Citation Nr: 18160621
Decision Date: 12/27/18	Archive Date: 12/27/18

DOCKET NO. 11-32 953
DATE:	December 27, 2018
ORDER
Entitlement to service connection for prostate cancer is dismissed.
Entitlement to a compensable rating for right index finger deformity with ankylosis prior to February 23, 2015, and to a rating in excess of 10 percent thereafter is dismissed.
Entitlement to an initial rating in excess of 10 percent for painful scar residual of a chin laceration is dismissed.
Entitlement to an initial rating in excess of 30 percent for disfiguring scar residuals of a chin laceration is dismissed.
Entitlement to an initial rating in excess of 10 percent for radiculopathy of the left lower extremity is dismissed.
Entitlement to an initial rating in excess of 20 percent for radiculopathy of the right lower extremity is dismissed. 
Entitlement to an initial rating in excess of 40 percent for degenerative disc disease and spondylosis of the lumbar spine is denied.
Entitlement to a rating of total disability based on individual unemployability (TDIU) is granted.
REMANDED
Entitlement to service connection for an acquired psychiatric condition is remanded.
FINDINGS OF FACT
1. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to service connection for prostate cancer.
2. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to a compensable rating for right index finger deformity with ankylosis prior to February 23, 2015, and to a rating in excess of 10 percent thereafter.
3. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to an initial rating in excess of 10 percent for painful scar residual of a chin laceration.
4. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to an initial rating in excess of 30 percent for disfiguring scar residuals of a chin laceration.
5. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to an initial rating in excess of 10 percent for radiculopathy of the left lower extremity.
6. In a June 2017 written communication, the Veteran, through his representative, requested to withdraw the issue of entitlement to an initial rating in excess of 20 percent for radiculopathy of the right lower extremity. 
7. Throughout the period on appeal, the Veteran’s degenerative disc disease and spondylosis of the lumbar spine have not manifested in unfavorable ankylosis of the thoracolumbar spine.
8. The Veteran is shown to be unable to secure and maintain substantially gainful employment due to his service-connected disabilities since March 11, 2013.
CONCLUSIONS OF LAW
1. The criteria for withdrawal have been met, and the appeal as to the issue of entitlement service connection for prostate cancer is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
2. The criteria for withdrawal have been met, and the appeal as to the issue of entitlement to a compensable rating for right index finger deformity with ankylosis prior to February 23, 2015, and to a rating in excess of 10 percent thereafter cancer is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
3.  The criteria for withdrawal have been met, and the appeal as to the issue of entitlement to an initial rating in excess of 10 percent for painful scar residual of a chin laceration cancer is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
4. The criteria for withdrawal have been met, and the appeal as to the issue of entitlement to an initial rating in excess of 30 percent for disfiguring scar residuals of a chin laceration cancer is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
5. The criteria for withdrawal have been met, and the appeal as to the issue of entitlement to an initial rating in excess of 10 percent for radiculopathy of the left lower extremity cancer is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
6. The criteria for withdrawal have been met, and the appeal as to the issue of entitlement to an initial rating in excess of 20 percent for radiculopathy of the right lower extremity is dismissed.  38 U.S.C. § 7105 (b)(2), (d)(5) (2012); 38 C.F.R. § 20.204 (2018).
7. The criteria for entitlement to an initial rating in excess of 40 percent for degenerative disc disease and spondylosis of the lumbar spine have not been satisfied. 38 U.S.C. §§ 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.321, 4.71a, Diagnostic Code 5242 (2018).
8. The criteria for entitlement to a rating of total disability based on individual unemployability (TDIU) have been satisfied as of November 25, 2015.  38 U.S.C. § 1155; 38 C.F.R. § 4.16.
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
The Veteran served on active duty in the United States Army from May 1966 to May 1968, and from March 1975 to February 1979.  This case comes on appeal of December 2009, March 2010, November 2011, March 2016, October 2016, and December 2016 rating decisions.  In his substantive appeal to the Board, the Veteran initially requested a videoconference hearing, however the Veteran withdrew that request in a June 2017 written communication. 
1. Entitlement to service connection for prostate cancer
2. Entitlement to a compensable rating for right index finger deformity with ankylosis prior to February 23, 2015, and to a rating in excess of 10 percent thereafter
3. Entitlement to an initial rating in excess of 10 percent for painful scar residual of a chin laceration
4. Entitlement to an initial rating in excess of 30 percent for disfiguring scar residuals of a chin laceration
5. Entitlement to an initial rating in excess of 10 percent for radiculopathy of the left lower extremity
6. Entitlement to an initial rating in excess of 20 percent for radiculopathy of the right lower extremity
Under 38 U.S.C. § 7105, the Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed.  A substantive appeal may be withdrawn in writing at any time before the Board promulgates a decision.  38 C.F.R. § 20.202 (2018).
Prior to the promulgation of a decision in this case, in a June 2017 signed, written statement, the Veteran authorized his representative to withdraw the pending appeals listed above.  The Veteran specifically requested these appeals be withdrawn and noted that he understood the consequences of this decision.  Accordingly, no allegations of errors of fact or law remain for appellate consideration with respect to these matters.  The Board does not have jurisdiction to review these issues on appeal and they are therefore dismissed.

Increased Rating
Disability evaluations are determined by the application of the facts presented to the VA’s Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4.  The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations.  38 U.S.C. § 1155; 38 C.F.R. § 4.1.
Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation.  Otherwise, the lower rating will be assigned.  38 C.F.R. § 4.7.  Reasonable doubt as to the degree of disability will be resolved in the Veteran’s favor.  38 C.F.R. § 4.3.
Where an increase in the level of a disability is at issue, the primary concern is the present level of disability.  Francisco v. Brown, 7 Vet. App. 55 (1994).  Where the evidence contains factual findings that demonstrate distinct time periods in which the service-connected disability exhibits symptoms that would warrant different evaluations during the course of the appeal, the assignment of staged ratings is appropriate.  See Fenderson v. West, 12 Vet. App. (1999); Hart v. Mansfield, 21 Vet. App. (2007).
When evaluating musculoskeletal disabilities, VA may, in addition to applying schedular criteria, consider granting a higher rating in cases in which the claimant experiences additional functional loss due to pain, weakness, excess fatigability, or incoordination, to include with repeated use or during flare-ups, and those factors are not contemplated in the relevant rating criteria.  38 C.F.R. §§ 4.40, 4.45; Mitchell v. Shinseki, 25 Vet. App. 32 (2011); DeLuca v. Brown, 8 Vet. App. 202, 204-07 (1995).  The provisions of 38 C.F.R. § 4.40 and 38 C.F.R. § 4.45 are to be considered in conjunction with the diagnostic codes predicated on limitation of motion.  See Johnson v. Brown, 9 Vet. App. 7 (1996).
In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25.  Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a Veteran’s service-connected disabilities.  38 C.F.R. § 4.14. 
Generally, separate disability ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one condition is not “duplicative of or overlapping with the symptomatology” of the other condition.  Esteban v. Brown, 6 Vet. App. 259, 262 (1994).  The Court has also held that within a particular diagnostic code, a claimant is not entitled to more than one disability rating for a single disability unless the regulation expressly provides otherwise.  Cullen v. Shinseki, 24 Vet. App. 74 (2010).
Entitlement to an initial rating in excess of 40 percent for degenerative disc disease and spondylosis of the lumbar spine
The Veteran was granted service connection for lumbar spondylosis and degenerative disc disease by a December 2009 rating decision at a rating of 10 percent.  Following the Veteran’s appeal and further examination, in a November 2011 rating decision, the AOJ increased the rating for the Veteran’s lumbar spine condition to 40 percent, effective the date of the claim.  The Veteran’s lumbar spondylosis and degenerative disc disease is rated under 38 C.F.R. § 4.71a, Diagnostic Code 5242, for degenerative arthritis of the spine. 
Diagnostic Code 5242 is rated under the General Rating Formula for Diseases and Injuries of the Spine (Rating Formula).  Under the Rating Formula, a 40 percent rating is warranted, in pertinent part, for forward flexion of the thoracolumbar spine measuring to 30 degrees or less; or, favorable ankylosis of the entire thoracolumbar spine.  To warrant a rating of 50 percent, there must be unfavorable ankylosis of the entire thoracolumbar spine.  To warrant a rating of 100 percent, there must be unfavorable ankylosis of the entire spine.  Ankylosis is stiffening or fixation of a joint as the result of a disease process, with fibrous or bony union across the joint.  Dinsay v. Brown, 9 Vet. App. 79, 81 (1996).
An alternative rating for spinal conditions is available under Diagnostic Code 5243 when there is a diagnosis of intervertebral disc syndrome.  The Board notes, however, that the Veteran has not been found to have a diagnosis of intervertebral disc syndrome at any point throughout the claim. 
The Veteran first underwent a VA examination in association with this claim in November 2009.  Although the examiner diagnosed the Veteran’s condition and attributed it to an in-service injury, the examiner did not record range of motion measurements at that time.  
In a December 2010 VA examination, the Veteran was found to have forward flexion of the thoracolumbar spine to 30 degrees, however forward flexion decreased to 10 degrees after repetition.  The Veteran was not found to have spinal ankylosis at this time.  Accordingly, as this was the first time range of motion had been measure in association with the claim, the Veteran was awarded a 40 percent rating effective the date of the claim.  
The Veteran underwent a new VA examination in February 2015.  At that time, there was shown to be some improvement in range of motion of the Veteran’s thoracolumbar spine.  The improvement was not deemed permanent as to warrant a reduction in the rating.  The Veteran also reported severe flare-ups every few months, lasting four to five days, and he claimed it was difficult for him to walk during that time. The Veteran was not found to have spinal ankylosis.     
Most recently, the Veteran underwent an additional VA examination in June 2016.  There the examiner noted that the Veteran complained of flare-ups two to three times per week that had made his condition worse.  The examiner reported that the examination was being conducted during a flare-up.  The Veteran had considerable limitation of motion and limitation of function due to pain, however ankylosis was not present.  
Although the Board recognizes that the Veteran’s lumbar spine condition causes significant pain and loss of function, and may indeed have worsened due to flare-ups, there is no indication that his condition has resulted in unfavorable ankylosis of the spine, to include during a flare-up.  Throughout multiple examinations during the appeal period, examiners have consistently ruled out ankylosis.  Furthermore, the Veteran’s VA treatment records do not document ankylosis at any point.  No further range of motion testing or estimation, whether in weight-bearing or nonweight-bearing, active or passive, or during flare-ups would avail the Veteran, as the evidence does not show, nor does he contend, that his back is fixed.  
The Board notes that the record documents pain and numbness due to radiculopathy of the left and right lower extremities.  Although these conditions have been found to stem from the Veteran’s service-connected lumbar spine condition, they have already been rated separately as directed by Note 1 of the Rating Formula.  
Accordingly, the preponderance of the evidence is against a finding that a rating in excess of 40 percent is warranted for degenerative disc disease and spondylosis of the lumbar spine at any point during the period on appeal.  As the preponderance of the evidence is against this finding, the “benefit of the doubt” rule is not applicable and the Board must deny the claim.  See 38. U.S.C. §5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 
7. Entitlement to a rating of total disability based on individual unemployability (TDIU)
It is the established policy of VA that all Veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled.  See 38 C.F.R. § 4.16.  In determining whether unemployability exists, consideration may be given to the Veteran’s level of education, special training and previous work experience, but not to his age or to any impairment caused by nonservice-connected disabilities.  See 38 C.F.R. §§ 3.341, 4.16, 4.19.
A total disability rating for compensation may be assigned where the schedular rating is less than total when the disabled person is, in the judgment of the rating agency, unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, provided that, if there is only one such disability, this disability shall be ratable at 60 percent or more.  If there are two or more disabilities, there shall be at least one disability ratable at 40 percent or more and the combined rating must be 70 percent or more.  See 38 C.F.R. § 4.16(a). 
Pursuant to 38 C.F.R. § 4.16(b), when a claimant is unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities, but fails to meet the percentage requirements for eligibility for a total rating set forth in 38 C.F.R. § 4.16(a), such case shall be submitted for extraschedular consideration. 
The ultimate question of whether a Veteran is capable of substantial gainful employment is not a medical one; that determination is for the adjudicator. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013); Floore v. Shinseki, 26 Vet. App. 376, 381 (2013).  As such, the focus of the examiner is not on whether the Veteran is unemployable due to his service-connected disabilities but the functional impairment caused solely by his service-connected disabilities. 
The Veteran first raised the issue of TDIU in an April 2016 correspondence, however TDIU is considered to be part and parcel of an increased rating claim when raised by the record during the appeal.  See Rice v. Shinseki, 22 Vet. App. 447 (2009).  Here, the Veteran has had pending appeals regarding the initial ratings of several disabilities—to include his lumbar spine disability—dating back to his August 2009 claim.  Accordingly, TDIU may be considered back to that date. 
The Veteran is currently service connected for lumbar spondylosis and degenerative disc disease at a rating of 40 percent, for disfiguring scar residuals of a chin laceration at a rating of 30 percent, for painful scar residuals of a chin laceration at a rating of 10 percent, for radiculopathy of the right lower extremity at a rating of 20 percent, for radiculopathy of the left lower extremity at a rating of 10 percent, and for a right index finger deformity with ankylosis at a rating of 10 percent.  The Veteran’s combined rating for these service-connected disabilities is 80 percent, as of April 26, 2016.  The combined rating was 70 percent, effective February 23, 2015, and the combined rating was 60 percent, effective August 26, 2009.  The Veteran’s lumbar spine disability was rated at 40 percent, effective August 26, 2009. 
This rating history means that the Veteran became schedularly eligible for TDIU on February 23, 2015, as a result of a combined rating of at least 70 percent, with one disability rated 40 percent or more.  Prior to that date, the Veteran did not meet the rating requirement for schedular eligibility.  The Board must therefore evaluate whether the Veteran has been unable to secure and maintain gainful employment throughout the entire claim period.  If, at any point after February 23, 2015, the Board makes such a finding, it may grant TDIU in the first instance.  If the Board finds that the Veteran was unable to secure and maintain gainful employment prior to February 23, 2015, it must refer the claim to the Director of Compensation Services to determine whether an extraschedular award of TDIU is warranted. 
The Board notes that the Veteran documented his employment history on a VA Form 21-8940 when applying for a TDIU.  There, the Veteran reported that he most recently worked full-time as a store clerk, approximately 35 hours per week, until October 28, 2015.  This information is corroborated by a report from the Veteran’s most recent employer, as well as by a January 2013 VA treatment record in which the Veteran described working 36 hours per week.  The Veteran reported that he left this most recent job after being assaulted during an armed robbery.  
Social Security Administration (SSA) documents show that the Veteran previously worked as a hardware installer from 1996 through December 2010, in addition to occasional contract welding from 2004 to 2007.  The Veteran was laid off from his hardware installation job in 2010 and applied for SSA disability benefits.  In July 2011, SSA determined that the Veteran was not disabled at that time.  The Board notes that there are significant differences in the definitions of disability within SSA and VA systems, therefore SSA are not binding on VA.  Holland v. Brown, 6 Vet. App. 443, 448 (1994).  On the other hand, there are also significant similarities between the two systems and the Board may view SSA findings as probative evidence. 
In June 2017, the Veteran submitted a formal vocational assessment from G.F., a Workers’ Compensation Practitioner.  After reviewing the claims file and interviewing the Veteran, G.F. evaluated the Veteran’s ability to secure or follow gainful employment, solely in light of his service-connected disabilities.  Ultimately G.F. concluded that the Veteran became unable to secure or maintain employment, to include sedentary employment, as of November 25, 2015. 
G.F. first noted, based on the most recent VA back conditions examination, that the Veteran’s service-connected lumbar spine condition limited the Veteran’s baseline range of motion, making him unable to perform tasks that required him to bend forward or move side to side.  The Veteran reported flare-ups that caused pain, fatigue, weakness, lack of endurance, and incoordination.  Combined, this interfered with the Veteran’s ability to sit, stand, and sleep.  Related to the back condition, the Veteran is also service-connected for mild to moderate radiculopathy of the bilateral lower extremities.  The Veteran’s overall back condition caused an abnormal gait and occasional limp, requiring constant use of a cane for ambulation, and occasional use of a back brace and walker.  
G.F. also referenced October 1, 2015 and November 25, 2015 physical therapy consultation notes from Columbia VA Medical Center.  In October 2015, the Veteran reported his lower back pain as a constant dull ache and occasional sharp pain.  He experienced pain radiating from his right buttock to his right toes and experienced numbness in his left toes.  He reported constant numbness and tingling in his right thigh region.  His pain was worse when working late at night and after prolonged activity, and was aggravated by standing, transitioning from sitting to standing, and walking.  Additionally, he was having fecal incontinence twice a month.  At the November consultation, the Veteran’s symptoms were nearly identical, however by that point he was reporting his pain level as a seven out of ten. 
In his interview with G.F., the Veteran reported daily pain from flare-ups of his back, during which he could not tolerate sitting or standing for long periods of time.  He also reported difficulty walking short distances as well as difficulty getting in and out of the shower. 
In addition to his lumbar spine disability with associated radiculopathy, G.F. noted that the Veteran’s function was limited due to his service-connected right index finger disability.  Due to the post-surgical finger ankylosis of his dominant hand, the Veteran experienced regular pain and had difficulty with grip, to the extent that he frequently could not hold a pen. 
G.F. concluded that the Veteran clearly could not meet the requirements of any employment requiring frequent physical activity or exertion.  G.F. also concluded that the Veteran could not secure or maintain sedentary employment.  According to G.F., the Veteran was precluded from sedentary employment due to his physical limitations.  Many sedentary level jobs, he explained, require either frequent (defined as from one-third to two-thirds of a full work day) or constant (defined as more than two-thirds of a full day) sitting.  Given the difficulty the Veteran reported with sitting for long periods of time, this would present problems maintaining a sedentary job.  Furthermore, the Veteran’s constant pain levels were sufficient to cause difficulty concentrating on tasks.  In addition, the frequency of his flare-ups would likely cause him to miss numerous work days, thereby preventing him from maintaining employment. 
Regarding the Veteran’s ability to secure gainful employment, G.F. noted that the Veteran had a high school education with additional basic courses in Math, English, and Reading from a technical college.  The Veteran’s main employment training was an on-the-job program in metal fabrication.  His entire employment history had involved physically-demanding jobs, based largely on skills he developed during his military experience.  The Veteran had not benefitted from any formalized computer training.  In short, G.F. concluded, the Veteran could not reasonably be expected to perform work for which he was qualified by virtue of his education and experience, and there would be no basis upon which to develop a vocational rehabilitation plan for acquiring a new set of skills for alternative semi-skilled or skilled work that would result in regular employment.  G.F. set the date at which the Veteran could not secure or maintain gainful employment as November 25, 2015, as this was the date where the evidence demonstrated that the Veteran’s lumbar spine disabilities became so severe as to preclude even sedentary employment.  
G.F.’s vocational assessment is probative, as it is thoroughly supported by reference to the Veteran’s medical records.  Indeed, the Board finds the report to be persuasive.  When accounting for the Veteran’s entire service-connected disability picture, the evidence favors a finding that the Veteran has been unable to secure or maintain gainful employment since November 25, 2015.  Based on the information in the Veteran’s VA examinations, VA treatment records, and the Veteran’s lay statements, the Veteran’s service-connected disabilities cause significant difficulty with walking, standing, sitting, writing, and grasping with his right hand.  These disabilities also cause difficulty concentrating due to pain.  These physical limitations are combined with the Veteran’s limited vocational opportunities due to his education and employment history.  The claim for TDIU is granted effective November 25, 2015.  
Prior to November 25, 2015, the Veteran was able to maintain gainful employment, as evidenced both by G.F.’s reports as well as the Veteran’s employment history.  The Board notes that the Veteran has not alleged that his employment through October 2015 was protected or did not provide income above the poverty level.  As the Veteran has only been deemed unemployable after meeting the schedular requirement for TDIU eligibility, referral for extraschedular consideration is not warranted. 
REMANDED ISSUE
Entitlement to service connection for an acquired psychiatric condition is remanded.
In a June 2017 brief, the Veteran’s representative noted that the Veteran had not been afforded a VA psychiatric examination and requested that the claim for an acquired psychiatric condition be remanded to afford the Veteran an examination.  
VA is obliged to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim.  38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79 (2006).
Here, the Veteran’s VA treatment records show potential diagnoses of both bipolar disorder and major depression.  At issue is whether an acquired psychiatric condition was caused by or had its onset in service.  The Veteran’s service treatment records do not document any history of a mental health condition, nor do separation examinations.  However, in his initial claim, the Veteran stated that his “mental state goes back to service” and that he was “on levy” twice.  He did not explain what this meant and the AOJ did not clarify.  Furthermore, in an April 2011 discharge summary after a mental health hospitalization, the Veteran’s psychiatrist, Dr. R.A.P., stated, “I discussed my concern on several occasions with both the patient and his wife about how atypical this presentation was and that manic or hypomanic episodes usually occur prior to the 7th decade of life.  It may be possible with his long history of alcohol dependence that a manic or hypomanic episode was masked and not brought to the attention of mental health providers.  The diagnosis of exclusion at this point in time is bipolar disorder not otherwise specified, as no other etiology was elucidated.”  In other words, Dr. R.A.P. expressed that it was unusual for a patient to first present with mental health symptoms such as the Veteran’s at such a late age.  This led her to believe that the Veteran’s condition may have existed earlier while being interpreted as symptoms of substance abuse.  
The Board believes that it is sufficient to trigger VA’s duty to assist by providing an examination.  
The matter is REMANDED for the following action:
1. Request the Veteran’s complete service personnel file, and associate it with the record.
2. Schedule the Veteran for a VA psychiatric examination.  The examiner should review the entire claims file, and the report of examination should include discussion of the Veteran’s documented history and assertions.  All indicated tests and studies should be accomplished and all clinical findings should be reported in detail.  
The examiner should clearly identify all current acquired psychiatric disorders.  Then, with respect to each such diagnosed disability, the examiner should render an opinion, as to whether it is at least as likely as not (i.e., there is a 50 percent or greater probability) that the disability had onset in, or is otherwise related to service.  
The examiner should set forth all examination findings, along with complete rationale for the conclusions reached, in a printed report.
3. Readjudicate the appeal.  If any benefits sought remain denied, issue a supplemental statement of the case and return the case to the Board.
 
V. Chiappetta
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Giaquinto, Associate Counsel 

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