Citation Nr: 18161211 Decision Date: 12/31/18 Archive Date: 12/31/18 DOCKET NO. 16-46 932 DATE: December 31, 2018 ORDER Entitlement to service connection for an audiological disorder, to include bilateral hearing loss, is denied. Entitlement to service connection by hyperlipidemia is denied. Entitlement to an increased disability evaluation for a scar of the right leg, currently rated as 10 percent disabling, is denied. REMANDED Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. Entitlement to service connection for a back disorder is remanded. Entitlement to service connection for a bilateral side disorder is remanded. Entitlement to service connection for a cardiovascular disorder is remanded. Entitlement to service connection for headaches is remanded. Entitlement to an increased disability evaluation for residuals of a right ankle fracture, currently rated as 20 percent disabling, is remanded. FINDINGS OF FACT 1. The Veteran does not have an audiological disorder, to include bilateral hearing loss for VA disability compensation purposes. 2. Hyperlipidemia is not a disability for VA purposes. 3. The Veteran’s scar of the right leg is painful, but is not at least 6 inches square, deep and nonlinear, or unstable; there are no disabling effects due to the scar. CONCLUSIONS OF LAW 1. An audiological disorder, to include bilateral hearing loss disability, was not incurred in or aggravated by service, and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1131, 1137, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2018). 2. The criteria for service connection for hyperlipidemia have not been met. 38 U.S.C. §§ 1101, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2018). 3. The criteria for a disability evaluation in excess of 10 percent for a scar of the right leg have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.321, 4.1, 4.2, 4.7, 4.118, Diagnostic Codes 7801 – 7805 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army National Guard from October 1985 to April 1986. He had additional service in the Army National Guard from August 1985 to May 1988. These matters come before the Board of Veterans’ Appeals (Board) on appeal of an October 2014 rating decision of the Regional Office (RO) of the Department of Veterans Affairs (VA) in Philadelphia, Pennsylvania. Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) imposes obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107, 5126; Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012, Pub. L. No. 112-154, §§ 504, 505, 126 Stat. 1165, 1191-93; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2018). The VCAA requires VA to assist a claimant at the time that he or she files a claim for benefits. As part of this assistance, VA is required to notify claimants of the evidence that is necessary in substantiating their claims, and provide notice that a disability rating and an effective date for the award of benefits will be assigned if service connection is awarded. 38 U.S.C. § 5103(a); 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002); Dingess v. Nicholson, 19 Vet. App. 473, 486 (2006). In this case, the agency of original jurisdiction (AOJ) issued a notice letter to the Veteran. The letter explained the evidence necessary to substantiate the Veteran’s claims of entitlement to service connection and an increased disability rating; the letter also explained the legal criteria for entitlement to such benefits. The letter also informed him of his and VA’s respective duties for obtaining evidence. The AOJ decision that is the basis of this appeal was decided after the issuance of an initial, appropriate VCAA notice. As such, there was no defect with respect to timing of the VCAA notice. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). VA also has a duty to assist a veteran with the development of facts pertinent to the appeal. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). This duty includes the obtaining of “relevant” records in the custody of a Federal department or agency under 38 C.F.R. § 3.159(c)(2), as well as records not in Federal custody (e.g., private medical records) under 38 C.F.R. § 3.159(c)(1). VA will also provide a medical examination if such examination is determined to be “necessary” to decide the claim. 38 C.F.R. § 3.159(c)(4). The claims file contains the Veteran’s available service treatment records, reports of post-service treatment, and the Veteran’s own statements in support of his claim. The Veteran was afforded a VA examination responsive to the claim for an increased disability evaluation. The opinion was conducted by a medical professional, following thorough examination of the Veteran, solicitation of history, and review of the claims file. The examination report contains all the findings needed to assess the Veteran’s service-connected disability on appeal, including history and clinical evaluation. See 38 C.F.R. § 3.327(a) (2018); Palczewski v. Nicholson, 21 Vet. App. 174, 182-83 (2007). As will be discussed below, the weight of the evidence demonstrates that the Veteran does not have an audiological disorder, to include bilateral hearing loss, related to his service. As such, a remand to provide the Veteran with a medical examination and/or to obtain a medical opinion as to the issue of entitlement to service connection for an audiological disorder, including bilateral hearing loss, is not necessary. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010). The claims file contains the Veteran’s available service treatment records, reports of post-service treatment, and the Veteran’s own statements in support of his claims. The Board has reviewed the Veteran’s statements and medical evidence of record and concludes that there is no outstanding evidence with respect to the Veteran’s claims. For these reasons, the Board finds that the VCAA duties to notify and assist have been met. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a) (2018). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service—the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. For chronic diseases, if chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). At the outset, the Board notes that Veteran does not claim, and the evidence does not reflect, that his claim is the result of combat with the enemy. Therefore, the combat provisions of 38 U.S.C. § 1154 are not applicable. 1. Entitlement to service connection for an audiological disorder, to include bilateral hearing loss, The Board acknowledges that the Veteran claimed that had he an unspecified audiological disorder related to injuries or events on active duty. The Board notes that whether service connection is claimed on direct or secondary basis, a necessary element for establishing such a claim is the existence of current disability. In this case, the Veteran must show that he currently has an audiological disorder, to include bilateral hearing loss, due to an event, disease, or injury in service. See Sanchez-Benitez v. Principi, 259 F.3d 1356, 1361-1362 (Fed. Cir. 2001). The Board finds that the weight of the evidence is against the existence of an audiological disorder, to include bilateral hearing loss. There is no evidence, including the Veteran’s own statements, reflecting that he has been treated or diagnosed with an audiological disorder, to include bilateral hearing loss. Moreover, although the Veteran once complained of decreased hearing related to headaches, there is no evidence that indicates that the Veteran meets the diagnostic criteria for bilateral hearing loss disability. See 38 C.F.R. § 3.385. The Veteran’s post-service treatment records do not reflect any complaints or treatment related to an audiological disorder, to include bilateral hearing loss. In this regard, the Veteran has not provided any medical evidence of treatment, complaints, or diagnoses related to an audiological disorder, to include bilateral hearing loss, in the years since his active duty. In fact, the Veteran has made no assertions of an audiological disorder, to include bilateral hearing loss, related to his active duty except as it relates to his claims for service connection. See Pond v. West, 12 Vet. App. 341 (1999). To this point, the Board notes that VA treatment records indicate that the Veteran repeatedly denied experiencing hearing loss, and in October 2014, the Veteran specifically requested that his VA audiological examination be cancelled; at that time, the Veteran indicated that he did not intend to claim service connection for bilateral hearing loss. However, the Veteran has not specified another audiological or ear disorder for which he is claiming service connection, and the evidence of record does not demonstrate that the Veteran has an audiological disorder. The United States Court of Appeals for the Federal Circuit (Federal Circuit) has noted that in order for a veteran to qualify for entitlement to compensation under those statutes, he or she must prove existence of a disability, and one that has resulted from a disease or injury that occurred in the line of duty. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability). Here, we are faced with nothing more than a single post-service complaint of hearing loss, followed by multiple denials of hearing loss and no evidence of any audiological disorder. The Veteran did not present any competent evidence of post-service audiological pathology (diagnosis). See Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000) (a Veteran seeking disability benefits must establish the existence of a disability and a connection between such Veteran’s service and the disability). The Board finds that the preponderance of the evidence is against the claim for service connection of an audiological disorder, to include bilateral hearing loss. The benefit-of-the-doubt doctrine is therefore not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). 2. Entitlement to service connection by hyperlipidemia The Veteran has claimed service connection for hyperlipidemia, also known as hypercholesterolemia or dyslipidemia. VA treatment records indicate that the Veteran was assessed as having hyperlipidemia. Under applicable regulations, the term “disability” means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1. The Board notes that, whether service connection is claimed on direct or secondary basis, a necessary element for establishing such a claim is the existence of current disability. An elevated cholesterol level represents only a laboratory finding, and not an actual disability in and of itself for which VA compensation benefits are payable. See 61 Fed. Reg. 20440, 20445 (May 7, 1996). A clinical finding such as hyperlipidemia, without a diagnosed or identifiable underlying malady or condition, does not constitute a disability for which service connection may be granted. The record contains no evidence that the Veteran’s hyperlipidemia has been associated with an underlying disability. As there is no basis in the law to grant the Veteran’s appeal, the claim for service connection for hyperlipidemia must be denied. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). 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. Separate evaluations may be assigned for separate periods of time based on the facts found. In other words, the evaluations may be staged. Staged ratings are appropriate for any rating claim when the factual findings show distinct time periods during the appeal period where the service-connected disability exhibits symptoms that would warrant different ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Here, the service-connected disability on appeal has not materially changed and a uniform evaluation is warranted for the rating period on appeal. 3. Entitlement to an increased disability evaluation for a scar of the right leg, currently rated as 10 percent disabling, The Veteran’s service-connected scar of the right leg is rated as noncompensable pursuant to Diagnostic Code 7804. See 38 C.F.R. § 4.20. Diagnostic Code 7804 pertains to unstable or painful scars. A 10 percent disability evaluation is assigned for one or two painful or unstable scars and three or four unstable or painful scars warrant a 20 percent disability evaluation. For five or more scars that are unstable or painful, a 30 percent disability evaluation is assigned. This is the highest rating available under this Diagnostic Code. Note (1) to Diagnostic Code 7804 provides that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. 38 C.F.R. § 4.118, Diagnostic Code 7804. Diagnostic Code 7801 provides ratings for scars, other than the head, face, or neck, that are deep or that cause limited motion. Scars in an area or areas of at least 6 square inches (39 sq. cm.) but less than 12 square inches (77 sq. cm.) are rated as 10 percent disabling. Scars in an area or areas of at least 12 square inches (77 sq. cm.) but less than 72 square inches (465 sq. cm.) are rated as 20 percent disabling. Scars in an area or areas of at least 72 square inches (465 sq. cm.) but less than 144 square inches (929 sq. cm.) are rated as 20 percent disabling. Scars in an area or areas exceeding 144 square inches (929 sq. cm.) are rated 40 percent disabling. Note (1) to Diagnostic Code 7801 provides that a deep scar is one associated with underlying soft tissue damage. 38 C.F.R. § 4.118, Diagnostic Code 7801. Diagnostic Code 7802 provides ratings for scars, other than the head, face, or neck, that are superficial or that do not cause limited motion. Superficial scars that do not cause limited motion, in an area or areas of 144 square inches (929 sq. cm.) or greater, are rated 10 percent disabling. Note (1) to Diagnostic Code 7802 provides that a superficial scar is one not associated with underlying soft tissue damage. 38 C.F.R. § 4.118, Diagnostic Code 7802. Diagnostic Code 7805 provides that any other scars (including linear scars) and other disabling effects of scars should be evaluated even if not considered in a rating provided under diagnostic codes 7800-04 under an appropriate diagnostic code. 38 C.F.R. § 4.118, Diagnostic Code 7805. After a review of all the evidence, the Board finds that the Veteran’s scar of the right leg does not approximate the criteria for a disability evaluation in excess of 10 percent for the entire rating period under Diagnostic Code 7804. A higher disability evaluation is also unavailable under Diagnostic Codes 7801 or 7805. The objective clinical evidence of record, namely the August 2014 VA examination, shows that the Veteran’s scar of the right leg is manifested by two linear scars that measure 11 cm and 3cm by .2 cm. As such, the Veteran’s scars do not exceed 6 square inches. Likewise, the scars are superficial, without skin breakdown, keloid formation, inflammation, or edema. Furthermore, there is no medical evidence that shows that his scars are unstable or painful; there were no pain or unstable skin in the area of his scar upon evaluation in August 2014. Additionally, the scars are not productive of adherence, and the Veteran’s scars do not cause limitation of motion or disfigurement. The Board observes that the Veteran has not made any complaints related to his scar of the right leg and that his VA treatment records do not show any related treatment. Therefore, a higher disability rating is not warranted for his scar of the right leg under Diagnostic Code 7804. To the extent that the Veteran contends that a higher disability rating should be assigned, the Board notes that a veteran is competent to report symptoms that he experiences at any time. See Layno v. Brown, 6 Vet. App. 465 (1994). However, the medical findings (as provided in the examination reports and clinical findings) directly address the criteria under which his scar of the right leg is being evaluated and are the most probative evidence of record as to whether an increase is warranted. REASONS FOR REMAND 1. Entitlement to service connection for gastroesophageal reflux disease (GERD) is remanded. 2. Entitlement to service connection for an acquired psychiatric disorder is remanded. 3. Entitlement to service connection for a back disorder is remanded. 4. Entitlement to service connection for a bilateral side disorder is remanded. 5. Entitlement to service connection for a cardiovascular disorder is remanded. 6. Entitlement to service connection for headaches is remanded. The Veteran has not yet been afforded VA examinations in connection with his claims for service connection of GERD, an acquired psychiatric disorder, a back disorder, a bilateral side disorder, a cardiovascular disorder, or headaches. The Board observes that the Veteran’s VA treatment records reflect diagnoses of and/or treatment for GERD, depression, posttraumatic stress disorder (PTSD), coronary arteriosclerosis, hypertension, back pain, headaches, and chronic pain. Accordingly, the Board finds that the Veteran should be afforded VA examinations regarding these claims for service connection. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C. § 5103A(d)(1); 38 C.F.R. § 3.159(c)(4). VA adjudicators may consider only independent medical evidence to support their findings; they may not rely on their own unsubstantiated medical conclusions. If the medical evidence of record is insufficient, VA is always free to supplement the record by seeking an advisory opinion, or ordering a medical examination to support its ultimate conclusions. See Colvin v. Derwinski, 1 Vet. App. 171 (1991). 7. Entitlement to an increased disability evaluation for residuals of a right ankle fracture, currently rated as 20 percent disabling, is remanded. The Veteran asserts that the symptoms of his service-connected residuals of a right ankle fracture are more severe than presently evaluated. The Board observes that Veteran has not been afforded a VA examination in connection with this disability since August 2014. As such, the Veteran must be provided with a VA examination which consider the current severity of his service-connected residuals of a right ankle fracture. See Green v. Derwinski, 1 Vet. App. 121, 124 (1991). See also Snuffer v. Gober, 10 Vet. App. 400, 403 (1997) (holding that the Veteran was entitled to a new examination after a two-year period between the last VA examination and the Veteran's contention that the pertinent disability had increased in severity). In this regard, the Board points out that the United States Court of Appeals for Veterans Claims (CAVC) in Correia v. McDonald, 28 Vet. App. 158 (2016), held that the final sentence of 38 C.F.R. § 4.59 requires that VA examinations include joint testing for pain on both active and passive motion, in weight-bearing and nonweight-bearing and, if possible, with range of motion measurements of the opposite undamaged joint. Thus, the CAVC’s holding in Correia establishes additional requirements that must be met prior to finding that a VA examination is adequate. In light of Correia, the Veteran must be provided a VA examination which provides range of motion in active motion, passive motion, weight-bearing, and nonweight-bearing, for the Veteran’s service-connected residuals of a right ankle fracture. Furthermore, VA must make all necessary efforts to obtain relevant records in the possession of a Federal agency. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. See also Bell v. Derwinski, 2 Vet. App. 611 (1992). All available VA treatment records for the claims on appeal should be associated with the Veteran’s claims file. The matters are REMANDED for the following action: 1. Contact the Veteran and request that he identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who have treated him for his service-connected disabilities on appeal. The Veteran should be requested to sign any necessary authorization for release of medical records to VA, and appropriate steps should be made to obtain any identified records. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. If the records are unavailable, notify the Veteran in accordance with 38 C.F.R. § 3.159. 2. After any additional records are associated with the claims file, the RO should schedule the Veteran for a VA ankle examination to ascertain the current severity and manifestations of the Veteran’s service-connected residuals of a right ankle fracture. The claims file should be made available to the examiner for review in connection with the examination. The examination reports should include a statement as to the effect of the service-connected residuals of a right ankle fracture on his occupational functioning and daily activities. In particular, the VA examination must include range of motion testing for the right and left ankles in the following areas: • Active motion; • Passive motion; • Weight-bearing; and • Nonweight-bearing 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 VA examiner should provide a complete rationale for any opinions provided. 3. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any gastrointestinal disorder, including GERD. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The VA examiner should identify all gastrointestinal disorders. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified gastrointestinal disability is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 4. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any acquired psychiatric disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The VA examiner should identify all psychiatric disabilities. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified acquired psychiatric disability is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 5. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any low back disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The VA examiner should identify all disabilities of the thoracolumbar spine. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified thoracolumbar spine disability is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 6. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any bilateral side disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified bilateral side disability is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 7. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any cardiovascular disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The VA examiner should identify all cardiovascular disabilities. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified cardiovascular disability is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 8. After any additional records are associated with the claims file, the RO should schedule the Veteran for an appropriate examination to determine the nature and etiology of any headache disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file. The VA examiner should identify all disabilities manifested by headaches. The examiner should then render an opinion as to each identified disability, including whether it is at least as likely as not (50 percent probability or more) that the identified headache disorder is related to active service. The provider is advised that the Veteran is competent to report symptoms, including continuity of symptoms, treatment, and diagnoses and the examiner must take into account, along with the other evidence of record, the Veteran’s statements in formulating the requested opinions. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. 9. After completing all indicated development, the RO should readjudicate the remaining claims on appeal, in light of all the evidence of record. If the benefits sought remain denied, the case should be returned to the Board after compliance with requisite appellate procedures. (Continued on the next page) GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Hallie E. Brokowsky, Counsel