Citation Nr: 0004215 Decision Date: 02/17/00 Archive Date: 02/23/00 DOCKET NO. 97-29 925 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for an acquired psychiatric disorder, and, if so, whether service connection is warranted for this condition. 2. Entitlement to an increased disability rating for degenerative joint disease of the lumbosacral spine (formerly evaluated as chronic lumbosacral strain), currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. L. Kane, Associate Counsel INTRODUCTION The appellant had active military service from October 1978 to April 1980. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 1996 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama, which found that new and material evidence had not been submitted to reopen a claim of entitlement to service connection for a "nervous condition" and denied a compensable rating for the appellant's service- connected back condition. An April 1998 rating decision then assigned a 10 percent disability rating for the appellant's back condition. However, this was not a full grant of the benefit sought on appeal because a higher disability rating is available under Diagnostic Code 5295. On a claim for an original or an increased rating, the claimant is generally presumed to be seeking the maximum benefit allowed by law and regulation, and such a claim remains in appellate status where a subsequent rating decision awarded a higher rating, but less than the maximum available benefit. AB v. Brown, 6 Vet. App. 35, 38 (1993). Therefore, this issue remains before the Board. In July 1999, the Board remanded this case for the purpose of providing the appellant a hearing. In October 1999, a hearing was held before the undersigned, who is the Board member making this decision and who was designated by the Chairman to conduct that hearing pursuant to 38 U.S.C.A. § 7107(c) (West Supp. 1999). Although the RO complied with the Board's Remand instructions, it is necessary to again REMAND the claim for an increased rating for the appellant's back condition for the reasons discussed below. As discussed below, the appellant's claim for an increased rating for his back condition is being remanded, in part, due to the receipt of additional evidence subsequent to the supplemental statement of the case (SSOC) of July 1998. See 38 C.F.R. § 19.37(a) (1999). It is not, however, necessary to remand his claim for service connection for a psychiatric disorder because the additional evidence is not relevant to that claim. The additional evidence did not show treatment for or diagnosis of an acquired psychiatric disorder. Therefore, it is unnecessary to remand this particular claim. The Board must consider all documents submitted prior to its decision and review all issues reasonably raised from a liberal reading of these documents. Suttmann v. Brown, 5 Vet. App. 127, 132 (1993) (citations omitted). Where such review reasonably reveals that the claimant is seeking a particular benefit, the Board is required to adjudicate the issue or, if appropriate, remand the issue to the RO for development and adjudication; however, the Board may not ignore an issue so raised. Id. On the other hand, the Board is not required to anticipate a claim for a particular benefit where no intention to raise it was expressed by the appellant. See Talbert v. Brown, 7 Vet. App. 352, 356-57 (1995); see also Brannon v. West, 12 Vet. App. 32, 34-35 (1998) ("[B]efore [the RO or Board] can adjudicate an original claim for benefits, the claimant must submit a written document identifying the benefit and expressing some intent to seek it"). In this case, the appellant's statements in 1996 made reference to "post traumatic stress" and an inability to maintain gainful employment. It is unclear whether it was his intention to specifically raise claims for service connection for post-traumatic stress disorder (PTSD) and/or for a total disability rating based on individual unemployability due to service-connected disability (TDIU). He is hereby advised of the need to file formal claims with the RO if he wishes to file such claims. FINDINGS OF FACT 1. In an August 1983 rating decision, the RO denied, on the merits, service connection for a "nervous condition." The appellant was notified of that decision in August 1983 and did not appeal. 2. Some of the evidence received since 1983 in support of the appellant's attempt to reopen his claim for service connection for a psychiatric disorder is material. 3. The appellant currently has various acquired psychiatric disorders, including major depression and anxiety disorder. 4. The appellant was treated for complaints such as depression during service, but diagnosis of an acquired psychiatric disorder was not rendered. 5. There is no medical evidence of a nexus, or link, between any current acquired psychiatric disorder and any disease or injury during service, and the claim for service connection is not plausible. CONCLUSIONS OF LAW 1. The August 1983 rating decision that denied service connection for a "nervous condition" is final. 38 U.S.C.A. § 7105(b) and (c) (West 1991); 38 C.F.R. § 3.160(d) (1999). 2. New and material evidence has been received, and the appellant's claim for service connection for an acquired psychiatric disorder is reopened. 38 U.S.C.A. §§ 5108 and 7105 (West 1991); 38 C.F.R. § 3.156(a) (1999). 3. The claim for service connection for an acquired psychiatric disorder is not well grounded, and there is no statutory duty to assist the appellant in developing facts pertinent to this claim. 38 U.S.C.A. § 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Although the appellant did not file a claim for service connection for a psychiatric disorder after his separation from service, the RO adjudicated entitlement to service connection for a "nervous condition" in the August 1983 rating decision since the service medical records showed treatment for personality disorders (mixed-type personality disorder and schizotypical personality disorder). The RO denied entitlement to service connection for a nervous condition, finding that the evidence of record only showed the presence of congenital or developmental disorders such as the appellant's personality disorders. A decision of a duly-constituted rating agency or other agency of original jurisdiction is final and binding as to all field offices of the Department as to written conclusions based on evidence on file at the time the veteran is notified of the decision. 38 C.F.R. § 3.104(a) (1999). Such a decision is not subject to revision on the same factual basis except by a duly constituted appellate authority. Id. The appellant has one year from notification of a decision of the agency of original jurisdiction to file a notice of disagreement (NOD) with the decision, and the decision becomes final if a NOD is not filed within that time. 38 U.S.C.A. § 7105(b) and (c) (West 1991); 38 C.F.R. §§ 3.160(d) and 20.302(a) (1999). A letter from the RO, advising the appellant of the August 1983 decision and of appellate rights and procedures, was issued in August 1983. He did not disagree with that decision; therefore, it is final. 38 U.S.C.A. § 7105 (West 1991). In January 1996, the appellant filed a claim for service connection for anxiety and depression. In order to reopen a claim which has been previously denied and which is final, the claimant must present new and material evidence. 38 U.S.C.A. § 5108 (West 1991). New and material evidence means evidence not previously submitted to agency decisionmakers which bears directly and substantially upon the specific matter under consideration, which is neither cumulative nor redundant, and which by itself or in connection with evidence previously assembled is so significant that it must be considered in order to fairly decide the merits of the claim. 38 C.F.R. § 3.156(a) (1999); see also Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). The claimant does not have to demonstrate that the new evidence would probably change the outcome of the prior denial. Rather, it is important that there be a complete record upon which the claim can be evaluated, and some new evidence may contribute to a more complete picture of the circumstances surrounding the origin of a claimant's injury or disability. Hodge, 155 F.3d at 1363. When presented with a claim to reopen a previously finally denied claim, VA must perform a three-step analysis. Elkins v. West, 12 Vet. App. 209 (1999). First, it must be determined whether the evidence submitted by the claimant is new and material. Second, if new and material evidence has been presented, it must be determined, immediately upon reopening the claim, whether the reopened claim is well grounded pursuant to 38 U.S.C. § 5107(a) based upon all the evidence and presuming its credibility. There is no duty to assist in the absence of a well-grounded claim. Epps v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997) cert. denied, sub nom. Epps v. West, 118 S.Ct. 2348 (1998). See also Winters v. West, 12 Vet. App. 203 (1999). Third, if the reopened claim is well grounded, VA may evaluate the merits of the claim after ensuring that the duty to assist under 38 U.S.C. § 5107(b) has been fulfilled. In the rating decision on appeal, the RO adjudicated this issue according to the definition of material evidence enunciated in Colvin v. Derwinski, 1 Vet. App. 171 (1991) ("a reasonable possibility that the new evidence, when viewed in the context of all the evidence, both new and old, would change the outcome" of the final decision). The Federal Circuit in Hodge declared this definition of material evidence invalid. Therefore, the determination as to whether the appellant has submitted new and material evidence to reopen this claim will be made pursuant to the definition of new and material evidence contained in 38 C.F.R. § 3.156(a), as discussed above. It is not necessary to remand this claim because no prejudice to the appellant results from the Board's consideration of this claim. He was provided notice of the applicable laws and regulations regarding new and material evidence, including 38 C.F.R. § 3.156. See Bernard v. Brown, 4 Vet. App. 384 (1993). Furthermore, the Board's review of this claim under the more flexible Hodge standard accords the appellant a less stringent "new and material" evidence threshold to overcome. Service connection means that the facts, shown by the evidence, establish that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated during service. 38 U.S.C.A. §§ 1110 and 1131 (West 1991); 38 C.F.R. § 3.303(a) (1999). It is the responsibility of a person seeking entitlement to service connection to present a well-grounded claim. 38 U.S.C.A. § 5107 (West 1991). Generally, a well-grounded claim is a "plausible claim, one which is meritorious on its own or capable of substantiation." Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). In order to be well grounded, a claim for service connection must be accompanied by supporting evidence that the particular disease, injury, or disability was incurred in or aggravated by active service; mere allegations are insufficient. Tirpak v. Derwinski, 2 Vet. App. 609, 610-611 (1992); Murphy, 1 Vet. App. at 81. In general, the appellant's evidentiary assertions are accepted as true for the purpose of determining whether a well-grounded claim has been submitted. King v. Brown, 5 Vet. App. 19, 21 (1993). A claim for service connection requires three elements to be well grounded. It requires competent (medical) evidence of a current disability; competent (lay or medical) evidence of incurrence or aggravation of disease or injury in service; and competent (medical) evidence of a nexus between the in- service injury or disease and the current disability. Epps v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997), cert. denied, sub nom. Epps v. West, 118 S.Ct. 2348 (1998); Caluza v. Brown, 7 Vet. App. 498, 506 (1995); aff'd 78 F.3d 604 (Fed.Cir. 1996) (table). The evidence received subsequent to August 1983 is presumed credible for the purposes of reopening the appellant's claim unless it is inherently false or untrue, or it is beyond the competence of the person making the assertion. Duran v. Brown, 7 Vet. App. 216, 220 (1995); Justus v. Principi, 3 Vet. App. 510, 513 (1992). See also Robinette v. Brown, 8 Vet. App. 69, 75-76 (1995). Since August 1983, the following evidence has been received: (1) the appellant's contentions, including those raised at a personal hearing in October 1999; (2) VA outpatient records for treatment between 1986 and 1999; (3) reports of VA examinations conducted in 1986 and 1998; (4) service medical records; (5) a report from Kodiak Island Mental Health Center dated in 1979; (6) private records from Carraway Methodist Hospital and Jackson County Hospital dated between 1996 and 1999; and (7) a report of psychiatric evaluation dated in May 1991. With the exception of some copies of service medical records that were previously associated with the claims file, the rest of the evidence received since 1983 is new in that it was not previously of record. It is necessary, therefore, to decide if this evidence is material. To be material, it must be (a) relevant in that it bears directly and substantially on the matter under consideration, and (b) so significant, either by itself or with other evidence, that it must be considered in order to fairly decide the claim. See 38 C.F.R. § 3.156(a) (1999). The Board concludes that the appellant has submitted material evidence concerning his claim for service connection for a psychiatric disorder. The basis of the RO's denial in 1983 was that there was no evidence showing that the appellant had an acquired psychiatric disorder, as opposed to disorders of congenital or developmental origin. New evidence has been obtained that shows diagnosis of acquired psychiatric disorders (i.e., major depression and anxiety disorder). This evidence bears directly and substantially on the specific matter under consideration (i.e., entitlement to direct service connection), and it is sufficiently significant that it must be considered in order to fairly decide the merits of the claim. 38 C.F.R. § 3.156(a) (1999). Accordingly, the Board concludes that this evidence is new and material evidence, and the claim for service connection for an acquired psychiatric disorder must be reopened. Despite the additional evidence, the reopened claim is not well grounded. See Elkins. There is evidence of a current disability, in that diagnoses of acquired psychiatric disorders have been rendered (anxiety disorder in 1991 and major depression in 1997). The appellant's service medical records showed treatment in 1979 for complaints such as depression, personality conflicts, loneliness, and suicidal ideations. It was initially determined that he had a personality disorder, either a mixed-type character disorder or a personality disorder with paranoid, schizoid, and obsessive-compulsive traits. In 1980, he had sudden onset of decreased functioning. It was determined that recent stress had to led to decompensation of "this severely characterologically impaired young man," and it was expressly determined that he did not have a psychiatric disorder treatable with medication. The diagnosis of mixed- type personality disorder was refined to a new classification of schizotypical personality disorder. It was for this condition that he was discharged from service. Even if the Board accepts the appellant's inservice complaints as evidence of incurrence of a disease during service, there is no medical evidence of a nexus, or link, between any inservice disease or injury and any current acquired psychiatric disorder. The post-service medical evidence does not show diagnosis of an acquired psychiatric disorder until 1991, more than 10 years after his discharge from service. There is no evidence showing that the appellant had a chronic psychiatric disorder prior to that time, and the medical evidence indicates that he has been receiving psychiatric treatment only since 1990. At no time has a medical professional indicated that any of the appellant's post-service acquired psychiatric disorders are in any manner related to his military service or began during service. In fact, the recent medical evidence suggests that all of the appellant's "problems" date to a closed head injury that he received in 1988. The only evidence linking the appellant's current psychiatric disorders to his military service consists of his current statements. Even accepting his statements as true, he cannot meet his initial burden under 38 U.S.C.A. § 5107(a) by simply presenting his own opinion. He does not have the medical expertise to render a probative opinion as to medical diagnosis or causation. See Edenfield v. Brown, 8 Vet. App. 384, 388 (1995); Robinette v. Brown, 8 Vet. App. 69, 74 (1995); Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). Therefore, the Board concludes that this claim is not well grounded. Until the appellant establishes a well-grounded claim, VA has no duty to assist him in developing facts pertinent to the claim, including providing him a medical examination at VA expense. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.326(a) (1999) (VA examination will be authorized where there is a well-grounded claim for compensation); see Morton v. West, 12 Vet. App. 477 (1999) (VA cannot assist a claimant in developing a claim that is not well grounded). When a claimant refers to a specific source of evidence that could make his claim plausible, VA has a duty to inform him of the necessity to submit that evidence to complete his application for benefits. See Epps v. Brown, 9 Vet. App. 341, 344-45 (1996), aff'd Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997). VA has no outstanding duty in this case to inform the appellant of the necessity to submit certain evidence to complete his application for VA benefits. See 38 U.S.C.A. § 5103(a) (West 1991). There is no indication of any medical records that might well ground this claim. The appellant has not alleged that any medical records exist that would contain medical opinions associating the claimed psychiatric disorder with his period of service. The Board notes that the basis of the RO's denial of this claim was that new and material evidence had not been submitted, and the RO did not, therefore, consider whether this claim was well grounded. When the Board addresses an issue that was not addressed by the RO, consideration must be given to whether the appellant will be prejudiced by the Board's consideration of the issue in the first instance. See Bernard v. Brown, 4 Vet. App. 384, 391 (1993). The relevant statutes and regulations regarding service connection were not included in the statement of the case, and the appellant did not specifically present argument as to the merits of his claim. However, his due process rights are not violated by this Board decision. When a claim is reopened on the basis of new and material evidence, if it is clear from the evidence that the reopened claim is not well grounded, then there is no way as a matter of law that the appellant could prevail. Winters, 12 Vet. App. at 208. In such a situation, a remand for the RO to determine that the claim is not well grounded would simply serve to impose an unnecessary burden with no gain to the appellant. Id., citing Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991) (strict adherence to requirements in the law does not dictate an unquestioning, blind adherence in the face of overwhelming evidence in support of the result in a particular case; such adherence would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran are to be avoided); cf. Brady v. Brown, 4 Vet. App. 203, 207 (1993) (a remand is unnecessary even where there is error on the part of VA, where such error was not ultimately prejudicial to the veteran's claim). In this case, the lack of medical nexus evidence is clear and indisputable, and it is not necessary to remand this claim. The presentation of a well-grounded claim is a threshold issue. Therefore, since the appellant has failed to present competent medical evidence that his claim for service connection for an acquired psychiatric disorder is plausible, the claim must be denied as not well grounded. Dean v. Brown, 8 Vet. App. 449 (1995); Boeck v. Brown, 6 Vet. App. 14, 17 (1993). There is no duty to assist further in the development of this claim, because such additional development would be futile. See Murphy, 1 Vet. App. 78. ORDER As new and material evidence has been received to reopen the appellant's claim for service connection for an acquired psychiatric disorder, the claim is reopened, and, to that extent, the appeal is granted. Entitlement to service connection for an acquired psychiatric disorder is denied. REMAND Additional evidentiary development and due process are needed prior to further disposition of the appellant's claim for an increased rating for his back condition. Subsequent to the supplemental statement of the case (SSOC) of July 1998, the RO received the appellant's treatment records from Jackson County Hospital and the VA Medical Center (VAMC) in Birmingham. If the statement of the case or SSOC was prepared before the receipt of additional evidence, a SSOC will be furnished to the appellant as provided in 38 C.F.R. § 19.31 unless the additional evidence is duplicative or not relevant to the issue on appeal. 38 C.F.R. § 19.37(a) (1999). In this case, this evidence was not duplicative of evidence already associated with the claims file, and it was certainly relevant to the back claim on appeal since it showed current objective findings regarding the appellant's service-connected back disability. Therefore, in accordance with 38 C.F.R. § 19.37(a), this claim is returned to the RO for consideration and the issuance of a SSOC. The appellant has indicated that he has received treatment at the VAMCs in Houston, Tuscaloosa, and Birmingham. The only VA records associated with the claims file have been submitted by the appellant. VA records are considered part of the record on appeal since they are within VA's constructive possession, and these records must be considered in deciding the appellant's claim. See Bell v. Derwinski, 2 Vet. App. 611, 613 (1992). Therefore, the RO must obtain the appellant's VA records. The appellant has also referenced treatment from Drs. Ted Wallace and David Marrick and American Family Care Facility. The appellant should be asked to submit releases for his actual treatment records and those should be requested. If any request is unsuccessful, the appellant should be informed that any records concerning treatment for his back condition would be relevant to his claim for an increased rating. It is important that his actual treatment records be presented. He should be told that it is his responsibility to present evidence in support of his claim, and he should be offered an opportunity to obtain and present such records if he wants them to be considered in connection with his claim. 38 C.F.R. § 3.159(c) (1999); see also 38 U.S.C.A. § 5103(a) (West 1991). The claims file shows that the appellant is receiving Social Security disability benefits. It is unknown whether this is based, in any part, on his service-connected back condition. Therefore, the RO should request all medical and adjudication records relating to the veteran's Social Security disability benefits. See Hayes v. Brown, 9 Vet. App. 67, 74 (1996) (VA is required to obtain evidence from the Social Security Administration, including decisions by the administrative law judge, and give the evidence appropriate consideration and weight). The appellant underwent a VA physical examination in March 1998 for his service-connected back disorder. The report of that examination is inadequate because it does not provide sufficient information for the Board to determine the current degree of impairment resulting from the appellant's back disorder. First, the majority of the examination report is comprised of answers to a specific series of questions to which the Board does not have access. There is a significant amount of information contained in those answers that can only be interpreted by reference to the questions. Since the Board does not have access to those specific questions, it is impossible to interpret the findings from the 1998 VA examination. The Board does not, therefore, have sufficient medical evidence upon which to decide the appellant's claim. On remand, the RO should obtain a comprehensive report of the March 1998 VA examination that includes the questions to which the examiner was responding. Second, although it was noted that the appellant has flare-ups, it is not clear from the examination report whether the appellant has any additional functional loss due to pain on use or during flare-ups. This information is necessary to evaluate his service-connected back condition, and he should be provided another VA physical examination to ensure that the duty to assist him has been fulfilled. Accordingly, this case is REMANDED for the following: 1. Ask the appellant to submit appropriate release forms for his treatment records from Drs. Marrick and Wallace and American Family Care Facility, as well as any other private physician that has recently treated him for his back condition. Request actual treatment records from these medical professionals and any other physician referenced by the appellant. If any request for medical records is unsuccessful, advise the appellant that his actual treatment records are important to his claim, and that it is his responsibility to submit them. See 38 C.F.R. § 3.159(c) (1999). Allow him an appropriate period of time within which to respond. 2. Obtain and associate with the claims file the appellant's medical records from (a) the VA Medical Center in Houston for all treatment from 1980 to 1994; (b) the VA Medical Center in Birmingham for all treatment from 1982 to the present; and (c) the VA Medical Center in Tuscaloosa for all treatment from 1982 to the present. 3. Obtain a comprehensive report of the March 1998 VA physical examination from the VA Medical Center in Birmingham. The RO should make sure that the report contains the specific questions that prompted the examiner's responses in the original examination report. 4. Request the appellant's medical and adjudication records from the Social Security Administration. The letter requesting such records should include a citation to appropriate legal authority requiring that other Federal agencies provide such information as the Secretary may request for the purposes of determining eligibility for or amount of benefits. See 38 U.S.C.A. § 5106 (West 1991). Associate all correspondence and any records received with the claims file. 5. After obtaining as many of the above records as possible and/or allowing the appellant an opportunity to submit such records, schedule him for an appropriate VA examination to evaluate the severity of his service-connected back condition. It is very important that the examiner be provided an opportunity to review the claims folder and a copy of this remand prior to the examination. The examiner should indicate in the report that the claims file was reviewed. The examiner must provide a complete rationale for all conclusions and opinions. All necessary tests and studies should be conducted in order to ascertain the severity of the appellant's service- connected back condition. The examination should include range of motion testing, and all ranges of motion should be reported in degrees. It is requested that the examiner indicate what is normal range of motion for the lumbar spine. All functional limitations are to be identified, including whether there is any pain, weakened movement, excess fatigability or incoordination on movement of the lumbar spine. The examiner should discuss whether there is likely to be additional range of motion loss due to any of the following: (1) pain on use, including during flare-ups; (2) weakened movement; (3) excess fatigability; or (4) incoordination. The examiner is asked to describe whether pain significantly limits functional ability during flare-ups or when the lumbar spine is used repeatedly. If there is no limitation of motion or function, or no objective indications of pain, such facts must be noted in the report. The examiner should elicit information as to precipitating and aggravating factors (i.e., movement or activity), and the effectiveness of any pain medication or other treatment for relief of pain. The examiner should discuss the effect the appellant's service-connected back disability has upon his daily activities. See DeLuca v. Brown, 8 Vet. App. 202 (1995). 6. Following completion of the above, review the claims folder and ensure that the examination report includes fully detailed descriptions of all opinions requested. If it does not, it must be returned to the examiner for corrective action. 38 C.F.R. § 4.2 (1999). 7. After completion of the above evidentiary development, readjudicate the appellant's claim for an increased rating for his service-connected back condition, with application of all appropriate laws and regulations and consideration of any additional information obtained as a result of this remand. If the benefit sought on appeal remains denied, provide the appellant and his representative an adequate supplemental statement of the case, which includes consideration of all medical evidence received since the supplemental statement of the case of July 1998, including the VA outpatient records and treatment records from Jackson County Hospital. Allow an appropriate period for response. Thereafter, subject to current appellate procedures, the case should be returned to the Board for further appellate consideration, if appropriate. The appellant has the right to submit additional evidence and argument on the matter that the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). The purposes of this REMAND are to accord due process and obtain additional information. No inference should be drawn regarding the final disposition of this claim as a result of this action. This case must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims 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. 1999) (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. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals