Citation Nr: 1329532 Decision Date: 09/16/13 Archive Date: 09/20/13 DOCKET NO. 10-18 248 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for lower extremity sciatica. 2. Entitlement to service connection for a cervical spine disability with radicular pain and numbness. 3. Entitlement to service connection for hemorrhoids. 4. Entitlement to service connection for degenerative disc disease of the lumbar spine. 5. Entitlement to service connection for migraine headaches. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. Young, Counsel INTRODUCTION The Veteran had active duty service from May 1981 to November 2007, when she retired. These matters come before the Board of Veterans' Appeals (Board) on appeal from a May 2008 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA) that, in pertinent part, denied service connection for left lower extremity sciatica, recurrent urinary tract infection, cervical spine disability with radicular pain and numbness, anal fissure, hemorrhoids, degenerative disc disease of the lumbar spine, and migraine headaches. A notice of disagreement were received in April 2009, a statement of the case was issued in September 2009. In November 2009 the Veteran requested an extension to file her Substantive Appeal (VA Form 9), which was granted in January 2010. A Substantive Appeal was received in March 2010 only as to the issues stated in the "Issues" section above. In October 2012 the Veteran appeared at a Travel Board hearing before the undersigned; a transcript of that hearing is of record. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND At the October 2012 Board hearing, the Veteran submitted additional evidence pertaining to all the issues currently on appeal. She did not waive her right to have the evidence considered by the agency of original jurisdiction in the first instance; in fact she requested that the additional evidence be sent to the RO for review. The Veteran also indicated that she received postservice treatment at a naval medical facility and that she would obtain those records and submit them to the Board in order that the Board send them to the RO. In February 2013 the Board received additional evidence related to the Veteran's claims. Under the circumstances, all of the newly received evidence must be first reviewed by the RO to determine if any changes are warranted in the RO's adjudications of the several disabilities. It is noted that the question of current diagnosed disability for the issues on appeal has been raised. Additionally, the Board notes that the Veteran had a VA general medical examination in December 2007 that addressed each of the issues on appeal. During the October 2012 hearing the Veteran indicated that she did not want to be scheduled for another examination. She stated "I do not care to see another doctor. I despise doctors." However, in view of the need to return the case to the RO for review of the additional records, the Board believes it appropriate to give the Veteran an opportunity to report for examination. It is again stressed that the question of current diagnosed disability for the issues has been raised. Accordingly, the case is REMANDED for the following actions: 1. The RO should ask the Veteran to identify the provider(s) of any additional treatment or evaluation she has received for the claimed disabilities (left lower extremity sciatica, cervical spine disability with radicular pain and numbness, degenerative disc disease of the lumbar spine, hemorrhoids, and migraine headaches), which are not already associated with the claims file, and to provide any releases necessary for VA to secure any non-VA records of such treatment or evaluation. The RO should obtain complete records of all such treatment and evaluation from all sources identified by the Veteran. The RO should specifically obtain any relevant treatment records (not already of record) from the Naval Hospital in Pensacola, Florida to include records from November/ December 2007 to the present. 2. After completion of the above to the extent possible, the RO should schedule the Veteran for appropriate VA examination(s) to determine the nature and etiology of the claimed (1) left lower extremity sciatica, (2) cervical spine disability with radicular pain and numbness, (3) degenerative disc disease of the lumbar spine, (4) hemorrhoids, and (5) migraine headaches. It is imperative that the claims file be made available to and be reviewed by the examiner(s) in connection with the examinations. All indicated evaluations, studies, and tests deemed necessary by the examiner(s) should be accomplished and all findings reported in detail. The appropriate examiner(s) should clearly identify all diagnoses involving any of the claimed disabilities. The low back examiner should specifically indicate whether the evidence, to include MRI studies already conducted, shows degenerative disc disease or other disability. As to each such current disability identified, the appropriate examiner(s) should offer an opinion as to whether that disability is at least as likely as not (a 50% or higher degree of probability) causally related to the Veteran's active duty service. A detailed rationale for all opinions expressed should be provided. 3. In the event the Veteran fails to report for the examination(s), the claims file should nevertheless be forwarded to an appropriate examiner(s) for review and for opinions regarding: a) whether medical diagnoses of any of the claimed disorders are warranted by on the totality of the evidence of record; and, b) whether it is at least as likely as not (a 50% or higher degree of probability) that any such current disability so diagnosed is causally related to service. The Board is particularly interested in medical clarification as to whether the evidence of record, to include MRI and/or x-ay studies, show degenerative disc disease of the low back. 4. After completion of the above and any other development which the RO may deem necessary, the RO should review the claims file (including the additional evidence the Veteran submitted after the September 2009 statement of the case (SOC)) and readjudicate the claims on appeal. If the benefits sought are not granted, the Veteran should be furnished an appropriate supplemental SOC and afforded an opportunity to respond. Thereafter, the case should be returned to the Board for further appellate review. 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 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). _________________________________________________ ALAN S. PEEVY Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).