Citation Nr: 9919508 Decision Date: 07/16/99 Archive Date: 07/21/99 DOCKET NO. 95-16 749A ) DATE ) ) On Appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts THE ISSUES 1. Entitlement to service connection for a psychiatric disorder. 2. Entitlement to service connection for a disorder manifested by loss of control of the legs. 3. Entitlement to an increased rating for a shell fragment wound of the right shoulder, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Mark E. Goodson, Associate Counsel INTRODUCTION The veteran served on active duty from December 7, 1967 to December 4, 1970. He also had 9 months and 21 days of active service prior to December 7, 1967. The way in which the matters currently before the Board of Veterans' Appeals (Board) were developed for appellate review warrants some explanation. First of all, the Board notes that, in a November 1993 decision, the RO denied service connection for a nervous disorder and loss of control of the veteran's legs. The RO also denied an increased (compensable) rating for residuals of a shell fragment wound of the right shoulder and a claim of entitlement to non- service-connected pension benefits. The veteran perfected an appeal of the denial of the matters pertaining to pension, loss of control of his legs, and the shell fragment wound of his shoulder. This was done by virtue of a May 1994 notice of disagreement (NOD) and a June 1995 VA Form 9 (Appeal to the Board of Veterans' Appeals). Although the NOD mentioned the claimed nervous disorder, the Form 9 does not mention that claim, and no other document of record appears to have served as a timely substantive appeal in this regard. Thus, the claim regarding a psychiatric disorder is subject to remand, infra, to give the veteran opportunity to present evidence and/or argument on the question of whether he has presented an adequate and timely substantive appeal of this denial. Additional matters affecting the procedural posture of this case include an August 1996 rating decision by which the RO assigned a 10 percent evaluation for the shell fragment wound of the right shoulder and granted basic entitlement to pension. Consequently, the pension issue is now moot. The Board notes that certain VA outpatient treatment records submitted during the pendency of the veteran's appeal reflect that the difficulties he has experienced with his legs were due to cerebellar degeneration and ataxia due to alcoholism. See, e.g., May 1993 VA hospitalization summary and June 1993 VA outpatient treatment notes. Additionally, in the veteran's substantive appeal, he argued that this disability may be due to Agent Orange exposure. Thus, an August 1996 supplemental statement of the case (SSOC) reflected that the RO's denial of service connection included leg dysfunction due to cerebellar degeneration or ataxia, both claimed as due to herbicide exposure. The Board will likewise consider the ataxia and cerebellar degeneration, claimed as due to herbicide exposure, as part of the veteran's appeal. The representative's appellate brief raises, for the first time, express claims of entitlement to service connection for arthritis of the spine, and for compression of the T-7 vertebra. The RO has not addressed these matters in the first instance; they are referred to the RO for appropriate action. FINDINGS OF FACT 1. The veteran does not have a current disability which is listed at 38 U.S.C.A. § 1116 or 38 C.F.R. § 3.309(e). 2. No competent medical evidence has been submitted to show a nexus between the veteran's period of military service or service-connected disability and cerebellar degeneration, ataxia, or any other disability which might be manifested by loss of control of his legs. CONCLUSION OF LAW The veteran's claim of entitlement to service connection for a disorder manifested by loss of control of his legs, including cerebellar degeneration and ataxia, is not well grounded. 38 U.S.C.A. §§ 1110, 1116, 5107 (West 1991); 38 C.F.R. § 3.303, 3.306, 3.307, 3.309(e), 3.310 (1998). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran and his representative contend that the veteran is entitled to service connection for a disorder manifested by loss of control of the veteran's legs, including cerebellar degeneration or ataxia. The veteran asserts alternative theories of service connection. First, he asserts that the disorder is due to wounds received in service because shell fragments have affected his brain or spinal cord. See July 1993 VA spine and peripheral nerve examination reports, and June 1995 VA Form 9. Secondly, he asserts that the disorder is due to exposure to Agent Orange. See June 1995 VA Form 9. In this regard, the threshold question before the Board is whether the veteran has presented a well-grounded claim. See 38 U.S.C.A. § 5107 (West 1991); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); see also Epps v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997), cert. den. sub nom. Epps v. West, 118 S.Ct. 2348 (1998). A person who submits a claim for VA benefits has the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded. Only if the claimant meets this burden does VA have the duty to assist him in developing the facts pertinent to his claim. 38 U.S.C.A. § 5107(a) and Epps, supra. If the claimant does not meet this initial burden, the appeal must fail because, in the absence of evidence sufficient to make the claim well grounded, the Board does not have jurisdiction to adjudicate the claim on the merits. Boeck v. Brown, 6 Vet. App. 14, 17 (1993). A well-grounded claim is a plausible claim, one which is meritorious on its own or capable of substantiation. Black v. Brown, 10 Vet. App. 279 (1997), citing Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). Such a claim need not be conclusive, but only possible, to satisfy the initial burden of 38 U.S.C.A. § 5107(a) (West 1991). Evidentiary assertions accompanying a claim for VA benefits must be accepted as true for purposes of determining whether the claim is well grounded, unless the evidentiary assertion is inherently incredible or the fact asserted is beyond the competence of the person making the assertion. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Where the determinative issue involves medical causation or a medical diagnosis, competent medical evidence to the effect that the claim is plausible or possible is required. Murphy, 1 Vet. App. at 81. "Although the claim need not be conclusive, the statute [§ 5107] provides that [the claim] must be accompanied by evidence" in order to be considered well grounded. Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). In the context of a claim of entitlement to service connection, this generally means that evidence must be presented which in some fashion links a current disability to a period of military service or to an already service connected disability. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. §§ 3.303, 3.310 (1998); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Evidence submitted in support of the claim is presumed to be true for purposes of determining whether the claim is well grounded. King v. Brown, 5 Vet. App. 19, 21 (1993). However, lay assertions of medical diagnosis or causation do not constitute competent evidence sufficient to render a claim well grounded. Grottveit v. Brown, 5 Vet. App. 91, 93 (1992); Espiritu v. Derwinski, 2 Vet. App. 492, 495 (1992). In short, in order to establish a well-grounded claim, the claimant must produce (1) medical evidence of a current disability; (2) lay or medical evidence that a disease or injury was incurred or aggravated in service; and (3) medical evidence of a link, or nexus, between the current disability and the in-service disease or injury. Epps, supra. This third element may be supplied by medical evidence which tends to link the current disability directly to in-service events, see 38 C.F.R. § 3.303(a), (d) (1998)("direct" service connection) and Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (Table); or by medical evidence which tends to link the current disability to complaints of continuity of symptomatology since service, see 38 C.F.R. § 3.303(b) and Savage v. Gober, 10 Vet. App. 489, 494-95, 497 (1997); or by medical evidence which links the current disability (in whole or in part) to an already service-connected disability, see 38 C.F.R. § 3.310 (1998), Libertine v. Brown, 9 Vet. App. 521 (1996) and Allen v. Brown, 7 Vet. App. 439 (1995); or by the application of certain statutory presumptions. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994); see, e.g., 38 U.S.C.A. § 1116 (West 1991 & Supp. 1998); see also 38 C.F.R. §§ 3.307, 3.309(e) (1998) (providing service connection for certain listed diseases as presumptively due to herbicide exposure in the Republic of Vietnam during the Vietnam Era), and Brock v. Brown, 10 Vet. App. 155, 160-64 (1997). In the present case, the veteran has not produced any medical evidence of a causal link between military service - including any in-service shell fragment wound(s) or herbicide exposure - and any current disorder manifested by loss of control of the veteran's leg. There is also no such link (in whole or in part) between his current service-connected shell fragment wound disability and the claimed disorder. Therefore, there is no medical evidence of a "nexus" which might well ground his claim on either a direct or secondary basis. See 38 C.F.R. §§ 3.303 (a), (d), 3.306, 3.310, supra; Caluza, Libertine, and Allen, supra. Although he has complained of chronic head and back pain since service, see July 1993 VA mental examination report, there is no medical evidence linking such complaints to any current disability which might cause him to lose control of his legs. See 38 C.F.R. § 3.303(b), supra; Savage supra. His lay assertions are of no evidentiary import in this regard because he is not shown to have the medical background, experience, or expertise necessary to render such an opinion. Therefore, his claim is not well grounded on any of the foregoing bases. As for his contention that his disability is due to exposure to herbicides during his service in Vietnam, there is no evidence that he has any of the disorders listed at 38 U.S.C.A. § 1116 or 38 C.F.R. § 3.309(e). These are the only diseases associated with exposure to herbicide agents for which service connection on a presumptive basis is allowed, and without a showing of competent evidence that the veteran has one of the listed diseases, a claim is not well- grounded on this basis. Brock, supra, 10 Vet. App. at 162- 64. Although there is evidence that the veteran developed alcoholic peripheral neuropathy in the 1990's, see, e.g., May 1993 VA hospitalization summary, it is neither alleged nor shown that he had the acute or subacute peripheral neuropathy referred to in 38 C.F.R. § 3.309(e), and in any event, the service medical records for the two-year period following his Vietnam service are devoid of any complaints, treatment, or diagnosis of peripheral neuropathy. See 38 C.F.R. § 3.309(e) Note 2 (1998). Thus, his claim of service connection, based upon exposure to herbicides, is not plausible. Accordingly, his claim is not well grounded on any basis, and the duty to assist is not triggered. Thus, even accepting as true the veteran's account of his shell fragment wounds and exposure to Agent Orange during service, see King supra, the Board nevertheless finds that evidence sufficient to make his claim well grounded has not been submitted. While he is certainly competent to provide testimony regarding the occurrence of an in-service event or injury, such as having a piece of wire debrided from his head, see Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990), there is no indication in the record that he has the medical expertise necessary to conclude that his current problems with his legs can be attributed to such an in-service event. Id. Although he has described the nature of his current difficulties, there has been no submission of evidence by competent authority that leg problems can be attributed to military service or already service-connected disability. The representative contends, in his appellate brief, that the Board should determine whether the RO complied with M21-1, Part III, 1.03(a) (Change 50) (Feb. 23, 1996) and M21-1, Part VI, 2.10(f) (Change 48) (Aug. 5, 1996), prior to denying the service connection claim. He further contends that, if the Board finds that the RO did not comply with these provisions, that the Board should remand the claim for "full development" of the claim. M21-1 Part VI, 2.10(f) provides that "the duty to assist will prevail while development is undertaken." A careful reading of this provision clearly shows the initiation of this "development" is predicated on the claim being "potentially plausible on a factual basis." Essentially, "potentially plausible on a factual basis" means the claim is well grounded. Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (Table); accord, Epps, supra. Consequently, development is undertaken pursuant to M21-1 Part VI, 2.10(f) only after the veteran has presented a well-grounded claim. As the veteran has not done so here, M21-1 Part VI, 2.10(f) is not applicable to his case. M21-1 Part III, 1.03(a) provides that "[b]efore a decision is made about a claim being well grounded, it will be fully developed." However, only when a claim is well grounded does the VA have an obligation to assist the claimant in "developing the facts pertinent to the claim." Robinette v. Brown, 8 Vet. App. 69, 77-74 (1995) (emphasis added) (referring to evidentiary development required by the duty to assist provided by 38 U.S.C.A. § 5107(a)); Epps, supra; Beausoleil v. Brown, 8 Vet. App. 459, 465 (1996). In contrast to the evidentiary development referred to in 38 U.S.C.A. § 5107(a), the provisions of M21-1, Part III, 1.03(a) refer to development of the claim. The requirement to fully develop a claim - as compared to development of the evidence underlying the claim - merely requires VA to ensure that the veteran has not filed a defective or incomplete application. See 38 U.S.C.A. § 5103 (West 1991); Robinette, 8 Vet. App. at 78. See 38 C.F.R. §§ 3.1(p), 3.160(a) (1997)(defining a claim as an application for VA benefits); see also M21-1, Part III, 1.01(a) (discussing development of pertinent facts "concerning a well-grounded claim"); M21-1, Part VI, 2.10(f) (discussed, supra); compare M21-1, Part III, 2.01(c) (during initial screening stage of claims processing, the RO shall review all applications and evidence immediately to determine if "a claim" is incomplete and requires "further development"). Indeed, M21-1, Part III, 1.03(a) relies upon Grottveit v. Brown, 5 Vet. App. 91 (1993), in which the United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999) (Court) stated that, "[i]f the claim is not well grounded, the claimant cannot invoke the VA's duty to assist [under 38 U.S.C.A. § 5107(a)] in the [evidentiary] development of the claim." Grottveit at 93, citing 38 U.S.C.A. § 5107(a). Therefore, until a veteran has submitted a well-grounded claim, VA is under no duty to assist the veteran in establishing the evidentiary elements of his claim. In other words, the requirement to "fully develop" a claim pursuant to M21-1, Part III, 1.03(a) is not identical to the duty to assist which arises after a well-grounded claim has been submitted; instead, it appears to merely reiterate the duty to inform under 38 U.S.C.A. § 5103. Consequently, ensuring that a claim is "fully developed" under M21-1 Part III, 1.03(a) means that, where the veteran's application for benefits is incomplete, VA shall notify the veteran of the evidence necessary to complete the application. Id. at 80. As there is no indication in the present case that the veteran's application is incomplete, or that he is aware of evidence which would render his claim well grounded, the RO complied with 38 U.S.C.A. § 5103 and 1.03(a). The representative also contends, in his appellate brief, that the holding of Ledford v. West, 136 F.3d 776 (1998) is unreasonable and erroneous, because it "requires" appellants to foresee and argue preemptively all errors the Board might commit, and because the appellant has no prior notice of the points upon which the Board will rely when deciding an appeal. However, Ledford does not stand for this proposition. In Ledford, The United States Court of Appeals for the Federal Circuit (Federal Circuit) held that the doctrine of exhaustion of administrative remedies requires an appellant to present issues at the administrative (RO and Board) level before the Court and the Federal Circuit will address those issues. 136 F.3d at 779-82. In any event, the Court bars the type of litigation by ambush which the representative eschews. See, e.g., Marsh v. West, 11 Vet. App. 468, 471-72 (1998). Here, the RO did not address the well groundedness of the veteran's claim. However, when an RO does not specifically address the question of whether a claim is well grounded, but instead, as here, proceeds to adjudication on the merits, there is no prejudice to the veteran solely from the omission of the well-grounded-claim analysis. Meyer v. Brown, 9 Vet. App. 425, 432 (1996). That proposition applies even where the RO has failed to provide the claimant with the laws and regulations pertaining to well-grounded claims, and notwithstanding that the Board denies the claim as not well grounded after the RO adjudicates the claim on the merits. Id. That is because the requirement that a claim be well grounded is merely a threshold matter, and its satisfaction does not, by itself, obtain anything for a claimant that he would not receive in a full merits adjudication. Id. Thus, the representative's contention here is inapposite. The representative contends that the Meyer decision, supra, ignores the statutory provision that claimants have the initial burden of submitting a well-grounded claim "[e]xcept when otherwise provided by the Secretary [of VA]," 38 U.S.C.A. § 5107(a), because the Secretary has provided such an exception via the promulgation of the aforementioned portions of M21-1. The representative's argument lacks merit because the portions of M21-1 to which he refers do not create an exception to 38 U.S.C.A. § 5107, as previously discussed. Finally, the representative contends that the veteran is entitled to the benefit of the doubt with respect to his claim. However, the benefit-of-the-doubt doctrine only applies if VA adjudicators reach the merits of the claim. As he has not presented a well-grounded claim, the Board does not reach the merits of the claim, and the benefit-of-the- doubt doctrine is inapplicable. 38 U.S.C.A. § 5107(b) (West 1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When evidence has not been submitted sufficient to make a claim well grounded, the Board does not have jurisdiction to adjudicate the claim on the merits. Boeck v. Brown, 6 Vet. App. 14 (1993). Therefore, this appeal must be denied. ORDER The veteran's claim of entitlement to service connection for a disorder manifested by loss of control of his legs is not well grounded; the appeal of this issue is therefore denied. REMAND It has been contended that the veteran is entitled to service connection for a psychiatric disorder. See, e.g., representative's appellate brief. However, before the Board may address these matters, it must determine whether it has jurisdiction to do so. See Marsh v. West, 11 Vet. App. 468, 471 (1998). Here, the veteran submitted a claim of service connection for a nervous disorder in April 1993. In November 1993, the RO denied his claim, and sent a letter to the veteran notifying him of that decision. In May 1994, the veteran submitted a NOD therewith. On May 10, 1995, the RO issued a SOC regarding the claimed nervous disorder. At that point, the veteran and his representative had 60 days to submit a substantive appeal regarding the nervous disorder in order to confer jurisdiction upon the Board to review that matter. See 38 U.S.C.A. §§ 7104, 7105 (West 1991); 38 C.F.R. §§ 20.101, 20.200, 20.202, 20.302, 20.305 (1998). Although the veteran submitted a VA Form 9 (Appeal to Board of Veterans' Appeals) in June 1995, the question arises as to whether this Form 9 constitutes an adequate substantive appeal. This is so because the Form 9 does not identify the nervous disorder as one of the issues appealed. It also does not set out specific argument relating to errors of fact or law made by the RO in denying his psychiatric disorder claim, or relate to specific items in the SOC regarding the claimed disorder. See 38 U.S.C.A. § 7105(d)(3) (West 1991); 38 C.F.R. § 20.202 (1998). Also, there does not seem to be any other document of record which would constitute both a timely and adequate substantive appeal as to this issue, even considering the VA Form 646 subsequently submitted by the veteran's representative. When the Board addresses in its decision a question that has not been addressed by the RO, the Board must consider whether the claimant has been given adequate notice of the need to submit evidence or argument on that question, and an opportunity to submit such evidence and argument, and to address that question at a hearing. Bernard v. Brown, 4 Vet. App. 384, 394 (1993). This includes questions of the Board's jurisdiction. Marsh, supra (vacating and remanding, pursuant to Bernard, Board's sua sponte dismissal of claim for lack of timely NOD). Here, the RO has not addressed the timeliness of appeal question. Thus, a remand is warranted for the RO to notify the veteran that the record presents these issues, and to provide him with opportunity to address them. 38 C.F.R. §§ 19.9, 20.203 (1998). The veteran and his representative also contend that the veteran is entitled to a rating in excess of 10 percent for the shell fragment wound of his right shoulder. In this regard, a review of record reveals that, during the pendency of his claim, the RO has not afforded him a medical examination in which the examiner has reviewed the claims folder. Proscelle v. Derwinski, 2 Vet. App. 629 (1992). This is particularly distressing in the case of a shell fragment wound, because an adequate examination of disability caused by such wounds requires careful consideration of the history of the wound. See, e.g., 38 C.F.R. § 4.56 (1998). Moreover, the medical evidence currently of record does not explain several questions raised by the record: to what extent any disability of the veteran's right shoulder is attributable to the service-connected shell fragment wound, as compared to the non-service-connected disabilities of cerebellar degeneration and ataxia (including falling accidents induced thereby)? Compare range of motion findings on July 1993 VA spine examination report with May 1993 VA hospitalization summary, April to May VA inpatient treatment notes, and June 1993 VA outpatient neurologic diagnoses. Are the veteran's complaints of "neck" pain identical to the complaints of upper back pain which have been historically diagnosed as due to his service-connected shell fragment wounds? See January 1997 VA joint examination report. How would a medical examiner reconcile the varying reports of scars associated with the shell fragment wound(s)? Compare September 1967 service medical records and VA examination reports dated August 1978 (general); July 1993 (spine); December 1995 (brain); and January 1997 (joints). Thus, a remand for a medical examination is warranted. 38 C.F.R. § 19.9 (1998). Additionally, certain VA records of treatment for the veteran's shoulder are mentioned in the file, but have not been obtained, as specified in the indented remand instruction paragraphs below. The RO needs to take reasonable steps to do so prior to the examination on remand. Bell v. Derwinski, 2 Vet. App. 611 (1992). Additionally, the May 1995 SOC, and SSOCs of August 1996 and October 1997 suggest that the RO has not specifically considered the veteran's claim in light of recent amendments to the rating criteria that have been used to evaluate the veteran's shell fragment wound disability. Cf. 38 C.F.R. Part IV (1992) with 38 C.F.R. Part IV (1998), particularly 38 C.F.R. §§ 4.55, 4.56, 4.73, Diagnostic Code 5301 (1992 and 1998); see 58 F.R. 33,235 (June 1993) and 62 F.R. 30,235 (June 1997); Karnas v. Derwinski, 1 Vet. App. 308 (1991) (when a regulation changes during the pendency of a claim for VA benefits, and the regulation substantively affects the claim, the claimant is entitled to resolution of his claim under the version of the regulation that is most advantageous to him). In this regard, the Board notes the similarity between the pre- and post-amendment versions of the applicable rating criteria. However, the Court has indicated that the Board must remand shell fragment wound cases, such as the present case, where the RO has not performed a Karnas analysis in the first instance. See Fisher v. West, 11 Vet. App. 121, 123 (1998). This case is REMANDED for the following actions: 1. The RO should contact the veteran and his representative and allow the veteran the opportunity to present evidence and/or argument on the questions of timeliness and adequacy of a substantive appeal as to the denial of service connection for a psychiatric disability. The RO should also offer the veteran the opportunity for a hearing on the matter. Copies of the foregoing notifications should be associated with the file. 2. The RO should take reasonable steps to obtain the following medical records: from the VA outpatient treatment center in Worcester, Massachusetts, records pertaining to treatment of the veteran's shoulder, neck and back, dated from November 1992 to April 1993 (indicated in the veteran's April 1993 claim). The RO should ask the veteran to identify the VA facility that treated his right shoulder "about one year" prior to the July 1993 VA spine examination (mentioned in the report of that examination), and to better identify the date(s) of such treatment; and the dates, locations, and sources of the x- rays of his shoulder that he mentioned in his June 1995 VA Form 9. If such treatment records are reasonably identified, the RO should take steps to obtain them. 38 C.F.R. § 3.159 (1998); Bell v. Derwinski, 2 Vet. App. 611 (1992). All materials obtained should be associated with the file. 3. Thereafter, the RO should arrange for an examination to determine the severity of the service-connected shell fragment wound of the veteran's right shoulder. The RO should provide the examiner with the claims folder and a copy of the rating criteria as they existed at the time the veteran submitted his claim (the "old rating criteria"), and as they currently exist (the "new rating criteria"). The examiner should review the claims file (particularly the service medical records), examine the veteran, conduct range of motion studies and any other studies that might be indicated, and describe all symptomatology attributable to the service-connected shell fragment wound in terms that comport with both the old and new rating criteria. Karnas v. Derwinski, 1 Vet. App. 308 (1991). The examiner should state whether the service-connected symptomatology is best characterized under either the old or new criteria as slight, moderate, moderately severe, or severe as to each muscle group affected. See 38 C.F.R. §§ 4.55, 4.56. The examiner should, if feasible, provide answers to the following questions, in light of the portions of the record cited in the body of this remand: (a) To what extent is any disability of the veteran's right shoulder attributable to the service- connected shell fragment wound, as compared to the non-service-connected disabilities of cerebellar degeneration or ataxia (including falling accidents induced thereby)? (b) Are the veteran's complaints of "neck" pain identical to the complaints of upper back pain which have been historically diagnosed as due to his service-connected shell fragment wounds? (c) How would the medical examiner reconcile the varying reports of scars associated with the shell fragment wound(s)? 4. Thereafter, the RO should take adjudicatory action on the question of timeliness of appeal of the denial of service connection for a psychiatric disorder. If the RO determines that a timely appeal has been submitted, then it should re-adjudicate his claim in light of any additional evidence received, and should address the question of whether his claim is well grounded, and address his assertion that he has a post-traumatic stress disorder due to service. See May 1994 notice of disagreement. If the claim is determined to be well grounded, then the RO should consider whether any evidentiary development is warranted, such as an examination, with the claims folder present, in order to determine the etiology of any mental disorder found. The RO should also adjudicate the veteran's claim of entitlement to an increased rating for a shell fragment wound of the right shoulder, considering his claim in light of 38 C.F.R. Part IV as it existed at the time he filed his claim, and as it currently exists. Karnas v. Derwinski, 1 Vet. App. 308 (1991). If any benefit sought is denied, the RO should issue a supplemental statement of the case (SSOC). The SSOC should contain a complete recitation of regulations applicable to filing substantive appeals, and a recitation of both the old and new diagnostic criteria for rating shell fragment wounds, including 38 C.F.R. §§ 4.55, 4.56. After the veteran and his representative have been given an opportunity to respond to the SSOC, the claims folder should be returned to this Board for further appellate review. No action is required by the veteran until he receives further notice. The purpose of this remand is to comply with governing adjudicative procedures. This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board or by the Court 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 F. HALSEY Member, Board of Veterans' Appeals