Citation Nr: 0002056 Decision Date: 01/27/00 Archive Date: 02/02/00 DOCKET NO. 98-05 215 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cheyenne, Wyoming THE ISSUES 1. Whether new and material evidence has been submitted to reopen a claim of entitlement to service connection for a cervical spine disorder. 2. Entitlement to a total rating based on individual unemployability due to a service-connected disability. REPRESENTATION Veteran represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD M.S. Lane, Associate Counsel INTRODUCTION The veteran served on active duty from April 1970 to November 1970. This matter comes to the Board of Veterans' Appeals (Board) on appeal from rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO), which determined that new and material evidence had not been submitted to reopen a claim of entitlement to service connection for impairment of the cervical spine and denied entitlement to total rating based on individual unemployability due to a service- connected disability. In October 1998, the RO issued a letter informing the veteran that his appeal was being certified to the Board and that he had 90-days in which to submit additional evidence concerning his claim. Following the expiration of that 90-day period, the veteran submitted two signed statements, the second of which was enclosed with several documents, including a copy of his birth certificate, a copy of his parent's marriage license, a copy of his mother's Certificate of Discharge from the Navy, and a copy of his father's death certificate and Certificate of Discharge from the Navy. Generally, any pertinent evidence submitted by the veteran or his representative which is accepted by the Board must be referred to the agency of original jurisdiction for review and preparation of a supplemental statement of the case unless this procedural right is waived. 38 C.F.R. § 20.1304(c) (1999). In this case, the evidence submitted by the veteran following the expiration of the 90-day period was not accompanied by a waiver of RO consideration. However, after reviewing the evidence submitted by the veteran, the Board believes that with the exception of evidence already associated with the claims folder, such as the veteran's previously stated contentions, the remaining evidence is not "pertinent" to the veteran's claim within the meaning of 38 C.F.R. § 20.1304, as it relates solely to the marriage and military service of the veteran's parents, and to the death of his father. Thus, the Board finds that consideration of this material by the RO pursuant to 38 C.F.R. § 1304 (1999) is not necessary. The Board notes that the issue of entitlement to a total rating based on individual unemployability due to a service- connected disability is discussed in the remand portion of this decision. FINDINGS OF FACT 1. In June 1990, the Board denied a claim of entitlement to service connection for a cervical spine disability. 2. Evidence submitted since the Board's June 1990 decision does not bear directly and substantially upon the specific matter under consideration; is merely cumulative of previously submitted evidence; and is not so significant that it must be considered in order to fairly decide the merits of the claim. CONCLUSION OF LAW Evidence submitted since the Board's final June 1990 decision is not new and material. The veteran's claim of entitlement to service connection a cervical spine disorder is not reopened. 38 U.S.C.A. §§ 5108, 7104 (West 1991); 38 C.F.R. §§ 3.156, 20.1100 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Relevant Law and Regulations Service Connection In general, applicable laws and regulations state that service connection may be granted for disability resulting from a disease or injury incurred in or aggravated by military service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1999). Service connection may be also be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). A preexisting injury or disease will be considered to have been aggravated by active service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C.A. § 1153; 38 C.F.R. § 3.306(a). Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during, and subsequent to service. 38 U.S.C.A. § 1153; 38 C.F.R. § 3.306(b). A veteran will be considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto. Only such conditions as are recorded in examination reports are to be considered as noted. 38 U.S.C.A. § 1111 (West 1991); 38 C.F.R. § 3.304(b) (1999). Finality/new and material evidence In general, Board decisions are final. 38 U.S.C.A. § 7104; 38 C.F.R. § 20.1100. A final decision cannot be reopened unless new and material evidence is presented. Pursuant to 38 U.S.C.A. § 5108, the Secretary must reopen a finally disallowed claim when new and material evidence is presented or secured with respect to that claim. Knightly v. Brown, 6 Vet. App. 200 (1994). Only evidence presented since the last final denial on any basis (either upon the merits of the case, or upon a previous adjudication that no new and material evidence had been presented), will be evaluated in the context of the entire record. Evans v. Brown, 9 Vet. App. 273 (1996). New and material evidence is defined as 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). In Hodge v. West, 155 F.3d 1356, 1363 (Fed. Cir. 1998), the Federal Circuit noted that new evidence could be sufficient to reopen a claim if it could contribute to a more complete picture of the circumstances surrounding the origin of a veteran's injury or disability, even where it would not be enough to convince the Board to grant a claim. In determining whether to reopen previously and finally denied claims, a three-step analysis was recently announced by the United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999) (hereinafter, "the Court"). Elkins v. West, 12 Vet. App. 209 (1999). Under the Elkins test, the Board must first determine whether the veteran has presented new and material evidence under 38 C.F.R. § 3.156(a) (1998) in order to have a finally denied claim reopened under 38 U.S.C.A. § 5108. Second, if new and material evidence has been presented, immediately upon reopening the claim, the Board must determine whether, based upon all the evidence of record in support of the claim, the claim as reopened (as distinguished from the original claim) is well grounded pursuant to 38 U.S.C.A. § 5107(a) (West 1991). Third, if the claim is well grounded, the Board may then proceed to evaluate the merits of the claim but only after ensuring the VA's duty to assist under 38 U.S.C.A. § 5107(b) (West 1991) has been fulfilled. Winters v. West, , 12 Vet. App. 203 (1999). For the purpose of establishing whether new and material evidence has been submitted, the credibility of the evidence, although not its weight, is to be presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). Factual Background Previously submitted evidence Treatment records dated in January 1970 from Ruidoso-Hondo Valley General Hospital and Gerald Champion Memorial Hospital reflect that the veteran was injured in a logging accident after a rubber tire skidding machine overturned and pinned the veteran underneath. He was subsequently treated for a cerebral concussion and multiple abrasions of the left upper extremity, left trunk, and both lower extremities. X-rays of the cervical spine reportedly revealed no evidence of fracture. Some muscle spasm was noted in the lumbar region with some lumbar lordosis noted due to muscle spasm and some pain reported on movement. Upon enlistment in February 1970, the veteran reported no history of any back trouble of any kind and an examiner found the veteran's neck and spine to be normal on examination. Service medical records reflect that in August 1970, the veteran fell down a flight of stairs, and subsequently reported experiencing pain in his low back and left rib area. Physical examination and x-rays were reportedly negative except for some scoliosis in the lower back. Throughout September 1970, the veteran continued to report pain in his lower back. On September 14th, 1970 an examiner noted that the veteran could not flex his spine to any extent, but noted possible "voluntary resistance of part of patient." The veteran was diagnosed with possible lumbosacral strain and malingering. On September 28th, the veteran was evaluated by a psychiatrist. The psychiatrist noted that the veteran claimed to have severe pain in his lower back and legs that prevented him from carrying out his duties. The psychiatrist further noted that the veteran had refused to return to training and was presently doing details in the company area pending completion of a Congressional Inquiry. The psychiatrist indicated that according to the Orthopedics Department, the veteran's concern regarding a back injury was "unwarranted." Upon examination, the psychiatrist found that the veteran's thought content showed a marked preoccupation with his alleged injury. The psychiatrist found that the veteran's concern over his injury appeared to be interfering with his functioning as a trainee, but that there was no evidence that he was psychiatrically unfit for duty. The psychiatrist diagnosed the veteran with hypochondriasis. A report of physical examination dated in October 1970 shows that the veteran was discharged on the basis of unsuitability. The examiner noted a diagnosis of hypochondriasis and indicated that the veteran's spine and neck were normal upon examination. In a report of medical history completed at discharge, the veteran reported a history of back trouble and indicated that he was unable to perform certain motions due to his back pain. On October 20th, 1970, an examiner noted that the veteran had been seen by numerous doctors for back pain, without any specific objective pathological findings ever being reported. The examiner found that his examination had been no different and that he was unable to obtain any positive findings. In a rating decision dated in March 1971, the RO granted service connection for the residuals of lumbosacral strain. VA orthopedic examinations conducted between October 1975 and February 1987 reflect ongoing complaints of low back pain accompanied by pain and numbness in the left leg. These examination reports are negative for any complaints or findings regarding the veteran's neck or cervical spine. During a February 1987 VA examination, x-rays of the cervical spine reportedly revealed good alignment, and that vertebral bodyheights and intervertebral disc spaces were well maintained. No evidence of fracture of subluxation was found. The veteran was diagnosed with the residuals of an injury to the lumbar spine with chronic strain. In November 1988, the veteran was examined by Dr. P.E., a private physician. Upon examination, Dr. P.E. noted that full cervical range of motion was present with no pain on axial compression. X-rays of the cervical spine reportedly revealed mild osteophyte formation, and minimal foraminal narrowing at C3-4 and at C6-7 with a small lateral osteophyte visible at C6-7. The veteran was diagnosed with mild cervical spondylosis with minimal changes at C3-4 and C6-7. In March 1989, the veteran filed a claim of entitlement to service connection for a cervical spine injury. He contended that he experienced a cervical spine injury prior to entering active duty and that this injury had been aggravated when he fell down a flight of stairs in service. The veteran subsequently submitted copies of his January 1970 treatment at Ruidoso-Hondo Valley General Hospital and Gerald Champion Memorial Hospital, which he contended proved the existence of a pre-service injury. During an April 1989 VA physical examination, the veteran again reported that he fallen down a flight of stairs in service, which aggravated a low back condition. The VA examiner reviewed the veteran's cervical spine x-rays but noted that his pain was restricted to his low back. The report of examination is negative for any complaints or findings regarding the veteran's cervical spine. In a signed statement submitted in May 1989, the veteran contended that 90 days prior to his entry into active service, he was involved in an accident that caused "damage to C3-4 C6-7 mild cervical spondylosis." He enclosed a signed statement from T.M., who indicated that he witnessed the January 1970 accident in which the veteran was pinned under the rear tire of a machine and that he was the individual who took the veteran to the hospital. In June 1989, the veteran was evaluated by Dr. W.C.R., a private physician. Dr. W.C.R. found that the veteran was possibly "10% disabled although this is very subjective." Dr. W.C.R. further found that due to the subjective nature of the veteran's complaints, it was quite possible that he had no disability with regard to his low back, although he reportedly did have significant disability with regards to "other areas of his back." The Board's June 1990 decision In June 1990, the Board denied the veteran's claim of entitlement to service connection for a cervical spine disability. The Board found that the record failed to demonstrate the existence of a preexisting cervical spine injury, and that although the veteran was treated in service for low back problems, there was no evidence in his service medical records of any complaints, treatment, or diagnoses related to his cervical spine. The Board further found that the first evidence of any cervical spine disability was dated many years after his discharge, and that there was no competent medical evidence relating this disability to any trauma sustained during service. The Board concluded that in the absence of any evidence of a cervical spine disability prior to entrance into service, and because such disability was not demonstrated either during service or for many years subsequent to service, service connection for a cervical spine disability was not warranted. Newly submitted evidence X-rays of the cervical spine taken in November 1994 reportedly revealed generalized osteoporosis. The vertebral body height was reportedly reserved and marked narrowing of the C6-7 interspace was found with practically complete disappearance of the interarticular space and minor osteophyte formation anteriorly at this level. The VA radiologist noted an impression of degenerative changes involving the cervical spine. VA outpatient records dated between April 1995 and August 1995 are negative for any complaints and treatment regarding the veteran's neck or cervical spine. In August 1995, the veteran again raised a claim of entitlement to service connection for a cervical spine disability. He contended that his osteoporosis of the cervical spine and the disappearance of a disc between C6 and C7 were causing him problems. The veteran also asserted that the accusation of hypochondriasis in his service medical records was unjust because there has since been enough medical evidence submitted to show that his back disabilities were real. With his statement, the veteran enclosed additional duplicates of the January 1970 hospital records from the Ruidoso-Hondo Valley General Hospital and the Gerald Champion Memorial Hospital. The veteran also enclosed a memorandum from the Department of the Army showing that they could find no basis for correction of the veteran's service medical records as he had requested. During a VA orthopedic examination conducted in September 1995, the veteran reported chronic severe low back pain. The report of examination is negative for any complaints or findings regarding the veteran's neck or cervical spine. In June 1996, the veteran reiterated previous contentions to the effect that a pre-service injury of the cervical spine had been aggravated by service. He submitted additional duplicates of his January 1970 hospital records, as well as duplicates of VA and private examination reports that were already on record prior to the Board's June 1990 decision. During a VA orthopedic examination conducted in October 1996, the veteran again reported that 90 days prior to service, he was in an accident in which a heavy weight fell on his neck and back. He further reported that he had experienced increasing pain in his neck and back since discharge. Examination of the cervical spine revealed no visible abnormalities, and dermatone evaluation of the upper extremities revealed no sensory deficits. The VA examiner noted that x-rays of the cervical spine taken in October 1996 reportedly revealed loss of intervertebral disc height and signal intensity at the C6-7 level. Some mild uncovertebral hypertrophy and anterior and posterior vertebral body spurring was also noted at the C6-7 level with mild bilateral neuroforaminal narrowing. The veteran was diagnosed with symptomatic early osteoarthritis of the cervical spine. Between March 1997 and February 1999, the veteran continued to submit additional copies of his January 1970 hospital records. The veteran also continued to submit additional copies of VA and private treatment records already of record. During a VA physical examination conducted in March 1998, the veteran again reported chronic back pain since 1970. The veteran was diagnosed with chronic back pain with mild degenerative joint disease. No specific complaints or findings were noted regarding the veteran's neck or cervical spine. In July 1998, the veteran was provided with a personal hearing at the RO. He testified that in January 1970, the incident involving the rubber tire skidding machine had resulted in injury to his back and neck. He further testified that this injury was later aggravated when he fell down a flight of stairs in service. The veteran indicated that he did not receive any treatment for his neck during service and that the first treatment he received for his neck had been with chiropractors shortly thereafter. In support of his claim, the veteran submitted a statement from Dr. J.F.R., who found that the veteran had marked degenerative disc disease of the cervical spine with some lysthesis of C6 forward on C7. Between November 1998 and February 1999, the veteran submitted several statements in which he restated his contention that he had injured his neck in 1970 and that this injury had been aggravated by his service in the military. Analysis Finality In June 1990, the Board denied the veteran's claim of entitlement to service connection for a cervical spine disability. That decision is final. 38 U.S.C.A. § 7104; 38 C.F.R. § 20.1100; see also Evans, 9 Vet. App. at 285. In order to reopen the claim, new and material evidence must have been submitted. 38 U.S.C.A. § 5018; 38 C.F.R. § 3.156. After reviewing the record, the Board is of the opinion that new and material evidence has not been submitted sufficient to reopen the veteran's claim of entitlement to service connection for a cervical spine disorder. In June 1990, the Board denied the veteran's claim on the basis that his statements and pre-service medical records failed to demonstrate the existence of a preexisting cervical spine disability, and that there was no evidence in his service medical records of any complaints, treatment, or diagnoses related to the cervical spine. The Board further concluded in its decision that the first evidence of a cervical spine disability was dated many years after his discharge, and that there was no competent medical evidence relating this disability to any trauma sustained during service. At the time of the Board's June 1990 decision, the evidence of record included the veteran's January 1970 hospital records, which noted treatment for a multiple lacerations, lumbar lordosis, and a cerebral concussion following a logging accident but no cervical; spine injury; service medical records which were negative as to cervical spine pathology; a November 1988 VA radiology report showing mild osteophyte formation in the cervical spine, and minimal foraminal narrowing at C3-4 and at C6-7; and the veteran's own contentions that he had suffered an injury to the cervical spine in January 1970 that was aggravated when he fell down a flight of stairs in service. Prior to the Board's 1990 decision, the veteran had also submitted lay testimony regarding his pre-service logging accident. Since filing to reopen his claim, the veteran has submitted virtually identical statements to those submitted in his previous claim in which he contended that his cervical spine disability was aggravated by service. He has also submitted VA and private treatment records reflecting diagnoses of osteoporosis and osteoarthritis of the cervical spine. However, he has submitted no additional evidence showing the existence of a preexisting injury, and no competent medical evidence demonstrating that his current cervical spine disability was either caused by or aggravated during his military service. Regarding the veteran's claim that he injured his neck prior to entering service, the Board wishes to note that it is cognizant of the Court's holding in Justus; that for the purpose of establishing whether new and material evidence has been submitted, the credibility of the evidence, although not its weight, is to be presumed. Justus, 3 Vet. App. at 513. However, the veteran's statements regarding his logging accident are identical to statements submitted during his previous claim. He has submitted duplicate copies of the January 1970 hospital records. It was based on this evidence that the Board concluded in its June 1990 decision that the veteran had failed to show the existence of a preexisting injury. At that time, the Board determined that the January 1970 records in fact revealed no evidence of any injury to his cervical spine following his logging accident, but rather that he had in fact been treated solely for lumbar lordosis, multiple lacerations, and a cerebral concussion. Thus, because the additional evidence submitted by the veteran consists of copies of the previously submitted January 1970 hospital records accompanied by virtually identical contentions regarding a preexisting injury, the Board finds that this additional evidence is merely cumulative of previously submitted evidence, and is therefore not so significant that it must be addressed in order to fairly decide the merits of the claim. Furthermore, regarding the veteran's claim that his cervical spine disability was either caused by and aggravated during his military service, the Board notes there is no evidence that the veteran possesses the requisite medical training are expertise necessary to render him competent to offer evidence on matters such as medical diagnosis or medical causation. In Moray v. Brown, 5 Vet. App. 211 (1993), the Court noted that lay persons are not competent to offer medical opinions and that such evidence does not provide a basis on which to reopen a claim for service connection. In Routen v. Brown, 10 Vet. App. 183, 186, (1997), the Court specifically stated: "[l]ay assertions of medical causation . . . cannot suffice to reopen a claim under 38 U.S.C. 5108." Although the veteran has submitted additional VA and private medical records, the records merely reflect recent treatment for his cervical and lumbar spine disorders. There is no indication in these records that any competent medical examiner has ever related the veteran's cervical spine disorder to service or ever determined that his cervical spine disorder was aggravated by such service. Therefore, because the veteran himself is not competent to provide such testimony, the Board finds that both the veteran's statements in this regard and his recently submitted treatment records do not bear directly and substantially upon the specific matter under consideration, and are not so significant that they must be considered in order to fairly decide the merits of the claim. In short, to date the veteran has submitted no additional evidence regarding a preexisting injury, and no competent medical evidence showing that his cervical spine disorder was caused by or aggravated during his military service. Therefore, the Board finds that the additional evidence which was submitted by the veteran as to these matters, consisting primarily of his own statements and previously submitted medical records, is merely cumulative of previously submitted evidence, does not bear directly and substantially upon the specific matter under consideration, and is not so significant that they must be considered in order to fairly decide the merits of the claim. Accordingly, the Board finds that new and material evidence has not been submitted, and the claim is not reopened. The benefit sought on appeal remains denied. Additional Matter When a claim is not well grounded, the VA does not have a statutory duty to assist a veteran in developing facts pertinent to his claim. 38 U.S.C.A. § 5107(a). However, the VA may be obligated to advise the claimant of the evidence needed to complete the application. This obligation depends upon the particular facts of the case and the extent to which the VA has previously advised the claimant of the evidence necessary to be submitted with a VA benefits claim. See Robinette v. Brown, 8 Vet. App. 69 (1995). In Graves v. Brown, 8 Vet. App. 522 (1996), the Court extended the Robinette analysis to situations, such as the instant case, in which new and material evidence is needed to complete an application for VA benefits. The Court in Graves held as follows: . . .when a veteran has made an application to reopen a claim and the Secretary is on notice of evidence which may prove to be new and material but has not been submitted with the application, the Secretary has a duty under section 5103 to inform the claimant of the evidence that is "necessary to complete the application." 8 Vet. App. at 525. By this decision, the Board informs the veteran of the type of evidence needed to reopen his claim for service connection. ORDER New and material evidence not having been submitted, the claim of entitlement to service connection for a cervical spine disorder is denied. REMAND The veteran is seeking entitlement to a total rating based on individual unemployability due to a service-connected disability. He essentially contends that he is unable to maintain gainful employment due to his service-connected lumbosacral strain. The Board observes that the veteran's lumbosacral strain is currently rated as 20 percent disabling and that this is his only service-connected disability. Initially, the Board concludes that the veteran's claim is well grounded within the meaning of the statutes and judicial construction. See 38 U.S.C.A. § 5107(a) (West 1991). When a veteran claims that he has suffered an increase in disability, or that the symptoms of his disability are more severe than is contemplated by the currently assigned rating, that claim is generally considered well grounded. Bruce v. West, 11 Vet. App. 405, 409 (1998); Proscelle v. Derwinski, 2 Vet. App. 629, 631-632 (1992). Having found the claim to be well grounded, VA has a duty to assist the veteran in the development of facts pertinent to his claim. See 38 U.S.C.A. § 5107(a). In accordance with this duty, and for the reasons and bases set forth below, the Board finds that further evidentiary development is necessary before the veteran's claim can be properly adjudicated. In January 1998, the veteran submitted a letter from the Division of Vocational Rehabilitation showing that he was being considered for eligibility in a vocational rehabilitation program. The Board notes that the veteran's vocational rehabilitation file is not associated with claims folder and it does not appear that such file was requested. Because the veteran is claiming that he is unable to obtain employment due to his lumbosacral strain, the Board finds that a review of the veteran's vocational rehabilitation file would be helpful in evaluating his claim. During his July 1998 personal hearing, the veteran testified that the Social Security Administration had recently denied his claim for disability benefits from that agency. He further testified that he intended to appeal that agency's decision. Because the complete records used by that agency in reaching their decision may contain additional information pertinent to the veteran's claim, the Board finds that the RO should obtain the veteran's Social Security file. See Murincsak v. Derwinski, 2 Vet. App. 363, 372 (1992) [VA's duty to assist includes obtaining records from SSA and giving appropriate consideration and weight to such evidence in determining whether to award or deny VA disability compensation benefits]. Decisions of the Board must be based on all of the evidence which is known to be available. 38 U.S.C.A. § 7104(a) (West 1991 & Supp. 1999). The record reflects that in January 1995, the veteran completed a "Notice of Accident" form for the Worker's Compensation Administration. This notice reflects that the veteran injured himself on the job after lifting a 25-pound container of popcorn cooking oil. However, there is no indication in this form as to whether the veteran was claiming that he suffered an injury and no indication in the record as to whether he subsequently filed a formal claim for worker's compensation benefits. The RO should determine whether such a claim was filed and, if so, the records pertaining to his worker's compensation claim should be obtained. In January 1998, the veteran submitted a document showing that he had been awarded benefits from a government assistance program in November 1995 based on a finding that he was "permanently disabled." The Board notes that the precise nature of this program is unclear from this document, as is the basis for the determination that the veteran was permanently disabled. Thus, the Board finds that while this case is in remand status, the RO should attempt to determine what agency promulgated this decision. Once the nature of the benefits involved has been determined, if necessary, the RO should then obtain the records used by that agency in reaching their conclusion. In addition, the Board finds that a VA social and industrial survey would also be helpful in order to determine if the veteran is unable to secure or maintain gainful employment as a result of his service-connected lumbosacral strain. Accordingly, this case is remanded for the following actions: 1. The RO should contact the veteran and request that he identify all VA or non-VA medical care providers who have treated him for his service-connected lumbosacral strain since December 1997. After securing any necessary releases, the RO should obtain copies of all treatment records referred to by the veteran which have not been previously obtained. Regardless of the veteran's response, the RO should obtain any available VA treatment records that may be pertinent to his claim. These records should then be associated with the claims file. 2. The RO should obtain the veteran's VA vocational rehabilitation folder, to include copies of all decisions, reports and records considered in making determinations as to the veteran's eligibility for vocational rehabilitation. 3. The veteran should also be asked to provide specific information regarding any claims for worker's compensation benefits in connection with his employment at Sierra Cinema. He must provide a written release for all employment records from that company, including all employment health records, documentation pertaining to any claim for worker's compensation benefits, and all clinical records created pursuant to any injuries claimed to have resulted from employment with that company, as well as any documents on file with the appropriate state agency. After securing the necessary releases, the RO should attempt to obtain copies of the records identified by the veteran, including, if possible, a copy of the decision regarding his worker's compensation claim. The RO should clearly document all efforts undertaken to obtain these records and associate any additional records obtained with the claims file. 4. The veteran should also be asked to provide specific information regarding the November 1995 award of government assistance benefits. He must provide a written release for all records used by the agency who awarded such benefits. After securing the necessary releases, the RO should attempt to obtain copies of the records identified by the veteran 5. The RO should contact the Social Security Administration and obtain any medical records or other documentary evidence that were used by that agency in deciding the veteran's claim for benefits, including a copy of the decision itself. 6. The veteran should be afforded a VA social and industrial survey to assess his recent employment history and day-to- day functioning. The individual conducting the survey should express an opinion with complete rationale as to the impact of the veteran's service-connected lumbosacral strain on his ability to secure or follow a substantially gainful occupation. The veteran's claims folder should be made available to the person conducting the survey. The report of the VA social and industrial survey should be associated with the veteran's claims folder. 6. Following completion of the foregoing, the RO should review the claims folder and ensure that all of the foregoing development actions have been completed in full. Then the RO should readjudicate the veteran's claims of entitlement to a total rating based on individual unemployability due to a service-connected disability. If deemed to be appropriate by the RO, additional evidentiary development should be undertaken. If the benefit sought on appeal remains denied, the veteran and his representative should be furnished with copies of a supplemental statement of the case and given an opportunity to respond. Thereafter, the case should be returned to the Board, if in order. The veteran has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim 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. Barry F. Bohan Member, Board of Veterans' Appeals