Citation Nr: 21029812 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 15-21 701 DATE: May 17, 2021 ORDER The appeal for a disability rating in excess of 10 percent since January 13, 2012, for a left wrist disability is dismissed. The appeal for an initial compensable disability rating for residuals of a left wrist surgical scar is dismissed. New and material evidence having been received, the petition to reopen a claim of service connection for hypertension is granted. New and material evidence having been received, the petition to reopen a claim of service connection for a lumbar spine disability is granted. New and material evidence having been received, the petition to reopen a claim of service connection for a left knee disability is granted. REMANDED The issue of entitlement to service connection for a lumbar spine disability is remanded. The issue of entitlement to service connection for a left knee disability is remanded. The issue of entitlement to service connection for hypertension is remanded. The issue of entitlement to service connection for obstructive sleep apnea (OSA) is remanded. FINDINGS OF FACT 1. At the January 2021 Board hearing, prior to the promulgation of a decision in the appeal, the Veteran withdrew the appeal for an increased rating for his left wrist disability. 2. At the January 2021 Board hearing, prior to the promulgation of a decision in the appeal, the Veteran withdrew the appeal for an increased rating for residuals of a left wrist surgical scar disability. 3. In a September 1998 rating decision, a VA regional office (RO) denied service connection for hypertension. Although notified of the denial in a September 1998 letter, the Veteran did not initiate an appeal or submit new and material evidence within one year. 4. Evidence associated with the file since September 1998, when considered by itself or in connection with evidence previously assembled, relates to an unestablished fact necessary to substantiate the claim of entitlement to service connection for hypertension. 5. In an April 1992 rating decision, a VA RO denied service connection for lumbar spine and left knee disabilities. Although notified of the denials in an May 1992 letter, the Veteran did not initiate an appeal or submit new and material evidence within one year. 6. Evidence associated with the file since April 1992, when considered by itself or in connection with evidence previously assembled, relates to an unestablished fact necessary to substantiate the claims of entitlement to service connection for lumbar spine and left knee disabilities. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the appeal for a disability rating in excess of 10 percent since January 13, 2012, for a left wrist disability by the appellant have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. The criteria for withdrawal of the appeal for an initial compensable disability rating for residuals of a left wrist surgical scar by the appellant have been met. 38 U.S.C. § 7105; 38 C.F.R. § § 19.55. 3. The September 1998 rating decision denying service connection for hypertension is final. 38 U.S.C. § 7105 (c) (West 2014); 38 C.F.R. §§ 3.104 (a), 20.302 (a), 20.1103 (2019). 4. As pertinent evidence received since the September 1998 denial is new and material, the criteria for reopening the claim for service connection for hypertension are met. 38 U.S.C. §§ 5108, 7105 (West 2014); 38 C.F.R. § 3.156 (2019). 5. The April 1992 rating decision denying service connection for lumbar spine and left knee disabilities is final. 38 U.S.C. § 7105 (c) (West 2014); 38 C.F.R. §§ 3.104 (a), 20.302 (a), 20.1103 (2019). 6. As pertinent evidence received since the April 1992 denial is new and material, the criteria for reopening the claims for service connection for lumbar spine and left knee disabilities are met. 38 U.S.C. §§ 5108, 7105 (West 2014); 38 C.F.R. § 3.156 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from August 1979 to August 1991. In January 2021, the Veteran testified at a Videoconference hearing before the undersigned Veterans Law Judge. The undersigned noted the issues on appeal and engaged in a colloquy with the Veteran toward substantiation of the claims. See Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A copy of the hearing transcript is associated with the claims file. Withdrawal The Board may dismiss any claim that fails to allege a specific error of fact or law in the decision being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all of the issues on appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the veteran or by his or her authorized representative. Id. 1. Entitlement to a disability rating in excess of 10 percent since January 13, 2012, for a left wrist disability 2. Entitlement to an initial compensable disability rating for residuals of a left wrist surgical scar The Veteran requested the withdrawal of his claims for increased ratings for his left wrist and left wrist scar disabilities at his January 2021 Videoconference Board hearing. Thus, there are no allegations of errors of fact or law for appellate consideration as to these issues. 38 C.F.R. § 20.202. The Board does not have jurisdiction to review these claims and they are therefore dismissed. Petition to reopen a previously denied claim Generally, a claim that has been denied in an un-appealed Board decision or an un-appealed RO decision may not thereafter be reopened and allowed. 38 U.S.C. §§ 7104 (b), 7105 (c). The exception to this rule is 38 U.S.C. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. 38 U.S.C. § 5108 (West 2014); 38 C.F.R. § 3.156 (a); see also Hodge v. West, 155 F. 3d 1356 (Fed. Cir. 1998). New evidence means existing evidence not previously submitted to agency decision makers. 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 sought to be reopened and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156 (a). The determination of whether newly submitted evidence raises a reasonable possibility of substantiating the claim should be considered a component of the question of what is new and material evidence, rather than a separate determination to be made after the Board has found that evidence is new and material. See Shade v. Shinseki, 24 Vet. App. 110 (2010). The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is "low." See Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). When determining whether the claim should be reopened, the credibility of the newly submitted evidence is presumed. See Justus v. Principi, 3 Vet. App. 510 (1992). The newly presented evidence need not be probative of all the elements required to award the claim, just probative of each element (or at least one element) that was a specified basis for the last disallowance of the claim. See Evans v. Brown, 9 Vet. App. 273, 283 (1996); see also Hodge, 155 F.3d at 1363 (noting that new evidence could be sufficient to reopen a claim if it could contribute to a more complete picture of the circumstances surrounding the origin of a claimant's injury or disability, even where it would not be enough to convince the Board to grant the claim). 3. Whether new and material evidence has been received to reopen a claim of service connection for hypertension The claim of service connection for hypertension was previously denied in an un-appealed September 1998 rating decision. Because new and material evidence has since been submitted, this claim will be reopened. In a June 1996 rating decision, the RO denied the Veteran's claim of service connection for hypertension because the evidence did not indicate a current diagnosis of hypertension. Although notified of this decision in a July 1996 letter, the Veteran did not initiate an appeal or submit new and material evidence within one year of the rating decision. The denial is final as to the evidence then of record and is not subject to revision on the same factual basis. See 38 U.S.C. § 7105 (b); see also 38 C.F.R. §§ 3.104, 3.156 (a), 20.302, 20.1103. In February 1998, the Veteran petitioned to reopen the service connection claim for hypertension. In a September 1998 rating decision, the RO granted reopening but denied the merits of service connection because the evidence did not indicate the Veteran's hypertension diagnosis was incurred in service or diagnosed within the presumptive period after discharge. The Veteran filed a timely notice of disagreement (NOD) but failed to timely perfect his appeal after the August 1999 statement of the case (SOC). The September 1998 rating decision denial of service connection is final as to the evidence then of record and is not subject to revision on the same factual basis. See 38 U.S.C. § 7104 (b); see also 38 C.F.R. §§ 3.104, 3.156 (a), 20.302, 20.1103. In January 2012, the Veteran petitioned to reopen the claim for service connection for hypertension. In an August 2012 rating decision, the RO denied reopening because the evidence was not new and material. The Veteran filed a timely NOD, and perfected the appeal following the April 2015 SOC. Evidence submitted since the final September 1998 rating decision consists of private and VA treatment records and personal statements from the Veteran to include his Board testimony. Treatment records are either duplicative of previously submitted records or are new but do not indicate a diagnosis during service, during the presumptive period after discharge, nor a nexus to service. The Veteran's testimony at his January 2021 Board hearing however is both new and material. The Veteran testified that at his separation examination that he was told his blood pressure reading indicated he had hypertension. Given the threshold for substantiating a claim to reopen is low, the evidence associated with the claims file since the September 1998 denial, when considered by itself or in connection with evidence previously assembled, relates to an unestablished fact necessary to substantiate the claim for service connection and raises a reasonable possibility of substantiating the claim. Thus, the claim of entitlement to service connection for hypertension is reopened and will be remanded for further development. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 4. Whether new and material evidence has been received to reopen the claims of service connection for lumbar spine and left knee disabilities The claims of service connection for a lumbar spine and a left knee disability were previously denied in an un-appealed April 1992 rating decision. Because new and material evidence has since been submitted, these claims will be reopened. In an April 1992 rating decision, the RO denied the Veteran's claims of service connection for lumbar and left knee disabilities because the Veteran did not demonstrate any current residuals from in-service complaints for these two conditions. Although notified of this decision by a May 1992 letter, the Veteran did not initiate an appeal or submit new and material evidence within one year of the rating decision. The denial is final as to the evidence then of record and is not subject to revision on the same factual basis. See 38 U.S.C. § 7105 (b); see also 38 C.F.R. §§ 3.104, 3.156 (a), 20.302, 20.1103. In January 2012, the Veteran petitioned to reopen his lumbar and left knee service connection claims. In August 2012 the RO provided the Veteran with VA examinations for his disabilities. In an August 2012 rating decision, the RO granted reopening but denied the underlying service connection claims. The Veteran filed a timely notice of disagreement (NOD), and perfected the appeal following the April 2015 SOC. By affording the Veteran new VA examinations after the Veteran submitted his petition to reopen, VA conducted a de facto reopening of the claim. See Falzone v. Brown, 8 Vet. App. 398, 404 (1995); see also Shade, 24 Vet. App. at 110. Thus, the claims of entitlement to service connection for lumbar spine and left knee disabilities are reopened and will be remanded for further development. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. REASONS FOR REMAND 1. The issue of service connection for a lumbar spine disability is remanded. 2. The issue of service connection for a left knee disability is remanded. 3. The issue of service connection for hypertension is remanded. 4. The issue of service connection for obstructive sleep apnea (OSA) is remanded. The matters are REMANDED for the following action: 1. BACKGROUND INFORMATION FOR THE RO ADJUDICATOR: The August 2012 VA medical examination reports and opinions are inadequate to resolve the lumbar and left knee claims. Furthermore, competent evidence has been submitted to warrant VA medical examinations for the Veteran's hypertension and OSA claims. THE REMAND DIRECTIVES FOLLOW. 2. Request the Veteran provide any service treatment records he possesses or identify and secure any relevant private medical records that are not in the claims file. IN PARTICULAR, REQUEST THE VETERAN PROVIDE ANY COPIES OF HIS COMPLETE 1991 SEPARATION EXAMINATION; COPIES OF ANY IMAGING OF HIS LUMBAR SPINE AND/OR LEFT KNEE; AND ALL PRIVATE RECORDS NOT OF RECORD REGARDING HIS LUMBAR SPINE AND LEFT KNEE TREATMENTS AND SURGERIES. If the Veteran identifies private records, make all appropriate attempts to locate such records and to associate them with the claims file. If the Veteran has no further evidence to submit, or, if after exhaustive efforts have been made, no records can be identified, so annotate the record. 3. Obtain all outstanding VA medical records and associate them with the claims file, to include from Decatur and Memphis VA medical centers (VAMCs). 4. Return the claims file to the August 2012 VA examiner and request he re-review the claims file and respond to the inquiries below. If the examiner is not available, arrange for another appropriate VA examiner to provide an addendum medical opinion to assist in determining the relationship between the Veteran's current lumbar spine diagnoses and his in-service complaints. All appropriate tests, studies and consultations must be accomplished, including a new medical examination if necessary, and all clinical findings must be reported in detail in the narrative portion of the examination report. A rationale must be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner MUST provide the following opinions: a) Were any of the Veteran's current lumbar spine diagnoses, to include degenerative joint arthritis, incurred in service or caused by an in-service injury, event or illness? Please fully explain your opinion. b) Given the medical evidence in this case, your experience and knowledge, and the state of medical science, is the Veteran's lay account of his development of his current lumbar spine disorder as related to his in-service low back complaints, diagnoses, and treatments consistent with the clinical findings? Please fully explain your opinion. The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: * The April 1979 entrance report of medical history indicated the Veteran denied recurrent back trouble. His entrance examination indicated a normal musculoskeletal and spinal evaluation. See "STR Medical," received February 14, 2014, pages 54-57 of 82. * In August 1983 the Veteran underwent a series of evaluations for "chronic recurrent" low back pain, to include physical therapy and imaging. See "Correspondence," received February 3, 2021, pages 54-55 of 122. See also "STR Medical," received February 14, 2014, page 17 of 129. * In October 1983 the Veteran complain of low back pain following a rigorous exercise program. He was assessed with chronic lumbosacral strain. See "Correspondence," supra, at page 53 of 122. See also "STR Medical," supra, at page 5 of 129. * In May 1985 the Veteran was assessed with an overuse injury to his abdomen and back musculature with spasm. The examiner advised him to avoid strenuous exercise for 3-5 days. A week later the examiner indicated the Veteran's overuse injury had resolved. See "STR Medical," supra, at pages 2-3 of 129. * Incomplete May 1991 examination prior to separation. The second page indicates the Veteran was assessed with "1" for his entire PUHLES profile. See "Correspondence," supra, at page 44 of 122. * In July 1991, one month prior to separation, the Veteran reported low back pain after twisting it two days prior. The examiner assessed him with a strain and restricted duty for three days. See "STR Medical," supra, page 5 of 129. * In September 1992 the Veteran reported stiffness in his low back after slipping two days prior. The evaluation revealed tenderness on his back muscles and difficulty bending. He was prescribed Motrin and advised to apply heat to the area. See "Correspondence," supra, at page 57 of 122. * The August 2012 VA medical examination report and opinion. The only in-service diagnosis the examiner acknowledged was the July 1983 diagnosis of lumbar sprain. The examiner also noted that imaging did not reveal arthritis. The examiner opined the Veteran's current low back pain was not likely due to any injury sustained in service because chronic low back pain can be from a variety of etiologies, including exercise, activities of daily living, and body habitus. The opinion did not address the Veteran's additional in-service complaints, his post-service complaints and treatments during the presumptive period after discharge, nor his lay statements regarding self-treatment of chronic low back pain since discharge. See "VA Examination," received August 13, 2012. * Private March 2015 and October 2015 MRI results, showing disc protrusion and the onset of degenerative changes. The Veteran underwent microdiscectomy in June 2015. See "Correspondence," supra, pages 58, 71-73, and 93-95, and 98 of 122. * January 2021 Board hearing testimony. See "Hearing Transcript," received January 11, 2021. A thorough explanation must be provided for the opinion rendered. If the examiner cannot provide the requested opinion without resorting to speculation, s/he must expressly indicate this and provide supporting rationale as to why the opinion cannot be made without resorting to speculation. The examiner must schedule a new examination only if necessary to provide an adequate opinion. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED, AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 5. Return the claims file to the August 2012 VA examiner and request he re-review the claims file and respond to the inquiries below. If the examiner is not available, arrange for another appropriate VA examiner to provide an addendum medical opinion to assist in determining the relationship between the Veteran's left knee diagnoses and his in-service complaints. All appropriate tests, studies and consultations must be accomplished, including a new medical examination if necessary, and all clinical findings must be reported in detail in the narrative portion of the examination report. A rationale must be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner must provide the following opinions: a) Were any of the Veteran's current left knee diagnoses, to include degenerative joint disease, chondromalacia, and meniscus pathology, incurred in service or caused by an in-service injury, event or illness? Please fully explain your opinion. b) Given the medical evidence in this case, your experience and knowledge, and the state of medical science, is the Veteran's lay account of his development of his current left knee disorder as related to his in-service left knee complaints, diagnoses, and treatments consistent with the clinical findings? Please fully explain your opinion. The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: * The April 1979 entrance report of medical history indicated the Veteran denied "trick" or locked knee. His entrance examination indicated a normal musculoskeletal evaluation. See "STR Medical," received February 14, 2014, pages 54-57 of 82. * In February 1984 the Veteran reported bilateral knee weakness and that his left knee felt like it would "give way" while squatting. On examination he was able to squat without difficulty. The examiner assessed the Veteran with normal knees and advised the Veteran to perform strengthening exercises. See "STR Medical," supra, page 10 of 129. * Incomplete May 1991 examination prior to separation. The second page indicates the Veteran was assessed with "1" for his entire PUHLES profile. See "Correspondence," supra, at page 44 of 122. * In June 1995 the Veteran complained of left knee pain, "popping" sounds, and reported an injury to his knee four months prior. The examination revealed tenderness to the midline patellar joint. The examiner assessed the Veteran with either a left knee strain or an internal derangement. In an October 1995 follow up, the Veteran reported increased pain. He was assessed with patellofemoral syndrome. See "Medical Treatment Record Non-Government Facility," received April 23, 1999, pages 3-4 of 6. * August 2012 VA medical examination report and opinion. The examiner opined the Veteran's current knee pain, physical examination findings, and imaging did not point to any pathology directly connected to his diagnosis of internal derangement, and that his current pathology was more likely than not due to normal physiologic wear. The opinion did not address the Veteran's lay statements regarding in-service left knee pain, self-treatment during and after service, and subsequent additional pathology. See "VA Examination," received August 13, 2012. * September 2012 left knee MRI conducted at the Memphis VAMC. See "Correspondence," supra, pages 8 and 28-30 of 122. * Operative report of left knee arthroscopy and partial medical meniscectomy. Post-operative diagnoses included medial meniscus tear and chondromalacia. See "Correspondence," supra, at page 4 of 122. * Private April 2014 records indicate the Veteran was diagnosed with osteoarthritis. See "Correspondence," supra, at page 12 of 122. * January 2021 Board hearing testimony. The Veteran reported burning and clicking sounds throughout service. See "Hearing Transcript," received January 11, 2021. A thorough explanation must be provided for the opinion rendered. If the examiner cannot provide the requested opinion without resorting to speculation, s/he must expressly indicate this and provide supporting rationale as to why the opinion cannot be made without resorting to speculation. The examiner must schedule a new examination only if necessary to provide an adequate opinion. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED, AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 6. Schedule the Veteran for an appropriate VA examination, consistent with VA rating protocols, to determine the nature and etiology of his current hypertension diagnosis. The entire claims file, including a copy of the Remand, must be made available to, and be reviewed by, the VA examiner. All appropriate tests, studies, and consultations must be accomplished, and all clinical findings must be reported in detail. An explanation must be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner must provide the following opinions: a) Was the Veteran's hypertension diagnosis incurred in service or caused by an in-service injury, event, or illness? Please fully explain your opinion. b) Given the medical evidence in this case, your experience and knowledge, and the state of the medical science, is the Veteran's lay account that he demonstrated the onset of hypertension (i.e. that he demonstrated pre-hypertension) at or near separation from service AND/OR during the presumptive period after discharge consistent with clinical findings? Please fully explain your opinion. The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: * Service treatment records (STRs) do not indicate the Veteran received treatment for high blood pressure during service. * In April 1992, within one year of discharge from service, the Veteran demonstrated blood pressure reading of 150/100. See "Medical Treatment Record Government Facility," received June 18, 1996. * In July 1997 the Veteran was diagnosed with hypertension. See "Medical Treatment Record Non-Government Facility," received December 13, 1991, 3 pages. * In June 1998 the Veteran reported chronic hypertension since 1990. See "Medical Treatment Record Government Facility," received September 21, 1999, page 14 of 35. * April 2019 Appellant's brief submitted by the Veteran's authorized representative, including a chart of the Veteran's blood pressure readings during service and a summary of medical literature indicating prehypertension is a strong indicator to the development of hypertension. See "BVA-General," received April 29, 2019. * January 2021 Board hearing testimony. The Veteran testified that he was told at his separation examination that he had hypertension. See "Hearing Transcript," received January 11, 2021. A thorough explanation must be provided for the opinions rendered. If the examiner cannot provide the requested opinions without resorting to speculation, s/he must expressly indicate this and provide supporting rationale as to why the opinions cannot be made without resorting to speculation. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED, AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 7. Schedule the Veteran for an appropriate VA examination, consistent with VA rating protocols, to determine the nature and etiology of his current OSA diagnosis. The entire claims file, including a copy of the Remand, must be made available to, and be reviewed by, the VA examiner. All appropriate tests, studies, and consultations must be accomplished, and all clinical findings must be reported in detail. An explanation must be given for all opinions and conclusions rendered. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner must provide the following opinions: a) Was the Veteran's current OSA diagnosis incurred in service or caused by an in-service injury, event, or illness? Please fully explain your opinion. b) Given the medical evidence in this case, your experience and knowledge and the state of medical science, is the Veteran's lay account that he demonstrated the onset of his current OSA diagnosis during service consistent with the clinical findings? Please fully explain your opinion. The examiner must review the entire record in conjunction with rendering the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: * STRs do not indicate the Veteran complained of sleep impairment during service. * In November 2013 the Veteran was diagnosed with mild to moderate OSA. See "Correspondence," supra, page 115 of 122. * In his May 2014 NOD, the Veteran stated he reported sleep problems to his flight surgeon and that he received permission to be relieved from duty anytime he felt daytime tiredness. See "NOD," received May 30, 2014. * In a statement received January 2021, the Veteran's former spouse stated she observed the Veteran gasp for air while sleeping and that he snored. She reported she would wake him up "fearing for his wellbeing." See "Correspondence," received January 11, 2021. * January 2021 Board hearing testimony. The Veteran testified that he had interrupted breathing at night and excessive sleepiness during the day. See "Hearing Transcript," received January 11, 2021. A thorough explanation must be provided for the opinion rendered. If the examiner cannot provide the requested opinion without resorting to speculation, s/he must expressly indicate this and provide supporting rationale as to why the opinion cannot be made without resorting to speculation. THE EXAMINER IS ADVISED THAT BY LAW, THE MERE STATEMENT THAT THE CLAIMS FOLDER WAS REVIEWED, AND/OR THE EXAMINER HAS EXPERTISE IS NOT SUFFICIENT TO FIND THE EXAMINATION/OPINION SUFFICIENT. 8. Following the review and any additional development deemed necessary, readjudicate the claims. If the claims are not granted, issue an appropriate supplemental statement of the case (SSOC) and forward the claims to the Board for adjudication. The Veteran has the right to submit additional evidence and argument on the matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). These claims must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112 (West 2014). Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Anwar, Attorney-Advisor 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.