Brannon v. West, 12 Vet. App. 32, 35 (1998). The term "pending claim" is defined under VA regulations as an application, formal or informal, which has not been finally adjudicated. 38 C.F.R. § 3.160 (c)(2012). Thus, for a claim to be considered pending, there must have been either a formal or informal application. The first mention of Raynaud's disease to VA on the Veteran's part comes from the December 26, 2002 correspondence, which noted a worsening in his overall condition and specifically noted the diagnosis of Raynaud's disease. Thus, even if there had been a diagnosis of Raynaud's disease at the time of the November 1995 claim, the Veteran's failure to identify the disability in the November 1995 claim, in light of the separate treatment of cold injury residuals and Raynaud's disease in the rating schedule, precludes the assignment of an effective date for Raynaud's disease corresponding to the November 1995 claim. In this case, it is the Veteran's own actions that provide the basis to deny the claim. While it is acknowledged that private treatment records establish an earlier diagnosis of Raynaud's disease than December 26, 2002, these private records were not submitted to VA prior to December 26, 2002. Even if they had been submitted, the mere existence of medical records cannot serve as a claim (formal or informal) for service connection. The CAVC in Criswell v. Nicholson, 20 Vet. App. 501 (2006) in pertinent part held that the mere existence of medical records generally cannot be construed as an informal claim; rather, there must be some intent by the claimant to apply for a benefit. See also Brannon v. West, 12 Vet. App. 32, 35 (1998); 38 C.F.R. § 3.155(a). Simply stated, the fact that the Veteran was being treatment for a disability at this time does not suggest or imply that the Veteran, or any Veteran, will immediately file a claim of service connection for this disability. Some disabilities simply have no connection to service from many year ago (even today, there is a clear question regarding whether this disability has any real connection with service). However, as clearly stated in Veteran law over many years, the first step in the process is that the Veteran must file a claim for the disability at issue for VA to address it. One exception to the above is that, once a formal claim for pension or compensation has been allowed or a formal claim for compensation disallowed for the reason that the service- connected disability is not compensable in degree, receipt of a report of VA examination will be accepted as an informal claim for increased benefits or an informal claim to reopen. The date of examination will be accepted as the date of receipt of the claim. See 38 C.F.R. § 3.157(b). However, in this case, there was no prior claim for compensation that was disallowed for the reason that Raynaud's disease was not compensable in degree. Having established the date of claim as December 26, 2002, we must next establish the date entitlement arose. As the date of claim is more than one year after service separation, the provisions of 38 U.S.C.A. § 5110(b)(1) are not applicable. Here, the evidence shows that the Veteran had been diagnosed with Raynaud's disease many years prior to his claim for service connection. A November 1997 prescription slip from Dr. Karjeker appears to represent the initial diagnosis of Raynaud's disease. Thus, the date entitlement arose is well prior to the date of claim. The date of claim, as the latter of the two dates, is the appropriate effective date in this case. In sum, the initial claim of entitlement to service connection for Raynaud's disease was received on December 26, 2002. That claim remained pending and unadjudicated at the time of the August 2009 rating decision which granted service connection for Raynaud's disease. The earliest date of a pending claim is later than the date entitlement arose and more than one year after service separation. Accordingly, an effective date of December 26, 2002, but not earlier, is warranted. To the extent that an earlier effective date is sought, the Board finds that a preponderance of the evidence is against such a claim. Service Connection Claim The Veteran is seeking service connection for a left hip disability on the basis that it is either related to service or to a service-connected disability. 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, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The CAVC has held that "Congress specifically limits entitlement for service- connected disease or injury to cases where such incidents have resulted in a disability. In the absence of proof of a present disability there can be no valid claim." Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); see also Rabideau v. Derwinski, 2 Vet. App. 141, 143-44 (1992). Service connection may be granted for disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Service connection may also be established the degree of disability resulting from aggravation of a nonservice-connected disability by a service-connected disability. See also Allen v. Brown, 7 Vet. App.439, 448 (1995). Under the regulation in effect at the time the Veteran filed his claim, service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a) (as in effect prior to October 10, 2006). That regulation was interpreted to permit service connection not only for disability caused by service-connected disability, but for the degree of disability resulting from aggravation to a nonservice-connected disability by a service-connected disability. Allen, 7 Vet. App. at 448 (1995). After a review of all of the evidence, the Board finds that the weight of the evidence demonstrates that there is no current left hip disability, but that symptoms identified by the Veteran are attributable to a lumbar spine disability. The Veteran's assertions regarding the left hip disability appear focused on the service treatment record showing that he fell on his left hip while playing basketball in February 1975. However, service treatment records reveal no diagnosis regarding the left hip at the time of the incident, as well as normal findings for the lower extremities at service separation, providing highly probative evidence against this claim. Post-service records also reveal no diagnosis regarding the left hip. The Veteran never mentioned the left hip after service until he filed the current claim. A VA examination was obtained in May 2010, at which time the Veteran reported that his hip pain starts in the left side of the lower lumbar spine and radiates into the left posterior buttocks and will go down the posterior thigh to the level of the foot. He also reported that the pain is accompanied by numbness. The examiner noted that testing was negative for hip pain, but positive for low back pain. The examiner diagnosed radiculopathy of the left lower extremity, otherwise a normal left hip with no intrinsic pathology found. An X-ray was negative for degenerative joint disease. Such evidence outweighs the Veteran's lay statements that he has such a disability separate from the back. The Veteran, at best, is simply citing a symptom of his back problem, not a hip disability for VA purposes. Thus, the only pathology found is encompassed by the Veteran's lumbar spine disability, for which service connection has been denied in a separate decision. There is no specific left hip disability found. The Board recognizes that the CAVC has held that the presence of a disability at any time during the claim process can justify a grant of service connection, even where the most recent diagnosis is negative. McClain v. Nicholson, 21 Vet. App. 319 (2007). However, Congress has specifically limited entitlement to service-connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C.A. § 1110. Hence, where the evidence does not support a finding of current disability upon which to predicate a grant of service connection, there can be no valid claim for that benefit. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer, 3 Vet. App. at 225. As there is no current left hip disability, the Board finds that service connection is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. Duties to Notify and Assist As noted above, the appeal involves a remand by the Board for additional evidentiary development. A remand by the Board confers on the claimant, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). While substantial compliance is required, strict compliance is not. D'Aries v. Peake, 22 Vet. App. 97, 105 (2008) citing Dyment v. West, 13 Vet. App. 141, 146-47 (1999). In this case, the RO substantially complied with the Board's December 2007 remand instruction by preparing a statement of the case with regard to the issue of entitlement to service connection for a left hip condition. The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C.A. §§ 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2011); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2012). The notice requirements of the VCAA require VA to notify the claimant of what information or evidence is necessary to substantiate the claim; what subset of the necessary information or evidence, if any, the claimant is to provide; and what subset of the necessary information or evidence, if any, VA will attempt to obtain. The Board notes that a "fourth element" of the notice requirement requesting the claimant to provide any evidence in the claimant's possession that pertains to the claim was removed from the language of 38 C.F.R. § 3.159(b)(1). See 73 Fed. Reg. 23,353-356 (April 30, 2008). The United States Court of Appeals for Veterans Claims (CAVC) issued a decision in the appeal of Dingess v. Nicholson, 19 Vet. App. 473 (2006), which held that the notice requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a service connection claim, including the degree of disability and the effective date of an award. Those five elements include: (1) veteran status; (2) existence of a disability; (3) a connection between a veteran's service and the disability; (4) degree of disability; and (5) effective date of the disability. The Veteran submitted his claim for service connection for a hip disability in October 2005. He was sent a letter in February 2006 which advised him of the information and evidence necessary to substantiate the claim. Since the letter was sent to the Veteran prior to the initial adjudication of the claim in April 2006, there exists no error in the timing of this notice. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). A January 2007 letter included notice of the evidence necessary to substantiate the claim on a secondary service connection basis. The timing deficiency with respect to this notice was cured by readjudication of the claim in May 2007. Mayfield v. Nicholson, 499 F.3d 1317, 1323 (Fed. Cir. 2007). The Board notes that the Veteran has not been provided specific notice regarding disability ratings and effective dates for the claimed hip disability. However, because the Board's decision herein denies the claim, no disability ratings or effective dates are being, or will be, assigned. Accordingly, there is no possibility of prejudice under the notice requirements of Dingess/Hartman. VA has made reasonable efforts to obtain relevant records and evidence. Specifically, the information and evidence that has been associated with the claims file includes the Veteran's service treatment records, post-service VA and private treatment records, records from the Social Security Administration, and the Veteran's written assertions and those of his attorneys. While the Board is remanding the increased rating and TDIU issues to obtain additional treatment records for Raynaud's disease, to the extent those records might establish an earlier diagnosis of Raynaud's disease, this would not impact the Board's finding with respect to the effective date for service connection, as the effective date assigned herein is based on the earliest pending claim of entitlement to service connection for Raynaud's disease. As set out in detail above, the mere existence of medical records cannot serve as a claim (formal or informal) for service connection; rather, there must be some intent by the claimant to apply for a benefit. See Criswell, 20 Vet. App. 501; Brannon, 12 Vet. App. at 35; 38 C.F.R. § 3.155(a). The Veteran asserted in July 2010 correspondence that he was informed by a VA employee by telephone that not all of his service treatment records were found, "or maybe just not sent." According to the Veteran, these records include evidence that he had Raynaud's disease in service. The Board finds that the entire service treatment records were obtained and there is no indication that there are any missing records. If a VA employee informed the Veteran that his records were missing, this is not recorded in claims file. While the Veteran is competent to relate information provided to him, the Board finds that the normal findings on the service separation examination for the upper and lower extremities, vascular system, and skin, are more persuasive than the Veteran's recent unsupported assertion that an apparently complete set of service treatment records is missing the very records that support in-service onset of the claimed disability. The Veteran's assertion as to missing records is not accurate. See Pond v. West, 12 Vet. App. 341, 345 (1999); and see Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (the Board may properly consider the personal interest a claimant has in his or her own case, and such interest may affect the credibility of testimony). The Veteran was afforded a VA examination in May 2010 to address the etiology of his claimed hip disability. The examiner's finding that there was no hip disability, but that the claimed hip symptoms were attributable to lumbar radiculopathy, obviated the need for an etiology opinion. The Board finds that the May 2010 examination was adequate because it was performed by a medical professional based on a review of claims file, solicitation of history and symptomatology from the Veteran, and a thorough examination of the Veteran. The resulting diagnosis and opinion were accompanied by a rationale that was consistent with the record, and that demonstrated an understanding of the record. Nieves-Rodriguez v. Peake, 22 Vet. App 295 (2008). ORDER An effective date of December 26, 2002, but not earlier, for the grant of service connection for Raynaud's disease is granted. Service connection for a left hip disability is denied. REMAND A remand is necessary regarding the issue of entitlement to service connection for an acquired psychiatric disability so that there is a complete record upon which to decide the claim. VA has a duty to make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate a claim, unless no reasonable possibility exists that such assistance would aid in substantiating the claim. 38 U.S.C.A. § 5103A(a) (West 2002 & Supp. 2012); 38 C.F.R. § 3.159(c), (d) (2012). While the RO obtained a medical opinion regarding whether there was a causal relationship between a current acquired psychiatric disability and a service-connected disability, the December 2011 VA examiner did not provide, and the RO did not request, an opinion regarding aggravation of an acquired psychiatric disability or a personality disorder by a service-connected disability. Service connection may be established for the degree of disability resulting from aggravation of a nonservice- connected disability by a service-connected disability. See also Allen v. Brown, 7 Vet. App.439, 448 (1995). The December 2011 opinion that it is less likely than not that depression and other mental health problems are directly caused by or related to Reynaud's disease does not address aggravation. In addition, service treatment records reveal that, in February 1975, the Veteran was treated for complaints that included low back pain. The examiner noted that the Veteran had fallen on his hip while playing basketball. The Veteran complained that he could not bend over or move, but was OK if he stood straight up. The impression was a muscle spasm with pain magnified by cerebral mechanisms. A May 2007 VA cold injury examiner noted this finding in support of his own finding that the Veteran demonstrated chronic pain behavior aggravated by underlying depression, which appears to be a long-term chronic issue. While it is far from clear, this opinion provides at least plausible support for a direct service connection theory of etiology for an acquired psychiatric disability (depression), as possibly related to service. Also, an April 1992 evaluation from R.D., M.D. reveals a complaint of low back pain that radiates into the left thigh. The Veteran noted that he had previously been involved in lifting weights and running and was "very depressed" at not being able to work out since his recent injury. In disability compensation (service connection) claims, VA must provide a medical examination and medical opinion 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. McLendon v. Nicholson, 20 Vet. App. 79 (2006). With respect to the factor of relationship of current disability to service, the CAVC has indicated that this element establishes a low threshold and requires only that the evidence "indicates" that there "may" be a nexus between the current disability or symptoms and a veteran's service. The types of evidence that "indicate" that a current disability "may be associated" with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology such as pain or other symptoms capable of lay observation. McLendon, 20 Vet. App. at 83; see also Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) (while there must be "medically competent" evidence of a current disability, "medically competent" evidence is not required to indicate that the current disability may be associated with service). A remand is also necessary regarding the increased rating issue for Raynaud's disease so that there is a complete record upon which to decide the claim. The Veteran submitted individual treatment reports from Dr. Karjeker and Dr. Jarfarian in support of his claim of entitlement to service connection for Raynaud's disease; however, the RO apparently did not request additional records from these providers. A prescription slip dated in November 1997 describes the initial treatment of Raynaud's disease and prescription of medication by Dr. Karjeker. In correspondence received in July 2010, the Veteran noted that Dr. Karjeker had treated him for 10 years for Raynaud's disease, and that Dr. Jafarian had treated him for 5 years for Raynaud's disease. Records from these providers are presumed to be relevant to the rating of the Veteran's Raynaud's disease during the period on appeal. While some records were submitted by the Veteran, there is no indication that all pertinent records were submitted. VA will make reasonable efforts to obtain relevant records not in the custody of a Federal department or agency, to include records from private medical care providers. The claimant must cooperate fully with VA's reasonable efforts to obtain relevant records from non-Federal agency or department custodians. The claimant must provide enough information to identify and locate the existing records, including the person, company, agency, or other custodian holding the records; the approximate time frame covered by the records; and, in the case of medical treatment records, the condition for which treatment was provided. If necessary, the claimant must authorize the release of existing records in a form acceptable to the person, company, agency, or other custodian holding the records. See 38 C.F.R. § 3.159(c)(1) (2012). The separate issue of entitlement to a TDIU is inextricably intertwined with the rating issue and the proposed development will encompass that issue. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation). Accordingly, the claim of entitlement to service connection for a psychiatric disability, the claim of entitlement to an increased initial rating for Raynaud's disease, and the claim of entitlement to a TDIU are REMANDED for the following action: 1. Obtain and associate with the claims file treatment records for Raynaud's disease from all providers for which the Veteran has provided the necessary authorization and identification. 2. Schedule an appropriate VA examination to determine the nature and etiology of any current psychiatric disability. The relevant documents in the claims file should be made available to the VA examiner. The examiner is directed to consider a service treatment record from February 1975, in which he was found to have a muscle spasm with pain magnified by cerebral mechanisms. Also consider a May 2007 VA cold injury examination, in which the examiner cited the above evidence in finding chronic pain behavior aggravated by underlying depression, which appears to be a long-term chronic issue. Also consider the April 1992 evaluation from R.D., M.D., who noted that the Veteran had previously been involved in lifting weights and running and was "very depressed" at not being able to work out since his lumbar laminectomy surgery. A lumbar spine disability is currently diagnosed, but is not a service-connected disability. The VA examiner is requested to offer an opinion as to whether it is at least as likely as not (i.e., to at least a 50-50 degree of probability) that a current acquired psychiatric disability is causally or etiologically related to the Veteran's active service. Indications of exaggeration should be noted (if any). The VA examiner is also directed to consider the Veteran's assertion that a current psychiatric disability is proximately due to or a result of a service-connected disability. A May 2011 VA examiner provided an opinion against secondary causation, but did not include an opinion regarding aggravation. Aggravation is defined for VA purposes as an increase in the level of disability (permanent worsening) that is not due to the natural progress of the disease. The VA examiner is requested to offer an opinion as to whether it is at least as likely as not (i.e., to at least a 50-50 degree of probability) that a current acquired psychiatric disorder or personality disorder was (1) caused by, or (2) worsened beyond the normal course of the disease by, any of the Veteran's service-connected disabilities. Note: The term "at least as likely as not" does not mean merely within the realm of medical possibility, but that the medical evidence for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. All opinions are to be accompanied by a rationale consistent with the evidence of record. If the requested medical opinion cannot be given, the examiner should state the reason(s) why. 3. Readjudicate the remanded claims. If any benefit sought on appeal is not granted, the Veteran and his attorney should be provided a supplemental statement of the case and an appropriate time period for response. The case should then be returned to the Board for further consideration, if otherwise in order. 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 Veteran is advised to appear and participate in any scheduled VA examinations, as failure to do so may result in denial of the claims. See 38 C.F.R. § 3.655 (2012). These issues must be afforded expeditious treatment. The law requires that all issues 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). ____________________________________________ JOHN J. CROWLEY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs