Citation Nr: 18156647 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 14-42 819 DATE: December 11, 2018 ORDER The application to reopen the previously denied claim of entitlement to service connection for a left hip disability is granted. The application to reopen the previously denied claim of entitlement to service connection for a left ankle disability is granted. REMANDED The following issues are remanded for further development: (1) whether new and material evidence has been received to reopen the previously denied claim for service connection for a left eye condition; (2) service connection for arthritis—to include arthritis in the extremities, the feet, toes, hands, fingers, and right elbow; (3) service connection for a left shoulder disability; (4) service connection for an upper back and/or a neck disability; (5) service connection for a disability of the feet; (6) service connection for chronic fatigue syndrome, also claimed as Gulf War Syndrome, fibromyalgia, and/or an unexplained multi-symptom illness; (7) service connection for a respiratory condition, to include asthma and/or bronchitis; (8) service connection for tuberculosis; (9) service connection for sleep apnea; (10) service connection for hypertension; (11) service connection for a digestive disorder, to include gastritis, chronic diarrhea, gastroesophageal reflux disease (GERD), and/or a pancreatic mass; (12) service connection for a breast mass; (13) service connection for migraine headaches; (14) service connection for diabetes mellitus, claimed as high glucose; (15) service connection for a neurological condition, claimed as unexplained electrical pain; (16) service connection for a left hip disability; (17) service connection for a left ankle disability; (18) service connection for thyroid cancer; and (19) an initial disability rating greater than 10 percent for a right knee condition. FINDING OF FACT In a September 1992 rating decision, a Department of Veterans Affairs (VA) Regional Office (RO) denied claims for service connection for left hip and left ankle disabilities. Evidence received since the September 1992 rating decision relates to prior unestablished facts. CONCLUSIONS OF LAW 1. The September 1992 rating decision is final; new and material evidence has been received to reopen the claim of entitlement to service connection for a left hip disability. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103. 2. The September 1992 rating decision is final; new and material evidence has been received to reopen the claim of entitlement to service connection for a left ankle disability. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty from July 1981 to October 1981 and from November 1990 to June 1992. Additionally, the Veteran had periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) with the United States Army Reserve. These matters come before the Board of Veterans’ Appeals (Board) on appeal from April 2011, July 2011, and December 2013 rating decisions of the VA RO in St. Petersburg, Florida. New and Material Evidence In a September 1992 rating decision, the RO denied the issues of entitlement to service connection for left hip and left ankle disabilities. In denying both issues, the RO acknowledged that the Veteran sustained injuries in service to the left hip and left ankle. The RO concluded, however, that the Veteran did not have current left hip and left ankle disabilities. The RO notified the Veteran of this rating decision via letter in November 1992 and she neither appealed nor submitted any evidence within one year of notification. Accordingly, the September 1992 rating decision became final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.156(b), 20.302, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362 (Fed. Cir. 2011); see also Buie v. Shinseki, 24 Vet. App. 242, 251-52 (2010). Generally, to reopen a previously denied, final claim, a claimant must present new and material evidence. See 38 U.S.C. § 5108. Evidence is “new” if it was not previously submitted to agency decision makers. Evidence is “material” if, when viewed by itself or with other evidence previously of record, it relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence previously of record and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). For the purpose of establishing whether new and material evidence has been received, the credibility of the evidence, but not its weight, is to be presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). Regarding both issues, the Board finds that new and material evidence has been received such that the applications to reopen service connection for the left hip and left ankle must be granted. Specifically regarding the left hip, an August 2017 VA treatment record lists hip arthralgia as one of the Veteran’s active medical problems. Similarly, an October 2010 MRI from CDI of Winter Park, Florida revealed an old complete tear and complete atrophy of the anterior talofibular ligament of the lateral ligament complex of the left ankle. This evidence is “new” in that it was not previously before agency decisionmakers. It is also “material” in that it relates to previously unestablished facts necessary for grants of service connection. As such, the claims are considered reopened. REASONS FOR REMAND 1. Missing Pages of an April 2012 Notice of Disagreement and Informal Claim In April 2012, the Veteran submitted a detailed statement which the RO interpreted as a notice of disagreement (NOD) for issues decided in rating decisions from April and July 2011. Additionally, the RO interpreted this statement as an informal claim for service connection for arthritis, sleep apnea, gastrointestinal issues, a neurological disorder, diabetes, bronchitis, Gulf War Syndrome, fibromyalgia, and chronic fatigue syndrome. However, it appears that pages 12 and 13 of the statement are not associated with the claims file. As the missing pages to this statement could impact any of the issues currently pending before the Board, remand is required so that a complete version may be associated with the Veteran’s claims file. 2. Service Connection for Thyroid Cancer and a Breast Mass; Application to Reopen Service Connection for a Left Eye Condition The Veteran’s April 2012 notice of disagreement addressed the issues of service connection for thyroid cancer, a breast mass, and a left eye condition. However, a statement of the case (SOC) has not yet been issued. Accordingly, a remand is required for the Agency of Original Jurisdiction (AOJ) to issue a SOC. 3. Service Connection for Arthritis, Chronic Fatigue Syndrome, Sleep Apnea, Hypertension, and a Neurological Condition The Board cannot make a fully-informed decision on these issues because no VA examiner has opined as to whether arthtitis, chronic fatigue syndrome, sleep apnea, hypertension, and a neurological disorder were caused by or arose in service. Accordingly, the Board remands these issues for the provision of VA examinations and medical opinions. With respect to the issue of arthritis, the Board notes that the Veteran has several claims which may overlap with the contended issue of arthritis, such as a left hip disability, a left ankle disability, a neck or upper back disability, and disabilities of the feet. In this regard, the Board notes that, in April 2012 and January 2014, the Veteran discussed the issue of arthritis in connection with symptoms she experienced in her hands, fingers, and right elbow. Accordingly, the examination and opinion obtained on remand will be limited to these areas of the body. Turning to chronic fatigue syndrome, the Board notes that the Veteran has referred to her symptoms as representative of Gulf War Syndrome, fibromyalgia, and an unexplained, multi-symptom illness. The record indicates—and the Veteran has plainly stated—that she never served in Southwest Asia. However, the Board still finds that remand is warranted so that a VA examination and medical opinion may be provided addressing service connection on a direct basis. 4. Service Connection for a Left Shoulder Disability, Left Hip Disability, Left Ankle Disability, a Disability of the Feet, an Upper Back and/or Neck Disability, a Digestive Disorder, a Respiratory Condition, and Migraine Headaches The Board remands these issues for the provision of additional VA medical opinions as the current ones of record are inadequate for adjudicative purposes. Specifically, regarding the left shoulder, the Veteran was provided a VA examination and medical opinion in March 2011. The examiner diagnosed the Veteran with a left shoulder rotator cuff tear and opined that it was less likely than not that the Veteran’s disability was caused by an incident during a period of INACDUTRA when a bulletin board fell onto the Veteran’s upper body. However, the examiner did not address other instances documented in the Veteran’s service treatment records (STRs) where she complained of left shoulder pain, such as in August 1990 when the Veteran complained of a burning pain in the area under the left shoulder blade when using her back and shoulder muscles. Turning to the left hip, the VA examiner in March 2011 indicated a normal left hip and did not provide a medical opinion. As stated above in the discussion regarding new and material evidence, the Veteran has now received a diagnosis of hip arthralgia. Regarding the left ankle and feet, similar to the left hip, the March 2011 VA examiner did not provide an etiological opinion because he provided a diagnosis of a normal left ankle. Further, in a June 2011 VA foot examination, the examiner stated that the Veteran had no current disabilities of the left foot and ankle because an x-ray from December 1991 was negative. As mentioned previously, an October 2010 MRI revealed an old tear of a ligament in the left ankle with complete atrophy. Additionally, in September 2010, Dr. Durham from Orlando Foot & Ankle diagnosed the Veteran with plantar fasciitis of both feet. Next, regarding an upper back or neck disability, the March 2011 VA examiner addressed only the Veteran’s cervical spine. The examiner did not examine or comment upon the Veteran’s thoracic spine. Similarly, regarding the issue of migraine headaches, the March 2011 VA examiner’s opinion did not discuss a March 1991 report of medical history wherein the Veteran reported experiencing recurrent migraine-type headaches in service. In regard to the issue of a respiratory condition, the March 2011 VA examiner provided a diagnosis of asthma via the Veteran’s subjective reports and opined that it was not related to service. However, the examiner’s rationale was vague and did not address whether symptoms representative of asthma first arose in service. Thereafter, in June 2011, another VA examiner again provided a diagnosis of asthma, but did not provide a medical opinion. Lastly, regarding the issue of a digestive disorder, the Veteran was provided a VA examination in October 2013. The examiner provided a diagnosis of gastritis and opined that it was less likely than not incurred in or caused by service because the Veteran’s in-service condition was inconsistent with current stomach-related complaints. However, the examiner did not address lay reports of the Veteran consistently and repeatedly experiencing nausea and vomiting since service. Additionally, since the October 2013 VA examination, VA received an October 2017 treatment record from Moffitt Cancer Center which discussed the Veteran’s long-term history of nausea and vomiting in connection with a discovery of a pancreatic mass. 5. An Initial Disability Rating Greater than 10 Percent for a Right Knee Condition The Veteran was most recently afforded a VA examination in connection with her right knee condition in March 2011. In April 2018, the Veteran’s representative stated that the Veteran’s current symptoms now more closely resembled the criteria for an evaluation higher than the current 10 percent rating. VA’s statutory duty to assist includes the duty to conduct a thorough and contemporaneous examination so that the evaluation of the claimed disability will be a fully informed one. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991). Where the evidence of record does not reflect the current state of the Veteran’s disability, a new VA examination must be conducted. Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 3.327(a). In light of the April 2018 statement, remand is necessary so that the Veteran may be provided an updated VA examination. The matters are REMANDED for the following action: 1. Associate a complete copy of the Veteran’s April 2012 NOD and informal claim with the claims file—i.e., one that contains pages 12 and 13 of the Veteran’s statement. 2. Obtain updated VA treatment records and associate them with the claims file—particularly those dated since January 2018. If no such records exist, the claims file should be annotated to reflect as such and the Veteran notified as such. 3. Send the Veteran and her representative a SOC that addresses the issues of: (a.) Service connection for thyroid cancer; (b.) Service connection for a breast mass; and (c.) Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a left eye condition. If the Veteran perfects an appeal by submitting a timely VA Form 9, these issues should be returned to the Board for further appellate consideration. 4. After the above has been completed to the extent possible, schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology of her hypertension. After examining the Veteran and thoroughly reviewing the Veteran’s claims file, the clinician must opine whether it is at least as likely as not (50 percent probability or more) that the Veteran’s hypertension was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (April 2012). Additionally, the clinician should provide a complete rationale for the requested opinion. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 5. After Items (1) through (3) have been completed to the extent possible, schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology of her sleep apnea. After examining the Veteran and thoroughly reviewing the Veteran’s claims file, the clinician must opine whether it is at least as likely as not (50 percent probability or more) that the Veteran’s sleep apnea was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (April 2012). Additionally, the clinician should provide a complete rationale for the requested opinion. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 6. After Items (1) through (3) have been completed to the extent possible, schedule the Veteran for an examination with an appropriate clinician to determine the existence, nature, and etiology of any neurological disorder. After examining the Veteran and thoroughly reviewing the Veteran’s claims file, the clinician must address the following: (a.) Please identify whether the Veteran has any neurological disorder by medical diagnosis. Attention should be paid to any potential disorder contemplated by the Veteran’s April 2010 statement wherein she described an electrical sensation in her hands. (b.) For each disorder identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disorder was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim. Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 7. After Items (1) through (3) have been completed to the extent possible, schedule the Veteran for an examination with an appropriate clinician to determine the existence, nature, and etiology of fibromyalgia and/or chronic fatigue syndrome. After examining the Veteran and thoroughly reviewing the Veteran’s claims file, the clinician must address the following: (a.) Please verify whether the Veteran currently has chronic fatigue syndrome and/or fibromyalgia. (b.) For each condition verified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the condition was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim. Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 8. After Items (1) through (3) have been completed to the extent possible, schedule the Veteran for an examination with an appropriate clinician to determine the existence, nature, and etiology of arthritis. After examining the Veteran and thoroughly reviewing the Veteran’s claims file, the clinician must address the following: (a.) Please identify whether the Veteran has arthritis in her hands, fingers, and right elbow. (b.) For each condition identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the condition was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim. Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 9. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of the Veteran’s left shoulder disability. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current left shoulder disabilities by medical diagnosis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 10. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of the Veteran’s left hip disability. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current left hip disabilities by medical diagnosis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 11. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of the Veteran’s left ankle disability. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current left ankle disabilities by medical diagnosis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In fulfilling part (b), the clinician must specifically comment upon whether the Veteran’s ligament tear and atrophy revealed in an October 2010 MRI are related to the Veteran’s repeated complaints of left ankle pain in service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 12. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of any disability of the feet. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any disability of the feet by medical diagnosis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In fulfilling part (b), the clinician must specifically comment upon the Veteran’s contention that the current condition of her feet was caused by the cumulative effects of running, marching, and completing other duties in combat boots over the course of her military career. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 13. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of any upper back and/or neck disability. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current any upper back and/or neck disabilities by medical diagnosis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 14. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the existence, nature, and etiology of migraine headaches. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please verify whether the Veteran currently suffers from migraine headaches. (b.) If migraine headaches are verified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the Veteran’s migraines were caused by, arose in, or are otherwise related to service. In fulfilling part (b), the clinician must specifically comment upon the Veteran’s report of experiencing migraine-type headaches in service as documented in a March 1991 report of medical history. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinion. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 15. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of the any respiratory condition. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current respiratory conditions by medical diagnosis, including asthma and bronchitis. (b.) For each disability identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disability was caused by, arose in, or is otherwise related to service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 16. After Items (1) through (3) have been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of any digestive disorder. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. If the clinician determines that an examination should be conducted, one should be scheduled. Thereafter, the clinician should address the following: (a.) Please identify any current digestion-related disorders by medical diagnosis, including gastritis, chronic diarrhea, GERD, and/or a pancreatic mass. (b.) For each disorder identified in part (a), please state whether it is at least as likely as not (50 percent probability or more) that the disorder was caused by, arose in, or is otherwise related to service. In fulfilling part (b), the clinician must specifically comment upon the October 2017 treatment record from Moffitt Cancer Center as well as lay reports regarding the Veteran experiencing nausea and vomiting consistently since service. In offering the requested opinion, the clinician must consider medical and lay evidence dated both prior to and since the filing of the claim (September 2009). Additionally, the clinician should provide a complete rationale for the requested opinions. If the clinician cannot provide an opinion without resorting to speculation, he or she should expressly indicate that and provide a supporting rationale as to why that is so. 17. After the above has been completed to the extent possible, schedule the Veteran for a VA examination to assess the current nature and severity of her service-connected right knee condition. Range of motion should be reported, including whether and the extent to which such motion is affected by pain, weakness, fatigue, lack of endurance, incoordination or other symptoms resulting in functional loss. (a.) Based upon a review of the medical records, lay statements submitted in support of the claim, and/or statements elicited from the Veteran during the examination, state whether the Veteran experiences flare-ups of his service-connected right knee condition, and how she characterizes the additional functional loss during a flare. (b.) If the Veteran describes experiencing flare-ups, identify the: i. frequency; ii. duration; iii. precipitating factors; and iv. alleviating factors. (c.) Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that during a flare-up, range of motion is additionally limited to 30 degrees flexion and/or 15 degrees extension. Please explain why or why not. (d.) Based upon the information elicited as a result of the foregoing, state whether it is at least as likely as not (50 percent probability or greater) that, during a flare-up, the disability is manifested by effusion and/or locking. If the examiner cannot provide the requested opinions without resorting to speculation, he or she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence in this case, or a lack of knowledge among the medical community at large, and not the insufficient knowledge of the individual examiner). If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner’s lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion. (Signature on Next Page) S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.S. Pettine, Associate Counsel