Citation Nr: 9802953 Decision Date: 01/30/98 Archive Date: 04/14/98 DOCKET NO. 91-22 299 DATE On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUE Whether new and material evidence has been submitted to reopen the veteran's claim seeking service connection for post-traumatic stress disorder (PTSD). ATTORNEY FOR THE BOARD T. Hal Smith, Counsel INTRODUCTION The appellant served on active duty from October 1964 to October 1966. He served in the Dominican Republic from April 1965 to May 1966. During the course of this appeal, the RO has recognized various private attorneys from the Advocates for Basic Legal Equality, Inc. (ABLE) as representing the veteran. In correspondence in recent years, it was learned that the lawyer who was most recently representing the veteran was no longer associated with the organization mentioned above. Numerous attempts were made to obtain a power of attorney from this organization with negative results. Correspondence dated in September 1997 was mailed to the veteran explaining the situation and requesting additional clarification, (without response from the veteran). Thus, it is believed that the Board has met its obligation regarding this matter, and the claim is before the Board once again. 38 U.S.C.A. 7105(b)(2) (West 1991); 38 C.F.R. 14.631(c)(1) (1996). This matter came before the Board of Veterans' Appeals (Board) on appeal from rating decisions by the Department of Veterans Affairs (VA) Regional Office in Cleveland, Ohio. In November 1992, the Board denied entitlement to service connection for PTSD. The appellant, through his attorney, duly appealed the Board's decision to the United States Court of Veterans Appeals (Court). In November 1993, Counsel for the Secretary and Counsel for the appellant submitted a joint motion for remand and to stay further proceedings in order to allow for further evidentiary development and readjudication of the claim. In an order dated November 19, 1993, the Court vacated the Board's November 1992 decision and remanded the record to the Board for further evidentiary development, readjudication and disposition in accordance with the joint motion for remand and to stay further proceedings. In October 1989, the Board denied service connection for an acquired psychiatric disorder, to include PTSD. In November 1990, the RO denied service connection for PTSD and a personality disorder, and the RO addressed both disorders in its Statement of the Case, noting that the previous Board decision was final. Subsequent documents perfected the veteran's appeal only with respect to his claim for service connection for PTSD. It is this issue which is properly before the Board. It is noted that during the appeal process of this claim, the Board obtained an opinion from its psychiatric adviser, Eugene M. Caffey, Jr., M.D. During the course of this appeal, the Court decided the case of Austin v. Brown, 6 Vet. App. 547 (1994). The Court questioned the process by which the Board obtained opinion from its medical advisers and noted that basic fair play required the Board to procure evidence "in an impartial, unbiased, and neutral manner." Id. at 552. Consequently, the Board has not considered Dr. Caffey's opinion in its determination in this case. CONTENTIONS OF APPELLANT ON APPEAL Essentially, it is contended that the veteran served under combat conditions in the Dominican Republic in 1965 and had experiences which resulted in a PTSD for which service connection should be granted. Specifically, it is contended that the circumstances under which the veteran was drafted, in light of his having been mugged shortly before he entered service, combined with his experiences under combat conditions while he was in the Dominican Republic as an ambulance driver, precipitated a psychiatric disorder properly classified as PTSD for which service connection should be granted. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. 7104 (West 1991 & Supp. 1996), has reviewed and considered all of the evidence and material of record in the veteran's claims files. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that while the appellant has submitted new and material evidence sufficient to reopen his claim, the preponderance of all of the evidence is against establishing service connection for PTSD. FINDINGS OF FACT 1. The RO has obtained all relevant evidence necessary for an equitable disposition of the veteran's appeal. 2. In October 1989, the Board held that service connection was not warranted for PTSD. 3. Evidence submitted since the October 1989 decision includes evidence not already of record and evidence relevant to the veteran's claim. 4. The record does not show that the veteran engaged in combat with the enemy; the record does not establish that the appellant was exposed to an event in service, claimed as a "stressor," that would support a valid diagnosis of PTSD. CONCLUSIONS OF LAW 1. New and material evidence has been received since the October 1989 decision of the Board that held that service connection for PTSD was not warranted, and the claim to establish service connection for PTSD is reopened. 38 U.S.C.A. 5107, 5108, 7105 (West 1991 & Supp. 1996); 38 C.F.R. 3.156(a) (1996). 2. PTSD was not incurred in or aggravated by military service. 38 U.S.C.A. 1110, 1154(b), 5107; 38 C.F.R. 3.303(c), 3.304(f) (1996). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Factual Background Evidence of record at the time of the October 1989 decision included the following a private hospitalization report dated in June 1964 which noted a diagnosis of a cerebral contusion; the service enlistment examination dated in October 1964 which noted no psychiatric findings; the service separation examination dated in August 1966 which noted no psychiatric abnormalities and the fact that the appellant reported that he was in good health; private treatment reports dated in 1981, 1983, and 1985 from Daniel J. Kuna, Ph.D., which noted a diagnosis of an adjustment disorder with mixed emotional features; a VA hospitalization report covering the period from August 19, 1983, to September 20, 1983, which noted a diagnosis of alcohol dependence; a private treatment report from Joel M. Kestenbaum, Ph.D., which noted a diagnosis of major depression, recurrent with psychotic features; a clinical evaluation report dated in March 1987 from a clinical therapist, a psychologist, and a psychiatrist which noted a diagnosis of PTSD; reports from Angelo Lauria, M.A., dated in 1987 and 1988 which noted a diagnosis of PTSD; a private treatment report from William F. Flynn, Ph.D., from September 1987 which noted a diagnosis of PTSD. Also of record at the time of the 1989 denial was a September 1987 VA psychiatric examination where PTSD was the diagnostic impression, and the November 1987 transcript of a personal hearing before a traveling panel of the Board in Cleveland, Ohio, at which time the veteran elaborated on his in-service stressors. Also of record was a copy of a publication of the Analysis Branch, United States Army Center of Military History entitled United States Army Unilateral and Coalition Operations in the 1965 Dominican Republic Intervention. In its October 1989 decision, the Board noted the appellant's contentions that the circumstances under which he was drafted, when combined with the experiences of combat while he was in the Dominican Republic as an ambulance driver, precipitated an acquired psychiatric disorder, specifically PTSD; however, the Board concluded, that a psychiatric disorder was not shown in service and that there was no independent verification of the incidents which were claimed by the appellant to provide the basis for the diagnosis of PTSD. In September 1990, the appellant submitted a request to reopen his claim of service connection for PTSD. Additional evidence submitted in support of the appellant's current claim includes: a morning report dated in April 1966, which notes that the appellant was assigned to Rodriguez Army Hospital for treatment; photocopies of service medical records which reflect that the appellant was hospitalized from April 2, 1966, to April 4, 1966, and notes a diagnosis of a passive aggressive personality disorder; private treatment reports.dated in 1974 from the Court Diagnostic and Treatment Center which notes that the appellant was a stable individual who reacted inappropriately during an initial period of stress connected with his divorce; private treatment reports dated from August 1977 from Thomas G. Sherman, M.D., which note a diagnosis of chronic anxiety secondary to environmental stress; private treatment reports from Ide Mental Health Center dated in 1981 and 1982 which show treatment for psychiatric symptoms but no report of a psychiatric diagnosis; and a private treatment report from Roberto Eudella, M.D., from December 1985 which notes diagnoses of dysthymic disorder, alcohol dependence, in remission, and a provisional diagnosis of PTSD. Additional evidence added to the record consists of a VA psychiatric examination from September 1990. At that time, the veteran had numerous complaints concerning his anger with the government, nightmares, past suicidal history, depression, feelings of being worthless, and his inability to sleep. On the mental status examination, the veteran interrupted the examination on several occasions by walking out of the room. He appeared anxious and irritable and did not appear to have an understanding why the examination was being conducted. The appellant was unable to give pertinent answers to key questions and became confused and irritable as the interview went on. His mood was clearly depressed and there was some suicidal and homicidal rumination. The veteran had vague paranoid thoughts and did have gross impairment of his cognitive functions, especially memory, concentration and attention. He was also vague with respect to time and place. Diagnoses made were of organic mental disorder due to head injury and substance abuse, and organic personality disorder. Another statement by Angelo Lauria, M.A., dated in June 1991 was added to the claims file. He noted that the appellant had been treated at his office on and off for a period of several years. He reiterated his opinion, noted in previous statements, that the appellant's primary diagnosis was PTSD. He also indicated that chronic PTSD resembled personality disorder especially with regards to mistrust of authority. Mr. Lauria noted that the veteran did not accurately fit the diagnosis of paranoid personality disorder and that, in any event, a paranoid personality disorder could be exacerbated by traumatic experiences. It was further noted that Mr. Lauria considered the appellant to be an honest historian. Details as to in-service stressors were provided in a September 1991 statement as provided by the veteran's representative. A January 1992 independent medical expert's opinion from John A Bullen, M.D., Assistant Professor of Psychiatry, Louisiana State University, Shreveport, Louisiana, was obtained and associated with the claims folder. Dr. Bullen concluded, after review of the appellant's medical record that "there is no evidence for any significant stressor out of the range of normal human endeavors which would give a diagnosis of post-traumatic stress disorder." It was further indicated that the appellant's "characteristics of mistrust, suspiciousness and feelings of persecution are not characteristics of post traumatic stress disorder but more related to paranoid personality traits." The current diagnostic impression was alcohol abuse, and mixed personality disorder with paranoid and antisocial traits. In summary, Dr. Bullen opined that PTSD was not present and that the appellant's alcohol abuse and personality disorder were contributing factors to his service problems and problems of daily living and that these diagnoses were not related to a single significant traumatic stressor. Also added to the record was the report of a VA examination from February 1993. At that time, the veteran complained that he was confused and forgetful. He presented a very slow psychomotor activity and totally flat affect. The impression was that he was trying to do his best but appeared forgetful and confused. He had a serious difficulty with recent and remote recall. He indicated that he got into trouble often with things he could not remember. The examiner's impression was that the appellant suffered from some organicity. The examiner stated there was some question as to how well the veteran would be able to manage funds, but that if there had been no difficulty in the past, changes should not be made. As a result of requests made by the RO for information to verify the veteran's alleged in-service stressors, responses were received from the United States Army and Joint Services Environmental Support Group (ESG) dated in November 1994, October 1995, and December 1995. The ESG reported in November 1994 that they did not provide stressors since they did not know what the veteran knew or personally witnessed. They were unable to provide general historical documentation or copies of records for a large period of time without a specific incident. ESG verified that elements of 82nd Airborne Division were stationed in the Dominican Republic from April 28, 1965, to September 21, 1966. It was pointed out that the veteran's duty assignments could be verified as they appeared in his Official Military Personnel File (OMPF) which could be obtained in writing through the National Archives and Records Administration. It was added that the veteran would have to furnish more specific information regarding the death of "[redacted]" in order for further research to be attempted. In an October 1995 response from ESG, it was noted that no "[redacted] [redacted]" was shown to have been killed during August 1965 in the Dominican Republic. In a December 1995 response from ESG, it was noted that the veteran's DA Form 20 indicated that he was assigned to the 584th Medical Company from April 30, 1965, to January 17, 1966, and to the 42nd Field Hospital from January 18, 1966, to May 29, 1966. His duty assignment with both units was light truck driver. It was noted that he was in the Dominican Republic during these assignments. The record shows that additional attempts to verify stressors through the National Archives and Records Administration (NARA) were unsuccessful in that the veteran did not respond to requests to fill out forms needed by the NARA. It was also stated that anecdotal incidents, including those related by the veteran, might be true but could not be verified. Also added to the file was a copy of the annual historical summary for the 42nd Field Hospital. (Specific reference to the veteran is not made in this publication, and it has not been relied on in making a determination in the veteran's claim.) Analysis The veteran's claim is well-grounded within the meaning of 38 U.S.C.A. 5107(a) (West 1991); that is, he has presented a claim which is plausible. Further, the Board is satisfied that all relevant facts have been properly developed. There is no indication that there are additional records which have not been obtained which would be pertinent to the veteran's claim. Thus, no further assistance is required to comply with the duty to assist as mandated by 38 U.S.C.A. 5107(a). Godwin v. Derwinski, 1 Vet. App. 419 (1991); White v. Derwinski, 1 Vet. App. 519 (1991). As reported above, service connection for PTSD was previously denied by the Board by final rating determination in October 1989. Claims that have been the subject of a prior denial may be reopened only upon the submittal of additional evidence, which, under the applicable statutory and regulatory provisions, is both new and material. "New and material evidence is defined by regulation as evidence not previously submitted which bears directly and substantially upon the specific matter under consideration, which is neither cumulative nor redundant, and which by itself or in connection with the evidence previously assembled is so significant that it must be considered in order to fairly decide the merits of a claim. 38 C.F.R. 3.156(a). ne Court has further articulated a "bright line" standard for materiality requiring reasonable possibility that the new evidence when viewed in the context of all the evidence, both new and old, would change the outcome. Colvin v. Derwinski, 1 Vet. App. 171 (1991). The Court has held that in determining whether new and material evidence justifies reopening of a claim, the evidence should be presumed to be credible. Once the claim is reopened, the presumption as to the credibility of the evidence no longer applies. Justus v. Principi, 3 Vet. App. 510 (1992). As indicated above, service medical records have been submitted which were not considered in the 1989 Board denial. It is the Board's determination that these records which reference in-service psychiatric symptomatology are relevant and probative in view of other evidence of record. Thus, evidence has been received subsequent to the Board's October 1989 decision which satisfies the regulatory definition of "new and material" and meets the criteria set forth in Colvin, Id. Service connection for PTSD requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor. If the claimed stressor is related to combat, service department evidence that the veteran engaged in combat or that the veteran was awarded the Purple Heart, Combat Infantryman Badge, or similar combat citation will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the claimed in-service stressor. 38 U.S.C.A. 1154(b) (West 1991); 38 C.F.R. 3.304(f) (1996). During the pendency of this appeal 38 C.F.R. 3.304 was amended, effective in May 1993, to include subsection (f), pertaining specifically to PTSD serviceconnection claims. Prior to the May 1993 amendment, PTSD claims were governed by provisions of the VA Adjudication Procedure Manual M21-1 [hereinafter M21-1], Subchapter XII, para. 50.45 (Jan. 25, 1989), that required essentially the same elements that were incorporated in 38 C.F.R. 3.304(f). Subsequently, the M21-1 provisions were amended to reflect the PTSD requirements set forth in 38 C.F.R. 3.304(f). See M2]-], Part VI, para, 11.38 (first sentence) (Feb. 13, 1997). The veteran is entitled to have his claim adjudicated under whichever regulatory or M21-1 provisions would be more favorable to him in light of the regulatory change while his case was on appeal to the Board. See Karnas v. Derwinski, 1 Vet. App. 308, 312-13 (1991). Also the Court has previously held that the M21-1 provisions of para. 7.46, pertaining to PTSD, were substantive rules and the equivalent to VA regulations. Hayes v. Brown, 5 Vet. App. 60, 67 (1993). The adoption of 38 C.F.R. 3.304(f) in May 1993 moots the M21-1 provisions regarding PTSD adjudications except where the M21-1 is more favorable to the veteran. Also during the pendency of this appeal, effective November 7, 1996, VA amended several sections of the Schedule for Rating Disabilities in order to update the portion of the Rating Schedule, pertaining to mental disorders, and, in part, to conform with changes with the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, (4th ed. 1994) (DSM-IV), replacing the 1980 3rd edition of DSM (DSM-III) and the 1987 revised 3rd edition (DSM) (DSM-III-R). 61 Fed. Reg. 52,695 (1996) (to be codified at 38 C.F.R. Part 4, 4.125 to 4.130). Under DSM-IV, the diagnostic criteria for PTSD, in pertinent part, shifts from an objective standard (seen in DSM-III-R) in assessing whether a stressor is sufficient to trigger to PTSD to a subjective standard. (Note: As this case turns on the absence of a confirmed stressor, the transition of DSM-III to DSM-IV will not affect the Board's conclusion below.) The November 1996 amendment has not changed the requirements of 38 C.F.R. 3.304(f) and the M2]-l provisions. The Board is not bound to accept the veteran's uncorroborated account of service or the opinions of mental health professionals that PTSD had its onset during the veteran's period of active duty service. Wood v. Derwinski, 1 Vet. App. 190 (1991). The Court in Zarycki v. Brown, 6 Vet. App. 91 (1993) set forth the framework for establishing the presence of a recognizable stressor which is the essential prerequisite to support the diagnosis of PTSD. The Court noted that the evidence necessary to establish the existence of the recognizable stressor during service will vary depending on whether or not the veteran was "engaged in combat with the enemy" under 38 U.S.C.A. 1154(b) (West 1991) and 38 C.F.R. 3.304 (1996). Whether or not a veteran "engaged in combat with the enemy" must be determined through recognized military citations or other service department evidence. In other words, the claimant's bare assertions that he "engaged in combat with the enemy" are not sufficient, by themselves, to establish this fact. The record must first contain recognized military citations or other supportive evidence to establish that he engaged in combat with the enemy." If the determination with respect to this step is affirmative, then (and only then), a second step requires that the veteran's lay testimony regarding claimed stressors must be accepted as conclusive as to their actual occurrence and no further development or corroborative evidence will be required, provided that the veteran's testimony is found to be "satisfactory," e.g., credible, and "consistent with the circumstances, conditions, or hardships of such service." (Emphasis added.) Zarycki at 98. In an elaboration and clarification of Zarycki, the Court noted in Moreau v. Brown, 9 Vet. App. 389 (1996), that 38 C.F.R. 3.304(f) (1996) requires three elements to support an award of service connection for PTSD: (1) a current medical diagnosis of PTSD; (2) medical evidence of a causal nexus between current symptomatology and the claimed in-service stressor; and (3) credible supporting evidence that the claimed inservice stressor occurred. The Court pointed out that since Zarycki, as well as Doran v. Brown, 6 Vet. App. 283 (1994) and West v. Brown, 7 Vet. App. 70 (1994), changes in M2]-] had rendered certain portions of those decisions no longer operative insofar as they were grounded in subsequently revised manual provisions. Further, the Court had held in Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996) as a matter of law that "if the claimed stressor is not combat-related, [the] appellant's lay testimony regarding the in-service stressors is insufficient to establish the occurrence of the stressor. In Moreau, the Court, citing M21-1 Part 41, 7.46.c (Oct. 11, 1995) held that "credible supporting evidence" of a noncombat stressor "may be obtained from" service records or "other sources." The Court, however, also held that while the M21-1 provisions did not expressly state whether the veteran's testimony standing alone could constitute credible evidence of the actual occurrence of a noncombat stressor, the Court's holding in Dizoglio mandated that the veteran's testimony by itself could not constitute "credible supporting evidence" of the existence of the claimed noncombat stressor. In West v. Brown, 7 Vet. App. 70 (1994), the Court further elaborated on the analysis in Zarycki. In Zarycki, the Court held that in addition to demonstrating the existence of a stressor, the facts must also establish that the alleged stressful event was sufficient to give rise to PTSD. Id. at 98-99. In West, the Court held that the sufficiency of the stressor is a medical determination, and therefore adjudicators may not render a determination on this point in the absence of independent medical evidence. The Court also held in West that a psychiatric examination for the purpose of establishing the existence of PTSD was inadequate for rating purposes because the examiners relied, in part, on events whose existence the Board had rejected. In this case, the veteran has contended that he has PTSD and that it had its inception during military service in the Dominican Republic. Specifically, the appellant, through his representative, argues that circumstances surrounding his induction into the service, racism experienced by the appellant during that time, and exposure to combat while in the Dominican Republic resulted in PTSD. It is asserted that the absence of a diagnosis of PTSD either during service or prior to the recognition of the diagnosis by the American Psychiatric Association in 1980 has no bearing on a grant of service connection for PTSD. It is argued that since the PTSD did not exist in 1966, and in view of the resemblance between symptoms of PTSD and some personality disorders, as noted by the veteran's clinical therapist in June, 1991, the diagnosis of a personality disorder during service was, in fact, PTSD. (See the representative's September 1991 argument on behalf of the veteran.) However, after review of the service hospitalization report from April 1966, it is the Board's conclusion that there is no evidence to suggest that the appellant's in-service condition was misdiagnosed or that PTSD was present at that time. In fact, on service separation examination in August 1966, no psychiatric abnormality was noted, and the appellant was considered qualified for immediate re-enlistment. Furthermore, the diagnosis of a personality disorder in April 1966 is consistent with the recent opinion of the independent medical expert in January 1992. It is also contended by the appellant that the record contains thorough documentation of service-related stressors to support the diagnosis of PTSD including his consistent re-telling of the stressful events to mental health providers, repeating PTSD symptoms in a military context, and the mental health providers' belief of the appellant's account. The Board points out that, although the consistent re-telling of an account may lend some credibility to that account, the lack of objective corroboration of the events identified by the appellant as stressors weighs against his claim. See Wood. Furthermore, it is noted that the veteran's DD-214 does not show an award for an in-service wound or of any combat citation. Although the claims file contains extensive personnel records pertaining to the veteran, there is no listing of any indicators of combat. By far the most important evidence in this case, however, is provided by these administrative records which do show that the veteran drove an ambulance in the Dominican Republic. The records, however, do not verify the alleged in-service stressors to include those regarding the death of a civilian child, or the death of "James Jones" in 1965 in the Dominican Republic. Thus, the record contains no presumptive evidence that the appellant "engaged in combat with the enemy." The Board concludes that the veteran has not met his burden of providing valid stressors. Based upon this evidence, the Board concludes that the appellant had no recognized awards or decorations denoting that he "engaged in combat with the enemy," nor do the service administrative or medical records provide a basis to support the conclusion that he personally "engaged in combat with the enemy." In light of this determination, under Moreau and Dizoglio, his statements, standing alone, are not sufficient to corroborate the existence of a recognizable stressor in service. There must be "credible supporting evidence" of the existence of such a stressor. In summary, then, the Board concludes that there was no confirmed stressor event in service, and that therefore, there is no valid basis on which to support a diagnosis of PTSD. In addition, while the Board has noted the appellant's contention that the opinions rendered by treating and examining health care professionals are entitled to greater weight than opinions of those persons whole involvement has been limited to review of the written record pursuant to Washington v. Derwinski, 1 Vet. App. 459 (1991), an independent medical expert's opinion was obtained in light of the numerous and varied diagnoses assigned to the appellant. That opinion indicated that a diagnosis of PTSD or any other acquired psychiatric disorder related to the appellant's period of service was not confirmed. And while the appellant has questioned the procedure followed by the Board to obtain an independent medical opinion and also the independent nature of that opinion, the Board's authority to seek an independent medical expert's opinion is provided pursuant to 38 U.S.C.A. 7109 (West 1991) and 38 C.F.R. 20.901 (1996). Furthermore, independent medical opinions are obtained in an effort to clarify complex medial questions or resolve conflicts in the medical evidence of record, and by their very nature the review of the entire record by an expert, not an employee of VA, is an independent medical opinion on the case. See Colvin. It should also be noted that the independent medical expert is not selected by the Board, but is selected by the dean of a medical school at the Board's request. The Board notes the veteran's opinion that he has PTSD related to service does not constitute competent medical evidence as there is no evidence that he is trained in the field of medicine. Espiritu v. Derwinski, 2 Vet. App. 492 (1992); Grottveit v. Brown, 5 Vet. App. 91 (1993). As the veteran has been unable to provide a verifiable stressor, the Board concludes that he does not have PTSD as a consequence of his service. ORDER Service connection for PTSD is denied. RONALD R. BOSCH Acting Member, Board of Veterans' Appeals NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. 7266 (West 1991 & Supp. 1996), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, 402, 102 Stat. 4105., 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.