Citation Nr: 21027595 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 17-39 971A DATE: May 6, 2021 ORDER New and material evidence having been received, the petition to reopen the claim for entitlement to service connection for a cervical spine disorder is granted. Entitlement to service connection for a cervical spine disorder is granted. Entitlement to service connection for scars on the face, head, and neck is denied. An effective date of January 19, 2012 for the grant of service connection for a right elbow disability is granted. An effective date of January 19, 2012 for the grant of service connection for a low back disability is granted. An effective date of January 19, 2012 for the grant of service connection for a right knee disability is granted. An effective date of January 19, 2012 for the grant of service connection for a left knee disability is granted. An effective date of January 19, 2012 for the grant of service connection for a left hand disability is granted. An effective date of January 19, 2012 for the grant of service connection for a right hand disability is granted. An effective date of January 19, 2012 for the grant of service connection for a right wrist disability is granted. An effective date of January 19, 2012 for the grant of service connection for a right thumb disability is granted. An effective date of January 19, 2012 for the grant of service connection for a left hip disability is granted. An effective date of January 19, 2012 for the grant of service connection for a right hip disability is granted. FINDINGS OF FACT 1. The June 2005 rating decision denied the claim for entitlement to service connection for a cervical spine disorder; the Veteran was notified of this decision and did not appeal it, and new and material evidence was not received within one year of the notice of this decision. 2. Evidence received since the June 2005 rating decision when considered by itself or in connection with evidence previously assembled, relates to unestablished facts necessary to substantiate the claim, and raises a reasonable possibility of substantiating the claim. 3. The Veteran's cervical spine degenerative joint disease and disc herniation are at least as likely as not related to a neck injury during service. 4. The Veteran did not have scars on his face, head, and neck is service. 5. A February 2000 rating decision denied the Veteran's initial claims for service connection for disabilities involving the hands, low back, right thumb, knees, right wrist, right elbow, and hips; the Veteran was notified of this decision that same month and did not appeal it, and new and material evidence was not received within one year of the notice of this decision. 6. An informal claim for benefits received in March 2005 for disabilities of the low back, hips, and knees was denied in a June 2005 rating decision. The Veteran was notified of this decision that same month and did not appeal it, and new and material evidence was not received within one year of the notice of this decision. 7. The RO did not receive another claim for service connection for disabilities involving the hands, low back, right thumb, knees, right wrist, right elbow, and hips until January 19, 2012. CONCLUSIONS OF LAW 1. The June 2005 rating decision that denied entitlement to service connection for a cervical spine disorder is final. 38 U.S.C. § 7105(c); 38 C.F.R. §§ 3.104, 3.156, 20.201, 20.302, 20.1100. 2. New and material evidence having been received since the June 2005 rating decision, the criteria to reopen the claim for entitlement to service connection for a cervical spine disorder have been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 3. The criteria for entitlement to service connection for a cervical spine disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 4. The criteria for entitlement to service connection for scars on the face, head, and neck have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a right elbow disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 6. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a low back disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 7. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a right knee disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 8. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a left knee disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155, 3.156(c), 3.400 (in effect prior to March 24, 2015). 9. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a left hand disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 10. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a right hand disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 11. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a right wrist disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 12. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a right thumb disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 13. The criteria for an effective date of January 19, 2012, but no earlier, for the grant of service connection for a left hip disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. 14. The criteria for an effective date of January 19, 2012, but no earlier, for a right hip disability have been met. 38 U.S.C. §§ 5103, 5103A, 5107(b), 5110; 38 C.F.R. §§ 3.155 (in effect prior to March 24, 2015), 3.156(c), 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1995 to December 1999. This appeal to the Board of Veterans' Appeals (Board) is from April 2014, December 2016, and May 2017 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified during a video conference hearing before the undersigned. A transcript of his hearing is in the record. In February 2015, the Veteran raised a CUE for the earlier effective date claims. This matter is referred to the RO for appropriate action. New and Material Evidence In order to reopen a claim which has been denied by a final decision, the claimant must present new and material evidence. 38 U.S.C. § 5108. New evidence means existing evidence not previously submitted to VA. 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. 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 and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. See Justus v. Principi, 3 Vet. App. 510, 513 (1993) (in determining whether evidence is new and material, the "credibility" of newly presented evidence is to be presumed unless the evidence is inherently incredible or beyond the competence of the witness). The language of 38 C.F.R. § 3.156(a) creates a low threshold for finding new and material evidence and views the phrase "raises a reasonable possibility of substantiating the claim" as "enabling rather than precluding reopening." Evidence "raises a reasonable possibility of substantiating the claim," if it would trigger VA's duty to provide an examination in adjudicating a non-final claim. Shade v. Shinseki, 24 Vet. App. 110 (2010). 1. New and Material evidence has been received to reopen the claim for entitlement to service connection for the cervical spine. The RO construed a March 2005 notice of disagreement for other issues to include a claim for entitlement to service connection for a cervical spine disorder. See March 2005 NOD. In a June 2005 rating decision, the RO denied the claim on the basis that there was no evidence that he had a current chronic neck disorder related to the neck complaints noted in service. The Veteran did not submit a notice of disagreement with the June 2005 rating decision. No new and material evidence was received by VA within one year of the issuance of the June 2005 rating decision. As such, the June 2005 rating decision became final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 1367-68 (Fed. Cir. 2011). Since the June 2005 rating decision, favorable medical opinions have been added to the record. See March 2016, July 2016, and October 2016 Medical Treatment Record Non-Government Facility and November 2016 Medical Treatment Record Government Facility. Nexus evidence is an essential element to establish service connection, and as there had previously been no nexus evidence linking the claimed disability to service, this evidence is both new and material. Thus, the claim is reopened. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) a causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be presumed for certain chronic diseases, such as arthritis, which develop to a compensable degree within one year after discharge from service, even though there is no evidence of the disease during the period of service. That presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Service connection for a recognized chronic disease can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (2013); 38 C.F.R. §§ 3.303(b), 3.309. To deny a claim for benefits on its merits, the preponderance of the evidence must be against the claim. See Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990) ("A veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' to prevail."). 2. Entitlement to service connection for a cervical spine disorder. The record shows that the Veteran has current diagnoses of cervical spine degenerative joint disease and disc herniation. See March 2015 Medical Treatment Record Non-Government Facility and June 2015 C&P Exam. He contends that these disorders are related to service. During his January 2021 hearing and in a prior statement, the Veteran reported that he was in a Humvee in 1999 that rolled over. This was reported as a motor vehicle accident when he went to sick call a couple of days later. See August 2017 NOD, and January 2021 Correspondence. A June 2017 email from P. Voss states that he spoke to the Veteran shortly after the rollover accident and he recalled that the Veteran frequently did not want to go out when people were getting together because his neck hurt from the accident. See August 2017 Email Correspondence. In June 2015, a VA clinician examined the Veteran and offered an opinion regarding the etiology of his cervical spine disorder. He noted that the Veteran reported having pain and stiffness in his neck along with pain that radiated to right shoulder and numbness in both hands. The Veteran also reported the problem began during basic training when he fell off a wall twice. The clinician opined that the Veteran's herniated disc in his neck was less likely than not incurred in or caused by service. There is no evidence in service treatment records that the Veteran had a chronic cervical spine condition or any significant injury that would result in one. He was seen in July 1997 for a stiff neck and other symptoms and was diagnosed with stomatitis and viral syndrome. He was also seen in February 1999 with a two day history of neck pain after a motor vehicle accident. There is no evidence following this incident that there were any residuals. Both the separation report history and exam are negative for any neck issues. The Veteran was employed in a physically demanding job. His current neck disorder was likely due to the normal aging process exacerbated by stressful biomechanical forces imposed during his years of employment. See June 2015 C&P Exam. Favorable opinions were also added to the record. In March 2016, Dr. M. Munro, the Veteran's chiropractor, diagnosed the Veteran with C8 radicular neuropathy and stated that while he did not have imaging to confirm what was causing the radiculopathy, disc protrusion, encroached foramina, and bony arthrosis were among the possibilities. From the Veteran's history, he had traumas dating back to his time in service. Jumping out of airplanes and vehicular accidents led to increased degeneration. The Veteran explained that he had been in a rollover accident in service, and while not confirmed that this accident caused the Veteran's current condition, it was more rather than less than likely. See March 2016 Medical Treatment Record Non-Government Facility. Dr. M. Munro offered a more detailed rationale in July 2016 and commented that an MRI showed the Veteran had the degenerative process of an 80 year old. He stated that the Veteran was involved in numerous daily activities that result in traumas to the spine. Jumping out of the back of service vehicles with over 70 pounds of gear harnessed to his back was one of those activities. The main incident was in January 1999 when he was involved in a vehicle rollover accident. After this accident, the Veteran began to experience whiplash symptoms that included neck pain and other symptoms. He noted a study that addressed the long-term effects of whiplash injuries that went untreated. Based on the records and his own findings, the Dr. Munro opined that the Veteran's neck pain was more likely than not caused by a vehicle accident during service in January 1999. See July 2016 Medical Treatment Record Non-Government Facility. In November 2016, a VA clinician noted the Veteran's service and stated he was required to participate in numerous activities that have resulted in trauma to the neck and spine. He reported that he injured his neck repeatedly when he jumped out of airplanes on active duty. He also jumped from vehicles with packs weighing 70 pounds or greater and had a fall in boot camp that resulted in injury to his back and neck. Upon examination, the clinician found that the Veteran's physical condition was much older than his stated age. His most serious injury was a rollover accident in January 1999. The Veteran reported that his neck was injured when he hit the roof. In the clinician's opinion, the Veteran's paresthesias to the upper extremities, neuropathies and neck pain are more likely associated with the trauma he received in service based on subjective and objective information of the history and physical. See November 2016 Medical Treatment Record Government Facility. All the opinions are probative, and their rationales are to some extent consistent with the record. Service treatment record do show that that he had been in a vehicle accident at the end of January 1999 and did not seek treatment until a couple of days later when he started to manifest a stiff neck. There was no follow-up and the October 1999 separation examination and medical history report were silent for any neck complaints or findings. See February 2014 STR Medical. Not everything the Veteran reported regarding his history is corroborated in the record. While he has reported having neck pain since boot camp due to an injury, service treatment records show in April 1997 that he only reported having low back pain since boot camp. See February 2014 STR - Medical. The Veteran reported to clinicians that he had injuries from jumping out of airplanes, but his Certificate of Discharge shows that he does not have any type parachute badge. See January 2012 Certificate of Release or Discharge from Active Duty. However, these discrepancies aside, the clinicians appear to view the rollover accident as the most significant of his injuries and the January 1999 vehicular accident has been corroborated in his service treatment records. Since the clinicians considered the rollover accident the primary injury, consideration of the other uncorroborated incidents does not significantly diminish the probative value of the opinions. Although there are no post-service treatment records related to the cervical spine prior to April 2014 when he had an MRI of his cervical spine, the Veteran did report having chronic neck pain in March 2005. Based on the above, the record contains evidence of a neck injury in service, complaints of chronic pain after service and reports of continuing symptoms since service, and current trauma-related cervical spine disorders. There is no evidence of any post-service injuries. For these reasons, the Board finds that the favorable opinions are consistent with the record. The VA examiner's opinion is also probative and even though it differs from the other opinions it is consistent with the record. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's current cervical spine disorders are at least as likely as not related to service. 3. Entitlement to service connection for scars on the face, head, and neck. The Veteran testified that he has scars on his head, face, and neck that are due to the same rollover accident that caused his cervical spine disability. See January 2021 Correspondence. The February 1999 service treatment record that documents the accident notes that the Veteran had some abrasions but indicates these were on his back. Furthermore, his October 1999 separation examination only noted tattoos on his skin, there was no evidence of scars. See February 2012 STR Medical. The Veteran has not had a VA examination for his scars but based on the record the Board finds that one is not needed. The duty to schedule an examination is only triggered when the record contains (1) competent evidence of a current disability (or persistent or recurrent symptoms of a disability), (2) evidence establishing that an event, injury, or disease occurred in service, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service, but (4) there is insufficient competent medical evidence on file to decide the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). While the vehicle accident in service is confirmed, he was only found to have abrasions on his back and his separation examination found no evidence of scars. Thus, there is no evidence of the reported injuries in service. Since scars, particularly those on exposed parts of the body such as the face and neck, would have been noted on the separation examination if present but were not, the Board finds that probative evidence, so the requirements for providing an opinion are not met. Since the evidence tends to show the Veteran did not have any injuries to the skin during service that produced scars on his head, face, or neck, a preponderance of the evidence is against service connection. The claim is denied. Earlier Effective Dates The statutory guidelines for the determination of an effective date of an award are set forth in 38 U.S.C. § 5110. The effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase of compensation, dependency and indemnity compensation, or pension, shall 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); 38 C.F.R. § 3.400. The effective date for an award of disability compensation to a veteran shall be the day following the date of discharge or release if application is received within one year from such date of discharge release. 38 U.S.C. § 5110(b)(1). On March 24, 2015, VA amended its adjudication regulations to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary, regardless of the type of claim or posture in which the claim arises. See 79 Fed. Reg. 57660 (Sept. 25, 2014). Here, the earlier effective for claims and appeals were filed prior to March 24, 2015, so the amendments are not applicable and will not be applied. Under the provisions of 38 C.F.R. § 3.105(a), previous determinations that are final and binding will be accepted as correct in the absence of clear and unmistakable error. In order for a claim of CUE to be valid, there must have been an error in the prior adjudication of the claim; either the correct facts, as they were known at the time, were not before the adjudicator, or the statutory or regulatory provisions extant at the time were incorrectly applied. Phillips v. Brown, 10 Vet. App. 25, 31 (1997); Damrel v. Brown, 6 Vet. App. 242, 245 (1994); Russell v. Principi, 3 Vet. App. 310, 313-14 (1992) (en banc). 4. An effective date prior to January 24, 2012 for the grant of service connection for a right elbow disability. 5. An effective date prior to January 24, 2012 for the grant of service connection for a low back disability. 6. An effective date prior to January 24, 2012 for the rang of service connection for a right knee disability. 7. An effective date prior to January 24, 2012 for the grant of service connection for a left knee disability. 8. An effective date prior to January 24, 2012 for the grant of service connection for a left hand disability. 9. An effective date prior to January 24, 2012 for the grant of service connection for a right hand disability. 10. An effective date prior to January 24, 2012 for the grant of service connection for a right wrist disability. 11. An effective date prior to January 24, 2012 for the grant of service connection for a right thumb disability. 12. An effective date prior to January 24, 2012 for the grant of service connection for a left hip disability. 13. An effective date prior to January 24, 2012 for the grant of service connection for a right hip disability. The Veteran contends that the effective dates should date back to when he filed his initial claims in November 1999. During his January 2021 hearing, he testified that he never received any correspondence from the VA regarding his initial claims. It was not until 2012 when he went to the unemployment office to get assistance finding a job that he learned from a VA representative that his claims had been denied. The Veteran stated that he never received the letter and that when he went to VA to confirm his address. When he told them his address, they said that the notification had not gone to that address. He stated that it was sent to his parents' address, which was not his address; instead, it was his home of record. He added that regardless of which address was used, it was never received and that if his parents had received it then they would have given it to him. He believed there was human error involved when dealing with the Post Office and that there was no way to verify that mail was received other than his word or VA's word. He added that he has responded to everything since 2012 in a timely manner to support his contention that he did not receive the original denial, and that it would have made no sense for him not to respond to the original decision. The Veteran also stated that even though he filed a claim in 2004 that was decided quickly, he assumed that the RO was still working on the earlier claims. Every time he called VA between 1999 and 2012 to check on the status of his claims, they just said it took a long time and that the claims were being processed. See January 2021 Correspondence. The record shows that prior to his discharge from active duty, the Veteran filed service connection claims for his hands, hips, knees, low back, right elbow, right wrist, and right thumb; his formal claim is dated in December 1999. See December 1999 Statement in Support of Claim and December 1999 Veterans Application for Compensation or Pension. In February 2000, the rating decision that denied these claims and the notification letter were sent to his address of record, which was his parents' address. See February 2000 Rating Decision Narrative and Notification Letter. Although the Veteran contends there is no way to prove that he received the February 2000 rating decision, under the presumption of regularity, VA employees are presumed to have performed their duties "correctly . . . and in accordance with the law." Crumlich v. Wilkie, 31 Vet. App. 194, 201 (2019). An appellant may rebut the presumption of proper mailing "by producing clear evidence that VA did not follow its regular mailing practices or that is practices were not regular." Id. at 205. Here, the evidence shows that the decision was mailed to the address of record and that it was not returned as undeliverable, so the presumption of regularity attaches. Once the presumption of regularity has attached, it may be rebutted by clear evidence of irregularity. Though a statement of nonreceipt standing alone is not enough to rebut the presumption, a statement of nonreceipt coupled with other evidence can be. Other evidence can include, for example, clear evidence to the effect that VA's regular mailing practices are not regular or that they were not followed. While clear evidence of irregularity specific to a particular case may be sufficient to rebut the presumption of regularity, it is not necessary that the evidence of irregularity be specific to the particular case. Here, the Veteran offered no clear evidence of irregularity to rebut the presumption of regularity. In addition to the presumption of regularity attaching, the Board also finds that the Veteran's assertion that he was not given notice of the decision is not credible and, therefore, not probative. See Layno v. Brown, 6 Vet. App. 465, 469-71 (1994); Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed Cir. 2006); see also Washington v. Nicholson, 19 Vet. App. 362, 367-68 (2005). The Veteran acknowledges in his testimony that in 2004 he filed claims for hearing loss and tinnitus and that he heard back quickly on those claims. Notably, the February 2005 decision that addressed these claims states that hearing loss was previously denied in a February 2000 rating decision and the associated code sheet shows all the issues that that are currently on appeal were also denied in February 2000. This decision was sent to the same address as the February 2000 rating decision. Furthermore, a June 2005 rating decision denied reopening five other claims that were previously denied in February 2000 and it was also sent to the same address as the February 2000 rating decision. None of the decisions were returned as undeliverable and, as shown, the Veteran had information in his possession long before 2012 that his initial claims had been denied in February 2000. Furthermore, the Veteran appealed the February 2005 decision to the Board and even the August 2007 Board decision notes that the hearing loss claim was initially denied in February 2000. Thus, it is clear from the record that the Veteran was given notice many times well before 2012 that his claims had been denied in February 2000. During the hearing, his representative points out that January 2000 correspondence to the Veteran misspelled the street address it was mailed to and the Veteran stated that as a result that he never would have received that letter. The Board finds it unlikely that a minor error such as two letters being transposed would prevent the correspondence for reaching the correct address; at most it would be returned as undeliverable if such a street did not exist. There is no evidence the correspondence was returned. Although he attributed incorrect spelling to human error and asserted he should not be penalized for VA's mistake, he does not assert nor does the evidence show that the February 2000 rating decision had a typo or that it was sent to a wrong address. The Board concludes that February 2000 rating decision that denied service connection for the right thumb, bilateral knees, right wrist, right elbow, bilateral hip, bilateral hand, and low back disability is final. The Veteran was notified of the decision and did not appeal it, and new and material evidence was not received within one year of notice of the decision. The next correspondence considered a claim for the low back, hips, and knees was received in March 2005. The June 2005 rating decision that denied the claims for service connection for the bilateral hips, low back, and bilateral knees is final. The Veteran was notified of the decision and did not appeal it, and new and material evidence was not received within one year of notice of the decision. After the claim for hearing loss was denied in February 2005 and claims for his low back, hips, and knees were denied in in June 2005, nothing else that could be construed as a claim was received until January 2012. Although January 24, 2012 is handwritten and was used as the date of receipt, it appears the document was date stamped on January 19, 2012. Resolving reasonable doubt in his favor, an effective date of January 19, 2012, but no earlier, is established for service connection for his right elbow, right wrist, right thumb, low back, knees, hands, and hips. S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Bredehorst, 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.