Citation Nr: 0721560 Decision Date: 07/18/07 Archive Date: 08/02/07 DOCKET NO. 06-05 232 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in No. Little Rock, Arkansas THE ISSUES 1. Whether new and material evidence has been submitted to reopen the claim of service connection for hearing loss. 2. Whether new and material evidence has been submitted to reopen the claim of service connection for tinnitus. 3. Whether new and material evidence has been submitted to reopen the claim of service connection for skin condition of the right hand. 4. Entitlement to service connection for skin condition of the right hand. 5. Whether new and material evidence has been submitted to reopen the claim of service connection for migraine headaches. 6. Entitlement to service connection for migraine headaches. 7. Whether new and material evidence has been submitted to reopen the claim of service connection for shin splints. 8. Whether new and material evidence has been submitted to reopen the claim of service connection for depression. 9. Whether new and material evidence has been submitted to reopen the claim of service connection for joint pain. 10. Whether new and material evidence had been received to reopen the claim of service connection for residuals of a lumbar spine injury. 11. Entitlement to service connection for residuals of a lumbar spine injury. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD A.M. Ivory, Associate Counsel INTRODUCTION The veteran had active service from January 1990 to May 1990 and November 1990 to July 1991. These matters come before the Board of Veterans' Appeals (Board) on appeal from a January 2005 RO rating decision. The veteran testified before the undersigned Veterans Law Judge at a hearing at the RO in January 2007. At the hearing, the veteran's representative submitted private medical records with a waiver of initial RO jurisdiction. The Board has accepted this additional evidence for inclusion into the record on appeal. See 38 C.F.R. § 20.800. Regardless of what the RO has done, the Board must address the question of whether new and material evidence has been received to reopen the claim, because the issue goes to the Board's jurisdiction to reach and adjudicate the underlying claim de novo. See Barnett v. Brown, 83 F.3d 1380, 1383 (Fed. Cir. 1996), aff'g 8 Vet. App. 1 (1995). In other words, the Board is required to first address whether new and material evidence has been presented before the merits of a claim can be considered. See Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001). The now reopened claims of service connection for skin condition of the right hand and service connection for migraine headaches are being remanded to the RO via the Appeals Management Center (AMC), in Washington, D.C. VA will notify the veteran when further action, on his part, is required. FINDINGS OF FACT 1. All notification and development action needed to fairly adjudicate the issues on appeal has been accomplished. 2. In a March 2003 rating action, the RO denied reopening the claims of service connection for hearing loss, tinnitus, residuals of a lumbar spine, and a skin condition of the right hand and denied the original claims of service connection for migraine headaches, shin splints, depression, and joint pain. The veteran did not enter a timely appeal from that decision. 3. The additional evidence received since the March 2003 rating decision is cumulative and redundant of evidence previously of record, does not relate previously unestablished facts necessary to substantiate the claims or raise a reasonable possibility of substantiating the claims of service connection for hearing loss, tinnitus, shin splints, depression and joint pain. 4. The additional evidence received since the March 2003 rating decision is more than cumulative and redundant of evidence previously of record, does relate previously unestablished facts necessary to substantiate the claim and raises a reasonable possibility of substantiating the claim of service connection for the residuals of a lumbar spine injury, migraine headaches and a skin condition of the right hand. 5. The veteran recently has submitted buddy statements that show that he did have in-service trauma to his back. 6. The currently demonstrated chronic low back strain is shown as likely as not to be due to an injury that the veteran suffered while on active duty. CONCLUSIONS OF LAW 1. New and material evidence has not been submitted to reopen the previously denied claim of service connection for hearing loss. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 2. New and material evidence has not been submitted to reopen the previously denied claim of service connection for tinnitus. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 3. New and material evidence has been submitted to reopen the previously denied claim of service connection for skin condition of the right hand. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 4. New and material evidence has been submitted to reopen the previously denied claim of service connection for migraine headaches. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 5. New and material evidence has not been submitted to reopen the previously denied claim of service connection for shin splints. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 6. New and material evidence has not been submitted to reopen the previously denied claim of service connection for depression. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 7. New and material evidence has not been submitted to reopen the previously denied claim of service connection for joint pain. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 8. New and material evidence has been submitted to reopen the previously denied claim of service connection for residuals of a lumbar spine injury. 38 U.S.C.A. § 5108 (West 2002 & Supp. 2006); 38 C.F.R. § 3.156 (2006). 9. By extending the benefit of the doubt to the veteran, his disability manifested by residuals of a lumbar spine injury is due to an injury that was incurred in active service. 38 U.S.C.A. §§ 1110, 1113, 1116, 5107, 7104 (West 2002 and Supp. 2006); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2006). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Duty to Notify and Assist Initially, the Board notes that, in November 2000, the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000) was signed into law. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, and 5107 (West 2002 & Supp. 2005). To implement the provisions of the law, VA promulgated regulations at 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2006). VCAA and its implementing regulations include, upon the submission of a substantially complete application for benefits, an enhanced duty on the part of VA to notify a claimant of the information and evidence needed to substantiate a claim, as well as the duty to notify the claimant what evidence will be obtained by whom. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b). In addition, they define the obligation of VA with respect to its duty to assist a claimant in obtaining evidence. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159(c). Considering the duties imposed by VCAA and its implementing regulations, the Board finds that all notification and development action needed to fairly adjudicate the claim on appeal has been accomplished. In September 2004, prior to the rating decision on appeal, the RO sent the veteran a letter informing him that to establish entitlement to service-connected compensation benefits the evidence must show credible supporting evidence of a disease or injury that began in or was made worse during service, or that there was an event in service which caused injury or disease; a current physical or mental disability; and a relationship between the current disability and an injury, disease or event in service. The September 2004 letter also stated the criteria needed for new and material evidence. The veteran was afforded time to respond before the RO issued the January 2005 rating decision on appeal. The Board accordingly finds that the veteran has received sufficient notice of the information and evidence needed to support his claim and has been afforded ample opportunity to submit such information and evidence. The September 2004 letter also satisfies the statutory and regulatory requirement that VA notify a claimant, what evidence, if any, will be obtained by the claimant and what if any evidence will be obtained by VA. See Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002) (addressing the duties imposed by 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b)). The September 2004 letter advised the veteran that VA is responsible for getting relevant records from any Federal Agency including medical records from the military, VA hospitals (including private facilities where VA authorized treatment), or from the Social Security Administration. The letters also advised the veteran that VA must make reasonable efforts to help the veteran get relevant records not held by any Federal agency, including State or local governments, private doctors and hospitals, or current or former employers. The letter advised the veteran that it was his responsibility to provide the RO with enough information about the records to enable the RO to request them from the person or agency having them, and advised the veteran that it was his responsibility to make sure the records were received by VA. A follow-up letter stated that if you have any information or evidence that you have not previously told us about or given, to us, and that information or evidence concerns the level of your disability or when it began please tell us or give us the evidence now. In the decision of Pelegrini v. Principi, 18 Vet. App. 112 (2004), the United States Court of Appeals for Veterans Claims (Court) held that proper VCAA notice should notify the veteran of: (1) the evidence that is needed to substantiate the claim(s); (2) the evidence, if any, to be obtained by VA; (3) the evidence, if any, to be provided by the claimant; and (4) a request by VA that the claimant provide any evidence in the claimant's possession that pertains to the claim(s). As explained, all four content-of-notice requirements have been met in this appeal. Pelegrini also held that the plain language of 38 U.S.C.A. § 5103(a) (West 2002), requires that notice to a claimant pursuant to the VCAA be provided "at the time" that, or "immediately after," the Secretary receives a complete or substantially complete application for VA-administered benefits. In that case, the Court determined that VA had failed to demonstrate that a lack of such pre-adjudication notice was not prejudicial to the claimant. As indicated, in the matters now before the Board, documents fully meeting the VCAA's notice requirements were provided to the veteran after the rating action on appeal. However, the Board finds that any arguable lack of full pre-adjudication notice in this appeal has not, in any way, prejudiced the veteran. The Board notes that the Court has held that an error in the adjudicative process is not prejudicial unless it "affects a substantial right so as to injure an interest that the statutory or regulatory provision involved was designed to protect such that the error affects 'the essential fairness of the [adjudication].'" Mayfield v. Nicholson, 19 Vet. App. 103 (2005), rev'd on other grounds, Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir. 2006). The Board finds that, in this appeal, any delay in issuing section 5103(a) notice was not prejudicial to the veteran because it did not affect the essential fairness of the adjudication, in that his claim was fully developed and readjudicated after notice was provided. As indicated, the RO gave the veteran notice of what was required to substantiate the claim on appeal, and he was afforded an opportunity to submit such information and/or evidence. Hence, the Board finds that any failure on VA's part in not completely fulfilling the VCAA notice requirements prior to the RO's initial adjudication of the claims is harmless. See ATD Corp. v. Lydall, Inc., 159 F.3d 534, 549 (Fed. Cir. 1998); Cf. 38 C.F.R. § 20.1102 (2006). More recently, the Board notes that, on March 3, 2006, during the pendency of this appeal, the Court issued a decision in the consolidated appeal of Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006), which held that the VCAA notice requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a service connection claim (veteran status, existence of a disability, connection between the veteran's service and that disability, degree of disability, and effective date pertaining to the disability). In this appeal, the first Dingess element (veteran status) is not at issue, and as noted above the September 2004 letter advised the veteran of the second and third Dingess elements (existence of a disability and connection between the veteran's service and that disability). In regard to fourth and fifth Dingess elements (degree of disability, and effective date pertaining to the disability), the RO advised the veteran of these elements in a follow-up letter. The Board also notes that there is no indication whatsoever that any additional action is needed to comply with the duty to assist the veteran in connection with the claim on appeal. The veteran's service medical records and post-service VA medical records have been associated with the claims file. Neither the veteran nor his representative has identified, and the file does not otherwise indicate, that there are any other VA or non-VA medical providers having existing records that should be obtained before the claims are adjudicated. The veteran had VA medical examinations in January 2003 and February 2003. The veteran was afforded a hearing before the undersigned Veterans Law Judge in January 2007. Under these circumstances, the Board finds that the veteran is not prejudiced by the Board proceeding, at this juncture, with an appellate decision on the claims for service connection. II. Analysis Service connection may be granted for disability resulting from disease or injury incurred or aggravated during a veteran's active service. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. § 3.303 (2006). Service connection may be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In order to prevail on the issue of service connection there must be: medical evidence of a current disability; medical evidence, or in some cases lay evidence, of in-service occurrence or aggravation of a disease or injury; and, medical evidence of a nexus between an in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247, 253 (1999); Pond v. West, 12 Vet. App. 341, 346 (1999). A. New and Material Evidence The veteran submitted his original claims of service connection for hearing loss, tinnitus, residuals of a lumbar spine injury and a skin condition of the right hand in February 1995. The rating decision in December 1995 denied the claims on the basis that the service medical records were silent on any in-service treatment or injury for the claimed conditions. The veteran was notified of the denial by a letter in December 1995 and did not file a timely appeal. In a March 2003 rating action, the RO denied reopening the claim of service connection for hearing loss, tinnitus, residuals of a lumbar spine injury, and skin condition of the right hand on the basis that new and material evidence had not been submitted. In the March 2003 rating action, the RO also denied service connection for migraine headaches, shin splints, depression, and joint pain. He did not enter a timely Notice of Disagreement with that determination. VA may reopen and review a claim that has been previously denied if new and material evidence is submitted by or on behalf of the claimant. 38 U.S.C.A. § 5108; 38 C.F.R. § 3.156(a); see also Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). In June 2004, the veteran applied to reopen his claims of service connection for hearing loss, tinnitus, residuals of lumbar spine injury, skin condition of the right hand, migraine headaches, shin splints, depression, and joint pain. Regarding petitions to reopen filed on or after August 29, 2001, as in this appeal, Title 38, Code of Federal Regulations, Section 3.156(a) defines "new" evidence as evidence not previously submitted to agency decision makers and "material" evidence as evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. See 66 Fed. Reg. 45,620, 45,630 (Aug. 29, 2001). New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last final denial of the claim(s) sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). "New and material evidence" can be construed as that which would contribute to a more complete picture of the circumstances surrounding the origin of a veteran's disability or injury, even when it would not be enough to convince the Board to grant the claim. Hodge v. West, 155 F.3d 1356 (Fed. Cir. 1998). In determining whether new and material evidence has been received, VA must initially decide whether evidence associated with the claims file since the prior final denial is, in fact, new. As indicated, "new" evidence is that which was not of record at the time of the last final disallowance (on any basis) of the claim, and is not duplicative or "merely cumulative" of other evidence then of record. This analysis is undertaken by comparing the newly received evidence with the evidence previously of record. After evidence is determined to be new, the next question is whether it is material. The provisions of 38 U.S.C.A. § 5108 require a review of all evidence submitted by or on behalf of a claimant since the last final denial on any basis to determine whether a claim must be reopened. See Evans v. Brown, 9 Vet. App. 273, 282-3 (1996). For purposes of the "new and material" analysis, the credibility of the evidence is presumed. Justus v. Principi, 3 Vet. App. 510, 512-513 (1992). The evidence associated with the records before the March 2003 rating decision included the veteran's service medical records, VA medical examinations from January 2003 and February 2003, and January 2002 buddy statements from R.P., J.N. and J.B. The evidence associated with the record since the March 2003 rating decision consists of a private physician letter from January 2007. The Board notes that the additional evidence was not before the RO in March 2003. However, in regard to service connection for hearing loss, tinnitus, shin splints, depression and joint pain, it is essentially cumulative and repetitive of the evidence that was previously of record. It does not relate a previously unestablished fact necessary to support the claims or otherwise raise a reasonable possibility of substantiating the claims. Accordingly, the Board finds that new and material evidence has not been submitted to reopen the claims of service connection for hearing loss, tinnitus, shin splints, depression and joint pain. However, in regard to the claims of service connection for residuals of a lumbar spine injury, skin condition of the right hand and migraine headaches the Board finds that the evidence is "new" in that it was not considered by the RO in March 2003. This new evidence also is "material" in that it relates to an unestablished fact necessary to support the claim. The new evidence consists of the medical opinion that the veteran's back complaints were "very likely" related to the injury in service. The doctor also opined that the skin condition of the right hand and the headaches were related to service. The Board accordingly finds that new and material evidence has been submitted to reopen the claims of service connection for residuals of a lumbar spine injury, a skin condition of the right hand and migraine headaches. B. Service connection for residuals of a Lumbar Spine Injury The veteran testified at the recent hearing that he had a lumbar spine condition as a result of an accident in service. The veteran also submitted buddy statements in January 2002. The buddy statement by J.N. described the in-service incident and that he witnessed the veteran pinned underneath a net that had fallen off a vehicle. In addition, J.N. stated that the veteran then complained of low back pain for the rest of their period of service but the veteran did not go to a hospital since they were in the middle of the desert. He also stated that the veteran complained of low back pain when they moved heavy items and during physical training tests and that the veteran was put on a waiver from the physical training tests. The veteran submitted a buddy statement from J.B. in January 2002. J.B. stated that he was a medic at a battalion aid station and that he saw the veteran after the camouflage net had fallen on him from the top of a tracked vehicle. He stated that the veteran was then put on light duty and shortly afterwards the unit then moved their position to a site close to the Iraqi border. The third buddy statement the veteran submitted was by R.P. R.P. stated that, once the veteran returned home, he complained of back pain during weekend drills after unloading equipment from vehicles and that the veteran was put on light duty and was given Ibuprofen. R.P. stated that the veteran was put on light duty lifting and had a waiver for his physical training tests as a result of his low back pain. The Board notes that a layperson is competent to testify in regard to the onset and continuity of symptomatology, including pain. Heuer v. Brown, 7 Vet. App. 379, 384 (1995); (Falzone v. Brown, 8 Vet. App. 398, 403 (1995); Caldwell v. Derwinski, 1 Vet. App. 466 (1991). In addition, a layperson can certainly provide an eyewitness account of a veteran's visible symptoms. Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). The Board finds that the buddy statements are sufficient to establish that the veteran had an in-service lumbar spine injury. The Board must now see if the veteran has current lumbar spine injury residuals due to the service incident. The veteran has submitted private treatment records for his low back pain. In September 1995, the veteran's private physician stated that x-ray studies revealed bony malformations at anterosuperior aspect of the L-4 cerebral end plate. The private physician stated that the veteran had a condition called lumbar facet syndrome and that physical activities worsened his condition. The veteran had a VA medical examination in January 2003. He stated that he had chronic low back pain with associated stiffness, particularly in the morning and that the back pain increased with ambulation on concrete or hard surfaces and somewhat uneven surfaces. He described an occasional sharp pain that went up his spine and down his legs when he stepped on a very uneven surface. He also reported a chronic continuous stiff feeling and an inflamed feeling in his lower back. The VA examiner stated that the veteran's chronic low back strain and pain was consistent with the in-service injury. The VA examiner opined that the veteran's chronic low back strain was least as likely as not related to his in-service injury. In January 2007 the veteran's private physician submitted a statement. The private physician stated that the veteran had chronic low back pain with right sided radiculopathy and that an April 2006 x-ray study revealed an old fracture of L4 superior end plate with L3/L4 degenerative disease. The findings of a physician are medical conclusions that the Board cannot ignore or disregard. Willis v. Derwinski, 1 Vet. App. 66 (1991). However, the Board is free to assess medical evidence and is not obligated to accept a physician's opinion. Wilson v. Derwinski, 2 Vet. App 614 (1992). The Board finds, after carefully considering the veteran's buddy statements, the private physician reports, and the VA medical examination report, that service connection for residuals of a lumbar spine injury should be granted. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt it is meant one that exists because an approximate balance of positive and negative evidence which does satisfactorily prove or disprove the claim. It is a substantial doubt that within the range or probability as distinguished from pure speculation or remote possibility. 38 C.F.R. § 3.102. See also 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Accordingly, by extending the benefit of the doubt to the veteran, service connection is warranted in this case. ORDER As new and material evidence has not been presented to reopen the claims of service connection for hearing loss, tinnitus, shin splints, depression and joint pain, the appeal to this extent is denied. As new and material evidence has been received to reopen the claims of service connection for a skin condition of the right hand and the migraine headaches, the appeal to this extent is allowed, subject to further development as discussed hereinbelow. As new and material evidence has been received to reopen the claim of service connection for residuals of a lumbar spine injury, the appeal in this regard is allowed. Service connection for the residuals of a lumbar spine injury is granted. REMAND Given the action taken hereinabove in reopening the claims of service connection for a skin condition of the right hand and migraine headaches, the Board finds that further action is required prior appeal handling of these matters. Accordingly, the RO should arrange for the veteran to undergo VA examinations in order to determine to the nature and likely etiology of the claimed skin condition of the right hand and his migraine headaches. The veteran is hereby advised that failure to report to the scheduled examinations may result in denial of the claim. See 38 C.F.R. § 3.655 (2005). Examples of good cause include, but are not limited to, the illness or hospitalization of the veteran and death of an immediate family member. If the veteran fails to report to the scheduled examination, the RO should obtain and associate with the claims file copy(ies) of the notice(s) of the examination sent to him by the pertinent VA medical facility at which the examination is to take place. The actions identified herein are consistent with the duties imposed by VCAA; however, identification of specific actions requested on remand does not relieve the RO of the responsibility to ensure full compliance with VCAA and its implementing regulations. Hence, in addition to the actions requested hereinabove, the RO should also undertake any other development and/or notification action deemed warranted by VCAA prior to adjudicating the claim remaining on appeal. Accordingly, these two remaining matters are REMANDED to the RO for the following action: 1. The RO should take appropriate action to contact the veteran in order to ask him to provide sufficient information, and if necessary, signed authorization, to enable VA to obtain any additional evidence pertaining to the claims, including VA treatment records. The RO should advise the veteran of the respective duties of VA and the veteran to provide evidence, and should ask the veteran to submit all pertinent evidence in his possession that is not already of record. Any additional evidence identified should be obtained in accordance with provisions of 38 C.F.R. § 3.159 (2006). All records/responses received should be associated with the claims file. If any records sought are not obtained, the RO should notify the veteran and his representative of the records that were not obtained, explain the efforts taken to obtain them, and describe further action to be taken. 2. The veteran should be scheduled for VA examinations to ascertain the nature and likely etiology of the claimed skin condition of the right hand and migraine headaches. The entire claims file must be made available to the physician designated to examine the veteran, and the examination reports should include discussion of the veteran's documented medical history and assertions. All appropriate tests and studies should be accomplished and all clinical findings should be reported in detail. Based on the review of the case, the examiner should opine as to whether it is at least as likely as not that the veteran has a skin condition of the right hand or migraine headaches that had their clinical onset during his period of active service. The examiners should set forth all examination findings, along with the complete rationale for all conclusions reached. 3. After completing the requested actions, and any additional notification and/or development deemed warranted, the issues on appeal should be reviewed with consideration of all pertinent evidence and legal authority. 4. If any benefit sought on appeal remains denied, the RO should furnish to the veteran and his representative an appropriate Supplemental Statement of the Case (SSOC) that includes clear reasons and bases for all determinations, and afford them the appropriate time period for response. Thereafter, if indicated, the case should be returned to the Board for the purpose of appellate disposition. The veteran may furnish additional evidence and/or argument during the appropriate time period. See Kutscherousky v. West, 12 Vet. App. 369 (1999); Colon v. Brown, 9 Vet. App. 104, 108 (1996); Booth v. Brown, 8 Vet. App. 109 (1995); Quarles v. Derwinski, 3 Vet. App. 129, 41 (1992). This REMAND must be afforded expeditious treatment. 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 38 U.S.C. §§ 5109B, 7112 (West Supp. 2006). ____________________________________________ STEPHEN L. WILKINS Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs