Citation Nr: 0000749 Decision Date: 01/10/00 Archive Date: 03/02/00 DOCKET NO. 95-04 466 DATE JAN 10, 2000 On appeal from the Department of Veterans Affairs Regional Office in Oakland, California THE ISSUES 1. Entitlement to service connection for bilateral hearing loss. 2. Entitlement to service connection for postoperative residuals of a ganglion cyst of the right foot. 3. Entitlement to an effective date, prior to December 14, 1995, for a grant of service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Richard A. LaPointe, Attorney at Law WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Mark J. Swiatek, Counsel INTRODUCTION The veteran had active military service from August 1964 to September 1968. The veteran brought a timely appeal to the Board of Veterans' Appeals (the Board) from April 1993 and May 1996 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Oakland, California. The Board in September 1998 remanded the case to clarify the veteran's intentions regarding a Board hearing. He did not respond to the RO letter of October 1998 that advised him that if he did not respond it would be presumed that he did not wish to have another hearing before the Board proceeded with his appeal. A copy of the letter was mailed to his attorney who did not respond. The case has recently been returned to the Board. Given that the veteran or his representative did not respond to the recent Board request, the Board will proceed with a decision on the record. FINDINGS OF FACT 1. The claim of entitlement to service connection for bilateral hearing loss is not supported by cognizant evidence showing that the claim is plausible or capable of substantiation. 2 - 2. The claim of entitlement to service connection for a ganglion cyst in the right foot is not supported by cognizable evidence showing that the claim is plausible or capable of substantiation. 3. The veteran's initial application to establish service connection for PTSD was received at the RO on December 14, 1995, the claim was continuously prosecuted and culminated with the RO granting service connection and assigning an effective date that reflected the date of receipt of the veteran's December 14, 1995 correspondence. 4. The VA treatment records that mentioned PTSD in 1993, received at the RO in January 1994 in connection.with a claim for service connection for hearing loss and a right foot disability, may not be reasonably viewed as indicating an intention to apply for service connection for PTSD and thus did not present an informal claim on that date. CONCLUSIONS OF LAW 1. The claim of entitlement to service connection for bilateral hearing loss is not well grounded. 38 U.S.C.A. 5107 (West 1991). 2. The claim of entitlement to service connection for postoperative residuals of a ganglion cyst of the right foot is not well grounded. 38 U.S.C.A. 5107. 3. The criteria for an effective date, prior to December 14, 1995, for a grant of service connection for PTSD have not been met. 38 U.S.C.A. 5107, 5110 (West 1991 & Supp. 1999); 38 C.F.R. 3.151, 3.155, 3.157, 3.160, 3.400 (1999). - 3 - REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Service connection for bilateral hearing loss and a ganglion cyst of the right foot. Factual Background The veteran's service medical records show entrance examination audiology reported a hearing threshold of 0 decibels at 500, 1,000, 2,000 and 4,000 Hertz bilaterally. The service medical records do not mention a ganglion cyst of the right foot. On the July 1968 separation examination, hearing was reported as 15/15 bilateral to the whispered voice and the clinical evaluation was reported as showing normal feet and ears. There was no diagnosis of a right foot abnormality or a hearing loss disability reported in the summary of defects and diagnoses and no mention of either as significant or interval history. The service medical records mention left ankle complaints in 1967. VA medical records beginning in early 1981 report in late 1983 a complaint of a right foot growth on the dorsolateral side just distal to the ankle that had been present for one and a half years. The assessment was right foot mass, lateral area distal to the ankle joint, possible ganglion versus "other". No pertinent medical history was reported during hospitalization in late 1986 and there was a contemporaneous report of right earache. Medical history obtained in mid 1993 included a reference to positive noise exposure in the 1960's with residual hearing loss. A right foot ganglion was excised in late 1989. A clinical record entry in December 1989 reported right foot pain complaints and noted no history of injury to the right foot. Complaints of postoperative right foot pain appear in. outpatient reports during the early 1990's. VA records in early 1991 show a reference to auditory acuity lateralizing to the left. Another report in early 1991 includes a past medical history of a right ankle growth present for 15 years. 4 - Audiology in May 1993 shows the complaint of decreased right ear hearing and history of noise exposure in service and occupational exposure. Hearing threshold levels in decibels were reported as 20/25/20/35/30 in the right ear and 15/15/20/15/25 in the left ear, respectively, at 500, 1,000, 2,000, 3,000 and 4,000 Hertz bilaterally. Speech recognition was 100 percent bilaterally. The assessment was of hearing essentially within normal limits with borderline high frequency loss, tympanograms, acoustic reflexes and word discrimination within normal limits. VA audiology in July 1994 shows the veteran's complaint of increased right ear hearing loss and tinnitus and once again a history of occupational and in service noise exposure. Hearing threshold levels in decibels were reported as 10/25/20/20/20 in the right ear and 15/15/15/no report/25 in the left ear, respectively, at 500, 1,000, 2,000, 3,000 and 4,000 Hertz. Speech recognition was 92 percent bilaterally. The assessment was of hearing essentially unchanged from two years previously. The examiner reported that hearing was reported as essentially within normal limits by pure tones with good speech recognition. VA medical records show that in early 1996 the veteran's complaints included decreased hearing in both ears and that tinnitus was among the disorders reported by an examiner. On a VA general medical examination in July 1997, the veteran recalled a fall in 1996 during maneuvers when he twisted his right ankle for which he was treated with an ankle brace and light duty. He recalled that a year later he developed a bony prominence over the ankle that was not painful and that a cyst was reported after he received an X-ray evaluation. He recalled that this continued until 1989 when he could no longer get his shoe on. The examination report also mentioned his complaint of decreased hearing greater on the right and his recollection of serving in a tank with recoiling rifles. He also reported intermittent tinnitus that became constant in both ears. Diagnoses included arthralgia of the right ankle and bilateral tinnitus and hearing loss according to patient history. 5 - Criteria Service connection may be granted for a disability resulting from personal injury or disease contracted in the line of duty. 38 U.S. C.A. 1110 (West 1991). Service connection connotes many factors but basically it means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. This may be accomplished by affirmatively showing inception or aggravation during service or through the application of statutory presumptions. Each disabling condition shown by a veteran's service records, or for which he seeks a service connection must be considered on the basis of the places, types and circumstances of his service as shown by service records, the official history of each organization in which he served, his medical records and all pertinent medical and lay evidence. Determinations as to service connection will be based on review of the entire evidence of record, with due consideration to the policy of the Department of Veterans Affairs to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. 38 C.F.R. 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. 3.303(d). Service connection may be granted for sensorineural hearing loss although not otherwise established as incurred in service if manifested to a compensable degree within 1 year from the date of separation from service provided the rebuttable presumption provisions of 3.307 are also satisfied. 38 C.F.R. 3.309. A threshold question to be answered is whether the veteran has presented evidence of a well grounded claim; that is, a claim that is plausible or capable of substantiation. Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). 6 - Although the claim need not be conclusive, it must be accompanied by supporting evidence. An allegation alone is not sufficient. Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). Three discrete types of evidence must be present in order for a veteran's claim for benefits to be well grounded: (1) There must be evidence of a current disability, usually shown by a medical diagnosis. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); (2) There must also be competent evidence of incurrence or aggravation of a disease or injury in service. This element may be shown by lay or medical evidence. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991); and (3) There must be competent evidence of a nexus between the in- service injury or disease and the current disability. Such a nexus must be shown by medical evidence. Lathan v. Brown, 7 Vet. App. 359, 365 (1995); Grottveit v. Brown, 5 Vet. App. 91. 93 (1993). In determining whether a claim is well grounded, the Board is required to presume the truthfulness of the evidence. Robinette v. Brown, 8 Vet. App. 61), 77-8 (1995); King v. Brown, 5 Vet. App. 19, 21 (1993). In order for a claim to be well grounded, there must be (1) competent evidence of a current disability (a medical diagnosis); (2) incurrence or aggravation of a disease or injury in service (lay or medical evidence); and (3) a nexus between the in-service disease or injury and the current disability (medical evidence). Caluza v. Brown, 7 Vet. App. 498 (1995). 7 - For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. 3.385. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert v. Derwinski, 1 Vet. App., 49 (1990). When, after consideration of all of the evidence and material of record in an appropriate case before VA, there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. 5107(b) (West 1991); 38 C.F.R. 3.102.) 4.3 (1999). Analysis Section 5107 of title 38, United States Code unequivocally places an initial burden upon the claimant to produce evidence that a claim is well grounded; that is, that the claim is plausible. Grivois v. Brown, 6 Vet. App. 136, 139 (1994); Grottveit v. Brown, 5 Vet. App. 91, 92 (1993). Because the veteran has failed to meet this burden, the Board finds that his claims for service connection for bilateral hearing loss and right foot ganglion cyst residuals are not well grounded and must be denied. The threshold question that must be resolved is whether the veteran has presented evidence of a well-grounded claim, that is, that either claim is plausible. 8 - In view of the evidence, the Board finds that the veteran has not met this initial burden and that as a result there is no further duty to assist the veteran in the development of his claims. The Board in remanding the case sought to ensure the veteran was afforded due process. The Board gave no indication or impression that the claims were well grounded. No examination was asked for in connection with the 1998 remand. The development asked for was consistent with that due in the preliminary development under the circumstances to insure due process. The RO did complete all actions requested. The veteran did not respond to the 1998 inquiry. No pertinent evidence has been reported since notice was given to the veteran and his representative that the appeal was soon being returned to the Board. Therefore, the Board finds that no additional assistance is required at this time. Stegall v. West, 11 Vet. App. 268 (1998); Robinette v. Brown, 8 Vet. App. 69, 77 (1995). In connection with the development of the claim, the Board observes that the RO has obtained an adequate record. The records that have been produced are comprehensive and permit an informed determination of the issues at hand. The essential elements of a well-grounded claim are evidence of a current disability (a medical diagnosis), of incurrence or aggravation of a disease or injury in service (lay or medical evidence depending on the circumstances), and of a nexus between the inservice injury or disease and the current disability (medical evidence). Caluza v. Brown, 7 Vet. App. 498 (1995). The veteran's initial claim for service connection of a right foot disorder and hearing loss was filed with the RO in late 1992, more than 20 years after service. Although the veteran in seeking service connection may reasonably, be seen as relying upon Hensley v. Brown, 5 Vet. App. 155 (1993) and 38 U.S.C.A. 1154, the Board must point out that the claim lacks medical nexus evidence critical to a well grounded claim and the legal standard would not create an exception to that requirement in this case. See, e.g., Libertine v. Brown, 9 Vet. App. 521, 524 (1996). - 9 - The veteran's situation is such that he may not rely on Peters v. Brown, 6 Vet. App. 540 (1994). Unlike the case at hand, there was medical evidence of record sufficient to well ground the hearing loss claim requiring a remand for further medical opinion. And, in light of Libertine there is a need for competent nexus evidence to well ground a claim relying on 38 U.S.C.A. 1154. Although the 199,e[ VA audiology did show diminished speech recognition meeting section 3.385 criteria, no medical opinion at the time linked the disorder to noise exposure in service. Although there was history given earlier that as transcribed suggested a link to noise exposure, VA audiology in 1993 did not confirm a hearing disability. Regarding a right foot ganglion cyst, there is no record of injury to the right foot in service or for many years thereafter. The veteran's history in the 1980's when he did not seek service connection did not indicate remote injury or continuity of symptomatology to service. More significant is that no current medical opinion links a right foot ganglion cyst disability to service. Where the determinative issue involves causation or a medical diagnosis, as is the case in the veteran's claims, competent medical evidence to the effect that the claim is possible or plausible is required. Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). The claimant does not meet this burden by merely presenting his lay opinion because he is not a medical health professional and does not constitute competent medical authority. Espiritu v. Derwinski, 2 Vet. App. 492 (1992). Consequently, the veteran's lay assertions cannot constitute cognizable evidence, and as cognizable evidence is necessary for a well-grounded claim, Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992), his lay assertions on matters of medical causation or etiology would not be entitled to any favorable presumption in the well-grounded determination. Assuming without argument that he has impaired hearing that meets the 3.385 criteria for consideration as a disability, there has been no medical opinion offered that the veteran currently has a hearing loss disability linked to service. Further, there is no competent evidence to establish a nexus to service for any current postoperative residuals of a right foot ganglion cyst, 10- In summary, a critical element missing is a nexus to service for any current hearing disability or right foot ganglion cyst residuals, which in this case requires probative medical evidence to well ground the claim. The veteran's assertions regarding causation are not competent and of no evidentiary value to well ground the claims. Grottveit, supra. Although the Board considered and denied the veteran's claims on;a ground different from that of the RO, which denied the claims on the merits, the appellant has not been prejudiced by the decision. This is because in assuming that the veteran's claims were well grounded, the RO accorded him greater consideration than his claims in fact warranted under the circumstances. Bernard v. Brown, 4 Vet. App. 384 (1993). The Board further finds that the RO has advised the appellant of the evidence necessary to establish a well grounded claim, and the veteran has not indicated the existence of any post service medical evidence that has not already been requested and/or obtained that would well ground the claims for service connection for hearing loss or right foot ganglion cyst. 38 U.S.C.A. 5103(a) (1999); McKnight v Gober, 131 F.3d 1483 (Fed. Cir. 1997); Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997). As the veteran has not submitted a well grounded claim of entitlement to service connection for bilateral hearing loss or a ganglion cyst of the right foot, the doctrine of reasonable doubt has no application in his case. II. Effective date, prior to December 14, 1995, for a grant of service connection for PTSD. Factual Background Included among VA outpatient treatment records received at the RO in January 1994 were reports that show the veteran on August 8, 1993, was being referred with a provisional diagnosis of rule out PTSD, cocaine abuse and history of alcohol abuse. It was noted he had been in a Vietnam group at a clinic. The impression of the consultant was PTSD, cocaine abuse and alcohol abuse. In October 1993 he sought medical assistance regarding,"my PTSD" and it was noted that he was to be assessed further regarding possible PTSD. The aforementioned records were among those obtained in connection with a claim for service connection for hearing and right foot and ankle disorders that the R,D denied in April 1993. The next reference to PTSD was in correspondence from the veteran received at the RO on December 14, 1995, wherein he requested that the RO address a "new issue" of service connection for PTSD related to combat experiences. He reported VA mental hygiene clinic treatment since 1991 and treatment at a Vet Center. In March 1996 he mentioned the treatment providers since 1991. A statement of VA Vet Center treatment received at the RO in early February 1996 shows the veteran had been seen from April 5, 1993, to September 3, 1993, presenting complaints of nightmares, more than a 20 year history of substance abuse and intrusive memories of Vietnam experiences. Regarding a diagnosis, it was reported that he had symptoms that appeared to be consistent with PTSD. VA outpatient treatment records received in March and May 1996 showed references to substance abuse history in 1991 and in late 1993 through mid 1994. Chronic dependence, alcohol, was reported after VA hospitalization in late 1992. In early 1993 there was a clinical history of flashbacks with cocaine abuse and nightmares to combat experience several times a month. VA psychiatric examination in April 1996 resulted in diagnoses of PTSD and cocaine abuse. The RO in May 1996 considered this evidence and granted service connection for PTSD and a 30 percent rating from December 14, 1995. The veteran was notified of the determination in May 1996. - 12 - VA medical records received at the RO in June 1996 included outpatient reports from May 1993 showing the veteran requested assistance finding employment and counseling regarding marital issues. The record ended in late July 1993 after he reportedly did not respond to RO contacts. In May 1994 he again sought information regarding employment and group workshops in response to a Vet Center notice he received. An assessment was deferred on several occasions with the last contact in early 1996 noting the case was closed. The veteran in January 1997 sought an earlier effective date for service connection of PTSD to the first part of 1993. He asserted that is when he started treatment and was diagnosed with PTSD. VA medical records received in July 1997 included Vet Center reports from 1993 showing a case-closing summary dated in early September 1993. The summary indicated that the veteran's case had been opened in early April 19913 and that problem status at closing consisted of sub-diagnostic PTSD that was unresolved, employment and homeless/housing for which referral and resources had been provided. Criteria Except as otherwise provided, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later. 38 U.S.C.A 5110; 38 C.F.R. 3.400. Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by the Department of Veterans Affairs, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought. - 13 - Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within 1 year from the date it was sent to the claimant, it will be considered filed as of the date of receipt of the informal claim. (b) A communication received from a service organization, an attorney, or agent may not be accepted as an informal claim if a power of attorney was not executed at the time the communication,was written. (c) When a claim has been filed which meets the requirements of 3.151 or 3.152, an informal request for increase or reopening will be accepted as a claim. 38 C.F.R. 3.155. A specific claim in the form prescribed by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by VA. (38 U.S.C. 5101(a)). A claim by a veteran for compensation may be considered to be a claim for pension; and a claim by a veteran for pension may be considered to be a claim for compensation. The greater benefit will be awarded, unless the claimant specifically elects the lesser benefit. 38 C.F.R. 3.151. A pending claim is an application, formal or informal, which has not been finally adjudicated. 38 C.F.R. 3.160. Effective date of pension or compensation benefits, if otherwise in order, will be the date of receipt of a claim or the date when entitlement arose, whichever is the later. A report of examination or hospitalization which meets the requirements of this section will be accepted as an informal claim for benefits under an existing law or for benefits under a liberalizing law or Department of Veterans Affairs issue, if the report relates to a disability which may establish entitlement. Acceptance of a report of examination or treatment as a claim for increase or to reopen is subject to the requirements of Sec. 3.114 with respect to action on Department of Veterans Affairs initiative or at the request of the claimant and the payment of retroactive benefits from the date of the report or for a period of 1 year prior to the date of receipt of the report. - 14 - (b) Once a formal claim for pension or compensation has been allowed or a formal claim for compensation disallowed for the reason that the service-connected disability is not compensable in degree, receipt of one of the following will be accepted as an informal claim for increased benefits or an informal claim to reopen, In addition, receipt of one of the following will be accepted as an informal claim in the case of a retired member of a uniformed service whose formal claim for pension or compensation has been disallowed because of receipt of retirement pay. The evidence listed will also be accepted as an informal claim for pension previously denied for the reason the disability was not permanently and totally disabling. (1) Report of examination or hospitalization by Department of Veterans Affairs or uniformed services. The date of outpatient or hospital examination or date of admission to a VA or uniformed services hospital will be accepted as the date of receipt of a claim. The date of a uniformed service examination which is the basis for granting severance pay to a former member of the Armed Forces on the temporary disability retired list will be accepted as the date of receipt of claim. The date of admission to a non-VA hospital where a veteran was maintained at VA expense will be accepted as the date of receipt of a claim, if VA maintenance was previously authorized; but if VA maintenance was authorized subsequent to admission, the date VA received notice of admission will be accepted. The provisions of this paragraph apply only when such reports relate to examination or treatment of a disability for which service-connection has previously been established or when a claim specifying the benefit sought is received within one year from the date of such examination, treatment or hospital admission. (2) Evidence from a private physician or layman. The date of receipt of such evidence will be accepted when the evidence furnished by or in behalf of the claimant is within the competence of the physician or lay person and shows the reasonable probability of entitlement to benefits. - 15 - (3) State and other institutions. When submitted by or on behalf of the veteran and entitlement is shown, date of receipt by the Department of Veterans Affairs of examination reports, clinical records, and transcripts of records will be accepted as the date of receipt of a claim if received from State, county, municipal, recognized private institutions, or other Government hospitals (except those described in paragraph (b)(1) of this section). These records must be authenticated by an appropriate official of the institution. Benefits will be granted if the records are adequate for rating purposes; otherwise findings will be verified by official examination. Reports received from private institutions not listed by the American Hospital Association must be certified by the Chief Medical Officer, of the Department of Veterans Affairs or physician designee. 38 C.F.R. 3.157. Upon request made in person or in writing by any person applying for benefits under the laws administered by the Department of Veterans Affairs, the appropriate application form will be furnished. 38 C.F.R. 3.150. Analysis As a preliminary matter, the Board notes that the veteran's claim for an earlier effective date for service connection for PTSD is well grounded. The Board is satisfied that all relevant facts have been properly developed and that no further duty to assist exists with respect to the claim. The law and regulations governing the appropriate effective date for service connection are set out in 38 U.S.C.A. 5110(a) and 38 C.F.R. 3.400 and provide that the effective date for disability compensation based on direct service connection shall be the later of the date of receipt of claim or the date entitlement arose. - 16 - The basis for the December 1995 effective date selected by the RO is readily apparent from the record. Noteworthy is that the veteran pursued other VA benefit claims earlier that included no reference to an intention to initiate a claim of services connection for PTSD. There is simply no pertinent communication from the veteran in the claims folder before the 1995 claim. The RO has granted service connection from December 14, 1995, and the Board has noted the veteran's contentions seeking an earlier effective date. In essence, it is contended that the veteran should receive an effective date in early 1993 rather than in December 1995 as determined by the RO. It is shown that on receipt of the veteran's correspondence in late 1995 the claim was continuously prosecuted culminating with the favorable RO decision. Contrary to his assertion of treatment since 1991, the record shows that the veteran was seen in 1993 several times and that apparently the diagnosis of PTSD was considered and described as "subclinical". Contemporaneous VA records noted other disorders. It appears that PTSD was not firmly established in the forefront of psychiatric diagnoses until the VA examination after the claim was filed in late 1995. There does not appear to have been any interruption in his corresponding with VA prior to 1995 in connection with claims or other disorders. What is notable from the correspondence is the absence of any mention of PTSD prior to late 1995 when he described the claim as a "new issue". Constructive receipt is not the main concern in this case but rather the significance to be accorded the records mentioning his evaluation for PTSD complaints included with records sought by the RO for other adjudication purposes. The Board notes the discussion in Norris v. West, 12 Vet. App. 413, 420-21 (1999) that current evidence actually or constructively of record could, in certain circumstances, establish a reasonably raised, informal claim. Although VA records that mentioned PTSD were received with other records pertinent to the consideration of other claims, no claim regarding PTSD had been made until December 1995 and, in the Board's opinion, none earlier could be reasonably inferred. In essence, there is no basis to find a pending claim in view of the record. - 17 - The Board observes that the terms application and claim are defined in 38 C.F.R. 3.1(p) as a formal or informal communication in writing requesting a determination of entitlement, or evidencing a belief in entitlement to a benefit. Under 38 C.F.R. 3.155(a) any written communication which indicates an intent to apply for an identified benefit may be considered an informal claim. If an executed application form is submitted to VA within one year after the date it was sent to the claimant, it will be deemed filed on the date the informal claim was received. The Board or VARO must review all the communications in the claims file, after the last final disallowance of the claim, which could be interpreted as a formal or informal claim. for benefits. Servello v. Derwinski, 3 Vet. App. 196, 198 (1992). A claim for VA benefits must be submitted in the form prescribed by the Secretary before any benefits can be awarded. See Mitscher v. West, 13 Vet. App. 123, 127 (1999). The veteran contends, in essence, that VA treatment records contain evidence of PTSD and thereby establish an informal claim for service connection for PTSD prior to 1995. Under section 3.157 the date of a VA report of examination or hospitalization maybe the date of a claim for increase or to reopen. However, the regulatory provision applies only when service connection has previously been established for the condition or when the claim is received within one year from the date of the VA medical documentation relied upon. Because a formal claim for PTSD had not been allowed, disallowed, or even filed, prior to the 1995 correspondence, these records may not be accepted as informal claims under 38 C.F.R. 3.157. Crawford v. Brown, 5 Vet. App. 33, 35-36 (1993). Additionally, the Board believes that 38 C.F.R. 3.155 does not benefit the appellant. This regulation defines an informal claim as any communication or action indicating intent to apply for one or more benefits. There is no indication from either the 1993 VA claim that the appellant was seeking a benefit in relation to PTSD. Although a claimant need not identify the benefit sought with specificity, some intent on the part of the veteran to seek benefits must be shown. See Brannon v. West, 12 Vet. App. 32, 34-35 (1998). - 18 - Under the facts of this case there is no indication that the veteran filed an informal claim or sought compensation benefits in relation to his PTSD until his application in late 1995. Consequently, the record does allow for an earlier effective date for VA compensation in this case based on a pending claim. Accordingly, the Board finds that the effective date of December 14, 1995, as determined by the RO is correct. See, for example the persuasive reasoning in Shannon v. West, No. 98-1688 (U.S. Vet. App. Oct. 15, 1999) and Lancelotti v. West, No. 98-186 (U.S. Vet. App. Oct. 25, 1999), citing Brannon. ORDER The veteran not having submitted a well grounded claim of entitlement to service connection for bilateral hearing loss, the appeal is denied. The veteran not having submitted a well grounded claim of entitlement to service connection for postoperative residuals of a ganglion cyst of the right foot, the appeal is denied. Entitlement to an effective date, prior to December 14, 1995, for a grant of service connection for PTSD is denied. RONALD R. BOSCH Member, Board of Veterans' Appeals - 19 -