Citation Nr: 0004584 Decision Date: 02/22/00 Archive Date: 02/28/00 DOCKET NO. 92-08 349A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Roanoke, Virginia THE ISSUES 1. Entitlement to an increased evaluation for migraine headaches, currently evaluated as 30 percent disabling. 2. Entitlement to a compensable rating for bilateral pes planus. (The issue of entitlement to payment or reimbursement of an unauthorized medical expense incurred on August 18, 1998, for ambulance service, is the subject of a separate decision). REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and his wife. ATTORNEY FOR THE BOARD A. Shawkey, Counsel INTRODUCTION The veteran served on active duty from July 1946 to February 1948. This matter comes to the Board of Veterans' Appeals on appeal from a February 1992 rating decision of the Department of Veterans Affairs (VA) regional office (RO) in Roanoke, Virginia, that denied the veteran's claim for a rating in excess of 30 percent for migraine headaches and denied his claim for a compensable rating for bilateral pes planus. REMAND In December 1991 the veteran requested that VA consider granting him an increased rating for his migraine headaches and bilateral pes planus due to an increase in severity in these disabilities. His claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, he has presented a claim which is plausible. However, for the reason that follows, VA's statutory duty to assist the veteran mandated by 38 U.S.C.A. § 5107(a) has not yet been fully met. A review of the claims file reveals that the veteran has not had a VA compensation examination with respect to his service-connected migraine headaches and bilateral pes planus for many years, since 1992. Consequently, the Board finds that the duty to assist in this case includes providing thorough and contemporaneous compensation examinations in regard to these disabilities so that a decision on this claim will be a fully informed one. Caffrey v. Brown, 6 Vet. App. 377 (1994); Green v. Derwinski, 1 Vet. App. 121 (1991). Accordingly, this case is REMANDED to the RO for the following action: 1. The RO should ask the veteran to identify (names, addresses, dates) all sources (VA or non-VA) of treatment for his migraine headaches and bilateral pes planus since 1992. The RO should then directly contact the sources and obtain the medical records, following the procedures of 38 C.F.R. § 3.159. 2. The RO should have the veteran undergo an orthopedic examination to determine the severity of his bilateral pes planus. The claims folder, including a copy of this remand, should be provided to and reviewed by the examiner prior to the examination. The examiner should be asked to provide specific findings consistent with the rating criteria (38 C.F.R. § 4.71a, Diagnostic Code 5276) to include: a) whether pes planus symptoms are relieved by built-up shoe or arch support b) whether there is weight-bearing line over or medial to great toes, inward bowing of the tendo achillis, pain on manipulation and use of the feet, bilateral or unilateral c) whether there is objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities d) whether there is marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo Achilles on manipulation, not improved by orthopedic shoes, or appliances 3. The RO should have the veteran undergo a VA neurological examination to determine the severity and frequency of his migraine headaches. The claims folder including a copy of this remand should be provided to and reviewed by the examiner prior to the examination. 4. The RO should thereafter review the veteran's claim for an increased rating for migraine headaches and for a compensable rating for bilateral pes planus. If any decision remains adverse, the veteran and his representative should be issued a Supplemental Statement of the Case. After the veteran and his representative have been given an opportunity to respond to the Supplemental Statement of the Case, the claims folder should be returned to this Board for further appellate review. No action is required of the veteran until he receives further notice. The purposes of this remand are to procure clarifying data and to comply with the governing adjudicative procedures. The Board intimates no opinion, either legal or factual, as to the ultimate disposition of this appeal. 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. C.W. Symanski Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 1999), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand 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) (1999).