Citation Nr: 18159475
Decision Date: 12/20/18	Archive Date: 12/19/18

DOCKET NO. 16-22 235
DATE:	December 20, 2018
ORDER
The application to reopen the claim for entitlement to service connection for hiatal hernia is granted.
Entitlement to service connection for hypertension is denied.
Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied.
Entitlement to an evaluation in excess of 10 percent for tinnitus is denied.
Entitlement to a compensable evaluation for erectile dysfunction (ED) is denied.
Entitlement to special monthly compensation (SMC) at a higher rate for loss of use of a creative organ is denied.
Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for right little finger ankylosis is denied.
Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for erectile dysfunction is denied.
Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for bilateral hearing loss is denied.

Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for tinnitus is denied. 
Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for gastroesophageal reflux disease (GERD) is denied.
Entitlement to an effective date earlier than October 22, 2012 for the grant of service connection for radiculopathy of the left lower extremity is denied.
Entitlement to an effective date earlier of July 11, 2014 for the assignment of a 70 percent evaluation for major depressive disorder is denied.
REMANDED
Entitlement to service connection for hiatal hernia is remanded.
Entitlement to service connection for obstructive sleep apnea is remanded.
Entitlement to service connection for migraine headaches is remanded.
Entitlement to an evaluation in excess of 40 percent for lumbar spine disability is remanded.
Entitlement to an evaluation in excess of 70 percent for major depressive disorder is remanded.
Entitlement to an increased evaluation for right little finger ankylosis is remanded.
Entitlement to a compensable evaluation for bilateral hearing loss is remanded.
Entitlement to an evaluation in excess of 10 percent for radiculopathy of the left lower extremity is remanded.
Entitlement to an evaluation in excess of 10 percent for GERD with diverticulitis and hepatitis B is remanded.
Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded.
FINDINGS OF FACT
1. In a January 2007 rating decision, the RO denied service connection for hiatal hernia.  The Veteran did not timely appeal this decision, nor did he submit new and material evidence within one year of the decision.
2. Evidence has been received since the January 2007 rating decision that relates to an unestablished fact that is necessary to substantiate the claim for service connection for hiatal hernia.  Specifically, service connection for GERD has been granted and evidence of umbilical hernia repair in 2014 was received.
3. The evidence does not show that the Veteran’s hypertension originated in service or is otherwise etiologically related to service, nor is it related to any service-connected condition.
4. The Veteran does not manifest PTSD, but he does manifest major depressive disorder that is service-connected.
5. The maximum schedular rating available for tinnitus is 10 percent; the Veteran does not contend his tinnitus presents such an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards.
6. The Veteran’s ED is shown to have been manifested by loss of erectile power, but not by deformity of the penis or any other functional limitation.
7. The Veteran is in receipt of the maximum level of SMC on the basis of loss of use of a creative organ available by law.
8. The Veteran’s first claim for service connection for right little finger ankylosis was received in June 2006 and denied by final rating decision in January 2007.
9. Service connection for right little finger ankylosis was established effective July 11, 2014, the date the application to reopen the claim was received by VA.
10. The Veteran’s first claim for service connection for erectile dysfunction, bilateral hearing loss, tinnitus, and gastroesophageal reflux disease was received on July 11, 2014.
11. The RO granted an effective date based on the first instance of VA treatment for lower extremity radiculopathy on October 22, 2012; the Veteran’s claim for a leg condition was received on July 11, 2014.
12. The Veteran’s claim for an increased rating for his major depressive disorder was received on July 11, 2014; it is not factually ascertainable that an increase in this disability occurred during the year preceding the claim.
CONCLUSIONS OF LAW
1. The January 2007 rating decision that denied service connection for hiatal hernia is final, and the criteria for reopening the claim have been met. 38 U.S.C. §§ 5108, 7105(c) (2012); 38 C.F.R. §§ 3.156, 20.1103 (2018).
2. The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1112, 1113, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a) (2018).
3. The criteria for service connection for PTSD have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304(f) (2018).
4. The criteria for the assignment of an evaluation in excess of 10 percent for tinnitus have not been met. 38 U.S.C. §1155 (2012); 38 C.F.R. §§ 3.321, 4.87, Diagnostic Code 6260 (2018).
5. The criteria for a compensable rating for ED have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. § 4.115 (b), Diagnostic Code (DC) 7599-7522 (2018).
6. The criteria for SMC at a higher rate for loss of use of a creative organ have not been met. 38 U.S.C. §§ 1114, 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.321, 3.350, 4.1-4.10 (2018).
7. The criteria for an effective date earlier than July 11, 2014 for the grant of service connection for right little finger ankylosis have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
8. The criteria for an effective date earlier than July 11, 2014 for the grant of service connection for erectile dysfunction have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
9. The criteria for an effective date earlier than July 11, 2014 for the grant of service connection for bilateral hearing loss have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
10. The criteria for an effective date earlier than July 11, 2014 for the grant of service connection for tinnitus have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
11. The criteria for an effective date earlier than July 11, 2014 for the grant of service connection for gastroesophageal reflux disease have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
12. The criteria for an effective date earlier than October 22, 2012 for the grant of service connection for radiculopathy of the left lower extremity have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. §§ 3.157, 3.400 (2018).
13. The criteria for an effective date earlier than July 11, 2014 for the assignment of a 70 percent evaluation for major depressive disorder have not been met. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty from June 1974 to June 1976 and from October 1981 to June 2001.
New and Material Evidence
The Secretary must reopen a finally disallowed claim when new and material evidence is presented or secured with respect to that claim. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. New evidence means existing evidence not previously submitted to agency decision makers. 38 C.F.R. § 3.156(a). 
Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. Id. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. Id.
1. The application to reopen the claim for entitlement to service connection for hiatal hernia is granted.
Service connection for hiatal hernia was denied in a January 2007 rating decision. The Veteran was denied service connection because there was no evidence of a current hiatal hernia disability or a relationship between the claimed disability and his active service. 
New and material evidence was not received within a year of notice of the decision. See 38 C.F.R. § 3.156 (b). The Veteran did not perfect an appeal of this decision and it became final. 38 U.S.C. § 7105; 38 C.F.R. §§ 20.302, 20.1103. 
Thereafter, the Veteran filed a claim to reopen, as well as a claim for increase for diverticulitis, hepatitis B, and a claim for service connection for acid reflux. See July 2014 Claim. The Veteran underwent a VA examination in July 2015 and was granted service connection for gastroesophageal reflux disease. 
The July 2015 VA examination report provides for a current diagnosis of acid reflux and the Board notes this service-connected disability can serve as the foundation for service connection for hiatal hernia on a secondary basis. Further, VA medical records show he underwent umbilical hernia repair in 2014, indicating the presence of a current disability that was not previously established. See January 2016 VA Medical Record.
As this evidence was not of record or considered in the January 2007 decision, it is new, and as this evidence may indicate a relationship between the Veteran’s current hernia disability and his service-connected GERD with diverticulitis and hepatitis B, it is material to the claim. Accordingly, new and material evidence has been received. The application to reopen the claim of entitlement to service connection for hiatal hernia is granted. 38 C.F.R. § 3.156. 
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. 
Certain chronic diseases, such as hypertension, will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303 (b), 3.307, 3.309(a).
2. Entitlement to service connection for hypertension is denied.
The Veteran contends his hypertension is due to service. See July 2014 Claim. 
The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. 
The Board concludes that, while the Veteran has a diagnosis of hypertension, the preponderance of the evidence is against a finding that it began during active service, is otherwise related to an in-service injury, event, or disease, or became manifest within one year of his separation from active service. 38 U.S.C. §§ 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.303, 3.307, 3.309.
For VA rating purposes, the term “hypertension” means that the diastolic blood pressure is predominantly 90 mm Hg or greater. The term “isolated systolic hypertension” means that the systolic blood pressure is predominantly 160 mm Hg or greater with a diastolic blood pressure of less than 90 mm Hg. See 38 C.F.R. § 4.104, Diagnostic Code 7101, Note (1). 
The Veteran’s blood pressure on entrance and separation from active service for both periods of duty fails to show a diagnosis of hypertension during service. See February 1980 Examination; see also March 2001 Examination. The Veteran reported at an August 2015 VA examination that he was diagnosed with hypertension in approximately 2013 and that he was prescribed medication. See August 2015 VA Examination. The examiner opined there was no evidence his hypertension was caused by service or a service-connected disability and the Veteran does not contend a service-connected disability caused or aggravated his hypertension. 
There is no evidence that the Veteran had hypertension in service or that it became disabling within one year after service. See 38 C.F.R. § 3.309 (a). 
The Veteran has not alleged and the medical records do not show that the Veteran’s hypertension manifested within one year of his separation from active service. Therefore, service connection may not be granted on a presumptive basis. Based on the forgoing, the Board finds that the preponderance of the evidence is against the Veteran’s claim for entitlement to service connection for hypertension pursuant to all theories of entitlement. Service connection for hypertension is denied. 38 U.S.C. §§ 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.303, 3.307, 3.309.
Finally, the Board has considered the Veteran’s lay statements in support of his claim.  The Veteran is certainly competent to state when he was initially diagnosed with this disorder.  Lay persons, however, are not competent to attribute this disability to his military service.  Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007).  He also is not competent to state what caused any underlying symptoms, where it has not been shown that he has a medical background to provide an opinion as to such.  In Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006), the Federal Circuit recognized lay evidence as potentially competent to support the presence of the claimed disability, both during service and since, even where not corroborated by contemporaneous medical evidence such as treatment records.  However, the Federal Circuit also went on to hold in Buchanan that the Board retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence.  Even in other precedent cases the Federal Circuit has recognized the Board’s “authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other items of evidence.”  Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
3. Entitlement to service connection for PTSD is denied.
The Veteran claimed service connection for PTSD on his July 2014 claim. See July 2014 Claim. He is already service-connected for major depressive disorder. 
There are particular requirements for establishing entitlement to 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). Those requirements are: (1) a diagnosis of PTSD in accordance with 38 C.F.R. § 4.125; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. 38 C.F.R. § 3.304 (f). 
Here, the Board notes the VA medical record and VA examinations of record do not show a diagnosis of PTSD. See March 2001 VA Examination; see also October 2006 VA Examination; see also April 2015 VA Examination.
The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. § 1110. See also McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Accordingly, where, as here, competent evidence indicates that the Veteran does not have the disability for which service connection is sought, there can be no valid claim for service connection for the disability. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). 
Thus, without persuasive evidence of current diagnosis of PTSD, there is no basis upon which to award service connection, and discussion of the remaining criteria of 38 C.F.R. § 3.304 (f) is unnecessary.
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
Increased Rating
Disability evaluations are determined by application of the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. 
An evaluation of the level of disability present must also include consideration of the functional impairment of the Veteran’s ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. 
4. Entitlement to an evaluation in excess of 10 percent for tinnitus is denied.
The Veteran contends he is entitled an increase evaluation for tinnitus. Under Diagnostic Code 6260, a 10 percent disability rating is assigned for recurrent tinnitus. Note (1) indicates that a separate evaluation for tinnitus may be combined with an evaluation under Diagnostic Codes 6100, 6200, 6204, or other diagnostic code, except when tinnitus supports an evaluation under one of those diagnostic codes. Note (2) states that a single evaluation should be assigned for recurrent tinnitus, whether the sound is perceived in one ear, both ears, or in the head. See 38 C.F.R. § 4.87, Diagnostic Code 6260. Therefore, under the applicable regulation, the maximum schedular rating that is available for tinnitus is 10 percent. The Veteran is already in receipt of that rating. 
Diagnostic Code 6260 explicitly prohibits a schedular rating in excess of 10 percent for tinnitus, whether perceived in one ear or both. Thus, the claim for a schedular rating in excess of 10 percent for tinnitus, including based on assignment of separate 10 percent ratings for each ear, must be denied as lacking legal merit. Sabonis v. Brown, 6 Vet. App. 426 (1994). 
As such, and because the record does not suggest and the Veteran has not asserted any basis for finding that the Veteran’s tinnitus otherwise presents such an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards, see 38 C.F.R. § 3.321 (b)(1), the claim for an increased rating must be denied. 
5. Entitlement to a compensable evaluation for ED is denied.
The Veteran seeks a compensable disability rating for his service-connected ED. 
The symptoms of ED are contemplated by an award of SMC for the loss of use of a creative organ. See 38 U.S.C. § 1114 (k). The Veteran is currently in receipt of SMC for his ED, effective from July 11, 2014. A compensable schedular rating for ED may also be assigned when there is associated deformity of the penis, pursuant to 38 C.F.R. § 4.115 (b), Diagnostic Code (DC) 7522. Under that DC, a 20 percent rating is warranted for deformity of the penis with loss of erectile power. 
The Veteran’s reports of being unable to perform sexually are compensated by his award of SMC for such impairment. However, additional compensation in the form of a compensable schedular rating is not warranted in this case, as the evidence of record does not establish that the Veteran has had a penile deformity at any time during the appeal period. Most notably, an April 2015 VA male reproductive system examination showed that while the Veteran was unable to achieve an erection sufficient for penetration and ejaculation, he reported normal anatomy with no penile deformity or abnormality (the Veteran declined a physical examination of his genitalia but provided this information to the examiner). See April 2015 VA Examination. 
Additional the available post-service treatment records do not show that the Veteran has a penile deformity to warrant a compensable schedular rating.  
In short, there is simply no evidence of penile deformity that would justify a compensable rating under DC 7522. Compensable schedular ratings are assigned to reflect impairment of earning capacity (from the disability in question). See 38 C.F.R. § 4.1. In this case, impairment of earning capacity due to ED has not been established. Consequently, a compensable rating for the ED separate from the Veteran’s award of SMC for such disability is not warranted. 
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim for an increased rating, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
6. Entitlement to special monthly compensation (SMC) at a higher rate for loss of use of a creative organ is denied.
The Board notes above that the Veteran has been granted special monthly compensation pursuant to 38 U.S.C. § 1114 (k) based on the loss of use of a creative organ for his erectile dysfunction. He is seeking a higher level of SMC for loss of use of a creative organ. 
SMC is a special statutory award granted in addition to awards based on the schedular evaluations provided by the diagnostic codes in VA’s Rating Schedule. Claims for SMC are governed by 38 U.S.C. 1114(k) through (s) and 38 C.F.R. 3.350 and 3.352. SMC is payable at a specified rate if the Veteran, as the result of service-connected disability, has suffered the anatomical loss or loss of use of one or more creative organs. 38 U.S.C. 1114 (k), 38 C.F.R. 3.350 (a). The rate of SMC compensation is a specific value that is adjusted annually, independent of any other awarded compensation. 38 U.S.C. 1114 (k). Here, the Veteran is currently in receipt of SMC for loss of use of a creative organ based upon the grant of service connection for erectile dysfunction. The law does not provide for a higher rate of SMC for loss of use of a creative organ. 38 U.S.C. 1114 (k). SMC rates are determined by statute and are not subject to the Board’s discretion; and the Board is specifically prohibited from granting benefits that are not authorized by law. See 38 U.S.C. 7104 (c); McTighe v. Brown, 7 Vet. App. 29, 30 (1994). As the disposition of this case is based on law and not the facts of this case, the claim must be denied. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994).
Effective Date
Generally, the effective date of an award of disability compensation based on an original claim shall be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a) (2012); 38 C.F.R. § 3.400 (2018). 
If the claim for service connection is received within one year of a veteran’s discharge from service, the effective date of an award of service connection will be the day following discharge from service. 38 U.S.C. § 5110 (b)(1) (2012); 38 C.F.R. § 3.400 (b)(2) (2018); see also Wright v. Gober, 10 Vet. App. 343, 347 (1997) (holding that § 5110(b)(1) “applies only to those awards of disability compensation actually based on a claim filed within one year after the veteran’s separation”). Otherwise, the effective date will be the later of the date of receipt of claim or the date entitlement arose. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (b)(2) (2018). The effective date of an award of increased compensation shall be the earliest date as of which it is factually ascertainable that an increase in disability had occurred, if an application is received within one year from such date. 38 U.S.C. § 5110 (b)(2) (2012). However, if the increase became ascertainable more than one year prior to the date of receipt of the claim, then the proper effective date would be the date of the claim. In a case where the increase became ascertainable after the filing of the claim, then the effective date would be the date of increase. See generally Harper v. Brown, 19 Vet. App. 125 (1997).
A specific claim in the form prescribed by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by VA. 38 U.S.C. § 5101(a) (2012); 38 C.F.R. § 3.151 (a) (2018). The term “claim” or “application” means a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1 (p) (2017). Nevertheless, a claimant without medical expertise is not expected or required to precisely name the disability for which he seeks service connection, rather VA must construe a claim for service connection to include any disability that may reasonably be encompassed by the claimant’s description of the claim. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Although “informal claims” are no longer recognized by VA, prior to March 2015 (i.e., during the pendency of the claims), any communication or action, indicating an intent to apply for one or more benefits under the laws administered by VA, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui generis may be considered an informal claim. Such an informal claim must identify the benefits sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. 
If received within one year from the date it was sent to the claimant, it will be considered filed as of the date of receipt of the informal claim. 38 C.F.R. § 3.155 (a) (2014). Similarly, prior to March 2015, a report of examination or hospitalization which meets the requirements of this section will be accepted as an informal claim for benefits if the report relates to a disability which may establish entitlement. 
Once a formal claim for pension or compensation has been allowed or a formal claim for compensation has been disallowed for the reason that the service-connected disability is not compensable in degree, receipt of a report of examination or hospitalization by VA or the uniformed services will be accepted as an informal claim for benefits. The date of outpatient or hospital examination or date of admission to a VA or uniformed services hospital will be accepted as the date of receipt of a claim. The provisions of this paragraph apply only when such reports relate to examination or treatment of a disability for which service connection has previously been established or when a claim specifying the benefit sought is received within one year from the date of such examination, treatment or hospital admission. 38 C.F.R. § 3.157 (2014).
7. Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for right little finger ankylosis is denied.
The Veteran’s first claim for service connection for residuals of right hand surgery was received in July 2006. See July 2006 Correspondence. Service connection was denied in January 2007 and the Veteran did not appeal that decision. See January 2007 Rating Decision. 
Thereafter, he filed an application to reopen the claim and service connection for right little finger ankylosis was established effective July 11, 2014, the date VA received his application to reopen. See July 2014 Claim; see also August 2015 Rating Decision. This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. 
The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence.
Overall, the Board must apply the statutory and regulatory guidelines for determining the effective date of an award of disability compensation as set forth in 38 U.S.C. § 5110, which essentially provides that the effective date of an award of compensation will be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110 (a). Thus, what is material in this case is when the record shows the application to reopen his claim for compensation for residuals of right hand surgery was filed. 
The applicable law and regulations clearly make it the Veteran’s responsibility to initiate a claim for compensation with VA if he seeks that benefit. While VA has a duty to assist a Veteran in developing facts pertinent to a claim, it is the Veteran who must bear the responsibility for coming forth with the submission of a claim for benefits under the laws administered by VA. See 38 U.S.C. § 5101 (a); 38 C.F.R. § 3.151 (a). 
Here, the evidence does not support a finding that the Veteran filed an application to reopen the claim prior to July 11, 2014. Consequently, an earlier effective date is not warranted. 
As the preponderance of the evidence is against an earlier effective date for the grant of service connection for right little finger ankylosis, the benefit-of-the-doubt doctrine is inapplicable and the claim must be denied. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz v. Principi, 274 F.3d 1361, 1365 (Fed. Cir. 2001).
8. Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for erectile dysfunction is denied.
The Veteran filed a claim for service connection for erectile dysfunction in July 2014 and service connection was established effective July 11, 2014, the date VA received his claim. See July 2014 Claim; see also June 2015 Rating Decision.
This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence. 
Here, the evidence does not support a finding that the Veteran filed a claim, formal or informal, prior to July 11, 2014. Consequently, an earlier effective date is not warranted. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (b)(2) (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
9. Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for bilateral hearing loss is denied.
The Veteran filed a claim for service connection for bilateral hearing loss in July 2014 and service connection was established effective July 11, 2014, the date VA received his claim. See July 2014 Claim; see also August 2015 Rating Decision.
This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence. 
Here, the evidence does not support a finding that the Veteran filed a claim, formal or informal, prior to July 11, 2014. Consequently, an earlier effective date is not warranted. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (b)(2) (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
10. Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for tinnitus is denied.
The Veteran filed a claim for service connection for tinnitus in July 2014 and service connection was established effective July 11, 2014, the date VA received his claim. See July 2014 Claim; see also August 2015 Rating Decision. 
This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection for tinnitus. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence. 
Here, the evidence does not support a finding that the Veteran filed a claim, formal or informal, prior to July 11, 2014. Consequently, an earlier effective date is not warranted. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (b)(2) (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
11. Entitlement to an effective date earlier than July 11, 2014 for the grant of service connection for gastroesophageal reflux disease (GERD) is denied.
The Veteran filed a claim for service connection for GERD in July 2014 and service connection was established effective July 11, 2014, the date VA received his application. See July 2014 Claim; see also August 2015 Rating Decision. This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence. 
Here, the evidence does not support a finding that the Veteran filed a claim, formal or informal, prior to July 11, 2014. Consequently, an earlier effective date is not warranted. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (b)(2) (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
12. Entitlement to an effective date earlier than October 22, 2012 for the grant of service connection for radiculopathy of the left lower extremity is denied.
The Veteran filed a claim for service connection for a leg condition in July 2014 and service connection was established for right lower extremity radiculopathy effective July 11, 2014, the date VA received his application. See July 2014 Claim; see also June 2015 Rating Decision.
This appeal ensued after the Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement. 
Thereafter, the RO granted an effective date of October 22, 2012 for service connection for left lower extremity radiculopathy based on VA treatment records showing lumbar spine disability associated with his left leg radiculopathy. See May 2016 Rating Decision. The Board interprets the RO’s grant of an effective date October 22, 2012 as under 38 C.F.R. § 3.157. However, the Board finds an effective date earlier than October 22, 2012 is not warranted. While the May 2016 rating decision discusses claims for increase in conjunction with the appeal for an earlier effective date for service connection, the Board finds that an effective date earlier than October 22, 2012 is not warranted under either theory as there was no identifiable communication from the Veteran prior to July 11, 2014 indicating an intent to file a claim.  See 38 C.F.R. § 3.400 (0)(2) (2018). 
The Veteran and his representative have not advanced any other specific contentions in support of his claim for an earlier effective date for the award of service connection. See May 2016 VA Form 9; see also June 2016 VA Form 9; see also January 2017 Correspondence. 
The Board finds the evidence does not support an earlier effective date prior to October 22, 2012 for the grant of service connection for lower extremity radiculopathy. 38 U.S.C. § 5110 (2012); 38 C.F.R. §§ 3.157, 3.400 (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
13. Entitlement to an effective date earlier of July 11, 2014 for the assignment of a 70 percent evaluation for major depressive disorder is denied.
The Veteran claimed an increased evaluation for major depressive disorder in July 2014 and the RO granted a 70 percent evaluation, effective July 11, 2014 in a June 2015 rating decision. See June 2015 Rating Decision. The Veteran filed a notice of disagreement with the effective date assigned. 38 U.S.C. § 7105 (c); 38 C.F.R. § 20.1103. See February 2016 Notice of Disagreement.
A review of the record reveals that the RO chose an effective date of July 11, 2014, for the assignment of an increased evaluation of 70 percent for the Veteran’s major depressive disorder because this was the date that he filed his claim for an increased rating. See July 2014 Claim. For the Veteran to receive an earlier effective date for this increased rating, the evidence must demonstrate either (1) an informal claim was filed during the period of July 11, 2013 to July 11, 2014, or (2) a factually ascertainable increase in disability occurred during the period of July 11, 2013 to July 11, 2014.
No communication was submitted by the Veteran or on his behalf during the one-year period prior to his July 2014 formal increased rating claim. The last communication received from the Veteran prior to his July 2014 increased rating claim was a correspondence regarding education benefits dated July 2007. As there were no communications received from the Veteran in the one-year period prior to his July 2014 claim, there is nothing that may be construed as an informal increased rating claim. 
Additionally, the medical evidence is negative for any factually ascertainable increase in disability in the one-year period prior to the Veteran’s July 2014 formal claim. Notably, there were no VA treatment records relating to mental health treatment from July 2013 to July 2014, although there are mental health treatment notes prior to this period. See June 2015 VA Medical Record. The first medical evidence to show an increase in disability is a May 2015 VA examination. Moreover, the Veteran has not claimed an increased rating major depressive disorder during the one-year period prior to his July 2014 claim. Rather, he has only generally argued for an earlier effective date. As such, there is no evidence showing a factually ascertainable increase in major depressive disorder, prior to the current effective date of July 11, 2014. As there are no documents or treatment records submitted that could be construed as an informal claim prior to July 11, 2014, and no competent evidence demonstrating that an increase in disability was factually ascertainable within one year prior to the receipt of the Veteran’s claim, the effective date of the assignment of a 70 percent evaluation for major depressive disorder cannot be earlier than the date of receipt of the application which is July 11, 2014. 38 U.S.C. § 5110 (2012); 38 C.F.R. § 3.400 (2018).
In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim of entitlement to an earlier effective date, that doctrine is not applicable. 38 U.S.C. § 5107 (b) (2012); 38 C.F.R. § 3.102 (2018); see also Ortiz, 274 F.3d at 1365. 
Additional Consideration
Finally, the Board is grateful for the Veteran’s decades of honorable service, and this decision is not meant to detract from that service. However, for the reasons listed above, the foregoing claims must be denied.
REASONS FOR REMAND
14. Entitlement to service connection for hiatal hernia is remanded.
As noted above, the Veteran underwent a VA examination in July 2015 and was granted service connection for GERD. Additionally, VA medical records show the Veteran underwent umbilical hernia repair 2014. See January 2016 VA Medical Record. The Board finds an examination is warranted to determine if there is a relationship between Veteran’s claimed hernia disability and his service-connected GERD with diverticulitis and hepatitis B. McClendon v. Nicholson, 20 Vet App. 79, 81 (2006).
15. Entitlement to service connection for obstructive sleep apnea is remanded.
The Veteran asserts he has a sleep disorder due to service or a service-connected disability. See July 2014 Claim. The Veteran was afforded a VA examination in August 2015 where the examiner found he did not manifest a sleep disorder aside from his service-connected major depressive disorder with chronic sleep impairment. See August 2015 VA Examination.
In support of his claim, the Veteran submitted an opinion from H.S., M.D. dated in January 2017 which notes the Veteran has been diagnosed with obstructive sleep apnea. See January 2017 Opinion. This opinion finds a relationship between the Veteran’s GERD and his major depressive disorder and his obstructive sleep apnea; however, this opinion is speculative and unclear as to the medical rationale that supports their examiner’s findings. The Board finds an additional examination is necessary to address the Veteran’s contention of a relationship between his newly demonstrated obstructive sleep apnea and his service-connected GERD and depressive disorder. McClendon, 20 Vet App. at 81; Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). 
16. Entitlement to service connection for migraine headaches is remanded.
The Veteran asserts he has a headache disorder due to service or a service-connected disability. See July 2014 Claim. The Veteran was afforded a VA examination where the examiner found he manifested non-specific headaches there were most likely caused by nonservice-connected cervical spine muscle spasms. See August 2015 VA Examination. 
In support of his claim, the Veteran submitted an opinion from H.S., M.D. dated in January 2017 which finds the Veteran has been diagnosed with migraine headaches. See January 2017 Opinion. This opinion finds a relationship between the Veteran’s service-connected tinnitus, service-connected major depressive disorder and his headaches; however, this opinion is speculative and unclear as to the medical rationale that supports their examiner’s findings. The Board finds an additional examination is necessary to address the Veteran’s contention of a relationship between his newly demonstrated migraine headaches and his service-connected disabilities of tinnitus and depressive disorder. McClendon, 20 Vet App. at 81; Nieves-Rodriguez, 22 Vet. App. at 304. 
17. Entitlement to an evaluation in excess of 40 percent for lumbar spine disability is remanded.
The Veteran contends his lumbar spine disability is worse than currently evaluated and that he cannot work as a result of this disability. See February 2016 Notice of Disagreement; see also November 2016 Opinion. 
The Veteran is evaluated under Diagnostic Codes 5242-5243 for intervertebral disc syndrome and he has been in receipt of a 40 percent evaluation since September 21, 2001. Importantly, the Veteran is status post L5-S1 lumbar fusion. He was last examined in May 2015 and the Board finds a current examination is warranted to ascertain the severity of his lumbar spine disability. See also Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide the veteran with a thorough and contemporaneous medical examination).
18. Entitlement to an evaluation in excess of 70 percent for major depressive disorder is remanded.
The Veteran contends his major depressive disorder is worse than currently evaluated and that he cannot work as a result of this disability. 
In support of his contention he submitted an opinion from H.S., M.D dated November 2016. See November 2016 Opinion. The examination report does not indicate whether the Veteran is currently working. The Board notes the Veteran was last examined by VA in March 2015. Further, this examination indicates the Veteran manifested impaired judgment. Accordingly, the Board finds a current examination is warranted to ascertain the severity of his depressive disorder. Id.
19. Entitlement to an increased evaluation for right little finger ankylosis is remanded.
The Veteran contends his right little finger ankylosis disability is worse than currently evaluated. See February 2016 Notice of Disagreement. He was last examined in August 2015 and the Board finds a current examination is warranted to ascertain the severity of his right little finger ankylosis disability. Id.
20. Entitlement to a compensable evaluation for bilateral hearing loss is remanded.
The Veteran contends his bilateral hearing loss disability is worse than currently evaluated. See February 2016 Notice of Disagreement. 
He was last examined in July 2015 and the Board finds a current examination is warranted to ascertain the severity of his bilateral hearing loss disability. Green, 1 Vet. App. at 124.
21. Entitlement to an evaluation in excess of 10 percent for radiculopathy of the left lower extremity is remanded.
The Veteran contends his left lower extremity radiculopathy disability is worse than currently evaluated. See February 2016 Notice of Disagreement. He was last examined in April 2015 and the Board finds a current examination is warranted to ascertain the severity of his left lower extremity radiculopathy disability. Id.
22. Entitlement to an evaluation in excess of 10 percent for gastroesophageal reflux disease, with diverticulitis and hepatitis B is remanded.
The Veteran contends his GERD disability is worse than currently evaluated. See February 2016 Notice of Disagreement. 
The Board notes the Veteran filed a claim for service connection for GERD and increased rating claims for diverticulitis and hepatitis B. See July 2014 Claim. The Veteran underwent a VA examination in July 2015 and was granted service connection for gastroesophageal reflux disease. See August 2015 Rating Decision. 
Thereafter, the RO reevaluated the Veteran’s disabilities of diverticulitis, hepatitis B, and GERD and assigned a single evaluation. See August 2015 Rating Decision. 
He was last examined in August 2015 and the Board finds a current examination is warranted to ascertain the severity of his GERD disability. Id.
23. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded.
As noted above, the Veteran has asserted that he is unable to work due to service-connected disabilities.  
However, he has not indicated whether his is unemployed or working and he has not submitted a claim for TDIU, which includes information regarding his education and employment history. While not required for appellate consideration, this claim would indicate to VA whether the Veteran is currently working or not and the Board finds it is necessary for adjudication. See Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009). The Veteran should be advised to submit a VA Form 21-8940 and submit any related employment records, or information and authorization to obtain any relevant records.
The matters are REMANDED for the following action:
1. Undertake appropriate development to obtain ALL outstanding VA treatment records that have not been associated with the claims file.
2. The AOJ should forward the appropriate forms, VA Form 21-8940 and VA Form 21-4192 for completion. Any relevant employment records identified should be obtained.
3. Schedule the Veteran for an examination to determine the etiology of his claimed hiatal hernia. The examiner is directed to review the claims file and provide the following opinion:
(a.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed hernia disability is caused by his service-connected GERD with diverticulitis and hepatitis B?
(b.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed hernia disability is aggravated by (increased beyond the normal progression of the disease) his service-connected GERD with diverticulitis and hepatitis B?
4. Schedule the Veteran for an examination to determine the etiology of his claimed obstructive sleep apnea. The examiner is directed to review the claims file and provide the following opinion:
(a.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed obstructive sleep apnea is caused by his service-connected GERD with diverticulitis and hepatitis B and/or major depressive disorder?
(b.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed obstructive sleep apnea is aggravated by (increased beyond the normal progression of the disease) his service-connected GERD with diverticulitis and hepatitis B and/or major depressive disorder?
The examiner is specifically requested to provide a review of the January 2017 opinion from H.S., M.D. and determine if this opinion is consistent with the record and medical principles. Explain your answer.
5. Schedule the Veteran for an examination to determine the etiology of his claimed migraine headaches. The examiner is directed to review the claims file and provide the following opinion:
(a.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed migraine headaches are caused by his service-connected major depressive disorder and/ or tinnitus?
(b.) Whether it is at least as likely as not (50-percent probability or greater) that the Veteran’s claimed migraine headaches are aggravated by (increased beyond the normal progression of the disease) his service-connected major depressive disorder and/ or tinnitus?
The examiner is specifically requested to provide a review of the January 2017 opinion from H.S., M.D. and determine if this opinion is consistent with the record and medical principles. Explain your answer.
6. Schedule the Veteran for a VA examination with an appropriate examiner to determine the current nature and severity of his service-connected major depressive disorder. The claims folder must be made available to the examiner for review with the examination. 
The examination report must reflect that such a review was conducted. The examiner should identify any symptoms that the Veteran currently manifests or has manifested that are attributable to his service-connected major depressive disorder. S/he must also distinguish, to the extent possible, between psychiatric symptoms attributable to the Veteran’s service-connected major depressive disorder and those attributable to nonservice-connected disorder(s). 
The examiner is also requested, if possible, to determine and specifically list all symptoms and the levels of social and occupational impairment experienced by the Veteran that are attributable solely to his major depressive disorder. 
A rationale for all requested opinions shall be provided. If the examiners cannot provide an opinion without resorting to mere speculation, they shall provide a complete explanation stating why this is so. In so doing, the examiners shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer(s).
6. Schedule the Veteran for a VA examination(s) to ascertain the current severity and manifestations of the Veteran’s service-connected lumbar spine disability with associated left leg radiculopathy. The claims file should be made available to the examiner for review with the examination. Additionally, the examiner must include range of motion testing of the lumbar spine in the following areas:
(a.) Active motion;
(b.) Passive motion;
(c.) Weight-bearing; and
(d.) Nonweight-bearing.
The examiner should offer an opinion as to whether pain could significantly limit functional ability during flare-ups or when the lumbar spine is used repeatedly. The examiner should specifically indicate whether, and at what point during, the range of motion the Veteran experienced any limitation of motion that was specifically attributable to pain. 
IF THE EXAMINATION DOES NOT TAKE PLACE DURING A FLARE, THE EXAMINER MUST GLEAN INFORMATION REGARDING THE FLARES’ SEVERITY, FREQUENCY, DURATION, AND FUNCTIONAL LOSS MANIFESTATIONS FROM THE VETERAN, MEDICAL RECORDS, AND OTHER AVAILABLE SOURCES. EFFORTS TO OBTAIN SUCH INFORMATION MUST BE DOCUMENTED. 
If there is no pain and/or no limitation of function, such facts must be noted in the report. If there is neurological impairment, the examiner should identify the nerve or nerves involved and determine the manifestations. The examiner should also comment on the impact of the Veteran’s lumbar spine disability on his ability to work. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. 
The examiner should identify all neurologic manifestations of the Veteran’s lumbar spine disability, and specifically address left lower extremity severity and impact on employment. 
7. Schedule the Veteran for a VA examination with an appropriate examiner to determine the current severity of his right little finger ankylosis. The claims folder must be made available to the examiner for review with the examination. The examination report must reflect that such a review was conducted. The examiner should describe all symptomatology due to the Veteran’s service-connected right little finger ankylosis disability, including any associated neurological impairments. 
All necessary testing must be performed. The examiner must further comment as to whether there is any pain, weakened movement, excess fatigability, or incoordination on movement, and the degree to which any additional range of motion is lost due to any of the following should be addressed: (1) pain on use, including during flare-ups; (2) weakened movement; (3) excess fatigability; or (4) incoordination. The examiner is asked to describe whether pain significantly limits functional ability during flare-ups. All limitation of function must be identified. If there is no pain and/or no limitation of function, such facts must be noted in the report. 
The examiner must also consider whether an additional evaluation is warranted for resulting limitation of motion of other digits, or for interference with overall function of the hand.  See Note following DC 5227.
8. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria.
A full description of the functional effects caused by bilateral hearing loss.  See Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007).
9. Schedule the Veteran for a VA examination to determine the current nature and severity of his service-connected GERD disability. The examination should include all studies, tests, and evaluations deemed necessary by the examiner. The examiner should provide an opinion on the impact and physical limitations of the Veteran’s GERD in relation to employment.
10. Finally, schedule the Veteran for a VA examination with an appropriate medical professional to determine if it is at least as likely as not (a degree of probability of 50 percent or higher) that the Veteran is precluded from substantially gainful employment on account of his service-connected disabilities alone and in combination.  In making this determination, the person should take into account the Veteran’s education and work history, but may NOT consider the Veteran’s age or any impairment caused by nonservice-connected disabilities.
11. The Veteran should be informed that failure to appear for these examinations, without good cause, may cause his claim to be denied.  See 38 C.F.R. § 3.655.  All efforts to schedule the examination should be documented in the file.
12. The AOJ must review the claims file and ensure that the foregoing development action has been completed in full.  If any development is incomplete, appropriate corrective action must be implemented.  If any report does not include adequate responses to the specific opinions requested, it must be returned to the providing examiner for corrective action.

 
T. BERRY
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	 J. Trickey