Citation Nr: 0006224 Decision Date: 03/08/00 Archive Date: 03/17/00 DOCKET NO. 98-14 774 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania THE ISSUES 1. Entitlement to service connection for a back disability secondary to service-connected postoperative residuals of subtotal thyroidectomy for hyperthyroidism. 2. Entitlement to an increased (compensable) rating for postoperative residuals of subtotal thyroidectomy for hyperthyroidism. REPRESENTATION Appellant represented by: Pennsylvania Department of Military Affairs Bureau for Veterans Affairs and Assistance WITNESSES AT HEARING ON APPEAL Appellant and his wife ATTORNEY FOR THE BOARD Kathleen Reardon Fletcher, Associate Counsel INTRODUCTION The veteran served on active duty from March 1953 to March 1957 and from May 1957 to April 1961. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 1998 rating decision by the Philadelphia, Pennsylvania RO that denied entitlement to service connection for a back disability secondary to service-connected postoperative residuals of subtotal thyroidectomy for hyperthyroidism and denied entitlement to an increased (compensable) rating for postoperative residuals of subtotal thyroidectomy for hyperthyroidism. In December 1999, a video-conference hearing was conducted by C.W. Symanski, who is the member of the Board rendering the final determination in this claim and was designated by the Chairman of the Board to conduct that hearing, pursuant to 38 U.S.C.A. § 7102(b) (West 1991). During the December 1999 video-conference hearing, the veteran's representative raised the issues of entitlement to service connection for a carotid artery disability, a neck disability and residuals of a stroke, all secondary to service-connected postoperative residuals of subtotal thyroidectomy for hyperthyroidism. Also, the veteran testified concerning the presence of a back disability in service, which contentions can be construed as an attempt to reopen a claim for service connection for the back condition on the basis of direct incurrence. Since these issues have not been developed for appellate review, they are referred to the RO for appropriate action. REMAND The veteran is currently service connected for postoperative residuals of subtotal thyroidectomy for hyperthyroidism. The veteran contends that he has a back disability that is secondary to his service-connected postoperative residuals of subtotal thyroidectomy for hyperthyroidism. Regulations provide that service connection may be granted for disability that is proximately due to or the result of a service- connected disease or injury. 38 C.F.R. § 3.310(a). In addition, service connection may also be granted for disability that has been aggravated by a service-connection disease or injury. Allen v. Brown, 7 Vet. App. 439 (1995). The statement of the case (SOC) and supplemental statement of the case (SSOC) provided to the veteran did not include mention of the regulation pertaining to secondary service connection (38 C.F.R. § 3.310). According to 38 C.F.R. § 19.29, a SOC must be complete enough to allow the appellant to present written and/or oral arguments before the Board. It must contain a summary of the applicable laws and regulations, with appropriate citations, a discussion of how such laws and regulations affect the determination, and the determination and reasons for the determination of the agency of original jurisdiction with respect to which disagreement has been expressed. Because the SOC and SSOC issued to the veteran in the present appeal did not contain a discussion of the regulation pertaining to secondary service connection, remand is also required to ensure him full procedural due process of law. The veteran also maintains that his service-connected postoperative residuals of subtotal thyroidectomy for hyperthyroidism are productive of greater impairment than is reflected by the currently assigned disability evaluation. The veteran's postoperative residuals of subtotal thyroidectomy for hyperthyroidism is currently rated as zero percent disabling under 38 C.F.R. § 4.119, Diagnostic Code 7900. Effective June 6, 1996, VA amended 38 C.F.R. § 4.119, which addresses the endocrine system. The April 1998 SOC cites to 38 C.F.R. § 4.119, Diagnostic Code 7900, as in effect prior to June 6, 1996. The veteran has not been provided with the revised criteria as contained in 38 C.F.R. § 4.119, Diagnostic Code 7900 (1999). As previously noted, a SOC must be complete enough to allow the appellant to present written and/or oral arguments before the Board. It must contain a summary of the applicable laws and regulations, with appropriate citations, a discussion of how such laws and regulations affect the determination, and the determination and reasons for the determination of the agency of original jurisdiction with respect to which disagreement has been expressed. See 38 C.F.R. § 19.29. Therefore, remand is required to ensure the veteran full procedural due process of law. Furthermore, when the veteran was last examined by VA in June 1997, the examiner noted that the hyperthyroidism was in clinical remission; however diagnoses did include hypertension and a weight loss was reported in the past year. Increased blood pressure and weight loss are among the criteria utilized in evaluating hyperthyroidism. Moreover, the examiner indicated that blood tests were to be performed in order to evaluate thyroid function and that the results were to be sent to the RO. It does not appear that the results of any thyroid function studies are of record. The Board regrets any further delay in this case. However, the Board concludes that additional development of the record is required prior to appellate disposition. Accordingly, the case is hereby REMANDED back to the RO for the following action: 1. The RO should contact the VA Medical Center in Coatesville, Pennsylvania and request that photocopies of the thyroid function tests reported to have been done in June 1997 be forwarded for inclusion in the claims folder. 2. Thereafter, arrangements should be made to have the veteran undergo a special endocrinology examination in order to ascertain the nature and severity of any residuals of hyperthyroidism which may be present. All special tests should be accomplished to include thyroid function studies. The examiner should ascertain for the record whether any symptoms now present are related to the service connected disability, to specifically include increased blood pressure or weight loss. The claims folder must be made available to the examiner for review, prior to conducting the examination. 3. The RO should then readjudicate the veteran's claim for an increased rating. Thereafter, the veteran should be provided with an appropriate supplemental statement of the case that includes all of the applicable law and regulations, to include 38 C.F.R. § 3.310 and the revised rating criteria concerning hyperthyroidism as contained in 38 C.F.R. § 4.119, Diagnostic Code 7900 (1999). The veteran and his representative should be given the applicable time to respond. Thereafter, this case should be returned to the Board, if otherwise in order. The appellant has the right to submit additional evidence and argument on the 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).