BVA9501394 DOCKET NO. 93-04 939 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in New York, New York THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim for service connection for a back disorder. 2. Whether new and material evidence has been submitted to reopen a claim for service connection for a right knee disorder. 3. Whether a timely substantive appeal was submitted for claims for service connection for residuals of injuries to the nose and ribs. 4. Entitlement to service connection for residuals of an injury to the nose. 5. Entitlement to service connection for residuals of an injury to the ribs. 6. Entitlement to service connection for residuals of a head injury. 7. Entitlement to service connection for residuals of an injury to the legs. ATTORNEY FOR THE BOARD K. Keyes, Associate Counsel INTRODUCTION The veteran served on active duty from February 1943 to March 1946 and from April 1951 to April 1952. In September 1965, the Department of Veterans Affairs (VA) Regional Office (RO) in New York, New York, denied a claim for service connection for a back disorder. The veteran was notified of that decision in January 1966, and he did not file an appeal. In January 1991, the RO denied a claim for service connection for a knee disorder. The veteran was notified of that decision in April 1991, and he did not file a timely notice of disagreement to initiate an appeal. The issues on appeal to the Board of Veterans' Appeals (Board) arise from November 1990 and July 1992 rating decisions of the RO in New York, New York. In November 1990, the RO denied claims for service connection for residuals of injuries to the nose and ribs. In July 1992, the RO denied the veteran's petitions to reopen claims for service connection for back and right knee disorders and denied his claims for service connection for residuals of injuries to the head and legs. In August 1992, the RO notified the veteran that the appeal period for the claims for service connection for residuals of the injuries to the nose and ribs had expired and that no further action could be taken on those claims. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends, in essence, that the RO committed error in denying his claims. Specifically, he contends that he suffered injuries to his back, right knee, and nose when a ship on which he served in August 1944 was torpedoed. He contends that his service medical records do not show these injuries but instead reflect that he suffered abrasions to his arms because the records are those of another person and that his records were lost. He also contends that during his second period of service, from April 1951 to April 1952, he cracked his ribs when an object fell on him. Finally, he contends that he filed a timely substantive appeal after the RO issued a March 1991 statement of the case regarding his claims for service connection for residuals of injuries to his nose and ribs. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. 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 new and material evidence has not been submitted to reopen claims for entitlement to service connection for a back disorder and a right knee disorder. It is also the decision of the Board that a letter with attachments submitted by the veteran's congressman in April 1991 constituted a timely substantive appeal as to the claims for service connection for residuals of injuries to the nose and ribs, but the Board finds that these claims and the claims for service connection for residuals of injuries to the head and legs are not well grounded and that, therefore, VA's statutory duty to assist the veteran in developing facts pertinent to his claim did not arise in this case. 38 U.S.C.A. § 5107(a) (West 1991). In regard to the claims that are not well grounded, the Board determines that the RO fulfilled VA's statutory obligation to notify the veteran of the evidence necessary to complete his application for the claims for these benefits. 38 U.S.C.A. § 5103(a) (West 1991); Robinette v. Brown, No. 93-985, slip op. at 12-13 (U.S. Vet. App. Sept. 12, 1994). FINDINGS OF FACT 1. The service medical records show that the veteran was injured in August 1944 when the ship on which he was serving was torpedoed by the enemy. He suffered abrasions to both forearms. The veteran was discharged to duty in good condition a few days after the enemy encounter. 2. On a report of medical history completed in connection with a March 1951 examination conducted when the veteran was recalled to active duty, the veteran noted that he had been treated in a hospital in England in 1944 for abrasions. 3. The RO denied service connection for a back disorder in September 1965. The veteran was notified of this decision in January 1966 but failed to file an appeal. 4. There are no complaints or findings of a back injury or disorder in the service medical records from either period of service. 5. The evidence received by the RO since the September 1965 RO decision denying the veteran's claim for service connection for a back disorder consists of the veteran's own statements that he injured his back in service in August 1944 when the ship on which he was serving was torpedoed; the medical findings about the veteran's back noted on VA examination and x-ray study conducted in June 1990; and a March 1992 statement from a fellow servicemember who served with the veteran on the torpedoed ship corroborating that the veteran had sustained injuries to his back. 6. Upon a June 1990 VA examination, the findings pertinent to the lumbar spine were normal lordosis, no increase of paralumbar muscular tension, a normal goniometric reading, some pain alleged over the right sacroiliac joint, no radiculopathy, and good flexibility and mobility. The condition of the veteran's back was deemed adequate for activities of daily living. A June 1990 VA x-ray of the lumbosacral spine reflected moderately severe L4- 5 and L5-S1 degenerative disc disease associated with mild generalized spondylosis of the lumbar spine. The sacroiliac joints were found to be normal in appearance for the veteran's age without evidence of significant degenerative changes. 7. The evidence received since the September 1965 RO decision denying service connection for a back disorder, when viewed in the context of all the evidence of record, does not raise a reasonable possibility of changing the outcome of the September 1965 RO decision. 8. The RO denied service connection for a right knee disorder in January 1991. The veteran was notified of this decision in April 1991 but failed to file a timely notice of disagreement initiating an appeal. 9. There are no complaints or findings of a knee injury or disorder in the service medical records from either period of service. 10. The evidence received by the RO since the January 1991 RO decision denying the veteran's claim for service connection for a right knee disorder consists of the veteran's own statements that he injured his right knee in service in August 1944 when the ship on which he was serving was torpedoed and a March 1992 statement from a fellow servicemember who served with the veteran on that ship stating that the veteran sustained an injury to his legs when the ship was torpedoed. 11. Upon a June 1990 VA examination, findings pertinent to the right knee were signs of more degenerative joint changes on the right than on the left, normal range of motion with some crepitation at the last end of flexion and extension on the right, ability to ambulate on both heels and toes and to adequately squat, good strength of the quadriceps, hamstring, anterior tibial and gastrocsoleus musculature bilaterally, no atrophy noted, and ambulation with a suspicious limp on the right due to alleged pain on ambulation. A February 1990 VA x-ray of both knees reflected bilateral degenerative changes that were greater on the right. 12. The RO issued a statement of the case as to the issues of service connection for residuals of injuries to the nose and ribs in March 1991. In April 1991, the RO received a letter from the veteran's congressman inquiring as to the status of the veteran's claims in general. Attached to this letter was a copy of an earlier letter expressing an intent to appeal the November 1990 RO decision denying service connection for residuals of injuries to the nose and ribs. 13. There are no complaints or findings of an injury to the ribs in the service medical records from either period of service. 14. Upon a June 1990 VA examination, there were no findings or symptomatology pertinent to a history of an injury to the left side of the thoracic cage. 15. There are no complaints or findings of an injury to the nose in the service medical records from either period of service. 16. On a report of medical history completed in connection with a March 1951 examination conducted when the veteran was recalled to active duty, the veteran checked that he had sinusitis. Upon examination, the doctor noted mild infrequent sinusitis. 17. Upon a June 1990 VA examination, the examiner noted a history of septoplasty and bilateral inferior turbinate cautery performed in March 1988. 18. Upon a June 1990 VA examination, findings pertinent to the nose were no nasal congestion, some difficulty breathing, no septal deviation, mucosa not congested, turbinate not hypertrophied, absence of wound over the nose, and no deformity noted. Upon a special VA ears, nose, and throat examination conducted in July 1990, the examiner's assessment was vasomotor rhinitis. 19. There are no complaints or findings of injuries to or disorders involving the head or legs in the service medical records from either period of service. 20. Other than the findings noted above regarding the nose and the right knee, there is no evidence in the claims file of any current disorders of the head or legs. 21. There is no medical evidence in the claims file reflecting a relationship between any current disorders and any injury or disease incurred in service. CONCLUSIONS OF LAW 1. The September 1965 decision of the RO denying service connection for a back disorder is final. 38 U.S.C.A. § 7105(c) (West 1991). 2. Evidence received since the RO's September 1965 decision denying service connection for a back disorder is not new and material, and the veteran's claim for service connection for a back disorder has not been reopened. 38 U.S.C.A. § 5108 (West 1991); 38 C.F.R. § 3.156(a) (1993). 3. A letter with attachments from the veteran's congressman, received by the RO in April 1991, does not constitute a timely notice of disagreement as to the January 1991 decision denying service connection for a right knee disorder. 38 U.S.C.A. § 7105 (West 1991); 38 C.F.R. §§ 20.201, 20.302(a) (1993). 4. A March 1992 statement from the veteran requesting that an attached letter be included with other evidence submitted in support of his claims does not constitute a timely notice of disagreement with the January 1991 decision denying service connection for a right knee disorder. 38 U.S.C.A. § 7105 (West 1991); 38 C.F.R. §§ 20.201, 20.302(a) (1993). 5. The January 1991 decision of the RO denying service connection for a right knee disorder is final. 38 U.S.C.A. § 7105(c) (West 1991). 6. Evidence received since the RO's January 1991 decision denying service connection for a right knee disorder is not new and material, and the veteran's claim for service connection for a right knee disorder has not been reopened. 38 U.S.C.A. § 5108 (West 1991); 38 C.F.R. § 3.156(a) (1993). 7. A letter with attachments from the veteran's congressman, received by the RO in April 1991, contains the necessary information to constitute a timely substantive appeal as to the claims for service connection for the residuals of injuries to the nose and ribs. 38 U.S.C.A. § 7105 (West 1991); 38 C.F.R. §§ 20.202, 20.302(b) (1993). 8. The claim for service connection for residuals of a nose injury is not well grounded, and therefore VA's statutory duty to assist the veteran in developing facts pertinent to his claim was not triggered in this case. 38 U.S.C.A. § 5107(a) (West 1991). 9. The claim for service connection for residuals of an injury to the ribs is not well grounded, and therefore VA's statutory duty to assist the veteran in developing facts pertinent to his claim was not triggered in this case. 38 U.S.C.A. § 5107(a) (West 1991). 10. The claim for service connection for residuals of a head injury is not well grounded, and therefore VA's statutory duty to assist the veteran in developing facts pertinent to his claim was not triggered in this case. 38 U.S.C.A. § 5107(a) (West 1991). 11. The claim for service connection for residuals of an injury to the legs is not well grounded, and therefore VA's statutory duty to assist the veteran in developing facts pertinent to his claim was not triggered in this case. 38 U.S.C.A. § 5107(a) (West 1991). 12. The RO fulfilled its statutory duty to notify the veteran of the evidence necessary to complete his application for service-connected compensation for residuals of injuries to the nose, ribs, head and legs. 38 U.S.C.A. § 5103(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Whether New and Material Evidence Has Been Submitted to Reopen a Claim for Service Connection for a Back Disorder. The veteran's service medical records contain no complaints or findings of a back injury or back disorder. In August 1965, the veteran submitted a claim for VA compensation or pension on which he wrote, "Making no claim but when torpedoed on Aug[ust] 14, 1944[, while aboard the] USS LST 921[,] lower back went out of place. Spent time in hosp[ital] in Falmouth, England[,] but received purple heart for other injuries. Back goes out of place every so often." Noting that there was no evidence of a back disorder in the veteran's service medical records, the RO denied the claim for service connection for a back disorder in September 1965 and notified the veteran of its decision in January 1966. The veteran did not file an appeal, and the decision became final. 38 U.S.C.A. § 7105(c) (West 1991). To reopen a finally denied claim, a veteran must submit new and material evidence. 38 U.S.C.A. § 5108 (West 1991). Evidence is new when not merely cumulative of other evidence on the record. Material evidence is relevant to and probative of the issue at hand and of sufficient weight and significance that there is a reasonable possibility that, when viewed in the context of all of the evidence, both old and new, the additional evidence will change the disposition of the claim. Vecina v. Brown, 6 Vet.App. 519, 522 (1994); Mintz v. Brown, 6 Vet.App. 277, 280 (1994); Colvin v. Derwinski, 1 Vet.App. 171, 174 (1991); see Manio v. Derwinski, 1 Vet.App. 140, 145 1991). For service connection to be granted, the law requires that there be a disability and that the disability result from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1993); see Rabideau v. Derwinski, 2 Vet.App 141, 143 (1992). In addition, the law provides that, in the case of any veteran who engaged in combat with the enemy in active service, satisfactory lay or other evidence of an injury incurred in service shall be accepted as sufficient proof of service incurrence of the injury if the evidence is consistent with circumstances of service and notwithstanding that there is no official record of service incurrence of the injury. 38 U.S.C.A. § 1154(b) (West 1991). The "issue at hand" in pertaining to the petition to reopen the finally denied claim for service connection for a back disorder is whether a current back disorder, if any, is the result of an injury to the back sustained in service. Colvin, 1 Vet.App. at 174. In determining whether new and material evidence has been submitted to reopen a finally denied claim, consideration must be given to all of the evidence submitted since the last final denial on the merits rather than limited to evidence received since the most recent denial of reopening. Glynn v. Brown, 6 Vet.App. 523, 528-29 (1994). In this case, the evidence submitted since the last final denial on the merits, i.e., the September 1965 RO decision, consists of the veteran's own statements that he injured his back in service in August 1944 when the ship on which he was serving was torpedoed; the medical findings about the veteran's back noted on VA examination and x-ray study conducted in June 1990; and a March 1992 statement from a fellow servicemember which corroborated the veteran's allegations that he sustained injuries to his back during service. With regard to the veteran's statements of having sustained an injury to his back aboard ship, the Board finds that this evidence is not "new" because the same statements were made by the veteran and were before the RO when it rendered its decision in September 1965, and therefore this evidence is cumulative. Colvin, 1 Vet.App. at 174. The Board also finds that the report of examination of the back in June 1990, while "new" because it was not before the RO when it rendered its decision on the merits in September 1965, is not "material" because, other than the examiner's note that the veteran "alleged some pain over the right sacroiliac joint," the examiner's findings as to the back did not reflect the existence of a current disability, a requirement for a grant of service connection. 38 U.S.C.A. § 1110 (West 1991); Rabideau, 2 Vet.App. at 143. Moreover, the Board notes with regard to the sacroiliac joint that the impression on the June 1990 x-ray report reflected that "[t]he s[acro]i[liac] joints are normal in appearance for the [veteran]'s age without evidence of significant degenerative changes." However, even assuming that a current back disability does exist, the Board concludes that the report is not "material" because it is not -- either in itself or viewed in the context of all the evidence, both old and new -- relevant to and probative of the "issue at hand" in this case, i.e., whether a current back disorder is the result of an injury to the back in service. 38 U.S.C.A. § 1110 (West 1991); Colvin, 1 Vet.App. at 174; see Rabideau, 2 Vet.App. at 143-44 (claim was not well grounded where there was no evidence causally linking a stroke to alleged service-connected hypertension). With regard to the June 1990 VA x-ray report of the lumbosacral spine, the Board finds that, while the report is "new" evidence, it is not "material" because, although it reflects current findings of degenerative disc disease, the report, like the other evidence received since the last denial of this claim on the merits, is not -- either in itself or viewed in the context of all the evidence -- relevant to or probative of the "issue at hand", i.e., whether a current disorder is the result of an injury to the back in service. 38 U.S.C.A. § 1110 (West 1991); Colvin, 1 Vet.App. at 174; see Rabideau, 2 Vet.App. at 143-44. Finally, the Board finds that the March 1992 statement from the fellow servicemember who served with the veteran on the ship that was torpedoed is "new" evidence because it provides corroboration of the veteran's own statements that he sustained a back injury in service. See Paller v. Principi, 3 Vet.App. 535, 538 (1992) (distinguishing corroborative evidence from cumulative evidence); see Justus v. Principi, 3 Vet.App. 510, 513 (1992) (for the purposes of reopening a finally denied claim, the credibility of the additional evidence submitted is presumed). The Board also concludes, however, that this statement, although relevant to and probative of one of the issues involved in the claim for service connection, i.e., whether the veteran sustained an injury to his back in service, is not "material" evidence because, like the other items of evidence, it is not -- either in itself or viewed in the context of all the evidence, both old and new -- relevant to and probative of the "issue at hand" in this case, i.e., whether a current back disorder is the result of an injury to the back in service. Colvin, 1 Vet.App. at 174; see Rabideau, 2 Vet.App. at 143-44. Accordingly, the Board concludes that the evidence submitted since the September 1965 RO decision denying service connection for a back disorder is not new and material evidence because it does not create a reasonable possibility that, when viewed in the context of all the evidence, both old and new, the additional evidence would change the disposition of the claim. Vecina, 6 Vet.App. at 522; Mintz, 6 Vet.App. at 280; Colvin, 1 Vet.App. at 174. Because the additional evidence received since the September 1965 RO decision is not new and material in light of applicable law, regulations, and Court decisions, it does not provide the required evidentiary basis to reopen the veteran's claim. The RO's prior denial in September 1965 of service connection for a back disorder remains final. 38 U.S.C.A. §§ 5108, 7105(c) (West 1991); 38 C.F.R. § 3.156(a) (1993). II. Whether New and Material Evidence Has Been Submitted to Reopen a Claim Service Connection for a Right Knee Disorder. A brief outline of the procedural history of this claim may facilitate an understanding of the Board's determinations regarding the lack of a notice of disagreement and the finality of the RO's January 1991 decision on the merits of the claim. The veteran was afforded a VA x-ray of both knees in February 1990. In May 1990, the RO received a letter from the veteran's congressman inquiring as to the status of the veteran's "long pending claim for compensation benefits." Attached to the congressman's letter was a copy of a VA application for compensation or pension dated as signed by the veteran in April 1989. Neither the application nor an attached undated description by the veteran of injuries he claimed to have sustained in service mentioned a right knee disorder. In June 1990, the veteran was afforded a VA examination in which he provided a history of having injured his right knee in service in August 1944 when the ship on which he was serving was torpedoed by the enemy. In light of the history provided by the veteran, the VA doctor examined his knees. In July 1990, the veteran submitted a statement of a fellow servicemember who had served with him on the ship that was torpedoed in August 1944. The servicemember wrote that, when the torpedo hit, the veteran "got his nose broken and had an injured leg or knee." In November 1990, the RO issued a rating decision which denied service connection for other claimed disabilities but which did not mention a right knee claim. The veteran was notified of this decision that same month, and a few days later he inquired about the status of his claim for service connection for a right knee disorder. The RO denied the right knee claim in January 1991 but apparently did not notify the veteran of this decision. In March 1991, the RO received a letter from the veteran's congressman inquiring about, among other things, the status of the veteran's claim for service connection for a right knee disorder. In April 1991, the RO notified the veteran of the denial of the right knee claim. Several days later, the RO received another letter from the veteran's congressman inquiring in general about the status of the veteran's claims but not mentioning the right knee claim specifically and reflecting no awareness that the right knee claim had been denied. In May 1991, the RO replied to the inquiry from the veteran's congressman and enclosed a copy of its April 1991 letter notifying the veteran of its denial of the claim for service connection for a right knee disorder. In March 1992, a month before the expiration of the time for filing a notice of disagreement with the denial of the right knee claim, the RO received a statement from the veteran requesting that the RO include an attached letter from another fellow servicemember "in evidence to [his] claim." This fellow servicemember, who also served on the ship that had been torpedoed in August 1944, stated that the veteran had sustained injuries to his "head, back and legs." In July 1992, the RO issued a rating decision in which it treated the veteran's claim regarding a right knee disorder as a claim to reopen a finally denied claim for service connection for that disorder. In denying the claim, the RO noted that "evidence submitted is considered new but not material to form a bas[i]s to reconsider the claim for service connection for . . . [a] right knee [disorder] . . . ." In treating the veteran's claim as a claim to reopen a finally denied claim, the RO apparently concluded that the veteran had not filed a timely notice of disagreement with its January 1991 rating decision denying service connection for a right knee disorder and that therefore that decision had become final. The Board agrees. In order to initiate an appeal to the Board of a determination on a claim by an agency of original jurisdiction, a claimant must file a notice of disagreement with that determination "within one year from the date that the agency mails notice of the determination to the claimant." 38 C.F.R. § 20.302 (1993). A notice of disagreement is "[a] written communication from a claimant or his or her representative expressing dissatisfaction or disagreement with an adjudicative determination by the agency of original jurisdiction and desire to contest the result . . . ." 38 C.F.R. § 20.201 (1993). In this case, there is evidence in the claims file of written communication with the RO on two occasions within one year of April 3, 1991, the date the RO mailed its letter of notification to the veteran of its denial of his claim for service connection for a right knee disorder. The first is the letter from the veteran's congressman, dated April 11, 1991, and received by the RO on April 16, 1991, inquiring in general about the status of the veteran's claims but not mentioning the right knee claim specifically and reflecting no awareness that the right knee claim had been denied. The second written communication is the March 1992 statement from the veteran requesting that the RO include an attached letter from a fellow servicemember "in evidence to [his] claim." The veteran's statement did not mention the right knee claim specifically and it did not express disagreement with or refer in any way to any determination regarding any claim or claims by the RO. Because neither statement expressed dissatisfaction or disagreement with an adjudicative determination, the Board finds that neither statement constituted a timely notice of disagreement with the January 1991 RO decision denying the veteran's claim for service connection for a right knee disorder. See Prenzler v. Derwinski, 928 F.2d 392, 394 (1991) (where letter from veteran did not "express dissatisfaction or disagreement" with an RO decision, it was not a valid NOD); see also Rowell v. Principi, 4 Vet.App. 9, 14-15 (1993) (where a timely NOD is not filed, Board lacks jurisdiction to review a claim de novo). Accordingly, the January 1991 RO decision, having not been appealed, became final. The legal standards for reopening a finally denied claim, the requirements for establishing service connection for a disability, and the special provisions in the law regarding satisfactory lay evidence brought by combat veterans is set forth in the second and third paragraphs of Part I of this decision and will not be repeated here. As was noted above with regard to the petition to reopen the claim for service connection for a back disorder, the "issue at hand" in this case pertaining to reopening the claim for service connection for a right knee disorder is whether a current right knee disorder, if any, is the result of an injury to the right knee sustained in service. Colvin, 1 Vet.App. at 174. In determining whether new and material evidence has been submitted to reopen a finally denied claim, consideration must be given to all of the evidence submitted since the last final denial on the merits rather than limited to evidence received since the most recent denial of reopening. Glynn, 6 Vet.App. at 528-29. In this case, the evidence submitted since the last final denial on the merits, i.e., the January 1991 RO decision, consists of the veteran's own statements that he injured his right knee in service in August 1944 when the ship on which he was serving was torpedoed and a March 1992 letter from a fellow servicemember, who also served on that ship, stating that the veteran had sustained injuries to his "head, back and legs." With regard to the veteran's statements of having sustained an injury to his right knee during service, the Board finds that this evidence is not "new" because the same statements were made by the veteran before the RO when it rendered its decision in January 1991. Colvin, 1 Vet.App. at 174. As to the March 1992 statement from the fellow servicemember that the veteran sustained an injury to his "legs" during service, the Board finds that the statement, construed liberally, is "new" evidence. In this regard, the Board notes that, given that the right knee is a part of the right leg, the statement that the veteran sustained an injury to the "legs" helps to corroborate, at least somewhat, the July 1990 statement of the other servicemember that the veteran injured his "leg or knee" in service, and both statements corroborate the veteran's own claim that he sustained an injury to his right knee in service . See Paller, 3 Vet.App. at 538 (distinguishing corroborative evidence from cumulative evidence); see Justus, 3 Vet.App. at 513 (for the purposes of reopening a finally denied claim, the credibility of the additional evidence submitted is presumed). The Board also concludes, however, that this statement, although relevant to whether the veteran sustained an injury to his right knee in service, is not "material" evidence because, even when viewed in the context of the other evidence, both old and new, including the medical findings upon VA examination of the knee in June 1990 and upon VA x-ray of the knee in February 1990, it is not relevant to and probative of the "issue at hand" in this case, i.e., whether a current right knee disorder is the result of an injury to the back in service. Colvin, 1 Vet.App. at 174; Rabideau, 2 Vet.App. at 144 (claim was not well grounded where there was no evidence causally linking a stroke to alleged service-connected hypertension). Accordingly, the Board concludes that the evidence submitted since the January 1991 RO decision denying service connection for a right knee disorder is not new and material evidence because it does not create a reasonable possibility that, when viewed in the context of all the evidence, both old and new, the additional evidence will change the disposition of the claim. Vecina, 6 Vet.App. at 522; Mintz, 6 Vet.App. at 280; Colvin, 1 Vet.App. at 174. Because the additional evidence received since the January 1991 RO decision is not new and material in light of applicable law, regulations, and Court decisions, it does not provide the required evidentiary basis to reopen the veteran's claim. The RO's prior denial in January 1991 of service connection for a right knee disorder remains final. 38 U.S.C.A. §§ 5108, 7105(c) (West 1991); 38 C.F.R. § 3.156(a) (1993). III. Whether a Timely Substantive Appeal Was Submitted for Claims for Service Connection for Residuals of Injuries to the Nose and Ribs. In November 1990, the RO denied the veteran's claims for service connection for residuals of injuries to the nose and ribs sustained during service. That same month the RO received a statement from the veteran in which he noted, "In regards to your correspondence of [November 20,, 1990] . . . I do not wish to contest the findings of the board regarding my ribs [and] nose . . . ." Nevertheless, in March 1991, before the time had run for filing a notice of disagreement with decision, the veteran's congressmen submitted a letter to the RO in which he noted the denial of the veteran's claims for service connection for residuals of injuries to the nose and ribs and stated, "Please accept this letter as notice of [the veteran's] intent to formally appeal this determination . . . ." The RO accepted the congressman's letter as a notice of disagreement with its November 1990 decision, and in March 1991 issued a statement of the case as to the two claims. The regulations provide that "a [s]ubstantive [a]ppeal must be filed within 60 days from the date that the agency of original jurisdiction mails the [s]tatement of the [c]ase to the appellant, or within the remainder of the 1-year period from the date of mailing of the notification of the determination being appealed, whichever period ends later." 38 C.F.R. § 20.302(b) (1993). According to this regulation, the veteran had until November 1991 to submit a substantive appeal to perfect his appeal to the Board of the denial of his claims for service connection for residuals of injuries to his nose and ribs. In August 1992, the RO sent the veteran notification of a July 1992 rating decision denying several claims other than his claims for service connection for residuals of injuries to his nose and ribs. At the end of the letter, the RO advised the veteran that "the appeal period in response to the [s]tatement of the [c]ase sent to you on March 21, 1991 has expired. Therefore, no further action can be taken on this claim." In September 1992, the veteran replied that he had forwarded his completed substantive appeal form to the RO in May 1991. In November 1992, in reply to a statement of the case which the RO sent that month in which it framed the issue regarding the claims for service connection for residuals of injuries to the nose and ribs as one of timeliness of the substantive appeal, the veteran submitted a copy of his September 1992 statement with an attached copy of a completed substantive appeal form dated as signed by the veteran on May 4, 1991. Because there is no evidence in the claims file that the RO received the substantive appeal dated May 4, 1991, at that time or at any time within the 1-year period after notification of the denial of the claims for service connection for residuals of injuries to his nose and ribs in November 1990, the Board does not accept the copy of the substantive appeal form dated May 4, 1991, which the RO received in November 1992, as having been timely filed. However, the Board notes that in April 1991, the RO received a letter from the veteran's congressman inquiring as to the status of the veteran's claims in general. Attached to this letter was a copy of an earlier letter expressing an intent to appeal the November 1990 RO decision denying service connection for residuals of injuries to the nose and ribs, which letter the RO had accepted as a notice of disagreement as to those claims. The Board finds that this letter, together with the attachment, contains the necessary information sufficient to express a general intent to continue the appeal as to the claims for service connection for residuals of injuries to the nose and ribs. 38 C.F.R. § 20.202 (1993). Accordingly, the Board concludes that the veteran's appeal of these claims to the Board was perfected, and the appeals are therefore considered below. IV. Service Connection for Residuals of an Injury to the Nose. For service connection to be granted, the law requires that there be a disability and that the disability result from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1993); see Rabideau, 2 Vet.App 141, 143 (1992). In addition, the law provides that, in the case of any veteran who engaged in combat with the enemy in active service, satisfactory lay or other evidence of an injury incurred in service shall be accepted as sufficient proof of service incurrence of the injury if the evidence is consistent with circumstances of service and notwithstanding that there is no official record of service incurrence of the injury. 38 U.S.C.A. § 1154(b) (West 1991). In making a claim for service connection for a disorder, the veteran has the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded. 38 U.S.C.A. § 5107(a) (West 1991). The Court has defined the term "well-grounded claim" as a "plausible claim, one which is meritorious on its own or capable of substantiation." Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). The Court has further noted that "[a]lthough the claim need not be conclusive, the statute provides that it must be accompanied by evidence." Tirpak v. Derwinski, 2 Vet.App. 609, 611 (1992); 38 U.S.C.A. § 5107(a) (West 1991). Moreover, the Court has stated that "[t]he quality and quantity of the evidence required to meet this statutory burden . . . will depend upon the issue presented by the claim." Grottveit v. Brown, 5 Vet.App. 91, 92- 93 (1993). Where the issue in a case is factual, competent lay testimony may suffice; however, "where the determination involves medical causation or a medical diagnosis, competent medical evidence to the effect that the claim is 'plausible' or 'possible' is required." Id. at 93. In this case, the veteran claims that a current nose disorder resulted from an injury to the nose in service. Although the service medical records show no complaints or findings of an injury to the nose in service, the veteran has submitted lay evidence (i.e., his own statements and the statements of two fellow servicemembers, one who stated that the veteran "got his nose broken" and the other who stated that the veteran sustained a head injury) in support of this aspect of his claim. 38 U.S.C.A. § 1154(b) (West 1991). For the purposes of establishing a well grounded claim, the Board presumes that this evidence is credible. See Justus, 3 Vet.App. at 513. Although there is no evidence in the service medical records of an injury to the nose in service, there is evidence in a March 1951 examination report of mild infrequent sinusitis. Moreover, the Board notes that there is evidence in the claims file of a current nose disorder. During the June 1990 VA examination, the examiner noted a history of septoplasty and bilateral inferior turbinate cautery performed in March 1988. In addition, another VA examiner's assessment upon a July 1990 special ears, nose, and throat examination was vasomotor rhinitis. However, the Board notes that, although there is medical evidence of current rhinitis, lay evidence of an injury to the nose in service, and medical evidence of mild infrequent sinusitis in service, the veteran did not submit medical evidence of an etiologic relationship between current rhinitis and either an injury to the nose in service or the mild infrequent sinusitis noted in 1951. A determination that a disease or injury suffered in service resulted in a current disability is necessary to establish service connection for that disability, and medical evidence showing such a causal relationship is plausible is necessary to establish a well grounded claim for service connection. 38 U.S.C.A. § 1110 (West 1991); see Rabideau, 2 Vet.App. at 144; Grottveit, 5 Vet.App. at 92-93 (1993); Clarkson v. Brown, 4 Vet.App. 565, 567 (1993); see also Espiritu v. Derwinski, 2 Vet.App. 492, 495 (1992) (lay persons are not competent to offer medical opinions). Because the veteran did not submit medical evidence of a causal relationship between a current disorder of the nose and an injury or disease incurred in service, the Board concludes that his claim for service connection for residuals of an injury to the nose in service is not well grounded. Finally, as to VA's obligation under 38 U.S.C.A. § 5103(a) to notify a claimant of the evidence necessary to complete his application, the Board finds that the RO complied with this obligation in its November 1990 notification letter of the denial of the claim in which it informed the veteran of that he "may submit evidence at any time showing the disability exists and was incurred in or aggravated by service . . . ." Robinette, slip op. at 12-13 (where a claim is not well grounded it is incomplete, and VA is obliged under 38 U.S.C.A. § 5103(a) to advise the claimant of the evidence needed to complete his application). In light of the foregoing, the Board concludes that the veteran's claim was not well grounded, and that the RO was not under a duty to assist the veteran in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). Although the RO did not specifically state that it denied the veteran's claim on the basis that it was not well grounded, the Board concludes that this error was harmless. See Robinette, slip op. at 13 (citing Grottveit, 5 Vet.App. at 93; Edenfield v. Brown, 6 Vet.App. 432 (1994) (per curiam order) (requesting briefing on whether remedy for deciding on the merits a claim that is not well grounded should be affirmance, on the basis of nonprejudicial error, or vacating of the Board decision). Accordingly, the Board denies the veteran's claim for service connection for residuals of a nose injury as not well grounded. See Robinette, slip op. at 13 (Court notes that dismissal is an inappropriate remedy for lack of a well grounded claim); but cf. Boeck v. Brown, 6 Vet.App. 14, 17 (1993) (if a claim is not well grounded, the Board does not have jurisdiction to adjudicate it). V. Service Connection for Residuals of an Injury to the Ribs. The legal requirements for establishing service connection, the special provisions in the law regarding satisfactory lay evidence brought by combat veterans, and the standards for establishing a well grounded claim for service connection are set forth in the first two paragraphs of Part IV of this decision and will not be repeated here. The veteran claims that a current disorder of the ribs resulted from an injury to his ribs which he sustained during his second period of service when an object fell on him. There are no complaints or findings of an injury to the ribs in the service medical records from either period of service. Moreover, upon VA examination in June 1990, there were no findings or symptomatology pertinent to the veteran's history of an injury to the left side of the thoracic cage. The examiner's diagnosis was "history of fracture, left side of the thoracic cage, no symptomatology." Although the service medical records show no complaints or findings of an injury to the ribs in service, the veteran has submitted his own statements of having sustained an injury to the ribs in service in support of this aspect of his claim. 38 U.S.C.A. § 1154(b) (West 1991). For the purposes of establishing a well grounded claim, the Board presumes that this is evidence is credible. See Justus, 3 Vet.App. at 513. However, the Board notes that, there is no evidence in this case of a current disability of the ribs resulting from an injury in service. A determination that a disease or injury suffered in service resulted in a current disability is necessary to establish service connection for that disability, and medical evidence showing the existence of a current disability and showing at least a plausible causal relationship between that disability and a disease or injury incurred in service is necessary to establish a well grounded claim for service connection. 38 U.S.C.A. § 1110 (West 1991); see Rabideau, 2 Vet.App. at 144; Grottveit, 5 Vet.App. at 92-93; Clarkson, 4 Vet.App. at 567; see also Espiritu, 2 Vet.App. at 495. Because the veteran did not submit medical evidence of a current disorder of the ribs or a causal relationship between a current disorder of the ribs and an injury or disease incurred in service, the Board concludes that his claim for service connection for residuals of an injury to the ribs is not well grounded. As to VA's obligation under 38 U.S.C.A. § 5103(a) to notify a claimant of the evidence necessary to complete his application, the Board finds that the RO complied with this obligation in its November 1990 notification letter of the denial of the claim in which it informed the veteran of that he "may submit evidence at any time showing the disability exists and was incurred in or aggravated by service . . . ." Robinette, slip op. at 12-13 (where a claim is not well grounded it is incomplete, and VA is obliged under 38 U.S.C.A. § 5103(a) to advise the claimant of the evidence needed to complete his application). In light of the foregoing, the Board concludes that the veteran's claim was not well grounded, and that the RO was not under a duty to assist the veteran in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). Although the RO did not specifically state that it denied the veteran's claim on the basis that it was not well grounded, the Board concludes that this error was harmless. See Robinette, slip op. at 13 (citing Grottveit, 5 Vet.App. at 93; Edenfield v. Brown, 6 Vet.App. 432 (1994) (per curiam order) (requesting briefing on whether remedy for deciding on the merits a claim that is not well grounded should be affirmance, on the basis of nonprejudicial error, or vacating of the Board decision). Accordingly, the Board denies the veteran's claim for service connection for residuals of a nose injury as not well grounded. See Robinette, slip op. at 13 (Court notes that dismissal is an inappropriate remedy for lack of a well grounded claim); but cf. Boeck v. Brown, 6 Vet.App. 14, 17 (1993) (if a claim is not well grounded, the Board does not have jurisdiction to adjudicate it). VI. Service Connection for Residuals of a Head Injury. The legal requirements for establishing service connection, the special provisions in the law regarding satisfactory lay evidence brought by combat veterans, and the standards for establishing a well grounded claim for service connection are set forth in the first two paragraphs of Part IV of this decision and will not be repeated here. The Board observes that when the RO received the March 1992 statement of the veteran's fellow servicemember stating that the veteran had sustained injuries to the head in service, the RO treated the statement as evidence in support of a claim separate from the claim for service connection for residuals of an injury to the nose. The Board has considered the statement as supporting evidence for the claim for service connection for residuals of an injury to the nose in Part IV of this decision and considers it here as evidence in support of a claim for residuals in general of an injury to the head. To the extent that the veteran contends that he sustained a head injury in service, the Board considers his own statements in this regard as evidence submitted in support of this aspect of his claim. 38 U.S.C.A. § 1154(b) (West 1991). For the purposes of establishing a well grounded claim, the Board presumes that this is evidence is credible. See Justus, 3 Vet.App. at 513. However, the Board notes that, there is no evidence in this case of a current disability of the head, not including the nose, resulting from an injury in service. A determination that a disease or injury suffered in service resulted in a current disability is necessary to establish service connection for that disability, and medical evidence showing such a causal relationship is plausible is necessary to establish a well grounded claim for service connection. 38 U.S.C.A. § 1110 (West 1991); see Rabideau, 2 Vet.App. at 144; Grottveit, 5 Vet.App. at 92-93; Clarkson, 4 Vet.App. at 567; see also Espiritu, 2 Vet.App. at 495. Because the veteran did not submit medical evidence of a current head disorder or of a causal relationship between a current head disorder and an injury or disease incurred in service, the Board concludes that his claim for service connection for residuals of an injury to the head is not well grounded. As to VA's obligation under 38 U.S.C.A. § 5103(a) to notify a claimant of the evidence necessary to complete his application, the Board finds that the RO complied with this obligation in its August 1992 notification letter of the denial of the claim in which it informed the veteran of that "[e]ven considering that you did sustain a head . . . injury in August 1944, there is no indication that these injuries resulted in a chronic condition of the head . . . to warrant service connection." Robinette, slip op. at 12-13 (where a claim is not well grounded it is incomplete, and VA is obliged under 38 U.S.C.A. § 5103(a) to advise the claimant of the evidence needed to complete his application). In light of the foregoing, the Board concludes that the veteran's claim was not well grounded, and that the RO was not under a duty to assist the veteran in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). Although the RO did not specifically state that it denied the veteran's claim on the basis that it was not well grounded, the Board concludes that this error was harmless. See Robinette, slip op. at 13 (citing Grottveit, 5 Vet.App. at 93; Edenfield v. Brown, 6 Vet.App. 432 (1994) (per curiam order) (requesting briefing on whether remedy for deciding on the merits a claim that is not well grounded should be affirmance, on the basis of nonprejudicial error, or vacating of the Board decision). Accordingly, the Board denies the veteran's claim for service connection for residuals of a head injury as not well grounded. See Robinette, slip op. at 13 (Court notes that dismissal is an inappropriate remedy for lack of a well grounded claim); but cf. Boeck v. Brown, 6 Vet.App. 14, 17 (1993) (if a claim is not well grounded, the Board does not have jurisdiction to adjudicate it). VII. Service Connection for Residuals of an Injury to the Legs. The legal requirements for establishing service connection, the special provisions in the law regarding satisfactory lay evidence brought by combat veterans, and the standards for establishing a well grounded claim for service connection are set forth in the first two paragraphs of Part IV of this decision and will not be repeated here. The Board observes that when the RO received the March 1992 statement of the veteran's fellow servicemember stating that the veteran had sustained injuries to the legs in service, the RO treated the statement as evidence in support of a claim separate from the claim to reopen a finally denied claim for service connection for residuals of an injury to the right knee. The Board has considered whether the statement constitutes new and material evidence to reopen the claim as to the right knee in Part II of this decision and considers it here as evidence in support of a claim for residuals in general of an injury to the legs. To the extent that the veteran contends that he sustained an injury to the legs in service, the Board considers his own statements in this regard as evidence submitted in support of this aspect of his claim. 38 U.S.C.A. § 1154(b) (West 1991). For the purposes of establishing a well grounded claim, the Board presumes that this is evidence is credible. See Justus, 3 Vet.App. at 513. However, the Board notes that, there is no evidence in this case of a current disability of the legs, not including the right knee, resulting from an injury in service. A determination that a disease or injury suffered in service resulted in a current disability is necessary to establish service connection for that disability, and medical evidence showing such a causal relationship is plausible is necessary to establish a well grounded claim for service connection. 38 U.S.C.A. § 1110 (West 1991); see Rabideau, 2 Vet.App. at 144; Grottveit, 5 Vet.App. at 92-93; Clarkson, 4 Vet.App. at 567; see also Espiritu, 2 Vet.App. at 495. Because the veteran did not submit medical evidence of a current disorder of the legs or of a plausible causal relationship between a current disorder of the legs and an injury or disease incurred in service, the Board concludes that his claim for service connection for residuals of an injury to the legs is not well grounded. As to VA's obligation under 38 U.S.C.A. § 5103(a) to notify a claimant of the evidence necessary to complete his application, the Board finds that the RO complied with this obligation in its August 1992 notification letter of the denial of the claim in which it informed the veteran of that "[e]ven considering that you did sustain a leg . . . injury in August 1944, there is no indication that these injuries resulted in a chronic condition of the legs . . . to warrant service connection." Robinette, slip op. at 12-13 (where a claim is not well grounded it is incomplete, and VA is obliged under 38 U.S.C.A. § 5103(a) to advise the claimant of the evidence needed to complete his application). In light of the foregoing, the Board concludes that the veteran's claim was not well grounded, and that the RO was not under a duty to assist the veteran in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). Although the RO did not specifically state that it denied the veteran's claim on the basis that it was not well grounded, the Board concludes that this error was harmless. See Robinette, slip op. at 13 (citing Grottveit, 5 Vet.App. at 93; Edenfield v. Brown, 6 Vet.App. 432 (1994) (per curiam order) (requesting briefing on whether remedy for deciding on the merits a claim that is not well grounded should be affirmance, on the basis of nonprejudicial error, or vacating of the Board decision). Accordingly, the Board denies the veteran's claim for service connection for residuals of a head injury as not well grounded. See Robinette, slip op. at 13 (Court notes that dismissal is an inappropriate remedy for lack of a well grounded claim); but cf. Boeck v. Brown, 6 Vet.App. 14, 17 (1993) (if a claim is not well grounded, the Board does not have jurisdiction to adjudicate it). ORDER New and material evidence not having been submitted, a petition to reopen a claim for service connection for a back disorder is denied. New and material evidence not having been submitted, a petition to reopen a claim for service connection for a right knee disorder is denied. A timely substantive appeal has been submitted as to a decision denying claims for service connection for residuals of injuries to the nose and legs. Because it is not well grounded, the veteran's claim for service connection for residuals of an injury to the nose or for rhinitis is denied. Because it is not well grounded, the veteran's claim for service connection for residuals of an injury to the ribs is denied. Because it is not well grounded, the veteran's claim for service connection for residuals of an injury to the head is denied. Because it is not well grounded, the veteran's claim for service connection for residuals of an injury to the legs is denied. JAN DONSBACH Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), 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 (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.