Citation Nr: 21025013 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 15-20 279 DATE: April 27, 2021 ORDER Entitlement to service connection for degenerative arthritis of the spine and spondylolisthesis is granted. REMANDED Entitlement to service connection for a skin disability, to include soft-tissue sarcoma, actinic keratosis, seborrheic keratosis, basal cell carcinoma, malignant melanoma, and benign skin neoplasms, is remanded. FINDINGS OF FACT 1. The Veteran engaged in combat with the enemy. 2. The evidence is evenly balanced as to whether the Veteran’s current degenerative arthritis of the spine and spondylolisthesis are related to service. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran’s favor, the criteria for service connection for degenerative arthritis of the spine and spondylolisthesis have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from May 1967 to June 1970, including service in the Republic of Vietnam. He received numerous medals and badges, including the Combat Infantryman Badge. These matters initially came before the Board of Veterans’ Appeals (Board) on appeal from an April 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In that decision, the RO denied reopening the issues of service connection for lower back injury, cancerous growths of lips and head (previously claimed as soft tissue sarcoma), and malaria, finding new and material evidence had not been submitted. The Veteran disagreed with the decision in July 2010, and following an April 2015 Statement of the Case, the Veteran submitted a timely appeal to the Board in June 2015. The Veteran requested a hearing in his June 2015 appeal to the Board and one was scheduled for April 2017. The Veteran did not attend the scheduled hearing and did not show good cause for missing the hearing or request a new hearing. In March 2019, the Board reopened the claims for service connection for a low back disability and a skin disability, characterized as benign skin neoplasms, and remanded both claims for additional development. The Board did not reopen the claim for entitlement to service connection for malaria, finding sufficient evidence to reopen the claim had not been received. As the only claim being decided herein is being granted, discussion of compliance with the Board’s remand instructions is unnecessary. Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge 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). Pursuant to 38 C.F.R. § 3.303(b), where a chronic disease is shown as such in service, subsequent manifestations of the same chronic disease are generally service connected. If a chronic disease is noted in service but chronicity in service is not adequately supported, a showing of continuous symptoms after separation is required. Entitlement to service connection based on chronicity or continuous symptoms pursuant to 38 C.F.R. § 3.303(b) applies only when the disability for which the Veteran is claiming compensation is due to a disease enumerated on the list of chronic diseases in 38 U.S.C. § 1101(3) or 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Arthritis is a chronic disease. 38 U.S.C. § 1101(3). Combat The Veteran’s receipt of the Combat Infantry Badge reflects that he engaged in combat with the enemy. When a veteran has engaged in combat with the enemy, satisfactory lay or other evidence “shall be accepted as sufficient proof of service connection” for certain diseases or injuries, even if “there is no official record of such incurrence or aggravation in such service.” 38 U.S.C. § 1154(b). This statute does not eliminate the need for evidence of a nexus; it merely reduces, for veterans who have engaged in combat with the enemy, the burden of presenting evidence of incurrence or aggravation of an injury or disease in service. Collette v. Brown, 82 F.3d 389, 392 (Fed. Cir. 1996). Entitlement to service connection for degenerative arthritis of the spine and spondylolisthesis. Following the Veteran’s separation from service, he filed a claim for service connection lumbar spine disability, which was denied in a December 1970 rating decision. He was subsequently denied service connection in May 1977, April 2001, and in the April 2010 rating decision on appeal. The Veteran wrote to VA in April 2009 that in service he was put on a light duty “no jumping” profile in service due to making a very hard landing, injuring his lower back. At that time, he said, he had complained that his left leg, from knee to toe lost feeling. In May 2020 the Veteran wrote he had been advised to terminate his jump status to avoid further damage to his back. In a February 2019 appellate brief, the Veteran’s representative argued damaging health effects that arise from chronic exposure to microtrauma are “cumulative trauma disorders” with a common feature of an element of overuse superimposed on progressive changes that accompany normal aging of the body. He cited multiple sources in explaining that these types of disorders, which primarily affect the soft tissues of the musculoskeletal system, are associated with repeated or sustained exertions in awkward or static postures, or with a high concentration of stress on the extremities as in hard landings and impacts. The Veteran’s DD-214 shows he is a recipient of the Parachute Badge, Combat Infantryman Badge, National Defense Service Medal, Vietnam Service Medal, and Vietnam Campaign Medal. The Veteran’s service treatment records indicate concern pertaining to his spine, including an undated radiographic report of his cervical and thoracic spine regions to rule out fracture and dislocation. An April 1969 treatment note shows he was prescribed muscle relaxants and referred to orthopedic, noting neck and ankle, and concluded with “light duty.” There is no separation examination available for review. As previously discussed, the Veteran’s combat service is significant because it allows a combat veteran to use satisfactory lay or other evidence to establish that he was injured or incurred disability while on active duty, even in cases where there is no official record that such injury or disability occurred. Reeves v. Shinseki, 682 F.3d 988, 998 (Fed. Cir. 2012) (quoting 38 U.S.C. § 1154(b)). At a November 2019 VA examination, the Veteran was diagnosed with degenerative arthritis of the spine which was documented by diagnostic testing. The November 2019 VA examiner opined the Veteran’s back disability was less likely than not related to service, writing that he “could not find where he was ever seen for lumbar spine.” Additionally, the VA examiner wrote that the Veteran had age-related degeneration that most likely is causing his discomfort. However, the examiner did not provide a rationale as to how he concluded that the Veteran’s back disability was age-related, which is particularly unconvincing when the Veteran has been claiming a back disability for about five decades prior to the examination. At a December 2019 VA examination by a different examiner, the Veteran was diagnosed with spondylolisthesis, lumbar scoliosis, and Bertolotti’s syndrome. The Veteran reported onset of lower back pain from jumping out of an airplane in 1969. The December 2019 VA examiner provided an opinion that the claimed condition was less likely than not from service as a parachutist, noting the Veteran’s service treatment records “are silent for the claim of a lower back condition.” Documenting the Veteran’s post-service treatment records showing low back pain in 2003 with no known etiology, and December 2019 X-Rays showing mild posterior subluxation, mild levo curvature of the lumbar neuraxis, and benign Bertolotti with no known etiology, she wrote the Veteran’s disability was less than 50 percent likely than not from service, without rationale or explanation. Both opinions from November 2019 and December 2019 are flawed in that they do not consider the competent and credible lay statements regarding the in-service injury and continuous symptoms. See Buchanan v. Nicholson, 451 F.3d 1331, 1336, n.1 (Fed. Cir. 2006) (noting that VA’s examiner’s opinion, which relied on the absence of contemporaneous medical evidence, “failed to consider whether the lay statements presented sufficient evidence of the etiology of [the veteran’s] disability such that his claim for service connection could be proven without contemporaneous medical evidence”). Not only has the Veteran on repeated occasions written to VA regarding his experiences in service, he also filed his first claim pertaining to his low back disability within one year of service, and thus, had communicated within one year to VA that he injured his back on active duty. While the Board could request yet another medical opinion, such a request could be construed as obtaining additional evidence for the sole purpose of denying a claim, which is impermissible. 38 C.F.R. § 3.304(c) (“The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination”); Gardner-Dickson v. Wilkie, No. 19-4765, 2020 U.S. App. Vet. Claims LEXIS 1927 (Panel Order), at *20 (denying petition for a writ of mandamus challenging a remand, but agreeing “with the petitioner that it ‘would not be permissible for VA to undertake... additional development if a purpose was to obtain evidence against an appellant’s case.’” (citing Mariano v. Principi, 17 Vet. App. 305, 312 (2003) and Hart v. Mansfield, 21 Vet. App. 505, 508 (2007)). The above evidence is sufficient to decide the claim. The Veteran’s representative accurately included in a March 2021 brief that lay evidence can be competent and sufficient to establish a diagnosis of a condition when a lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). Moreover, the lack of consideration of the Veteran’s competent and credible lay statements regarding his injury and symptoms in service to include as due to combat is precisely what the combat rules were designed to prevent. As the Federal Circuit indicated in Reeves v. Shinseki, Congress enacted the law relating to combat, now codified at section 1154(b), because of its concern that combat veterans faced “major obstacle[s]” when seeking to assemble the medical records necessary to establish that they suffered an injury or disease while in service. 682 F.3d at 998 (quoting 38 U.S.C. § 1154(b)). In many instances, medical records do not survive combat conditions. Id. Based on the above evidence, the combat rules as interpreted in Reeves, and resolving reasonable doubt in his favor, the Board finds that the Veteran’s low back disability of degenerative arthritis of the lumbar spine and spondylolisthesis was incurred during his combat service. Thus, service connection is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. REASONS FOR REMAND Entitlement to service connection for a skin disability, to include soft-tissue sarcoma, actinic keratosis, seborrheic keratosis, basal cell carcinoma, malignant melanoma, and benign skin neoplasms, is remanded. The Veteran has claimed entitlement to service connection for a skin disability and has been diagnosed with multiple different skin disorders since service. He has also reported that he was diagnosed with soft tissue sarcoma, something he is competent to do. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (a layperson is competent to report a contemporaneous medical diagnosis). The Board has characterized the disability for which service connection is being claimed broadly. See Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009) (a claim must be characterized and addressed based on the reasonable expectations of the non-expert claimant and the evidence in processing the claim). In a September 2000 claim for service connection, the Veteran wrote he had been treated for soft tissue sarcoma since June 1969. He wrote in December 2008 he has had cancerous growths removed from his lip and head that continuously return. In his May 2015 appeal to the Board, the Veteran wrote that doctors have told him his skin condition was soft tissue sarcoma. As the Veteran served in Vietnam, he is presumed exposed to herbicide agents. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6). Soft tissue sarcoma, other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma, is a disease presumed service connected in veterans exposed to herbicide agents. § 1116(a)(2)(B); 38 C.F.R. § 3.309(e). Service treatment records show the Veteran underwent removal of skin growths in September 1969, and at the time was diagnosed with granuloma pyogenicum. Post-service medical records show a history of soft tissue sarcoma on the Veteran’s lip noted in April 2003 and December 2009. In November 2000, the Veteran had a slow growing lesion on his back and was concerned about skin cancer. In May 2003, it was noted that two years prior the Veteran had basal cell carcinoma on his back, confirmed by pathology. In April 2003, the Veteran presented with lesions on his scalp, signs of actinic keratosis, raised lesions on the top and sides of his scalp, and a consult referral to dermatology for evaluation for malignancy. At that time, it was noted the Veteran has a history of soft tissue sarcoma on the lip with repeat removals, and that lip sarcoma was removed about 15 years prior and scalp lesions were removed three to four years prior; past Agent Orange exposure was also noted in the history with soft-tissue sarcoma. In February 2009 the Veteran was seen again for dark colored lesions on the top and back of his head. In a February 2019 brief, the Veteran’s representative, citing to VA’s own public health website, wrote that it is not uncommon for persons to relate a problem of soft tissue sarcoma initially to something else, not realizing what skin condition it is. The brief cited to multiple other references in support of service connection of the Veteran’s skin disability, including a peer-reviewed study by Clemens, et al, published in the Journal of the American Medical Association (JAMA), which suggested that exposure to Agent Orange may increase the incidence of even non-melanotic invasive skin cancer (NMSC) among veterans when compared with the general population. At a November 2019 VA examination, the Veteran was diagnosed with seborrheic keratosis (dermatitis or eczema) from August 2009, basal cell carcinoma (tumors and neoplasms of the skin, including malignant melanoma) from November 2000, and neurofibroma (other skin condition) from January 2010. Twelve scars were identified on the Veteran. The Veteran recalled developing skin diseases in his upper and lower extremities while in Vietnam and was seen by dermatology in service when he developed a nodule over his left chest that was removed in 1969, attributed to an insect bite. After service, he has been seen for neurofibroma of the left upper eyelids, basal cell carcinoma of the left side of his back, actinic keratosis of the upper extremities, and seborrheic keratosis of the scalp. The examiner noted malignant skin tumors of the back diagnosed as basal cell carcinoma in November 2000, which was in remission. The November 2019 VA examiner opined it was “less likely as not” that the Veteran’s skin disability was “caused by the skin during service.” This was because the Veteran’s treatment for granuloma pyogenicum in 1969 “is not the same condition that the Veteran has been treated for post-service, variously as basal cell carcinoma, actinic keratosis, and seborrheic keratosis.” The examiner concluded all of the Veteran’s post-service skin diseases are related to sunlight and have “nothing to do with a diagnosis of granuloma” from service. This opinion is inadequate. The dispositive question pertaining to service connection in this case is whether the Veteran has had a skin diagnosis during the appeal period which is related to his active duty, to include diseases recognized as presumptively caused by his presumed Agent Orange exposure, and not whether the Veteran’s current skin disorder is caused by his particular skin disorder in service. The examiner continued to focus throughout the opinion on whether current disorders were the same as his granuloma in service, but did not address the cause of the scarring. The examiner also documented in the report that the Veteran had malignant basal cell, and in the opinion referred to his condition as benign neoplasms. The November 2019 examiner did not address whether Agent Orange caused any of the Veteran’s current skin disorders, regardless of any presumption, did not address the notations of a history of soft tissue sarcoma in the Veteran’s treatment records, and attributed his current skin diagnoses to sunlight, but did not provide an explanation why or address the likelihood that the sun exposure included during his service in Vietnam. The RO requested a new examination and opinion in December 2019. The examiner wrote that basal cell carcinoma from November 2000 and neurofibroma from January 2010 are resolved skin conditions. The December 2019 VA examiner provided an opinion that the Veteran’s seborrheic keratosis and actinic keratosis are less likely than not, less than 50 percent probability, caused by pyogenic granuloma. Similar to the previous inadequate VA examination, the examiner focused on whether the Veteran’s current skin condition was caused by granuloma due to having appeared in the service treatment records and did not address soft tissue sarcoma or Agent Orange exposure at all. Given the above, a new VA opinion by an appropriate specialist physician, is warranted. The opinion should identify all skin disorders that the Veteran has had since service, to specifically include whether it is at least as likely as not that the Veteran has had soft tissue sarcoma other than other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma. Then, the opinion should indicate whether any skin disability is related to anything in service, to include presumed herbicide agent exposure and sunlight in service. The matter is REMANDED for the following action: Request a medical opinion from an appropriate specialist physician. If an examination is deemed necessary, one should be conducted, to include via telehealth if appropriate. The opinion should identify all skin disorders that the Veteran has had since service, to specifically include whether it is at least as likely as not that the Veteran has had soft tissue sarcoma other than other than osteosarcoma, chondrosarcoma, Kaposi’s sarcoma, or mesothelioma. Then, the physician should indicate whether any such skin disability is related to anything in service, to include presumed herbicide agent exposure and sunlight. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Kuczynski, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303. Department of Veterans Affairs YOUR RIGHTS TO APPEAL OUR DECISION The attached decision by the Board of Veterans' Appeals (Board) is the final decision for all issues addressed in the "Order" section of the decision. The Board may also choose to remand an issue or issues to the local VA office for additional development. If the Board did this in your case, then a "Remand" section follows the "Order." However, you cannot appeal an issue remanded to the local VA office because a remand is not a final decision. The advice below on how to appeal a claim applies only to issues that were allowed, denied, or dismissed in the “Order.” If you are satisfied with the outcome of your appeal, you do not need to do anything. Your local VA office will implement the Board’s decision. However, if you are not satisfied with the Board's decision on any or all of the issues allowed, denied, or dismissed, you have the following options, which are listed in no particular order of importance: • Appeal to the United States Court of Appeals for Veterans Claims (Court) • File with the Board a motion for reconsideration of this decision • File with the Board a motion to vacate this decision • File with the Board a motion for revision of this decision based on clear and unmistakable error. Although it would not affect this BVA decision, you may choose to also: • Reopen your claim at the local VA office by submitting new and material evidence. There is no time limit for filing a motion for reconsideration, a motion to vacate, or a motion for revision based on clear and unmistakable error with the Board, or a claim to reopen at the local VA office. Please note that if you file a Notice of Appeal with the Court and a motion with the Board at the same time, this may delay your appeal at the Court because of jurisdictional conflicts. If you file a Notice of Appeal with the Court before you file a motion with the Board, the Board will not be able to consider your motion without the Court's permission or until your appeal at the Court is resolved. How long do I have to start my appeal to the court? You have 120 days from the date this decision was mailed to you (as shown on the first page of this decision) to file a Notice of Appeal with the Court. If you also want to file a motion for reconsideration or a motion to vacate, you will still have time to appeal to the court. As long as you file your motion(s) with the Board within 120 days of the date this decision was mailed to you, you will have another 120 days from the date the Board decides the motion for reconsideration or the motion to vacate to appeal to the Court. You should know that even if you have a representative, as discussed below, it is your responsibility to make sure that your appeal to the Court is filed on time. Please note that the 120-day time limit to file a Notice of Appeal with the Court does not include a period of active duty. If your active military service materially affects your ability to file a Notice of Appeal (e.g., due to a combat deployment), you may also be entitled to an additional 90 days after active duty service terminates before the 120-day appeal period (or remainder of the appeal period) begins to run. How do I appeal to the United States Court of Appeals for Veterans Claims? Send your Notice of Appeal to the Court at: Clerk, U.S. Court of Appeals for Veterans Claims 625 Indiana Avenue, NW, Suite 900 Washington, DC 20004-2950 You can get information about the Notice of Appeal, the procedure for filing a Notice of Appeal, the filing fee (or a motion to waive the filing fee if payment would cause financial hardship), and other matters covered by the Court's rules directly from the Court. You can also get this information from the Court's website on the Internet at: http://www.uscourts.cavc.gov, and you can download forms directly from that website. The Court's facsimile number is (202) 501-5848. To ensure full protection of your right of appeal to the Court, you must file your Notice of Appeal with the Court, not with the Board, or any other VA office. How do I file a motion for reconsideration? You can file a motion asking the Board to reconsider any part of this decision by writing a letter to the Board clearly explaining why you believe that the Board committed an obvious error of fact or law, or stating that new and material military service records have been discovered that apply to your appeal. It is important that your letter be as specific as possible. A general statement of dissatisfaction with the Board decision or some other aspect of the VA claims adjudication process will not suffice. If the Board has decided more than one issue, be sure to tell us which issue(s) you want reconsidered. Issues not clearly identified will not be considered. Send your letter to: Litigation Support Branch Board of Veterans' Appeals P.O. Box 27063 Washington, DC 20038 VA FORM DEC 2016 4597 Page 1 CONTINUED ON NEXT PAGE Remember, the Board places no time limit on filing a motion for reconsideration, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to vacate? You can file a motion asking the Board to vacate any part of this decision by writing a letter to the Board stating why you believe you were denied due process of law during your appeal. See 38 C.F.R. § 20.904. For example, you were denied your right to representation through action or inaction by VA personnel, you were not provided a Statement of the Case or Supplemental Statement of the Case, or you did not get a personal hearing that you requested. You can also file a motion to vacate any part of this decision on the basis that the Board allowed benefits based on false or fraudulent evidence. Send this motion to the address on the previous page for the Litigation Support Branch, at the Board. Remember, the Board places no time limit on filing a motion to vacate, and you can do this at any time. However, if you also plan to appeal this decision to the Court, you must file your motion within 120 days from the date of this decision. How do I file a motion to revise the Board's decision on the basis of clear and unmistakable error? You can file a motion asking that the Board revise this decision if you believe that the decision is based on "clear and unmistakable error" (CUE). Send this motion to the address on the previous page for the Litigation Support Branch, at the Board. You should be careful when preparing such a motion because it must meet specific requirements, and the Board will not review a final decision on this basis more than once. You should carefully review the Board's Rules of Practice on CUE, 38 C.F.R. § 20.1400-20.1411, and seek help from a qualified representative before filing such a motion. See discussion on representation below. Remember, the Board places no time limit on filing a CUE review motion, and you can do this at any time. How do I reopen my claim? You can ask your local VA office to reopen your claim by simply sending them a statement indicating that you want to reopen your claim. However, to be successful in reopening your claim, you must submit new and material evidence to that office. See 38 C.F.R. § 3.156(a). Can someone represent me in my appeal? Yes. You can always represent yourself in any claim before VA, including the Board, but you can also appoint someone to represent you. An accredited representative of a recognized service organization may represent you free of charge. VA approves these organizations to help veterans, service members, and dependents prepare their claims and present them to VA. An accredited representative works for the service organization and knows how to prepare and present claims. You can find a listing of these organizations on the Internet at: http://www.va.gov/vso/. You can also choose to be represented by a private attorney or by an "agent." (An agent is a person who is not a lawyer, but is specially accredited by VA.) If you want someone to represent you before the Court, rather than before the VA, you can get information on how to do so at the Court’s website at: http://www.uscourts.cavc.gov. The Court’s website provides a state-by-state listing of persons admitted to practice before the Court who have indicated their availability to the represent appellants. You may also request this information by writing directly to the Court. Information about free representation through the Veterans Consortium Pro Bono Program is also available at the Court’s website, or at: http://www.vetsprobono.org, mail@vetsprobono.org, or (855) 446-9678. Do I have to pay an attorney or agent to represent me? An attorney or agent may charge a fee to represent you after a notice of disagreement has been filed with respect to your case, provided that the notice of disagreement was filed on or after June 20, 2007. See 38 U.S.C. § 5904; 38 C.F.R. § 14.636. If the notice of disagreement was filed before June 20, 2007, an attorney or accredited agent may charge fees for services, but only after the Board first issues a final decision in the case, and only if the agent or attorney is hired within one year of the Board’s decision. See 38 C.F.R. § 14.636(c)(2). The notice of disagreement limitation does not apply to fees charged, allowed, or paid for services provided with respect to proceedings before a court. VA cannot pay the fees of your attorney or agent, with the exception of payment of fees out of past-due benefits awarded to you on the basis of your claim when provided for in a fee agreement. Fee for VA home and small business loan cases: An attorney or agent may charge you a reasonable fee for services involving a VA home loan or small business loan. See 38 U.S.C. § 5904; 38 C.F.R. § 14.636(d). Filing of Fee Agreements: If you hire an attorney or agent to represent you, a copy of any fee agreement must be sent to VA. The fee agreement must clearly specify if VA is to pay the attorney or agent directly out of past-due benefits. See 38 C.F.R. § 14.636(g)(2). If the fee agreement provides for the direct payment of fees out of past-due benefits, a copy of the direct-pay fee agreement must be filed with the agency of original jurisdiction within 30 days of its execution. A copy of any fee agreement that is not a direct-pay fee agreement must be filed with the Office of the General Counsel within 30 days of its execution by mailing the copy to the following address: Office of the General Counsel (022D), Department of Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420. See 38 C.F.R. § 14.636(g)(3). The Office of the General Counsel may decide, on its own, to review a fee agreement or expenses charged by your agent or attorney for reasonableness. You can also file a motion requesting such review to the address above for the Office of the General Counsel. See 38 C.F.R. § 14.636(i); 14.637(d). VA FORM DEC 2016 4597 Page 2 SUPERSEDES VA FORM 4597, APR 2015, WHICH WILL NOT BE USED