Citation Nr: 18154196
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 15-42 504A
DATE:	November 29, 2018
ORDER
New and material evidence has been received to reopen a claim of entitlement to service connection for an upper back disability.
New and material evidence has been received to reopen a claim of entitlement to service connection for a lower back disability. 
Entitlement to an initial rating for irritable bowel syndrome (IBS) in excess of 30 percent is denied. 
Entitlement to an effective date prior to July 28, 2011, for the award of service connection for IBS is denied.  
REMANDED
Entitlement to service connection for a left shoulder disability, to include as secondary to a service connected disability, is remanded. 
Entitlement to service connection for a right shoulder disability, to include as secondary to a service connected disability, is remanded.
Entitlement to service connection for an upper back disability, to include as secondary to a service connected disability, is remanded.
Entitlement to service connection for a lower back disability, to include as secondary to a service connected disability, is remanded.
Entitlement to service connection for a left-hand disability (claimed as left-hand pain), to include as secondary to a service connected disability, is remanded.
Entitlement to service connection for a bilateral hand disability (claimed as tingling in the hands), to include as secondary to a service connected disability, is remanded. 
Entitlement to service connection for a bilateral feet disability (claimed as tingling in the feet), to include as secondary to a service connected disability, is remanded.
Entitlement to service connection for headaches, to include as secondary to a service connected disability, is remanded.
Entitlement to a rating for posttraumatic stress disorder (PTSD) with panic disorder in excess of 50 percent is remanded. 
FINDINGS OF FACT
1. The Veteran’s claim for service connection for an upper back and a lower back disability was previously denied by a March 1999 rating decision; the Veteran did not appeal the decision and documentation constituting new and material evidence was not actually or constructively received within the one-year appeal period.
2. Additional evidence received since the March 1999 rating decision is not cumulative or redundant of the evidence of record at the time of that decision, relates to an unestablished fact necessary to substantiate the claim for service connection for an upper back and a lower back disability, and raises a reasonable possibility of substantiating the claims.
3. Throughout the appeal period, the Veteran’s IBS was manifested by more or less constant abdominal pain, cramping, and alternating diarrhea and constipation.
4. On August 21, 1997, VA received the Veteran’s original claim seeking service connection for IBS. 
5. A March 1999 rating decision denied service connection for IBS.  The Veteran did not appeal that decision and new and material evidence was not actually or constructively received within one year following notice.
6. On August 15, 2012, the VA received the Veteran’s petition to reopen the claim of service connection for IBS.
7. A June 2013 rating decision declined to reopen the claim seeking service connection for IBS. 
8. An April 2015 rating decision granted service connection for IBS effective December 16, 2014. 
9. An August 2016 rating decision granted service connection for IBS effective July 28, 2011.   
CONCLUSIONS OF LAW
1. The March 1999 rating decision denying service connection for an upper back and lower disability is final.  38 U.S.C. § 7105 (2012); 38 C.F.R. §§ 20.200, 20.201, 20.302, 20.1103 (2017).
2. New and material evidence has been received to reopen the Veteran’s claims for service connection for an upper back and lower back disability.  38 U.S.C. § 5108 (2012); 38 C.F.R. §§ 3.156 (2017).
3. Throughout the appeal period, the criteria for entitlement to an evaluation in excess of 30 percent for IBS have not been met.  38 U.S.C. §§ 1155, 5107(b) (2012); 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.21, 4.114, Diagnostic Code (DC) 7319 (2017).
4. The criteria for an effective date prior to July 28, 2011, for the award of service connection for IBS have not been met.  38 U.S.C. § 5110 (2012); 38 C.F.R. §§ 3.156, 3.400 (2017).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty from June 1989 to July 1997.  
This matter is before the Board of Veterans’ Appeals (Board) on appeal from June 2013 and an April 2015 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO).  
The Board notes that a June 1998 rating decision denied service connection for headaches, left hand pain, and tingling sensation in the hands and feet.  New and material evidence was received regarding these claims during the appellate period.  VA failed to re-adjudicate the claims in light of the new and material evidence submitted.  As such, the June 1998 rating decision did not become final and new and material evidence is not needed for these claims.  See Mitchell v. McDonald, 27 Vet. App. 431, 436 (2015) (stating that a new decision must be issued that is “directly responsive” to the new evidence); see also Bond v. Shinseki, 659 F.3d 1362, 1367 (Fed. Cir. 2011); Beraud v. McDonald, 766 F.3d 1402, 1407 (Fed. Cir. 2014) (stating that because VA failed to re-adjudicate a claim in light of new and material evidence received during the appellate period, the claim remained pending despite an intervening adjudication).
The Board notes that a November 2014 rating decision continued a 50 percent evaluation for the Veteran’s PTSD with panic disorder.  Additionally, an August 2016 rating decision granted a 30 percent evaluation for the Veteran’s IBS effective July 28, 2011. 
A. Duties to Notify and Assist 
Any error in notice or assistance on the petition seeking to reopen claims of service connection for and upper back and a lower back disability is harmless given the favorable determination on that aspect of the claims.
Regarding the increased rating and effective date claims, the Veteran has not raised any issues with the duty to notify or duty to assist.  See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). 
B. New and Material Evidence 
A claim for service connection for an upper and lower back disability was originally denied in a March 1999 rating decision on the basis that pain was not a disability.  The RO notified the Veteran of its decision, and of his appellate rights.  The Veteran did not appeal the decision, nor did VA actually or constructively receive any new and material evidence within a year following notification.  38 U.S.C. § 7105(c); 38 C.F.R. §§ 3.156, 20.200, 20.201, 20.302, 20.1103.  Accordingly, the claims may now be considered on the merits only if new and material evidence has been received since the time of the prior adjudication.  38 U.S.C. § 5108; 38 C.F.R. § 3.156(a); Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001).
Generally, a claim which has been denied may not thereafter be reopened and allowed based on the same record.  38 U.S.C. §§ 7104, 7105.  However, pursuant to 38 U.S.C. § 5108, if new and material evidence is presented or secured with respect to a claim which has been disallowed, the VA Secretary shall reopen the claim and review the former disposition of the claim. 
New evidence is defined as existing evidence not previously submitted to agency decision makers.  Material evidence is defined as existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim.  38 C.F.R. § 3.156(a).  New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim.  Id.  In determining whether evidence is new and material, the credibility of the new evidence must be presumed.  Fortuck v. Principi, 17 Vet. App. 173, 179-80 (2003); Justus v. Principi, 3 Vet. App. 510, 513 (1992). 
The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is “low.”  See Shade v. Shinseki, 24 Vet. App. 110, 117 (2010).  Furthermore, in determining whether this low threshold is met, VA should not limit its consideration to whether the newly received evidence relates specifically to the reason why the claim was last denied, but instead should ask whether the evidence could reasonably substantiate the claim were the claim to be reopened, either by triggering VA’s duty to assist or through consideration of an alternative theory of entitlement.  Shade, 24 Vet. App. at 118 (2010).
If the Board determines that the evidence submitted is both new and material, it must reopen the case and evaluate the claim in light of all the evidence.  Justus, 3 Vet. App. at 512.  Such evidence is presumed to be credible for the purpose of determining whether the case should be reopened; once the case is reopened, the presumption as to the credibility no longer applies.  Id. at 513.
Here, the evidence received since the March 1999 rating decision includes caselaw that allows pain to be disability if it causes functional impairment.  See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (finding that “pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability”).  This evidence was not before adjudicators when the Veteran’s claims were last denied in March 1999, and it is not cumulative or redundant of the evidence of record at the time of that decision.  It also relates to an unestablished fact necessary to substantiate the claim for service connection for an upper back and a lower back disability, and raises a reasonable possibility of substantiating the claims.  Accordingly, the claims are reopened and to this extend only the appeal is granted. 
C. Increased Rating
Disability ratings are determined by applying the criteria set forth in VA’s Schedule for Rating Disabilities.  Ratings are based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes.  See 38 U.S.C. § 1155; 38 C.F.R. § 4.1.  In evaluating the severity of a particular disability, it is essential to consider its history.  38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991).  When the appeal is from the initial rating assigned with an award of service connection, the severity of the disability at issue from the initial assignment of the disability rating to the present is to be considered, and “staged” ratings may be assigned, based on facts found.  See Fenderson v. West, 12 Vet. App. 119 (1999).
Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating.  Otherwise, the lower rating will be assigned.  See 38 C.F.R. § 4.7.  When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant.  38 U.S.C. § 5107 (b); 38 C.F.R. §§ 3.102, 4.3.
For IBS, a maximum 30 percent rating is assigned for severe irritable colon syndrome with diarrhea or alternating diarrhea and constipation with more or less constant abdominal distress.  See 38 C.F.R. § 4.114, DC 7319.  
In a June 2015 statement, the Veteran stated he has to use the restroom when he is exposed to cool air, cool food, or cool liquids.  He added that sometimes he has to use the bathroom 10 to 15 times per day and sometimes defecates on himself. 
In a December 2015 statement, the Veteran reported that he experienced immediate severe cramping on both sides of his stomach when he attempts to engage in mild exercises.  
In a March 2016 VA examination, the Veteran reported having years of chronic nausea and diarrhea.  Specifically, the Veteran reported loose watery bowel movements three to six times per day.  The Veteran’s nausea was noted to occur daily and to worsen when he thought about certain foods.  However, the Veteran was not on continuous medication to control his IBS.  Also, episodes of bowel disturbance with abdominal distress, or exacerbations or attacks of IBS were not noted.
Since the Veteran is receiving the maximum rate available, a higher rating is only available on an extraschedular basis.  
The United States Court of Appeals for Veterans Claims (Court) has provided a three-pronged test for determining whether extraschedular consideration is warranted.  Thun v. Peake, 22 Vet. App. 111, 114 (2008), aff’d sub. nom. Thun v. Shinseki, 573 F.3d 1366 (Fed. Cir. 2009).  First, as a threshold factor, there must be a finding that the evidence of record presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate.  Id.  In this regard, the Board must compare the level of severity and symptomatology of the claimant’s service-connected disability with the established criteria found in the Rating Schedule for that disability.  If the rating criteria reasonably describe the claimant’s disability level and symptomatology, then the claimant’s disability picture is contemplated by the Rating Schedule, in which case the assigned schedular evaluation is adequate and no referral is required.  Id. Second, if the schedular criteria are found to be inadequate to evaluate the claimant’s disability, the Board must determine whether the exceptional disability exhibits other related factors such as marked interference with employment or frequent periods of hospitalization.  Id.  If so, then under the third step of the inquiry the case must be referred to the Under Secretary for Benefits or the Director of the Compensation and Pension Service for a determination of whether, to accord justice, the claimant’s disability picture requires the assignment of an extraschedular rating.  Id.
Here, though, no such special referral or consideration is warranted since the regular schedular standards applied in this case adequately describe and provide for the Veteran’s IBS symptoms and consequent disability level.  The evidence reflects the Veteran has experienced constant abdominal pain with diarrhea throughout the period on appeal.  As a lay person, the Veteran is competent to report the frequency and severity of symptoms associated with IBS. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a lay person is competent to report on that of which he or she has personal knowledge).  Considering the criteria in DC 7319, the Board finds that the currently assigned 30 percent rating addresses the Veteran's symptoms.  
Marked interference with employment beyond that contemplated by the schedular criteria has not been shown.  38 C.F.R. § 4.1.  The record does not reflect a disability picture that is so exceptional or unusual that the normal provisions of the Rating Schedule would not adequately compensate him for his service-connected disability.  Ordinarily, the VA Rating Schedule will apply unless there are exceptional or unusual factors that would render application of this schedule impractical.  See Fisher v. Principi, 4 Vet. App. 57, 60 (1993); Fanning v. Brown, 4 Vet. App. 225, 229 (1993).  As such, special referral for extraschedular consideration is not warranted in this instance.  Accordingly, the Veteran’s symptomatology does not warrant a disability rating in excess of 30 percent.
D. Effective Date
An August 2016 rating decision granted service connection for IBS effective July 28, 2011.    
Generally, except as otherwise provided, the effective date of an evaluation and award of pension, compensation, or dependency and indemnity compensation based on an original claim; a claim reopened after final disallowance; or a claim for increase, will be the date of receipt of the claim, or the date entitlement arose, whichever is later.  See 38 U.S.C. § 5110; 38 C.F.R. § 3.400.
The term “claim” or “application” means a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit.  38 C.F.R. § 3.1(p).
Regulations defining a “claim” were revised, effective March 24, 2015.  See 79 Fed. Reg. 57,660 (Sept. 25, 2014).  The revision eliminated informal claims and required claims on specific forms.  In this case, however, the applicable regulations are those prior to the revision, as this claim was pending prior to March 24, 2015.  As such, the Board will apply the regulations effective prior to March 24, 2015 regarding defining a claim.  
A formal claim is one that has been filed in the form prescribed by VA.  38 C.F.R. § 3.151(a).  An informal claim may be any communication or action indicating an intent to apply for one or more benefits under VA law.  Thomas v. Principi, 16 Vet. App. 197 (2002); see also 38 C.F.R. §§ 3.1(p), 3.155(a).  An informal claim must be written and must identify the benefit being sought.  See Rodriguez v. West, 189 F.3d 1351 (Fed. Cir. 1999); Brannon v. West, 12 Vet. App. 32, 34-35 (1998). 
To determine when a claim was received, the Board must review all communications in the claims file that may be construed as an application or claim.  See Quarles v. Derwinski, 3 Vet. App. 129, 134 (1992).
Turning to the facts of the case, on August 21, 1997, VA received an original claim from the Veteran seeking service connection for IBS.  In a March 1999 rating decision, the RO denied service connection for IBS.  The March 1999 rating decision became final when the Veteran failed to appeal that decision and new and material evidence was not actually or constructively received within one year following notice. 
As the March 1999 decision is final, it is not subject to revision in the absence of clear and unmistakable error (CUE) in the decisions.  38 U.S.C. §§ 5109A, 7105; see Rudd v. Nicholson, 20 Vet. App. 296 (2006) (finding that only a request for revision based on CUE could result in the assignment of an effective date earlier than the date of a final decision).  A sympathetic reading of the Veteran’s statements and testimony do not reflect that the Veteran has raised a claim of CUE regarding this decision.  See Andrews v. Nicholson, 421 F.3d 1278, 1282 (Fed. Cir. 2005).  Therefore, the finality of this rating decision precludes the Veteran from obtaining an effective date prior to the date of the March 1999 rating decision. 
As such, the Board next considers whether any statement received after the March 1999 rating decision was an informal or formal claim seeking benefits for a IBS. 
The first mention of an intent to reopen a claim seeking service connection for IBS following the March 1999 rating decision occurred on July 28, 2011.  The record reflects that on July 28, 2011, VA received a VA Form 21-0820, Report of General Information, which listed the intent to file for an increased rating or service connection for various disabilities.  This form did not indicate an intent to seek benefits for IBS.  However, on August 15, 2012, the VA received a correspondence that referenced the July 28, 2011, VA Form 21-0820 and indicated a desire to file for service connection for IBS.    
Even when all statements received prior to July 28, 2011, and after the March 1999 rating decision are sympathetically construed, there is no indication that prior to July 28, 2011, and after March 1999, the Veteran expressed an intent to file a claim of service connection for IBS.  Brokowski v. Shinseki, 23 Vet. App. 79 (2009).  Therefore, the earliest date of claim after the final March 1999 rating decision is the VA Form 21-0820 that was received on July 28, 2011, and which is the basis of the currently assigned effective date.  
Thus, the Board finds that the Veteran is not entitled to an effective date prior to July 28, 2011, for the award of service connection for IBS, and the claim must be denied.
REASONS FOR REMAND
1. Entitlement to service connection for a left shoulder disability, to include as secondary to a service connected disability; entitlement to service connection for a right shoulder disability, to include as secondary to a service connected disability; entitlement to service connection for an upper back disability, to include as secondary to a service connected disability; entitlement to service connection for a low back disability, to include as secondary to a service connected disability; entitlement to service connection for a left-hand disability (claimed as left-hand pain), to include as secondary to a service connected disability; entitlement to service connection for a bilateral hand disability (claimed as tingling in the hands), to include as secondary to a service connected disability; entitlement to service connection for a bilateral feet disability (claimed as tingling in the feet), to include as secondary to a service connected disability, and entitlement to service connection for headaches, to include as secondary to a service connected disability are remanded.
The Veteran was scheduled for VA examinations in connections with his claims in May 2013 and June 2016, but did not attend either VA examination.  Regarding the May 2013 VA examination, the Veteran explained in a July 2013 notice of disagreement that he was not informed of the VA examination.  He specified that a message was left on his phone regarding the appointment but his phone was not working and by the time he secured a working phone and retrieved the message, the date for the VA examination had passed.  
The Veteran was offered another VA examination in June 2016 and the Veteran failed to attend.  The Veteran, in an August 2016 VA Form 9, explained that he did not receive notification regarding the June 2016 VA examination.  
The Board concludes that the Veteran has presented good cause for his failure to attend the VA examinations.  See 38 C.F.R. § 3.655.  Regarding the May 2013 VA examination, the Veteran did not have notice of the date of the VA examination because his phone was not working.  As to the June 2016 VA examination, a review of the record shows that the Veteran’s address listed in his August 2016 VA Form 9 is different than the address the VA sent a November 22, 2016 letter to.  This letter was returned to the VA was undeliverable.  Thus, it is possible that the notification regarding the June 2016 VA examination was never delivered to the Veteran.  Additionally, the Veteran has attended VA examinations in the past, which adds credibility to his assertions that he never received notification.  As such, the Board finds that the Veteran has presented good cause for failing to attend his May 2013 and June 2016 VA examinations.   
2. Entitlement to a rating for PTSD with panic disorder in excess of 50 percent is remanded.
A. VA Examination 
The Veteran was last examined by VA regarding the severity of his PTSD with panic disorder in October 2014.  Subsequently, a statement received in June 2015 indicates an increase in the Veteran’s psychiatric symptoms.  Additionally, in the June 2015 statement the Veteran complained about the adequacy of the October 2014 examination.  As such, a new examination assessing the current severity of the Veteran’s PTSD with panic disorder is needed.
B. Private Treatment Records
The Veteran reported that he has been treated for the claimed disability by Dr. N.R.  The Board acknowledges that the RO made two attempts to secure records from this provider in October 2015.  As the Board is remanding the issue for a new VA examination, the Board finds that another attempt should be made to secure these records.  See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c).
The matters are REMANDED for the following actions:
1. Obtain and associate with the claims file VA treatment records from April 2016 to the present. 
2. Contact the Veteran and afford him the opportunity to identify or submit any additional pertinent evidence in support of his claims, to include records from Dr. N.R.  Based on the response received, attempt to procure copies of all records which have not previously been obtained from identified treatment sources. 
3. After completing the development in 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature, extent, and etiology of his left shoulder, right shoulder, upper back, and lower back disabilities.  The examiner is asked to provide an opinion on the following questions:
(a.) Identify all current chronic left shoulder, right shoulder, upper back, and lower back disabilities that have existed since July 2011.  The examiner should indicate if there is any pain that caused functional impairment.
(b.) Is it at least as likely as not that any diagnosed left shoulder, right shoulder, upper back, and lower back condition(s), was caused by the Veteran’s service-connected disabilities (PTSD with panic disorder; IBS; cervical spine; sensory deficits in right ear, posterior temporal area, upper extremity, and upper chest; and tinnitus)?  
(c.) Is it at least as likely as not that any diagnosed left shoulder, right shoulder, upper back, and lower back condition(s) was aggravated (that is, any increase in severity beyond the natural progression of the condition) by the Veteran’s service-connected disabilities listed above?  
(d.) If an arthritic condition of the left shoulder, right shoulder, upper back, and lower back is diagnosed, the examiner should offer an opinion on whether it is at least as likely as not that the Veteran had any arthritic condition of the left shoulder, right shoulder, upper back, and lower back within a year of his discharge from service. 
A complete rationale for all opinions must be provided.  If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation.  The clinician must indicate whether there was any further need for information or testing necessary to make a determination.  Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner.
4. After completing the development in 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature, extent, and etiology of his hand and feet disabilities.  The examiner is asked to provide an opinion on the following questions:
(a.) Identify all current chronic hand and feet disabilities that have existed since July 2011.  The examiner should indicate if there is any pain that caused functional impairment.
(b.) Is it at least as likely as not that any diagnosed hand and feet condition(s), was caused by the Veteran’s service-connected disabilities (PTSD with panic disorder; IBS; cervical spine; sensory deficits in right ear, posterior temporal area, upper extremity, and upper chest; and tinnitus)? 
(c.) Is it at least as likely as not that any diagnosed hand and feet condition(s) was aggravated (that is, any increase in severity beyond the natural progression of the condition) by the Veteran’s service-connected disabilities listed above.  
A complete rationale for all opinions must be provided.  If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation.  The clinician must indicate whether there was any further need for information or testing necessary to make a determination.  Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner
5. After completing the development in 1 and 2, schedule the Veteran for an examination by an appropriate clinician to determine the nature, extent, and etiology of his headaches.  The examiner is asked to provide an opinion on the following questions:
(a.) Is it at least as likely as not that any diagnosed headache condition, was caused by the Veteran’s service-connected disabilities (PTSD with panic disorder; IBS; cervical spine; sensory deficits in right ear, posterior temporal area, upper extremity, and upper chest; and tinnitus)? 
(b.) Is it at least as likely as not that any diagnosed headache condition was aggravated (that is, any increase in severity beyond the natural progression of the condition) by the Veteran’s service-connected disabilities listed above?  
A complete rationale for all opinions must be provided.  If it is not possible to provide any opinion requested, a specific measurement, or an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training).
6. After completing the development requested in items 1 and 2, schedule the Veteran for an examination by appropriate clinician to determine the current severity of his service-connected psychiatric disorder.  The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. 

 
L. BARSTOW
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S. Patel, Associate Counsel 

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