Citation Nr: 0005154 Decision Date: 02/28/00 Archive Date: 03/07/00 DOCKET NO. 96-44 044 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office in Buffalo, New York THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Vietnam Veterans of America WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD Suzie S. Gaston, Counsel INTRODUCTION The veteran had active military service in the Marine Corps from February 1954 to August 1973. He then was a member of the Marine Corps Reserve from August 1973 to November 1977. This matter came before the Board of Veterans' Appeals (hereinafter Board) on appeal from a rating decision of November 1995, by the Buffalo, New York Regional Office (RO), which denied the veteran's claim of entitlement to service connection for PTSD. The notice of disagreement with this determination was received in February 1996. The statement of the case was issued in August 1996. The substantive appeal was received in September 1996. The veteran appeared and offered testimony at a hearing before a hearing officer at the RO in June 1997. A transcript of the hearing is of record. VA treatment reports were received in December 1997. A supplemental statement of the case was issued in December 1997. The appeal was received at the Board in July 1998. The veteran has been represented throughout his appeal by Vietnam Veterans of America, which submitted written argument to the Board in December 1999. After receipt of the claims folder at the Board, additional evidence was received. In particular, a letter from the veteran's brother was received in February 1999. Also received was a letter from the veteran's representative with accompanying medical evidence, received in December 1999. Generally speaking, such evidence will be accepted by the Board, but only if received within 90 days following notification to the veteran of the transfer of the records to the Board, or if good cause for a delay beyond 90 days is shown on motion of the appellant. 38 C.F.R. § 20.1304 (1999). In this case, a June 22, 1998 letter notified the veteran that the case was being transferred to the Board. The evidence thereafter received in February and December 1999, was well after the 90-day period had expired. He has not submitted a motion to demonstrate that there was good cause for his delay in submitting this evidence. Therefore, pursuant to 38 C.F.R. § 20.1304, the Board is precluded from considering the additional evidence in this appeal. However, as this matter must be remanded for the reasons discussed further below, this additional evidence is referred to the RO for their consideration. FINDINGS OF FACT 1. The veteran has contended that he experienced stressors, namely being subject to rocket attacks during his service in Vietnam, and these claimed stressors are presumed to be credible for the purposes of determining whether his claim is well-grounded. 2. There is current medical evidence of a diagnosis of PTSD of record, and this diagnosis is apparently based on the veteran's claimed stressor experiences. CONCLUSION OF LAW The claim of entitlement to service connection for PTSD is well grounded. 38 U.S.C.A. § 5107(a) (West 1991); Caluza v. Brown, 7 Vet. App. 498 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curiam) (table). REASONS AND BASES FOR FINDINGS AND CONCLUSION In Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997), cert. denied sub nom. Epps v. West, 118 S. Ct. 2348 (1998), the United States Court of Appeals for the Federal Circuit (Federal Circuit) held that, under 38 U.S.C. § 5107(a), the Department of Veterans Affairs (VA) has a duty to assist only those claimants who have established well grounded (i.e., plausible) claims. More recently, the United States Court of Appeals for Veterans Claims (Court or CAVC) issued a decision holding that VA cannot assist a claimant in developing a claim which is not well grounded. See Morton v. West, 12 Vet. App. 477 (July 14, 1999), req. for en banc consideration by a judge denied, No. 96-1517 (U.S. Vet. App. July 28, 1999) (per curiam). Once a claimant has submitted evidence sufficient to justify a belief by a fair and impartial individual that a claim is well-grounded, the claimant's initial burden has been met, and VA is obligated under 38 U.S.C. § 5107(a) to assist the claimant in developing the facts pertinent to the claim. Accordingly, the threshold question that must be resolved in this appeal is whether the appellant has presented evidence that the claim is well grounded; that is, that the claim is plausible. In order for a claim to be well grounded, there must be (1) a medical diagnosis of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between an in-service injury or disease and the current disability. Epps, 126 F.3d at 1468; Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (per curiam) (table). Where the determinative issue involves medical causation or etiology, or a medical diagnosis, competent medical evidence to the effect that the claim is "plausible" or "possible" is required. Epps, 126 F.3d at 1468. Further, in determining whether a claim is well-grounded, the supporting evidence is presumed to be true and is not subject to weighing. King v. Brown, 5 Vet. App. 19, 21 (1993). Review of the evidentiary record reflects that the veteran served on active duty from February 1954 to August 1973. The veteran's report of separation from service (DD Form 214) reflects that he received the Good Conduct Medal and his military occupational specialty was identified as a computer programmer. The service medical records, including the enlistment examination of February 1954, as well as the separation examination conducted in March 1973, reflect no complaints, findings or diagnoses of a psychiatric disorder. They are entirely negative for information supporting the veteran's pending claim. The report of a VA compensation examination conducted in September 1991 reflects evaluation of a physical disability; this report does not reflect any complaints or findings of a psychiatric disorder to include PTSD. The veteran's initial claim for service connection for PTSD was received in March 1995. Received in May 1995 were VA treatment records dated from June 1994 to March 1995, which show that the veteran received clinical evaluation and treatment for several disabilities, including a psychiatric disorder diagnosed as PTSD. The records indicate that the veteran was admitted to the hospital in June 1994 for the purpose of being detoxified from alcohol; he underwent a chemical dependence treatment program. The records indicate that the veteran was readmitted into the hospital in January 1995 for the purpose of being detoxified from alcohol. On evaluation, the veteran indicated that he served in Vietnam for a total of 19 months, during which time he was involved in combat and witnessed people getting hit and killed. The veteran indicated that he experienced intrusive and distressing thoughts about Vietnam on a daily basis ever since his discharge from service; he stated that his thoughts involved thinking about when he was fired upon and was almost killed. He noted that he felt anxious when he thought about those things. The veteran stated that he experienced Vietnam combat related nightmares at least once a month; he noted that his last flashback was approximately 2 years ago. The pertinent diagnosis was PTSD; the veteran was admitted into the inpatient PTSD program. The above-cited records reflect that the veteran was admitted to the inpatient PTSD program at the VA Medical Center (VAMC) in Buffalo from March 6 to March 31, 1995. During his period of hospitalization, the veteran reported having severe PTSD symptoms ever since his return from Vietnam, which included sleep difficulty, anger, anxiety, emotional numbing and depression. The veteran denied any prior acute psychiatric admissions, but had been an outpatient in the Copin House Treatment program for substance abuse and PTSD. The veteran denied any suicidal or homicidal ideations; however, he reported that at one time he tried to hang himself when he was incarcerated, and that he overdosed on 2 occasions in the 1970's on cocaine. On mental status evaluation, he was alert and oriented and he was cooperative. His speech was spontaneous; his emotional state was fair. No obvious clinical depression was noted. He denied suicidal or homicidal ideations; no signs of psychosis or mania. Concentration and memory was good; judgment and insight were good. The pertinent diagnosis was PTSD, chronic, severe; he was admitted into the PTSD program. Received in August 1996 was a statement from the veteran, wherein he indicated that he arrived in Vietnam on or about April 30, 1967 and was first assigned to Headquarters, III Marine Amphibious Force, located outside of DaNang; he stated that he was assigned to work in the S-1 section (Personnel). The veteran stated that he was later transferred to the Force Logistic Command a few miles north of DaNang (Red Beach) along Route 1. The veteran reported being under direct enemy fire in the form of frequent rocket attacks; he stated that because of the frequency of those attacks, they were on alert for days at a time. The veteran described an incident during which he thought that he was having a nightmare about a rocket barrage, just to wake up and find himself alone in his hooch in the midst of a real attack; he managed to make it to the bunker, but several hooches were destroyed. The veteran noted that the shock and severity of that attack was extremely frightening to him. The veteran also recalled another incident during which he was caught in the middle of a severe rocket attack on his way back to his quarters after taking a shower; he stated that that was also a frightening event the memory of which has remained with him over the years. At his personal hearing in June 1997, the veteran testified that he was first assigned to third Marine Amphibious Force Headquarters at DaNang; he was subsequently reassigned to the Force Logistics Command outside of DaNang, where he served as a stenographer and chief clerk in the S1 section. The veteran also testified that he was responsible for preparing casualty reports. The veteran acknowledged that he was not directly involved in armed combat and that he never fired a weapon during his tour in Vietnam. The veteran indicated that he was exposed to enemy rocket and mortar fire while at the base. He stated that while he did not recall the specific dates, he remembered an incident when they received word that someone had hit a fuel dump at the airfield; he noted that there was a tremendous explosion that looked a lot like a nuclear explosion. The veteran recalled another incident, which occurred while he was sleeping, and they came under a barrage; he stated that he had to run into the bunker. The veteran also recalled an incident during which he was caught in the middle of a rocket attack on his way from the showers; he was very afraid of being killed while naked. The veteran indicated that he used to experience recurrent nightmares involving Vietnam and flashbacks, which resulted in three failed marriages. The veteran related that he self medicated with alcohol; however, he subsequently became involved in the Narcotics Anonymous program and only associates with people in that program. The veteran indicated that he did not receive any psychiatric treatment during service or within the year following his discharge from active duty. Of record is an Environmental Support Group (ESG) worksheet, wherein the veteran indicated that he served with the 3rd Marine Amphibious Force Headquarters from April to October 1967 near DaNang; he subsequently served with the Force Logistics Command from October 1967 to May 1968, in Red Beach (10 miles north of DaNang). The veteran reported three separate incidents: a fuel dump at the airfield in DaNang was hit causing a huge explosion (6/67-7/67); the unit took rocket attack fire (10/67-12/67); and being caught out in the open on the way from the showers during a rocket attack (1/68-2/68). The veteran indicated that as the stenographer for General Olsen, he was responsible for casualty reports; he stated that he also volunteered for moving body bags on occasion. By letter dated June 26, 1997, the VA asked the Marine Corp Historical Center to assist them in determining whether the veteran's account of his experiences were reasonable in view of his particular in-service duties. A report was prepared by the Headquarters United States Marine Corp in July 1997, indicating that verification of the veteran's PTSD stressors could not be accomplished due to insufficient information provided by the veteran. The letter stated that there were no records of DaNang as a post or a geographic entity, and that all USMC records were filed by unit designation. It was further stated that up to two months of command chronologies could be copied for free and there was a fee for any additional copying of command chronologies. It was stated that the veteran should be advised of the need to list in his order of priority the unit command chronologies he desired to be copied. By letter dated July 29, 1997, the VA informed the veteran that additional information was required in order to initiate a further ESG search. He was advised that there were no records of DaNang as a post or a geographic entity, and that all USMC records were filed by unit designation. He was also asked to provide specific dates of his alleged rocket attacks. The veteran did not reply to this letter. Received in December 1997 were VA treatment reports dated from February 1996 to November 1997, which show that the veteran was afforded clinical attention and treatment for several disabilities, including PTSD. Among these records is the report of an evaluation conducted in February 1996, at which time it was indicated that the veteran presented with a self-reported history of trauma from war zone exposure. His readjustment following Vietnam was characterized by increased irritability and disturbing memories from Vietnam; it was noted poor anger management and growing emotional attachment disrupted his marriage. A brief mental status review found no evidence of psychoticism; he denied current suicidal/homicidal ideation. His speech and thought processes were clear. Psychomotor testing including the Mississippi Combat Scale and BDI; on the Mississippi , he produced a score reflective of the nature and intensity of symptomatology characteristic of Vietnam veterans with PTSD, but the BDI revealed his current mood to be asymptomatic of depression. It was concluded that his adjustment profile was consistent with PTSD, chronic and combat-related. The veteran was accepted into the domiciliary where he received treatment for PTSD and substance abuse from March to September 1996. Having discussed the evidence of record and applying the legal standards of well-groundedness to the current claim seeking service connection, the Board notes that the veteran has contended that he was exposed to multiple stressor incidents during his service, namely witnessing enemy rocket attacks. Solely for the purpose of determining the well- groundedness of his claim, these contentions will be deemed credible. See King, 5 Vet. App. 19. There has also been continued medical evidence of a diagnosis of PTSD and this diagnosis is apparently attributed to the alleged stressor incidents. Given this information, the Board finds the claim of service connection for PTSD is now at least plausible. ORDER The claim of entitlement to service connection for PTSD is well grounded. To this extent only, the appeal is granted. REMAND Having discussed the evidentiary record above, the Board that the veteran's DD Form 214 is within the claims file. However, the veteran's complete service personnel records are not within the claims file. Therefore, the veteran's specific dates of service in Vietnam are not verified. Nor have the veteran's units, places of duty, and duty assignments in Vietnam been verified. Nor is it known whether the veteran was in receipt of any further medals, awards, or commendations, other than the Good Conduct Medal identified on the DD Form 214. Furthermore, as previously discussed, the veteran was informed by VA, in a letter dated July 29, 1997, that additional information was required in order to initiate a further ESG search. He was advised that there were no records of DaNang as a post or a geographic entity, and that all USMC records were filed by unit designation. He was also asked to provide specific dates of his alleged rocket attacks. The veteran did not reply to this letter. The Board notes, however, that the veteran was not informed by the VA in their July 1997 letter of the other information contained in the reply from the Marine Corps Historical Center. Namely, they did not notify the veteran of the ability to obtain up to two months of command chronologies for free, with a fee for any additional copying of command chronologies, and the need for the veteran to list in his order of priority the unit command chronologies he desired to be copied. It is possible that if such command chronologies were obtained and reviewed that they may support the veteran's history of having witnessed rocket attacks near his place of duty. Therefore, it is important that the veteran be given another opportunity to specify the dates of command chronologies which he would like to obtain in order to fully comply with the duty to assist in this case. The Board finds that the presence of service personnel records in this case is critical to a review of the veteran's service in Vietnam and a review of whether his claimed stressors are subject to verification. The claim must be remanded so that the RO can obtain and review the veteran's complete service personnel records for pertinent information. It is also critical that the veteran be informed of the possibility of obtaining command chronologies which may help verify his claimed stressors, that he be given another opportunity to specify the dates for which chronologies should be obtained, and that an effort be made to obtain such chronologies from the Marine Corps Historical Center. For these reasons, the Board finds that a remand is necessary. In addition to the above, the Board notes that that service connection for PTSD requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed inservice stressor actually occurred, and a link, established by medical evidence, between current symptomatology and service. If the claimed in-service stressor is related to combat, service department evidence that the appellant engaged in combat or that the appellant was awarded a combat citation will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the claimed inservice stressor. See 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. § 3.304(f) (as in effect prior to March 7, 1997). Where, however, the VA determines that the appellant did not engage in combat, the appellant's lay testimony, by itself, will not be sufficient to establish the alleged stressor. Instead, the record must contain service records or other independent credible evidence to corroborate the appellant's testimony as to the alleged stressor. Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). Those service records which are available must support and not contradict the appellant's lay testimony concerning the non-combat stressors. Doran v. Brown, 6 Vet. App. 283, 289 (1994). Also, in Cohen v. Brown, 10 Vet. App. 128 (1997), the Court cited the three elements required by section 3.304(f) to warrant a grant of service connection for PTSD: (1) a current, clear medical diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in- service stressor. Cohen, at 138. The Court further held that, if the claimed stressor is not combat related, a veteran's lay testimony regarding in-service stressors is insufficient to establish the occurrence of the stressor and must be corroborated by "credible supporting evidence." Id. at 142. Claims for service connection for PTSD are evaluated in accordance with the criteria set forth in 38 C.F.R. 3.304(f). In June 1999, revised regulations concerning PTSD were published in the Federal Register which reflected the decision in Cohen v. Brown. The regulations were made effective from the date of the Cohen decision, becoming effective on March 7, 1997, during the pendency of the veteran's appeal. See Direct Service Connection (Post- Traumatic Stress Disorder), 64 Fed. Reg. 32,807 (1999) (to be codified at 38 C.F.R. § 3.304(f) (1999)). In particular, 38 C.F.R. § 3.304(f) was revised to read that service- connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. The Court has held that where the law changes after a claim has been filed or reopened, but before the administrative or judicial appeal process has been concluded, the version most favorable to the appellant will apply unless Congress provides otherwise. Karnas v. Derwinski, 1 Vet. App. 308 (1990). Therefore, the veteran should be afforded the opportunity to have his claim reviewed under the most favorable of the foregoing criteria. The Court has also held that when the Board addresses in its decision a question that has not yet been addressed by the RO, the Board must consider whether the claimant has been given adequate notice of the need to submit evidence or argument on the question, whether he has been given an adequate opportunity to actually submit such evidence and argument, and whether the statement of the case provided the claimant fulfills the regulatory requirements. See 38 C.F.R. § 19.29. If not, the matter must be remanded to the RO to avoid prejudice to the claimant. Bernard v. Brown, 4 Vet. App. 384, 393 (1993); 38 C.F.R. § 19.9. Moreover, if the claim remains denied, a supplemental statement of the case addressing the new criteria is required. 38 U.S.C.A. § 7105 (West 1991 & Supp. 1998); 38 C.F.R. §§ 19.29, 19.31 (1998). Finally, while the diagnosis of PTSD is shown by the record, questions remain as to whether the diagnosed PTSD is the result of the veteran's active military service, whether the veteran had combat, whether he experienced a valid PTSD stressor while on active duty so as to support a diagnosis of PTSD, and whether there is competent medical evidence linking the symptoms he is experiencing as a result of his PTSD to any of the alleged stressors which are verified. As his claim of service connection for PTSD is now well grounded, any pertinent additional medical records of treatment should be requested and associated with the record. Furthermore, if pursuant to other requested development, either the veteran's participation in combat (to which a claimed stressful event is related), or a noncombat-related stressor is corroborated, a VA psychiatrist should be given the opportunity to examine the veteran and determine whether any diagnosis of PTSD is the result of any verified in- service stressor. See Russo v. Brown, 9 Vet. App. 46 (1996). In view of the above, this case is hereby REMANDED for the following: 1. The RO should contact the veteran and request that he provide the names and addresses of all medical care providers who have treated him for his claimed PTSD. The RO should request that the veteran furnish signed authorizations for release to the VA of private medical records in connection with each non-VA source identified. The RO should attempt to obtain any such private treatment records, as well as any VA medical records, not already on file, which may exist and incorporate them into the claims folder. 2. The RO should also request the veteran's complete service personnel records, to include his Official Military Performance File (OMPF), from the National Personnel Records Center (NPRC). If for any reason, the OMPF is not available, the NPRC should specifically so indicate. These records should be reviewed to ascertain where the veteran was assigned in Vietnam, the dates of such assignments, and what type of duties he performed while in Vietnam. 3. The RO should contact the veteran and provide him with another opportunity to provide a comprehensive statement containing as much detail and information as possible concerning the specifics (i.e., who, what, where, when, specific dates, and units involved) of the combat actions and/or stressful events that he alleges to have experienced during active military service. The veteran is also hereby informed of the possibility of obtaining command chronologies which may help verify his claimed stressors, and he should be given another opportunity to specify the dates for which such chronologies should be obtained 4. Regardless of whether the veteran responds to RO's inquiry, above, the RO must then review the entire file, including the veteran's previous statements of stressors and any additional information submitted by the veteran or otherwise obtained pursuant to this remand, and prepare a summary of all the claimed stressors. This summary and all associated documents, to include copies of the veteran's DD Form 214 and complete OMPF, should be sent to the Commandant of the Marine Corps, Headquarters, United States Marine Corps, Code MMSB10, Quantico, Virginia 22134- 5030. They should be requested to provide any information which might corroborate the veteran's alleged stressors, to include verification of claimed rocket attacks allegedly witnessed by the veteran. Command chronologies for those months specified by the veteran, pursuant to the previous request, should also be requested. 5. Following the above, the RO must make a specific determination, based upon the complete record, as to whether the veteran was engaged in combat and whether he did experience any of his claimed stressor(s) (whether in combat or otherwise) and determine whether the evidence is sufficient to establish the occurrence of the stressor(s). If so, these findings should be specified for the record. 6. If, and only if, the RO determines that the record establishes the existence of a stressor or stressors, the RO should specify those stressors for the record. If there is no such verification, the RO need not undertake another examination of the veteran. If however, there is such verification, the RO should then schedule the veteran for a VA psychiatric examination in order to determine, after a review of all pertinent evidence and evaluation of the veteran, whether he currently meets the diagnostic criteria for PTSD. In determining whether the veteran has PTSD due to an inservice stressor, the examiner is hereby notified that only the verified history detailed in the reports provided by the Marine Corps Commandant and/or by the RO may be relied upon. If a diagnosis of PTSD is deemed appropriate, the examiner should explain how the diagnostic criteria of the Fourth Edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders are met, to include identification of the specific stressor(s) underlying any PTSD diagnosis, and comment upon the link between the current symptomatology and one or more of the in-service stressors found to be established by the RO. The claims folder, to include a copy of this remand, along with any additional evidence obtained pursuant to this remand, should be provided to the examiner for review. The examination report should reflect review of pertinent material in the claims folder and include the complete rationale for all opinions expressed. All necessary special studies or tests, to include psychological testing and evaluation, such as the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorders, should be accomplished. The examiner's typewritten report must include all examination results, along with the complete rationale underlying all opinions expressed, citing, if necessary, to specific evidence in the record. The report should be associated with the other evidence on file in the veteran's claims folder. 7. With regard to all the instructions set forth above, the RO should inform the veteran of his obligation to cooperate by providing the requested information to the extent possible, and by reporting for any scheduled examination(s). The RO should also inform the veteran that his failure to cooperate may result in adverse action with regard to his claim, pursuant to 38 C.F.R. § 3.158 and § 3.655. 8. Upon completion of the above, the RO should review the evidence and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, including if any requested examination opinions are not provided, appropriate corrective action should be taken. 9. When the RO is satisfied that the record is complete, the RO should review all of the evidence of record and readjudicate the issue of entitlement to service connection for PTSD, in light of the Cohen case. The RO should also consider the revised 38 C.F.R. § 3.304(f) and apply the version most favorable to the veteran. If the determination remains unfavorable to the veteran, the RO should furnish him and his representative with a supplemental statement of the case, in accordance with 38 U.S.C.A. § 7105 (West 1991). The supplemental statement of the case should include citation to and discussion of both versions of 38 C.F.R. § 3.304(f). Thereafter, the veteran and his representative should be given the opportunity to respond. The case should then be returned to the Board for further appellate consideration, if otherwise in order, following appropriate appellate procedure. By this REMAND the Board intimates no opinion, either legal or factual, as to the ultimate determination warranted in this case. The purpose of this REMAND is to further develop the record. No action is required by the veteran until he receives further notice. The appellant 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. BRIAN LEMOINE Acting Member, Board of Veterans' Appeals