BVA9502684 DOCKET NO. 93-13 019 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to service connection for residuals of a right hand injury. 2. Entitlement to service connection for chronic headaches. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Richard E. Coppola, Associate Counsel INTRODUCTION The veteran served on active duty from May 1968 to April 1970. This matter came before the Board of Veterans' Appeals (Board) on appeal from a rating decision of June 1992 from the Montgomery, Alabama, Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for residuals of a right little finger and hand injury and chronic headaches. The RO also denied service connection for a psychiatric disorder and a heart condition. The veteran did not appeal the latter determinations. In November 1992, the veteran submitted an informal claim for benefits for right arm disability incurred as a result of VA treatment. In March 1993, the veteran clarified that he was seeking entitlement to benefits in accordance with 38 U.S.C.A. § 1151 (West 1991). This issue is not developed or certified for appeal, and is referred to the RO for appropriate action. REMAND In his application for disability benefits, the veteran claimed service connection for residuals of an injury to the small finger of the right hand. He stated that his right little finger and hand had always felt numb on use since 1969. The service medical records show that he was seen in October 1968 and reported smashing his right fifth finger in a truck latch. Examination revealed avulsed pulpy flesh over the ventral aspect of the middle phalanx. Subsequent X-ray examination was negative for bony abnormalities. He was seen on follow-up approximately three weeks later and complained of pain and numbness in the finger when exposed to cold weather. The remaining service records do not show additional treatment for residuals of that injury, but they do show that he underwent excision of a wart from the fourth finger of the right hand in March 1969. They also show that he was seen for hand pain in September 1969 as a result of an injury sustained in a football game a week earlier. It is not clear from the service medical record which hand was injured. In June 1992, the RO denied service connection for residuals of a right little finger and hand injury. The veteran submitted a notice of disagreement with respect to the denial of service connection for "a little finger injury on the right hand." The statement of the case lists the issue as service connection for a right fifth finger injury. Thereafter, the veteran submitted a statement requesting VA surgical records be obtained in support of his "right hand" disability claim. Although the RO has limited this issue of service connection to residuals of the right fifth finger, it is reasonable to conclude from the veteran's correspondence that he has appealed the denial of service connection for residuals of a right hand injury to include the right fifth finger. In support of his claim for service connection he has submitted additional VA and private medical records dated from June 1992 to May 1993. This evidence includes VA records of hospitalization and surgery for right ulnar nerve entrapment, private medical records of treatment for right ulnar nerve paresis, and electromyography (EMG) and nerve conduction velocity (NCV) studies. Although it appears that the evidence was submitted to the RO, it appears that this evidence was not previously considered by the RO in its denial. The veteran has not waived consideration by the RO of this evidence, see 38 C.F.R. § 20.1304(c) (1993), but the RO will have an opportunity to consider the report because the case will be remanded for additional development. The Board notes that the additional medical records refer to treatment and examination by VA and private examiners whose records are not currently part of the claims folder. The veteran seeks entitlement to service connection for chronic headaches, i.e., migraines. An October 1992 statement from Hamp H. Greene, M.D., which contains a current diagnosis of migraine. Dr. Greene reported that the veteran's medical history revealed classic migraines intermittently. In his application for disability benefits, the veteran reported treatment for migraine headaches by Walter Pugh, M.D., 2900 McGehee Road, Montgomery, Alabama, 36111, from 1971 to the present. He also indicated treatment by Dr. Pettis, Cleveland Avenue, from 1970 to 1971, but indicated that Dr. Pettis was deceased. Although the veteran did not submit treatment reports and the RO did not request copies of these medical records, such records of treatment may provide competent evidence as to continuity of symptoms and render the claim well grounded. Accordingly, his claim may be capable of substantiation on this basis. Under the circumstances, the Board is persuaded that the following development is warranted. Accordingly, the claim is REMANDED for the following actions: 1. The RO should request from the veteran a comprehensive statement identifying all VA and non-VA sources of medical treatment received since separation from active duty for the disabilities at issue, and to furnish signed authorizations for release to the VA of private medical records in connection with each non-VA medical source he identifies. Of specific interest are records of the reported treatment for migraine headaches by Walter Pugh, M.D., 2900 McGehee Road, Montgomery, Alabama, 36111, from 1971 to the present, and Dr. Pettis, Cleveland Avenue, from 1970 to 1971, in the event that records from his practice might still be available. The medical evidence in the claims folder indicates that there were recent EMG and NVC studies conducted by Drs. Miller, Epperson and McPherson; however, this should be clarified by the veteran. Copies of the medical records from all sources he identifies (not already in the claims folder) should then be requested. All records obtained should be added to the claims folder. 2. With the additional information obtained by the RO or provided by the veteran, the RO should make a specific determination, based upon the complete record, with respect to whether or not the veteran has presented a well-grounded claim with regard to either issue. The veteran should be accorded examination with regard to any issue which the RO determines is well grounded. The examiner should be instructed to set forth the history of symptoms as reported by the veteran as well as all pertinent findings. The examiner should express an opinion as to the probability of a relationship between current findings and any injury noted during service if the record does not otherwise establish continuity of symptomatology. The claims folder or copies of all pertinent records should be made available to the examiner for review. The veteran and his representative should then be provided with a supplemental statement of the case, if in order, that includes any additional pertinent law and regulations and a full discussion of the evidence in his case. The appropriate response time should be allowed. The case should be returned to the Board, if in order, after compliance with all regulatory appellate procedures. No action is required of the veteran until he is so informed. The Board intimates no opinion as to the ultimate decision warranted in this case, pending completion of the requested development. CHARLES E. HOGEBOOM 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 deter- mination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This action has been taken in accordance with the Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).