Citation Nr: 9825492 Decision Date: 08/25/98 Archive Date: 07/27/01 DOCKET NO. 91-43 352 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUE Entitlement to the restoration of service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD N. W. Fabian, Associate Counsel INTRODUCTION The veteran had active duty from August 1964 to August 1968. This matter comes to the Board of Veterans' Appeals (Board) from a May 1991 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In that decision the RO found that clear and unmistakable error had occurred in the January 1990 rating decision in which service connection for PTSD was granted, and severed service connection for that disorder. The RO found that clear and unmistakable error had occurred in the decision granting service connection, because the claimed stressors were not supported by the service medical or personnel records. The veteran perfected an appeal of the May 1991 decision. This case was previously before the Board in July 1992, at which time it was remanded to the RO for the purpose of obtaining verification of the veteran's claimed stressors. That development has been completed to the extent possible and the case returned to the Board. In the May 1991 decision the RO also determined that new and material evidence had not been submitted to reopen a claim of entitlement to service connection for the residuals of a right knee injury. Service connection for the residuals of a right knee injury was denied in January 1980, and that decision became final in the absence of an appeal. In an August 1991 statement the veteran expressed disagreement with the RO's determination that new and material evidence had not been submitted. This statement constitutes a notice of disagreement with that determination. See Tomlin v. Brown, 5 Vet. App. 355, 357 (1993) (defines a valid notice of disagreement). The issue has not been developed for appeal, however, and is being remanded for the issuance of a statement of the case. 38 U.S.C.A. § 7105; see Slater v. Brown, 9 Vet. App. 240, 244 (1996) (the filing of a notice of disagreement initiates the appellate process); see also Black v. Brown, 10 Vet. App. 279 (1997) (the Board has no jurisdiction to address an issue if the appeal has not been perfected). In an August 1991 statement the veteran also claimed service connection for the residuals of a back injury. This issue has not been adjudicated by the RO and is referred to the RO for appropriate action. See Shockley v. West, 11 Vet. App. 208, 214 (1998) (a jurisdiction-conferring notice of disagreement cannot be filed if the claim has not been adjudicated by the RO, and that claim remains pending before the RO). CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he has PTSD as the result of stressors that occurred during his service in Vietnam. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1998), 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 the January 1990 decision granting service connection for PTSD was not the product of clear and unmistakable error. FINDINGS OF FACT 1. All relevant evidence necessary for an informed decision on the veteran's appeal has been obtained by the RO. 2. Service connection for PTSD was granted in a January 1990 rating decision, and that decision became final in the absence of an appeal. 3. The January 1990 decision considered the correct law and evidence as it then existed, and did not contain an undebatable error that would have lead to a manifestly different result if corrected. CONCLUSION OF LAW The decision granting service connection for PTSD was not clearly and unmistakably erroneous, and service connection for PTSD is restored. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. §§ 3.105(a) and (d), 3.304(f) (1997); VA Adjudication Procedure Manual, M21-1, Subchapter XII, 50.45 (1989). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board notes as an initial matter that in a November 1990 rating decision the RO proposed to sever service connection for PTSD on the basis that the January 1990 decision granting service connection was based on clear and unmistakable error. The veteran was notified of the proposed severance in February 1991, and was provided the opportunity to submit evidence and arguments in rebuttal of the proposed severance. The decision to sever service connection was made in May 1991, which was more than 60 days following the notification to the veteran of the proposed severance. The Board finds, therefore, that the procedural requirements for severing service connection as shown in 38 C.F.R. § 3.105(d) were met. I. Law and Regulations Previous determinations that are final and binding, including decisions of service connection, will be accepted as correct in the absence of clear and unmistakable error. Where evidence establishes such error, the prior decision will be reversed or amended. Service connection will be severed only where evidence establishes that the grant of service connection was clearly and unmistakable erroneous, and the burden of proof is on VA to show that the decision was clearly and unmistakably erroneous. See Baughman v. Derwinski, 1 Vet. App. 563, 566 (1991) (the burden of proof for severing service connection is at least as high as the veteran's burden in overturning a prior unfavorable determination); 38 C.F.R. § 3.105(a) and (d). The definition of clear and unmistakable error in severing service connection is also the same as that which applies to the veteran in an attempt to overturn a prior unfavorable decision. Graves v. Brown, 6 Vet. App. 166 (1994). The determination of whether a decision was based on clear and unmistakable error requires a three-pronged analysis: 1) either the correct facts, as they were known at the time, were not before the adjudicator, rather than a disagreement on how the facts were interpreted, or that the pertinent statutory or regulatory provisions were incorrectly applied; 2) the error must be undebatable, and of the type that, had it not been made, would have manifestly changed the outcome of the case at the time it was made; 3) the determination of whether a decision contained clear and unmistakable error must be based on the record and law that existed at the time the decision was rendered. Damrel v. Brown, 6 Vet. App. 242 (1994), citing Russell v. Principi, 3 Vet. App. 310 (1992). While a CUE determination must be based only upon the evidence of record at the time of the challenged decision. Russell, 3 Vet. App. at 314. A determination to sever service connection, is not similarly limited. Venturella v. Gober, 10 Vet. App. 340 (1997)(Steinberg, J., concurring). Although the same standards applied in a determination of CUE in a final decision are applied to a determination whether a decision granting service connection was the product of CUE for the purpose of severing service connection, § 3.105(d) does not limit the reviewable evidence to that which was before the RO in making its initial service connection award. Daniels v. Gober, 10 Vet. App. 474, 480 (1997). Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. § 1110. Subsequent to the May 1991 severance of service connection and the initiation of the veteran's appeal, a specific regulation pertaining to service connection for PTSD was issued. 38 C.F.R. § 3.304(f) (1993). Prior to the promulgation of 38 C.F.R. § 3.304(f), entitlement to service connection for PTSD was determined by applying the provisions of the VA Adjudication Manual (M21- 1), which, at the time, required essentially the same elements as are now contained in 38 C.F.R. § 3.304(f), except that the M21-1 provisions required service records to support the assertion that a veteran was exposed to a stressor. See Cohen v. Brown, 10 Vet. App. 128, 138 (1997), citing the VA Adjudication Procedure Manual, M21-1, Subchapter XII, 50.45 (Jan. 25, 1989). According to 38 C.F.R. § 3.304(f), in determining whether the occurrence of the claimed inservice stressor is supported by credible evidence, if the claimed inservice stressor is related to combat, service department evidence that the veteran served in combat will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the inservice stressor. If the veteran did not serve in combat, the record must contain corroborative evidence that the inservice stressor occurred. The corroborating evidence is no longer required to be in the service records, but may include statements from individuals with whom the veteran served. See Moreau v. Brown, 9 Vet. App. 389, 395 (1996). The M21-1 provisions pertaining to PTSD are "the equivalent of [VA] regulations." Hayes v. Brown, 5 Vet. App. 60, 67 (1993). Inasmuch as the provisions of M21-1 have not been published in accordance with the Administrative Procedures Act, manual provisions that are more restrictive than applicable laws and regulations cannot be applied to the veteran's detriment. Cohen v. Brown, 10 Vet. App. 128 (1997). The Manual M21-1 provisions relied upon the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), which defines and requires specific symptomatology and stressors in diagnosing PTSD. Pursuant to 38 C.F.R. § 3.304(f), 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. The regulation makes no reference to any criteria, in terms of the sufficiency of the symptomatology or the stressor, to be applied in determining if the veteran has PTSD. When service connection for PTSD was severed in May 1991, the RO applied the Manual M21-1 provisions in determining whether clear and unmistakable error had occurred in the January 1990 rating decision in which service connection was granted. II. Factual Background A. Veteran's Statements and Testimony In May 1974 the veteran claimed entitlement to VA compensation benefits for an injury to the right elbow, which he claimed to have received May 4, 1966, as the result of shrapnel wounds in Vietnam, and an injury to the right knee. He did not state under what conditions the elbow was injured, and he made no reference to any emotional or psychological problems arising from his service in Vietnam. In June 1989 the veteran claimed entitlement to service connection for PTSD, at which time he reported having been in combat in Vietnam. In August 1989 he was asked to provide detailed information on all of the events during service that he found to be most upsetting. In a September 1989 statement he reported that on completion of Advanced Infantry Training at Camp Pendleton he was asked to volunteer for a special unit that would be attached to the Force Reconnaissance Units and carry out specially assigned tasks. He stated that he volunteered for this unit because he knew that the Force Reconnaissance Units were the elite units of the Marine Corps. He further stated that in January 1965 he began training at Cherry Point, North Carolina, with 200 other Marines. Due to the difficulty of the training the group was reduced to 30 men, including himself. The group of 30 Marines was then moved to various Marine bases around the country, at which they received specialized training in concealment, evasion, escape, the use of weapons, insertion and extraction techniques, and jungle survival. He stated that in May 1965 the group was transferred to the Third Force Reconnaissance Unit, Third Marine Amphibious Force at Da Nang, Vietnam. The veteran also stated that he was assigned to the Alpha Company's Fourth Team of the Third Force Reconnaissance Unit in June 1965. He reported that his Team Leader, a gunnery sergeant by the name of [redacted] , with more than 25 years of experience in the Marine Corps, taught him how to overcome his fear and become an effective soldier. He stated that on their next encounter with the enemy he killed a man, which caused his self-esteem to "soar" because he was now in the ranks of the "Mud Marines"-he had bloodied himself in combat action. He also stated that [redacted] took him under his wing and taught him everything he needed to know about reconnaissance, running their team, and the Marine Corps. He reported that Force Reconnaissance's primary duty, and that of their team, was to gather intelligence on the Vietcong and North Vietnamese, which was done by carrying out long-range patrols that would last from four to 10 days. He said that they worked in 10-man teams using helicopter insertions and extractions into the area of operation, that in the first three months of his assignment to the Fourth Team they lost half their men, and that he was made assistant team leader during this period. He stated that the code of conduct for the unit prohibited them from applying for decorations, including the Purple Heart. He stated that in September 1965 the unit was returning from a mission when they stopped to rest outside a small village. A group of small children came out of the village to beg, and he noticed a young girl of 10 or 11 years of age approaching the group of men with a large basket. He thought her behavior suspicious and ordered her to stop, and when she failed to do so he shot her. After she fell, the basket that she had been carrying exploded. He stated that he could remember the look on her face as he observed her dead body, and that he saw her face in those of his two young daughters. He reported that by December 1965 all but three of the original members of the team had been killed, that Gunny [redacted] was killed in late November, and that he was made Team Leader in January 1966. He stated that in late January the team's patrols became longer and they went deeper into enemy territory, further than any American unit had gone before. He also stated that his team was the very first to enter the area around Khe Sahn, and the first to go into the area bordered by Laos and the de-militarized zone. He further stated that many of these patrols lasted two to three weeks at a time, and that they were re-supplied by helicopter drops. He said that by March 1966 he and a man named [redacted] were the only original team members left. At that time the team assumed new duties with a "government specialist," Charles Bowen, as an advisor. He reported that the new duties consisted of going out into the various villages to kill the village elders that were pro-Communist, about which he and [redacted] protested because it was "morally wrong." He reported that on April 29, 1966, his team was "inserted" into a landing zone just outside a small hamlet near Hue City and encountered an ambush during which [redacted] was killed. He stated that [redacted] was just ahead of him and he saw his head explode, and he was splattered with his brain material. After this happened the team finished the assignment for which they were dropped at the site, which was killing three families in the hamlet. He also stated that on May 6, 1966, the team went on his last patrol. They were "inserted" into a field of rice paddies, when four mortar rounds hit them. He said that he saw a flash of white light and that he awoke some time later, and that his right arm was in a pool of blood. He gave himself two morphine injections so that he would stay conscious in order to apply a tourniquet to his right arm to keep from bleeding to death and to avoid the Vietcong. He remembered nothing else that occurred until he awoke at the medical station at Da Nang, where the chaplain was giving him the last rites. He stated that he spent the next 20 months in the hospital in San Diego, California, "getting put back together." The veteran also stated that since the end of the war he had 22 different jobs in the same number of years and that he had a very hard time with authority figures. He stated that in July 1988 he made contact with the Vietnam Veterans Outreach Readjustment Counseling Center (Vet Center) because his wife found him curled up in the fetal position in a closet, mumbling about Vietnam. He further stated that he had previously had disturbing nightmares. In March 1991 the veteran submitted a copy of his September 1989 statement, to which minor details had been added. He again stated that he was wounded by shrapnel on May 6, 1966, outside Marble Mountain while on temporary duty with the Third Reconnaissance Unit, which resulted in his evacuation to the continental United States. He also reported that he was visited by the Central Intelligence Agency (CIA) while hospitalized in June 1967 and was asked to return to Vietnam as a civilian "contractor," which he refused. In his August 1991 substantive appeal the veteran claimed that his discharge certificate shows that he served in a combat zone, in that he was awarded the Vietnam Service Medal. He admitted that the documents verifying the occurrence of his claimed stressors had been destroyed, if they had ever existed. He made no reference to having been recruited into the reconnaissance unit while still in training, and stated that around April 1965 there was a shortage of qualified M-60 machine gunners, so that the units would loan machine gunners to whatever unit needed them. He stated that not only was he qualified on the M-60, he was also trained to use C-4 explosives, so that after he arrived in Vietnam he was constantly "loaned out" to other units, including the Third Reconnaissance Battalion. He further stated that he participated in Operation Starlight in August 1965 against the North Vietnamese, and that he participated in the rescue of Special Forces Camp A-106 or A- 108 in December 1965, in which Lance Corporals [redacted] and [redacted] and Corporal [redacted] were killed. He reported that these men were the first men to have been killed in action whom he had known. He stated that he reported back to his own unit, the Third Light Anti-Aircraft Marine Battalion, only on payday and to pick up mail because he "felt more at home" with the men of the reconnaissance unit. He indicated that "[redacted] " was a special friend of his, in that they shared packages from home and got drunk together. He also stated that he reported to Captain [redacted] of the Third Reconnaissance Unit, and that he could not remember the name of the commanding officer of the unit to which he was officially assigned. He also reported that Staff Sergeant [redacted] was shot in the face and killed on April 20th outside Hue City when the North Vietnamese ambushed the unit. He stated that he had frequent nightmares about seeing this man's face explode, splattering blood and gray brain matter all over him. He further reported the death of Corpsman [redacted] , who was killed after the veteran was evacuated to the United States. He stated that the Corpsman had been a "priest-surrogate father" to the men in the unit, and that the Corpsman removed leeches from him and treated his raw sores, jungle rot, fever, and flesh wounds. In an August 1991 statement he again claimed to have been assigned to temporary duty to other units as an M-60 machine gunner, including helicopter units 164 and 264, the Third Force Reconnaissance Unit, and the Air Force Security Unit for the Da Nang air base, and that the unit to which he was actually assigned had no means of keeping track of him. He stated that his primary duty with these units was as an M-60 gunner, but that one day he could be manning a bunker at Da Nang, the next day he would be a gunner on a helicopter, and the following day he could be on a reconnaissance patrol. During a February 1992 hearing the veteran testified that he received ongoing treatment from the Vet Center for PTSD. He also testified that he had been unemployed since April 1991 due to problems with his right knee and PTSD. He further testified that his service personnel record had a 17-month lapse in which nothing was entered in his record, which occurred because he was not with his assigned unit. He again explained having been loaned out to other units as an M-60 gunner. He stated that for almost nine months he saw his own unit only to be paid and pick up his mail. He also stated that during this nine-month period he spent approximately 30 days at Da Nang, and that the rest of the time he was out in the field fighting with combat units. When asked to describe the incidents that he considered to be his primary stressors, he recounted three events that occurred in his nightmares: the killing of an 11-year old girl who was carrying explosives toward his unit; the death of his friend [redacted] by an exploding bouncing betty that caused blood and brain matter to splatter over him; and being blown off a generator that he was repairing by an incoming rocket. He stated that as a result of being blown off the generator he was hospitalized for 17 months. He also stated that of the 72 people that went with him to Vietnam, only four were still alive. He claimed that while in Vietnam he checked out and signed for M-60 machine guns, 400 to 500 claymore mines, and an unknown quantity of C-4, but that he had not been able to obtain the records of this. In conjunction with the Board's July 1992 remand, in September 1992 the veteran was asked to provide specific details regarding his service in Vietnam, including the specific units in which he served, the dates of that service, the unit organization of the men he had seen killed and the dates, places, and circumstances of their deaths. In an October 1992 statement he reported that, in order to provide the maximum detail concerning his Vietnam experiences, he had asked all of the friends and relatives to whom he had written while in Vietnam to return his letters to him. He then listed all of the men he knew who had been killed in action, including the dates of their deaths and their unit organizations. That list included Lance Corporal [redacted] killed December [redacted] , 1965; [redacted] , also killed December [redacted] , 1965; Staff Sergeant [redacted] , killed April 24, 1966; Corpsman [redacted] , killed May [redacted] 1966; and Lance Corporal [redacted] , also killed December [redacted] , 1965. The veteran stated that Lance Corporals [redacted] and [redacted] and Corporal [redacted] were killed in a joint Marine Corps and Army of the Republic of Vietnam operation outside the Que Son Valley, approximately 30 miles south of Da Nang, when ambushed by the North Vietnamese. He stated that he remembered the incident well because it was the first time they had called in B-52 bomber strikes. He further stated that his letters had reminded him of two men who were on the Missing In Action list, those being First Lieutenant [redacted] , who disappeared January [redacted] 1966, and Lance Corporal [redacted] , who disappeared January [redacted] 1966. He reported that he could not remember the circumstances of their disappearances because they were assigned to other platoons, and his unit was on a mission near Quang Tri when the men disappeared. The veteran further stated that his letters home had reminded him of the death of Gunnery Sergeant [redacted] , who had lost both his legs and testicles to a bouncing betty and committed suicide after having been evacuated to the United States. He stated that the incident in which he killed the 11-year old girl occurred in early December 1965, at which time he was attached to the Second Platoon, First Force Reconnaissance Company. He also stated that Staff Sergeant [redacted] was his platoon leader on that patrol, which also included Corporal Joe Schuster and privates [redacted] and Ed Smith. He said that when the incident occurred the platoon was on a reconnaissance patrol along the coast near the villages of An Cuong and An Thoi, which was about nine miles south of Chu Lai. The veteran further stated that during Operation Starlight he was temporarily attached to HMM-164 of the Third Marine Air Wing, Third Marine Amphibious Force, as a door gunner on a medical evacuation helicopter. He reported that late in September 1965 his helicopter made endless evacuations of wounded Marines. He stated that he was unable to remember much about Operation Justice Way, other than that he participated in numerous reconnaissance patrols in the jungles and rice paddies. He indicated that the only thing he could remember was carrying his heavy M-60 machine gun through the jungle. He also stated that the individuals to whom he reported while serving in Vietnam included Captain [redacted] , Commanding Officer of B Battery, 3rd Light Anti-Aircraft Marine Battalion; Major [redacted] , Commanding Officer of the First Force Reconnaissance Company in 1965; and Captain [redacted] Major [redacted] , and Major [redacted] , Commanding Officers of the Third Force Reconnaissance Company in 1966. He stated that he was not able to remember the names of his commanding officers in HMM-164 and HMM-264 because he was assigned to that unit for only a short period of time. The veteran again reported that, because he was qualified as an M-60 gunner, he was "loaned out" to other units almost as soon as he arrived in country. He stated that in late September or early October 1965 he was loaned to the First Force Reconnaissance Unit as an M-60 gunner, even though he was not qualified for reconnaissance. He also stated that, although he only returned to his assigned unit to pick up his mail and pay, he was not officially assigned to the reconnaissance unit because that assignment would have required the completion of reconnaissance training, and he could not leave the unit to receive the training because they needed M-60 gunners. In the October 1992 statement the veteran contended that a number of VA mental health professionals have diagnosed his psychiatric symptoms as PTSD, which indicates that at some point in his life he must have suffered a traumatic incident. He further contended that, according to the mental health professionals, his combat experiences in Vietnam were the stressors that caused him to have PTSD. He stated that there was no doubt in his mind, or the minds of those providing his psychiatric care, that while serving with the First and Third Force Reconnaissance Units and the HMM-164 and HMM-264 he saw men maimed, wounded, and killed violently, and as proof of that he had submitted their names and the dates and circumstances surrounding their deaths. He again claimed that there was an 18-month gap in his service records. In a February 1995 statement the veteran's spouse outlined the history of his emotional problems since they met in 1971. In a February 1995 report his vocational counselor provided the opinion that the veteran is totally unemployable due to the symptoms of PTSD, which include depression and volatility. In a February 1995 statement the veteran stated that his basic premise had been that he was "loaned out" to various units because he was qualified on the M-60 machine gun and the other units in the Third Marine Amphibious Force needed machine gunners. He then stated, in terms he referred to as a "devil's advocate," that, assuming that he never left the unit to which he was assigned, he nonetheless experienced stressors. He stated that the corporal of the guard was killed one night while trying to disarm a Marine, and that the veteran had to help set up a security perimeter for a helicopter to come in and evacuate the corporal. He also described an incident in which another Marine "cracked up" and fired on the camp, and the veteran helped disarm him. He did not state when these incidents occurred, or the names of any of the individuals involved. He further stated that on October 27, 1965, the Vietcong attacked the Marble Mountain helicopter pad and the Da Nang air base with sappers and mortar fire, resulting in the destruction of 47 aircraft, the killing of three Marines, and the wounding of 91 others. He stated that the bunker next to his was hit, wounding all three of the men inside, that shrapnel and debris "blew" him down into his bunker, and that "we" killed 41 Vietcong that night. He reported that this incident could be verified in The Marine Corps Story by J. Robert Moskin, and that Time and Newsweek magazines ran pictures of the event in their November 1, 1965, issues. He also claimed that a causal connection between this event and his PTSD symptoms is established by the fact that he has had repeated nightmares and recurrent thoughts about the event. He did not provide the names or the unit organizations of the men who were wounded. He also reported that right after the 1965 Tet truce the Da Nang airbase was hit with 120 millimeter mortars, that two Marines in the tent next to his were wounded, and that he helped bandage the wounds. He stated that this incident could be verified in Time and Newsweek magazines for the week of January 4, 1966, and that he continued to have nightmares about this event. He again did not provide the names or unit organizations of the men who were wounded. The veteran further reported that on April 5, 1966, the local government of Da Nang revolted against the Saigon government, and a civil war nearly erupted. He stated that he and six other Marines were ordered to guard one of the gates to the airfield, and that a unit of South Vietnamese soldiers attempted to enter the base. After three hours of negotiations, during which the Marines were armed and ready, the South Vietnamese returned to their barracks. There is no indication that a confrontation actually occurred. The next day he witnessed a Buddhist monk set himself on fire outside the gate, and an angry mob of Vietnamese threw rocks at the Marines at the gate, including the veteran, for 40 minutes. He claimed that these events could be verified in any book about the Vietnam War, including The Vietnam War: Day to Day, by John S. Bowman, and The Marine Corps Story by J. Robert Moskin. He also claimed that he continued to see the burning Buddhist monk in his nightmares. The veteran further claimed that from September 1965 to May 1966 he was involved with a number of security patrols around his unit's area of operation. On one patrol their radio operator stepped on a booby trap and broke his leg and had to be evacuated by helicopter. On numerous security patrols they found evidence of the Vietcong having been in the area, and they set up their own booby traps. They heard one of the mines explode and a patrol later found blood in the area, but no bodies. He claimed that as a result of participating in the security patrols he has intrusive thoughts and high anxiety, especially in crowds or when dealing with superiors. B. Medical Evidence The veteran's service medical records show that in January 1964 [sic] he was treated for an abrasion with cellulitis and laxity of the medial collateral ligament of the right knee. On May 7, 1966, he was admitted to the Station Hospital at Da Nang, Vietnam, with a history of a compound fracture of the right humerus. The hospital summary makes no reference to a shrapnel injury. At that time he was evacuated to the continental United States for disposition and the consideration of a Medal Evaluation Board. The report of a February 1967 Medical Evaluation Board (MEB), which was conducted at the Naval Hospital in San Diego, California, shows that the veteran was admitted to the sick list at Da Nang, Vietnam, on April 15, 1966, with the diagnosis of a nonunion of a fracture of the lateral epicondyle of the right humerus. The report indicates that on April 15, 1966, while working on a generator at Da Nang, he received a shock and was thrown to the ground, which caused re-injury to the right elbow. The MEB report does not show that he incurred any injuries as the result of an explosion or mortar attack. He was returned to full duty in February 1967, after receiving extensive treatment for the injury to the right elbow. The service medical records make no reference to the veteran having received treatment for an abdominal injury, or an injury to the right knee or right elbow, other than that shown above. The report of his July 1968 separation examination shows that he had a four-inch scar on the right arm, but no other abnormalities were found on examination. VA treatment records in April and June 1974 show that he reported having injured his right elbow at age four, and that he re-injured the elbow in Vietnam in 1966 when a mortar shell explosion blew him off a generator. In conjunction with a June 1977 VA medical examination he reported fracturing the right humerus in April 1966 when he was hit by shrapnel in a mortar shell explosion, at which time he reported to have been in combat in Vietnam. VA treatment records also indicate that the veteran received counseling from the Vet Center beginning in August 1988. Although the treatment records were not received until March 1991, they are deemed to have been "of record" when the January 1990 decision granting service connection for PTSD was rendered. Bell v. Derwinski, 2 Vet. App. 611 (1992). The August 1988 counseling record shows that the veteran reported being unemployed due to the abuse of pain medication that he was required to take due to injuries to his right knee that were incurred in Vietnam from mortar shrapnel. He claimed to have had 27 surgeries on the knee, including a total knee replacement. He reported having been in Vietnam from 1965 to 1966, and that he served in the Third Force Reconnaissance Unit in ten-man team operations against the Vietcong. He also reported having seen a great deal of combat, including being one of two survivors of his team. He stated that he was wounded when he came home from Vietnam, for which he was hospitalized for 18 months. He also stated that since he had discontinued using the pain medication he realized that "something" about Vietnam was bothering him. He reported having difficulty sleeping and in relating to others, which he understood as resulting from his experience in Vietnam. As a result of the initial interview the counselor provided a diagnosis of possible PTSD. A September 1988 treatment record indicates that the veteran was having "legal problems" due to having forged a prescription in order to support his drug habit, a charge to which he had plead guilty and was awaiting sentencing. He reported that the Marine reconnaissance unit to which he had been assigned was put under the control of the CIA, which used the unit for assassinations. He stated that after the men in the unit complained of being used in that manner they were sent out on a mission during which eight of the ten men in the unit were killed by mortar rounds. He asserted that this was evidence that the unit had been betrayed because an evacuation helicopter did not appear for two hours and because no Vietcong came and checked the bodies. In November 1988 the veteran reported seeing two men killed by mortars during his first two weeks in Vietnam. In December 1988 he reported witnessing his first casualty in Vietnam while still at Da Nang, in that a man was killed by a mortar barrage. He stated that during his first reconnaissance mission the man crawling in front of him tripped a "bouncing betty," which caused blood to splatter on him. In January 1989 he reported an incident in which he killed two North Vietnamese and was shot in the thigh. In February 1989 he stated that his unit was transferred to the CIA, which he perceived as a betrayal by the Marine Corps. In March 1989 he described several missions that his unit performed for the CIA, including the assassination of a North Vietnamese general and the examination of his body after it had decayed. In June 1989 he reported an incident in which an 11-year old girl carrying a basket approached his team while they were on patrol. She failed to stop when ordered to do so, and he shot her. He said that he cut her body in half with his automatic weapon, that he still remembered the look on her face after he had killed her, and that he dreamed about the event since it happened. An August 1989 treatment record indicates that the diagnosis of PTSD was rendered, but the clinical findings to support the diagnosis were not provided. The report of a September 1989 VA psychological evaluation indicates that the veteran was administered the Minnesota Multiphasic Personality Inventory (MMPI) and a Structured Clinical Interview for PTSD. In the context of the Structured Clinical Interview he reported having been attached to the Third Force Reconnaissance Unit as a rifleman. He stated that his duties were exclusively combat related, in that he served as team member and later as a team leader for a small reconnaissance team. He reported having fired a weapon in the combat situation, being under enemy fire, being exposed to dead or wounded men on a daily basis, and experiencing the threat of death or injury daily. The specific incidents that he reported included killing a young child who was carrying explosives, participation in the assassinations of pro-Communist village elders and their families, and an ambush in which his entire team, with the exception of himself and one other man, was killed. The psychologist referenced the veteran's September 1989 statement pertaining to his Vietnam experiences in explaining the details of his combat experiences. The veteran also reported having intrusive thoughts, combat nightmares, the exacerbation of symptoms by war-related stimuli, diminished interest in significant activities, estrangement from others, emotional numbing, a sleep disorder, irritability, difficulty concentrating, hypervigilance, an exaggerated startle response, and survivor guilt. The psychologist determined that the MMPI and the Structured Clinical Interview were consistent with PTSD. The report of a September 1989 VA psychiatric examination shows that the veteran reported having served 11 months in Vietnam on a long-range reconnaissance team. He stated that he saw very heavy casualties and had high combat exposure. He also stated that the goals of their missions were to ambush enemy patrols and assassinate enemy personnel. He reported that when he visited the Vietnam War Memorial in 1984 he located the names of 72 men who were killed during the 11 months he was in Vietnam. He stated that one of his best friends was killed by a bullet to the head, and that a week later he himself was seriously injured by a mortar blast. He claimed that as a result of the mortar blast he suffered severe shrapnel injuries to his right elbow, abdomen, and right knee, and that the man who was with him lost his right leg and several fingers. He was able to give himself a shot of morphine and apply tourniquets, but did not remember anything else until he was in the field hospital at Da Nang. He reported having undergone abdominal surgery for the removal of shrapnel, and being hospitalized for 21 months for the treatment of his injuries. He stated that during this time he had five surgeries to his abdomen, including the removal of some intestines, eight surgeries on his right elbow, and 12 surgeries on his right knee. The veteran further reported that during the 21 months in the hospital he had disturbing nightmares about several of his experiences in Vietnam, including an incident in which a bullet hit his friend while he was nearby. He also dreamt about shooting an 11-year old girl who was carrying a satchel charge, and of a parade of the dead who were killed in Vietnam, many of whom he knew. He stated that the nightmares gradually decreased in frequency and intensity until 1984, when he visited the Vietnam Memorial and the frequency of his nightmares increased. He stated that he had received treatment from the VA clinic for the previous 15 months. The veteran stated that he had denied being a Vietnam veteran for many years and that he avoided all material that reminded him of Vietnam because it caused heightened physiological arousal. He stated that prior to beginning therapy he had a period of dissociation, in which his wife found him in a fetal position in a closet. He could not remember what caused this incident, although he surmised that it may have been caused by the sound of helicopters. He denied abusing drugs or alcohol. He reported having strong feelings of survival guilt, intrusive recollections involving the shooting of the 11-year old girl, emotional numbness, a pervasive distrust of authority, problems with irritability and angry outbursts, periods of depression, and numerous jobs. As a result of the veteran's reported history and symptoms, and a mental status examination, the examining psychiatrist provided a diagnosis of PTSD, moderately severe. The Axis III diagnoses included status post shrapnel injuries to the right elbow and ulnar nerve, the abdomen, and the right knee. The medical evidence received subsequent to the January 1990 rating decision in which service connection for PTSD was granted included additional VA treatment records. An August 1990 treatment record shows that the veteran described a mission during which two of the men on his reconnaissance team were killed, and he killed the three North Vietnamese who attacked the team and found out that they were all teenage boys. In October 1990 he described a mission in which a gunnery sergeant that he admired was killed. A November 1990 treatment record shows that the veteran discussed the assignment of his reconnaissance team to the CIA. He stated that after this occurred the team "did some assassination work, primarily, with some kidnapping." He reported that a Vietnamese interpreter who accompanied the team would point out who was to be killed, and that the team would sometimes kill the entire family. He described another mission in which the team was ambushed by a bunch of kids and driven down a hillside. By the time they reached the bottom of the hill only two men were left--the veteran and a man named [redacted] . He stated that the next time they went out [redacted] was killed when a round hit the upper part of his body and it exploded. A January 1992 report from the veteran's VA psychiatrist shows that the veteran was receiving treatment for PTSD arising from his combat experiences in Vietnam. The psychiatrist stated that the diagnosis of PTSD was based on the veteran's description of sufficient combat stressors and their resulting expression in current symptoms consistent with a diagnosis of PTSD by the criteria shown in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III- R). In a February 1992 report his counselor at the Vet Center also indicated that his reported history and symptoms met the criteria for a diagnosis of PTSD. A September 1993 VA hospital summary shows that the veteran was hospitalized from June to September 1993 for the treatment of PTSD. The stressors to which the PTSD was attributed were described as the veteran's service with the Third Force Reconnaissance Unit from September 1965 to May 1966. The statement of stressors indicates that he served in heavy combat for nine months, he was wounded by mortar rounds, he was the only survivor of his team, and that he was left by the enemy for dead. The summary of his problems shows that while in Vietnam he suffered the most extreme exposure to war-related death and dying and that he demonstrated severe PTSD symptoms that were exacerbated by having to live with severe war wounds. The hospital summary further shows that, in terms of his military history, the veteran reported that his military occupational specialty (MOS) was in the infantry, and that on arriving in Vietnam he was assigned to guard a small missile compound. Because he was qualified for the M-60 machine gun, he was loaned out to other units. He reported flying on medical evacuations as a machine gunner, serving with the Third Reconnaissance Unit, and being assigned to a "special team." He stated that while assigned to the "special team" he was wounded by enemy mortar rounds on May 6, 1966, was the only survivor of his team, and was left by the enemy for dead. He also stated that his gut was split open and that he pushed his intestines back inside his body. He was reportedly evacuated to a medical unit and regained consciousness while a priest was giving him the last rites. This injury allegedly resulted in is evacuation from Vietnam. As stressful events he also reported his first firefight; the killing of a gunnery sergeant and his best friend, [redacted] ; seeing all of his team killed except for a man named [redacted] ; doing "Phoenix program work" in Vietnam; and killing a young Vietnamese girl who was carrying a satchel charge. The progress notes pertaining to this hospitalization show that he reported seeing the shooting of a young Vietnamese girl who was carrying a basket into a crowd of soldiers. He stated that he tried to get the girl to stop, but that she ignored him. After she was shot the basket exploded and she was propelled 20 feet into the air. He did not report who had shot the girl. The report of a psychological assessment by the psychologist from whom the veteran and his spouse receive treatment, the date of which is not shown, indicates that he received regular treatment since July 1992 for PTSD. The stressors reported by the veteran included watching his friend being blown up after stepping on a mine; his assassination of two Americans who had joined enemy forces; being lost in the jungle for five days with no food, water, or radio; and being left for dead after six of the men in his unit were killed. He also reported being instructed on leaving Vietnam that his wounds were to be reported as being caused by an exploding generator, and that his report of any of the events that occurred while he was on loan to the special forces would not be tolerated. The report of a July 1994 VA psychiatric examination indicates that the case file was reviewed in detail by the examiner in conjunction with the examination. The examiner noted that the veteran served in Vietnam for approximately 10 months, that he received training in anti-aircraft weaponry and as a generator operator, and that he received the Vietnam Campaign Medal and other decorations. During the examination the veteran reported that although his MOS was an anti-aircraft batteryman, he was loaned out to other units in which he participated in long-range reconnaissance patrols. He provided the names of several peers who were killed, including [redacted] and [redacted] . He described repeated combat exposure, including the events reported previously. The examiner noted that none of the claimed events were documented in the veteran's case file, which the veteran attributed to having been told by the CIA that he would have to fabricate a story to cover the classified activities in which he participated in Vietnam. The examiner also noted that although the veteran claimed to have been injured in May 1966 while on a reconnaissance mission, his service medical records showed that he was tending a generator when he was shocked and fell on his right elbow. Although the veteran claimed to have undergone six abdominal surgeries to repair the penetrating shrapnel wounds, including the removal of some of his intestines, none of this was documented in his medical records. He claimed to have received shrapnel injuries to his right knee, but the medical evidence showed that he suffered an abrasion to the right knee as the result of a fall on gravel after he left Vietnam. The examiner further noted that on examination at his separation from service no abnormalities were revealed, with the exception of a scar on the elbow. The examiner stated that the veteran's assertion that he began treatment at the Vet Center in 1988 due to a dissociative episode in which he was crouching in the closet was not supported by the records from the Vet Center, which showed that he initiated treatment because of his problems involving the illegal use of narcotic medications. The examiner noted the reported traumatic events in the records from the Vet Center and stated that although the veteran claimed that his counselor at the Vet Center believed his recitations of these events, the counselor expressed skepticism about the veteran's history when contacted personally by the examiner. The examiner also stated that the veteran had consistently described a full spectrum of symptoms characteristic of PTSD, including sleep disturbance, recurrent nightmares and intrusive recollections about his Vietnam experiences, exaggerated startle response, social withdrawal, numbing of emotional reactivity, and survivor guilt. The examiner further stated that although the veteran's military history was not supported by the evidence in the case file, he is likely to have PTSD if he did experience repeated combat exposure. In a February 1995 report his counselor at the Vet Center stated that the veteran demonstrated quite severe symptoms of PTSD, and that there was no doubt in his mind that the trauma occurred in Vietnam. In a February 1995 report his psychologist provided the opinion that she is certain that the veteran's PTSD is a result of his experiences in Vietnam. C. Service Department Records The veteran's discharge certificate shows that he served in the United States Marine Corps from August 1964 to August 1968 and that his MOS was anti-aircraft batteryman. He was awarded the Good Conduct Medal, the National Defense Service Medal, the Vietnam Service Medal, the Republic of Vietnam Campaign Medal, and the Rifle Qualification Badge as an M-14 Sharpshooter. In October and November 1989 the RO requested the veteran's service records for the purpose of verifying the stressors that he alleged to have occurred in Vietnam. The service records, which were received in December 1989, show that from October to December 1964 the veteran was assigned to Camp Pendleton for combat training. In January 1965 he was transferred to Cherry Point, North Carolina, for training as an "F C Operator," and as an anti-aircraft batteryman. In September 1965 he was assigned to Battery A, 1st Light Anti- Aircraft Marine Battalion, 1st Marine Air Wing, as an anti- aircraft batteryman. In November 1965 he was transferred to Battery B of the same organization as a generator operator. He remained assigned to Battery B until May 8, 1966, at which time he was transferred to the United States Naval Hospital in San Diego. His assignment remained in San Diego until July 1967, when he was transferred to 29 Palms as a General Section Chief. The section of his service personnel records pertaining to combat history, expeditions, and awards shows that he participated in counter-insurgency operations in the Republic of Vietnam from September 1965 to May 1966. The personnel records also show that he was awarded the same citations as shown on his discharge certificate. The record of his sea and air travel shows that he left Cherry Point North Carolina, on April 29, 1965, and arrived at Vieques Island, Puerto Rico, on that date. He returned to Cherry Point on May 7, 1965. In August 1965 he left San Francisco en route to Vietnam, and arrived at Da Nang on September 2, 1965. He left Da Nang on May 7, 1966, and arrived at Travis Air Force Base, California, on May 9, 1966. Based on this evidence, in a January 1990 rating decision the RO granted service connection for PTSD. The rating decision indicates that this determination was based on the results of the September 1989 psychiatric examination, which resulted in a diagnosis of PTSD, and the veteran's service records, which showed that he participated in counter-insurgency operations in Vietnam from September 1965 to May 1966. Additional service records, which were received in October 1996, show that the veteran's weapons firing record prior to going to Vietnam included the M-14 and the pistol. The only MOS he was given was Anti-Aircraft Batteryman. In November 1993 the United States Army and Joint Services Environmental Support Group (ESG) was asked to verify the events to which the veteran claimed to have been exposed while serving in Vietnam. In March 1994 the ESG provided copies of the Command Chronology for the 1st Light Anti- Aircraft Missile Battalion, Marine Wing Headquarters Group 1, 1st Marine Aircraft Wing (Advanced), Fleet Marine Force, Pacific, for September and December 1965. These documents show that during September 1965 the unit conducted anti- aircraft exercises throughout the month, but the report does not indicate that any contact with the enemy occurred. The sequential listing of events, which includes a daily and hourly recitation of occurrences within the unit, shows that on September 9 two unidentified people attempted to infiltrate the Battery "B" perimeter. On being challenged the people retreated, and pursuit was unsuccessful. On September 27 two unknown aircraft passed within the zone and were locked on by the batteries. The aircraft were then identified as friendly. The listing of events makes no further reference to any response to a perceived threat. A Narrative Summary for December 1965 shows that in that month the battalion conducted its annual service practice on the island of Ky Hoa, near Chu Lai. The exercise was determined to be successful. The document also provides specific data on personnel strength, including the number of personnel in each MOS who joined or were dropped from the unit during the month. The summary shows that the unit's readiness category would decline if further losses occurred and qualified replacements were not received. On December 20 Battery "C" reported the detection of approaching personnel. An infantry unit observed three personnel and directed automatic weapons fire, with unknown results. On December 27 Battery "C" reported flares and small arms fire west-southwest of their position, which information was relayed to Wing G-2. The report makes no reference to any reported enemy activity by Battery "B." In March 1996 the Marine Corps Historical Center (Center) was asked to provide the relevant records from the veteran's assigned unit in order to verify the occurrence of his claimed stressors. In May 1996 the Center responded that Marine Corps casualty reports verified that Lance Corporal [redacted] , Lance Corporal [redacted] and Corporal [redacted] were all killed in action on December [redacted] , 1965 in the vicinity of Chu Lai while serving with the 1st Force Reconnaissance Company, Headquarters Battalion, 3rd Marine Division. Staff Sergeant [redacted] was killed in action on April [redacted] 1966, in the vicinity of Phu Bai while serving with the same unit. The Center also verified that the Vietnam Veterans Memorial listed a Hospital Corpsman Vas being killed in Vietnam May [redacted] , 1966. The report from the Center also shows that service information on individual Marines was not maintained at the Center, and that it was not possible to verify whether the veteran was "loaned out" to other Marine units. In April 1997 the RO requested that information from the Unit Diary Section of the Marine Corps. In May 1997 the Personnel Management Support Branch of the Marine Corps provided a report showing that a search of the unit diaries for "B" Battery, 1st Light Anti-Aircraft Marine Battalion from September 3, 1965, to May 7, 1966, failed to reveal that the veteran was temporarily assigned to other units. Copies of the unit diaries for September, October, and November 1965 and January, February, March, April, and May 1966 show that the veteran was on duty in that unit and also show that other Marines were transferred into and out of the unit during the applicable time period. The unit diaries do not indicate that the unit came under attack, that any members of the unit were wounded, or that anyone in the unit had any contact with the enemy during this time. An October 1997 Report of Contact shows that a staff member at the RO contacted Major [redacted] , Secretary of the Force Reconnaissance Association at the Marine Corps base at Camp Pendleton in order to verify the veteran's claimed stressors. Major [redacted] was asked to describe the minimum awards that a Marine would receive for having completed training for 1st Force Reconnaissance. The Major responded that the service records should reflect that the Marine had been awarded Reconnaissance Wings, an Airborne Badge, a Navy Diver Badge, and a Reconnaissance Badge, and that a Ranger or Pathfinder Badge may have been awarded. The Major was also asked whether a Marine could be temporarily assigned to a reconnaissance team. The Major responded that a Marine could be temporarily assigned to reconnaissance headquarters for financial, administrative, or logistical support, but that under no circumstances would a Marine be allowed to participate in a reconnaissance patrol without first having completed the reconnaissance training. In response to the RO's inquiry as to whether a comprehensive listing of former and current reconnaissance Marines existed, the Major responded that the Association maintained such a listing, but that the veteran was not listed as a former member of 1st Force Reconnaissance. The RO staff member also informed the Major that the veteran had provided the names of Marines who had been killed in action between December 1965 and May 1966. The Major responded that during the time that the veteran served in Vietnam he (Major [redacted] ) was the operations officer for 1st Force Reconnaissance and probably knew any man who was killed. When asked if he recognized the name of [redacted] , the Major provided the additional names of R[redacted] , [redacted] , and [redacted]. When told that the veteran had given those names for the men with whom he had served, the Major responded that [redacted] had been his radioman until his death, but that the Major did not know the veteran. The Major further stated that this and other such information about Marine involvement in the Vietnam War is common knowledge, in that many books have been written about the role of the Marines in the conflict. He stated that the specific book about the five men killed in action is Inside Force Reconn by M. L. Lanning and R. Stubbs and is probably available in any base or public library. III. Analysis At the time service connection for PTSD was granted in January 1990, the evidence of record included the veteran's service medical records, service personnel records, VA treatment records through January 1990, the veteran's September 1989 statement, and the report of the September 1989 VA psychiatric examination. The VA September 1989 VA examination contained a diagnosis of PTSD, which was supported by the results of testing. In granting service connection the RO relied on service department records showing that the veteran had participated in counter insurgency operations. Many, if not most of the stressors reported by the veteran on the September 1989 VA examination have been contradicted by subsequently obtained evidence. However, some of the reported stressors, including being under fire, would conceivably have been consistent with the service department report that he participated in counter insurgency operations. Under current case law the veteran's claim would have been considered well grounded. There was medical evidence of a current disability, competent medical evidence linking that disability to stressors in service, and lay evidence of inservice stressors. Gaines v. West, No. 97-39, slip op. at 5 (U.S. Vet. App. Aug 6, 1998). A well grounded claim is one that is plausible. Murphy v. Derwinski, 1 Vet. App. 78 (1990). Assuming that the provisions of, M21-1, Subchapter XII, 50.45 (Jan. 25, 1989) were controlling, the RO could not have granted service connection without service department records supporting the assertion that the veteran was subject to a stressor of sufficient severity to support the diagnosis of PTSD. The RO interpreted the service department record of the veteran's participation in counterinsurgency as providing the necessary support for the veteran's claimed stressors. The evidence supporting a claimed stressor need not confirm every detail of that stressor. Suozzi v. Brown, 10 Vet. App. 307 (1997). It appears that the RO had before it the correct facts and law as they existed at the time of the decision. Subsequent evidence has cast serious doubt on some of the stressors reported by the veteran. However, a reasonable mind could still conclude that there was supporting evidence for stressors reported by the veteran and that some of those stressor had actually occurred. The Board cannot say that the RO committed clear and unmistakable error when it interpreted the service department record as supporting the stressors reported by the veteran. While it could be argued at this point, that the preponderance of the evidence is against the veteran's claim, the Board is unable to discern an error in the rating decision granting service connection for PTSD that was undebatable and would have lead to a different result if corrected. A dispute as to how evidence was weighed cannot constitute CUE, and the Board cannot find such error simply because it would have weighed the evidence,or viewed the veteran's credibility, differently than did the RO. See Crippen v. Brown, 9 Vet. App. 412, 418 (1996). Accordingly, the Board concludes that CUE has not been demonstrated in the January 1990 rating decision granting service connection for PTSD, and that service connection for that disability must be restored. ORDER The appeal for the restoration of entitlement to service connection for PTSD is granted. REMAND As previously stated, in August 1991 the veteran filed a notice of disagreement with the May 1991 determination that new and material evidence had not been submitted to reopen a claim of entitlement to service connection for the residuals of a right knee injury. To ensure full compliance with due process requirements, this issue is REMANDED to the RO for the following development: After undertaking any development that is deemed appropriate, the RO should re- adjudicate the issue of whether new and material evidence has been submitted to reopen the claim for service connection for the residuals of a right knee injury. If the benefit requested on appeal remains denied, the veteran and his representative should be furnished a statement of the case pertaining to that issue and be given the opportunity to submit a substantive appeal. The case should be returned to the Board for consideration of any issue that remains in a denied status and for which a valid substantive appeal has been submitted. The Board intimates no opinion as to the ultimate outcome of this case. The veteran need take no action until he is notified. This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Veterans Appeals for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West Supp. 1998) (Historical and Statutory Notes). In addition, VBA's ADJUDICATION PROCEDURE MANUAL, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44-8.45 and 38.02-38.03. Mark D. Hindin Member, Board of Veterans' Appeals NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1998), 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. Appellate rights do not attach to those issues addressed in the remand portion of the Board's decision, because a remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1997).