Citation Nr: 1328419 Decision Date: 09/05/13 Archive Date: 09/16/13 DOCKET NO. 12-35 721 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to an initial compensable rating for scar residuals of a right thumb laceration. 2. Entitlement to an initial compensable rating for bilateral hearing loss. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD John Kitlas, Counsel INTRODUCTION The Veteran served on active duty from June 1950 to April 1951, and from April 1951 to April 1956. This matter is before the Board of Veterans' Appeals (Board) on appeal from October 2010 and June 2011 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). The October 2010 rating decision, in pertinent part, granted service connection for scar residuals of a right thumb laceration, evaluated as noncompensable (zero percent) effective May 18, 2010. The June 2011 rating decision, in pertinent part, granted service connection for bilateral hearing loss, and assigned a noncompensable rating effective March 31, 2011. The Veteran appealed, contending that compensable ratings were warranted for both disabilities. He did not disagree with the effective date assigned for these disabilities. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). This case was previously before the Board in May 2013, at which time it was remanded for further development to include new VA medical examinations to determine the current severity of the Veteran's service-connected scar residuals of right thumb laceration and the bilateral hearing loss. Such examinations were accomplished in June 2013. All other development directed by the Board's remand was substantially accomplished. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (Remand not required under Stegall where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (2002). Despite the foregoing, for the reasons addressed in the REMAND portion of the decision below the Board finds that further development is still required regarding the hearing loss claim. Accordingly, this claim is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. The record also reflects the Veteran submitted evidence directly to the Board, and in a July 2013 statement, the Veteran's representative stated that the Veteran waived initial consideration of such evidence by the agency of original jurisdiction (AOJ) in accord with 38 C.F.R. § 20.1304 (2012). FINDINGS OF FACT 1. All reasonable notification and development necessary for the equitable disposition of the Veteran's appeal regarding his right thumb scar residuals claim has been completed. 2. Service connection was denied for residuals of right hand fracture to include arthritis with pain and limited grip by the October 2010 decision, and the Veteran did not appeal that denial. 3. The record reflects the Veteran has two (2) linear scars of the right thumb that are laceration residuals. These scars are not deep nor do they cover an area or areas of at least 6 square inches (39 square centimeters); nor are they painful or unstable; nor are they demonstrated to result in other functional impairment such as limitation of motion of the joint affected. CONCLUSION OF LAW The criteria for a compensable rating for scar residuals of a right thumb laceration are not met. 38 U.S.C.A. §§ 1155, 5103, 5103A, 5107 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.159, 4.1, 4.2, 4.31, 4.10, 4.118, Diagnostic Code 7800- 7805 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSION Preliminary Matters The Board notes at the outset that, in accord with the Veterans Claims Assistance Act of 2000 (VCAA), VA has an obligation to notify claimants what information or evidence is needed in order to substantiate a claim, as well as a duty to assist claimants by making reasonable efforts to get the evidence needed. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A and 5107 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2012); see also Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002). The Board notes that the right thumb scar residuals claim originates from a disagreement with the initial rating assigned for this disability following the establishment of service connection. In Dingess v. Nicholson, 19 Vet. App. 473, 490-1 (2006), the United States Court of Appeals for Veterans Claims (Court) held that in cases where service connection has been granted and an initial disability rating and effective date have been assigned, the typical service- connection claim has been more than substantiated, it has been proven, thereby rendering section 5103(a) notice no longer required because the purpose that the notice is intended to serve has been fulfilled. Thus, VA's duty to notify in this case is satisfied. See also Dunlap v. Nicholson, 21 Vet. App. 112 (2007); Goodwin v. Peake, 22 Vet. App. 128 (2008). In addition, the Board finds that the duty to assist a claimant in the development of his case has been satisfied regarding the right thumb scar residuals claim. The Veteran's service treatment records are on file, as are various post-service medical records. Further, the Veteran has had the opportunity to present evidence and argument in support of this claim, and nothing indicates he has identified the existence of any relevant evidence that has not been obtained or requested. For example, he has not identified any outstanding evidence which demonstrates symptoms of the service-connected disability that is not demonstrated by the evidence already of record. Moreover, he was accorded VA medical examinations in September 2010 and June 2013 which included findings regarding the symptomatology of the right thumb scar residuals. These findings are consistent with the treatment records on file and the relevant rating criteria. No inaccuracies or prejudice is demonstrated with respect to these examinations, nor has the Veteran indicated this disability has increased in severity since the most recent examination. Accordingly, the Board finds that these examinations are adequate for resolution of this case. Consequently, the Board finds that the duty to assist the Veteran has been satisfied in this case. The Board notes that it has thoroughly reviewed the record in conjunction with this case. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence submitted by the appellant or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (The Board must review the entire record, but does not have to discuss each piece of evidence). Rather, the Board's analysis below will focus specifically on what the evidence shows, or fails to show, on the claims. See Timberlake v. Gober, 14 Vet. App. 122, 129 (2000) (Noting that 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). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of his current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). When considering whether lay evidence is competent the Board must determine, on a case by case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376- 77. The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C.A. § 7104(a) (West 2002). Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt shall be given to the claimant. 38 U.S.C.A. § 5107(b). When a reasonable doubt arises regarding service origin, such doubt will be resolved in the favor of the claimant. Reasonable doubt is doubt which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. 38 C.F.R. § 3.102. The question is whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which event the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990). Legal Criteria and Analysis Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable, general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability, 38 C.F.R. § 4.2; resolving any reasonable doubt regarding the degree of disability in favor of the claimant, 38 C.F.R. § 4.3; where there is a question as to which of two evaluations applies, assigning the higher of the two where the disability picture more nearly approximates the criteria for the next higher rating, 38 C.F.R. § 4.7; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disability upon the person's ordinary activity, 38 C.F.R. § 4.10. See Schafrath v. Derwinski, 1 Vet. App. 589 (1991). The degree of impairment resulting from a disability is a factual determination and generally the Board's primary focus in such cases is upon the current severity of the disability. Francisco v. Brown, 7 Vet. App. 55, 57-58 (1994); Solomon v. Brown, 6 Vet. App. 396, 402 (1994). However, in Fenderson v. West, 12 Vet. App. 119 (1999), it was held that the rule from Francisco does not apply where the appellant has expressed dissatisfaction with the assignment of an initial rating following an initial award of service connection for that disability. Rather, at the time of an initial rating, separate ratings can be assigned for separate periods of time based on the facts found - a practice known as "staged" ratings. More recently, the Court held that "staged" ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). With regard to the Veteran's request for an increased schedular evaluation, the Board will only consider the factors as enumerated in the applicable rating criteria. See Massey v. Brown, 7 Vet. App. 204, 208 (1994); Pernorio v. Derwinski, 2 Vet. App. 625, 628 (1992). In every instance where the schedule does not provide a zero percent evaluation for a Diagnostic Code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. As the Veteran's claim of service connection for the right thumb scar residuals was received in May 2010, this service- connected disability is to be evaluated based upon the rating criteria for scars as revised effective October 23, 2008. See 73 Fed. Reg. 54,710 (October 23, 2008) (This amendment shall apply to all applications for benefits received by VA on or after October 23, 2008.). Scar disabilities are evaluated pursuant to the criteria found at 38 C.F.R. § 4.118, Diagnostic Codes 7800 to 7805 (2012). Diagnostic Code 7800 pertains to burn scars of the head, face, or neck; scars of the head, face, or neck due to other causes; or other disfigurement of the head, face, or neck. 38 C.F.R. § 4.118 (2012). As this appeal involves a thumb scar, this Diagnostic Code is not for application. Diagnostic Code 7801 pertains to burn scars or scars due to other causes, not of the head, face, or neck, that are deep and nonlinear. 38 C.F.R. § 4.118 (2012). Under this Code, a 10 percent rating is to be assigned when the scar(s) cover an area or areas of at least 6 square inches (39 sq. cm) but less than 12 square inches (77 sq. cm). Area or areas of at least 12 square inches (77 sq. cm) but less than 72 square inches (465 sq. cm) is assigned a 20 percent rating. Area or areas of at least 72 square inches (465 sq. cm) but less than 144 square inches (929 sq. cm) is assigned a 30 percent rating. Area or areas of 144 square inches (929 sq. cm) or greater is assigned a 40 percent rating. The September 2010 VA scars examiner reported that the Veteran had a vertical 1 inch long scar on the medial surface of the right thumb. The examiner stated that the Veteran also had a 0.5 inch long horizontal scar at the base of the right thumb. The examiner also reported that the scars were superficial; i.e., they were not deep. The more recent June 2013 VA scars examiner found the Veteran to have 2 linear scars of the right thumb, with one on the medial surface vertically and one on the base horizontally. The first scar was 2.5 cm long x 0.1 cm wide, while the second scar was 1.25 cm long x 0.1 cm wide. Thus, the competent medical evidence shows that the service- connected right thumb scars are not deep or nonlinear, nor do they cover an area or areas of at least 6 square inches (39 square centimeters). Therefore, the Veteran does not satisfy the criteria for a compensable rating under Diagnostic Code 7801. Diagnostic Code 7802 pertains to burn scars or scars due to other causes not of the head, face, or neck, that are superficial and nonlinear. 38 C.F.R. § 4.118 (2012). Under this Code, a 10 percent rating is assigned when the scar(s) cover an area or areas of 144 square inches (929 sq. cm) or greater. No other rating is provided by this Code. Note (1) states that a superficial scar is one not associated with underlying soft tissue damage. Although the record indicates that the service-connected right thumb scars are superficial, they have also been found to be linear. More importantly, as detailed above, his thumb scars do not cover an area of at least 6 square inches (39 square centimeters). Therefore, they clearly do not cover an area or areas of 144 square inches (929 sq. cm) or greater. Consequently, the Veteran is not entitled to a compensable rating under this Diagnostic Code. Prior to October 23, 2008, Diagnostic Code provided for evaluation of superficial, unstable scars, and Diagnostic Code 7804 provided for evaluation of a superficial scar that is painful on examination. Effective October 23, 2008, Diagnostic Code 7803 was eliminated, and Diagnostic Code 7804 was revised to pertain to scars that are both unstable and/or painful. Diagnostic Code 7804 provides that one or two scars that are unstable or painful warrant a 10 percent evaluation; three or four scars that are unstable or painful warrant a 20 percent evaluation; five or more scars that are unstable or painful warrant a 30 percent evaluation. 38 C.F.R. § 4.118 (2012). An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Id. at Note (1). If one or more scars are both unstable and painful, the rater is to add 10 percent to the evaluation that is based on the total number of unstable or painful scars. Id. at Note (2). Scars evaluated under Diagnostic Codes 7800, 7801, 7802, or 7805 may also receive an evaluation under DC 7804, when applicable. Id. at Note (3). In this case, the September 2010 VA scars examination found that the Veteran's right thumb scars were not painful or unstable. Similarly, the June 2013 VA examination found that the Veteran did not have any scars that were painful or unstable. Therefore, he is not entitled to a compensable rating under Diagnostic Code 7804. Diagnostic Code 7805 provides that other scars (including linear scars) and other effects of scars evaluated under Diagnostic Codes 7800, 7801, 7802, and 7804 require the evaluation of any disabling effect(s) not considered in a rating provided under Diagnostic Codes 7800-7804 under an appropriate diagnostic code. 38 C.F.R. § 4.118. Prior to October 23, 2008, the rater was directed to rate other scars on limitation of function of the affected part. 38 C.F.R. § 4.118 (2008). In this case, the Veteran maintains that he developed arthritis of the right thumb and hand due to the initial injury, and experiences pain and functional impairment such as limitation of motion as a result thereof. He also submitted a January 2011 private treatment report from D. O. Sagini, M.D., which related an assessment of right hand arthritis with decreased thumb function when compared to the contralateral side. However, service connection was denied for residuals of right hand fracture to include arthritis with pain and limited grip by the October 2010 decision, and the Veteran did not appeal that denial. Accordingly, such impairment is not for consideration in evaluating the dermatological disability of service-connected right thumb scar residuals. The Board also notes that a September 2010 VA hand, thumb, and fingers examination report noted that the Veteran fell and sustained a right thumb laceration, which was repaired with sutures, in 1953. The diagnosis was osteoarthritis and deformity of the proximal phalanx of the right thumb, compatible with old trauma. The examiner commented, after a review of the Veteran's claims file, that it was less likely as not that his osteoarthritis and deformity of the proximal phalanx of the right thumb, compatible with old trauma, was the same as, or was a result of, the fall in service in which he sustained a laceration on his right thumb. A similar opinion was expressed by the June 2013 VA examiner. Moreover, the January 2011 treatment report from Dr. Sagini does not actually relate the etiology of the right hand arthritis with decreased thumb function to active service. Therefore, the Board finds the osteoarthritis and deformity of the proximal phalanx of the right thumb are not manifestations of the service-connected dermatological disability of right thumb scars. The Board further notes that the September 2010 VA scars examination found that the Veteran's scars did not result in other functional impairment such as limitation of motion of the joint affected. The examiner also maintained that scars had no other disabling effects. Similarly, the June 2013 VA examiner opined that it was less likely than not (less than 50 percent probability) that the Veteran's claimed functional impairment of the right hand was due to or aggravated by scar residuals of right thumb laceration that occurred in the service. In view of the foregoing, the Board finds that the Veteran does not warrant a compensable evaluation for his service- connected right thumb scar residuals under Diagnostic Code 7805. Although 38 C.F.R. § 4.118 provides for evaluation of other skin disorders, none of the other Diagnostic Codes pertains to scar(s). Therefore, the Board finds that the Veteran does not meet or nearly approximate the schedular criteria for a compensable rating under any of the potentially applicable Diagnostic Codes. In making this determination, the Board has considered the Veteran's contentions that he experienced pain and functional impairment of the right hand. However, more weight was given to the competent medical findings that such impairment was not due to the service-connected dermatological disability that is the subject of this appeal. The Board notes that it also considered the potential applicability of "staged" ratings pursuant to Fenderson, supra, and Hart, supra. However, a thorough review of the record does not demonstrate any distinctive periods where the service-connected right thumb scar residuals met or nearly approximated the criteria for a compensable rating. Therefore, "staged" ratings are not warranted in this case. In exceptional cases an extraschedular rating may be provided. 38 C.F.R. § 3.321. The Court has set out a three-part test, based on the language of 38 C.F.R. § 3.321(b)(1), for determining whether a Veteran is entitled to an extraschedular rating: (1) the established schedular criteria must be inadequate to describe the severity and symptoms of the claimant's disability; (2) the case must present other indicia of an exceptional or unusual disability picture, such as marked interference with employment or frequent periods of hospitalization; and (3) the award of an extraschedular disability rating must be in the interest of justice. Thun v. Peake, 22 Vet. App. 111 (2008), aff'd, Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). In this case, as noted above, the record indicates the Veteran does not experience any functional impairment or other symptomatology due to his service-connected right thumb scar residuals. In fact, the record shows the scars are not painful, tender, deep, or nonlinear. Therefore, he does not have an exceptional or unusual disability picture so as to render inadequate the established schedular criteria. The Board also takes note of the fact that the September 2010 and June 2013 VA examinations reflect that, in addition to the aforementioned right thumb scars, the Veteran has a scar of the right index finger. However, as the service- connected disability is thumb scar residuals, the finger scar is not for consideration in the instant case. Lastly, the Board notes that notes that, in Rice v. Shinseki, 22 Vet. App. 447 (2009), the Court held that a claim of entitlement to a total rating based upon individual unemployability (TDIU) is part of an increased rating claim when such claim is expressly raised by the Veteran or reasonably raised by the record. The Court further held that when evidence of unemployability is submitted at the same time that the Veteran is appealing the initial rating assigned for a disability, the claim for TDIU will be considered part and parcel of the claim for benefits for the underlying disability. Id. In this case, nothing in the record indicates the Veteran is unable to obtain or maintain substantially gainful employment due to his service- connected right thumb scar residuals. In fact, the record reflects he does not experience any functional impairment or other symptomatology due to this service-connected disability. Therefore, no further discussion of entitlement to a TDIU is warranted in this case. For these reasons, the Board finds that the preponderance of the evidence is against the Veteran's claim for a compensable rating for his service-connected right thumb scar residuals. As the preponderance of the evidence is against this claim, the benefit of the doubt doctrine is not for application in the instant case. See generally Gilbert, supra; see also Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). Consequently, the benefit sought on appeal with respect to this claim must be denied. ORDER An initial compensable rating for scar residuals of a right thumb laceration is denied. REMAND VA rating criteria for the evaluation of hearing loss disability provide ratings from zero (noncompensable) to 100 percent, based on the results of controlled speech discrimination tests together with the results of pure tone audiometry tests which average pure tone thresholds at 1000, 2000, 3000, and 4000 Hertz. 38 C.F.R. §§ 4.85-4.87; Diagnostic Codes 6100 to 6110. The evaluation of hearing impairment applies a rather structured formula which is essentially a mechanical application of the rating schedule to numeric designations after audiology evaluations are rendered. Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). When the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. 38 C.F.R. § 4.86. Further, when the average puretone threshold is 30 decibels at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. Id. In this case, the Veteran was accorded VA audio examinations in May 2011, August 2011, and June 2013. However, both the August 2011 and June 2013 VA examiners indicated that the test results were not reliable. Further, the record includes audiological evaluation reports from Audio Consultants of SW Florida dated in July 2011 and March 2012, and the audiographs for these evaluations indicate a more severe hearing loss than what was demonstrated on the May 2011 VA examination. Although no speech discrimination scores appear to be included on these reports, the audiograph itself suggests the type of exceptional hearing loss pursuant to 38 C.F.R. § 4.86 that would warrant consideration of Table VIa based only on purteone threshold average. The Board notes, however, that pursuant to 38 C.F.R. § 4.85(a) an examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. Here, it is not clear from the July 2011 and March 2012 private evaluation reports from Audio Consultants of SW Florida that they were conducted in accord with these requirements. In Savage v. Shinseki, 24 Vet. App. 259, 260 (2011), the Court held that, "in some circumstances, VA does have a duty to return for clarification unclear or insufficient private examination reports or progress notes, or the Board must explain why such clarification is not necessary." The Court specifically named unclear application of the Maryland CNC test as a circumstance warranting remand. Id. at 270. In view of the foregoing, the Board finds that a remand is required in order to obtain clarification from Audio Consultants of SW Florida regarding the results of the July 2011 and March 2012 audio evaluations, to include whether these evaluations were conducted pursuant to the requirements of 38 C.F.R. § 4.85(a). Additionally, as a remand is already required in this case, and the June 2013 VA audio examiner determined that the results of that evaluation were unreliable, the Board finds that another examination should be conducted to evaluate the current nature and severity of the Veteran's service- connected hearing loss. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. The AMC/RO should request the names and addresses of all medical care providers who have treated the Veteran for his hearing loss since June 2013. After securing any necessary release, the AMC/RO should obtain those records not already on file. 2. The AMC/RO should notify the Veteran that he may submit lay statements from individuals who have first-hand knowledge, and/or were contemporaneously informed of the nature, extent and severity of his hearing loss symptoms and the impact of the condition on his ability to work. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 3. The AMC/RO should contact the Veteran's private medical provider at the Audio Consultants of SW Florida, and ask him or her to determine (i) if the Maryland CNC word list was used during audiological testing completed in July 2011 and March 2012; (ii) the numeral decibel levels in all frequencies for the July 2011 and March 2012 evaluations; and (iii) if these evaluations were performed by a state- licensed audiologist. Document all efforts made to obtain this clarification. 4. After obtaining any additional records to the extent possible, the Veteran should be afforded a new examination to evaluate the nature and severity of his service-connected hearing loss. The claims folder should be made available to the examiner for review before the examination. 5. After completing any additional development deemed necessary, the AMC/RO should readjudicate the issue on appeal in light of any additional evidence added to the records assembled for appellate review. If the benefits requested on appeal are not granted to the Veteran's satisfaction, the Veteran and his representative should be furnished a Supplemental Statement of the Case (SSOC), which addresses all of the evidence obtained after the issuance of the last SSOC in June 2013, and provides an opportunity to respond. The case should then be returned to the Board for further appellate consideration, if in order. By this remand, the Board intimates no opinion as to any final outcome warranted. 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). ______________________________________________ M. N. HYLAND Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs