Citation NR: 9632347 Decision Date: 11/18/96 Archive Date: 12/02/96 DOCKET NO. 94-17 272 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Roanoke, Virginia THE ISSUES 1. Entitlement to service connection for a gastrointestinal disorder as secondary to the veteran's service-connected post-traumatic stress disorder (PTSD). 2. Entitlement to service connection for loss of teeth as secondary to the veteran's service-connected PTSD. REPRESENTATION Appellant represented by: Virginia Department of Veterans Affairs ATTORNEY FOR THE BOARD B. W. Lemoine, Associate Counsel INTRODUCTION The veteran had active military service from November 1968 to November 1970. The Board of Veterans' Appeals (Board) received this case on appeal from a July 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), which denied the veteran's claim seeking entitlement to service connection for a gastrointestinal disorder as secondary to the veteran's service-connected PTSD. Also appealed was a December 1992 rating decision which denied the veteran's claim seeking entitlement to service connection for loss of teeth as secondary to the veteran's PTSD. The Board notes that a May 1994 rating decision of the RO denied the veteran's claim for service connection for residuals due to Agent Orange exposure. However, that issue has not been developed for appellate review inasmuch as, according to the records before the Board, the veteran has not filed a notice of disagreement, has not been provided with a supplemental statement of the case, and has not filed a substantive appeal. Accordingly, that issue is not before the Board at this time. REMAND The veteran and his representative contend, in essence, that his service-connected PTSD has caused him to develop a gastrointestinal disorder, which subsequently caused him to lose his teeth. Therefore, the veteran argues that both of his claimed disorders have been caused by his PTSD. Review of the record reveals that the veteran is currently evaluated as 100 percent disabled as a result of his service-connected PTSD. The veteran has indicated, in several statements, that all his dental treatment has been provided by private physicians and that all his gastrointestinal treatment has been provided by the VA. Review of private medical billing records submitted by the veteran reveals that he received dental treatment from the office of S. Bell, D.D.S. While the veteran submitted the billing records for his dental treatment, the actual records of treatment have not been submitted by the veteran and these records have not been obtained by the RO. Also submitted by the veteran were VA outpatient treatment records which revealed that in May 1992, the veteran complained of recurrent diarrhea and was diagnosed with irritable bowel syndrome. In June 1992, the veteran complained of recurrent heartburn and regurgitation and examination revealed inflammation of the distal esophagus, a small hiatal hernia, and a normal stomach and duodenum. The impression was distal esophagitis and gastroesophageal reflux disorder. Subsequent VA outpatient treatment records through May 1993 revealed that the veteran continued to be treated with Tagamet for his gastroesophageal reflux disorder. However, it is unclear to the Board whether the RO has obtained all the veteran's VA outpatient treatment records. The VA does not have a statutory duty to assist a claimant in developing facts pertinent to a claim which is not well- grounded. 38 U.S.C.A. § 5107(a) (West 1991). See also Boeck v. Brown, 6 Vet.App. 14, 17 (1993) and Grivois v. Brown, 6 Vet.App 136, 140 (1994). However, if the claimant’s application for benefits is incomplete, the VA shall notify the claimant of the evidence necessary to complete the application. 38 U.S.C.A. § 5103(a) (1995). An application is incomplete if the VA is put on notice of the likely existence of competent medical evidence that would, if true, would be relevant to, indeed, necessary for, a full and fair adjudication of an appellant’s claim. Robinette v. Brown, 8 Vet.App. 69, 77 (1995). Given the veteran's arguments regarding private dental treatment and VA treatment of his gastrointestinal disorder, it appears that additional medical records probably do exist; and the Board is of the opinion that this evidence is relevant and necessary for, a full and fair adjudication of the appellant’s claim. The claims folder contains no record of the RO instructing the appellant to provide such records. Thus, under the circumstances of this case, the Board is of the opinion that the RO has been put on notice that relevant evidence exists, or could be obtained, which, if true, would make the appellant’s claim “plausible”; and the RO failed to assist the appellant pursuant to the provisions of 38 U.S.C.A. § 5103(a). Robinette, 8 Vet.App. at 80. The Board further notes that the RO should consider the veteran's claims in accordance with Allen v. Brown, 7 Vet.App. 439 (1995), which held that when aggravation of a veteran's nonservice-connected condition is proximately due to or the result of a service-connected condition, such veteran shall be compensated for the degree of disability over and above the degree of disability existing prior to aggravation. Accordingly, further appellate consideration will be deferred and the case is REMANDED to the RO for the following actions: 1. The RO should take the appropriate steps to contact the veteran in order to obtain information pertaining to medical treatment he has received for any gastrointestinal and dental disorders. Based on information provided by the veteran, the RO should undertake to obtain copies of all records from the identified treatment sources and associate them with the claims folder. The veteran should also be asked to submit any medical evidence in his possession which tends to support his claims. Any documents received by the RO should be associated with the claims folder. 2. The RO should take the appropriate steps to secure copies of all of the veteran’s VA treatment records and associate them with the claims folder. 3. After the development requested above has been completed, the RO should again review the record. Any further indicated development should be undertaken. If any determination remains unfavorable to the veteran, the RO should furnish him and his representative with a supplemental statement of the case, in accordance with 38 U.S.C.A. § 7105 (West 1991). Thereafter, the veteran and his representative should be given the opportunity to respond. The case should be returned to the Board for further appellate consideration, if otherwise in order, following appropriate appellate procedure. By this REMAND the Board intimates no opinion, either legal or factual, as to the ultimate determination warranted in this case. The purpose of this REMAND is to further develop the record and ensure due process of law. No action is required by the veteran until he receives further notice. STEPHEN L. WILKINS Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741 (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1995). - 2 -