Citation Nr: 18160665
Decision Date: 12/27/18	Archive Date: 12/27/18

DOCKET NO. 10-24 248
DATE:	December 27, 2018
REMANDED
Entitlement to service connection for residuals of a sciatic nerve injury is remanded.
Entitlement to service connection for a left knee disability, to include residuals of dislocation, is remanded. 
Entitlement to service connection for a right knee disability, to include residuals of dislocation, is remanded.
Entitlement to service connection for a bilateral foot disability, to include as secondary to a sciatic nerve injury, is remanded.
Entitlement to service connection for osteoarthritis of the back, to include as secondary to a sciatic nerve injury, is remanded.
Entitlement to service connection for bilateral carpal tunnel syndrome is remanded.
Entitlement to service connection for tachycardia, to include as secondary to service-connected posttraumatic stress disorder (PTSD), is remanded.
INTRODUCTION
The appellant served on active duty in the U.S. Army from January 1983 to March 1988.  She is the recipient of the Army Achievement Medal and the Army Good Conduct Medal on two occasions.
This matter comes before the Board of Veterans’ Appeals (Board) from an April 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia.  The appellant filed a timely Notice of Disagreement (NOD), received in October 2009.  A Statement of the Case (SOC) was issued in May 2010.  A timely substantive appeal was received in June 2010.  Supplemental Statements of the Case (SSOC) was issued in May 2011 and August 2018.
The appellant requested a hearing before a Decision Review Officer (DRO) in July 2010.  Such hearing before a Decision Review Officer was held in December 2010.  A transcript is of record.
The appellant requested a travel Board hearing before a Veterans Law Judge in July 2010.  This request was withdrawn in October 2010, when the appellant reiterated her request for the aforementioned DRO hearing instead.  The attorney requested a Board hearing by videoconference in August 2018.  However, the request for a Board hearing by videoconference was withdrawn in September 2018.  Thus, the request for a Board hearing is deemed withdrawn.  38 C.F.R. § 20.704(e).
The appellant’s attorney requested a hearing before a Decision Review Officer again in August 2018, in response to the August 2018 SSOC.  38 C.F.R. § 3.103(c)(1) affords the right to “a hearing,” not multiple hearings.  See also 38 C.F.R. § 20.700(a).  Neither the appellant nor her attorney have provided good cause as to why a second hearing before a Decision Review Officer should be provided.  As such, providing a second Decision Review Officer hearing is not required.  38 C.F.R. §§ 3.103(c)(1), 20.700(a).
The grant of service connection for posttraumatic stress disorder (PTSD) in an August 2018 rating decision constitutes a full award of the benefit sought on appeal with respect to that claim.  See Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir. 1997) (holding that a separate notice of disagreement must be filed to initiate appellate review of “downstream” elements such as the disability rating or effective date assigned).  Indeed, an NOD regarding, inter alia, the initial evaluation of PTSD was received in October 2018.  
Generally, the filing of a NOD confers jurisdiction on the Board and the next step is for the Agency of Original Jurisdiction (AOJ) to issue an SOC.  See Manlincon v. West, 12 Vet. App. 238 (1999).  However, because the Board’s review of the record reveals that the RO is still taking action on this issue, see October 26, 2018, letter, the Board will not exercise formal jurisdiction over it at this time.
The Board observes an October 25, 2018, letter stated that the October 2018 correspondence could not be accepted as a timely NOD with respect to a July 2011 rating decision, which, inter alia, denied entitlement to a TDIU.  However, to the extent that the October 2018 NOD regarding the initial rating assigned for PTSD indicated that the appellant and her attorney sought entitlement to a TDIU as part and parcel of the increased rating claim, the Board notes that such is indeed part of the PTSD increased rating claim.  See Rice v. Shinseki, 22 Vet. App. 447, 453-54 (2009).  
REASONS FOR REMAND
During the appellant’s December 2010 DRO hearing, she reported that she received treatment for her back pain and sciatic nerve problems at 97th General Hospital in Frankfurt, Germany, in 1987 or 1988.  An orthopedist reportedly told her that she had a bad sciatic nerve and it was possible that the cause of which was carrying and delivering a ten-pound baby.  Following separation from service in March 1988, she was treated for sciatica at the 209th Medical Clinic, a uniformed services hospital, in Hanau, Germany, in May 1988 and July 1988.  
The appellant testified that she had been seen at the 97th General Hospital and the 209th Medical Clinic prior to April 1987, but had been told by records clerks that there was no record of her previously having been seen.  She reported a minor post-service traffic accident in 1990, which jarred her back.  X-rays taken after the accident at Darnall Army Clinic, in Texas, were negative.
She also reported that a private chiropractor diagnosed bad sciatic nerve and degenerative osteoarthritis in 1996, and noted that she had previously provided VA information to obtain records from this chiropractor.  
With respect to carpal tunnel syndrome, she first sought treatment during her second tour at the 97th General Hospital in Frankfurt, Germany.  Her first post-service treatment for carpal tunnel syndrome was in 1998 at Family Medicine Clinic in Copperas Cove, Texas.  She also contended that she developed tachycardia secondary to her PTSD, which was first diagnosed in 2004 at the Family Medicine Clinic in Copperas Cove, Texas.  
Received in September 2013 were VA Forms 21-4142 upon which the appellant identified medical facilities for VA to contact and request records.  Private facilities included Family Medicine Clinic in Copperas Cove, Texas, and Metroplex Pavilion RTC.  She also noted that the U.S. Army would have records from after her active service, as she was seen as a dependent spouse at Army medical facilities between 1988 and 1996. 
VA has an obligation to undertake reasonable efforts to obtain private records, which generally must consist of an initial records request and at least one follow-up request if the records were not received.  See 38 U.S.C. § 5103A(b); 38 C.F.R. § 3.159(c)(1).  A review of the record reveals that no attempts have been made to obtain these relevant records from Family Medicine Clinic or Metroplex Pavilion RTC.  
With respect to military hospital records and the appellant’s post-service Army medical records, the Board observes that such are Federal records.  The duty to assist includes making as many requests as necessary to obtain relevant records in the custody of a Federal department or agency.  
Thus, a remand is warranted to enable the RO to take appropriate measures to obtain these potentially relevant records.  See McGee v. Peake, 511 F.3d 1352, 1357 (Fed. Cir. 2008) (noting that Congress has explicitly defined VA’s duty to assist in terms of relevance); see also Golz v. Shinseki, 590 F.3d 1317, 1320-21 (Fed. Cir. 2010) (noting that “[r]elevant records for the purpose of § 5103A are those that relate to the injury for which the claimant is seeking benefits and have a reasonable possibility of helping to substantiate the veteran’s claim.”). 
The Board observes that the appellant also discussed a 1996 chiropractor who first diagnosed degenerative arthritis in her December 2010 DRO hearing.  However, no VA Form 21-4142 is of record for a chiropractor.  It is unclear if this chiropractor was part of the Family Medicine Clinic, for which a VA Form 21-4142 was received.  If the appellant wishes to identify other medical providers, she is invited to do so as this matter is already being remanded.
The matters are REMANDED for the following action:
1. Undertake appropriate efforts to obtain copies of medical records from the following sources: 
(a.) 97th General Hospital in Frankfurt, Germany, from the appellant’s 1983-1988 active service and from 1988-1996 when she was a dependent spouse;
(b.) 209th Medical Clinic, a uniformed services hospital, in Hanau, Germany, from the appellant’s 1983-1988 active service and from 1988-1996 when she was a dependent spouse; 
(c.) Darnall Army Clinic in Texas, from the appellant’s 1983-1988 active service and from 1988-1996 when she was a dependent spouse;
(d.) Family Medicine Clinic in Copperas Cove, Texas, from 1996 to 2008; and
(e.) Metroplex Pavilion RTC in Killeen, Texas.
All attempts to secure this evidence must be documented in the claims file.  If, after making reasonable efforts to obtain the named records, they are not able to be secured, provide the required notice and opportunity to respond to the appellant and her attorney. 

 
K. Conner
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Behlen, Associate Counsel

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