Citation Nr: 1329564 Decision Date: 09/16/13 Archive Date: 09/20/13 DOCKET NO. 11-02 289 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in North Little Rock, Arkansas THE ISSUES 1. Entitlement to service connection for residuals of appendix surgery. 2. Entitlement to service connection for residuals of tooth surgery. REPRESENTATION Veteran represented by: Veterans of Foreign Wars of the United States WITNESSES AT HEARING ON APPEAL Veteran and his spouse ATTORNEY FOR THE BOARD L. J. N. Driever INTRODUCTION The Veteran had active service from June 1968 to June 1970. These claims come before the Board of Veterans' Appeals (Board) on appeal of June 2009 and May 2010 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in North Little Rock, Arkansas. The Veteran and his spouse testified in support of these claims during a video-conference hearing held before the undersigned Veterans Law Judge in August 2011. The Veteran's assertion that he developed gum and tooth pain secondary to in-service tooth extractions raises a claim for service connection for a dental condition solely for VA outpatient dental treatment purposes. The Board refers this claim to the RO for appropriate action. The appeal is REMANDED to the RO via the Appeals Management Center (AMC) in Washington, DC. VA will notify the Veteran if further action is required. REMAND The Board sincerely regrets the delay associated with this remand, but further action, including obtaining additional medical information, is necessary before the Board adjudicates these claims. See 38 C.F.R. § 19.9 (2012). During his hearing, the Veteran identified treatment records that are outstanding and need to be obtained in support of these claims. Specifically, he indicated that he received dental treatment and had gotten cream for his appendectomy scar at McClellan, the VA Medical Center in Little Rock, Arkansas. See transcript at 5, 13-14 (Aug. 9, 2011). In addition, to date, no medical professional has offered opinions as to whether the Veteran has residuals of his in- service appendectomy and alleged in-service dental trauma. Such opinions are crucial given that the Veteran contends that he has been manifesting multiple lay-observable symptoms since the in-service appendectomy and alleged in- service dental trauma, including abdominal pain, a painful scar at the site of the appendectomy, tooth and gum pain, bleeding from the nose, headaches, difficulty eating, and earaches. On remand, an additional attempt should also be made to obtain the Veteran's treatment records from Dr. Lonzo William. Accordingly, the case is REMANDED for the following action: 1. Obtain and associate with the claims file the Veteran's complete treatment records from the McClellan, VA Medical Center in Little Rock, Arkansas. 2. Obtain and associate with the claims file the Veteran's complete treatment records from Dr. Lonzo William. 3. After the outstanding treatment records are associated with the claims file, afford the Veteran a VA examination(s) for the purpose of determining whether he has residuals of his in-service appendectomy and any residuals of in-service dental trauma. The examiner must: a. Review the claims file and indicate in writing in the record that such review occurred. b. Refer to all pertinent information of record, paying particular attention to: i. the Veteran's service treatment records, which do not confirm dental trauma, but show that he underwent an appendectomy and tooth extractions and received dentures during service; and ii. the Veteran's assertions that he experienced dental trauma while undergoing the confirmed dental treatment and now has residuals of that trauma and the confirmed appendectomy; c. Record in detail the Veteran's reported history of abdominal and dental complaints and in-service dental trauma; d. Offer an opinion as to whether the Veteran experienced dental trauma secondary to his in-service dental procedures; e. Accepting as competent the Veteran's reports of lay- observable abdominal, scar, tooth and gum pain, bleeding from the nose, headaches, difficulty eating, and earaches, offer an opinion as to whether the Veteran has residuals of his in-service appendectomy and/or any objectively confirmed in-service dental trauma. f. Provide detailed rationale, with references to the record, for all opinions expressed. g. If such an opinion cannot be expressed without resorting to speculation, identify in writing in the record any outstanding evidence that could be obtained to aid in providing such an opinion. 4. Next, ensure that the VA examination report(s) complies with the instructions noted above and, if not, return it to the examiner(s) for correction. 5. Finally, readjudicate the Veteran's claims based on all of the evidence of record. If any benefit sought on appeal is not granted in full, provide the Veteran and his representative with a supplemental statement of the case and allow an appropriate time for response. 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). These claims 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). _________________________________________________ P.M. DILORENZO Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals 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).