Citation Nr: 0006247 Decision Date: 03/08/00 Archive Date: 03/17/00 DOCKET NO. 98-19 368A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUE Entitlement to service connection for the cause of the veteran's death. REPRESENTATION Appellant represented by: To be clarified ATTORNEY FOR THE BOARD Michael P. Vander Meer, Counsel INTRODUCTION The veteran served on active duty from November 1944 to July 1946. This case is before the Board of Veterans' Appeals (Board) on appeal from an August 1998 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. The appeal was docketed at the Board in 1998. REMAND The official death certificate reflects that arteriosclerotic vascular disease was a factor in the veteran's death, at age 68, in May 1995. The appellant avers that disablement attributable to "shrapnel wounds in" the chest sustained by the veteran in service played a role in the heart disease implicated in his death. In this regard, evidence of non-VA origin dated in apparently 1988 reflects that the veteran had retained steel, "WW II" incurred, in his chest. In a February 1998 statement, Dr. Charles F. McGinty, Sr., who stated that he knew the veteran "when he was alive" but did not treat him during the course of his terminal illness, indicated that such World War II chest injury "could have...complicated" the heart disease implicated in his death. The death certificate reflects that the veteran died while hospitalized at St. Francis Medical Center in Cape Girardeau, Missouri. The February 1998 statement from Dr. McGinty reflects that the veteran was in the St. Francis facility from May 21 to May 28, 1995, and that such physician had reviewed the clinical records "covering" such period. However, such records, which presumably include the terminal hospitalization summary, have not yet been procured by the RO. Inasmuch as the appellant is contending that service- incurred disablement played a role in the veteran's death, the Board, in accordance with the pertinent analysis advanced by the United States Court of Appeals for Veterans Claims in Costantino v. West, 12 Vet. App. 517 (1999), is of the opinion that 'the clinical documentation pertaining to the veteran's final [terminal period of] hospitalization', id. at 520, should be obtained by the RO before further appellate action ensues. Further development to facilitate the accomplishment of the foregoing is, therefore, specified below. The Board's perusal of the file also reveals the submission to the RO of an August 1997 item from Francis J. Siebert, a private attorney, wherein such individual indicates that he was "representing" the appellant in her claim. It is also noted that, in the "Signature of Appointed Representative" space on the appellant's Form 9, which was received in December 1998, such attorney (i.e., Mr. Siebert) signed his name in such space. However, the file does not appear to reflect the appendage of a power of attorney executed in favor of Mr. Siebert and it is unclear whether he is in fact representing the appellant in her above-captioned claim. Further development to clarify the foregoing is, consequently, specified below. 1. The RO should contact the appellant relative to the following matters: (a.) To request that she provide the street address of St. Francis Medical Center, Cape Girardeau, Missouri, as well as any dates in which the veteran was hospitalized at such facility, in addition to May 21-28, 1995, during the year preceding his death. Then, in light of the response (if any) received and after obtaining any necessary authorization, the RO should take appropriate action to obtain copies of all pertinent clinical records from the St. Francis facility, to specifically include all reports prepared in conjunction with the veteran's terminal period of hospitalization at such facility from May 21-28, 1995. (b.) To inquire of the appellant whether she desires to be represented in her appeal by attorney Francis J. Siebert; if the appellant responds in the affirmative, then the RO should, in such event, provide her with the pertinent power of attorney documentation by which she may appoint Mr. Siebert (or any other representative or service organization she may elect) as her personal representative. 2. Then, after undertaking any development deemed necessary in addition to that specified above, the RO should readjudicate the issue on appeal. 3. If the benefit sought on appeal is not granted to the appellant's satisfaction, both she and any representative which she may appoint pursuant to the development set forth in the first numerical directive hereinabove, should be provided a Supplemental Statement of the Case. The appellant should be provided appropriate notice of the requirement to perfect an appeal with respect to any issue(s) addressed therein which does not appear on the title page of this decision. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. In taking this action, the Board implies no conclusion, either legal or factual, as to the ultimate outcome warranted. No action is required of the appellant unless she is otherwise notified. F. JUDGE FLOWERS Member, Board of Veterans' Appeals The appellant has the right to submit additional evidence and argument on the matter the Board has remanded to the RO. Kutscherousky v. West, 12 Vet. App. 369 (1999). 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).