Citation Nr: 18150083 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 14-35 328 DATE: November 14, 2018 ORDER Entitlement to service connection for bilateral hearing loss disability is granted. Entitlement to service connection for tinnitus is granted. Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. REMANDED Entitlement to service connection for right foot tendonitis, to include as secondary to bilateral pes planus, is remanded. Entitlement to service connection for left foot tendonitis, to include as secondary to bilateral pes planus, is remanded. Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for bilateral pes planus is remanded. Entitlement to service connection for right heel calcaneal spur, to include as secondary to bilateral pes planus, is remanded. Entitlement to service connection for left heel calcaneal spur, to include as secondary to bilateral pes planus, is remanded. Entitlement to service connection for hemorrhoids is remanded. FINDINGS OF FACT 1. The Veteran’s bilateral hearing loss disability is related to exposure to loud noises in service. 2. The Veteran’s tinnitus began during active service. 3. The Veteran’s PTSD is related to a malfunction during a parachute jump during a period of active duty for training (ACDUTRA). CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss disability are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 3. The criteria for service connection for PTSD are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.6, 3.102, 3.303(a), 3.304(f). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1976 to August 1978, with an additional period of active duty for training (ACDUTRA) from April 1976 to August 1976. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an April 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in March 2018. A transcript of that hearing is of record. The issue of entitlement to a temporary total convalescence rating pursuant to 38 C.F.R. § 4.30 is separately docketed and awaiting further administrative action according to the Board’s Veterans Appeals Control and Locator System (VACOLS). As such, this issue will not be adjudicated at this time. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 1. Entitlement to service connection for bilateral hearing loss disability The Veteran contends that he has a bilateral hearing loss disability that was caused by exposure to loud noise in service, such as the sound of weaponry firing. The Board notes that the Veteran’s military occupational specialty (MOS) during his period of active service with the marines was rifleman, which is consistent with the Veteran’s report of being exposed to the sound of weaponry firing. The Board concludes that the Veteran has a current diagnosis of bilateral hearing loss disability that is related to exposure to loud noises in service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Although the March 2013 VA examination found that the Veteran did not have a hearing loss disability for VA purposes, a May 2013 private treatment record shows the Veteran has a current diagnosis of bilateral hearing loss disability, noting hearing thresholds in the right ear of 30 decibels at 500, 1000 and 2000 Hertz, 25 decibels at 3000 Hertz, and 20 decibels at 4000 Hertz, as well as left ear hearing thresholds of 40 decibels at 500 and 1000 Hertz, 35 decibels at 2000 Hertz, 25 decibels at 3000 Hertz, and 20 decibels at 4000 Hertz. Speech discrimination scores were 76 percent in the right ear and 72 percent in the left ear. These results meet the requirements to be considered a hearing loss disability according to 38 C.F.R. § 3.385. A June 2013 letter from a private audiologist discussed the Veteran’s work with weaponry and accompanying excessive noise exposure in service. The audiologist found a 15 decibels downward shift at the frequencies 500-6000 Hertz in the right ear and 10 decibels at the frequencies of 2000 and 6000 Hertz in the left ear, over the course of service. The audiologist considered this shift to be significant, and concluded that based upon the noise exposure and the significant hearing threshold shift in service, the Veteran’s bilateral hearing loss was caused by or contributed to by noise exposure during service. The Board recognizes that the March 2013 VA examination found no current hearing loss disability, and provided a negative etiological opinion because the Veteran’s hearing was within normal limits upon enlistment and separation. As was noted by the private audiologist, there is a downward shift between the hearing thresholds recorded in the September 1976 entrance examination and the August 1978 separation examination, although the Board notes that the Veteran’s hearing was not tested at 3000 and 6000 Hertz in the entrance examination. The Board finds that the private May 2013 opinion has at least as much probative value as the March 2013 VA examination opinion, and will resolve doubt in favor of the Veteran to find that a nexus exists between current bilateral hearing loss disability and the in-service exposure to the noise of weaponry firing. The Veteran’s claim of entitlement to service connection for a bilateral hearing loss disability is thus granted. 2. Entitlement to service connection for tinnitus The Veteran asserts that he has tinnitus that was incurred in service due to exposure to loud noise. The Board concludes that the Veteran has a current diagnosis of tinnitus that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran, as a lay person, is competent to diagnose tinnitus. Charles v. Principi, 16 Vet. App. 370 (2002). The March 2013 VA examination noted that the Veteran reported tinnitus since he was in the military, but provided a negative nexus opinion because “the cited evidence does not show findings related to tinnitus.” This assertion appears to be an indication that the Veteran’s service medical records (SMRs) do not contain tinnitus findings. This examination does not consider the Veteran’s competent lay report of tinnitus since service, and is thus of limited probative value. The June 2013 private audiologist’s opinion acknowledged the Veteran’s report of tinnitus that began while in the military, and concluded that the Veteran’s tinnitus was caused by or contributed to by noise exposure during service. As rationale the audiologist pointed to the exposure to excessive noise levels without adequate hearing protection in the military and a demonstrated significant shift in the Veteran’s hearing thresholds. The Board finds that the June 2013 private opinion has more probative value because it considers the Veteran’s competent report of experiencing tinnitus since service. The evidence is at least in equipoise, and the Board finds that it is at least as likely as not that the Veteran’s tinnitus began during his active military service. The Veteran’s claim of entitlement to service connection for tinnitus is granted. 3. Entitlement to service connection for PTSD The Veteran contends that he has PTSD due to his in-service experiences of a malfunction during a parachute jump in service, and knowing two friends who died after driving off a mountain. The Board concludes that the Veteran has a current diagnosis of PTSD that is related to a malfunction during a parachute jump, which was performed during a period of ACDUTRA. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The term “active military naval, or air service” includes active duty, any period of active duty for training (“ACDUTRA”) during which the individual concerned was disabled or died from disease or injury incurred or aggravated in line of duty, and any period of inactive duty training (“INACDUTRA”) during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty. 38 U.S.C. § 101(24). ACDUTRA includes full-time duty in the Armed Forces performed by the Reserves for training purposes. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c). Inactive duty training includes duty, other than full-time duty, prescribed for the Reserves. 38 U.S.C. § 101(23)(A). In this case, the DD214 for the Veteran’s service from April 1976 to August 1976 states specifically that the Veteran’s separation is relief from “ADT”, or active duty for training, and that his service was with the Army National Guard. Therefore, the Veteran’s service from April 1976 to August 1976 was ACDUTRA, rather than regular active duty. There are particular requirements for establishing service connection for PTSD in 38 C.F.R. § 3.304(f) that are separate from those for establishing service connection generally. Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Establishing service connection for PTSD requires “(1) a current medical diagnosis of PTSD; (2) a link between the current symptoms and an in-service stressor; and (3) ‘credible supporting evidence that the claimed in-service stressor occurred.’” Kays v. Snyder, 846 F.3d 1208, 1211 (Fed. Cir. 2017) (citing 38 C.F.R. § 3.304 (f)). One of the Veteran’s stressors is that during one of his parachute jumps his parachute became tangled such that he was afraid that it would collapse as he was coming down. The Veteran reported this stressor in several statements, as well as in his March 2018 hearing testimony. The Veteran’s personnel records indicate that he completed several parachute jumps in August 1976. The Board finds that this record of parachute jumps is credible supporting evidence. It is at least as likely as not that one of those jumps included a malfunction in which the Veteran’s parachute became tangled such that the Veteran felt frightened. Therefore, the in-service stressor of a tangled parachute is conceded. The stressor of knowing two individuals who died after driving off a mountain has not been corroborated by supporting evidence, and thus will not be further discussed in this decision. A March 2013 VA examination found that the Veteran did not have a current diagnosis of PTSD. However, the Veteran has been diagnosed with PTSD multiple times in his treatment records, including by a VA clinician in April 2015, and by a private psychologist in July 2013. The July 2013 private opinion discussed the incident in which the parachute became tangled and the Veteran feared for his life as a stressor, and noted that the Veteran experiences nightmares in which his parachute does not open and he falls to his death. The psychologist went on to find that the Veteran meets the diagnostic criteria for service-connected PTSD. Although this private opinion has a scanty rationale, the Board finds that the discussion of the incident with the tangled parachute indicates that this in-service event is the basis of the PTSD, and resolves doubt in favor of the Veteran to find that the evidence is at least in equipoise as to whether the Veteran’s PTSD is related to the difficult parachute jump during his period of ACDUTRA. Therefore, the Veteran’s claim of entitlement to service connection for PTSD is granted. REASONS FOR REMAND 1. Entitlement to service connection for left foot tendonitis, to include as secondary to bilateral pes planus, is remanded. 2. Entitlement to service connection for right foot tendonitis, to include as secondary to bilateral pes planus, is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for left foot tendonitis or right foot tendonitis because no VA examiner has opined whether the Veteran’s left foot tendonitis or right foot tendonitis had its onset during service, or is at least as likely as not due to the Veteran’s experience of frequent running during both ACDUTRA and active service, as well as parachute jumps during his period of ACDUTRA. As an examination is going to be conducted, an opinion should also be obtained as to whether it is at least as likely as not that the Veteran’s left foot tendonitis or right foot tendonitis is caused or aggravated by the Veteran’s pes planus. 3. Entitlement to service connection for a neck disability is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for a cervical spine disability because no VA examiner has opined whether the Veteran’s cervical spine disability was incurred in service, to include both the parachute jumps performed during the Veteran’s period of ACDUTRA and a fall during active service, which the Veteran states resulted in seeking treatment for back pain in June 1978. 4. Entitlement to service connection for a low back disability is remanded. The March 2013 VA examiner found that it was less likely than not that the Veteran’s lumbar lordosis was aggravated by military service because lumbar lordosis is an exaggeration of the natural lumbar curve, and that the back pain he developed in 1978 has nothing whatsoever to do with the lumbar lordosis noted in the 1976 entrance examination. The examiner stated that the lumbar lordosis is simply an anatomic variant, with no predictability for future back problems. The examiner also stated that the Veteran’s current lumbar degenerative disc disorder and degenerative joint disease is simply due to normal aging of his back and the fact that he has been sedentary since his neck injury and surgery in 2001. The examiner has thus indicated that the lumbar lordosis may be a congenital defect, which is defined for VA purposes as a condition that is more or less stationary in nature and is generally precluded from service connection by regulation and to which the presumption of soundness does not apply. See 38 C.F.R. §§ 3.303(c), 4.9, 4.127. Moreover, the examiner has indicated that the lumbar lordosis may be entirely unrelated to the Veteran’s current low back disability, in which case the Veteran’s current low back degenerative disc disease (as opposed to a congenital defect) did not preexist service, and an opinion as to whether current low back degenerative disc disease was caused by service, (rather than whether a preexisting disability was aggravated by service), is necessary. Regardless, the Board notes that the Veteran has asserted that his low back disability was caused by his period of ACDUTRA, which was not considered by the examiner. Therefore, an addendum opinion should be obtained. 5. Entitlement to service connection for bilateral pes planus is remanded. The March 2013 VA examiner found that the Veteran’s preexisting bilateral pes planus was not aggravated beyond its natural progression by military service because pes planus was noted in the 1976 entrance examination but not in the 1978 exit examination. The examiner also found no current pes planus. This examination does not consider the Veteran’s assertion that the pes planus was incurred during his period of ACDUTRA from April 1976 to August 1976, and was first noticed in the September 1976 entrance examination for active duty. Moreover, the examination does not consider whether the October 1976 report of bilateral heel pain represents an aggravation of the pes planus. Upon remand, a supplemental opinion should be obtained that considers these theories of entitlement. The agency of original jurisdiction (AOJ) should send the Veteran a VCAA notice letter that notifies him and his representative of any information or lay or medical evidence not previously provided that is necessary to substantiate his service connection claims based on ACDUTRA and INACDUTRA service. 6. Entitlement to service connection for left heel calcaneal spur, to include as secondary to bilateral pes planus, is remanded. 7. Entitlement to service connection for right heel calcaneal spur, to include as secondary to bilateral pes planus, is remanded. The March 2013 examiner provided a negative nexus opinion, stating that the Veteran’s service treatment records (STRs) document one episode of bilateral heel pain in 1976, and that x-rays were not done until 2011, 35 years later, and they showed only small spurs. This opinion does not discuss the Veteran’s competent report of foot pain since service. Moreover, it is unclear why the length of time between the in-service heel pain and the x-rays, or the size of bone spurs, support a negative opinion. Upon remand, a supplemental opinion should be obtained. This supplemental opinion should also consider whether the Veteran’s left and right calcaneal spurs are proximately due to, or aggravated by, pes planus in order to avoid further delay for development if pes planus is eventually service connected. 8. Entitlement to service connection for hemorrhoids is remanded. The March 2013 examiner provided a negative nexus opinion, finding no establishment of chronicity of the in-service hemorrhoids because there are no surgical reports from hemorrhoid surgery in 1989 and 1990. The Board notes that the Veteran had a hemorrhoidectomy in June 2015, which should be discussed as evidence of chronicity. Moreover, the examiner did not consider the Veteran’s ACDUTRA service. Upon remand, a supplemental opinion should be obtained. A remand is required to allow VA to obtain authorization and request the records of the 1989 and 1990 hemorrhoid surgeries. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for the facilities that performed hemorrhoid surgery in 1989 and 1990. Make two requests for the authorized records from the facilities identified unless it is clear after the first request that a second request would be futile. 2. Issue notice in compliance with the Veterans Claims Assistance Act (VCAA) that advises the Veteran of the criteria for service connection for disabilities based on any periods of ACDUTRA or INACDUTRA. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of left foot tendonitis and right foot tendonitis. After reviewing the claims file, the examiner must provide the following opinions: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right foot tendonitis and/or left foot tendonitis is/are related to service, to include the Veteran’s report of excessive walking or running and parachute jumps during a period of active duty for training (ACDUTRA) from April 1976 to August 1976, or overuse while walking or running during the period of active service from October 1976 to August 1978? Rationale must be provided for the opinions proffered. In rendering the requested opinions, the clinician must reconcile his/her opinion with the evidence of record that the Veteran sought treatment for bilateral heel pain in October 1976, and has stated that he experienced foot pain since service in a February 2014 VA treatment record; and that a May 2015 private medical opinion stated that a variety of musculoskeletal complaints, including ankle/foot complaints, were caused and contributed to by service, and were aggravated and accelerated in active duty, noting physical trauma during military service and a fall from an ammunition bunker. (b.) If the right foot tendonitis and/or left foot tendonitis is/are not related to service, is it at least as likely as not (50 percent or greater probability) that right foot tendonitis and/or left foot tendonitis is/are proximately due to or aggravated beyond its natural progression by pes planus? Rationale must be provided for the opinions proffered. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any neck disability. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran has a neck disability that was caused by service, to include parachute jumps and physical training during the period of active duty for training (ACDUTRA) from April 1976 to August 1976, and an active duty fall resulting in the Veteran seeking treatment for low back pain in June 1978. Rationale must be provided for the opinion proffered. In rendering the requested opinion, the clinician must reconcile his/her opinion with the evidence of record that the Veteran reported neck stiffness and cramps during and since service in his March 2018 hearing testimony; and that the Veteran also experienced a significant post-service injury in March 2001. In a June 2001 private treatment record, he reported pain in his neck since the injury, and a November 2003 private treatment note indicated that the Veteran developed cervical pain subsequent to the March 2001 injury. A March 2001 initial medical report for worker’s compensation related to this injury stated that the Veteran’s past medical history was negative for previous significant injuries, operations, or illnesses. The examiner is also advised that a May 2015 private opinion stated that a variety of musculoskeletal complaints, including neck complaints, were caused and contributed to by service, and were aggravated and accelerated in active duty, noting physical trauma during military service and a fall from an ammunition bunker. 5. Obtain an addendum opinion from an appropriate clinician regarding the nature and etiology of current low back disability, to include degenerative disc disease. After reviewing the record, the clinician is to provide the following opinions: (a.) Is it at least as likely as not (50 percent or greater probability) that current low back disability, to include degenerative disc disease, was caused by or incurred during the Veteran’s active duty for training (ACDUTRA) from April 1976 to August 1976? (b.) The examiner should also opine as to whether it is at least as likely as not that the lordosis of the spine noted in the September 1976 entrance examination was incurred during the Veteran’s period of ACDUTRA from April 1976 to August 1976. The Veteran had ACDUTRA from April 1976 to August 1976, and thereafter, active service from October 1976 to August 1978. The clinician is advised that the Veteran’s January 1976 and July 1976 examinations for ACDUTRA indicate a normal spine. Rationale must be provided for the opinions proffered. In rendering the requested opinions, the examiner must reconcile his/her opinion with the Veteran’s contentions that he has experienced low back pain since service, and attributes it to parachute jumps during ACDUTRA as well as the physical rigors of infantry training. (c.) If the Veteran’s low back disability is less likely than not caused by or incurred during the Veteran’s ACDUTRA, is the lordosis of the spine noted in the September 1976 entrance examination prior to his active service from October 1976 to August 1978 a preexisting congenital defect or a preexisting low back disability? For purposes of VA compensation, a congenital “defect” is defined as a condition that is more or less stationary in nature (i.e., not capable of improving or deteriorating). Rationale must be provided for the opinion proffered. In rendering the requested rationale, the examiner must reconcile his/her opinion with the March 2013 VA examination report which appears to indicate that lumbar lordosis may be a congenital defect. The clinician is asked to clarify if the lordosis of the spine noted in September 1976 is a congenital defect or a preexisting low back disability, and the basis for such opinion. (d.) If the lordosis of the spine noted in the September 1976 examination is a congenital “defect,” is it at least as likely as not (50 percent or greater probability) that the Veteran’s current low back disability was caused by a superimposed disease or injury during active service, such as the rigors of training or a fall resulting in back pain in June 1978? Rationale must be provided for the opinion proffered. (e.) If the lordosis of the spine noted in the September 1976 examination is a preexisting disability, is it at least as likely as not (50 percent or greater probability) that the preexisting low back disability was aggravated (meaning a non-temporary increase in severity) by service? If so, was any increase in severity clearly and unmistakably due to its natural progress? Rationale must be provided for the opinion proffered. In rendering the requested opinion, the examiner must reconcile his/her opinion with the Veteran’s belief that his back was injured or aggravated by the physical rigors of training and a fall resulting in back pain in June 1978. A March 2001 initial medical report for worker’s compensation related to on-the-job injury stated that the Veteran’s past medical history is negative for previous significant injuries, operations, or illnesses, and discussed pain in the lower back in connection with this injury. The examiner is also advised that a May 2015 private opinion stated that a variety of musculoskeletal complaints, including back complaints, were caused and contributed to by service, and were aggravated and accelerated in active duty, noting physical trauma during military service and a fall from an ammunition bunker. 6. Forward the claims file to an appropriate clinician and obtain the following opinions regarding the Veteran’s pes planus: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s pes planus was incurred during or caused by his period of ACDUTRA from April 1976 to August 1976? The clinician is advised that although the Veteran did not seek treatment for foot pain, he asserts that he began experiencing foot pain during this period, which he relates to the physical rigors of his training, including running, walking, and parachute jumps. The clinician is to consider whether the Veteran’s pes planus was incurred during this period of ACDUTRA, but was not identified until the September 1976 entrance examination for active duty service. The clinician is advised that the Veteran’s January 1976 and July 1976 examinations from ACDUTRA did not indicate pes planus, and that the Veteran has reported foot pain since service. (b.) If the Veteran’s pes planus was not incurred during or caused by his period of ACDUTRA, was it at least as likely as not (50 percent or greater probability) aggravated (meaning a non-temporary increase in severity) by active service? If so, was any increase in severity clearly and unmistakably due to its natural progress? The clinician is to consider whether the October 1976 report of bilateral heel pain represents an aggravation of the Veteran’s pes planus. The clinician should also discuss the February 2014 VA treatment note in which the Veteran reports foot pain since service. Each opinion offered must be supported by a complete rationale. The examiner is advised that a May 2015 private opinion stated that a variety of musculoskeletal complaints, including foot/ankle complaints, were caused and contributed to by service, and were aggravated and accelerated in active duty, noting physical trauma during military service and a fall from an ammunition bunker. 7. Forward the claims file to an appropriate clinician and obtain the following addendum opinions. (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right heel calcaneal spur and/or left heel calcaneal spur are related to service, to include physical training and parachute jumps during the Veteran’s period of ACDUTRA from April 1976 to August 1976, and active service incidents such as physical training including walking/running and a fall resulting in back pain in June 1968? The examiner must discuss the Veteran’s report of foot pain since service, including in a February 2014 VA treatment note. (b.) If the Veteran’s right heel calcaneal spur and/or left heel calcaneal spur are not related to service, is it at least as likely as not (50 percent or greater probability) that they are proximately due to aggravated beyond their natural progression by pes planus? Any opinion offered must be supported by a complete rationale. The examiner is advised that a May 2015 private opinion stated that a variety of musculoskeletal complaints, including foot/ankle complaints, were caused and contributed to by service, and were aggravated and accelerated in active duty, noting physical trauma during military service and a fall from an ammunition bunker. 8. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hemorrhoids were incurred in or caused by service, to include a period of active duty for training (ACDUTRA) from April 1976 to August 1976, and a period of active service from October 1976 to August 1978. The January 1976 enlistment examination for the period of ACDUTRA did not indicate hemorrhoids, but hemorrhoids were noted in the July 1976 separation examination from the period of ACDUTRA, and hemorrhoids were also noted in the September 1976 entrance examination for the period of active service and the August 1978 separation examination for the period of active service. The examiner is to consider whether the Veteran’s hemorrhoids were incurred during his period of ACDUTRA. The Veteran states that he has had recurrent hemorrhoids since service. Any opinion offered must be supported by a complete rationale. 9. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If any benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his   representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. U. R. POWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Budd, Counsel