Case Studies

This Veteran, a native of Puerto Rico, served in the United States Army from October 1977 to March 1978 during peacetime.  In February 1978 he was training as an infantryman at Fort Benning during nighttime exercises when he tripped over a root and fell hard on the temporal region of his head.   He was dazed, in pain, experiencing vertigo, very loud noise in his ear and bleeding from his ear.  His fellow soldiers encouraged him to get up and complete the exercise.  After about twenty minutes he was able to and completed the exercise and returned to his bunk.  He promptly fell asleep and woke up in the hospital.  He was hemorrhaging from his affected ear, had pain, headache, vertigo and severe tinnitus.  He was discharged from the hospital and continued his training for about one week.  Upon completion of his training he was sent to the 65th Infantry at Guayama, Puerto Rico.  

After seven days at Guayama he was admitted back into the hospital with a bleeding ear, headaches, severe tinnitus and pain.  After three days of treatment the doctors were concerned, he may have contracted meningitis.  This gave him severe anxiety and he suffered a “nervous breakdown” in the hospital and was transferred to the larger VA hospital/mental health facility in San Juan where he remained for forty-five days.  He was diagnosed with Major Depressive Disorder.  After his hospitalization he was informed he was being discharged from the Army.

He never recovered from this accident and struggled with severe tinnitus, anxiety, depression, vertigo, headaches and chronic pain for years.  He filed a claim in 2007 and was denied three times, each time filing an appeal.  He was not having any success and his mental health was declining.

He hired our firm in October 2010.  We went to work immediately to gather evidence, research, and develop a strategy.  We then hired medical experts to establish a nexus with service.  And after much research, legal argument and advocacy, we were finally able to obtain success for the Veteran.

Veteran served in the United States Marines from February 1972 through January 1974. Within this time frame he served a temporary duty assignment (TDY) of 30 days assisting in the evacuation of Da Nang.

The Veteran suffered psychological disorders beginning in his childhood at the age of 9.  However, his enlistment exam found him “normal, with borderline intelligence, high mild retardation”. He would probably not be fit to serve in today’s Armed Forces, but due to Defense Secretary McNamara’s “Project 100,000”, mental standards were downgraded.

As an historical note, Project 100,000, also known as McNamara’s Folly, and pejoratively as McNamara’s Morons and McNamara’s Misfits, was a controversial 1960s program by the United States Department of Defense to recruit soldiers who would previously have been below military mental or medical standards Project 100,000 soldiers included those unable to speak English, who had low mental aptitude, minor physical impairments and those who were slightly over-or underweight. This Project was promoted as a response to President Lyndon B. Johnson’s War on Poverty by giving training and opportunity to the uneducated and poor.  

Project 100,000 was initiated by Defense Secretary Robert McNamara in October 1966 to meet the escalating manpower requirements of the American government’s involvement in the Vietnam War. Inductees of the project died at higher rates than other Americans serving in Vietnam and following their service had lower incomes and higher rates of divorce than their non-veteran counterparts. The project was ended and has been the subject of controversy.  

The Veteran first filed his claim with the VA in May 1978 for service connection for a nervous condition. His claim was denied, and since he did not file a Notice of Disagreement within one year of the June 1978 rating decision his claim was closed. He then filed a claim for service connection for an allergic swelling condition which was denied in September 1981. This time he filed his NOD promptly and was denied again in October 1983. He again filed for “nerves” in September 1983 which the VA acknowledged and reopened the claim but again denied service connection while allowing non-service-connected pension to continue. He continued throughout the mid-1980s to go back and forth with the VA, only ever receiving denials of his claim.  Feeling thoroughly discouraged, the Veteran withdrew his claim in August 1985.

Meanwhile, the Veteran’s mental health was consistently declining with hospitalizations and several types of ineffective medications. After receiving a diagnosis of panic disorder and agoraphobia the Veteran filed a new claim in May 1988. Whatever that various names of the mental illness diagnoses, the Veteran believed his mental illness had been exacerbated during his time of service, specifically his time in Vietnam. After 20 more additional years on the hamster wheel with the VA going round and round with appeals, denials, and remands the Veteran hired our firm in or around February 2010.

We immediately filed a Brief on the Veteran’s behalf appealing the Board’s decision to the CAVC, requesting a remand and readjudication and vacating the Board’s August 2008 decision.   We were successful and submitted an Expert’s Report of additional evidence backing up the Veteran’s claim that his symptoms worsened in 1974 upon his discharge and that his time in service worsened his condition. After two years of more back and forth with the VA we were finally granted a rating decision for service connection with a 100 percent rating effective January 12, 1999 for panic disorder and agoraphobia. But we believed that the effective date was inadequate.

We responded with our timely Notice of Disagreement for an earlier effective date, and after much more litigation, including another Expert Report, C & P examination, appeals and a Writ of Mandamus, the Veteran was granted an earlier effective date of May 19, 1988.

The Veteran, a native of Puerto Rico, was in the United States Army from August 1970 to January 1973 during the Vietnam Era. He was an infantryman in combat in Vietnam. When he hired our firm in September 2011 to help him get service connection for a mental illness, he was only service connected at a 50% rating for a shell fragment wound. He had received his most recent denial the month before and had filed an NOD.

The two major stressors that occurred in Vietnam which led to his depression was 1) in December 1971 he was in the point man position and was hit by a booby trap. He and several fellow soldiers were seriously injured, and one was killed. 2) The Veteran and some of his fellow servicemen were lost in the jungle in Vietnam for one month until a helicopter found them. Despite these facts, the Veteran continued to experience repeated VA denials. Realizing that he could not win on his own, he finally hired our veterans disability law firm.

We got to work right away in building his case. We hired our psychiatric expert in Puerto Rico to meet with the Veteran and prepare an expert report. In the meantime, we were reviewing the Veteran’s C-file with a fine-toothed comb. While the VA conceded the Veteran had in fact experienced these two major stressors, they were insisting that there was no in-service diagnosis of depression. Our attorneys, however, found the proverbial needle in the haystack in the C-file service treatment records a notation that the Veteran had seen a medical professional on January 5, 1972, and the medical professional noted in the record: “patient appears depressed and has expressed he wants to die”. This was shortly after the booby trap incident. With this information and our psychological expert’s report we submitted this new evidence.

As a result, in a September 2013 rating decision, the Veteran was granted service connection for tinnitus at 10% effective January 2010 and service connection for Major Depressive Disorder NOS claimed as mental illness and TBI at 50% rating effective January 2012.

The Veteran, a native of Puerto Rico, was in the United States Army May 13, 1982 to May 12, 1985, National Guard from January 3, 1991 to July 6, 1991 and the Army from May 4, 2000 to May 5, 2001. He served during peacetime, the Gulf Ware Era and in Kosovo. His MOS was a Military Policeman and Driver.

During service he suffered from severe headaches which later developed into migraines. He also suffered from Irritable Bowel Disease, Depression, loss of hearing, tinnitus, vertigo and hypertension. From the time he was discharged he fruitlessly filed claims and received constant denials for service connection for his illnesses.

Frustrated, he hired our VA disability law firm in 2013. After reviewing his claims, medical records, VA responses and VA medical records, our attorneys came up with a successful strategy. When the Veteran began his claim process in the early 2000’s no one had suggested he be checked for Meniere’s Disease. Even though we are a law firm, our attorneys and staff have an admirable amount of medical knowledge and our firm even has its own in-house physician. We also have medical, psychological and vocational experts in our arsenal, which we then relayed to the Veteran and suggested that he see a physician to confirm if we were correct in our opinion of what he may be suffering from. Sure enough, the Veteran received a confirmed C & P exam for Meniere’s Disease, just as our attorneys had suspected.

In a November 2013 DRO decision we were able to obtain for the Veteran a rating decision for service connection of 100% for Meniere’s Disease effective October 2006 (date of his reopened claim) and 30% rating for Migraine Disorder effective October 2006.

This Veteran was in the United States Navy during the Vietnam era and peacetime from December 1972 to December 1975 and then served in the National Guard. He served on the USS Lexington.

He filed his first claim with the VA in 2000, was denied, and did not appeal. He reopened his claim in March 2002 and after eight years of frustration and lack of success he hired our veterans benefits law firm in September 2010.

The Veteran injured his lower back in a fall while in service in 1975. At the time he was diagnosed with a contusion of lumbosacral attributed to fall, and it worsened into a herniated lumbar disc. After discharge, the Veteran worked as an assistant plumber for two years digging ditches, and when his back could no longer sustain that level of stress, he became a painter. By 1990 the Veteran was unable to work as a painter any longer due to unbearable back pain.

After he hired our firm after his latest denial, we worked with him and his treating physicians, and had him attend C & P exams. We also filed NOD’s for every denial he received and wrote strong evidentiary letters to the VA on his behalf. By August 2012 we were able to get his rating increased to 60% in a DRO decision for post traumatic discogenic disease of lumbosacral spine effective March 2002. However, we did not believe the Veteran was being adequately compensated. We responded with our Notice of Disagreement and in a March 2014 DRO decision we obtained service connection for Depressive Disorder rated 70% effective April 2011, TDIU effective March 2002, and DEA established March 2002. In a May 2014 DRO decision, we also obtained Special Monetary Compensation (SMC Housebound) effective April 5, 2011 on behalf of the Veteran.

This Veteran served on active duty in the Army in the early 1970s, during the Vietnam era. While in the service he was mistreated by other members of the service and began developing mental problems. The medical corps said he had a personality disorder and he was eventually kicked out of the service with a discharge under other than honorable conditions. In the early 1990s he filed a claim for his depression. His claim was eventually denied on the grounds that the character of his discharge – under other than honorable conditions – barred him from receiving VA benefits. He hired two different attorneys, and the VA continued to deny his claim.

The case eventually made its way to the Board where it was again denied. The Veteran hired us to appeal his case to the U.S. Court of Appeals for Veterans Claims. Although the character of his discharge was under conditions other than honorable, we were aware of exceptions to this bar. One exception involves proving that the Veteran was “insane” at the time he committed the offenses that led to his other than honorable discharge.

On reviewing his file, we discovered that the Board overlooked several key letters from treating psychiatrists that indicated that the Veteran had a mental disability at the time of his service. The Board had ignored this evidence. We argued successfully that the Board made a mistake. As a result, we were able to get his case remanded back to the Board.

Once the case was back at the Board, we gathered an additional expert report from a psychologist who concluded that the Veteran did not have a personality disorder – which VA does not consider a disability – but was actually exhibiting the early symptoms of Major Depression. We submitted the additional argument together with additional expert evidence. The Board made a decision in this Veteran’s favor.

This Veteran filed a claim in the mid 1990s for increased ratings as well as for schizophrenia. Eventually, the Board denied all his claims. The Veteran hired us to appeal his case to the U.S. Court of Appeals for Veterans Claims. Upon review of his file, we discovered that the Board had ignored evidence that the Veteran suffered additional limitation due to the pain his service-connected disabilities caused him.

The Board also denied the psychiatric claim on the grounds that there was no evidence that the schizophrenia was related to service. However, we discovered that the Veteran’s psychiatric records showed that he was preoccupied with his physical pain, and the records suggested that he had some mental problems due to the constant pain. As a result, we successfully argued that the Board had failed to consider a claim for secondary service connection – that is, it failed to consider whether the Veteran had a mental disability that was caused by the chronic pain from his service connected physical disabilities. We got his case remanded back to the Board.

Once back at the Board, we developed additional evidence for this Veteran. We scheduled him for an evaluation with a private forensic psychologist. We obtained his x-rays and MRIs and had an expert radiologist review them and write a report. We also scheduled the Veteran for an evaluation by a vocational expert.

The Board issued a decision, but instead of granting the claims, it remanded the case back to the regional office for another VA exam. After more than an additional year of waiting, the regional office finally made a decision. They granted service connection for the Veteran’s mental disability as secondary to his service-connected physical disabilities.

This Veteran had not worked at a regular job since returning from Vietnam around 1970. He supported himself on and off with various activities, but mostly driving a cab. The PTSD began to affect his judgment and his ability to run his cab business. He eventually lost any income he did have through driving a cab. For a number of years the Veteran tried to live on about $700 per month. This was extremely difficult and the financial problems worsened his PTSD.

Finally, the Veteran hired us to represent him at the Court of Appeals for Veterans Claims. We discovered that his file showed that although he was only rated at 50 percent for his PTSD, he was unable to work and had difficulty getting along with people. The Veteran also had low GAF scores. We found that the Board failed to adequately consider the evidence that he was unable to work due to his PTSD, and we also found that the Board failed to adequately consider the significance of his low GAF scores. We successfully argued for a remand.

When the case was returned to the Board, we obtained the report of an expert psychologist who discovered that the evidence in the record confirmed that the Veteran’s PTSD made him unable to maintain a gainful occupation. We filed additional arguments with the Board and submitted the additional expert report. Also, we argued that the case raised an informal claim for TDIU (Total Disability Individual Unemployability).

Due to the sensitive nature of the trauma, this Veteran never said anything about the incident. He was eventually discharged from the service in the late 1960s. The Veteran tried to deal with the situation by himself, never telling anyone about it. His difficulties resulted in a failed marriage and many difficulties with co-workers on the job. Eventually, the problem became too severe and he began seeking help at the VA.

Most of the VA treating psychologists recognized his symptoms as being consistent with someone who had sustained military sexual trauma. Nevertheless, the VA denied his claim on the grounds that there was no proof that the sexual trauma happened. All he had was his word, and the statements from friends and family who testified that they noticed an immediate change in his behavior upon returning from the service.

The Veteran hired us to represent him before the U.S. Court of Appeals for Veterans Claims. We discovered that the Board considered the statements of all his friends and family except for his wife. His wife had provided a statement to support her husband’s claim. The Board overlooked this statement. We capitalized on this mistake and successfully got the case remanded back to the Board.

On remand to the Board, we were able to obtain a letter from his treating social worker at the VA. The social worker concluded that the Veteran’s symptoms were consistent with someone who had experienced sexual trauma. We filed additional arguments and submitted the additional evidence. The result: The Board granted service connection for PTSD as a result of the in-service sexual assault.

As a result of Agent Orange exposure, this Veteran developed Type II Diabetes. He was service connected for diabetes and also PTSD. He was rated at 50 percent for the PTSD and 20 percent for diabetes. He filed to increase his PTSD rating and his diabetes rating. The Board and regional office denied him an increase. He hired us to handle his appeal to the U.S. Court of Appeals for Veterans Claims.

In terms of background, the Veteran’s PTSD symptoms made it impossible for him to be around people. As a result, the Veteran could not work a regular job. He tried to earn a little extra money by fixing cars from his garage at home. If he was lucky, he was able to earn a few hundred dollars a month. However, the PTSD symptoms aggravated his physical pain from a non-service connected back disability as well as his diabetes. As a result, he eventually had to give up doing auto repairs. His only income was his VA check for his combined rating of 60 percent. Needless to say, money was very tight for this Veteran.

On review of his file, we discovered that the severity of his PTSD had fluctuated during various time periods. The Board failed to consider higher ratings for the different time periods where the condition was worse. We successfully argued that the Board failed to consider what are called “staged ratings”. As a result, we successfully obtained a remand of his case.

Once the case was back at the Board we developed more evidence in his case. We had his case reviewed by an expert forensic psychologist with whom we often work. She was able to determine that his PTSD symptoms were much more severe than the 50 percent rating. She also noted the research that indicates a clear relationship between psychiatric problems and physical pain. She gave the opinion that due to the PTSD symptoms the Veteran lost all his income and was not able to work or otherwise earn a living. In addition, we argued that he was entitled to TDIU.[br]The Board issued a decision in the case and increased his rating for PTSD to 70 percent, but remanded back to the regional office his claim for TDIU. The Board wanted to schedule the Veteran for a compensation and pension (C&P) exam. Once the case was back at the regional office VA scheduled the Veteran for the C&P exam. We helped prepare him for the exam. Once the exam was over, we made a Freedom of Information Act request to obtain a copy of the C&P exam report. We wanted to see what the VA examiner said. The C&P exam report was largely favorable. In the meantime, we had also contacted a vocational expert who evaluated the Veteran and determined that the Veteran’s PTSD made him unable to maintain gainful employment. We submitted additional argument along with the vocational expert’s report.

This Veteran’s occupational specialty exposed him to asbestos. Decades later he developed asbestosis. He filed a service connection claim, which the VA eventually granted. But VA awarded 0 percent. He filed an appeal. During his appeal, his medical problems continued to increase. Chest x-rays began showing pleural effusion, and he was eventually diagnosed with mesothelioma – a terminal lung cancer associated with asbestos exposure. Because his pulmonary function test results were not high enough for a 10 percent rating under the diagnostic code for asbestosis, the Board denied his claim.

This Veteran hired us to handle his appeal to the U.S. Court of Appeals for Veterans Claims. Upon review of his file we discovered that his pulmonary function test results were high enough for a compensable rating – meaning greater than 0 percent – if the VA had used the diagnostic codes for pleural effusion, which this Veteran had. We were able to successfully get his case remanded back to the Board.

At first, the Veteran thought he could handle the case at the Board on his own. But he eventually enlisted our help. We got to work in obtaining reports and records from his private pulmonologist and oncologist. His oncologist gave the opinion that the Veteran had mesothelioma linked to his Navy service. Further, we hired a private medical expert to also review the file and write an expert opinion. We filed additional arguments and evidence directly to the regional office. Despite the Veteran’s age, the regional office sat on the case for a very long time. The Veteran continued to call us wondering the status of the case. We contacted VA but received the usual runaround. Eventually, the regional office made a decision and awarded 100 percent service connection for the mesothelioma. The Veteran received a back pay check in excess of $80,000.

The veteran worked with lead and other toxic chemicals during service. He began to experience some seizures and other difficulties during service, but the medical corps could not find anything wrong with him. His separation exam was “normal.” About 20 years after service he developed severe chemical sensitivity to the point that he could not be around any synthetic substances. He became virtually confined to his home. All synthetic items had to be removed from his home.

He began filing for benefits and VA denied him repeatedly. The VA rejected the idea that anything was wrong with him. They believed it was all “in his head” and there was no connection to service. In particular, the VA could not accept a 20 year gap between discharge from service and when the symptoms began. The veteran appealed his denials through the regional office and several times to the Board. The matter was remanded several times and he was given multiple VA compensation and pension exams. All the VA examiners consistently found ways to say his injuries either did not exist or that there was no way they could be connected to service.

After his last Board denial, the veteran retained our law firm to represent him on appeal to the U.S. Court of Appeals for Veterans Claims. We successfully argued that the Board failed to expand the scope of his claim to include other theories or disabilities that were suggested by the evidence. We got the case overturned on appeal and remanded back to the BVA.

Due to the complexity of the medical issues, we retained one of the world’s leading experts in neuropsychiatry and organic brain issues. This expert was one of only 9 experts in the world with his level of qualifications. We submitted over 100 pages of additional medical expert materials, establishing that there were scientific studies and laboratory test results that supported a delay in the onset of symptoms associated with chemical exposure. The Board found yet another reason, however, to remand the case back to the regional office.

Once the case was back at the regional office, we obtained additional medical expert opinions from the veteran’s treating physician, and submitted more argument to support the claim. We also began aggressively pushing VA to make a decision on the claim. Finally, after 17 years of appeals, the regional office granted service connection and awarded 100 percent disability with a back pay award that exceeded $300,000.

The veteran served on active duty in the Marine Corps in the early 1970s–during the Vietnam War. He had TDY in Vietnam. Unfortunately, his DD-214 did not reflect his time in Vietnam. Prior to his discharge the veteran began experiencing some psychiatric symptoms, but these complaints were not documented anywhere in his service medical records. Within a year of his discharge from the Marine Corps the veteran found himself hospitalized in the psychiatric ward of a private hospital. He was initially diagnosed with a psychotic disorder. The records from the private hospitalization were no longer available.

By the mid 1970s the veteran could no longer work. He survived as best he could but it was not easy. Somebody finally suggested that he go to VA and seek benefits. He went to VA. Not surprisingly, the VA denied him. By 1989 the VA had already denied the veteran twice. He had begun to give up hope, and so he waited another 10 years before filing again for a psychiatric disability. But the VA denied him again. He appealed to the Board and was denied. This process of repeated denials and appeals continued for almost another 10 years.

Finally, the veteran retained our law firm to represent him in his appeal. We successfully appealed his case to the U.S. Court of Appeals for Veterans Claim. We were able to obtain a remand of his claim. When the case went back to the Board we began to acquire the evidence we needed to win his claim. We had his matter reviewed by a physician who gave the opinion that the veteran’s psychiatric condition was due to his service in Vietnam.

The Board, however, was not interested in granting the claim so easily. The Board remanded the case back to the regional office for another VA examination. Normally, the Board will remand for another VA exam if it is unwilling to accept a favorable report from a private doctor. The VA examiner was sufficiently persuaded by our private doctor that she wrote a report that was somewhat helpful–although not entirely favorable. Accordingly, we obtained another expert evaluation from a former VA psychologist. Our second expert gave the opinion that the military experiences in Vietnam aggravated a pre-existing condition.

But the VA continued the denial of the claim. So we filed additional argument to the point that the VA sent the veteran for yet another exam. We suspected that VA was trying to develop evidence to support another denial. We filed argument against this tactic. We also discovered that VA was going to be sending the veteran to QTC, which is a private medical examination company. The VA usually uses QTC when they want to obtain evidence against a claim. Nevertheless, we found the identity of the doctor at QTC and we sent her all the private expert reports and provided a detailed explanation as to why service connection was appropriate. Because of our proactive efforts, we were able to influence the QTC examiner to write a favorable opinion.

As a result, the VA issued a rating decision awarding 100 percent service connection and more than 13 years back pay, which amounted to more than $375,000. The veteran had not worked since the mid 1970s and this award represented more money than he had ever seen in his entire life.

This Veteran was scheduled to be discharged from Camp Kilmer, New Jersey. The Veteran notified his father and a friend that he was getting out, and they made arrangements to go to New Jersey to meet him. The Veteran had his separation physical, which included a urine test. The doctor in the medical corps told him that there was protein in his urine and that he needed to stay over and come back the next day for another urine test. The Veteran advised his father and friend that he would be delayed in getting out due to protein in his urine. The next day his urine test was negative. The medical corps recorded a negative urine test result, and made no record of the initial positive test result.

The Veteran got out of the service and went on with his life. His life went on as normal for many decades. He married and had a family. However, in the 1990s he began having some trouble with his kidneys. It was found that he had high blood pressure, which the doctors said was a factor in the onset of his kidney disease.

The kidney disease progressed to the point that he needed dialysis. He eventually got on the list for a kidney transplant. But before he could get the transplant, he had to have heart surgery to address some heart issues. Thankfully, the Veteran received a kidney transplant and did fairly well under the circumstances.

He then remembered his discharge exam from the Army in the early 1950s. He remembered that the doctor told him he had protein in his urine. After some research he learned that protein in the urine could be a sign of early kidney disease. But there was no record of the positive urine test. The Veteran looked up his old friend who met him at Camp Kilmer almost 5 decades earlier. He remembered the Veteran advising him that he had to be held over due to protein in the urine. The Veteran got a statement from his friend and filed a claim.

Naturally, the VA denied him on the grounds that there was no proof anything happening with his kidneys in service. The Board also denied the Veteran. He then appealed to the U.S. Court of Appeals for Veterans Claims. He hired us to represent him.

We discovered that the Board did not adequately consider the statements of the Veteran’s friend. We were able to successfully argue for a remand.

When the case was remanded we discovered that the Veteran’s separation exam report contained several clues. First, the negative urine test result was marked as a “re-check”. We reasoned that there would not have been a “re-check” unless there was an initial positive test result. We also noticed that he had a systolic blood pressure of 135. We suspected that this might have been borderline hypertension in service. We hired a top medical expert.

Our medical expert reviewed the case and found that it would not have been the standard practice to do a re-check of a urine test unless the first test was positive. Establishing this then allowed us to prove that the Veteran was telling the truth. The medical expert also found that the Veteran had the beginnings of hypertension during service. Hypertension then led to the kidney disease. Based on this, the medical expert concluded that it was at least as likely as not that the Veteran’s kidney disease was related to service.

The Board had the Veteran go to a C&P exam. The C&P examiner partially agreed with our medical expert. The case went back to the Board where service connection was granted. The case then returned to the regional office to be implemented. However, 6 weeks after the favorable award – and after our Veteran client had been appealing for more than a decade – he died of complications of his kidney disease. His death came as a shock to his surviving wife. He had not even received the money from VA for his back pay.

We immediately filed to substitute his wife on all his pending claims, including accrued benefits. We also filed to obtain service-connection for the cause of death.

We submitted additional arguments to the regional office, and obtained and submitted an additional medical expert report regarding the cause of the Veteran’s death. The result: almost 12 years back pay awarded for accrued benefits, and service-connection for the cause of death.

The veteran served active duty in the early 1960s. An older service member sexually assaulted the veteran during his time in the service. Understandably, the veteran never told anyone about this tragic event. The veteran was honorably discharged.

Following service the veteran did the best he could to go on with his life. He did relatively well for a while. But as the years passed the trauma from the assault began to create more and more problems. The veteran eventually went to the VA and was diagnosed with PTSD. He filed a claim for service connection.

But because the incident was not documented in his service records and because so many years had passed since discharge, the VA did not believe him. They denied the claim repeatedly. This prompted numerous levels of appeals. The veteran eventually appealed to the U.S. Court of Appeals for Veterans Claims. At this point the veteran made contact with our office. The Court of Appeals eventually remanded the claim back to the regional office. Fortunately, the VA granted service connection, but did not award a sufficient rating. Even though the veteran had been unable to work for at least 5 years, the VA only awarded a 50 percent rating.

Just prior to making its decision, the VA sent the veteran to a VA examination. The VA doctor gave an inaccurate report, which suggested that the veteran’s symptoms were not that severe. Naturally, we appealed the decision, and argued that VA should have assigned a 100 percent rating. However, the file contained a very unfavorable VA examination. Strategically, we had to counteract the VA examiner’s report.

Therefore, we determined that we needed to have the veteran examined by one of the leading expert’s in sexual assault. We ended up flying the veteran to the West coast to be examined by this leading expert. We obtained a favorable report and submitted additional argument to the VA. But we did not stop there. We retained another notable psychologist who specializes in veteran’s cases. He also gave an opinion favorable to the veteran’s claim. We submitted additional argument and then waited for VA’s response.

Finally, the VA issued a decision granting the veteran 100 percent for his PTSD.

The veteran served during the Vietnam era but was injured during training in upstate New York. The veteran suffered a severe blow to the head and right hand. The hand injury eventually resulted in the partial amputation of several fingers. His immediate medical care during the service focused on the hand injury as it was more critical.

However, shortly after discharge the effects of the head injury caused the veteran to be hospitalized for severe psychiatric complaints. He spent many years in and out of a psychiatric hospital. His friends and family noticed immediately that he was not the same person as he was before the service. As a result of his hand and psychiatric injuries, the veteran was not able to sustain significant gainful employment much past the 1970s.

His problems not only prevented him from pursuing an occupation, but it resulted in his divorce. Before the accident in service he was considered normal. He did well in high school and had no other difficulties. But after the accident the veteran had difficulty remembering things and at times had difficulty carrying on a normal conversation. He suffered frequent nightmares of the accident and he was largely dependent on his elderly parents for survival.

He began filing claims for VA benefits. The VA granted him service-connection for the hand injury because the service medical records clearly documented the hand injury. However, the rating for a finger amputation was minimal. As a result, the money was not sufficient to sustain him.

The VA, however, denied the brain/psychiatric claims. The VA did not believe the veteran suffered a head or brain injury during service. They refused to believe his story. Basically, the VA did not see any service medical records for treatment of any brain or psychiatric complaints. The VA repeatedly denied the claim, and the veteran continued to re-file his claims–but to no avail. The only medical records concerning the brain were after service and the VA thought that any brain or psychiatric disability was due to something that happened after service.

Finally, the veteran hired our law firm to represent him on appeal at the U.S. Court of Appeals for Veterans Claims. He was trying again to reopen his claim for a psychiatric disorder. We filed a brief with the Court and were able to get the case remanded back to the Board. Once the case was returned to the Board we arranged to have the veteran examined by a well-known forensic psychologist. The psychologist diagnosed the veteran with PTSD as a result of the documented in-service hand injury.

Our strategy was that if we could show that the veteran had PTSD caused by a documented in-service stressor, then we could prevail. Our forensic psychologist assisted provided us with the medical evidence to support our theory.

The Board did not initially accept our private medical evidence. Instead, the Board remanded the case back to the regional office for another VA exam. While we were waiting for the VA exam, we obtained additional medical reports from another private psychologist and several of the veteran’s treating VA doctors. All the doctors concurred with our theory of the case. We submitted these additional reports. Finally, the VA scheduled the veteran for a compensation and pension exam. By this time, the file contained numerous favorable medical opinions. Undoubtedly, this evidence helped to influence the VA examiner who wrote a favorable opinion.

We continued to submit additional argument and medical reports for almost an additional three years before VA made a decision. We continued to call VA to determine the status. We were advised that VA had made a decision. But we waited almost 8 months for VA to mail us the decision. The result: 100 percent service connection for an acquired psychiatric disorder with an award of almost $250,000 in back pay.

The veteran served in the U.S. Air Force during the Vietnam era. During service he witnessed a plane crash wherein several of his friends died. He developed PTSD as a result of this incident.

The veteran filed a claim for PTSD, but the VA denied the claim. The VA sent the veteran to its own doctors who kept saying the veteran did not have PTSD. As a result, the VA repeatedly denied the veteran’s claim. In fact, on one occasion a VA doctor diagnosed the veteran with PTSD but then later changed his mind and wrote another letter saying the veteran did not have PTSD.

In addition, the VA denied the veteran based on the fact that he could not prove that the plane crash took place. In other words, the VA said there was no proof of a stressor in service. Through several more layers of appeals, the evidence was finally discovered proving this plane crash actually took place. But that did not change VA’s determination to deny the veteran’s claim. For 16 years the VA continued to deny the claim. The veteran was examined by numerous VA doctors and they continued to change his diagnosis repeatedly.

The veteran finally hired our law firm to handle his appeal. We arranged for an evaluation with one of the leading PTSD experts and a professor at a major university. The doctor examined the veteran for several days and produced a favorable–and extensive–evaluation that proved the veteran had PTSD due to the plane crash in service.

We submitted our additional argument and expert evidence to the Board. The Board, however, was unwilling to grant the claim. Instead, it remanded the claim back to the regional office for yet another VA exam. We instructed our client to take the private expert’s report to the examination. The private evaluation was persuasive and we were able to secure a favorable report from the VA examiner.

As a result, the VA finally granted service connection for PTSD after 16 years of fighting VA.

The veteran died of lung cancer for which he was service-connected as a result of Agent Orange exposure. His widow made a claim for DIC benefits. The VA denied her claim on the grounds that she was not his surviving spouse. The VA relied on documents showing that she and the veteran divorced decades before his death.

The VA denied her claim repeatedly. She appealed to the Board, which also denied her claim. She then appealed to the U.S. Court of Appeals for Veterans Claims. She hired our law firm to assist her in her appeal.

The Board’s decision relied on the evidence of the divorce between the parties. Indeed, the file contained a judgment of divorce and the two parties were not living together at the time of his death.

However, the widow submitted numerous statements indicating that she and the veteran continued to reside together after the divorce and held themselves out to the public as still being married. The Board ignored her statements regarding the continued cohabitation.

We were able to get the Board’s decision overturned on appeal because of the Board’s failure to consider crucial pieces of evidence indicating the existence of a common law marriage. The widow and the veteran resided in a statement that allowed common law marriage. The evidence in the file included the widow’s statements and bank statements and credit card statements showing joint accounts. We successfully got the case overturned and sent back to the Board.

On remand, we submitted additional statements from family and friends testifying as to the common law relationship between the parties. We also highlighted the joint financial accounts and other evidence. The Board issued another decision, which granted the benefits and awarded the widow almost $100,000 in back pay.

The veteran served during the Korean Conflict, and as a result of the stress of combat he developed an ulcer. He obtained service connection for the ulcer.

With the help of his doctors the veteran was able to manage his ulcer for many years. In the mid 1990’s the ulcer progressively worsened, which resulted in the overall deterioration in his health.

Unfortunately, the veteran also developed prostate cancer in the late 1990s. His prostate cancer was unrelated to his time in the service. The doctors attempted to treat the prostate cancer, but it continued to progress. In an effort to prevent the cancer from metastizing the doctor put the veteran on some very strong chemotherapy drugs. Unfortunately, the chemo drugs caused the veteran’s service-connected ulcer to bleed and cause him anemia and further deterioration in his health. As a result, the doctors were forced to stop the use of the most potent chemo drugs.

Without the strong chemo drugs, the prostate cancer eventually spread to the veteran’s brain and he died.

His widow filed a claim with the VA for service connection for the cause of her husband’s death. The VA denied the claim and she appealed to the U.S. Court of Appeals for Veterans Claims. The Court remanded her claim back to the Board, which again denied the claim. By this time, the widow retained our law firm. We again appealed her case back to the U.S. Court of Appeals for Veterans Claims where we successfully obtain a remand of the case.

Upon remand, we obtained another medical expert who found that it was the service-connected ulcer that caused the need to stop the aggressive chemotherapy. And without the chemo drugs, the cancer spread to the veteran’s brain and he died. The VA, however, was initially unwilling to accept our private medical expert, and the Board obtained a medical opinion from its own expert. The VA’s expert, not surprisingly, gave the opinion that the ulcer had nothing to do with the veteran’s prostate cancer.

We responded by obtaining an opinion from a medical school professor who was board certified in oncology and hematology. He gave the opinion that under the unique facts of this case, the ulcer did prevent the use of the more aggressive chemotherapy drugs, thus allowing the cancer to spread to the brain. The result was death.

The Board again decided the case, but this time it was forced to concede that our client’s position was correct. The widow’s benefits were granted, and she was awarded $150,000 in back pay.

This Veteran served in the United States Coast Guard from December 1942 through December 1945 during World War II in the Pacific Theatre. His MOS was a Signalman on the Coast Guard Cutter Mesquite. The Veteran claims his hearing loss began in service when he was in the wheelhouse of the Coast Guard cutter and guns were fired overhead, immediately causing ringing in both ears. He was also assigned to the Chain Locker on the cutter where the exceptionally large chain for the anchor was pulled up and stored while at sea. He oversaw the pulling up of the anchor without ear protection in this confined locker. He never received treatment in service because there was not a doctor on board and field hospitals were filled with combat injuries whenever they were not at sea.

His original claim was filed in September 2006 for service connection for bilateral hearing loss, tinnitus, vertigo secondary to tinnitus and dental issues. All were denied in a March 2011 Board decision.

The Veteran hired our firm in May 2011 to appeal the Board’s decision. We argued for a remand for further development and we prevailed at the U.S. Court of Appeals for Veterans Claims.

In a January 2015 decision we were able to get the Veteran granted service connection for Meniere’s Disease with hearing loss, vertigo, and tinnitus.

Veteran served from August 1966 until November 1967 in the United States Navy during the Vietnam era. He was on a submarine and listened to sonar.

While on leave he was in a water-skiing accident where he hit his head hard on the water and immediately suffered from lower back pain. He was hospitalized for three days in South Carolina. While in the hospital he was unable to walk. He received a medical discharge and was able to walk again upon discharge.

Veteran was a high school graduate performing manual labor. This was the only skill he was trained to do. Eventually his back pain became so severe that he was no longer able to work. He survived on Social Security Disability beginning October 1990.  Due to the severity of his pain and being unable to work he also developed depression. He filed his first claim for service connection regarding his back disorder (spondylolisthesis, lumbosacral spine bilateral radiculopathy, sciatica left and right sides and depressive disorder secondary to back pain) with the VA April 1991, with assistance from a VSO.  

This began his 23-year long fight with the VA. He was initially granted 10% service connection for his back issue, which he appealed and was granted 20% in October 1998. This was appealed and after a March 2010 Board decision denied him an increase in percentage of service connection. Due to these denials, he hired our law firm in July 2010.  

After many more appeals and litigation, we were able to finally achieve for the Veteran in a December 2014 rating decision from our March 2012 Notice of Disagreement an increased rating from 20% to 40% for his service-connected spondylolisthesis lumbosacral spine problem with a much earlier effective date of April 1991. In that same decision the Veteran was awarded an earlier effective date of April 1991 (effective date was originally 2010) for left and right sciatica with a 20% rating. We were also able to win for him TDIU effective April 1991.  However, we were not quite done, as we believed there was still more money on the table. We persisted in developing the Veteran’s depression claim. Finally, in a January 2015 rating decision the Veteran was granted a 30% rating for persistent depressive disorder effective June 2010, with an increase to 50% effective February 2014. 

Veteran was in the United States Army from September 28, 1967 to May 2, 1969 during the Vietnam Era. He was a heavy equipment/heavy vehicle operator. During his service he was in Korea, and in March 1968 he did a four-month tour of Fort Beaver in Korea, only ten kilometers from the DMZ. He was with the 44th Engineer Battalion. During his time at Fort Beaver he made many trips into the DMZ unaware of the spraying of the herbicide Agent Orange. Even at Fort Beaver he and his fellow soldiers noted the grass and trees being lush and green in May, and as the summer progressed the grass and trees turned yellow, then brown and died. They thought it was odd.

Unfortunately, the Veteran contracted Non-Hodgkin’s Lympoma in 2008 – 2009. He filed a claim for service connection in September 2009, was denied, appealed to the Board and the Board also denied in 2012. So, he hired our firm to represent him at the US Court of Appeals for Veterans Claims. We were successful in our representation of the Veteran and the claim was remanded back to the Board. The Court issued a panel decision in the matter. See here. Tragically, the Veteran died in October 2014 before we could develop his claim. His surviving spouse rehired our firm in December 2014 to pursue her DIC claim. Our motion for substituted claimant was granted in February 2015.

We continued to develop the claim to help the widow win service connection for the cause of death. We hired a medical expert to address the interplay between the Veteran’s non-Hodgkins lymphoma (NHL), Agent Orange exposure, and the Veteran’s hepatitis C infection. Our expert concluded that a liver transplant would have saved the Veteran’s life but the NHL prevented him from getting on the transplant list. Hence, the cause of death was hastened by the NHL.

This Veteran was in the United States Army from April 21, 1993 to September 3, 1993 during the Gulf War Era, and later in the National Guard until 1999.

The Veteran experienced sexual assault while in the Army. She said she was assaulted by her Drill Sergeant in basic training but did not report it. Her mental health deteriorated when she was sent to El Salvador with her National Guard unit and she claimed she was threatened with assault by a superior and endured constant sexual harassment. She was hospitalized in El Salvador for a mental breakdown, and was then transferred to the VAMC in Knoxville, TN due to the seriousness of her mental illness. She was hospitalized for one month in Knoxville and diagnosed with paranoid schizophrenia and PTSD and was discharged from service.

She filed her claim for PTSD in 1999 and was denied. She persisted with the help of a VSO and managed to obtain in a January 2010 rating decision service connection for paranoid schizophrenia/PTSD but only at 50% effective August 16, 1999. She hired our veterans benefits law firm shortly after that decision and we filed a Notice of Disagreement on her behalf.

Due to the seriousness of the Veteran’s condition we engaged several medical, psychological and vocational experts to prepare reports on her behalf since she also could not work. We also obtained a report from her privately treating psychologist. We submitted this additional evidence along with a very extensive argument as to why the Veteran should have an increased rating and be entitled to TDIU. Our claim made its way to the Board, and in October 2014 the Board made a favorable decision and the claim went back to the Regional Office for implementation.

Eight months later in a June 2015 rating decision the Veteran was granted a rating of 100% effective May 2015 for paranoid schizophrenia and PTSD, and TDIU effective August 1999.

This Veteran was in the United States Army during the Vietnam Era from December 1968 to July 1970.  He was stationed in Korea as a Driver and a Night Guard.

One night in 1969 the Veteran was out at a bar with a friend while stationed in Korea.  His friend left to meet someone, and after consuming two drinks the Veteran exited the bar to return to base.  He was attacked by four young male Korean nationals, beaten, dragged into an alley and sexually assaulted.  The Veteran got himself back to the base where he showered and “passed out”.  The Veteran was embarrassed and ashamed and hid the fact of his assault for thirty-five years.  He never mentioned it during service and as a result there was no record of anything in his service medical records or personnel file.  Instead, he coped by abusing alcohol and drugs.  Upon his return home his wife, niece, longtime friends and fellow church members noticed a drastic difference in the Veteran’s demeanor and behavior.  He would have nightmares, night sweats, be afraid to leave the house, become violent in his sleep, have violent outbursts, be depressed and anxious and have anger issues.  He had confided in his wife that he had been sexually assaulted in Korea and she pleaded with him to get help.  He refused for many years because of the temperature of society at the time and his embarrassment that if he acknowledged this it made him “less than a man.”  Unfortunately, his refusal to seek help led to his divorce.  His employer and fellow employees found him impossible to work with because of his anger and mood swings and he eventually lost his job.  People that knew him before Korea were shocked at the person he had become.  He filed his claim for service connection for PTSD in July 2004 and began mental health treatment at the VAMC.  

Accordingly, the VA has acknowledged that because personal sexual assault “is an extremely personal and sensitive issue many incidents of personal assault are not officially reported, and victims of this type of in-service trauma may find it difficult to produce evidence to support the occurrence of the stressor.”  And so, it began, the cycle of denials and appeals since there was “no evidence.”  Frustrated, the Veteran hired our veterans disability law firm in September 2010 to represent him in an appeal of an October 2009 Board decision, which again denied service connection.

We were able to get his claim overturned and remanded at the US Court of Appeals for Veterans Claims. Once the case was back at the Board of Veterans Appeals we realized that we had to find a way to verify the stressor.  But there was very little evidence to work with. We had statements from friends and family testifying to a drastic change in his behavior from before service until after. We also had the report of a treating mental health professional who gave the opinion that the Veteran presented with the typical presentation of someone who was the victim of sexual assault. We combined the two pieces of evidence, the lay statements of friends and family and their observations, with the professional opinion of a mental health professional stating that the Veteran’s behavior matches the behavior of someone who had been sexually assaulted, to successfully convince the VA to grant benefits for the MST.

Eventually, after many C & P mental examinations and continued legal advocacy we were able to obtain service connection with a 50% rating for the Veteran.  This was not good enough.  After five years of advocating on behalf of the Veteran, obtaining many lay statements from friends and relatives who knew him before Korea (even his ex-wife), and many psychological exams, letters and opinions supporting the claim, the Veteran was granted a 100% rating and service connection in an August 2015 rating decision.

This Veteran was in the United States Marine Corp from February 7, 1974 to March 15, 1974 when he received a medical discharge. The Veteran was born with a condition called hypospadias. Prior to military service he had six different surgeries to correct the congenital condition. Upon the Veteran’s induction examination, he was deemed fit for duty.

While in boot camp training the Veteran was running with his sea bag and suddenly experienced pain in his abdomen and groin. He could not complete the run. Upon examination he reported having pain and burning while urinating and urinating blood. Shortly after, he was medically discharged.

The Veteran filed his first claim for service connection in June 1975. He was denied as the VA erroneously said his condition was congenital, and therefore not eligible for service connection. While it was true the hypospadias was congenital, the urinary condition that surfaced in boot camp was not a congenital condition. That was the VA’s error, which they refused to acknowledge. He reopened his claim in 2009, but the VA still refused to budge in its erroneous decision regarding his urinary condition.

After many years of unfavorable decisions and frustration, the Veteran finally hired our veterans disability law firm to represent him in his CAVC appeal in December 2012. We were able to successfully have the Board’s decision vacated. We continued to represent him in the claim process and develop his claim more fully.

We hired a Urology expert to prepare a report we could submit on the Veteran’s behalf explaining the medical facts about his current urological condition (which began in service), and how they differed from his congenital hypospadias. We submitted this report, buddy statement from a lifelong friend who was also beside him in boot camp, and our own statement in support of the claim laying out the facts.

As a result of our efforts, in an August 2015 rating decision, the VA finally granted service connection for urethral stricture disease rated 60% effective 2009, TDIU effective April 2009 and DEA with an established date of January 2015.

The Veteran was in the United States Air Force from February 1965 to October 1968 and August 1969 to January 1971 during the Vietnam Era. He spent twelve months in Vietnam during his service. Prior to being sent to Vietnam the Veteran was playing basketball on base when he fell and injured his shoulder, hip, knee, and arm. He was taken to the clinic where it was determined he needed more care, so he was transferred to a VAMC in another state. While hospitalized for his physical injuries he was also diagnosed with anxiety and depression and treated for the same.

While in Vietnam one of the PTSD stressors the Veteran experienced was being on night patrol by himself on the Tan Son Nhut Air Base and the base was overrun with Viet Cong. He was alone with his rifle and was traumatized having to defend himself and he felt he surely would be killed.

When he hired our firm in April 2011, he had a 50% rating for PTSD and was unable to get any higher on his own. We hired two psychological experts to study the Veteran and his records and prepare expert reports for us. Over the course of the next four years, we argued for our Veteran with facts and reports. We ended up before the Board five times before we were able to obtain a favorable decision. In June 2015, the Board acted favorably and in an October 2015 RO implementation we finally obtained for the Veteran an increased rating for PTSD to 70% effective December 2005, and TDIU and DEA effective April 2012.

The Veteran was in the United States Army from February 12, 1985 to February 11, 1989 during peacetime. While in service in Fort Carson, Colorado around 1987 the Veteran was sent for a routine psychological evaluation/assessment by a female Army psychiatrist. Unbeknownst to the Veteran she was under video surveillance for sexual assault of male Army patients. The Veteran (verified by surveillance footage) consumed a soda offered by the doctor which had been laced with a date rape drug. The Veteran soon passed out, was tied to a bed and sexually raped and assaulted by this woman. Unfortunately, he was one of many. Shortly thereafter he had to testify at her Court Martial trial, and he was very traumatized by the assault and the aftermath. So much so, he legally changed his name.

After his discharge he was so traumatized by this crime that he avoided all female mental health personnel, female co-workers and any relationship with women. He was unable to interact with any female without experiencing intense discomfort and anxiety. His way of dealing with the crime committed upon him was to suppress any memory of it and live in denial so that he could hold a job and function. The only indication of PTSD was sleep disturbance treatment the Veteran sought in 1988 on base.

Post service he was employed as a bus driver. Due to his mental distress he had a difficult time interacting with fellow employees and his superiors. By this time, many years after his discharge he had found a woman he could trust and got married. He was on the verge of being fired when his wife and father-in-law, a practicing psychologist, convinced the Veteran to obtain mental health care to save his job. He would only see a male practitioner. He started visiting a practitioner at his local VAMC, but the atmosphere at the VAMC reminded him too much of his military trauma, and he did not keep up with his treatment. He was able to continue with a private practitioner, but to heal he had to deal with his military trauma that he had smothered for years. Unearthing the trauma made him extremely anxious and unsettled and eventually could no longer work due to his PTSD.

He filed his original claim for PTSD in December 2010 through a VSO. After receiving a denial in May 2011, he filed an NOD. Having no success with his claim, he hired our firm in November 2013. In developing his claim, the only concession the VA had made was a diagnosis of “sub-PTSD” in 2010, but this did not qualify the Veteran for service connection.

We dug in and had the Veteran evaluated by our expert psychiatrist. He completed a report stating the Veteran did, indeed suffer from PTSD and had suppressed it and tried to cope on his own for years. We argued on behalf of the Veteran in correspondences accompanying our expert report in 2015, and after a 2015 VA exam agreed with our private practitioner’s diagnosis, we finally achieved a favorable Board decision implemented by the RO.

The Veteran was in the United States Army from September 1969 to May 1971. He was involved in combat in the Republic of Vietnam. It was presumed that he was exposed to Agent Orange.

At the time of his death on September 24, 2001, the Veteran was service connected for PTSD and TDIU from 1997. In early September 2001 he was taken to the emergency department of his local hospital where it was discovered he had diabetes mellitus, advanced cardiovascular disease with a previous myocardial infarction (heart attack), and end stage metastatic pancreatic cancer. The Veteran was in his early 50’s. He was transferred to a larger medical center and died shortly thereafter. An autopsy was completed, and the finding was he died of a pulmonary embolism, because of his advanced cardiovascular disease. It was noted in subsequent reports that if the pulmonary embolism had not killed him suddenly, the pancreatic cancer surely would have in a very short period of time.

Shortly after his death, his surviving spouse filed a DIC claim and service connection for the cause of death. Before hiring our firm, she went through a VSO and two other Veteran’s Compensation attorneys. None of the three had any success in getting her claim granted. The problem was that the Veteran had only recently been diagnosed with diabetes mellitus, which was presumptive to Agent Orange exposure, and the fatal pancreatic cancer was not presumptively associated with Agent Orange exposure. There was also the issue of a pulmonary embolism as cause of death. The VA argued he had only been diagnosed with diabetes one month prior in August 2001, and that was certainly not enough time to develop end stage metastatic pancreatic cancer (one month) secondary to the diabetes.

After years of denials and three prior advocates and attorneys, the widow hired our veterans disability law firm, and we immediately began to comb through the Veteran’s records. In conjunction with our team of medical experts, we noted the cause of death was actually the pulmonary embolism which was pretty much hidden in the autopsy report. Since the pulmonary embolism was secondary to coronary artery disease, which is presumptive to Agent Orange, we secured a victory for out client. We submitted our new evidence and in a BVA decision in August 2015 implemented by the RO in December 2015, fourteen years after the Veteran died, his surviving spouse was granted DIC and service connection for cause of death (pulmonary embolism secondary to advanced cardiovascular disease presumptive cause, Agent Orange).

Veteran, a native of Puerto Rico, was in the United States Army from January 2000 to May 2005 during the Gulf War.  His MOS was Air Ambulance Mechanic and he was stationed in Germany.

While in service he suffered from lumbar pain and was treated for it.  He was also honorably discharged due to his lumbar pain.  His chronic, severe pain resulted in the Veteran experiencing depression.  He was hospitalized in service in Germany in December 2003 for depression.

Upon his discharge in 2005 the Veteran was hospitalized over twelve times for psychiatric problems.  His longest hospitalization was for five months in 2011.  He was afraid he was going to harm the mother of his child and her boyfriend, so he admitted himself for in patient psychiatric care.  

There is no question he suffered from in service lumbar pain and a psychiatric disorder.  The VA however, thought otherwise.  The Veteran struggled with them since filing his claim in 2005 and out of utter frustration came to us in May 2010.  The Veteran tried on his own to obtain service connection but without success.  Neither he nor the service organization could help him prevail.  In 2011 BVA decision we were able to obtain for the Veteran service connection for his lumbar spine condition at a 40% rating and tinnitus at a 10% rating.  But we still needed to service connect the psychiatric disorder.

So, we began to build his case for service connection for his depression.  We hired psychological experts, along with updated VA medical treatment records and presented them as new evidence.  After five years of pressuring the VA to do right by this Veteran he was granted service connection for Major Depressive Disorder at a 70% rating effective April 2007, service connection for Migraine Headaches at a 50% rating effective December 2005 and TDIU effective April 2007.

The Veteran, a native of Puerto Rico, served in the United States Army from June 20, 1976 to October 5, 1976, and on active duty from October 27, 1982 to September 9, 1983. While on active duty the Veteran began experiencing severe mental distress such as depression and anxiety and had great difficulty adjusting to the military. He also missed his wife and two daughters and was having difficulty coping with this emotionally. The Veteran was treated for his psychiatric issues while in service, and finally had to be discharged due to a neuropsychiatric disorder. He continued to receive out-patient treatment at the VAMC and with his private psychiatrist, and was eventually service connected for a neuropsychiatric disorder NOS.

The Veteran continued his psychiatric treatment and was declared mentally incapacitated in 1999 by Social Security and began disability benefits through the SSA. The Veteran could no longer work and his mental condition was declining. In April 2010 he hired our firm to help him obtain a higher evaluation for Generalized Anxiety Disorder and TDIU.

As we developed the claim, we sent the Veteran to our psychiatric expert in Puerto Rico who spent time with the Veteran and prepared an expert report for us. The Veteran confided in our expert that he had attempted suicide “a few times” while he was on active duty because he was so despondent. We submitted this new evidence, along with our argument and the Veteran’s private doctor’s records in November 2010 and February 2011.

Unfortunately, the VA moves at a glacial pace and the Veteran, severely suffering from mental illness committed suicide in December 2012, before we had any response from the VA. Sadly, we now had a Dependency and Indemnity Compensation (DIC) claim on our hands for his surviving spouse.

After substituting the Veteran’s spouse, in a February 2016 rating decision we obtained entitlement to accrued benefits for increased evaluation for generalized anxiety at 100% from October 28, 2008 to December 21, 2012, service connection for cause of death and DEA.

The Veteran served in the United States Army from August 1969 to November 1970 during the Vietnam Era. In boot camp in South Carolina at the age of 19 the Veteran was raped by two male soldiers. He never reported the incident to anyone because of shame and humiliation.

He harbored this secret for thirty years out of embarrassment and disgust. In 2004 he could no longer mentally handle the depression and anxiety. As a result, he was forced to see a psychiatrist and explain what he had been hiding for over thirty years. Shortly after he began psychiatric treatment, he filed a claim for service connection for PTSD due to military sexual assault. Unfortunately, the VA denied his claim, as the VA stated there was nothing in his records proving this happened.

The Veteran explained that at the age of 19 in 1969 and in his first month in the military, the last thing he was going to do was report this. As a victim this 19-year-old young man was especially terrified and devastated. All he could come up with to escape from the perpetrators of this heinous crime was to claim knee injuries and pain and request a transfer to a sedentary position off that base due to knee pain. He expressly indicated that he used the pretext of his knee pain as a basis to seek multiple transfers to different occupational specialties as a means of escaping contact with the rapists who were in his basic unit. He was too ashamed to speak of the assault and so he used other pretexts to justify the multiple requests for transfer

Because the VA believed that there was no evidence to corroborate the military sexual assault, the VA continued to deny the claim. The Board in their several denials, emphasized that the STRs showed only knee pain. The Veteran clearly indicated, and the Board acknowledged, that he never reported the incident to anyone; therefore, it would not be expected to find reference to the sexual assault in the STRs. He further explained that although he had knee pain, it was a socially acceptable basis to request a transfer. Further, the Board conceded that the Veteran changed occupational specialties multiple times, but insisted this fact was on the grounds that the transfer was due to his knee pain, ignoring the Veteran’s explanation that he used the knee pain was a means to transfer without disclosing the military sexual assault. The Veteran never disclosed the sexual assault and therefore he used another, less humiliating reason, to justify his requests for transfer.

The Veteran finally hired our veterans disability law firm after years of denials. We got to work right away. First, we took his case to the U.S. Court of Appeals for Veterans Claims. We successfully obtained a remand back to the Board. Then, we hired our psychiatric medical expert to study the case and prepare a report for new evidence. In essence, our psychiatric expert opined that the Veteran used the knee problems as a socially acceptable means to achieve transfer. This explains why the requests for transfer were done under the guise of the knee complaints. Accordingly, that the requests for transfer did not mention the sexual assault was to be expected and, as our expert observed, is consistent with the presentation of many sexual assault victims. The Veteran’s actions following the assault are completely logical and consistent with how male on male rape victims respond per our expert’s report.

As a result, we were finally able to achieve service connection for this Veteran in a May 2016 decision.

The Veteran was in the United States Army during peacetime and the Gulf War from August 1979 to March 1980.

This very troubled Veteran hired our firm in October 2012 after having no success with his claim for service connection beginning in 1992. He did not appeal the claim and it was not reopened until 2009. The Veteran was continuously denied service connection for schizophrenia since records he submitted were well past the one year of discharge from service, and his induction exam in June 1979 found him fit for service, and his discharge exam agreed. However, he was disruptive, unruly and unmanageable and that is why he was discharged.

This was an exceedingly difficult claim to substantiate. To further develop the claim, we relied heavily on the Veteran’s two brothers’ lay statements which were incredibly detailed accounts of a very mentally ill individual post service. The Veteran had been in prison since his discharge and in and out of psychiatric facilities. While the lay statements played a large part in obtaining service connection, it was not until we discovered a social security examination which was within one year of his discharge that diagnosed him with schizophrenia that we were able to prevail.

With this new evidence, we were able to obtain for the Veteran in a June 2016 DRO decision service connection for paranoid schizophrenia with a 100% rating effective September 9, 2009 and DEA.

The Veteran served in the United States Army August 10, 1971 to August 1973, and the National Guard from 1973 to 1976. He was a Medical Corpsman Specialist.

The Veteran filed his first claim for service connection for PTSD and some minor medical issues in 2011. He was denied in a February 2013 rating decision and filed a Notice of Disagreement. A February 2016 DRO decision was deferred. That was when the Veteran hired our firm to help him in the pursuit of his claim. In June 2016 we started the process of developing his claim.

The Veteran’s initial time in service was uneventful, but it was his time in the National Guard that created several stressors for him from which he never quite recovered. He was a Black male in the predominantly white National Guard in Louisiana. It is well documented historically that this was not a very open minded, accepting part of our country at the time. Rather, racism, prejudice and discrimination were rampant. Our Veteran was the victim of this unfortunate cultural mindset.

The first stressor the Veteran encountered was in Tent City in Fort Chaffee, Arkansas. He was asked to work the bridge platoon and make the “Black boys work like MULES”. If he did so he would receive a promotion. He refused and was retaliated against by being harassed, humiliated and disrespected by the white soldiers. The second stressor the Veteran experienced was right after the bridge platoon incident in August 1975. A deadly storm, possibly a tornado, swept through the Tent City and many soldiers were “injured and killed.” The Veteran states he is still haunted by the screams, darkness and death cries and not being able to help anyone even though he was a combat medic. The following morning at about 7:00 AM a staged attack occurred on the veteran when a large group of white soldiers circled around him and made a Police Call. Then the Sergeant verbally attacked him, humiliated him and hit him in the jaw and upper chest with closed fists. The Veteran fought back and was attacked by the Sergeant with a mop and broom that another soldier had retrieved for him. The Veteran again fought back, and had false charges, court martial and demotion of rank brought against him. He was also imprisoned for thirty days. The Veteran’s account is corroborated by two eyewitness buddy statements. These three stressors happened in proximity to each other and were the cause of the Veteran’s PTSD.

Unfortunately, the VA did not agree. As such, the Veteran received many unfortunate denials. This prompted him to finally reach out to our veterans disability benefits law firm. We had the Veteran’s medical records reviewed by our psychological expert who also examined the Veteran. She prepared a report that concluded that these stressors caused the Veteran’s PTSD. After service he became an increasingly angry, isolated person. Also using as additional evidence lay statements from his wife, sister, mother, and adult children stating the drastic change in the Veteran after service. He also had two inpatient psychiatric hospitalizations and has an unnatural fear of storms, so much so that he is obsessed by the weather. With all of our new evidence and our argument we were finally able to obtain service connection for PTSD at 100% and DEA.

This Veteran was in the United States Marines during the Vietnam era and peacetime, from June 13, 1973 to July 18, 1977.  His MOS was Radio Communications.  His plan was to make a career of the military, but his head injuries in service resulting in narcolepsy put an end to his dream.

The Veteran was very fit and an excellent athlete.  He received permission from his commanding officers to work out four times per day so that he would be in top shape for any base sports competitions.  Whatever the competition was, basketball, volleyball, power lifting, etc. the Veteran always dominated and brought home the trophy for his team.  He was their secret weapon in sports.  Unfortunately, all this training took a toll on the Veteran’s body and he had what he thought was a hernia in 1976 (all of these competitions also contributed to later knee problems also).  He was operated on at the VA medical center, and was told when they opened him up, they could not find a hernia, and thought he had an enlarged lymph node.  They closed him up and from that point forward the Veteran had many abdominal issues, such as pain, cramping, bloating and nausea.  Years later, after his discharge he had surgery in 1987 to correct the botched VA surgery in 1976.  However, this strong, athletic man was told he could never lift over ten pounds again without ruining the corrective abdominal surgery, which turned out to be a ventral hernia misdiagnosed by the VA resulting in him needing to wear a daily brace.

While in service he also suffered three head injuries. One in a field movement, one tripping in the shower and hitting his head, and the most serious one when he was accidentally elbowed in the head during a base basketball game and was knocked unconscious.  Shortly after the basketball injury he developed what we now know to be narcolepsy.  At the time, the VA misdiagnosed him with “seizures”.  After his discharge from the service he worked for the US Postal Service for several years.

He filed his first claim for service connection for his vernal hernia in 1992.  Thus, began a long, frustrating battle with the VA.  He had to give up his job at the Post Office in 1994 due to his narcolepsy, and supported his family on Social Security Disability while going back and forth with the VA.  After receiving an unfavorable rating decision in April 2016, the frustrated Veteran hired our firm to represent him in August 2016.

To counteract the negative C&P exams, we obtained a medical expert.  We thoroughly studied the file and conducted extensive medical research.  Often, the key to winning these cases is medical research and the combination of medical research plus expert witnesses to address a nexus with service.  We applied this approach to this Veteran’s case.  Thus, after many denials and rating decisions, appeals to the Board and Notices of Disagreement we were able to obtain a positive result for this Veteran.

This Veteran, a native of Puerto Rico, served in the United States Marine Corp from June 28, 1977 until November 18, 1980. He was eighteen years old when he joined and spent his second year in Guantanamo Bay, Cuba. His MOS was infantry.

He hired our firm in May 2011 when his appeal for service connection was denied. While in Guantanamo Bay his best friend, a fellow Marine, had an “M16 go off in his face blowing his head off”. He believes his friend was murdered by another Marine after an argument. While the Veteran was not present in the same room, he was close by and witnessed the aftermath – the blood-soaked room, etc. The Veteran also felt extreme guilt, as he felt if he had been there this tragedy would have been prevented. The Veteran was extremely upset and was hospitalized at the time for one week against his will for psychiatric reasons. 

Upon his discharge he experienced nightmares, anger issues, hallucinations and overwhelming sadness. He was hospitalized for psychiatric reasons at the VA Medical Center a few times.  However, this was prior to PTSD being a recognized illness, as it was just being discovered in 1980. He filed his first claim in June 1995 for nervous disease and was denied. While battling the VA before hiring us he was able to work as a truck driver, since he was not around people and did not have to have any interactions. Even this eventually became intolerable for him and he could no longer work and started receiving social security disability. He also had more psychiatric hospitalizations.

When the Veteran came to us, we enlisted two expert reports and submitted new evidence to the Board. After three years of silence and relentless follow up by our veterans disability law firm, we received a statement of the case in October 2014 maintaining the denial of service connection for PTSD. We appealed to the Board and in March 2016 the Board approved our appeal for PTSD and the claim went back to the RO for a rating decision. In a September 2016 rating decision, the Regional Office gave the Veteran a 100% evaluation for PTSD effective November 2006 and DEA established November 2006.

The Veteran was in the United States Army during the Vietnam Era from May 8, 1969 to January 12, 1972. He was in combat in Vietnam from December 1969 to November 1970. He was in Quadrant IV in South Vietnam and worked on and inside of CH-47 helicopters. His base received several mortar attacks and he experienced many horrors. His service medical records show a history of “nervousness, fear and fear of being attacked”. He was hospitalized in a psychiatric unit for three weeks in 1973 at the VAMC for nervousness.

The Veteran hired our veterans disability firm in March 2014 after many years of a lack of success with the VA. He tried for years on his own without success. When he came to us he had only obtained service connection for diabetes at 20%. He had also originally filed a claim in 1993 for PTSD but was denied and did not appeal. He had reopened his claim in October 2010.

In our research of the Veteran’s records it was evident he had suffered from mental illness both in service and afterwards for many years. Our strategy was to obtain a psychiatric expert report to submit as new evidence to the VA, which we did in 2014. The Veteran also attended many C & P exams for his PTSD and the examiner concurred. We also obtained lay statements from his wife and brother. By June 2016 the Board decided favorably on our appeal and in a November 2016 rating decision the RO finally granted the Veteran service connection at a 100% rating for an acquired psychiatric disorder, PTSD and anxiety effective October 18, 2010 the date of his reopened claim.

This Veteran was in the United States Marines from June 1969 to August 1970. He was involved in combat in the Republic of Vietnam in DaNang from January 1970 to August 1970.

Upon discharge he did not have a mental health diagnosis, but as time progressed the Veteran began drinking heavily to “forget” what had happened in combat. As the years went by he became increasingly depressed, angry, unable to get along with people and eventually lost his marriage and his job.

He filed his first claim for service connection for PTSD with the VA in 2006. He received a rating of 50% for PTSD with depression effective March 2006. He disagreed with the rating and wrangled unsuccessfully with the VA until he hired our veterans disability law firm in December 2010.

We immediately filed an NOD in response to his latest denial and three years later in an April 2013 DRO decision we managed to obtain TDIU effective March 2006, and an increase in his PTSD rating from 50% to 70% effective March 2006. We filed a Notice of Disagreement in pursuit of an earlier effective date.

We obtained an expert psychological report for the Veteran and submitted it along with our argument. He was given a C & P exam which concurred with our evidence. We also submitted several buddy/lay statements as to the distinct change in the Veteran’s mental health post-Vietnam.

In a May 2016 DRO decision, the Veteran was granted an earlier effective date of April 2004 for PTSD with depression. We appealed this to the Board, and in a Board decision March 2017 (implemented surprisingly quickly by the RO also in March 2017) we were able to obtain an earlier effective date of April 2004 for the Veteran’s TDIU and DEA.

The Veteran served in the United States Navy during the Gulf War and peacetime from July 1981 to July 1985 and September 1985 to June 2004. He was a “Spotter” on the USS A.W. Radford and a Watch Supervisor/Naval Gunfire Supervisor R/T Talker. He was engaged off the coast of Lebanon firing at and killing Hezbollah insurgents. On a day in September 1983 he had to confirm 125 rounds had hit their target.

He was also on the USS San Jacinto in 1991 involved in launching tomahawk missiles in anti-warfare support of two United States ships. These two stressors caused his PTSD, but he was a career Naval service member and forced himself to suppress the horrors he had witnessed. He rose through the ranks and was highly decorated, while privately self-medicating himself with alcohol and suffering from depression and anxiety. He reported this to no one out of fear and shame.

He retired from the Navy in 2004 after almost 25 years and began employment in a managerial position with an esteemed Naval Contractor. By 2012 the Veteran was no longer able to work due to his abuse of alcohol and his depression and anxiety. One day driving to work he had a psychotic episode in which he believed his car was talking to him and upon arrival at work they called an ambulance and he was hospitalized for a period for psychosis. He resigned his position and entered his initial claim in 2012.

According to the Veteran he was denied service connection for his mental illness, as he claimed the VA told him all his records had been lost or did not exist. He was treated over the next two years by a private psychiatrist and one at the VAMC. His wife was now supporting the family and he was collecting Social Security Disability. He was having no success with his claim and this was causing major financial stress in his family and marriage. After receiving yet another denial in March 2014, he hired our firm in April 2014.

We immediately began assembling medical records both private and VA from 2012 forward and hired a forensic psychiatrist to provide an expert opinion report. By this point in time, all his treating physicians concurred he was suffering from PTSD.

We submitted the newly acquired evidence along with our arguments, and in a Board decision in March 2017 we were finally successful. The RO’s April 2017 implementing rating decision granted the Veteran service connection at a 100% rating for PTSD/unspecified depressive disorder with anxious disorder and alcohol use disorder effective February 24, 2012 and DEA established February 24, 2012.

The Veteran, a native of Puerto Rico, was in the United States Army from January 21, 1974 to January 14, 1976 and January 30, 2003 to July 2, 2004 during the Vietnam Era, peacetime and the Gulf War. After his discharges he was employed for many years as a Custodian for the Puerto Rican government, which required heavy labor.

The Veteran had to stop working due to service-connected injuries he received to his shoulders and back. One of his duties was reloading heavy ammunition boxes onto trucks. This caused impingement in both of his shoulders and lumbar spine pain. To repeat, he was already service connected for these conditions, and was attempting to receive TDIU when he filed a claim in 2010. The VA denied him as they believed the reason for his inability to work was for non-service connected health problems.

Frustrated at his inability to win TDIU on his own, he hired our veteran’s firm in May 2010 after his denial for TDIU. We developed his claim, even hiring an expert to prepare a report concluding the Veteran was in fact depressed, but his depression was secondary to his service-connected shoulder and back pain. We filed our new evidence with the VA in early 2011, and in a BVA decision on May 5, 2017, six years later, we prevailed. The Regional Office granted TDIU and DEA effective April 8, 2009.

This Veteran served in the United States Army from July 1969 to April 1972.  He did two tours in Vietnam and was a volunteer Door Gunner for the 121st Assault Helicopter Company under enemy fire many times.

While in Vietnam the Veteran began drinking alcohol to “forget” the horrors he had seen and experienced in combat.  Upon his discharge he was employed for many years at a large North American meat processor/supplier.  Unfortunately, the Veteran’s drinking exacerbated upon his return and he complained of nervousness, depression, anxiety and blackouts and attempted to self-medicate.  By July 2006, the Veteran was unable to work any longer as he was suffering from epilepsy and PTSD.  He began collecting Social Security Disability and filed his first VA claim.

Unfortunately, the VA denied his claims for epilepsy, PTSD and other ailments time and again, because they insisted his maladies were caused by his alcohol abuse and were not service connected.  After a 2007 appeal to the CAVC which was heard in April 2014, seven long years later, the Veteran received yet another unfavorable decision.  He hired our firm in July 2014 to represent him and his claim since he was at his wits end.  All he had been able to obtain on his own with help from a VSO was service connection for PTSD with only a 50% rating in 2011.

Our firm was dismayed at the poor treatment this combat Vietnam Veteran was receiving from the VA.  After a thorough review of his claims file and much strategizing, we decided it was best to obtain an expert psychiatric report and an expert vocational report.  After filing a May 2015 Notice of Disagreement and obtaining expert reports, (and much correspondence with the VA) we finally triumphed in a July 2017 rating decision.

The Veteran was in the United States Army from August 12, 1955 to August 1, 1957, and the Reserves August 1957 to August 1961 during peacetime. He was stationed in Fort Drum, New York where he participated in Active Duty for Training (ACDUTRA) in July and August 1959. The Veteran died of Metastatic Lung Cancer in 1982.

The Veteran’s widow filed a claim for service-connected death benefits and was denied for years. After receiving a Board denial in September 2010, she hired our veterans disability law firm to represent her in a CAVC appeal. We successfully got her claim remanded at the Court.

We continued to develop evidence and argument in her case. The issue at hand was the surviving spouse’s quest for service connection for cause of death due to herbicide exposure at Ft. Drum in 1959. While the VA acknowledges Agent Orange was sprayed at Fort Drum in 1959, they argue it was in an area inaccessible to any of the troops. However, the Veteran’s spouse recalled him coming home in August 1959 and describing to her how they were sprayed from a helicopter with a burning liquid that caused their skin to redden and burn. She distinctly remembers the conversation because she was pregnant at the time and remembers feeling very squeamish and nauseous as her husband recounted the story.

The VA was stubborn and while we were successful obtaining Board remands, every single time the Regional Office would deny. We submitted Vegetative Reports for Fort Drum from 1959, the spouse’s lay statement and several other lay statements from children of other servicemen at the time in Fort Drum whose fathers had died from some form of cancer related to the herbicide exposure. The RO stood firm and said our information was not specific enough, while we argued the Veteran was due the benefit of the doubt, as it was as least as likely as not from his medical records that the exposure took place and caused his cancer. By August 2017 the RO had dug in with their consistent denials. Finally, in a persuasive argument to the Board that it was at least as likely as not due to herbicide exposure, since there was no proof to dispute this, the Board granted service connection.

The Veteran was a member of the United States Marines during peacetime from July 1976 to July 1979, February 1981 to April 1982 and April 1982 to November 1987. His MOS was Rifleman.

While in service the Veteran seriously injured his knee in a regimental football game. He was treated in the hospital. He also claimed to have injured his back while using heavy machinery in Guam in service. As his time in service progressed the Veteran gained a lot of weight due to his knee and back injuries/pain and was put into a weight control program.

After his discharge he filed his first claim in 1993 for various medical issues. In 1994 he was denied service connection for all his claims and did not file a Notice of Disagreement, resulting in the claims being closed. He filed a new claim in 2008 and in a much-delayed rating decision he was only granted service connection for Right Foot Strain at 10% in May 2013. He had many conditions for which he was hoping to get service-connected, but was only successful with one of the claims. After this disappointing decision he hired our veterans disability law firm in March 2014 for our help and expertise. By now, the Veteran had gained quite a bit of weight and was now morbidly obese with many health issues due to his morbid obesity resulting from his back injury in service.

We immediately filed a Notice of Disagreement and began developing our claim with the help of the Veteran’s copious medical records. With our new evidence we were successful in an October 2016 rating decision granting service connection for left and right knee strain at 10% effective August 2011. However, four other medical conditions were not addressed in this decision, and we aggressively pursued a response. We finally received a response in a rating decision dated December 15, 2016. The Veteran was awarded service connection for gastric ulcer with an evaluation of 60% effective March 2012, intervertebral disc syndrome with degenerative arthritis, lumbosacral strain and Schmort Disease of the thoracolumbar spine at 10% effective August 2011 and sciatica left and right lower extremities with an evaluation of 10% effective November 2016.

While we were on the right path, we believed the Veteran deserved more. We obtained two separate expert reports, the Veteran’s statement, social security disability records and private physician treating records. With this new evidence we were able to prevail in an August 2017 rating decision obtaining TDIU and DEA effective September 2012.

The Veteran was in the United States Navy from April 17, 1984 to February 26, 1987 and February 27, 1987 to April 30, 2004. He was in the Navy during the Gulf War and peacetime. His rating was Quality Assurance Inspector of Submarines.

The Veteran was able to obtain service connection for chronic asthma and obstructive sleep apnea with the assistance of a VSO. But he hired our veterans disability law firm in April 2016 after he was denied a higher rating for asthma and obstructive sleep apnea in a February 2016 BVA decision.

We researched the Veteran’s c-file and medical records and determined he had a better claim for TDIU that we believed we could obtain for him. Even though the Veteran had a college degree, because of his chronic asthma and sleep apnea he had a problem holding a job. He was only able to work at Target as a cashier and at a warehouse as a stock clerk because he was constantly sleepy during the day from his sleep apnea and would often be late for work from oversleeping after being up most of the night with the sleep apnea. He was not qualified to teach, which would have been the natural progression of his college degree, as his daytime lethargy and fogginess was a huge issue. He also received several traffic citations for falling asleep behind the wheel during the day. The Veteran was last able to work in February 2004. Besides his sleep problems, any industrial or manufacturing atmosphere severely exacerbated his asthma, as chemicals and dust caused him to have acute asthma attacks.

We hired a Vocational Expert to prepare a report illustrating why the Veteran was unable to work. We submitted our argument and our new evidence to the BVA in an appeal and they granted us a favorable decision. In a September 2017 RO implementation of the Board decision, the Veteran was granted TDIU and DEA effective May 1, 2004.

Veteran served in the United States Marines during the Vietnam era and peacetime from June 1972 to June 1976. He was a radiographer, weapons and electronic repairman, and a rifle range coach.

He began experiencing tinnitus in one ear in 1994, and in both ears by 2000. His hearing loss began in 2004. He filed a claim for service-connected bilateral hearing loss and tinnitus in December 2004. He was denied.

He hired our firm in 2012 to represent him after 8 years of trying to battle the VA on his own.

The Veteran contends that his bilateral hearing loss and tinnitus are related to in-service noise exposure while calibrating artillery and during rifle training. The Board had conceded in-service acoustic traumas, to include repeated, unprotected exposures to noise from rifles, pistols, 175mm self-propelled guns, generators, etc. When the audiograms performed at his enlistment and separation are compared, the records show a bilateral 10dB upward threshold shift at 2000Hz and several additional shifts at other frequencies. 

When the audiograms performed at his enlistment and separation are compared, the records show a bilateral 10dB upward threshold shift at 2000Hz and several additional shifts at other frequencies. While the hearing threshold for 3000Hz in his left ear at his separation was 25dB the enlistment audiogram did not test that frequency. Since he submitted his original December 2004 claim for service connection numerous etiological opinions—private and VA—have been submitted.

In March 2016 we obtained an expert report to submit as new evidence supporting his hearing loss and tinnitus claim. By September 2017, the Board granted our appeal and after an October 2017 DRO review the Veteran was awarded a rating of 100% for bilateral hearing loss effective November 2006 (date of his reopened claim) and a 10% rating for tinnitus also effective November 2006.

This Veteran served in the United States Army from August 2009 to September 14, 2011 with service in Iraq (non-combat).  His duties were Quartermaster and Chemical Equipment Repairer.  The Veteran attributes his PTSD to three specific in-service events.  First, he was in a Humvee accident and sustained a concussion.  Second, he witnessed and had to stand by helplessly while his buddy was tasered and “beaten up bad” by the military police.  And third, in 2011 he was notified by a Red Cross letter that his father was dying.  He returned home and sat by his father’s hospital bedside for two days while he watched his father suffer and die from cancer.  This was particularly upsetting to the Veteran because his mother died when he was five and his father raised him and his siblings on his own in a loving, stable family environment.  He was extremely close to his father.

Once he returned to Iraq, he began abusing alcohol and marijuana.  He had several conflicts with his Sergeant who he thought was “always picking on him and singling him out”.  He also at this point had difficulties getting along with others.  Due to his behavior he was “chaptered out early” with a general discharge under honorable conditions.

Upon his discharge and returning home his behavior spiraled with his abuse of alcohol and marijuana and he ended up being hospitalized for psychiatric problems.  He managed to get himself back on track and sober with counseling and medication.  He filed his claim for service connection for PTSD in 2012, which the VA misplaced, starting a cycle of years of VA denials.

After receiving another unfavorable decision in October 2014, he realized he needed more legal expertise with the VA and hired our veterans benefits firm in November 2014.  We engaged a psychological expert to address the onset of his psychiatric problems, with particular emphasis on the stressors from service and his notable problems after experiencing the stressors.  We developed legal arguments and submitted our medical expert evidence.  Eventually, in 2017 after DRO review we were able to obtain for the Veteran service connection for PTSD with persistent depressive disorder at 70% effective September 2011, TDIU effective September 2011, and an establishment date of September 2011 for DEA.  While we were successful in our results, the Veteran’s sleep apnea secondary to depression had not been addressed.  We filed a NOD.  In a BVA appeal decision the Board agreed to service connection for the sleep apnea and remanded to the RO for implementation.  We were successful in getting the Veteran service connection for sleep apnea secondary to PTSD at a 50% rating effective August 2013.

This Veteran served in the United States Navy during the Vietnam era stateside from May 1967 to August 1968 with an honorable discharge.

In 2005 the Veteran filed a claim for PTSD. The Veteran’s claim in 2005 stated that a fellow recruit perpetrated a personal assault in basic training. While the Veteran was lathering his hair in the shower an assailant turned the water scalding hot. After the Veteran jumped away from the hot water and cleared the soap from his eyes he saw the assailant standing there laughing. He recalled other incidents where he witnessed recruits endure physical training that he perceived to be violent and abusive. He began to use marijuana to cope with his psychological distress. His unauthorized possession and use of the same resulted in an administrative separation due to unfitness. He had requested a hardship discharge due to his “fight or flight response” and was denied. He was later granted an honorable discharge.

The Veteran advised us that he grew up as the only Jewish child in an all Irish neighborhood in New York City in the late 1940’s. As a result, he was the object of much ridicule and abuse by other boys in the neighborhood.

The Board denied the Veteran’s 2005 claim based on two findings of fact that necessitated the denial of the claim: (1) the claimed stressor is not sufficient for a diagnosis of PTSD; and (2) the record does not contain credible supporting evidence that the claimed stressor occurred in the first place.

In August 2005, a VA examiner concluded that he had PTSD and secondary depression. Although she did not review the claims file, she noted that his response of fear and humiliation dissuaded him from reporting the assault. She noted that, afterward, he began to use marijuana and requested a hardship discharge. She concluded that the PTSD and depression “is most likely related to a traumatic event he experienced in the military.” But a VA physician’s initial psychiatric assessment dated March 2011 notes her remark that disagreed with her diagnosis since he did not sustain any physical injury. Without reviewing the claims file or providing any reasoned medical explanation the VA physician noted the criteria for PTSD had not been met.   

The Veteran hired our law firm to represent him with the CAVC in February 2013. We were able to successfully get the case overturned on appeal at the U.S. Court of Appeals for Veterans Claims because the March 2011 VA medical opinion was inadequate. It failed to provide an adequate rationale.  The VA examiner erroneously thought that the Veteran needed to be “harmed” by the shower incident—meaning physical injuries.  Moreover, the VA examiner failed to address whether criteria for PTSD was met with respect to the Veteran seeing abuses against recruits by company commanders.  The VA examiner also appeared to impose an objective standard to the Veteran relative to his response of intense fear, helplessness or horror.  

On remand, we obtained an expert medical report supporting the Veteran’s claim that his PTSD was service connected.  He was also collecting social security benefits since 2008 for depressive disorder and cannabis abuse disorder, as the SSA considered him 100 percent disabled.  We submitted our new evidence to the Board, and they remanded the claim to the RO in October 2014, eventually resulting in the grant of service connection for a mental disorder with a 70 percent evaluation and deferral for further development of the TDIU claim.

Eventually, in December 2017 we were able to obtain TDIU effective 2005 for the Veteran.  

The Veteran was in the United States Army from September 29, 1970 to September 9, 1971 during the Vietnam War. His MOS was Infantry Small Arms. The Veteran was stationed in Germany. In June or July of 1971, the Veteran was drugged, tied up and raped by his Sergeant. After this happened a second time the Veteran reported it to his Captain and was told by his Captain “Keep quiet or be branded a homosexual and get a dishonorable discharge.” The Sergeant that raped him was “highly decorated” and the Captain “didn’t want to ruin his career”. The Veteran was also told if he did not report the rapes, he would receive an early honorable discharge.

By way of background information, the Veteran grew up in a physically abusive home where he took the brunt of his stepfather’s beatings to protect his five younger siblings. He convinced his mother to let him enter the military at age seventeen to escape the abuse at home and to make something of his life. Tragically, the rapes destroyed him emotionally and any chance he had of a successful military career. The Veteran attempted suicide in August 1971 to escape the trauma he was going through.

After his discharge he managed to maintain low level employment until 2009, when his PTSD became too disruptive for him to work. After three psychiatric hospitalizations, the Veteran filed his claim for service connection for PTSD in March 2012. In a March 2013 decision, the Regional Office denied his claim on the basis his PTSD was caused by his childhood abuse and beatings, and not by being drugged, raped and tied up twice by a superior in service. The Veteran filed a Notice of Disagreement in September 2013 and then hired our veterans disability law firm in September 2014 to pursue and develop his claim.

In developing the Veteran’s claim, we hired three separate psychiatric and psychological experts to speak with the Veteran and prepare expert reports on his behalf. We submitted our expert reports and our argument to the Board and received a favorable decision in May 2017. We followed up with the RO continuously until they finally implemented the Board’s decision in December 2017.

We were able to obtain for the Veteran in the December 2017 decision granting service connection for PTSD with Major Depressive Disorder at 70% evaluation effective February 2012 and TDIU and DEA also effective February 2012. We obtained service connection for PTSD even with a childhood history of abuse.

The Veteran is a native of Puerto Rico who served in the United States Army during peacetime.  His period of service was February 4, 1976 through February 1, 1979. For the majority of his time he was stationed near Stuttgart, Germany in cold and wet conditions.  

In service the Veteran injured his knee and sprained his back during road marches and soccer games for which he received treatment. At a December 1978 physical examination, the Veteran complained of continued back pain and a nervous condition that he had been dealing with for over two years. At his separation examination the Veteran stated that he suffered from back pain from training in the cold, wet weather while carrying heavy ammunition boxes on his head and back. It is also noted in his separation exam he suffered from “nervous trouble”. At the conclusion of his separation examination he was given a “profile” concerning cold weather exposure. This would seemingly validate the Veteran’s claim of various health conditions occurring because of the “cold weather exposure.”

He sought compensation for his cold weather related back injuries and other conditions he believed were service related. In an August 2010 rating decision his claims were denied. That is when he hired our veterans benefits firm to represent him in his appeal to the Board. By this point in time the Veteran was in severe back pain and had also had back surgery. He was also mentally ill and had been hospitalized several times for psychiatric problems.  

By 2015, with much back and forth with the VA we were able to engage three different experts to concur with our opinion that the Veteran’s back problems and depression were linked, and service connected. We submitted these reports as new evidence to appeal the Veteran’s claim denials. Finally, in a November 2017 decision the Board granted service connection and the Veteran’s claim was sent to the Regional Office for implementation.

In a February 2018 rating decision the Veteran was granted service connection for major depressive disorder, recurrent with psychotic features previously rated as neuropsychiatric nervous condition (claimed as depression and sleep disturbances) associated with right L5-S1 hemilaminectomy; microdiscectomy residuals; moderate degenerative changes of the lumbar spine claimed as back pain, degeneration of the lumbar spine, lumbar sprain and laminectomy at a 100% rating effective February 22, 2008.  He was also granted DEA established as of February 22, 2008.

Veteran served in the United States Air Force from September 15, 1969 through July 12, 1971 during the Vietnam era.  He was a Supply Clerk at Dover Air Force Base. He received an honorable, hardship discharge when his father died suddenly.

The Veteran contends that his mental illness first manifested itself while he was playing squash in 1970 at the Base gym.  He accidentally broke his racquet, and upon returning it to the counter he believed people were ridiculing him.  Shortly after he began hearing voices.  He was hospitalized at Dover AFB and was treated with lithium. 

After going home to Oregon, the Veteran’s mother and sister both realized the Veteran was mentally unwell, experiencing paranoia and off his medication. He took off and wandered around the country by automobile doing odd jobs. By 1974 the Veteran was experiencing acute schizophrenic episodes with probable reactive depression. However, the veteran reports he began experiencing paranoia and hearing voices while in service. Further, lay evidence of his sister and a close friend report he was exhibiting a change in his behavior shortly after service, including paranoia.

There was a lot of inconsistency in the Veteran’s statements in his medical records which led to his 1994 claim for service connection for psychiatric disability manifested within one year of service to be denied. We believed the Veteran’s inconsistencies further proved he was suffering from mental illness. However, the Veteran did not appeal this decision within one year and the claim was closed.

The Veteran went on to tragically experience twenty-eight psychiatric hospitalizations and three suicide attempts while taking lithium for forty-three years. He reopened his claim January 26, 2007. He was again denied service connection and in February 2008 filed a Notice of Disagreement. The Veteran hired our firm in January 2016, and we appealed to the Board. It was remanded to the RO in February 2017 and we obtained a favorable expert report for the Veteran stating that it was at least as likely as not that his psychiatric condition began in service. A March 2017 C and P examination by a VA doctor also agreed that the Veteran’s mental illness manifested within one year of discharge.

We received notification in March 2018 that a decision had finally been made and it was decided that the Veteran’s bipolar disorder was service connected, with a 100% rating effective the date of the reopened claim, January 26, 2007. DEA was also established as of January 26, 2007.

The Veteran was in the United States Army during the Gulf War from February 1992 to August 1992 and July 1999 to August 2001. His MOS was Metalworker. Throughout his service he often complained of depression and anxiety and was treated for the same. In January 1991, he was even hospitalized at Fort Leonard Wood in Missouri for psychiatric distress. A particularly triggering episode when he was in service was finding out his brother back on the East Coast had committed suicide.

Upon his discharge his mental health was declining, and he sought treatment at various VAMC’s. He was again hospitalized for psychiatric reasons in 2013. Twenty-two years after his initial VA misdiagnosis, VA doctors finally correctly diagnosed him with bipolar disorder with psychotic symptoms, and not depression and anxiety as the VA had previously diagnosed.

After his hospitalization he filed his first claim for service connection for his mental illness, tinnitus and bilateral hearing loss in 2013 with the help of a VSO. As we all know, these claims can drag on for years. By January 2015 he hired our veterans benefits firm when he could only obtain service connection for tinnitus and bilateral hearing loss.

We reviewed his claims file and medical records, both VA and private records, and determined the best course would be to obtain an expert psychiatric report from our esteemed Expert Psychiatrist.

Expert reports can be expensive, but we pay for the report upfront and only accept reimbursement for the report if the Veteran receives a favorable award. This is what sets us apart from other law firms and is key in obtaining favorable VA decisions.

We submitted our expert’s report, along with our argument and received a successful March 2018 DRO decision. The Veteran was granted service connection at a 100% rate for Bipolar Disorder with Current Psychotic Symptoms effective February 27, 2013 (the date of his initial claim) and DEA established February 27, 2013.

The Veteran, a native of Puerto Rico, was in the United States Army from June 1964 to December 1964 and March 2005 to December 2005 during the Vietnam Era and peacetime.

His earlier time of service was uneventful; however, a mission he was sent on in 2005 caused him his greatest trauma. He was sent on a classified mission to Honduras in support of the Special Forces. His official title was “translator”. Upon arrival in Honduras, this became quite a different role. The Veteran and his fellow “translators” were told they were now going to be “role players.” This involved playing the role of an enemy operative imprisoned as part of an anti-terrorism exercise. The details were horrific; the “role players” were stripped of clothing, doused with cold water continuously, “tortured” and isolated and held in individual cells for an undetermined amount of time. After several days of this the Veteran began experiencing a mental collapse and was medevacked to a hospital in Honduras. Upon admittance it was also discovered he had a pulmonary embolism which required emergency surgery. He was then sent to a hospital in Puerto Rico to recuperate.

The Veteran filed his first claim in 2008 and was denied service connection. He hired our firm in September 2010 to represent him. We analyzed his claim file along with all his medical and psychological records and decided the strongest course of action would be to obtain an expert psychological analysis and report.

In March 2011 we submitted our new evidence, along with a Buddy Statement and did not hear from the Board until April 2015, despite many, many follow up letters and telephone calls. The Board finally made a favorable decision based on our submission and remanded the claim to the RO in April 2015 for implementation. In an August 2017 DRO decision (which we were not notified of until April 2018, eight months later) the Veteran was granted an earlier effective date of May 22, 2008 from July 10, 2013 and service connection for PTSD at 50% rating, service connection for right eye partial vision loss 10% effective August 2017, service connection for moderate lumbosacral strain/Myositis at 40% rating effective May 2010, Tinnitus at 10% rating effective December 2005, TDIU and DEA effective May 2010 and Special Monthly Compensation effective May 15, 2008 to July 1, 2008.

The Veteran was in the United States Army during peacetime from August 28, 1980 to September 25, 1980. His time in service was brief, but traumatizing. He entered service as a seventeen-year-old looking to escape a physically abusive home life. As a child he experienced nighttime bedwetting (nocturnal enuresis) from both psychological stress from the beatings and because of a physical condition he suffered from. After having surgery around age twelve repairing his urethra, he never experienced nocturnal enuresis again and had a normal physical and psychological examination upon entrance to the military.

The Veteran’s stressor occurred during boot camp when his Drill Sergeant berated him for not having the proper form during push-ups. She punished the entire unit and told them because of the Veteran’s unacceptable push-up form the entire unit would have to do extra physical training the next day. The Drill Sergeant, a female, further degraded him by kicking him very hard in the buttocks in front of the unit and making fun of him.

That night the members of the Veteran’s unit assaulted him while he was sound asleep because they were angry about the punishment. The Veteran said he was held, tied down and then beaten by several individuals with bars of soap inside of socks, while he was trapped with a blanket over his head. This sadistic ritual is called a “blanket party”. During the beating, the Veteran urinated on himself from fear and terror. After that incident the Veteran wanted no part of the military and voluntarily told medical personnel he suffered from nocturnal enuresis, which was an automatic discharge.

After discharge the Veteran was able to obtain only menial employment as he had dropped out of the ninth grade. Within a short period of time he began self-medicating his PTSD with drugs and alcohol. After being addicted for several years the Veteran became sober and filed a claim for service connection for PTSD. Having no success, he hired our veterans disability law firm in January 2015. We hired an esteemed psychiatrist to review the Veteran’s records, interview him and prepare an expert report detailing how the in service “blanket party” caused the Veteran’s PTSD. He provided us with a lengthy report we submitted as new evidence. In a successful December 2016 decision, we were able to obtain for the Veteran service connection for PTSD with Unspecified Depressive Disorder at 100% rating effective November 13, 2013. We also believed the Veteran was entitled to SMC as he was housebound and needed assistance. It was denied in a January 2018 decision, we filed a Notice of Disagreement and submitted several lay statements from the Veteran’s family members describing how he cannot/will not leave the house and the level of care he required in his daily existence. We succeeded in an April 2018 decision obtaining entitlement to Special Monthly Compensation.

The Veteran, a native of Puerto Rico, was in the United States Army from September 1977 to September 1980 and March 1992 to September 1992 during the Gulf War and peacetime. He was a Heavy Equipment Operator.

The Veteran filed his first claim for service connection in 2011 and received a negative decision in October 2011 which he appealed. After not receiving a response from the VA for five years regarding his appealhe hired our veterans disability law firm in January 2016 to represent him. We reviewed his file, advised the VA of our representation and pressed for a decision. We finally received a BVA decision in September 2017, essentially remanding every single medical issue the Veteran was experiencing. Their position was the Veteran had not had any recent VA examinations and they were requesting he have them before they would make a final decision. He previously submitted his private treating physician’s records.

After a February 2018 C & P examination backed our claim, we also hired a vocational expert to prepare a report regarding the Veteran’s inability to work due to his Wegener’s Granulomatosis. We submitted our new evidence and argument for service connection. We were able to locate service treatment records (STRs) showing the Veteran being treated for chronic and severe nosebleeds while in service, which was a precursor to his Granulomatosis diagnosis.

In a May 2018 rating decision the Regional Office granted the Veteran service connection for Wegener’s Granulomatosis 100% effective October 22, 2010, Renal Involvement secondary to Granulomatosis 80% effective February 15, 2018, Chronic Rhinitis secondary to Granulomatosis 100% effective February 15, 2018, increased rating for Left and Right Cervical Radiculopathy to 20% effective February 15, 2018, DEA established October 22, 2010 and Special Monthly Compensation (housebound) effective February 15, 2018.

The Veteran was in the United States Marines from March 23, 1973 to March 22, 1977 during the Vietnam Era and peacetime. The Veteran’s problems began when as a 21-year-old young man he was on liberty from Camp Pendleton in California and taking a walk with his wife in July 1973. A group of five men walked by and made an inappropriate comment to the Veteran’s wife. The Veteran confronted the men and they beat him up by punching him in the head and kicking him in the head and face when he fell to the ground. He thinks he then blacked out and woke up in the emergency room. He suffered a fractured jaw, scalp lacerations and lost teeth. Two days later he had surgery to repair his mandible and was hospitalized for five weeks.

According to a lay statement from the Veteran’s now ex-wife, he was never the same after that incident. She stated he was happy go lucky and easygoing and after that attack he slowly began to change, becoming enraged easily, startling easily, being combative and argumentative with everyone and drinking heavily.

The Veteran filed his first claim in 1978 before PTSD was a recognized disorder. He was denied and his life began to spiral out of control. He could not be around people and always wanted to be alone and his ex-wife stated he would take off in his car for two to three months and live on the road, or jump on a freight train and travel across the country to deal with his demons. After many years and zero success, after his latest denial the Veteran hired our veterans disability law firm in April 2014. We immediately filed a Notice of Disagreement in May 2014. The VA was consistently denying the Veteran’s mental illness claim stating he had preexisting mental health issues because he had spent a short period of time in a juvenile detention center as a young teen and post service issues of fighting and heavy drinking. While this was true, we needed to provide enough evidence to show the beating he received in service contributed to his PTSD, which had a delayed onset, which is par for the course.

We hired a psychiatrist to interview the Veteran and prepare an independent medical examination and a psychologist to analyze the VA examiner’s examination notes, critiquing them and pointing out the errors. By July 2015 we submitted this new evidence and our argument on behalf of the Veteran. Almost three years later we finally received a favorable response via a DRO decision.

This Veteran, a native of Puerto Rico, was in the United States Air Force during the Vietnam Era from August 20, 1969 to July 13, 1973.  He was stationed at Loring Air Force Base in Maine as a B-52 Mechanic.

He originally injured his back while lifting a heavy toolbox while repairing a B-52 in service in 1971.  His pain progressively became worse and chronic.  He started suffering from depression secondary to his back injury.  Upon his discharge he filed his first claim with the VA on November 16, 1973 for a nervous disorder, stemming from his chronic back pain.  He was denied in January 1974 and appealed in May 1974.  At his October 1974 hearing he withdrew his claim as it was made known to the Veteran that receiving benefits for a “nervous disorder” would “look bad” and possibly hurt his civilian career when he graduated college and began his job hunt.  He was attending college at the time and went on to receive his bachelor’s degree.

After many years in a management position at a factory he could no longer perform his job with his chronic back pain and depression.  He filed a claim in May 2009 for back pain and major depressive disorder and in a November 2010 decision he was granted service connection for fibro myositis, lumbosacral paravertebral muscles at a 40% rating effective October 2008.  His depression claim was denied.  At the time of his claim he had also started mental health treatment at VAMC.

The Veteran needed more help with his claim and hired our firm in December 2010 after his depression claim was denied.  We worked diligently with the Veteran and combed through his medical records, both private and VA to further develop his claim.  We also hired several medical, psychological and vocational experts to prepare reports as additional evidence in support of the merits of the Veteran’s claim.  By September 2016 we had appealed the repeated denials and received another unfavorable rating decision in April 2018.  We appealed to the Board and the BVA rendered a decision in June 2018 granting service connection for Major Depressive Disorder and TDIU.

In an August 2018 RO rating decision, the Veteran was granted service connection with a rating of 50% for Major Depressive Disorder with depression, anxiety and nervous condition effective May 12, 2009.  TDIU and DEA were granted effective May 12, 2009.

The Veteran served in the United States Army stationed in Germany from November 1955 to November 1957. He was involved an in-service automobile accident in 1957 which injured his back and resulted in an early discharge. In November 1957 he filed a claim for service connection for his back injury from the in-service auto accident and was told his records were destroyed in a fire and therefore he was denied. Twenty-one years later in February 1978 he was totally disabled due to the auto accident, unable to work full time, and was denied again.

Inexplicably, however, the Veteran received his records and STR’s in the mail in 2005 from the VA. He again filed a claim since there was now proof of his in-service accident, and three years later in 2008 he was granted service connection at a 20% rating effective September 2005 for degenerative disc disease. He filed an NOD in January 2009 and testified in April 2010 that he had been unable to work due to his back disability since 1988. The Board remanded the issue in April 2012. Many denials later he finally received an earlier effective date for his lower back disorder of November 1957 but was remanded for TDIU. In March 2016 he was granted TDIU effective July 2015, as the VA deemed it was not warranted for an earlier date.

Disgusted and frustrated, he hired our veterans law firm in October 2017, and in a June 2018 BVA decision implemented by the RO in August 2018 we were able to argue for an earlier effective date for TDIU and DEA of January 2009. This awarded the Veteran over $170,500.00 in past due benefits.

However, armed with the Veteran’s records, this fight is not over. We will be representing him before the CAVC for an earlier effective date for TDIU back to 1957.

The Veteran was in the United States Army from May 1990 to May 1994 during the Gulf War and peacetime. He was a combat veteran having spent time in Iraq and Kuwait. His MOS was Cannoneer. The Veteran was involved in several combat engagements such as being under enemy fire for one week straight in Kuwait while firing over four hundred rounds himself. The Veteran stated he also “Scored direct hits and destroyed targets during live fire with direct fire engagement with a Howitzer.” While in service he also injured his back lifting the breach of a gun and was treated in 1993 for his back injury while in service. (This in-service event contributed to his degenerative disk disease years later).

Unfortunately, after his time in combat, the Veteran began suffering from depression and PTSD. He filed his first claim for service connection for his mental health disorders in 1994 and was denied. He did not appeal this claim and began self-medicating with alcohol, which declined into cocaine and methylamphetamine addiction. Post service and heavily addicted to drugs, the Veteran entered rehabilitation with the VA many times over the years, afraid he was going to commit suicide.

The Veteran reopened his claim in 2005 and was again denied in 2006. He persisted with his claim with no success, and was diagnosed by the VA with depression in June 2012. By June 2016, the Veteran was in a hopeless mind set and found his way to our veterans benefits law firm. We immediately hired a psychologist to review the Veteran’s medical records, and she prepared an expert report in favor of the Veteran. We also obtained three lay statements from the Veteran’s family members that were quite detailed in describing his PTSD decline since service. The Board agreed, and granted a favorable decision in June 2018.

In an August 2018 rating decision, the RO implemented service connection for PTSD at 50% effective March 31, 2011, and 70% effective April 4, 2013, service connection for Degenerative Disc Disease Lumbar Spine at 20% effective March 31, 2011 and service connection for Radiculopathy, Right Leg Extremity at 40% effective March 31, 2011.

Veteran served in the United States Army from June 30, 1971 to November 6, 1975 during the Vietnam era and peacetime at Fort Ord, California.  

The Veteran received an undesirable discharge due to three occasions of going AWOL and committing an unarmed bank robbery in March 1975. He also suffered from pre-existing mental illness since childhood. He had been in and out of boys’ homes and juvenile detention centers since the age of 10 when the Courts took him away from his mother. His formal education ended in the ninth grade. He was given the opportunity to enter the Armed Forces at age 18 and jumped at the chance, to “make something of himself” and get more education. At his induction exam he was classified “normal” but was never examined by a mental health professional despite his prior diagnosis.

His longest period being AWOL was 1131 days, triggered by his brother’s arrest for robbery and murder. He attempted to get a hardship discharge so he could go home to his mother and younger sister in this dark time in his family, but he felt it was taking too long and just left—again, demonstrating an irrational decision-making process due to his mental illness.  During most of his service he was AWOL, so of course this led to an other than honorable discharge. Since childhood, his diagnoses varied between schizophrenia and bipolar disorder.

In November 2006, the Veteran filed his first claim for mental illness being exacerbated by his time in service and began the process of trying to amend his discharge status. In 2012 the Board denied his claim for service connection due to his other than honorable discharge. However, the CAVC’s Memorandum Decision vacated the Board’s decision denying the claim and remanded to the Board for further development.  

The Veteran hired our veterans disability law firm to represent him in January 2013 to properly develop his claim. In November 2015, the Board granted the Veteran’s eligibility, ruling that the other than honorable discharge was not a bar to VA benefits. We proceeded to obtain two Expert Reports from a psychologist and a psychiatrist and presented this additional evidence as a rebuttal to a VA psychologist’s findings. Eventually, we obtained a favorable Board of Veterans Appeals decision that determined that the Veteran’s other than honorable discharge was not a bar to VA benefits.

In September 2018, we were able to obtain the Veteran service connection for bi-polar disorder at a 70% rating effective November 3, 2006, and TDIU effective November 13, 2006, and DEA with an establishment date of November 13, 2006. The Veteran was deemed incompetent and his sister has been appointed as his chosen fiduciary agent.

This Veteran, a native of Puerto Rico, was in the United States Army from July 1953 to May 1955. He served during the Korean Conflict and in peacetime. After his discharge he went to medical school and became a practicing physician for over fifty years.

He hired our firm in June 2018 for one specific purpose. When he hired us, he already had service connection for Irritable Bowel Syndrome rated 30%, but he wanted a higher rating. But to do so it required us to bring in the psychiatric component of his disability picture. The VA refused to consider how the IBS affected his mood.

Due to our presence in the case, in just three months time, we were able to obtain for the Veteran service connection for Depressive Disorder secondary to IBS at a 100% rating effective July 22, 2011.

The Veteran was in the United States Marines from June 6, 1979 to August 25, 1981 during peacetime. His MOS was Rifleman. The Veteran had a troubled childhood, began drinking alcohol at age twelve, and eventually dropped out of high school. He joined the Marines at age seventeen hoping for a better life.

Unfortunately, during a live fire training exercise a fellow Marine’s rifle exploded in the fox hole, sending bullets spraying everywhere in the occupied fox hole. The Veteran feared for his life. This incident traumatized him so severely that he was unable to continue in the military and was discharged. He began using drugs and drinking alcohol daily. His life was in disarray and he was unable to hold down a job. He filed his first claim for service-connected PTSD in 2012. He was denied.

The Veteran realized that he could not win the claim on his own or with only a VSO. So, the Veteran hired our veterans disability benefits law firm in May 2015 after not receiving any favorable decisions. We ordered an independent medical review of his psychological/psychiatric records and submitted our expert’s report as new evidence. In a successful BVA decision in May 2018 implemented in June 2018 we obtained service connection for Psychiatric Disorder including Panic Disorder at 50% effective October 18, 2013. We disagreed with this evaluation and submitted our argument. In a September 2018 rating decision, we were able to have the Panic Disorder evaluation increased from 50% to 100% effective October 18, 2013 and granted DEA.

The Veteran served in the United States Air Force from January 13, 1969 to January 2, 1973 during the Vietnam War.  His Air Force specialty code was Aircraft Electronic Navigation Equipment Repairman for the Avionics Maintenance Squad.  He spent time at three different Royal Thai Air Force Bases in Thailand, one of which was Korat Royal Air Force Base where he was from June 1972 until December 1972.

He was first diagnosed with heart disease at the young age of 43, in 1991.  From 1991 through 2018 he had numerous cardiac events, such as two bypasses, nine angioplasties and thirteen stents.  The Veteran began his service connection claim quest in 2011.  By October 2017 he realized he could not handle the case on his own and hired our veterans disability law firm.  

Normally, Agent Orange exposure is presumed if a Veteran worked on the perimeter of any of the air bases in Thailand, since this is allegedly the only area on the bases where the herbicide was sprayed.  Most military job descriptions (AF specialty codes, MOS) that qualify for service connection are guards, canine patrol units and any other MOS that strictly worked the perimeter of these bases.  Our Veteran’s specialty did not fall under any acceptable category.  This was why VA denied him over and over for service connection.  

We immediately went to work to obtain evidence to prove his actual exposure while in Thailand.  We obtained more research documentation, the Veteran’s own statements and Buddy Statements and were able to establish that he did indeed repair planes on the perimeter of the base and that he also lived in a building on the perimeter of the base in the area where there would have been overspray.

As a result of our efforts, we prevailed and in a Board decision in August 2018 presumptive service connection was granted.  An October 2018 rating decision granted the Veteran service connection for ischemic heart disease including coronary artery disease (CAD) and coronary artery bypass grafting procedure associated with herbicide exposure, at a 100% rating, effective July 2011, and DEA establishment date effective July 2011.

This Veteran was in the United States Air Force from May 1971 to December 1972. He was an Airman at Whitemans Air Force Base, Missouri.

On July 1, 1972, the Veteran and three other Airmen were returning to the base from a night out approximately one hundred miles away. The Veteran was the designated driver since he had not had any alcohol to drink. It was not the Veteran’s vehicle. Tragically, over ninety miles into the trip back to base the Veteran fell asleep behind the wheel and crashed into a bridge, with a steel pole impaling the car through the engine. Despite having severe injuries, himself, the Veteran was the only one conscious and he pulled two of his friends out of the back seat with open head injuries but could not get the front passenger out. The Veteran himself sustained two compound fractures of his arm, passed out at the scene and woke in the hospital. Two of his friends were seriously injured, and his front seat passenger died. The Veteran’s physical injuries healed, but he never recovered mentally. Shortly after, he was discharged due to his mental health problems.

The Veteran filed his first claim with the VA in April 2005, after he could no longer work due to his mental illness. He was denied service connection in June 2006. His only source of income was Social Security. He hired our veterans benefits firm in June 2011 to represent him before the CAVC. We were successful in our representation and his claim was remanded to the Board. In January 2012 we continued our represent of him in his BVA claim.

The VA kept denying him service connection for PTSD because the Veteran had told various examiners he had been suffering from depression since the age of five due to his horrific upbringing (young, unmarried mother, given to grandparents to raise who abused him physically and possibly sexually, drinking and smoking marijuana at age twelve, gang member for five years as a few examples). However, it was evident to us that the tragic automobile accident was the cause of the Veteran’s PTSD symptoms. We hired two separate psychiatric experts to interview the Veteran over the phone and prepare their reports based on review of his voluminous medical records and their interviewing of him. He had also been hospitalized over the years for PTSD, had not driven a car since 1994 and had constant nightmares reliving the accident.

We further developed the claim with the help of the Veteran’s daughter’s written statements and the Veteran’s own statement. By December 2013 we were able to get the Veteran service connection for PTSD, but only a 50% rating effective April 2005. We filed an NOD and appealed to the BVA. In a September 2018 BVA decision, implemented in October 2018 by the RO, we were finally able to get an increased rating for PTSD with depressive disorder to 70%, effective May 2010, TDIU effective May 2010 and DEA.

The Veteran was in the United States Army from March 1987 to November 1991 during the Gulf War and peacetime. He was diagnosed with Myasthenia Gravis in 1999 and hired our firm in June 2014 to help him get service connection. The VA continuously denied his claim for service connection by adamantly refusing to acknowledge he had early onset symptoms in service. Our job was to disprove this.

We enlisted the aid of one of our medical experts and he prepared a very thorough report disputing the VA’s stance. As it turns out, the Veteran did have Alopecia Areata (which is an auto-immune disorder) while in service and was treated for it. To summarize the report, it found that alopecia areata is indeed a precursor to the type of Myasthenia Gravis the Veteran was diagnosed with in 1999. There are two types of MG, and the VA was assuming he had the kind that does not begin with alopecia as an early symptom. They were incorrect. Our medical researchers were able to ascertain this distinction. We also highlighted his service treatment records which showed a history of treatment for symptoms such as dizziness, headaches, loss of balance and other symptoms that usually predict the onset of Myasthenia Gravis.

With all our evidence submitted on appeal, the BVA granted service connection for Myasthenia Gravis in February 2016. The Veteran had also developed depression at this point secondary to the MG. In the usual back and forth dance with the VA, we were able to ultimately accomplish the following for the Veteran:

• Service connection for muscle weakness left and right upper extremities residuals of myasthenia gravis at 20% each effective December 2004;
• Service connection for muscle weakness left and right lower extremities residuals of myasthenia gravis at 10% each same effective date;
• Service connection for persistent depressive disorder with anxious distress residuals of myasthenia gravis at 50% rating effective November 2018, and once the combined ratings were sufficient;
• TDIU and DEA effective November 2018.

The Veteran was in the United States Navy during the Vietnam Era from December 22, 1972 to December 9, 1974. His MOS was as a Seaman Apprentice, and his plan was to have a career in the Navy. He grew up in a small town in the South where it was considered an honor to join the military upon high school graduation and make something of yourself. The Veteran was following in the footsteps of his father, uncles, cousins and close male friends.

Unfortunately, his plans and life derailed when he became a victim of military sexual assault. The Veteran had just finished boot camp and was celebrating with his buddies when most of them met up with family members visiting, leaving the Veteran on his own. He decided to clean up and shower and join friends for dinner. The area was relatively empty as most everyone was visiting with family. As he entered the shower with just a towel wrapped around his waist he was attacked from behind and a blanket was put over his head and fastened with a belt. A sharp object was held to this throat and he was shoved onto the floor with a knee on his back and a sharp object held to his throat and told his throat would be slit if he struggled or screamed. He was sexually assaulted, and the attacker ran off before he could get the blanket off his head. He never saw the person and to this day does not know who it was. He was also told he would be killed if he reported the incident. The Veteran was an innocent 18-year-old who was unable to cope with the assault and feared for his life if he reported it.

He remained in the Navy for two years, where he began drinking and smoking heavily to try and forget the assault and was filled with rage and wanted to kill someone, but he did not know who. He trusted no one as he did not know who his attacker was and no longer felt safe. He started taking measures to protect himself when in the shower or bathroom, and he was labeled “odd” and ridiculed, but he could not explain his actions out of fear of retaliation. A Naval career was no longer an option for the Veteran, as he felt extremely unsafe and his mental health was disintegrating.

Upon his discharge he was able to secure employment for several years but distanced himself from friends and family and became a loner. The Veteran states he feared being labeled “homosexual,” so he entered his first and only marriage in his forties, and finally confided in his wife. She misconstrued what he told her and told all their friends and family he was “homosexual.” This filled him with rage and exacerbated his PTSD symptoms. He had only confided in one other person, and that was right after his discharge when his lifelong friend was home from the Army in Germany for Christmas. His friend sympathized but understanding the military mindset in 1972 he agreed with our Veteran to keep quiet about it.

It was not until many years later, after divorcing his wife, that he went to the VAMC for psychological counseling and filed his first claim for PTSD due to MST. This was in 2011, and not only were his claims denied for the next six years, but the VA psychiatrist did not allow him to enter an MST therapy group. He finally sought private psychiatric care until he could no longer work, and his money ran out.

After receiving yet another PTSD denial in July 2016 a fellow Veteran recommended him to contact our veterans disability law firm.

After reviewing his file we proceeded by obtaining his one buddy statement, two from his sisters, his private psychiatric records and even a copy of a C & P exam from 2012 where the Veteran had disclosed to the examiner the full details of his sexual assault! The treatment of this Veteran was disgraceful. At this point the Veteran had been unemployed for over twelve years, had thoughts of suicide and was living month to month on SSA.

We submitted our new evidence in an appeal to the Board and in a BVA decision in October 2018 we finally prevailed for the Veteran. The RO implemented the Board’s decision in November 2018 and the Veteran was granted service connection for PTSD at a 70% rating effective December 12, 2011, TDIU effective September 13, 2014 and DEA established September 13, 2014.

The Veteran, a native of Puerto Rico, was in the United States Army from July 1981 to May 1990, February 2003 to April 2004, April 2004 to May 2006 and the National Guard April 8, 1991 to February 6, 2003 during the Gulf War and in peacetime. His MOS was Unit Supply Specialist. He was in Iraq from February 2003 through April 2004 as a Military Police Officer.

The Veteran reports having PTSD, alcohol abuse, migraine headaches, TMJ and various other ailments, aches and pains from his time in service. He has been unable to work since 2006, due to his PTSD, depression, anxiety and panic. He also only has a GED so job opportunities are not plentiful for the Veteran.

He filed his first claim through a VSO in February 2010. He was denied service connection in July 2013 for over twenty different physical and mental ailments, filed a Notice of Disagreement and hired our firm in August 2013. The Veteran had already been through several C & P examinations by the time he hired our firm. We went over his records with a fine-tooth comb and discovered a May 2011 C & P exam where the VA psychologist diagnosed him as suffering from PTSD. The Veteran’s source of his PTSD and mental disorders stem from an incident when he was in Iraq. The Veteran stated that a soldier “begged” him to be deployed to Iraq, the Veteran agreed, and six months later he was accompanying the soldier’s body back home to Puerto Rico. The guilt and anguish he felt was compounded by an incident that occurred when the plane with the body landed. The Veteran opened the casket and his deceased comrade was bleeding from a gunshot wound to his neck. The Veteran had to stitch the wound closed and clean up and redress his comrade before delivering the body to the wife. He never recovered from his guilt and the gruesome sight of his bleeding, deceased friend.

With the results of the VA exam, our argument and our own expert’s report, we received a positive BVA decision granting service connection for migraines, but remanding for all other issues. In a June 2017 rating decision, the RO implemented service connection for migraines at 30% effective February 23, 2010. This was not sufficient. We persisted and were able to obtain an August 2018 rating decision for TDIU and DEA effective November 7, 2016 based on a 2016 Disability Benefit Questionnaire. We were still waiting on the rest of the claim and did not stop pressuring the VA for a response. We finally prevailed in a November 2018 rating decision implementing service connection for PTSD with Major Depressive Disorder, General Anxiety, Panic and Alcohol Disorder effective October 27, 2010 and Tempo Mandibular Joint Disorder with Bruxism related to PTSD at 20% effective October 27, 2010.

The Veteran was in the United States Marines from December 1967 to December 1969 during Vietnam. His MOS was Infantryman/Rifleman and he served in Vietnam for over one year. The Veteran hired our firm in August of 2013 after we received a favorable CAVC ruling on another matter regarding his discharge status. The short version is he was AWOL over 100 days in Vietnam and he received an other than honorable discharge. Our firm was able to convince the Court the Veteran was “Insane” during the times he went AWOL, therefore entitling him to VA benefits notwithstanding his other-than-honorable discharge.

With that decision, his original claim from November 2008 was reopened and we proceeded to develop it. In a November 2018 rating decision from the Regional Office we were able to obtain for the Veteran presumptive service connection for Diabetes Mellitus Type II secondary to herbicide exposure at 20% evaluation effective November 2007, service connection for neuropathy, chronic kidney disease stage II at 60% rating effective July 2010, increased to 100% effective May 2017, service connection for left and right lower peripheral neuropathy at 10% effective August 2010 and entitlement to DEA effective August 16, 2017.

The Veteran was in the United States Navy during peacetime from August 22, 1978 to November 18, 1982. He was a Medic and Navy Seal. He spent two years at Camp Lejeune, which we contend was the source of his Metastatic Male Breast Cancer.

The Camp Lejeune water contamination problem occurred at Marine Corps Base Camp Lejeune from 1953 to 1987. In February 2014, the Centers for Disease Control and Prevention found that the contaminated water at Lejeune significantly increased the risk of multiple diseases including cancer and ALS. United States Marine Corps (USMC) service members and their families living at the base bathed in and ingested tap water that was contaminated with harmful chemicals at concentrations from 240 to 3400 times levels permitted by safety standards. An undetermined number of former base residents later developed cancer or other ailments, which many blame on the contaminated drinking water. Victims claim that USMC leaders concealed knowledge of the problem and did not act properly in trying to resolve it or notify former base residents that their health might be at risk.

In 2009 the U.S. Federal government-initiated investigations into the allegations of contaminated water and failures by U.S. Marine officials to act on the issue. In August 2012, President Obama signed the Janey Ensminger Act into law to begin providing medical care for people who may have been affected by the contamination. The Janey Ensminger Act established a presumption of service connection for illnesses associated with contaminants in the water supply at Marine Corps Base Camp Lejeune between the 1950s and 1980s, which provided healthcare to family members of veterans who lived at Camp Lejeune while the water was contaminated. Ensminger was one among thousands of victims of the Camp Lejeune water contamination scandal, which is believed to be one of the largest water contamination incidents in United States history.

The Veteran contracted male breast cancer in 1999. He was successfully treated and entered remission. In 2009 the cancer returned. He filed his claim for service connection in March 2014, and because he was so ill, he received a quick denial in April 2014. He hired our veterans disability law firm in May 2014 and we immediately filed a Notice of Disagreement. We received another denial via a Statement of the Case in August 2014. We then filed a Form 9 requesting Board review and proceeded to gather new evidence. The problem was that there was a VA physician stating the breast cancer was not service connected. We hired our own expert to prepare a report and requested a report from the Veteran’s treating oncologist who believed it was from his time at Camp Lejeune. The Veteran had no family history whatsoever and did not have the BRCA gene for genetically inherited breast cancer. We submitted both of these reports to the Board along with our argument as new evidence. The Veteran was terminal and time was running out, and due to the infamous delays with the VA the best we could hope for was some financial security for his surviving spouse. Unfortunately, the Veteran died in February 2017 and we filed for substitution of the surviving spouse in March 2017. We received a favorable Board decision in April 2018.

In an RO implementation in November 2018 the Veteran’s surviving spouse was granted service connection for Metastatic Stage 4 Breast Cancer (accrued purposes) at 100% effective March 25, 2013, service connection for cause of death and DEA established March 25, 2013.

This Veteran is a native of Puerto Rico and served in the United States Army January 15, 1978 to June 2, 1978, February 11, 2003 to May 21, 2003 and July 23, 2006 to November 28, 2007. His most recent service (and cause of his medical and psychological problems) was in Iraq. He was in Iraq in combat for fourteen months. The Veteran was a Combat Engineer and IED Specialist.  While in Iraq he also fell nine feet from a working area injuring his lower extremities and suffering migraines. He also witnessed the death of two friends and at least fourteen more comrades severely injured.

While in Iraq he began experiencing severe panic attacks and extreme anxiety whenever he had to be in a truck or a tank. His earlier service years were unremarkable physically and emotionally, but the fourteen months in Iraq destroyed his life as he knew it and left him physically and mentally ill. He was also treated for depression, panic attacks and anxiety while in Iraq at the clinic.  

He filed his original claim for service connection in 2008. He was denied. He then hired our veterans disability law firm in September 2010. Our team of veterans benefits attorneys analyzed the Veteran’s case and a psychological expert’s report was deemed necessary. Many explanatory letters were also written on the Veteran’s behalf, as he was a Persian Gulf Veteran. He had also been diagnosed with adjustment disorder, major depressive disorder and PTSD in 2008 for which he was receiving ongoing treatment.

After submitting our expert’s report, more evidence, and legal argument, a DRO review was done in December 2018. We succeeded in convincing VA to grant TDIU, and service connection (partial) for depressive disorder, 70% effective October 31, 2008. DEA was also granted with an establishment date of October 31, 2008.

The Veteran, a native of Puerto Rico, was in the United States Army during the Gulf War from July 2002 to February 2009. He is a combat Veteran who did three tours in Iraq. His MOS was as a Driver delivering fuel all over Iraq. His convoy experienced many attacks and encounters with IED’s. The Veteran was involved in many life and death situations, and in early 2009 while in service he sought medical help for his anxiety. He was given anti-anxiety medication, but since he was a driver he was told he could not take it when he was driving, and the driving was one of the sources of his anxiety.

Two months after his discharge in April 2009 he sought treatment at the VAMC for anxiety, agoraphobia, depression, nightmares, survivors’ guilt, anger and being easily startled. He had also injured his back from so many long trips and hours of driving while delivering fuel in Iraq and was also being treated for lumbar spasms. His wife and two daughters noticed a big change in his personality and all of them were having a difficult time adjusting. He was put on an anti-depressant, but the VA examiner erred in not giving him a PTSD diagnosis.

He filed his claim in 2009 and received a denial of all his conditions for service connection in September 2009. After two frustrating years of going it alone with the VA he hired our veterans benefits firm in May 2011. After aggressively pursuing the Veteran’s claim status we received a rating decision in August 2011. It was unacceptable. The Veteran was granted service connection for PTSD, but only at 50% and denied service connection for lumbar spine disability. We immediately filed an NOD and went about gathering medical records, two separate expert reports and submitted at least eight different pieces of correspondence arguing on the Veteran’s behalf for a higher rating and earlier effective date. One of our expert reports was from a psychiatrist, and the other was from a Vocational expert for our pursuit of TDIU for the Veteran.

After seven long years, the BVA finally produced an acceptable decision for the Veteran. In a December 2018 implementation, the RO granted service connection for PTSD at an increased rating of 70%, earlier effective date of February 2009, 40% rating lumbar spine disability effective July 2010, TDIU effective July 2010 and DEA.

This Veteran was in the United States Air Force from September 1973 through October 1973 during the Vietnam era and reported for basic training at Lackland Air Force Base in Texas to be trained as an airplane mechanic.  

Prior to service in May 1972 she had a laminectomy performed on her L 4-5 discs. She received a medical waiver to join the Air Force and it was her understanding her waiver stated she was not to perform any physical conditioning. Upon her arrival her medical waiver was missing, and she was ordered to participate in all physical conditioning. She knew she would be unable to do this and she argued for an examination. Instead, she was told to “pull her pants down” in a room occupied by several men (non-medical) to prove she had scars on her back from surgery. This was degrading, demoralizing and traumatizing. She was also berated and belittled for wanting to learn how to be a mechanic and was told by a superior officer that she was taking a job away from a decent man.

On her sixth day of PT during basic training she seriously injured her back and was admitted to the USAF Medical Center at Lackland AFB. Shortly after her hospitalization she was given an EPTS (existed prior to service) discharge. Her treating physician at the base instructed that she would be unable to sit for her flight home to Philadelphia from Texas and she should be air evac in a litter from the base. This did not happen. Instead, she was taken to the San Antonio airport, dropped off and told she was taking a commercial flight home. She was in tears and agonizing pain. While using the airport restroom, she was unable to stand and had to be picked up off the floor and placed in the airline’s wheelchair. To quote the Veteran “I entered the Air Force proud and healthy, and to exit the Air Force I literally had to crawl out”.  

In March 1974, the Veteran began her claims process with the VA. After many years of additional surgery and the emergence of PTSD (due to the stress of her injury in basic training and her shameful treatment) the Veteran appealed and was denied many times from March 1974 to July 1997. She was unsuccessful in her claim for service connection for aggravation of her back condition.  

In April 2008, after consistently losing her appeals, the Veteran hired our firm to represent her.  We first had to get her case overturned on appeal at the U.S. Court of Appeals for Veterans Claims, which we did successfully. We hired an expert, a neurosurgeon who was also a psychiatrist, to provide a report on her back condition which she believed had been aggravated in service, and to provide a report explaining her declining mental health and suffering of PTSD due to her back injury. By December 2016 we succeeded in having the Board grant her service connection for PTSD effective January 2003 (when she reopened her claim) at 30%, and effective November 2015 at 100%, as she declined mentally. We filed a Notice of Disagreement for an earlier effective date and had an additional expert report completed. In November 2018 Mr. Gang also sent correspondence to the VA arguing why this should be granted.

In a January 2019 decision the Veteran was granted PTSD with depressive disorder and rated 100%, with an effective date of January 2003 (the date of her reopened claim).

This Veteran was in the United States Army from March 17, 1981 until October 28, 1988 during peacetime.

She was in a bus accident in 1981 while in service and suffered a moderate traumatic brain injury and was hospitalized for one week.  At issue was whether this brain injury or head trauma induced and/or triggered her later diagnosis of Multiple Sclerosis.  While in service she complained of headaches and weakness in her upper body.  At the time of service she had a CT scan and it reportedly showed no abnormalities of the brain.  This fact would later serve as VA’s primary reason to deny her claim.

After being diagnosed with Multiple Sclerosis she filed her claim for service connection with the VA in 2005.  The VA continually denied all her claims for service connection for many years.  As her disease progressed and the VSO was not having any success in her claim, she hired our veterans disability law firm in February 2011.  After a thorough review of her file we hired a renown Forensic Neurologist to conduct an expert analysis.  He was able to explain that a CT scan does not rule out MS.  We prepared extensive legal argument and presented it with an expert neurologist’s opinion.  Further, as part of our overall strategy, we had her file a new claim for depression, and with our guidance she achieved an RO rating decision granting benefits for an unspecified depressive disorder, rated at 30% effective September 2012, right and left upper extremity neurological impairment increased to 20% /30% effective July 2017, left lower extremity neurological impairment 20% effective July 2017 and voiding dysfunction at 20%.  This was a victory in that all these conditions were a direct result of the Veteran’s multiple sclerosis, which the VA refused to service connect back to the bus accident.

We then proceeded to continue to advocate on behalf of the Veteran.  In a 2019 rating decision we were able to obtain TDIU effective May 2005 and an establishment date of May 2005 for DEA.

This Veteran served in the United States Army during peacetime. He served from March 12, 1981 to June 14, 1985 in Wuerzberg, Germany.

Sometime between October and December 1983 he was beaten and sexually assaulted in a “blanket party” in his barracks by several unit members. After this incident, the Veteran was traumatized, and his behavior changed radically. He was disciplined thirty-six times after this assault in his remaining time in service.

Upon his discharge he returned to the United States and his personal life fell apart. His marriage ended in divorce and he moved in with his mother who barely recognized the person he had become per her lay statement. He was angry, lashing out, depressed and anxious. He filed his first claim for PTSD in August 2010. After six years of no success, he hired our veterans law firm in April 2016.

The first thing we did was analyze why his claim was consistently being denied. Not surprisingly, the VA had incorrect information causing them to keep denying the claim. When the Veteran was first sent to Germany the plan was for his wife and two children to accompany him. He was told at the time that they could not accompany him initially because he had to apply for family housing once he arrived in Germany, he could not do it prior to that. So, he went solo to Germany and upon his arrival applied for family housing off base but there was a waiting list. He lived in the barracks from September 1983 until the end of December 1983, when his family arrived. In their ignorance, the VA kept denying his claim stating he could not have possibly been assaulted in the barracks because he lived off base with his family, and never lived in the barracks. Once we determined this egregious error, we took steps to correct the misinformation.

We submitted new evidence in the form of four different lay statements regarding the change in the Veteran post assault, hired two psychological experts to prepare independent reports on behalf of the Veteran and highlighted the VA’s own C & P exam report stating several times “evident behavior changes” in the Veteran. We also submitted argument proving the Veteran did indeed live in the barracks during the time of the assault.

In a September 2017 Board decision, they finally acknowledged we had provided “credible, independent evidence” and granted service connection for PTSD and sent the claim back to the RO for implementation. After a lengthy delay, in a January 2019 rating decision the Veteran was granted service connection for PTSD with Major Depressive Disorder and alcohol and opioid use disorder at a 100% rating effective August 2012. He was also given an establishment date of August 2012 for DEA.

The Veteran was in the United States Army during the Gulf War from August 2005 to December 2006 and the National Guard from 2001 to 2009. She was on active duty in Iraq as a Gate Guard from June 2003 to August 2003. The Veteran’s goal was to serve her time and go on to obtain a college degree. This became impossible because of the stressors she experienced, both in Iraq and sexual harassment by superiors.

While in Iraq she was assigned to work at a control point when a military vehicle under mortar fire was hit and the soldiers were trapped inside. The Veteran tried to get them out of the burning vehicle but she couldn’t and they all perished. She also was in a position when she and her unit were under mortar fire for seven straight days. She was also a victim of sexual harassment, being offered a promotion for sexual favors. This is backed by lay statements and several buddy statements. Another stressor she experienced was in the National Guard during a training exercise in the California desert when she was left for three days alone in the desert without food or water and did not leave her post “because you are not supposed to ever leave your post”. When she was recovered, she ended up in the hospital in renal failure due to dehydration.

By all accounts, the Veteran entered the military an intelligent, energetic woman who performed her duties with ease. By 2006, after experiencing the above stressors and trauma, she was no longer able to work and was on Social Security Disability. She has not been able to work since. She filed her first claim for service connection for mental illness in September 2008 and was denied. She did not appeal this claim, therefore it was closed.

Her mental issues were becoming worse and so she hired our veterans benefits law firm in November 2017 to represent her after she had filed another in 2013 that had been denied. We analyzed her file and requested an expert psychiatric report. Our expert psychiatrist in a twenty-six-page report agreed and argued her mental illness was 100% service connected. We also had the results of a 2016 VA psychiatric examination which agreed with our expert. Armed with this new evidence, we appealed to the BVA and were rewarded with a favorable decision in November 2018.

The Veteran was in the United States Navy from June 1960 to June 1963. Upon induction the Veteran was 5’8” and 180 pounds. At his discharge he had ballooned up to 240 pounds and was obese. Thus began a lifelong battle of high blood pressure, heart disease, high cholesterol and diabetes.

When the Veteran passed away in June 2006, he had been in a battle with the VA for service connection for Coronary Artery Disease. He did not survive to see his claim come to fruition. The Veteran’s widow was accorded substitution, and she persisted in the claim for service connection.

After eleven frustrating years of denials, the widow hired our veterans disability law firm in November 2017. We hired two experts to prepare reports expounding on why the Veteran’s death was service connected. These reports, along with our arguments were finally enough to attain a favorable BVA decision in December 2018.

This Veteran was in the United States Air Force from June 1960 to June 1964 and November 1965 to September 1966.

Veteran suffered on and off during his time in service from gastrointestinal distress.  During service he received treatment many times for stomach cramps, nausea, diarrhea, etc.  He filed his first claim for service connection in 2007 after being diagnosed with lupus and ulcerative colitis/IBS.   He made a valiant effort through his VSO but continued to be denied for the next 7 years.  After trying on his own or with the help of a non-attorney VSO, he finally hired our veterans disability law firm when he needed representation before the CAVC in February 2014.  

We painstakingly reviewed his voluminous claims file and quickly ascertained where the Board erred.  We developed several sophisticated legal arguments that resulted in us prevailing before the U.S. Court of Appeals for Veterans Claims and getting his case remanded to the Board.

We continued to represent the veteran after the Court remand.  After thoroughly reviewing his claim file, we decided to hire an expert to address the cause of the Veteran’s illnesses, lupus and ulcerative colitis.  Our expert’s analysis proved that the Veteran’s condition, indeed, began during service and thus should be service connected.

Accordingly, twelve years after the Veteran’s first claim we were able to obtain for him 90% service connection for his autoimmune and ulcerative colitis diseases and an award of TDIU. 

The Veteran was in the United States Air Force during the Vietnam War from April 1969 to April 1973. He hired our veterans benefits firm in January 2014 because he had been unable to obtain a higher rating for PTSD on his own. The VA kept denying his appeals for an increased rating and he was stuck at 30%.

After analyzing his C-file our attorneys felt we could help get an increased rating. We submitted our arguments and in a June 2014 rating decision his service-connected PTSD was increased from 30% to 100% effective February 2014. This effective date was incorrect, as the Veteran had originally filed his claim in February 2005, and had also filed a timely NOD.

Over the next six years we relentlessly appealed this error and were continuously denied. Contained in the C-file was a clearly date-stamped (by the VA) form with the February 2005 date. We finally had a successful appeal to the BVA in February 2019 and in a November 2020 RO implementation the Veteran was granted an earlier effective date of February 2005 at 100% rating due to the clear and unmistakable error of the VA.

The Veteran served in the United States Army from September 1966 to September 1969 during the Vietnam Era.  The Veteran hired our firm in May 2013 to represent him before the CAVC in an attempt to obtain an earlier effective date for TDIU.  When he hired our firm in 2013, he was service connected for PTSD at 50%, with some other disabilities totaling a combined rating of 60%.  He was being denied an earlier effective date from 2009 and his appeal was now at the CAVC level.

We successfully represented him at the CAVC and got his claim remanded for further review.  To do this, we thoroughly analyzed and studied his voluminous claims file and we discovered that the Board erred in not addressing key facts and applying the correct regulations.  The case went back to the Board where we developed more evidence and submitted additional legal arguments.  However, despite the overwhelming strength of our arguments, the Board denied the claim again and we again appealed back to the CAVC.  We were again successful in overturning the Board’s decision and getting the matter remanded back to the Board.  

The Veteran had last been employed full time in 2002.  He was a self-employed mechanic with his own business from 1991 to 2002.  The Board kept denying the claim based on the belief that the Veteran was still working.  Although he technically still worked on cars, the business was losing money due to his carelessness on repairs that stemmed from his PTSD.  We submitted his business records, tax returns, Social Security information and medical records proving he was unable to work full time after 2002.  We presented a case for marginal employment by demonstrating that his business was actually taking a loss.

As a result of our arguments, in an April 2019 decision, he was granted an earlier effective date for TDIU based on entitlement grant on an extra scheduler basis.  

The Veteran was in the United States Navy during the Vietnam Era from November 27, 1968 to November 19, 1969, the Naval Reserves December 1966 to November 1968 and June 1973 to March 1975. The Veteran was stationed in Catania, Sicily, Italy and participated in a covert mission in Libya.

While in service in 1969 the Veteran was diagnosed with papilloma of the uvula and a hiatal hernia. After his discharge with the help of a VSO the Veteran obtained service connection for the hiatal hernia and GERD. His severe GERD (gastroesophageal reflux disease) resulted in anxiety and depression.

After being continuously denied service connection for the depression disorder the Veteran hired our veterans benefits firm in October 2016. To add insult to injury, the VA also withdrew the service connection award for GERD as part of a severe error on their part.

Our firm went to work to regain the Veteran his service connection for GERD and advocate for service connection for his depressive disorder.

In a February 2019 Board decision, implemented by an April 2019 RO decision, we were able to obtain service re-connection for the Veteran’s GERD at 30% rating effective December 2015 (the original date granted and the original rate granted), service connection for Acquired Mental Disorder Major Depressive Disorder secondary to GERD at a 100% rating effective May 2013, and DEA with an establishment date of May 2013.

The Veteran was in the United States Army during the Gulf War from November 2005 to 2008, and the Reserves until June 2015. His MOS was Electronic Technician. He was deployed three times to Afghanistan where he was engaged in combat. He was under rocket and small arms fire and returned fire on the enemy. The Veteran also searched and cleared homes and buildings. One of his worst stressors was as a first responder to a helicopter crash where twelve of our soldiers were killed and he had to gather body parts. Two of his best friends in his unit were also killed in action. While in service in 2007 the Veteran had to be hospitalized for two weeks due to PTSD. Upon the Veteran’s discharge he was already service connected at 70% for PTSD and Bipolar Disorder.

The Veteran completed his Bachelor of Science degree in Criminal Justice. He then proceeded to secure employment as a corrections officer from December 2015 to August 2016, when he was let go because of overuse of sick time due to migraine headaches. His PTSD was also triggered in the prison environment and he could not manage his duties.

The Veteran hired our firm in March 2017 after being denied TDIU and having his PTSD/Bipolar Disorder rating reduced from 70% to 50% in a March 2017 rating decision. We hired a Vocational Expert to review the Veteran’s file and prepare a report on his expert opinion regarding the Veteran’s employability. After reviewing his medical records our Expert determined it would be impossible for the Veteran to hold a job because of his PTSD and debilitating headaches. We filed a Notice of Disagreement and went on to submit our argument with our expert report. In a September 2018 rating decision his evaluation for PTSD/Bipolar disorder was increased back to 70% effective March 2017. However, the issue of TDIU was not addressed.

We resubmitted our expert’s vocational report along with our additional argument as to why TDIU was justified. In an April 2019 Board decision, implemented by the RO in April 2019 we were successful in obtaining for the Veteran TDIU and DEA as of August 2, 2016, increased rating for Cluster Headaches from 30% to 50% effective March 16, 2017 and increased rating for Lumbar Spine Degenerative Disc Disease from 20% to 40% effective April 1, 2017.

The Veteran was in the United States Army during the Vietnam War from November 10, 1964 to August 13, 1966. He was in the Republic of Vietnam from September 1965 to July 1966. His MOS was Clerk. He experienced stressors while in Vietnam which caused his PTSD.

Prior to developing PTSD, the Veteran was a successful Engineer at a large automotive manufacturer. As his symptoms worsened, he realized he was a functioning alcoholic. He drank to soothe his nerves. When the Veteran realized he was an alcoholic he sought help and has been sober since 1989. However, with the start of the Gulf War in the early Nineties, the Veteran’s PTSD was triggered again as the war was all over the media. Again, he sought treatment for his PTSD and decided to file a claim for service connection in 2013.

His stressors in service in Vietnam were loading killed in action soldiers for shipment back to the United States at Tan Son Nhut and encountering enemy mortar and rocket attacks at Tan Son Nhut. He also experienced terrible racism and was called awful names as a young African American male. His superiors and their racist attitude towards him often bullied him, ridiculed him and threatened to send him to the front lines if he didn’t do what they wanted and because he was Black.

Unfortunately, his claim was denied in May 2014. He was working with a VSO and they continued to assist him with no success until he hired our veterans disability law firm in January 2018.

We submitted our argument and medical records and were able to prevail in an April 2019 DRO decision. The Veteran was granted service connection for PTSD and unspecified depressive disorder at 100% effective February 26, 2013, DEA and special monthly compensation (housebound) effective February 26, 2013.

This Veteran was in the United States Army from October 1969 to August 1970 and again in August 1971 to July 1971 in Vietnam. He was, unfortunately one of the Project 100,000 inductees. He joined at the young age of 17 and was originally stationed in Germany. He was told if he finished his two years in Germany, he could then be sent to Vietnam for another two years which was his strongest desire, being young, immature and not understanding the ramifications of being in a war zone. As part of the Project 100,000, his IQ was also in the low/average range.  

From the moment the Veteran arrived in Vietnam he realized the profound stress of the combat theatre. He soon began self-medicating with illegal substances such as marijuana and heroin.  Because of his drug use, the Veteran began having disciplinary problems. He was apprehended in an off-limits area and was caught with drugs a few times. He was suffering mental trauma daily while in Vietnam and would do anything to get back to the United States. In July 1971, the Veteran’s commanding officer recommended that he be given an Undesirable Discharge.  Accordingly, the Veteran requested a discharge for the good of the service on July 9, 1971 which would get him home six months ahead of time. And on July 24, 1971 he was discharged for the good of the service under other than honorable conditions. He did not understand at the time that this would preclude him from Veteran’s benefits.    

Once discharged he returned home and began a life of alcoholism and drug addiction to cope with what was later recognized as Post-Traumatic Stress Disorder. PTSD was not recognized in the DSM until 1980. He was also incarcerated for two years. As the years passed the Veteran had great difficulty adjusting to life, sought treatment for his mental illness, and became sober.

In February 2000 he filed his first claim with the VA for service connection for PTSD. In connection with his claim he submitted a report from a private psychologist that was treating him. The psychologist stated that “the Veteran qualified for the definition of temporary insanity at that time” and was using drugs to cope with severe anxiety. In a July 2006 rating decision, the RO denied the Veteran’s claim due to the nature of his discharge, stating he was barred from any benefits.  

In December 2010, the Veteran hired our firm to represent him before the U.S. Court of Appeals for Veterans Claims (CAVC). In July 2012 we succeeded in obtaining for him a remand vacating the Board’s decision and having his claim readjudicated.   

For approximately two and a half years the Veteran’s claim bounced back and forth between the Board and the RO. The RO refused to acknowledge the Board’s recommendations and we were forced to file a Writ of Mandamus at the U.S. Court of Appeals. Now equipped with three expert reports and the Veteran’s mother’s lay statement we finally received a rating decision from the RO in June 2015.

After fifteen years of battling the VA we were able to obtain for the Veteran a 100% service connected rating for PTSD with depressive disorder NOS and alcohol use disorder and cannabis use disorder in sustained remission and DEA entitlement effective October 31, 2005.

Unfortunately, the Veteran soon had additional health problems which resulted in three more claims being filed in May 2018, January 2019 and May 2019. The Veteran claimed he had now developed lung cancer because of Agent Orange exposure in Vietnam. We were able to obtain for the Veteran service connection with a 100% rating for bilateral upper lobectomies effective March 2018, service connection with a rating of 10% for bilateral hearing loss effective May 2019 and tinnitus also 10% effective May 2019.  

This Veteran served in the United States Army from April 1967 to April 1969.  He was in the Medical Corp in Germany.  He is a native of Puerto Rico who also described himself as a “conscientious objector” to the Vietnam war.

His induction examination was normal, physically and mentally.  While working in the Dispensary in Germany he began complaining of back pain, nerves and depression.  He had ongoing clashes with his Sergeant and was punished for “bizarre behavior” with extra duty.  He had shown up late to formation dressed in civilian clothing.  He was very embarrassed and shamed for this and it added to his mental distress.  His service medical records implied that he was also abusing alcohol, cocaine and heroin to self-medicate during this time.  He was hospitalized for “oddness and bizarre behavior” on base in November 1968.  He was put on psychotropic medications and appeared to stabilize him until his discharge.

He filed his first claim with the VA in 1977 seeking service connection for his mental issues (which had declined since his discharge) and back problems.  Despite his best efforts and the assistance of veterans’ service organization officers, the Veteran continue to experience denial after denial over the next three decades.  After thirty-two years of struggling with the VA his claim was denied once again in December 2009.  At that point, he realized he needed a lawyer.  A such, he hired our veterans disability law firm in October 2010 and we engaged a forensic psychologist to prepare an expert report for the Veteran illustrating that his mental health issues had their onset on active duty.  We also addressed the onset of his low back problems.  We litigated his case for many years, hiring experts, submitting numerous legal arguments, and even litigating the issue of an alleged overpayment from VA.

After many decades of denials and appeals we were finally able to prevail by getting the Board to grant service connection for lumbosacral spine degenerative disease and lumbar spasm, and major depressive disorder.  Forty-one years after the Veteran began his claim process, we finally prevailed on his behalf.  But we did not stop after merely winning service connection for him.  We further appealed for an increased rating and were able to obtain 70% service connection for the depression and 20% for his back, for a combined rating of 80% effective November 2003.  We were also able to obtain an establishment date for DEA effective November 2003 in May 2019.  The Veteran never gave up, and we never gave up fighting for him.

The Veteran was in the United States Army during the Gulf War and peacetime from September 24, 1987 to January 25, 1994. First, he served in Saudi Arabia and then in Somalia.

While in Saudi Arabia he was working at the seaport one day unloading a ship when a trailer fell on him and pinned him underneath. Several NCO’s had to lift the trailer off the Veteran and he injured his back and legs. The Veteran stated that if he had been in a slightly different spot, he would have suffered a traumatic brain injury and may not have survived. This was the first stressor the Veteran experienced prior to his diagnosis of PTSD. The second stressor he suffered was witnessing “an American getting his leg blown off”.

After his discharge, the Veteran worked for a number of years on offshore oil rigs. However, his back pain became significant and he also suffered from foot problems relating to the in-service trailer falling on him. He needed to take narcotic medication for his pain and could no longer be employed on an oil rig to due to safety issues while taking the medication. The Veteran filed his claim for service connection in March 2012. In 2014 he hired our veterans benefits law firm to represent him after his claim was denied.

In developing his claim, we hired a Vocational Expert to study the Veteran’s file and prepare a report on his chances of gainful employment. We also presented our argument and lay statements from witnesses to the trailer accident and in May 2019, after five years of fighting with the VA we received a favorable DRO decision.

The Veteran was granted service connection for PTSD at a 70% rating effective March 6, 2012, TDIU and DEA effective April 12, 2012 and service connection for Bilateral Metatarsalgia and Plantar Fasciitis and Pes Planus at a 30% rating effective June 5, 2014.

The Veteran was in the United States Army during peacetime from March 2, 1978 to January 21, 1986. Her MOS was Licensed Practical Nurse/Health Aide. During the course of her service she was stationed in Germany two separate times.

While in Germany in 1980 she had a consensual sexual relationship with another service member. This relationship resulted in an unwanted pregnancy. The Veteran was only twenty years old at the time and neither party was interested in a serious relationship or having a child. The Veteran states she had minimal counseling from the Army medical personnel and proceeded to have an abortion. This was against her religious beliefs, but at the time she felt it was her only option. She regarded her behavior as a “sin” for which she would never be forgiven and could not forgive herself.

Fast forward years later after her discharge and the Veteran is married and pregnant with twin sons. After she gave birth prematurely, she is told her sons will be disabled for life. She immediately began spiraling downward into a deep depression, as she believes it is her fault and she is being punished for having an abortion years ago in service.

Her depression becomes so debilitating she has to leave her job as a nurse and collect Social Security Disability. She filed her first claim for service connection for depression in 2012. After six years of fighting the VA she received an unfavorable decision in November 2018 and immediately hired our firm.

Our attorneys painstakingly combed through her c-file, we prepared our argument that her depression is service-connected dating back to her in service abortion, and hired a psychiatric expert to prepare a report on the Veteran’s behalf. In a January 2018 Board decision implemented by the Regional Office in April 2019 the Veteran is granted TDIU and DEA effective December 19, 2011. We pursued her increased evaluation claim for depression and in another BVA decision in May 2019 the Veteran was granted 100% service connection for Depressive Disorder effective December 19, 2011.

This Veteran was in the United States Air Force in Korea September 1950 to September 1954 and March 1955 to October 1957.

Veteran served as a clerk at an Air Force base in Korea. By August 1952, the then 21-year-old had all but three teeth extracted over a 4 to 5-month period. Veteran filed a claim in 1972 citing malnutrition since he was unable to eat due to only having 3 teeth and ill-fitting dentures while in service. Upon his induction he weighed 155 lbs., at his lowest weight he was 110 lbs. (at a height of 6 feet). Only upon returning stateside eight months after his extractions was he able to receive an appropriate dental device. The damage was already done. He was never able to return to his induction weight of 155 lbs. and was increasingly, chronically and debilitatingly ill from 1965 until his passing in October 2014.

Unable to work due to constant fatigue, weakness and chronic pain, Veteran filed a claim initially with the VA in 1972. He was denied service connection in 1974. To add insult to injury, most of the Veteran’s records were then destroyed in the 1973 St. Louis fire, all that survived the fire was his September 1954 medical separation exam record. The Veteran lived on monthly social security payments, as the SSA concurred he was totally disabled and incapable of working since the 1960s. Unfortunately, the VA did not agree.

In 1991 he filed a new claim with the VA seeking service connection for the loss of his teeth. In its 1992 decision the VA determined “service-connected extraction of teeth non compensable” since there was “no service trauma” to his teeth.

After many years of appeals, remands, and denials, the Veteran hired our law firm in December 2012 to represent him at the CAVC. Due to the lack of knowledge and diagnoses of autoimmune diseases in the 1950’s and 1960’s the Veteran suffered many years before these conditions were identified, thinking his ailment was malnutrition, perhaps scurvy, due to his many tooth extractions in service (a symptom of scurvy is loosening teeth. However, the Veteran’s teeth were not extracted due to looseness, but due to severe caries (decay)). Decades later he was accurately diagnosed because of medical and scientific advances. We then proceeded, with the Veteran’s approval, to have his malnutrition claim dismissed and proceeded instead with claims of Sjogren’s Syndrome, Peyronie’s disease, Reynaud’s Syndrome, scleroderma, Dupuytren’s syndrome, and TDIU.

We obtained medical and dental expert reports and resubmitted our new evidence. The reports addressed the question of why would a healthy 21-year-old have all but 3 of his teeth extracted over a period of a few short months? What underlying condition(s) could create such havoc in a healthy young man’s mouth? Our experts determined the Veteran, while in service, was more likely than not suffering from an autoimmune disorder called Sicca Syndrome which causes extreme dry mouth and dry eyes leading to severe tooth decay; hence, the need for the extreme nature of the multiple extractions. The key to this case was recognizing that the dental decay was due to dry mouth which was, in turn, an early symptom of the autoimmune disorder. Thus, we used a dental expert to establish the in-service onset for this autoimmune disorder and establish service connection for Sjogren’s Syndrome and scleroderma and eventually TDIU.

Unfortunately, the Veteran passed in October 2014. His surviving spouse substituted for him soon after. The VA finally granted service connection for autoimmune disease at 60% effective November 1994 and increased to 100% March 2006 due to the Veteran’s worsening condition. He was also granted TDIU in a June 27, 2019 decision. Our client’s story was featured in Stars and Stripes.

This Veteran, a native of Puerto Rico, served during the Gulf War and peacetime from February 1982 to August 1990. He was in the United States Army in Fort Dix, New Jersey and Germany.

His MOS was a Tank Gunner. He was involved in a training accident in 1988 that resulted in the Veteran injuring his lower back and being diagnosed with lumbosacral herniated nucleus pulposes. This required the Veteran to have hemilaminectomy discectomy surgery in January 1989.

After his discharge he attended school and obtained his bachelor’s degree. He worked for Hewlett Packard for almost fifteen years and was let go because of staff reduction. During his career, his back pain became chronic and the Veteran began suffering from depression and anxiety.

In August of 1990 he had received service connection for his back at a low rating. Over the years he attended many C & P examinations in the hopes of receiving a higher rating. By August 2013, the Veteran was very frustrated and getting nowhere. After receiving an unfavorable result, he hired our firm in September 2013. As we know the VA operates at a glacial pace, and after many NOD’s, a vocational expert’s report and constant, patient persistence we were able to prevail in August 2019 from a December 2018 rating decision.

The Veteran was granted service connection for Unspecified Depressive Disorder with anxiety previously diagnosed as anxiety disorder not otherwise specified with somatization features as secondary to the service-connected disability of Status Post Laminectomy L5-S I with Degenerative Joint Disease, L4 left L5 Bilateral SI Lumbar radiculopathies granted with an evaluation of 30% effective June 18, 2009, TDIU effective May 2009 and DEA with an establishment date of May 2009.

The Veteran was in the United States Army during peacetime on active duty February 9, 1976 to May 8, 1976 and in the National Guard for many years after. In May 1978, while driving home from his two weeks of annual field training at Fort Bragg the Veteran was in a serious automobile accident. He lost control of his vehicle and overturned several times. He severely injured his knee, fractured his left and right clavicles and was rendered unconscious. He was taken by ambulance to the hospital, was treated, stabilized and temporarily released until he could be scheduled for knee surgery. He returned a few days later and had extensive knee repair surgery. He was hospitalized for over a week.

After the accident he spent many years working domestically and internationally as a regulator/accountant for an international credit union. As time progressed his already service-connected knee injury deteriorated. He eventually developed bursitis in his hip as he was overcompensating from his knee pain.

Eventually, he needed total knee replacement surgery and was no longer able to work or travel for his job. He began collecting Social Security disability. He hired our veterans disability law firm in December 2017 when he was unsuccessful in obtaining TDIU with a Veteran’s Service Organization, as he was completely incapacitated with back and knee pain. He had also had service connection for his hip and leg problem severed.

In developing the Veteran’s claim, we hired a Vocational Expert to study his medical records and prepare a report for us to submit to the VA. Our expert opined the Veteran could not work and was totally disabled. This report and the SSD records were very helpful. The case presented a challenge because the Veteran had an extensive white-collar, sedentary work history and most of his service-connected problems were orthopedic in nature.

In an October 2018 Board decision implemented in December 2018 we were able to have the Veteran’s service connection restored for both left hip bursitis associated with total knee replacement and limited extension of left thigh at 10%. We persisted in our fight to obtain TDIU and received another favorable Board decision implemented by the Regional Office in February 2019 for TDIU and DEA. However, the effective date was not good enough. It was determined to be September 1, 2016 and we believed an earlier effective date of the Veteran’s total knee replacement surgery was warranted. Finally, in an August 2019 Board decision we were granted TDIU and DEA effective September 14, 2011 and Special Monthly Compensation from September 1, 2016 to June 30, 2018.

The Veteran served in the United States Army from April 7, 1975 to April 6, 1978 and November 8, 1978 to November 7, 1982. He served as an Honor Guard at military funerals, at the morgue, funeral home and burial detail. He was also a Medic.

For five of his seven years of service as an Honor Guard he attended military funerals, most times three per day, visited the funeral homes to check the deceased’s uniform (hands on), met and greeted family members, was a pallbearer at the service and escorted the body to the cemetery by riding in the hearse. He was also stabbed in the neck while in the Army and hospitalized. The Veteran numbed his feelings with alcohol, and unfortunately continued to do so.

Upon his discharge from the Army he became a truck driver. He dealt with insomnia, night sweats, dreams of death, and visions of death to the point he felt like “I’m being abused by death.” He also started having back problems from years of being a pallbearer up to three times a day. He could no longer function as a truck driver due to his mental state and depression. His stepson died in 2014 and the Veteran is so traumatized by his time in service around death that he could not even attend his stepson’s funeral.

He filed his first claim for service connection with the VA in August 2010 for PTSD and back problems. He was denied over the next seven years until he hired our veterans disability law firm on September 11, 2017.  

We obtained an expert’s report that the VA eventually deemed much more thorough than their own C & P examiners. We were initially able to obtain the Veteran service connection for PTSD at 50% evaluation effective March 2010, left and right radiculopathy at 10% effective August 2010 and degenerative disc disease of the lumbar spine to include intervertebral disc syndrome at a 50% rating effective August 2010.

In June 2019 we advanced his claim for TDIU. In September 2019 we received a favorable rating decision granting TDIU effective August 6, 2010, DEA established August 2010, and confirmed continuation of the PTSD and back problems.

Veteran was in the United States Airforce during the Vietnam Era from September 1964 to March 1968.  He was an Air Policeman at Goodfellow Air Force Base in San Angelo, Texas.

While in service in February 1967 he was in a single car motor vehicle accident which resulted in a head injury, a lacerated artery and scalp, a concussion and amnesia. He had surgery to repair his artery and was hospitalized for ten days.  

Prior to the Veteran’s automobile accident, he had received exemplary reviews and recommendations to be a career Air Force member.  After his accident he had a drastic personality change (noted by his siblings) for the worse.  He also began abusing alcohol and drugs in an apparent effort to self-medicate his post-accident depression and anxiety.  The Veteran attributed his severe mood change to his closed head injury from the accident.  He was eventually discharged due to his alcohol abuse.

He continued down his troubled, self-medicating path of drug and alcohol abuse until 1984, when he sought help, was hospitalized for detoxification and rehabilitation. He maintained his sobriety until his death in December 2015 from heart disease.

He filed his original claim in December 2005 for TBI from the accident, lumbar and cervical spine injury and left and right neuropathy.  He was in constant, chronic physical pain from his back and neuropathy, and mental anguish from his psychiatric disorder.  He did not want to jeopardize his sobriety, so he chose conservative treatment for over twenty years with a pain management physician and also received psychiatric care.

He had to stop working at age 58 in 2004 and received social security disability.  He had residences in New Jersey and Arizona and would spend months in each location.  This contributed to a lot of confusion with his treatment at the Phoenix, VAMC and the New Jersey VAMC.  He was consistently denied service connection for his maladies.  He was denied repeatedly for about 7 years before he finally decided to hire our veterans disability benefits law firm.

He hired our firm in 2011 and we began to research and devise a new strategy to help him win.  We obtained several expert reports on the Veteran’s behalf, along with a report from his treating pain management physician.  We had a psychologist due neuro-psychological testing on him, we obtained a forensic psychiatric evaluation, and an evaluation by an internal medicine doctor.  All of these evaluators concluded that the Veteran’s change in personality was due to trauma and his depression was due to reduced blood flow to the brain associated with the traumatic brain injury. They all opined that the Veteran was totally disabled as a result of these conditions.  Unfortunately, he died before we could get a resolution for him and his surviving spouse was substituted in January 2017.  

We continued advocating on her behalf in our quest to obtain service connection for the accrued benefits.  Finally, in a September 2019 Board decision, we were able to obtain for his surviving spouse service connection for acquired psychiatric disorder as a residual of TBI at 70% (increased from 50%) effective December 2005, lumbar and neuropathy service connection and TDIU effective December 2005.

The veteran served in the United States Army during peacetime from February 1983 to January 1986, and later in the Reserves. He was stationed in Germany receiving Air Traffic Control training. Upon his discharge he worked for the United States Postal Service for nine years until he was medically separated from employment.

While in service he was in two automobile accidents, the first in August 1984 and the second in January 1986. In the first accident, he injured his neck and cervical spine. In the second, a more serious accident, he was the driver of an automobile that flipped over twice, causing him to lose consciousness, sustain a closed head injury and a traumatic brain injury. He developed depression, anxiety, agitation, and some psychosis. He filed his first claim for service connection in 1996 after being medically terminated from the USPS. The veteran’s claim languished in the appeals system for more than a decade.

After his final denial at the Board of Veterans Appeals, the veteran hired our veterans disability law firm to represent him at the U.S. Court of Appeals for Veterans Claims. We successfully obtained a Joint Motion Remand from the Court. Initially, we had some success and obtained service connection for Major Depressive Disorder, but only at a 50 percent rating effective July 2001. We had submitted additional evidence in the form of the veteran’s medical records, including from a 1996 psychiatric hospitalization. We believed the veteran was entitled to a much higher rating and so we hired a private psychiatrist to evaluate the veteran’s records and provide us with an expert report. We also discovered a VA examiner’s 1999 diagnosis of service connection for a head injury. By this time, 2014, many strides had been made in the diagnosis of closed head injuries resulting in delayed psychiatric conditions. Our expert wrote a strong report opining the veteran suffered from “late onset organic based psychosis” due to his automobile accidents while in service.

In a September 2019 Board decision, implemented by the RO in September 2019 we were successful in obtaining service connection at 100 percent for Major Depressive Disorder with Psychotic Features with an earlier effective date of January 21, 1999.

The Veteran was in the United State Navy during the Vietnam War from December 18, 1964 to December 14, 1967. His rating was Air Intelligence Officer, Air Support Coordinator and Public Affairs Officer. While in Vietnam two of the ships he was on were the USS Princeton and USS Eldorado. He was also involved in Operation Jackstay in 1966.

The Veteran developed Diabetes Mellitus in 1975 at the relatively young age of 34. He was also slim and fit and had no family history of diabetes. The Veteran attempted to obtain service connection fir diabetes mellitus secondary to herbicide exposure (Agent Orange) during his time on the USS Eldorado. He was denied in a September 2010 decision, as the Eldorado was not on the list of vessels operating within inland waterways in Vietnam. At the time of these earlier decisions, the law had not yet changed to afford presumptive service connection to Blue Water Navy veterans.

He hired our veterans disability law firm in 2011 to represent him before the CAVC and we were successful in having the decision vacated. Once the case was remanded back to the Board we began work to develop the evidence we needed. We needed to prove the Veteran’s exposure to Agent Orange to obtain presumptive service connection for him.

In our research we discovered another serviceman from the Eldorado during the same time period had obtained service connection for PTSD due to the Eldorado encountering small arms fire coming from the shores. Therefore, the Eldorado had to have been in an inland waterway or they would never have been under small arms fire from the shore. With this information, and photographic proof of the Veteran being on the USS Eldorado during this time, we submitted our argument with new evidence in March 2012. In a May 2016 rating decision, we were able to obtain service connection for Diabetes Mellitus at a 20% evaluation secondary to herbicide exposure effective August 25, 2003 and service connection for diabetic neuropathy. We filed a Notice of Disagreement in July 2016, as we were looking for more service-connected issues and a higher rating. We were denied in a July 2018 rating decision. We filed another NOD and proceeded to develop our claim. Armed with an expert’s report and a letter from the Veteran’s treating VA physician we submitted our new evidence. In a September 2018 rating decision, we successfully obtained bilateral diabetic retinopathy and cataracts increased from 10% to 40% effective April 2018, right lower extremity peripheral neuropathy sciatic nerve increased from 10% to 20% effective April 2018, service connection for peripheral neuropathy right lower extremity femoral nerve granted at 20% effective April 2018, service connection for right upper extremity peripheral neuropathy granted at 40% effective April 20, 2018. Service connection for peripheral neuropathy left lower extremity femoral nerve granted at 20% effective April 2018 and service connection for amputation, right foot, 3rd toe granted at 0% effective January 2018. We filed a Form 9 for an increased rating for diabetes mellitus in October 2018, and received a favorable BVA decision in January 2019.

This Veteran served in the United States Air Force from December 1965 until April 1966 with an honorable discharge. During his time in the Air Force, he suffered from debilitating tension headaches. In April 1966 he spent three weeks in the hospital in a psychiatric ward for his painful headaches and was also treated with sedatives. He was deemed unfit for duty due to a “nervous condition” and tension headaches in his separation exam and was discharged.

The Veteran suffered for many years after his discharge with mental illness, migraines and other physical ailments, one being coronary artery disease. In 1989 the Veteran began psychiatric treatment. He was on and off medication for years due to the negative side effects he experienced.  

In 2005 he filed his first claim for service connection for his mental illness. Over the years during his VA pension examinations, his mental illness was misdiagnosed as several different mental illnesses. In a July 2006 rating decision, it was noted he had bipolar disorder, hypertension, coronary artery disease and diabetes mellitus, but was denied service connection.  The Veteran appealed this decision. At a C & P exam in November 2007 he was diagnosed with tension headaches and bipolar disorder.  

He was denied service connection, again, in a rating decision in 2009 from the Regional Office and appealed to the Board. After being denied in a February 2010 BVA decision he appealed to the U.S. Court of Appeals for Veterans Claims (“CAVC”). He hired our law firm to represent him at that time to assist him in his struggle with the VA to obtain service connection for his debilitating mental illness. Unfortunately, years of mental illness and poor physical health took their toll and the Veteran died of a heart attack in August 2010. By September 2010, our firm obtained substitution for his surviving spouse and we proceeded with her as the substitute beneficiary and with her DIC claim.

After 8 more years of litigation, our veterans disability law firm, advocating on behalf of the Veteran/surviving spouse, finally obtained service connection for the psychophysiologic nervous system reaction. It was an incomplete victory, as the effective date was 2007. We continued to litigate the matter, believing that the effective date should go back to 1966. As part of our continued litigation strategy, we hired a psychiatric expert to furnish us with a report to address the issues and further support the appeal.

In a late 2019 decision, we were finally granted service connection for psychophysiologic nervous system reaction effective April 29, 1966 (when the Veteran was originally discharged due to his “nervous condition”) at 100 percent rating for 54 years of back pay in VA benefits.  The DIC claim was also granted.

The Veteran was in the United States Army from August 1969 to August 1971 during the Vietnam Era. He was drafted at age nineteen and was sent to Vietnam. His MOS was Cook for Combat Engineer/Ration Driver. As part of his job, he also had to drive the rations vehicle between camps. While doing this he was shot at and feared for his life. He also had to pick up dead bodies from the side of the road that had sometimes been left there for days. He was traumatized by this, and this was the basis of his eventual PTSD diagnosis.

The Veteran hired our firm in October 2016 after he had received a denial for increased rating for PTSD (currently at 30% when he hired us) and entitlement to TDIU. We hired one of our medical experts to prepare a report justifying an increase in rating and illustrating that the Veteran was unable to work due to his mental health and had not worked for a long time. We submitted our new evidence and between April and November 2019 based on a Board decision in April 2019 we were able to achieve the following:

• Service connection for Obstructive Sleep Apnea 50% effective February 2014
• Increased rating for PTSD from 30% to 50% effective December 2010
• TDIU and DEA effective January 2017
• Service connection for Erectile Dysfunction with special monthly compensation for loss of use of a creative organ effective September 2013
• Service connection for diabetes mellitus (Agent Orange presumptive) and tinnitus at 10%

As of this writing we are still pursuing an active claim for an earlier effective date for TDIU which has been remanded by the Board.

The Veteran served in the United States Air Force from April 1999 to August 2006 during the Gulf War. Her Air Force Specialty Code was Visual Information Specialist, and later, Medical Technician. Sadly, the Veteran had been sexually abused as a child and raped at the age of sixteen. She received counselling for this trauma and was physically and mentally sound upon her examinations to enter service.

Upon discharge she was suffering from PTSD because of two in service stressors. In 2004 she was pregnant and past her due date when she was being examined by a male military OB/GYN. Against her will, and without telling her what he was doing while he was vaginally examining her, he tried to induce labor. The Veteran protested and asked him to stop but he did not. This triggered all the memories and trauma she had put to rest from her childhood and caused her to feel she was being sexually assaulted again. She immediately left and went to see a female OB/GYN. After the birth of her baby, she was then in an automobile accident which left her vehicle totaled and left her very shaken up. These two stressors caused her mental anguish and precipitated the onset of her PTSD. In all the denials she received the VA would not grant service connection as they adamantly believed that her PTSD was due to her childhood sexual trauma and not service related.

In April 2018 she hired our firm to help her. We hired one of our psychiatric experts to study her claim and records and prepare a report based on his expert opinion. His opinion relied heavily on the fact that she was mentally sound upon entry to service, and clearly the cause of her PTSD was the in-service triggers. Given our knowledge of the presumption of soundness, we were able to ask the right questions of the private forensic psychiatrist, which resulted in a report that was in favor of our client. We submitted the resulting psychiatric report, combined with the Veteran’s private therapist’s records, and make persuasive legal argument.

As a result, in a November 2019 DRO decision we were able to obtain for the Veteran service connection for PTSD at 100% effective September 2015 and DEA.

The Veteran served in the United States Navy from November 1983 to November 2003 during the Gulf War and peacetime. Most of her service time was spent on a nuclear submarine. She was diagnosed with non-small cell lung cancer in January 2013.

She initially had a full VA medical exam in December 2012, due to bronchial issues, coughing and sore throat. The VA examiner diagnosed her with pneumonia. One month later she was diagnosed with Stage 4 non-small cell lung cancer. In March 2013, the Veteran filed a claim for misdiagnosis, negligence, and service connection. This form of cancer occurs mostly in smokers, radiation exposure or other toxic chemical exposure. Since the Veteran had never smoked and the cancer was fast moving and aggressive, she thought at the least she could obtain service connection for ionized radiation exposure on the nuclear submarine. She knew any VA malpractice claim could drag on for years, time she did not have. Although she had come to a logical conclusion, the VA denied her claim as her radiation exposure was .028 REM and to qualify for cancer related radiation exposure one had to measure at least 10 REM. She did not receive the denial until September 2013, six months later.

In November 2013 she hired our veterans benefits firm in pursuit of her claim. She had been unsuccessful in achieving service connection on her own and with the help of a veterans’ service officer. With her condition being terminal, we began to work on her matter right away. Since it was self-evident that she was dying from lung cancer and she had never touched a tobacco product, we felt an in-depth analysis of her records by one of our medical experts would be our only chance, as all arrows pointed to exposure to something in her twenty years in the Navy on a nuclear submarine. After much digging it was discovered that she had also spent a lot of time welding and painting on the submarine. Our research uncovered a link between welding and lung cancer. Our medical expert was able to provide medical literature demonstrating that it was as likely as not that her lung cancer was due to exposure to fumes from welding, arc welding, TIG welding and painting without proper respiratory protection. That she had performed welding in service was plainly documented in her file. We developed medical expert opinions to support this theory. Unfortunately, she died before the claim could be resolved. We then moved to substitute her husband and had him also pursue a DIC claim.

Six years after her death, her surviving spouse was granted service connection for accrued benefits for non-small cell lung cancer 100% effective March 2013, and service connection for the cause of death.

This Veteran, a native of Puerto Rico, was in the United States Marines from October 28, 1997 to October 3, 2005. He has many physical and mental issues stemming from his time in service. The Veteran believes his depression began in 2001 when he was five minutes late for formation and was demoted from his position as a Corporal. He felt he was being discriminated against as a Hispanic male and felt ignored when his case came before the Military Court. As time progressed the Veteran experienced what he felt were racist behaviors towards him and in a 2004 taunting incident he snapped and said he was going to kill several of the Marines that were berating him. He was disarmed and hospitalized in a psychiatric unit.

Another stressor the Veteran experienced was during his time in Iraq in 2003, when he witnessed a fellow Marine and his helicopter explode into flames and he could not save him. He was also traumatized by having to remove corpses, mutilated and dismembered bodies and seriously injured soldiers from helicopters. The Veteran’s mother told our psychologist expert that the Veteran was a normal, happy go lucky young man his entire life prior to service. In a July 2005 in service exam the Veteran was diagnosed as anxious, depressed and unable to sleep. He was prescribed anti-anxiety medication and Zoloft.

After his honorable discharge in October 2005 the Veteran filed his first claim in December 2005. He was denied and filed a Notice of Disagreement in March 2006. He received an unfavorable rating decision in June 2009. While awaiting the decision the Veteran began suffering from chronic cervical pain which gave him terrible tension headaches. He was also hospitalized twice for suicide attempts. After service, the Veteran was unable to maintain a job due to his severe depression and anxiety and attempted to attend University. When his mental health spiraled out of control he had to drop out of school. He lives with his mother and has been collecting Social Security since 2007.

Getting nowhere, and feeling worse and worse, the Veteran hired our veterans disability law firm in 2011. We hired an expert psychologist to interview the Veteran and his mother in Puerto Rico, and he prepared an independent medical examination and report. He concluded the Veteran was suffering from severe depression and was unable to work. With this new evidence and our supporting argument, we submitted all to the VA in 2012. By February 2016 we received a favorable rating decision granting TDIU effective October 27, 2014, service connection for Depression rated 50% effective October 2014 and service connection for rhinitis at 30% effective October 27, 2014.

We did not agree with the depression rating nor the effective dates. We appealed and in a February 2019 DRO decision we were able to obtain for the Veteran an increased rating for Depression from 50% to 100% with an earlier effective date of April 19, 2007, service connection for sinusitis at 30% rating effective October 4, 2005, Cervical Strain with Associated Tension Headaches at 20% rating effective March 2010 and 30% effective November 6, 2014, an earlier established date for DEA of April 19, 2007 and Special Monthly Compensation effective April 19, 2007. Unfortunately, the VA wanted to declare the Veteran incompetent. Thankfully, after a November 2019 field examiner met with the Veteran, competency was declared in a November 2019 decision.

The Veteran was in the United States Army from September 1976 to September 1979, the National Guard from 1979 to 1983 and the United States Navy August 1983 to January 1995. He was a musician in each branch of service, while taking the time to get his college degree in music while in the National Guard.

In 1995 he injured his shoulder and had surgery and was no longer able to play instruments with the same skill. Upon discharge he found employment as an automobile salesman. As his injury progressed from his shoulder to his hand he had to give up music altogether. He became very depressed. He was let go from several auto dealerships because of his depression which also caused him brain fog.

He filed his claim for service connection for Major Depressive Disorder in 2006 when he could no longer work. He hired legal counsel and had a moderate degree of success. However, by 2018 he needed representation before the CAVC and he was referred to our firm. We filed a Brief and a Joint Motion of Remand was issued by the Board.

At this point in time the Veteran had been granted TDIU effective August 2010 and service connection for Major Depressive Disorder effective March 2007 at a 70% rating.

Our argument was for an earlier effective date for TDIU. We submitted arguments and in a November 2019 rating decision the Veteran was granted an earlier effective date for TDIU as of March 2007, and DEA established March 2007. While we were hired for a specific situation, we were able to get a substantial amount of past due benefits for the Veteran.

This Veteran, a native of Puerto Rico, was in the United States Army with service in the Republic of Vietnam from October 1967 to May 1969, and the National Guard from February 2003 to May 2003.  He experienced significant stressors due to his time in a combat theatre.  It was presumed that he was exposed to herbicides/Agent Orange while in Vietnam.

The Veteran was diagnosed with diabetes in 2010 and was able to obtain service connection for diabetes mellitus at a rating of 20% effective December 2010.  He began to experience neuropathy from the diabetes and subsequently depression.  The VA repeatedly denied him additional benefits for the other disabilities connected to service.  So, he hired our veterans disability law firm in March 2012 to help him develop his claim for more benefits, as his illnesses were progressing, and he was unable to fight the VA on his own.

We worked with his physicians in Puerto Rico, obtained expert medical and vocational reports and never let up the pressure on the Veteran’s behalf with the VA.  This was a man whose MOS was Artillery in Vietnam, lost comrades and survived a bombing of a building he was in.  He returned home to Puerto Rico and continued to serve in the National Guard and spent thirty-two years as a Policeman.  The Veteran certainly deserved VA benefits.  Unfortunately, in 2019 the Veteran developed Prostate Cancer, one of the presumptive illnesses of Agent Orange exposure.

In a December 2019 rating decision we were able to obtain for the Veteran service connection for Prostate Cancer at a 100% rating effective October 2019, Depressive disorder NOS diabetes mellitus Type II secondary at 100% effective December 2010, TDIU effective May 2017, Special Monthly Compensation (SMC) and DEA with an established date of December 2010.

The Veteran served in the United States Navy during the Gulf War and in peacetime from December 1985 to October 1992.   His rating was a Satellite Operator/Radioman.  Initially he was stationed on a ship but due to the sensitivity of his position he was separated from most of his fellow crew and only had contact with the Captain of the ship.  After his time at sea at an undisclosed location, he was assigned to the Pentagon in Washington, D.C. as a Radioman.  He had an extremely high security clearance, and the nature of his position was highly stressful and required him to be highly vigilant, secretive, have limited personal interaction and predisposed him to suspiciousness and paranoia.  He was also in a motor vehicle accident while in the Navy in 1986, which resulted in a pinched nerve in his neck.

He filed his original claim with the VA in April 2011 for schizophrenia, claiming he had felt “watched and followed” while performing his duties in service.  He was receiving treatment at a VAMC for his mental disorder and for his chronic pain from the motor vehicle accident which had progressed as he aged.  His claim was denied and appealed several times without success.  The problem was that his service medical records did not contain any mention of any psychiatric symptoms or complaints.  There was simply no in-service documentation of an event to which service connection could be linked.  As a result, the Veteran experienced repeated denials.  As such, the Veteran realized that he needed legal representation before the Board.  So, he hired our veterans benefits firm in January 2016.

After a thorough review of his claim file we decided two expert reports would greatly lend weight to the Veteran’s claim.  We had to overcome the absence of documentation of a mental health issue in service.  The Veteran also became homeless for a while because of his schizophrenia, being unable to work.  We were determined to get the best possible outcome for this Veteran.  The key to this case was our understanding of the prodromal period of schizophrenia.  In other words, schizophrenia has a developmental time period when it is developing behind the scenes without active symptoms or being detected by medical personnel. This time period can be several years, with these disorders typically manifesting in the late teens or early twenties.  We retained a forensic psychiatrist who understood this feature of schizophrenia and he as able to establish that the prodrome of the Veteran’s schizophrenia would have dated back to the time period of active duty.  We made this argument to VA and submitted these expert opinions.

In a December 2019 BVA decision and an RO implementation we were able to obtain for the Veteran service connection for cervical spondylosis with degenerative cervical intervertebral disc (formerly pinched nerve in neck) service connection of 30% effective April 2015, radiculopathy/cervicalgia left upper extremity secondary to pinched nerve service connection and 30% rating effective April 2015, same condition upper right extremity 20% rating with service connection effective April 2015, service connection for tinnitus (from years of radio operation) 10% effective March 2014, DEA established date May 10, 2011 and service connection for Paranoid Schizophrenia at 100% effective May 10, 2011.

The Veteran was in the United State Marines from February 16, 1973 to August 13, 1978 during peacetime and the Vietnam Era. His MOS was as an Artillery Spotter.

He submitted his first claim for service connection in February 2007 and was denied in November 2007. The Veteran began experiencing anxiety and depression in service in 1976 and sought treatment. He attributed this to a physical and sexual assault upon his person by his superior training Sergeant in June 1973. One night after inspection the Sergeant told him his brass was tarnished and slammed his head and face into a steel bedpost, causing his eye to bleed and swell shut. After lights out he was called in to the same Sergeant’s office and was sexually assaulted. He was told if he ever spoke of it he would be killed. There were no witnesses to the sexual assault, but the other recruits witnessed the physical assault. This Sergeant had a terrible reputation for physical abuse and was feared by all under his command. He was a very tall, muscular Vietnam Veteran who was an African American and stated many times he hated “white boys”. They were terrified of him and many were on the receiving end of his physical assaults. Due to their fear, they did not report him.

The Veteran spiraled emotionally and was eventually separated from the Reserves for “psychiatric reasons”. The problem with his PTSD being service-connected stemmed from the opposing opinions of two different VA psychiatrists. The Veteran had been a troubled young teenager, and one psychiatrist insisted his mental illness preceded service from his teenage years, and the other opined he was mentally fit at induction despite childhood trauma and therefore his PTSD was a result of his in-service assaults.

The Veteran filed a new claim seeking service connection in 2010 and was denied in May 2013 after many more VA mental health examinations and treatment. After his latest denial he hired our firm in August 2013. We immediately filed an NOD and began digging through the voluminous claims file and Veteran’s medical records. We discovered new evidence in his medical records from 2011 and 2017 that was not available when the 2007 decision was made. We also hired a psychiatrist to prepare an expert report on when and if his PTSD was service connected. Our expert was 100% certain the Veteran’s PTSD was from his in-service assaults and stated as much in his 2016 report. We also discovered a VA physician’s notes from a 2007 C & P exam stating the Veteran was “deeply affected in every area of his life and functioning” for the past thirty-four years, which places the Veteran’s mental disorder as originating in 1973. With all this new evidence we were confident we could obtain a favorable decision for the Veteran.

A December 2019 rating decision, implementing the Board’s November 2019 favorable decision of our appeal finally granted the Veteran service connection for PTSD with psychotic features at 100% rating effective February 2007 and DEA.

This Veteran was in the United States Army from October 1959 to January 1962.  After he was discharged, he joined the Army National Guard from December 1973 to December 1974 and April 19, 1974 to April 21, 1974.

On April 20, 1974 while directly proceeding to training at Fort Drum in New York, the Veteran, along with other National Guardsmen, was a passenger on an Army rented bus.  There were several buses filled with Guardsmen en route together.  The bus hit a bridge abutment, overturned and burst into flames.  The Veteran was rendered unconscious and suffered head trauma, left hip abrasions and left knee contusions.  He was hospitalized and categorized as temporarily totally disabled for military duty.  He also witnessed a friend lose his eyesight when the bus was burning due to a machine gun going off.  

Post service he was employed as a Hospital Technician, sterilizing instruments and stocking operating rooms and procedure rooms with necessary supplies.  After the bus accident he began suffering terrible headaches which progressed into migraines.  After his hospital position he then went to work at an international airport as a baggage checker, which required lifting heavy luggage.

After many years of suffering from bad headaches, he also became depressed.  He filed his initial claim with the VA for service connection in July 2009.  He tried multiple times to obtain his VA benefits on his own or with the help of a VSO.  Each time his appeals were denied.  Having no success with his claim, he finally hired our veterans benefits firm in November 2010.

We went to work to address the reasons why VA was denying the claim. Specifically, there was insufficient evidence of a nexus with service.  We developed a comprehensive strategy and employed the services of several outside forensic medical experts to obtain evidence of a nexus.

As a result, within only 2 years, our law firm was able to get the Veteran service connection for head trauma at 40% effective September 2009.  Over the next nine years we proceeded to advocate on behalf of the Veteran, as we felt he was due much more.  After many more years of C & P exams, further appeals, legal arguments and expert reports, the Board in December 2016 remanded the Veteran’s claim for two new examinations.  A VA TBI exam and a VA Headache exam.  In both instances the examiners agreed with us that his headaches and subsequent PTSD were service related to the bus accident.  This was an example of where our advocacy and our expert reports helped to sway the VA C&P doctors to write favorable reports, thus forcing the VA to grant the claims.

In a January 2020 DRO decision we were able to obtain for the Veteran service connection for PTSD at 30% rating effective March 19, 2009, DEA with an established date of July 30, 2009, post traumatic headaches at 30% effective July 2009, lumbar spine degenerative disc disease at 10% effective March 2009, and most importantly TDIU effective July 30, 2009.

The Veteran was in the United States Army from August 1988 to February 1992. He was in combat in Iraq, Kuwait and Saudi Arabia. The Veteran was a Tank Armor Crewman, Gunner, Driver and Ammunition Loader. One of his combat missions involved wiping out members of the Iraqi Republican Guard in February 1991.

The Veteran suffered from Delayed Post Traumatic Distress Disorder. This was not widely recognized after his discharge, and thus began a long battle for diagnosis and service connection with the VA. On September 11, 2001 he was en route (flying) to Dulles Airport in Washington, D.C. and this further exacerbated his PTSD.

He submitted his first claim in December 2001 and began a lengthy procedural journey. He was denied in a June 2003 rating decision. This went on for years. The Veteran hired our firm in March 2016. When he hired our firm, he had only been able to obtain service connection for a sleep disorder at 30% rating effective September 2001 in November 2014.

We appealed to the Board and the November 2016 decision was partially favorable and returned to the RO for implementing. In a February 2017 rating decision, the RO granted service connection for PTSD at 30% effective September 2001, increasing to 70% effective April 2010. In November 2017 we were able to also obtain service connection for tension headaches at 50% rating effective May 2017.

Throughout the years after his discharge the Veteran received extensive psychiatric care for his PTSD. He also self-medicated with alcohol and marijuana to forget the nightmares he had of “burned bodies and oil wells”. He was filled with rage and described himself as a “Dr. Jekyll Mr. Hyde”. His marriage disintegrated due to his mental illness, and his wife divorced him. The Veteran claimed the only thing that stopped him from suicide was his seven-year-old (at the time) daughter. He was and still is living in Germany since his discharge and has bounced from job to job as his anger issues and physical assault of co-workers results in him being fired. He was forced to go on German welfare, as he is no longer able to work. He lives a very isolated life as he cannot be in crowds or personal relationships because of his PTSD.

Although we were successful in obtaining service connection for PTSD, we did not feel the Veteran had been given a high enough rating. We compiled all his private and VA medical records, his treatment plans, his medications and mental health hospitalizations and submitted along with our argument.

Nineteen years after his first claim, we were able to obtain for the Veteran in a January 2020 rating decision implementing a successful December 2019 Board decision, a 100% rating for Sleep Disorder and PTSD effective September 2001 and DEA.

The Veteran was in the United States Army during the Vietnam War from February 1968 to March 1971. He was in Vietnam from May 1970 to January 1971. His MOS was Cook, Supply Sergeant and Infantryman. While in Vietnam he was a Cook at Firebase LZ Uplift. They were under constant mortar and rocket attacks. In January 1971 during one enemy attack the Veteran was on his way back to his barracks to get a recipe when they were attacked and he was sent flying through the air at high speed into a wooden post which he hit with his abdomen. He was also knocked unconscious. When he came to, he was in great pain in his abdominal area, but pushed his pain aside as he assisted more seriously wounded soldiers. After being in pain for a week or so he sought medical attention and had to be medevacked to a hospital. He was suffering from internal abdominal bleeding and required blood transfusions. Unfortunately, through these transfusions he contracted Hepatitis C, which went undiagnosed for years.

After the trauma of the constant attacks the Veteran received a psychiatric discharge in March 1971 and was evaluated at 30% for “nervous disorder”, later known as PTSD. He obtained employment with his local VA as a physical therapy assistant for over thirty years. He attempted to reopen his claim in 1985 for increased rating for PTSD, but was unsuccessful. By 2007 he had finally been diagnosed with Hepatitis C and was granted service connection.

After a DRO decision in February 2014 refused to grant an increased rating greater than 30% for PTSD the Veteran hired our veterans benefits law firm in April 2014. As we worked to develop the claim the Veteran supplied us with lay statements, a buddy statement and all of his documentation that was very helpful to us. We obtained two expert reports and submitted them along with our argument. In an October 2017 decision we were successful in obtaining for the Veteran an increased rating to 70% for PTSD, Depressive Disorder and Peptic Ulcer effective June 2007 through December 2013, and 100% rating effective December 2013. As the Veteran’s health declined, we also believed he was entitled to TDIU. We persisted in our arguments and in an August 2018 decision he was granted TDIU and DEA effective January 2013. We made one more attempt for an earlier effective date and it was granted in a January 2020 decision (earlier effective date March 4, 2012).

The Veteran was in the United States Army during the Vietnam Era from February 1972 to February 1974. He was stationed in Germany. While in Germany he was in an in-service automobile accident with injuries. After his discharge he returned home and became a commercial truck driver. Eventually his injuries from the accident made it too uncomfortable for him to continue driving a truck. He had injured his back in the accident. His chronic pain also resulted in depression.

Because the VA believed there was insufficient evidence of a nexus with service, it denied the Veteran’s claim multiple times.

The Veteran turned to our veterans disability law firm to help. The Veteran hired our firm in October 2014 to help him obtain service connection—since he was unable to win the claim on his own or with the help of a VSO. After evaluating his situation, we decided obtaining expert reports would greatly assist in achieving our goal for the Veteran. We retained three separate experts to make our strongest case. We conducted additional research and legal arguments. We submitted this with three high-powered medical expert reports. As a result, in an April 2019 DRO decision the Veteran was granted service connection for depressive disorder NOS at 50% rating effective September 2013. We appealed this rating and in a September 2019 rating decision his rating was increased to 70% effective July 2019. In another September 2019 rating decision, he was granted service connection for degenerative arthritis (lumbar spine) 40% rating effective July 2019, and in a final February 2020 decision following a successful December 2018 BVA appeal the Veteran was granted TDIU and DEA effective August 2015.

The Veteran, a native of Puerto Rico, served in the United States Army during peacetime and in the Gulf War era January 11, 1980 to June 10, 1980 and February 10, 2003 to May 29, 2003. He is a non-combat Veteran. For his total eight months of service he was stationed in Puerto Rico.  In 2003 while in service the Veteran fell and injured his left knee. He spent three days in the hospital. Shortly thereafter, he was discharged. He obtained a job in a Municipal Center coaching and training various youth sports teams. He loved his job.

Unfortunately, his knee pain became chronic and he was in constant pain, while overcompensating by putting extra pressure on his right knee and lower back. He eventually had to rely on a cane, but the damage was already done to his right knee also. In August of 2009, no longer able to work and suffering from constant chronic pain the Veteran filed his first service connection claim. By this time, he was also severely depressed because of the chronic pain and having to leave a job he loved. He had several psychiatric hospitalizations, and even contemplated suicide.  

Frustrated with the negative results he was getting from the VA he hired our veterans disability law firm in January 2012. After months of requesting and waiting for the Veteran’s claims file we finally received it and determined that the best strategy would be for the Veteran to claim depression secondary to his knee and back problems. The VA did not agree. In 2014 we hired an expert psychologist to provide a report after examining the Veteran. Our expert concurred and the Veteran was certainly suffering from a depressive disorder due to his chronic pain incurred from the fall in service damaging his knee.

Four years later, we were finally granted service connection on behalf of the Veteran, but we believed the ratings were too low. After our NOD we were able, in June 2018 to receive higher ratings for left and right knees and depressive disorder at 50%. We did not agree with this and forged on until a Board decision in March 2020 led to an RO implementation of depressive disorder at 100% effective October 13, 2009, entitlement to special monthly compensation with an earlier effective date, earlier entitlement date of October 2009 for DEA, entitlement to housing compensation, and left knee and right knee chondromalacia patella at 30% rating effective August 2009.

The Veteran served in the United States Army and Navy during the Gulf War and peacetime. He was in the Army from February 22, 1980 to August 20, 1980 the Army National Guard from September 1984 to November 1989, and the Navy from January 2, 1990 to August 10, 1993. He received honorable discharges from the Army, but less than honorable discharge from the Navy.

While in the National Guard he fractured his right tibia and fibula in a skiing accident. He required surgery to repair the fracture, and in his healing process his right leg ended up being shorter than his left leg. This condition required him to have a special orthotic lift and orthotic shoe. This was provided to him until his time in the Navy. The one he was using needed to be replaced, as it was worn out. He tried unsuccessfully to have it replaced several times. In the meantime, he was forced to work and walk on the ship without it. This caused him tremendous pain and discomfort, as he had to constantly limp. This made the Veteran incredibly angry and depressed, so he took matters into his own hands and left the ship unauthorized three different times trying to get the correct orthotic devices. He was punished for this and spent 85 days in the brig. However, this was fine with him as it allowed the pain to stop since he did not have his orthotics and all he could do in the brig was rest. This eventually led to the Veteran getting into a physical altercation, which led to his less than honorable discharge. So, for claim purposes, his Navy service time precludes him from being eligible for any benefits for those three years. We advocated for the Veteran, trying to persuade the VA he was “insane” at the time which would nullify his less than honorable discharge, but they were not having it.

The Veteran filed his first claim for service connection for his leg fracture through a VSO organization in February 1996 and was successful. However, he was suffering from chronic pain in his leg and hip, contributing to and triggering mental distress. His fracture had been aggravated by his heavy lifting responsibilities in the Navy. Due to his discharge status he was denied an earlier effective date.

As time went by the Veteran developed mental illness secondary to his chronic pain which was misdiagnosed several times by the VA as Adjustment Disorder, Bipolar Disorder and Schizotypal Disorder. By 2013 the Veteran had had enough. He was on complete disability from the Social Security Administration since 1995, but the VA refused to concede any service connection for his mental illness and increase his rating for his leg fracture. He hired our firm in April 2013 after an unfavorable March 2013 decision by the RO. We prepared our argument and pursued the Veteran’s claim in November 2013 based on the Section 1151 theory. We tried another strategy in appealing: arguing that the Veteran should be granted TDIU. This was also denied in September 2015, so we proceeded by obtaining an expert Psychiatric evaluation and report for the Veteran and a Vocational expert’s evaluation and report based on the Veteran’s situation/condition.

We submitted our new evidence by March 2017 and received a favorable BVA decision two years and three months later in June 2019. In a March 2020 RO implementation of the Board’s 2019 decision we were finally able to obtain for the Veteran TDIU effective July 21, 2011, DEA established May 2020, service connection for depressive disorder rated 70% effective July 21, 2011 and service connection for leg inequality at 20% effective March 1999.

This Veteran was in the United States Air Force from June 21, 1977 to April 30, 1995. He was in Korea twice, Carswell AFB, Ellsworth AFB and Little Rock AFB. His MOS was Vehicle Mechanic.

During his time in service he was in a water skiing accident and lost 95% of the use of one of his shoulders, he fell off of a truck’s tailgate and injured his knee and back, suffered hearing loss from working around jet engines all day, and was particularly traumatized when he had to recover dead bodies from a plane crash while at Carswell AFB. He believes this was when his depression started, as he recognizes he behaved irrationally at the time by taking up to twenty showers per day to get the “dead bodies off of him”.

He filed his first claim for service connection for Coronary Artery Disease in the early 2000’s and was granted service connection at 60%. Over the next fifteen years he had no success with his other claims. As a result, he hired our veterans benefits firm in February 2016 after being fed up with his constant denials for service connection. Through the years of his treatment with VA providers for his depression he was told to “man up” and “suck it up”. Needless to say, these words of encouragement did not help treat his depression. He was forced to turn to private practitioners at a greater cost. The culmination of the damage to his body from his in-service injuries over time increased his pain level, which began in 1979 and developed into constant chronic pain throughout the 1980’s and 1990’s. The chronic pain contributed to his depression and malaise.

We had the Veteran contact our expert psychiatrist, and after our expert evaluated the Veteran’s medical records and had a two-and-a-half hour consultation with him, our expert was able to provide us with a comprehensive report linking the Veteran’s physical conditions to his depression. With this new evidence, we moved forward.

After several unproductive rating decisions and NOD’s in April 2019 the Board agreed the new evidence we provided was sufficient to reopen the Veteran’s claim and granted service connection for psychiatric disorder secondary to service connected CAD, service connection for residual lumbar spine, right shoulder, right ankle with hip graft, sinusitis and hearing loss.

In a March 2020 DRO decision, we finally obtained for the Veteran an earlier effective date of May 2008 at 60% rating for CAD post myocardial infarction, TDIU and DEA effective May 31, 2009 and Special Monthly Compensation Housebound Criteria met effective May 31, 2009.

This Veteran was in the United States Marines during the Vietnam Era from November 1966 to November 1969. He remained stateside. The Veteran’s mental disorder began at the Marine Corp Depot, San Diego, CA when he was beaten and raped not once, not twice, but in excess of three times when he was in service. The first assault he reported, and nothing was done, the subsequent assaults he was warned to not say anything or they would have a “blanket party” with him and eventually they would kill him. He was only able to confide in the Chaplain after the first assault, as he feared for his life.

After his discharge he coped by abusing drugs and trying to bury the memories and forget the horror of the attacks. He attempted suicide several times in the 1970’s and was hospitalized. The Veteran eventually realized he was in a very self-destructive cycle and fought to become clean and sober and began psychiatric treatment in 2009.

In July 2012, the Veteran with the help of a VSO filed his first claim for service connection for PTSD due to military sexual trauma. True to form, he was denied in an August 2013 decision even though he had reported one of the assaults in service. He hired our firm in November 2013 and we immediately filed a Notice of Disagreement and proceeded to develop the claim. Over time we gathered lay statements from the Veteran which were horrifyingly detailed and submitted a statement in support disputing the findings of an erroneous 2016 VA psychiatric exam.

We eventually reached the level of appeal to the BVA, and in a May 21, 2019 remand to the RO we received a favorable decision. In March 2020, the RO granted service connection for Psychiatric Disorder including PTSD and Major Depressive Disorder at 100% rating effective July 5, 2012 and decreased to 50% rating effective November 3, 2017. The Veteran had experienced significant psychological improvement after maintaining his sobriety, attending regular counseling and weaning off methadone.

The Veteran was in the United States Navy during peacetime from July 7, 1978 o August 2, 1978. While in basic training he was harassed by his drill instructor. On one occasion the drill instructor screamed in the Veteran’s face “Are you a pu**y?” The Veteran replied, “No, are you?”. This act of insubordination led to the Veteran’s early discharge. The Veteran states this was not the only instance of sexual name calling he experienced by a superior.

The Veteran suffered severe psychological trauma as a child. He witnessed his mother shoot herself at age twelve and die in front of him, he was raised by Nuns from age three to eleven, lost his father at age twelve and was a loner most of his life. He entered the military at age seventeen, which was noticeably young. Pre and post military, the Veteran had a history of psychiatric hospitalizations. He also attempted suicide several times.

Due to mental illness which the Veteran stated was exacerbated in the military, he went on Social Security Disability in 2003, and last held a job in 2008. He filed his first claim for service connection in August 2014 through a VSO. He was denied in May 2015, filed an NOD in June 2015, was denied again in September 2018, and hired our veterans disability law firm in October 2018. We filed a Form 9 in November 2018.

The Veteran was mentally ill, and we felt his illness had been exacerbated by his time in the military and the interaction with his drill instructor. We hired an expert psychiatrist to evaluate the Veteran and prepare a report which we submitted as new evidence.

Eventually, we were able to obtain a favorable Board decision in March 2020 and a fast RO implementation also in March 2020.

The Veteran, a native of Puerto Rico, was in the United States Army during the Gulf War from October 2002 to September 2003, May 2005 to June 2006 and June 2007 to August 2008. His MOS was Military Police. The Veteran filed his first claim with the VA in 2010 and was granted minimum service connection in March 2011. He filed a Notice of Disagreement in July 2011 and received a July 2013 Statement of the Case denying him. He hired our firm in August 2013, frustrated that he had waited two years for a negative response. We immediately filed a Form 9 Appeal to the Board.

The Veteran served in Guantanamo Bay, Honduras, and Iraq. His main stressor occurred in Iraq. He was involved with training the Iraqi Police Force and performed security raids with them. During one raid the Humvee he was in was damaged by an IED, instantly killing his friend right next to him who was blown up. While escaping the incapacitated Humvee, he and fellow soldiers were under enemy fire the entire time. He witnessed friends burning to death, and others shot when they were trying to escape the burning Humvee. “I thought I was going to die that day” the Veteran later stated. He was traumatized by that incident in 2007 and received psychiatric treatment the rest of his time in Iraq. Once discharged, he continued his psychiatric treatment and medications and developed full blown PTSD.

As with most things with the VA, it didn’t happen quickly, but as we developed our claim, we were able to chip away and get better results gradually. We obtained an expert psychiatric report, and along with the Veteran’s updated records we were able to submit new evidence. In a July 2016 DRO decision we were able to obtain service connection for sleep apnea at 50% secondary to PTSD affective October 12, 2010. (When the Veteran hired us initially, he had already obtained a 10% evaluation for PTSD). We continued on and in a May 2018 BVA decision implemented by the Regional Office in December 2019 we obtained an increased rating to 70% for PTSD and major depressive disorder effective April 19, 2017, service connection for lumbosacral strain with intervertebral disc syndrome at 40% effective October 12, 2010, service connection for cervical spine strain (chronic) at 20% effective October 12, 2010 and service connection for left and right lower extremity radiculopathy (sciatica) at 20% effective October 12, 2010. While this was a significant development, we believed the Veteran deserved a higher rating for PTSD. We appealed to the Board and were successful. In a March 2020 rating decision, the Veteran’s PTSD rating was increased to 100% effective March 3, 2010 and he was granted Special Monthly Compensation effective October 12, 2010.

The Veteran served in the United States Army during the Gulf War from November 2001 to March 2002, February 2003 to May 2003 and the Puerto Rican National Guard from 2000 to June 2006.  The Veteran served in Iraq.

The Veteran’s first in service injury occurred in April 2003 during a training exercise when he fell 10 to 15 feet off a bridge and was unconscious.  Unfortunately, his service treatment records are missing this information and treatment.  Because of the absence of in-service documentation, the VA continued to deny the Veteran’s claim for many years.  As a result, he eventually hired our veterans disability law firm to help him.

Given the lack of documentation of the injuries in service, we went to work to obtain several buddy statements from witnesses and from his treating medic at the scene.  The Veteran stated that this was when his migraine headaches began.  In another accident during active duty training the Veteran fell off a Humvee injuring his lower back and neck in October 2004.  From these two incidents the Veteran was suffering from migraines, chronic back pain, and chronic neck pain.

We decided a medical expert’s report would help in proving the Veteran’s claims.  We hired one of our medical experts to review the service records and the eyewitness/buddy statement accounts.   The medical expert was able to tie the accidents together and illustrate and connect the origin of the Veteran’s injuries and the ongoing conditions.  We did extensive research and prepared thorough legal arguments.  We then submitted our arguments and expert reports as new evidence. As a result, in a March 2018 rating decision we were granted service connection for migraine headaches at 30%.  We then filed an NOD and, in a June 2019 decision, the rating was increased to 50% effective April 2009.  We pushed forward as there had been no mention of the neck and back injuries, and in an April 2020 decision, we finally obtained service connection for lumbar disc disease at 40%  rating effective July 2010 and service connection for cervical disc condition at 20% rating also effective July 2010.

The Veteran was in the United States Marines during the Vietnam Era from August 1968 to June 1970.  His MOS was Machine Gunner.  While in Vietnam he was engaged in combat.  Some of the stressors he experienced causing his PTSD were having to fire his machine gun often, witnessing loss of life, carrying critically injured and dismembered bodies to safety, having his friend die next to him in combat, and having to wait several hours with his body.

After his discharge he was employed by the United States Postal Service for thirty-two years.  When he retired, his PTSD symptoms became more acute and he sought treatment and service connection.  Over the years he was unable to obtain service connection and contracted Parkinson’s Disease which is known to be linked to Agent Orange exposure.  He was consistently denied service connection for Parkinson’s, even though he was in combat in Vietnam!

The Veteran hired our firm in September 2017 after another denial he received.  We analyzed his situation and decided a new C & P exam was needed.  The VA examiner agreed with our conclusion that the Veteran was suffering from PTSD and should be service connected for Parkinson’s Disease presumptive to Agent Orange exposure.  We submitted our new evidence and in an April 2020 DRO decision we were able to obtain the following for the Veteran:

• Service connection for PTSD at a 70% rating effective August 2014;
• Clear and unmistakable error in not rating left hand shrapnel increased to 10% effective August 2014;
• Left- and right-hand tremors each at 20% effective October 2015;
• Left and right lower extremity bradykinesia each at 10%; 
• Service connection for Parkinson’s Disease presumptive to Agent Orange herbicide exposure at 30% effective October 2015; and
• Special monthly compensation for loss of use of a creative organ.

We are still actively pursuing a claim for TDIU and Obstructive Sleep Apnea secondary to PTSD for this Veteran.

The Veteran was in the United States Army from June 23, 1977 to June 22, 1980 during peacetime, and in the Army Reserves from February 11, 1981 to April 3, 1990. His MOS was Military Police.

According to his service medical records, the Veteran was treated for knee problems while in service from September 1986 to July 1987. In September 1986 he sprained his right knee, and in July 1987 he fell in the shower and injured his right knee. He filed his first claim for service connection in 1991 for his knee and was denied. He did not appeal. As the years went by his knee pain became increasingly worse and he had at least three different knee surgeries at the VAMC, two of which were complete knee replacements on the same right knee.

After the service he worked as a laborer until the company went out of business, and then as a cook. He was last able to work in August 2007 because he could not stand and prepare food at his cook job, and he could not find sedentary employment. He reopened his claim for service connection for his right knee in March 2008 and received service connection, but with a low rating. He went back and forth disputing the VA over the next six years with no results. Because he was unable to achieve the results he needed on his own, he hired our firm in April 2014 after his March 2013 denial.

We filed a Notice of Disagreement in August 2014 and proceeded to gather our evidence. We consulted a vocational expert who reviewed the Veteran’s records and ascertained he could no longer work due to his knee and hip degeneration. (His hip began degenerating as a result of his limping for several years because of his botched knee surgery). We submitted our expert’s report and had a degree of success in an April 2019 decision. The Veteran was granted service connection at 10% for right hip degeneration effective September 2012, and service connection for right knee replacement was increased to 100% effective March 2013.

We appealed to the Board and the claim was remanded to the RO, which made an April 2020 decision granting the Veteran TDIU with degenerative joint disease and DEA effective May 1, 2014.

This Veteran was in the United States Army from January 1966 to October 1968. He did two tours in Vietnam and was a Combat Veteran. His MOS was Paratrooper, Cannoneer, Gunner and Combat Soldier. After a back injury from too many hard landings he could no longer function as a Paratrooper. He was severely injured in Vietnam by a booby trap and an enemy mortar attack.

After his discharge he suffered nightmares, depression and anxiety. Since PTSD was not recognized yet, the Veteran suffered for years trying to cope. He lost his first wife in a car accident, went on to marry two more times, and both ended in divorce because of what we now know were his PTSD symptoms. He worked for many years in Shipping and Receiving and stopped working in 2006.

He hired our veterans disability law firm in February 2013 when he was unsuccessful in obtaining service connection for PTSD. We analyzed his case and determined he should be service connected for PTSD, without a doubt. After we discovered the VA had lost many of the Veteran’s records, we set about creating our argument. We hired two psychiatric experts to prepare reports concluding his PTSD was service connected, and one vocational expert opining he was unable to work at all. We also gathered two lay statements on behalf of the Veteran describing his deteriorating mental condition in his everyday life. After many C & P exams, denials, appeals and our latest new evidence, the Board ruled in our favor in a September 2019 decision which was sent to the RO to implement. Unfortunately, it took the RO eight months to implement the decision.

When they finally did the Veteran was granted service connection for PTSD at a 70% rating effective July 2007, TDIU effective July 2007, DEA established date of July 2007 and SMC effective November 2011.

The Veteran was in the United States Army from February 24, 1982 to May 25, 1983 and June 27, 1982 to August 13, 1982 during peacetime. In July of 1982, the Veteran was on a twelve-mile march with her rucksack and rifle when she caught her foot on a bush and fell heavily to the ground on her right side. She was bruised and battered from the fall and suffered a stress fracture of her tibia. Shortly after her accident she was medically discharged from service.

Upon discharge she continued to receive treatment for her injuries at the VAMC. In 1983 she filed her first claim for service connection with the VA. In a December 1986 decision she was denied. She continued her treatment and attended C & P exams in which the VA examiner would state her issues “were as likely as not” service connected. She would be briefly elated, until the decision would come back “less likely than not”. She was disgusted and discouraged. She could not accept that VA medical professionals would say yes, and the VA would ignore their statements and deny her. She gave up.

Sometime in 2012 as her injuries worsened into arthritic conditions and fibromyalgia and so she filed a new claim. Again, she was denied in August 2013. She was ready to give up again, when coincidentally her good friend ran into a childhood neighbor while on vacation in Florida. This childhood neighbor happened to be one of our firm’s attorneys. Our attorney and the Veteran connected and she hired our veterans benefits firm in May 2014. We immediately filed a Notice of Disagreement. We also hired an expert for an independent medical review and report of the Veteran’s medical records. With new evidence (the expert report) we submitted it along with supporting correspondence in August 2015.

Four years later we prevailed in a December 2019 BVA decision which was implemented in May 2020 by the RO.

The Veteran was in the United States Army from August 23, 1972 to August 19, 1974 during the Vietnam War. His MOS was Light Weapons/Infantry. He spent most of his time in service in Germany.

The Veteran encountered three main stressors during his time in service. The first was in August 1972 during a nighttime driving range shooting exercise. The Veteran witnessed his drill Sergeant being accidentally shot by another serviceman and killed right in front of them. The second stressor occurred in his barracks in Germany. His friend was on medication and during his sleep he vomited and aspirated and died. The Veteran tried to wake him up the next morning and realized his friend was dead. The third stressor was when the Veteran suffered a mild stroke (transient ischemic attack) while in service. The VA denied his claim.

He then hired our veterans disability law firm in May 2019 after being unsuccessful in his attempts to get service connected for any mental health disorder. We submitted our argument and in an April 2020 BVA decision implemented by the Regional Office the Veteran was granted service connection for Major Depressive Disorder claimed as PTSD with a 30% rating. We appealed this as we believed the rating should be higher. We were successful in a May 2020 decision having the Veteran’s rating increased to 70% effective March 10, 2011.

This Veteran was in the United States Army from May 1974 to June 1974, and September 1975 to December 1976 during the Vietnam era at Fort Hood, Texas.

Upon his discharge he filed a claim in 1977 for a nervous disorder. He claimed the social adversity of boot camp was a factor in causing manifestation of his psychotic disorder. His claim was denied in August 1977 due to the VA determining he was mentally ill prior to service. This was based on a hospitalization of the Veteran prior to service. However, the medical records show he had been using LSD (a hallucinogenic) and Veteran believes he was misdiagnosed with a mental illness “nervous disorder” due to the side effects of LSD usage.

After years of struggling with mental health issues and battling the VA with no success, the Veteran engaged a Veteran Service Organization on his behalf in 1983. The VA again denied his claim in March 1999, 22 years after his original claim in 1977, and sixteen years after the VSO had been advocating on his behalf. In these ensuing years, the Veteran struggled heavily with schizophrenia, unable to work and had several psychiatric hospitalizations for various durations of time.

In September 2012, he was again denied by the VA. The Veteran had also hired another law firm in New York to represent him, and they terminated their relationship with him and suggested he should “represent himself.”

He came to Gang & Associates, significantly enough, on the 4th of July 2013 and engaged our services on his behalf. Within ten days, on July 15, 2013 we expeditiously filed a Notice of Disagreement for Decision Review Officer (DRO) review with the VA’s Regional Office on behalf of the Veteran. We then elevated the appeal to the Board of Veterans Affairs (BVA) for review. His schizophrenia claim was consistently denied, because of that pre-service misdiagnosis of “nervous disorder”. By June of 2016 we were able to provide enough evidence to the BVA that the Veteran, had indeed, been diagnosed prior to service and was able to show how an LSD “trip” could be misconstrued in a medical setting as schizophrenia. Also, both of his induction exams prior to service had found him mentally and physically fit. Finally, in 2018 the BVA granted service connection for Schizophrenia with a 10% rating due to the unrelenting commitment of the attorneys at Gang & Associates.

We then immediately filed a Notice of Disagreement, as clearly the Veteran was 100% disabled by Schizophrenia. Finally, after the Veteran’s 43-year struggle with the VA we were able to obtain a definitive Compensation and Pension exam for him in March 2020 that concluded he was 100% disabled with Schizophrenia.

In May 2020, the Board issued a favorable rating decision granting 100% disability effective February 7, 1977 since the disease did, in fact, manifest within one year of his 1976 discharge.

The Veteran was in the United States Army during the Vietnam War from February 19, 1969 to December 26, 1970. His MOS was Spec-4 Illustrator, but while in Vietnam was an Infantry Light Equipment Operator. He spent the earlier part of his military service as an Illustrator at Ft. Sill, Oklahoma. He had no combat training other than basic training at Fort Campbell before being sent to Vietnam. The Veteran spent most of 1970 in Vietnam and witnessed and participated in atrocities. He was bullied and hazed by his fellow servicemen as he was not assigned to any particular unit and was a temporary duty person. He was always the “new guy”, and no one trusted him or wanted to have his back. He was also given the worst duties to perform that no one else wanted to do due to his temporary status. This usually involved participating in ambushes. After a botched ambush, he was ordered to go slit the throats of the surviving wounded Vietcong. He could not disobey orders but could also not bring himself to slit their throats. He ended up choking the surviving wounded to death and is haunted by their faces to this day. He also witnessed the killings of women and children in Vietnam, piled up bodies, the death of his lieutenant and was under mortar attack daily. This was very damaging to the Veteran’s mental health.

After the war, the Veteran returned home and could only function in solitary occupations. He had a career building houses with one partner, as mentally he could not interact with others without feeling and displaying anger and frustration. The Veteran suppressed the war trauma memories and anguish for forty years before he finally admitted to himself that he needed mental help. He first went to the VAMC in 2010 seeking evaluation and relief from his forty-year battle with PTSD. The examiner diagnosed him as a “malingerer,” even though he was quite explicit in his C & P exam as to the several stressors he witnessed and personally experienced in combat in Vietnam.

The Veteran filed his first claim for PTSD in September 2010. The VA consistently denied his claim for PTSD stating he was self-diagnosed, had presented himself for medical help in 2010 stating “I have PTSD and I need help.” After pointlessly struggling with the VA for seven years, he finally hired our veterans disability law firm in February 2017.

Over the next three years we chipped away at the VA denials by developing our argument, obtaining buddy statements and family statements and commissioning three different expert psychiatric and psychological reports of the Veteran’s mental condition. This evidence led to three rating decisions gradually increasing the Veteran’s evaluation. In July 2018 we obtained service connection for PTSD at 30% effective September 1, 2010. In June 2015 we obtained an increased rating to 50% from 30%. And finally, in a May 2020 rating decision we obtained a PTSD evaluation of 70%, TDIU and DEA effective October 6, 2016.

The Veteran was in the United States Navy from February 27, 2006 to November 19, 2007 during the Gulf War. He was on the USS Nimitz which offered support through the Straits of Hormuz. He was a Systems Organizational Maintenance Technician and an Aviation Electronic Technician. After discharge from the Navy he was in the Army National Guard from March 18, 2009 to April 7, 2009.

The Veteran’s nightmare began when he was a young 19-year-old who was raped and threatened by his male Senior Chief while on the USS Nimitz. He was on the USS Nimitz from May 2007 to November 2007. The rapes occurred in areas of the ship where the Veteran’s screams could not be heard. He was also told by his superior that if he said anything he would be punished and dishonorably discharged. The Senior Chief also threatened his life. Understandably, the Veteran was traumatized and began acting out which led to his untimely discharge.

He also was unsuccessful in the Army National Guard and was released after a short time. He was shot in the shoulder by friendly fire while in the Army and this added to his mental health deterioration.

By 2011 the Veteran had been diagnosed with PTSD and filed his first claim for service connection in June 2011. He was granted 10% rating for service connection for PTSD. This was not a good result for the Veteran. After struggling with his mental health a few more months, the Veteran attempted suicide in 2012 and was hospitalized for a long period of time. In May 2013 he received an increased rating to 70% but felt this was still not high enough. He then hired our veterans disability law firm in March 2015 to represent him on this issue.

We reviewed his claim and retained two separate experts to prepare reports on the Veteran’s behalf regarding his military sexual trauma and his friendly fire injury. We submitted our new evidence and our argument and received a favorable April 2020 rating decision increasing the PTSD with alcohol disorder evaluation to 100% effective July 16, 2019 and DEA established June 16, 2019. In a final May 2020 rating decision TDIU was granted.

Veteran served in the United States Army during the Vietnam era from August 1972 through May 1973 when he received an honorable discharge for hardship. He was at Fort Riley, Kansas and Fort Polk, LA for the duration of his service. His MOS was Motor Transportation Operator.

While in basic training the Veteran was severely beaten during a combat exercise and “hog-tied,” beaten, and strangled with a rope tied around his neck during POW training. This was supported by three “buddy statements”, as there were no medical records available confirming his broken nose, broken ankle/leg, black eye, chipped teeth and many bruises. He passed out from the strangulation of the rope around his neck. He also claimed he was exposed to mustard gas, causing him to suffer from lifelong sinusitis. 

Upon his discharge the Veteran filed his first claim in July 1973. In a January 1974 rating decision his claim was denied. Over the years his claims for service connection for sinusitis, deviated septum, neck disability, back disability, right leg disability, PTSD and diabetes mellitus were appealed and denied with help from a VSO.  

In a November 2012 appeal to the CAVC, his case remanded back to the Board for further development. The Veteran submitted new evidence to the Board in July 2014 and service connection for a back disability was granted, all other claims were again denied.  Overwhelmingly frustrated and unable to win his claim with the help of a non-attorney VSO, the Veteran hired our firm December 2014.

After a thorough review of his situation and claim, the Veteran agreed to abandon the neck and sinus claim, and we were able to get a remand for his PTSD claim (from the beatings), his leg claim, and his deviated septum claim.

After six years of challenging the VA, we were able to obtain in June 2020 a decision granting the Veteran TDIU effective August 2004, PTSD and depression an increased rating from 30% to 70% effective August 2004 to July 2018, and a 100% rating effective July 2018. He was also granted basic eligibility for Dependent Educational Assistance (DEA) previously established July 2020 to an earlier established date for the total disability rate of August 2004.

The Veteran served in the United States Air Force during the Gulf War from May 2007 to March 2008.  He hired our firm in November 2016 after he was repeatedly denied an increased rating for panic disorder without agoraphobia.  He was service connected at 50% and wanted a higher rating as he was unable to work since 2012 due to his panic disorder.

We chipped away at the denials over the next four years, by hiring experts, conducting intensive legal and medical research, and presenting hard-hitting arguments.  We were eventually able to obtain increased ratings for some physical injuries that were service connected (right shoulder, left foot,etc).  By June 2020, we were able to increase his ratings to an 80% combined rating.  With his now higher combined rating we obtained an vocational expert to address his ability to work.  Our Vocational Expert’s report opined that the Veteran was too disabled and could not work due to his service connected disabilities, and we were able to get win him decision granting TDIU and DEA effective February 2013.

The Veteran served in the United States Air Force from February 2002 to August 2006 during the Gulf War. He spent most of his time in Afghanistan under the fear of hostile military and terrorist threats and attacks.

When the Veteran hired our veterans benefits law firm in August 2017, he had just received his latest denial decision. He was service connected at 10% for tinnitus, allergic rhinitis, and pseudo folliculitis barbae and 0% for herpes simplex. He had been denied for PTSD and major depressive disorder, and various shoulder, ankle, and knee disabilities. He had been struggling with service connection issues and did indeed have an expert report done prior to engaging our firm. Frankly, there was nothing wrong with the report, but the VA shot it down anyway. The experts we engage, medical, psychological, and vocational, are well acquainted with precisely what will give the VA cause to reconsider a claim. Many of them are former military examiners and are quite familiar with the VA process and how to work with us to the Veteran’s advantage in his or her claim.

Before incurring the cost of further experts, we tried to submit additional evidence using the existing STR’s and our argument. But eventually we hired another expert to analyze the Veteran’s conditions and provide us with another expert report. After much back and forth with the VA in a June 2019 rating decision we were able to get the Veteran an increased rating from 0% to 60% effective January 2014 for Herpes Simplex. We realized we needed more ammunition and hired yet another expert for his report and opinion. After submitting this new evidence in a June 2020 BVA decision implemented on June 16, 2020 by the RO, we were able to obtain for the Veteran service connection for the following:

• PTSD/MDD 70% rating effective January 2014, 100% rating effective April 2019;
• Left shoulder tendonitis with arthritis service connected at 20% effective July 2016;
• Left and right ankle sprain at 10% each effective January 2014;
• Right knee instability and MCL strain at10% each effective January 2014; and
• Special Monthly Compensation (housebound) effective April 2019 with DEA effective October 2015.

This Veteran was in the United States Navy right out of high school from August 21, 1985 to January 23, 1986. His time in the Navy was noticeably short. The Veteran’s first few weeks were fine, but as his time progressed he was harassed, bullied and assaulted by some of his fellow servicemen. They would steal items from him, accuse him of stealing from them and “beat him up”. He had always had a sunny, friendly disposition and this made him the target of bullies. He notified his superiors of the problems, but nothing was ever done about it. The Veteran states he was told “they would put something negative in my records that would ruin my life if I didn’t stop reporting the harassment and assaults”.

The harassment became so unbearable that the Veteran suffered a mental collapse and was hospitalized at the base in the psychiatric ward. He was under observation for two days and was diagnosed with Adjustment Disorder. At the time, not as much was known about PTSD, so a lot of members of the military with PTSD at that time were commonly diagnosed with Adjustment Disorder. It was recommended that he be separated from the Navy after his psychiatric assessment, and it was noted in his records that he was “discharged with borderline intellectual function.”

The Veteran received private psychiatric treatment after his discharge for many years. He also saw the VA psychiatrist, but he found her to be dismissive and not paying attention to him. By 2008 he was disabled due to PTSD and could no longer work. He survived on Social Security disability and by living with his mother.

In January 2013, the Veteran filed his first claim for service connection for PTSD and depression. He was denied in August 2014, and fortunately did not waste any more time and hired our firm in September 2014. We immediately filed a Notice of Disagreement and began gathering the Veteran’s medical records and requesting the VA claims file. He had already been diagnosed with Adjustment Disorder while in service, upon which we began to build the case.

We obtained an expert psychiatric report on the Veteran’s behalf which stated he had “multiple assaults and stressors” while in service, causing PTSD. We appealed with a lay statement from the Veteran’s mother, private psychiatric records and luckily enough letters the Veteran’s mother had saved that he wrote to her while in service describing his troubles.

We prevailed in an August 2018 Board decision, implemented by the RO in a July 2020 rating decision. We were able to obtain the Veteran service connection for PTSD with Major Depressive Disorder at a 100% rating effective January 17, 2013 (the date of his original claim) and DEA.

The Veteran was in the United States Army during peacetime from February 1977 to November 1982. His MOS was Wheel Mechanic in Korea and he performed work on all types of vehicles. During his service while performing his daily job he was exposed to lethal chemicals such as gasoline lacquer thinners and methyl chloride. While in service the Veteran was treated for headaches, loss of energy, depression and anxiety. All these maladies are clearly reported in his service treatment records.

After being continuously denied, the Veteran hired our firm in August 2011 after we received a successful JMR for him before the CAVC. His appeal was remanded for further development for an Organic Brain Condition secondary to in service chemical exposure.

Once the Veteran hired our veterans disability law firm we proceeded to develop his claim with five different medical expert reports disagreeing with the VA medical examiner and strengthening the Veteran’s service connection claim. The problem was because after discharge the Veteran worked for many years in an automobile body shop and the VA time and again attributed his disease to his civilian auto body work. We firmly persisted in our claim development and eventually with all our new evidence an August 2015 C & P examiner agreed with our medical experts regarding service connection.

Our persistence paid off and in a May 2016 rating decision the Veteran was granted service connection for Delusional Disorder, Somatic Type Secondary to Chemical Exposure with Associated Pain at a 100% rating effective August 2007.

Tragically, and all too commonly, the past due benefits check was issued to the Veteran on June 28, 2016 and he passed away from brain cancer on June 30, 2016.

The problem was that the money did not hit the Veteran’s bank account until July 1st. The bank then returned the money to the VA. We then began legal action in the State of Florida to obtain the money for the Veteran’s surviving family members on the grounds that it was released prior to his death. We repeatedly wrote to the VA for release of the money, but VA consistently ignored us. Finally, after 4 years of trying to secure VA’s cooperation without resorting to litigation, we filed a Writ of Mandamus or Petition for Extraordinary Relief with the U.S. Court of Appeals for Veterans Claims. This resulted in the VA releasing the money to the Veteran’s estate and we were able to secure the money for his surviving children.

The Veteran served in the United States Army during peacetime from March 1985 to March 1988 and May 1988 to February 1993. While in service the Veteran spent two days in 1987 lifting and stacking heavy metal desks. This was the cause and beginning of his long journey of chronic back pain and suffering.

He was treated sporadically, yet consistently for lower back pain from that day forward. This was also the origin or beginning of a long-standing degenerative process of his lumbar spine. Being in constant chronic pain also caused the Veteran to fall into a severe depression. By 2010 the pain was so intense the Veteran could no longer work. The VA believed that there was no nexus with service and so repeatedly denied his claims. The Veteran was unable to win his claim on his own or with the help of a VSO.

As such, he hired our firm in 2015 to represent him before the CAVC. We were able to successfully overturn the Board’s denial at the CAVC and get the case remanded back to the Board. We then hired a psychiatric/neurosurgeon expert to review the Veteran’s records and prepare an expert report for submission to the Board. This dual-credentialed expert was able to address the spine problems and the psychiatric problems. We did further research and prepared legal arguments. We then submitted the expert report and evidence, which strongly supported the Veteran’s claim of an in-service injury being the start of his disability. The Board remanded the claim in July 2019 and in two RO implementations in December 2019 and August 2020 the Veteran was granted service connection for Major Depressive Disorder Recurrent and Severe at 70% effective December 12, 2012, Degenerative Changes Lumbar Spine at 20% with same effective date and TDIU and DEA effective December 12, 2012.

The Veteran, a native of Puerto Rico, was in the United States Army from October 1968 to October 1970. He spent one year in Vietnam. His MOS was Combat Engineer and later promoted to Specialist. His initial stressor occurred in Vietnam when he had just completed clearing a road for mines and moments later his supervisor drove on the road and a mine detonated killing the supervisor. Naturally, the Veteran was traumatized. Shortly after discharge he sought treatment for his mental health and nervous condition in 1971.

The anxiety and depression he suffered worsened, and he sought psychiatric hospitalization in 2003. After being denied service connection for his mental health disorder, the Veteran hired our firm in September 2013.

We hired three separate experts to examine the Veteran’s records and interview him. First was his treating psychologist in Puerto Rico, second was one of our medical experts and third was our vocational expert as we were also attempting to obtain TDIU for the Veteran. He had been unable to work for years due to his worsening mental health. We submitted our new evidence and began the agonizingly slow process of litigating the appeal with the VA.

As a result, in a decision in April 2015, the BVA granted benefits, which implemented by the RO in January 2017. We were able to obtain for the Veteran service connection for an unspecified depressive disorder (depression, PTSD, and nervous condition) secondary to right shoulder dislocation at a 30% rating effective August 2008. This was a start. We filed an NOD and in an October 2018 DRO decision the rating was increased to 100% from 30% effective September 2017. We appealed for an earlier effective date and were granted 100% effective May 2017, and 50% prior to May 2017. We achieved an earlier effective date and a higher rating. The next step was obtaining TDIU. On the strength of our argument and our vocational expert’s report, in an August 2020 rating decision we obtained TDIU and DEA effective September 2010 for the Veteran.

The Veteran, a native of Puerto Rico, was in the United States Army from July 2002 to October 2002 and February 2003 to June 2003 during the Gulf War. He spent some time in Kuwait. While in service he suffered from cervical pain and was issued medication for it. At the same time, he was also suffering from headaches but did not mention it to his medical provider and just took the same medication for his headaches that he had been prescribed for his neck pain.

The VA denied the claim on the grounds that there was no nexus with service.

As a result, he Veteran hired our veterans benefits law firm in November 2013 to assist him in obtaining service connection for more disorders and higher ratings. When he came to us for help, he was only connected for headaches at 0%.

We reviewed his records and discovered he had permanently injured himself in service in Kuwait while he was carrying heavy crates of ammunition and fell injuring his back and right shoulder and fell again during a drill trying to grab his rifle injuring his spine and right shoulder. Over the next two years we hired three different medical experts to interview the Veteran and analyze his service and medical records. By June 2015 we were able to obtain a 90% combined rating for the Veteran due to right shoulder injury, right ulnar neuropathy and lumbar spine disorder. However, he was denied TDIU, and so we continued his appeal. In the meantime, one of our three medical experts explained how the Veteran’s in service chronic cervical pain was contributing to his headaches. We obtained an increased rating to 30% for his headaches effective July 2019. We were finally granted TDIU and DEA effective June 2015 in a June 2019 rating decision. We appealed for an earlier effective date based on medical records and the BVA granted our appeal in December 2019 and the RO implemented it in August 2020.

The Veteran was in the United States Army during the Gulf War from November 29, 1990 to November 13, 1996. He was stationed in Nuremberg, Germany and his MOS was Personnel Administration Specialist. He planned on being a career military serviceman, but was in a serious automobile accident, which changed his course.

The automobile accident is the stressor for his PTSD. The Veteran was on his way to the base from home in Nuremberg, Germany on the Autobahn when his vehicle broke down. He was pulled over on the side of the road sitting in his vehicle awaiting assistance when he was rear-ended by an eighteen-wheel tractor trailer. The entire back half of his car disappeared. It was totaled. The Veteran injured his head, neck, shoulders and back and was taken by ambulance to the hospital. He suffered a concussion, headaches and neck and back trauma in the accident. Afterwards the Veteran stated his behavior changed from a go getter career military type to a mediocre soldier. He was having flashbacks of the accident and was in chronic physical pain from it. He could not concentrate on his duties and ended up being discharged within months of the accident.

The Veteran returned to the United States with his family and obtained a series of customer service positions. Eventually his physical and mental health declined as he was in two more motor vehicle accidents and could no longer maintain employment. He filed his first claim in January 2014 and received an unsuccessful decision in late 2015. He hired our firm to represent him in December 2015.

We developed the Veteran’s claim and engaged two experts to prepare reports after viewing the Veteran’s file. One was a Vocational Expert and the other was a Psychiatric Expert. We submitted the reports along with our arguments and any new evidence we had obtained. Slowly but surely, we were able to obtain service connection for the Veteran. In a February 2018 decision we obtained service connection for Gastroesophageal Reflux Disorder (GERD) at 10% effective March 2017. In a January 2020 decision we were able to get the GERD rating increased to 30%. In a June 2020 decision we were granted service connection for Bilateral Pes Planus and Plantar Fasciitis with Right Foot Hallux Valgus and Morton’s Neuroma at 30% effective February 2017. In a July 2020 decision GERD and Hiatal Hernia received an increased rating from 30% to 60% effective February 2017. And finally, our greatest success was achieved in an August 2020 DRO decision granting service connection for PTSD, TDIU, DEA and Special Monthly Compensation effective November 5, 2013.

The Veteran was in the United States Army during the Gulf War and peacetime from March 24, 1989 to March 23, 1992. He was a Heavy Construction Equipment Operator. He was in Iraq from September 1990 through April 1991 driving trucks and delivering petroleum to the front. While in Iraq and supporting the 1st Cavalry Division he witnessed a fellow soldier step out of the petroleum truck and step on a cluster bomb which killed him instantly. A second incident occurred on the road to Basra to deliver fuel when the Veteran’s unit encountered enemy resistance. The Veteran witnessed tanks, medical vehicles and US soldiers being blown up and dismembered. The third stressor the Veteran experienced was when he was at Fort Hood, after Iraq, and a fellow soldier standing three feet away from him put an M16 into his mouth and committed suicide.

The Veteran filed his first claim in May 2008 which was denied in July 2009. With the help of a VSO the Veteran filed an NOD in July 2009. Seven years later in August 2016 he finally received a decision from the Board denying his physical disability claims and remanding his psychiatric disorder claim for further development. He had had enough. In October 2016 he hired our veterans disability law firm to represent him. He was being treated by a VA psychiatrist since 2008, but they kept denying service connection because although he was in Iraq, he was not technically a “combat veteran.”

We gathered the Veteran’s medical, psychiatric, and psychological records, and once again appealed to the Board. The Board, now in possession of all the Veteran’s STR’s, delivered a favorable decision in March 2020, but once again remanded the Veteran to obtain a VA examiner’s psychiatric evaluation. Luckily, this time we were able to have the Veteran examined by a VA psychiatric examiner who knew what he was doing, and in a July 2020 examination determined the Veteran did suffer from PTSD and all prior exams were incorrect.

This exam result, along with the Veteran’s detailed account of his in service stressors, resulted in a September 2020 RO rating decision of service connection for PTSD at a 70% rating effective May 2008, Lumbar Intervertebral Disc Syndrome (from a fall onto a log in a confidence course in service) 40% rating effective April 2018, Tinnitus at 10% effective August 2015 and Peripheral Neuropathy at 10% effective April 2018.

The Veteran was in the United States Navy from December 1969 to February 1973.  He served on board the USS Ouellet as a Gunfire Control Technician (Weapons) in Vietnam during the war.  His stressors occurred when the ship came under hostile fire, witnessing the crash and death of an F-4 pilot, and being robbed at gunpoint while off-duty.  The Veteran also  believes he was exposed to Agent Orange during the two times the ship docked in Da Nang to offload missiles for several days.

When the Veteran hired our firm in October 2017, he had recently been diagnosed with bladder cancer.  He was already service connected at 30% for PTSD due to the above-mentioned stressors and Diabetes Mellitus due to presumptive Agent Orange exposure.  While the VA agreed he had been exposed to Agent Orange, they were not yielding on the AO contributing to the bladder cancer.  (This was before the change in the regulations that added bladder cancer to the list of presumptive diseases associated with Agent Orange exposure).  Our goal was to obtain service connection for his bladder cancer secondary to Agent Orange exposure.  There was a brief period in the Veteran’s life when he smoked cigarettes, and the VA was going all out to defend the case on the grounds that his past smoking caused the bladder cancer.

We began by hiring two experts to research and opine on the two separate areas.  One to establish a nexus between Agent Orange exposure and bladder cancer and the other to prepare a report that the Veteran’s sleep apnea should be service connected as secondary to PTSD.

With this new and material evidence we began to slowly chip away at the denials and start developing our case.  Between June 2018 and November 2020, we were able to obtain for the Veteran the following:

• Increased rating for PTSD from 30% to 70% effective March 2018;
• Service connection for Obstructive Sleep Apnea secondary to PTSD at 50% effective February 2014;
• Service connection for bladder cancer at 100% effective January 2015;
• Erectile Dysfunction and special monthly compensation for loss of use of a creative organ effective December 2013; and
• Special Monthly Compensation (housebound) effective January 2015.

The Veteran, a native of Puerto Rico, was in the United States Army from July 1980 to November 1980 and January 1991 to July 1991 on active duty in the Persian Gulf. His MOS was Military Police. Before and after his service in the Persian Gulf he was in the Puerto Rican National Guard for twenty years. The Veteran’s experience was featured in an interesting article entitled “Into the Desert: The Story of the Puerto Rico National Guard in Operation Desert Shield/Desert Storm”.

The Veteran also experienced combat and being under fire from daily SCUD missile attacks. He has cervical and lumbar spine degeneration and injuries which occurred in the Persian Gulf. He was policing the POW’s meal tent when a violent storm caused the roof to collapse, and the POWs began rioting. He was injured in the collapse of the roof, but they managed to subdue the riot. These stressors contributed to his severe PTSD. He also compounded his injuries during training when he was unrestrained in a two-and-a-half-ton military vehicle which hit a ditch and toppled the Veteran out onto his shoulder, reinjuring his back and neck.

The Veteran hired our firm in June 2012 to obtain an increased rating for PTSD and TDIU. We hired multiple experts to prepare reports as new evidence. We also obtained eyewitness buddy statements and family member statements regarding the Veteran’s PTSD and physical injuries. He had already been service connected for his shoulder, lumbar spine and cervical neck injuries and we were able to get him a rating increases for all the disabilities to 20% from 10%. In addition, in a September 2020 rating decision his PTSD rating was increased from 30% to 100% effective September 2020 and special monthly compensation (housebound) also effective September 2020. In a most recent November 2020 RO implementation of a January 2018 Board decision, we finally obtained TDIU and DEA for the Veteran effective January 2018.

The Veteran served in the United States Army from March 1965 to March 1967 during the Vietnam Era. He served in Vietnam as a construction machine operator. The Veteran died at the age of 69 in 2011 from acute myelodysplastic leukemia (AML). In his lifetime he was never granted service connection based on presumptive exposure to Agent Orange. He had spent time in the Republic of Vietnam.

The VA consistently denied the widow’s claim for service connection for the cause of death based on acute myelodysplastic leukemia. Frustrated with the help she was receiving from non-attorney advocates, the widow reached out to our veterans disability law firm.

She hired our firm in September 2019 to try and obtain service connection for cause of death based on AML. This was a difficult achievement as AML was not on the list of Agent Orange presumptive diseases. A VA examiner reviewed the Veteran’s records and concluded his death was not service connected. We disputed this finding and hired a medical expert to review the same documentation and prepare an expert report for us. Our expert was able to determine that the VA C&P examiner was incorrect in his assessment of our client’s case. This report was the evidence that clearly tipped the scales in our favor. Our expert comprehensively explained how AML is contracted due to benzene exposure (dioxins) and Agent Orange contains this chemical. He explained that there was no other conclusion that could be drawn as to the Veteran’s exposure to benzene than Agent Orange exposure, as one does not typically ever encounter exposure to this chemical in everyday life and it was at least as likely as not secondary to Agent Orange exposure while on active duty.

In an October 2020 decision the BVA agreed with our expert and granted service connection for cause of death. A November 2020 RO implementation granted service connection for cause of death and DEA effective November 2018.

The Veteran served in the United Marines from April 1991 to July 2011. Her MOS was Motor Transport. She served at many US bases and in Japan. Her first stressor contributing to her PTSD and other mental health issues occurred when she was on the telephone in her barracks and a male serviceman attacked her and threw her down on her bed. She screamed but people thought it was a joke and no one came to her aid. Thankfully, she fought off her attacker. Her second stressor occurred also in the US when she was raped in a field by an MP who had a history of sexual assault at Guantanamo Bay. She fought back with a tire iron, and she was the one in trouble for “assaulting an MP”. She pressed charges and the court martial of the MP was thrown out and he was transferred. Her superiors let her know she did a bad thing by reporting him and she had no support except from student MP’s who knew what this man was like. Another stressor occurred when her close friend shot herself and died in Iraq. The final serious stressor occurred in Japan in 2005 when she was involved in a fatal automobile accident and a Japanese National was killed by a drunk driver. She was in another vehicle also involved in the accident and witnessed the entire accident.

After rating decision in October 2013 that erroneously denied her claim, the Veteran hired our veterans benefits law firm to pursue a CUE (clear unmistakable error) claim for her. While she was service connected for many physical ailments, i.e. service connection for PTSD 70%, effective 9/11/12; left rotator cuff 10%, effective 9/11/12; DDD 10%, effective 9/11/12; right hip 10%, effective 9/11/12; left knee 10%, effective 9/11/12; right knee 10%, effective 9/11/12; asthma 10%, effective 9/11/12; hypertension 10%, effective 9/11/12; fibrocystic breast disease 0%, effective 9/11/12; uterine fibroids 0%, effective 9/11/12; residual scars 0%, effective 9/11/12; acne 0%, effective 9/11/12; and migraine headaches 0%, effective 9/11/12, all of the effective dates were incorrect. The VA incorrectly maintained the position that she filed her first claim September 2012, when in fact she had filed it January 2012 within the correct appeal time frame. By arguing this and backing it up with proof, over the next five years we were finally able to prove that the VA was wrong and that the prior decision was clearly and unmistakably erroneous.

In a BVA remand in September 2020, implemented in November 2020, we were able to get the Veteran an earlier effective date of August 2011 on all relevant issues, increased ratings for uterine fibroids, removal of uterus and Special Monthly Compensation for loss of a creative organ. We were also able to get her PTSD/Major Depressive Disorder with severe psychotic features increased to 100% rating effective August 2011.

The Veteran served in the United States Army during the Korean Conflict from June 1953 to June 1956. While in service this Veteran was shot and fell from a utility pole injuring his knees. After his discharge he became employed with the VA as an HVAC technician. The Veteran is currently wheelchair bound in a nursing home and unable to walk. At the time of this writing, he is 85 years old. After spending his time in service and working as a civilian for the VA for many years, the Veteran certainly deserved compensation for his service-connected injuries. By the time the Veteran hired our firm to represent him before the CAVC he had been battling the VA since at least 1998. We were able to get his claim remanded at the CAVC in 2010, but this resulted in a disappointing outcome and a financially unsubstantial decision for the elderly Veteran. He rehired our firm in April 2014 to represent him in his past due benefits/service connection claim. At the time he was service connected at a minimal percentage for his in-service knee injuries which had rendered him wheelchair bound in his later years. On behalf of the Veteran, we hired a vocational expert and a medical expert to prepare their reports opining on his inability, for many years, to fully function due to his service-connected injuries.

Our persistence paid off. In a November 2020 rating decision, the Veteran was granted:

• Service connection of 40% for post-operative right knee condition effective November 2013;
• Service connection for right and left foot cold injury each at a 30% rating effective July 2012;
• Right knee instability 10% effective October 2013; and
• TDIU and DEA effective October 2013.

We are still in the process of pursuing further claims for the Veteran.

The Veteran served in the United States Army in Germany and Kuwait during the Gulf War from September 1987 to February 1995. He participated in combat simulated training at Air Assault School both as a student, and then as an instructor.  This was where his knee damage/injury first began.

He was then sent to Kuwait at the end of the Gulf War and was stationed at Camp Doha, where a little-known military disaster occurred on July 11, 1991.  In brief, many, many military vehicles were kept on the base and one day a fire started in the heater of one of the combat vehicles.   It was the largest loss of military vehicles and ammunition since World War II.  The fire raged for hours before it was contained.  Clean up was blocked for three to four days as live ammunition was still smoldering and could be deadly.  As clean up began, in which this Veteran was a participant, the worst case scenario happened.  There was an explosion as feared, and three servicemen were killed during the cleanup operation.  As witness to this the Veteran developed PTSD.  He also later found out he had been picking up ammunition debris with thinly-gloved hands that contained uranium and he suffers from possible uranium exposure.

Despite the well-documented nature of his service, the VA continued to deny the claims.  The Veteran realized that he was not getting anywhere on his own.

As such, the Veteran hired our firm in November 2018 after being denied anything greater than a combined rating of 40% service connection for his knee problems.  We analyzed the Veteran’s records both medical and non-medical and obtained a buddy statement describing the explosion he had been in in Kuwait.  In July 2020, the BVA remanded the Veteran’s knee issues and PTSD claim due to our new evidence. In a December 2020 RO implementation we were able to obtain for the Veteran service connection for right knee condition at 10% effective May 2011, 100% rating for right knee replacement effective December 2019 to February 2021 then 60% rating from February 2021 forward, PTSD at 70% rating effective May 2011 (date of Veteran’s fist claim for PTSD) and special monthly compensation (housebound) December 2019 to February 2021.

The Veteran entered the United States Army at the age of 18  and served from July 1977 to October 1977.  While in service he required surgery for an abscessed hand, and this became the trigger for his lifelong battle with mental illness.  He was diagnosed as schizophrenia and suffered from a personality disorder and passive aggressive disorder.  He was unable to continue in the service.  Shortly after his discharge he was hospitalized for two months in a psychiatric unit.  Over the years he applied many times for service connection for mental illness and was denied.  He was also in and out of psychiatric treatment.  

The VA often denies claims for psychiatric disorders when there is the presence of a personality disorder.  The VA tries to portray all of a veteran’s mental health problems as being due to a personality disorder, which is considered congenital (born with it) and not capable of being service connected.  However, most people with personality disorders also have concurrent non-personality disorders, or acquired psychiatric disorders that can be service connected.  The key is convincing VA that there are comorbid conditions.

In this case, the Veteran had been represented by VSO’s and other law firms, but no one had any success.  His prior representatives did not understand how to deal with the personality disorder issue.  But things changed when he hired our veterans benefits law firm in November 2017.  We analyzed his situation and prepared our arguments on appeal.  We hired psychiatric experts and thoroughly researched his issues.  As a result, by September 2018 we were able to obtain a BVA remand.  In a January 2021 rating decision, the Veteran was granted service connection for other specified trauma and stressor related disorder at 70% rating effective February 2012.

The Veteran served in the United States Marines from May 1973 to March 1976 as a Field Radio Operator during the Vietnam Era and peacetime.  He was also in the National Guard from August 1981 to June 1982 and July 1984 to July 1986 as a Tank Driver.  In 1981 he suffered a traumatic injury in service when two 2 ½ ton military trucks rolled back into each other, and he was pinned by the neck between the two tailgates.  He suffered injuries both physical and emotional from that accident.

Due to inadequate documentation and insufficient evidence of a nexus, the VA repeatedly denied his claims.

He hired our firm in December 2016 when he was unable to obtain service connection stemming from this accident through a VSO.  We reviewed his file and decided we needed a mental health expert’s report as new evidence, and felt we had enough information in the Veteran’s service treatment records to get service connection for his physical injuries.  He also suffered from severe hearing loss and tinnitus, which we argued was directly related to his time spent as a Field Radio Operator.

We submitted our new evidence in an appeal to the BVA, which resulted in a favorable decision in November 2018.  In a January 2019 and January 2021 RO implementation, and an April 2019 rating decision we were able to obtain for the Veteran the following:

Service connection for:

• Cervical strain at 10% effective October 2012;
• Bilateral hearing loss 60% effective October 2012;
• Tinnitus 10% effective October 2012;
• Acquired psychiatric disorder to include PTSD and generalized anxiety disorder 70% effective October 2013;
• Right and left upper extremity neuropathy at 20% each effective February 2019;
• Bilateral pes planus, plantar fasciitis and calcified cancal spurs 10% effective August 2010 increased to 50% effective January 2021; and
• DEA effective January 2021.

As of the time of this writing, we are still working on a claim for service connection for sleep apnea secondary to PTSD. 

The Veteran served in the United States Marines from September 1981 to July 1984 and April 1988 to November 1992. He had various duties over his time in service. He attended cooking school and was a food service provider, he was in an amphibious assault group and on a helicopter squad. He served aboard the USS New Orleans in the Persian Gulf during the Gulf War.

Experiences while on the USS New Orleans are the basis of his current mental illness. The Veteran claims prior to service he was perfectly normal, well-adjusted, and happy. While onboard the USS New Orleans, he witnessed the USS Tripoli hit a mine and have a hole blown in its side resulting in injuries and twelve deaths. The surviving servicemen were taken on to the USS New Orleans, and the USS New Orleans took over the mine search as part of a mine countermeasure detail. The Veteran was traumatized by what he had witnessed and was in fear for his life that they too would hit a mine. When on land he was also traumatized by having to fly over burning oil fields in Saudi Arabia as he could not see through the smoke and was on constant high alert of an attack through the blackness.

He was treated after service for psychiatric issues and applied for service-connection for his psychiatric disorder. After constant denials by the VA, he hired our veterans disability law firm in October 2013 to represent him. In 2014 we sent the Veteran to two separate psychological experts who interviewed both the Veteran and his wife. They prepared substantial reports diagnosing him with PTSD, dissociative personality disorder, and possible multiple personalities disorder.

We submitted this new evidence and made key legal arguments. As a result, in 2019 the BVA remanded his mental illness claim. In a January 2021 DRO decision the Veteran was finally awarded service connection for unspecified trauma or trauma related disorder at a 70% rating effective October 2007. Without our firm’s persistence and additional expert reports this would not have been the outcome.

The Veteran served in the United States Army in Korea during the Korean Conflict from August 1951 to May 1953. While in service the Veteran injured his lower back in combat in Korea. After his discharge he filed a claim for service connection and was denied for the next sixty years. He became incapacitated from his back injury in 1984 and was no longer able to work. Prior to his incapacitation he was a construction worker, and when that became too painful, he worked in the deli at a supermarket until he could no longer stand up anymore from the pain.

He hired our firm in November 2014. We began thoroughly researching his claim. We then hired medical experts to address the cause of his disabilities. Our expert was able to render an opinion in favor of a nexus with service. As a result, we were able to get him service connected for degenerative arthritis lumbar spine, but only at 20% rating effective April 2010 in an October 2016 RO decision. We fought this and the BVA increased his rating to 40% in January 2019 based on their interpretation of “additional symptoms.”

We had already sent an expert report with new evidence which enabled the increased rating. But we believed the Veteran was entitled to much more and so we engaged a vocational expert in our pursuit of TDIU for this Korean Combat Veteran.

With our new vocational expert report submitted as new evidence, we were finally able in a January 2021 RO decision to obtain TDIU and DEA effective April 2010 for the Veteran.

The Veteran served in the United States Army from February 1999 to July 1999 and June 2005 to March 2006 during the Gulf War. He was in both Iraq and Kuwait. His MOS was Gun Truck Driver and Gunner. The Veteran’s initial service in 1999 was without incident. However, during his second tour in September 2005 his convoy was ambushed in Iraq by insurgents. The Veteran’s weapons (two of them) malfunctioned, and he was anguished to learn three of his comrades were killed as he was trying to protect them.

The Veteran subsequently developed depression, anxiety, insomnia, and PTSD. He was treated at the time with counseling and medication and was then sent to Camp Navistar in Kuwait. He was still struggling with insomnia, depression, and anxiety. One night as he was preparing for bed, he received a message that the Chaplain needed to speak with him. The Chaplain told him he had heard from the Red Cross and back home in the United States his wife had suffered some sort of breakdown and was passed out on the couch nude and his two- and three-year-old toddlers were playing outside alone in the snow. This was January 2006. The local police had called Child Protective Services and they would be taking his children away. Already struggling with his mental issues from combat, the Veteran was deeply anguished and completely distraught. He was advised to go through the chain of command and request emergency leave. The following day he saw a combat stress counselor who prescribed him Ativan to help alleviate his anxiety over the situation at home. Years later, after the Veteran hired our firm to represent him in his claim, one of our attorneys and our psychiatric expert discovered in the Veteran’s service treatment records that he had also been prescribed an antipsychotic medication for his PTSD by another military practitioner which had not been noted at the time. This was a significant discovery because it was this information that turned the whole claim around for the Veteran.

After taking the Ativan, and with the antipsychotic already in his system, he paid a visit to his commanding officer to request emergency leave. The CO requested paperwork verifying the situation at home which the Veteran provided. The CO then denied his request. Understandably, the Veteran reacted in an angry, frustrated way and attempted to punch his CO in the face but instead grazed his shoulder. This altercation resulted in the Veteran receiving an other-than-honorable discharge, which made him ineligible for any VA benefits.

The Veteran spent twelve years fighting his discharge status on his own without success. He hired us in March 2018. We provided at least twelve buddy statements in the Veteran’s favor, two psychiatric expert reports and our argument that the Veteran was insane at the time of the incident. The Veteran also has no recall of the physical fight. With all our strong evidence the Board determined the Veteran was insane at the time of the incident in a December 2020 decision. Theis means that under the regulations, the Veteran would be eligible for VA benefits even though he had an other-than-honorable discharge. On January 7, 2021, the RO implemented the decision, granting service connection for PTSD and MDD at 70% effective July 2016, DEA and TDIU also effective July 2016.

The Veteran was in the United States Air Force from November 1982 to May 1985 during peacetime. His Specialty Rating Code was Aviation Jet Engine Mechanic. His job required him to lift heavy objects and contort himself into small places to work on the engines. After years of this the decline of his musculoskeletal health began. After discharge he became a bus driver for a luxury touring company. In 1999 he had to retire due to chronic back and leg pain that the Veteran believed originated in service. He began collecting Social Security Disability in 1999 and filed his first claim for service connection in 2005. The VA repeatedly denied him over the next two years. Frustrated, he realized he needed professional assistance and so he hired our veterans disability benefits law firm in 2007.

We worked tirelessly for this Veteran over the course of the next decade. We appealed his case numerous times to the U.S. Court of Appeals for Veterans Claims and we continued to fight the VA. We had numerous experts to address the cause of his spine problems, but VA kept obtaining more medical opinions from their own doctors to support the continual denial of the claim. We continued to obtain more medical opinions from our experts to counter the VA doctors. In the end, we had the last word and we were able to demonstrate how the opinions of the VA doctors were less persuasive or reliable than the opinions of our experts.

We prepared our arguments and hired a vocational expert to prepare a report opining on the Veteran’s unemployability due to chronic pain. At this point, the Veteran had developed Major Depressive Disorder because of the chronic pain and his feelings of hopelessness dealing with the VA. We were successful and, in April 2020, May 2020 and February 2021 we were able to obtain the following for the Veteran:

• Upper and lower back condition rated 20% effective September 2005, increased to 40% effective July 2018;
• TDIU and DEA effective September 2018;
• Major depressive disorder with anxious disorder increased rating to 70% from 50% effective May 2020;
• Radiculopathy lower left and right extremities increased rating to 20% each effective September 2005; and
• Earlier effective date for TDIU and DEA of July 2018.

As a result, fourteen years later, he was granted service connection.

The Veteran served in the United States Army from May 1990 to April 1994. He was sent to Saudi Arabia and was an Infantryman. He had been trying to get service connection for various in-service conditions and VA repeatedly denied his claims. He hired our firm in May 2015 to assist him.

When he first arrived in Saudi Arabia he panicked, as he felt extremely underqualified after boot camp to be thrust into the midst of the Gulf War since he essentially enlisted as a lark. He began having panic attacks and felt extremely stressed and depressed while in Saudi Arabia.

As we proceeded to develop his claim it was noted that he was on full Social Security Disability since 2013. He had been diagnosed with PTSD, panic disorder and depression and was unable to work. We began researching and thoroughly reviewing his claims file. We decided that we needed to hire experts to help us prove his case. We obtained expert reports, and additional medical evidence. We submitted our arguments, our Vocational Expert’s report, and many, many psychiatric and medical records from his STR’s backing our conclusions, and the Veterans’ Social Security Disability records. After three years of such back and forth with the VA we finally achieved our first victory in a June 2018 rating decision granting left side sciatica at 20% rating effective April 2018. From this starting point, many appeals and at least five BVA remands and rating decisions later, by March 2021 we were able to obtain on behalf of the Veteran the following:

• Left knee strain 10% rating effective February 2008
• Degenerative arthritic spine increased rating from 20% to 40% effective July 2020
• Left ankle fracture post-surgical with hardware 10% rating effective July 2020
• Painful scars left ankle 10% effective July 2020
• PTSD with depressive disorder rating increase to 70% effective June 2020
• TDIU and DEA effective October 2011

The Veteran served in the United States Marines from July 1977 to January 1980 and January 1980 to January 1983. She suffered from childhood depression prior to military service which was exacerbated by her time in service due to military sexual trauma, which also contributed to her PTSD. The Veteran also spent some time stationed at Camp Lejeune, which medical examiners believe is the cause of her Frontotemporal Dementia. It is well documented that the contaminants ingested at Camp Lejeune cause neurobehavioral disorders, one of which is dementia. Studies are showing that the contaminated water at Camp Lejeune is responsible for so many more disorders than originally thought. Her dementia also exacerbates her depression and PTSD.

The Camp Lejeune water contamination problem occurred at Marine Corps Base Camp Lejeune from 1953 to 1987. During that time, United States Marine Corps (USMC) service members and their families living at the base bathed in and ingested tap water that was contaminated with harmful chemicals at concentrations from 240 to 3400 times levels permitted by safety standards. An undetermined number of former base residents later developed cancer or other ailments, which many blame on the contaminated drinking water. Victims claim that USMC leaders concealed knowledge of the problem and did not act properly in trying to resolve it or notify former base residents that their health might be at risk.

In 2009 the U.S. federal government-initiated investigations into the allegations of contaminated water and failures by U.S. Marine officials to act on the issue. In August 2012, President Obama signed the Janey Ensminger Act into law to begin providing medical care for people who may have been affected by the contamination. The Janey Ensminger Act established a presumption of service connection for illnesses associated with contaminants in the water supply at Marine Corps Base Camp Lejeune between the years 1953 and 1987and which provided healthcare to family members of veterans who lived at Camp Lejeune while the water was contaminated. Ensminger was one among thousands of victims of the Camp Lejeune water contamination scandal, which is believed to be one of the largest water contamination incidents in United States history.

The VA repeatedly denied the Veteran’s claims. With insufficient assistance from non-attorneys, she began searching for legal representation.

The Veteran hired our veteran disability law firm in September 2017 after two years of denials by the VA for service connection. Over the next four years we developed her claim with experts, conducted extensive legal and medical research, and submitted our arguments while highlighting the cogent opinions in the medical reports.

By May of 2019 we were successful at the Board, receiving a remand on all issues. In an implementing March 2021 RO decision the Veteran was granted an increased rating from 20% to 40% for degenerative joint disease effective February 2019, PTSD/MDD and frontotemporal dementia at 70% effective September 2015, TDIU and DEA effective September 2015 (the date of her initial claim) and Special Monthly Compensation effective February 2019.

The Veteran was in the United States Navy from October 25, 2001 until September 20, 2002 during the Gulf War. The Veteran was only twenty years old and very immature. During service he received multiple non-judicial punishments (NJP) for offenses including failing to go to his place of duty, communication of disrespect, communication of a threat, willfully disobeying a lawful order, violation of a lawful general order, and attempted breaking of restriction. He was discharged under other than honorable conditions due to misconduct.

RO decisions in October and November 2006 affirmed his other than honorable discharge status for VA purposes due to his willful and persistent misconduct. The Veteran hired our veterans disability law firm to represent him on appeal at the CAVC. The CAVC vacated the Board’s denials and remanded it back to the Board. In furthering our development of the case, we hired a psychiatric expert to study the Veteran’s records and issue his expert report. We examined closely the Veteran’s state of mind at the time of service. We believed that the “misconduct” was merely an early sign of emerging mental illness that went undiagnosed in service. We presented this report along with our argument and in a February 2021 decision, after fifteen years of battling the VA, the Veteran was found to be insane, per VA regulation, at the time of the commission of his offenses underlying his other than honorable discharge. This meant that he was entitled to VA benefits even though he had an other-than-honorable discharge (OTH). He was no longer banned from receiving service connection and benefits. In a March 2021 rating decision, the RO granted service connection of 100% for PTSD and bipolar disorder effective April 2006.

The Veteran was in the United States Army from July 1967 to July 1970 during the Vietnam Era. He was in the DMZ in Korea and served as an auto mechanic. He hired our veterans disability law firm in January 2018 to represent him at the CAVC after many unsuccessful years on his own. We were successful in obtaining a remand for service connection for Ischemic Heart Disease. In a November 2019 BVA decision service connection for Ischemic Heart Disease secondary to PTSD was granted, but an increase in rating from 30% for PTSD was denied, and his claim for TDIU was remanded.

Our work was just beginning. We hired three individual experts, a medical doctor, a psychologist, and a vocational expert to evaluate the Veteran’s situation and prepare expert reports. With this new evidence we once again found ourselves appealing the PTSD rating and the claim for TDIU before the CAVC. We received a remand for both and in a March 25, 2021 rating decision the Veteran was granted an increased rating for PTSD from 30% to 70% effective September 2009, TDIU effective April 2015 and Special Monthly Compensation for being housebound effective August 2015.

The Veteran was in the United States Air Force from July 1964 to March 1965 during the Vietnam Era, and in the Army from March 1983 to October 1985 during peacetime. During his time in service, he suffered many injuries which resulted in post service connection for various disabilities.

The Veteran at times had a combined rating of 100%. Despite this he was consistently denied TDIU. He hired our veterans disability law firm to represent him at the CAVC after being denied TDIU at the Board level in April 2020. We were successful in obtaining a remand from the Court.

The Veteran was employed as a Registered Nurse for many years. However, once his disabilities became too painful to continue his employment he had to stop working and apply for Social Security Disability. He had filed his first claim with the VA in 2009 and had fought for eleven years with no success. After thorough research of his records, we were able to discover an error in the decision-making process. The VA had overlooked his service connection for peripheral neuropathy, which we brought to their attention, and this was the final missing piece which allowed him to be granted TDIU and DEA in an April 2021 BVA decision, implemented by the RO also in April 2021.

Everyone reading this would likely agree that the VA appeals system is a flawed and frustrating process. So much so that we probably dedicate a good portion of our workday addressing the concerns of people fed-up and tired of the VA system. Nevertheless, as zealous advocates and trusted advisors, it is our job to reassure our clients that, no matter how complex the issue or bleak the outlook, progress is being made, even if at a seemingly glacial pace. A recent case at our firm is a great example of that.

Our client served in the Army from 1965 to 1967, including one year of service in Vietnam. In May 1966, a 200-pound box fell on his head while he was unloading a truck. He was hospitalized for three days. Decades after he was discharged, in 2005, our client filed a claim for service connection for his head injury.

Eventually, in August 2010, VA granted service connection for residuals of traumatic brain injury (TBI) and assigned a 10% rating. VA also denied service connection for depression because the evidence didn’t show that it was related to his other, already service-connected disabilities. VA, however, did not address whether the veteran’s depression was related to his TBI.

Accordingly, our client filed a Notice of Disagreement, asserting that he was entitled to a higher rating because he suffered from dizziness, poor concentration, and disorientation that frequently led to him becoming lost. VA continued our client’s 10% TBI rating. In January 2011, the veteran appealed to the Board, asserting that VA did not consider favorable medical records and lay statements concerning his level of impairment.

Over three years later, in mid-2014, our client retained us as his representative. We quickly recognized that VA had failed to link our client’s acquired psychiatric disorder – manifested by symptoms of depression, anxiety, panic, trauma, mania, and psychosis, as well as cognitive and dementia symptoms, including impairments in concentration, memory, and following instruction – to his TBI, and therefore engaged an accomplished medical expert to establish that nexus. Notwithstanding our expert’s well-reasoned opinion, in November 2015, five years after the veteran filed his Substantive Appeal, the Board remanded his case for a VA examination to “determine the current extent and severity” of his TBI.

That VA examination then did not take place until June 2018. The examiner diagnosed TBI and post-traumatic headaches, and noted that the veteran’s cognitive facets were normal, except that he had mild short-term memory problems. The examiner opined that our client’s residuals of TBI included daily headaches, which were not prostrating, and dizziness or vertigo.

Based on this June 2018 VA examination, the Board, in November 2018, determined that our client was entitled to no more than a 10% rating. However, once again, neither his acquired psychiatric disorder nor his cognitive and dementia symptoms were mentioned in that decision. Accordingly, we appealed to the U.S. Court of Appeals for Veterans’ Claims, arguing that the Board had failed to account for the evidence needed to properly rate his TBI. And the Court agreed, issuing a Memorandum Decision in March 2020.

In November 2020, the Board once again remanded our client’s appeal for a rating in excess of 10%. Eventually, in September 2021, VA finally administered an examination not only establishing that the veteran’s acquired psychiatric and cognitive disorders were as likely as not a result of his TBI, but that they were totally disabling.

Accordingly, in a December 2021 decision, VA granted service connection for major neurocognitive disorders to include TBI, assigning an evaluation of 100%. However, VA continued to make mistakes, assigning an effective date of September 9, 2021, for this award – the date of VA’s most recent examination. After yet another Board remand, in June 2022, VA, in October 2022, finally assigned a 100% rating for his major neurocognitive disorder with TBI retroactive to March 7, 2005.

As one can see, this case is a model of frustration. At the outset, it took VA five years to award service connection for TBI. And once service-connected, VA inexplicably refused to acknowledge that our client’s psychiatric and cognitive symptoms developed because of his in-service TBI. Eleven years later, once VA finally did concede the nexus, VA massively short-changed him on the effective date.

In all, it took 17 years for VA to get it right. However, throughout the 8-years that we were his representative, we supported an understandably exacerbated client, preached patience, and, when necessary, zealously advocated on his behalf. In the end, our client was awarded a total of $525,756 in past-due benefits (less our fee), and, notwithstanding how long it took, today he is satisfied and extremely gracious for all our work and, perhaps more crucially, for standing by him through the years.

The veteran served on active service with the U.S. Army from December 1966 to November 1969.  The Board decision denied entitlement to TDIU.  The veteran retained our law firm to represent him before the U.S. Court of Appeals for Veterans Claims.

The veteran was in receipt of a 60-percent disability rating for residuals of status-post radical prostatectomy. He was also service-connected for anxiety disorder. The issue was whether or not the preponderance of the evidence showed that these disabilities rendered him unable to secure or follow an occupation of substantial gain.

We argued that contrary to the Board’s findings, the veteran’s age or duration of work did not cause him to “retire.” The Board, however, did note some lay and medical evidence suggesting that the reason for his leaving work it was his prostatectomy-related urinary problems. The evidenced indicated that our client did not just “retire.”  

In the litigation, we observed that the primary problem was the Board’s failure to appreciate the fact that the only medical evidence that considers the genitourinary residuals and anxiety problem and whether or not their aggregate effects preclude securing or following a non-marginal occupation is the favorable October 2010 private opinion from a nurse practitioner. Although the VA General Medical Examination report and the VA psychologist’s Mental Disorders Examination concluded that continued gainful employment was possible, neither opinion was based on the reality that two service-connected disabilities were for consideration. We raised this issue in the litigation in detail several times. Yet the Board continued to ignore these critical arguments. Buckley v. West, 12 Vet. App. 76, 83 (1998); Peyton v. Derwinski, 1 Vet. App. 282, 285-86 (1991).

We noted again that the VA physician said he could address TDIU “only as it relates to his service [-] connected prostate cancer.” Was argued that this was an explicit admission that the opinion was not also based on the psychiatric disability. Because the VA physician failed to consider the complete disability picture, his opinion was based on an inaccurate factual predicate. Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993). “[T]he central inquiry in determining whether a [V]eteran is entitled to a TDIU rating is whether that [V]eteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” 38 C.F.R. § 4.16(a); Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). We argued that the VA examiner’s failure to consider the full spectrum of employability effects attributable to the residuals of the prostatectomy and the psychiatric disability his opinion lacked sufficient detail and was not relevant to the TDIU inquiry. § 4.16(a); 38 C.F.R. §§ 4.1, 4.2; Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303-04 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007).

Accordingly, we successfully argued that the Board’s statement of reasons or bases was inadequate.

The veteran served on active duty from February 1967 to February 1970, including service in Vietnam.

The Board denied the entitlement to service connection for PTSD.  Following the Board’s denial, the veteran retained our firm to represent him before the U.S. Court of Appeals for Veteran’s Claims.

We argued that a remand was warranted for the PTSD claim for two reasons: (1) inadequate reasons and bases in failing to discuss medical evidence of PTSD; and (2) failure to fulfill the duty to assist in providing a medical exam.

We argued that under 38 U.S.C.A. § 7104(d)(1), a decision of the Board shall include a written statement of the Board’s findings and conclusions, and the reasons or bases for those findings and conclusions, on all material issues of fact and law presented on the record.  Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990).  Moreover, the Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005). 

In denying the veteran’s PTSD claim, the Board stated that “the medical records do not report a diagnosis of PTSD…”  The Board concluded: “Based on the absence of a current diagnosis of PTSD, and the multiple negative findings of PTSD, service connection for PTSD must be denied.”   

In rendering this conclusion, the Board failed to address evidence of record indicating a PTSD diagnosis.  By way of example, but not limitation, we noted a November 2004 Vet Center Intake Report that stated: “Veteran displays symptoms associated with chronic PTSD such as flashbacks; nightmares; intrusive thoughts; flattened affect; depression; anxiety; long-term memory impairment.”  The examiner further stated that “[p]oor judgment and insight interfere with his ability to think abstractly and to recover from PTSD.”  Moreover, Group Progress Notes from January 2005 reported that the veteran’s symptoms are consistent with PTSD, and with chronic PTSD.  In several other record citations, the veteran’s symptoms were noted to be consistent with PTSD.  
The argued that the Board’s decision contained not even a hint that it considered any of this evidence.  We observed that the Board is required to explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).  Here, the Board not only failed to adequately explain its rejection of the favorable evidence, it omitted the evidence entirely from consideration.  The Board focused on only the few pieces of negative evidence while ignoring the plethora of favorable evidence.  As such, its reasons and bases statement was clearly inadequate and a remand was required.

The veteran served on active duty from November 1970 to July 1971.  He was discharged from the service with an other than honorable discharge.  As such, the Board denied a claim for service connection for a psychiatric disability on the grounds that the veteran did not have qualifying service.  After receiving the final Board denial, the veteran retained our veterans benefits law firm to represent him before the U.S. Court of Appeals for Veterans Claims.

When the veteran first retained us, we determined that he was facing the denial of entitlement to service connection for a psychiatric disorder; and the propriety of the termination of his non-service-connected pension benefits on the basis of the character of his discharge from the active military service.

  The Board issued two decisions, dealing separately with the two issues.  However, the determinative issue in both decisions was the same, to wit: whether or not the veteran was insane (within the meaning of 38 C.F.R. § 3.354(a)) at the time of the alleged misconduct such that the character of discharge would not be a bar to benefits.  See 38 U.S.C. § 5303(b).  

The Board in the decision on appeal noted that in June 1971 the veteran’s commanding colonel recommended approval of an undesirable discharge and that a psychiatric report indicated that the veteran was responsible for his actions.  In the psychiatric report, medical corps physician opined that there was not sufficient evidence of psychoses to warrant a medical disposition, and he rendered a diagnosis of schizoid personality with features of emotional instability. The medical corps physician further opined that the veteran was capable of distinguishing right from wrong and was responsible for his actions.  

Accordingly, in discussing whether the veteran was insane at the time of the alleged misconduct, the Board ostensibly relied upon and adopted the 1971 opinion of the medical corps physician.  The Board concluded that the veteran was capable of distinguishing right from wrong, was responsible for his actions, and was not found to be insane at the time.  

The Board then made a brief reference to the March 2005 report of the veteran’s treating psychiatrist.  Our client’s treating psychiatrist was the Chief of the Mood Disorders Clinic at the VAMC.  The Board characterized treating doctor’s report as merely suggesting that the veteran’s discharge should be changed to a medical discharge due to major depression under honorable conditions.  The Board provided no further analysis of the reports of the treating doctor.

The Board then offered its own interpretation of the treating doctor’s report, suggesting it was being proffered to support the notion that the veteran had an excuse for his alleged misconduct. 

We argued that to the contrary, the report of the treating doctdor said much more than what the Board acknowledged in the decision on appeal.  In fact, the treating doctor, the Chief of the VA Mood Disorders Clinic, directly refuted the 1971 report of the medical corps physician upon which the Board relied in rendering its decision.  The treating doctor stated that what  the medical corps doctor described in his April 1971 report was not a personality disorder, but instead a worsening episode of major depression that would have responded to treatment.  The veteran’s treating doctor then stated: “In addition, the ‘improper behavior’ exhibited by [the veteran] while in the military was likely beyond his control due to his psychiatric illness and can also be attributed to his medical condition.”  Despite finding Dr. Sokolski more persuasive previously, the Board in the present decision ignored the conclusions and implications contained in Dr. Sokolski’s reports.   Instead, the Board essentially adopted the discredited 1971 report of Dr. Rubenstein, which was refuted by the Chief of the VA Mood Disorders Clinic—a doctor whom it previously found to be the most persuasive.  

The crux of our argument before the Court was that the medical corps opinions  relied upon by the Board contained opinions not relevant to a determination of insanity as defined by the VA regulations.  Specifically, the Board made note of the veteran’s allegedly knowing right from wrong and being responsible for his conduct.  However, we argued that in the case of Gardner v. Shinseki, the Court observed that whether a person knew right from wrong or was responsible for his behavior was not germane to a determination of insanity within the context of VA regulations.  

It is interesting to note that the Board in Gardner determined that there was no indication that Mr. Gardner’s behavior at the time of his misconduct resulted from any disease that placed his mental capacity beyond his control.  Similarly, in this case, we argued that the veteran’s treating doctor directly opined that the alleged misconduct was out of our client’s control due to mental illness.  The Court in Gardner also noted that it is error to rely on aspects of the Model Penal Code definition of insanity when determining insanity within the context of VA regulations.  

We successfully argued that the Board decision was in error due to its application of the wrong standard of insanity in a case involving an other than honorable discharge.

The veteran served on active duty from July 1952 to June 1954.

The Board denied service connection for the following issues: 

• Entitlement to service connection for chronic renal failure.
• Entitlement to service connection for a right knee disability to include as secondary to a service-connected right ankle disability.
• Entitlement to service connection for a right hip disability to include as secondary to a service-connected right ankle disability.

The veteran contended that his kidney/renal problems began during active duty.  The veteran discharged from active duty in June 1954.  On the day of his discharge exam, the veteran’s initial urine screen showed albumin in the urine.  The medical corps advised him to come back the next day for a re-check.  The veteran’s father and friend had traveled to meet him, and they were delayed in picking him up due to the holdover for a urine screen re-check.  The veteran underwent the recheck of his urine and it was negative. The Medical Corps men noted the recheck as being negative. The veteran eventually discharged and returned to civilian life. He suffered no problems for several decades following discharge. However comment in the early 1990s he developed kidney problems that eventually led to total kidney failure and a kidney transplant. He filed for service connection, claiming the kidney problem had its origins in active duty due to the protein in his urine during his discharge exam 45 years earlier.

To support his claim, he tracked down his old friend that was present at his discharge location in 1954 who provided a statement to support the veterans’ contentions that he was held over a day to have his urine re-checked.

Notwithstanding the arguments and evidence the veterans submitted, the Board denied the claim on the grounds that there was no evidence of in-service kidney problems.

The veteran did not know where to turn following the Board’s denial.  Eventually, he found our law firm and retained us to represent him before the U.S. Court of Appeals for Veterans Claims.  We litigated the case before the Court.

We understood the nature of the Board’s error.  The Board is required to consider all evidence of record and to address in its decision all potentially applicable provisions of law and regulation.  See 39 U.S.C.A. §7104(a); Weaver v. Principi, 14 Vet. App. 301, 302 (2001).

In this particular case, we argued that the Board failed to consider lay statements of the veteran and a buddy.  The veteran stated that his separation from service was delayed due to albumin in his urine.  In addition, the veteran submitted a buddy statement from a friend, who went to meet the veteran at the time of his discharge and who corroborates the veteran’s assertion that his discharge was delayed due to albumin in his urine.  .  

The veteran further explained that he had protein in his urine at the time of discharge but due to human error it was not properly recorded in his medical records.  He left Korea and sailed to San Francisco, and then took a train to Camp Kilmer, N.J.  He was met at Camp Kilmer by is father and his friend.  He had a physical the day before and was then told to come back the next day without eating to have his urine checked again because they had found protein in it the other day.  The veteran admits to not scrutinizing his discharge or medical records at the time, which presumably would have disclosed the error.  The veteran clearly stated that he was told by a medical examiner that he had protein in his urine.  The veteran states that this fact was never properly recorded in his medical records.  Finally, the lay evidence was also specifically raised by the veteran’s service representative. 

Notwithstanding, we saw that the Board’s decision lacked any discussion of the lay evidence.  Rather, the Board treated the lay evidence simply as part of the veteran’s contentions. Moreover, the Board rejected the medical opinions of the veterans’ private doctors in support of the claim because they were allegedly contradicted by the medical records, which appear to be negative for albumin or protein in the urine.  The Board notes that although the private doctors state that their reports are based on records showing protein in the urine during service, no such records were provided.  

Accordingly, the Board summarily rejected the veteran’s lay evidence, citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992).  The Board observed that the veteran is not competent to offer diagnoses or medical opinions regarding the cause of his condition.  It further opined that the veteran was not competent to say that he had albumin in his urine during service.   

In litigating the issue before the U.S. Court of Appeals for Veterans Claims, we did not dispute the citation to Espiritu for the proposition that a lay person is not competent to make a medical diagnosis or provide a medical opinion on etiology.  The veteran does, however, dispute the Board’s conclusion that he is not competent to testify that he had albumin in his urine.  

In this respect, we argued that the Court in Washington v. Nicholson, 19 Vet. App. 362 (2005) cautioned that the Board must consider the purpose for which the lay evidence is being introduced.  A careful reading of the lay statements showed that the veteran was merely relating a diagnosis told to him by a medical examiner.  In fact, the lay evidence indicated that his discharge was delayed a day and the stated reason for the delay was the protein in the urine. The lay evidence was not offered as a diagnosis or an opinion on etiology, but merely to relate something the veteran had first-hand knowledge of, to wit: what he heard a medical examiner tell him after a routine urinalysis.  

The etiologic issues were not in dispute.  Essentially, medical evidence of record indicates that there was a clear relationship between protein in the urine and his current condition.  It is also stated in the record that proteinuria is an early sign of kidney problems.  The veteran also submitted medical literature, which is of record, that states that early kidney disease is often diagnosed with protein in the urine.    

In addition, the VA exam reports found against an etiological relationship between service and the current condition because they claimed there was no evidence of medical or lab reports showing proteinuria or albuminuria in service.  The VA reports did not challenge the axiom that protein or albumin in the urine may be an early sign of kidney problems.  The VA examiners essentially concluded that since there were no medical records of protein or albumin in the urine in service, there is no nexus with service.

Therefore, the crux of the issue in this case was whether there were early symptoms in service of what was later diagnosed as chronic renal failure.  The veteran offered lay evidence that he was told by medical examiners that he had protein in his urine, which delayed his discharge.  He further contends that a mistake was made and this positive urine test result was improperly recorded in his records.             

On the other hand, the Board’s decision, and the opinions of the VA examiners, relied exclusively on the fact that the medical records did not contain a reference to protein in the urine.  (The veteran acknowledged that the lack of contemporaneous records may be a factor the Board can consider and which weighs against the veteran’s lay evidence.)

Our argument in this case focused on the proper usages of lay evidence.  We argued that the Board failed to consider the purpose of the lay evidence and improperly dismissed it as being a lay opinion on medical issues.  The Board decision in this case was basically saying that the lay evidence cannot be credible absent corroborating clinical records.  The Board’s decision did not address the competency of the lay evidence.  Rather, the Board’s decision made clear that it improperly determined that the lay statements lacked credibility simply because it was not corroborated by contemporaneous medical records.  See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  We argued that lay evidence may provide sufficient support for a claim of service connection, and it is error for the Board to require medical evidence to support that lay evidence.  Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993).  It is also error for the Board to treat lay testimony as merely part of the veteran’s contentions; it must explain its reasons for rejecting the testimony.  See Hatlestad v. Derwinski, 1 Vet. App. 164, 169-70 (1991).

Moreover, we argued that it was error to conclude that the veteran was not competent to testify as to a diagnosis told to him by a medical professional.  A witness must have personal knowledge in order to be competent to testify to a matter.  See Fed. R. Evid. 602.  (See Rucker v. Brown, 10 Vet. App. 67, 73 (1997)(noting that although the formal rules of evidence do not apply before the Board, reference to the Federal Rules of Evidence may be appropriate if it assists in articulating the reasons for a decision)).  Personal knowledge is that which comes to the witness through the use of his senses as opposed to their opinions or conclusions drawn from the facts.  United States v. Brown, 540 F.2d 1048, 1053 (10^th Cir. 1976) cert. denied, 429 U.S. 1100 (1977).   The veteran made clear that he was told and heard that he had protein in his urine, and as such he was merely reporting a contemporaneous medical diagnosis told to him by a medical examiner.  See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).  His lay evidence was not an etiological opinion or an attempt by a lay person to render a diagnosis.  Thus, we argued that the Board’s citation to Espiritu was misplaced on this point.

We successfully argued that there was simply no Board discussion of the lay evidence, either the veteran’s descriptions of what took place in June 1954 or the buddy statements. 

A remand was warranted based on the Board’s inadequate reasons or bases statement as well as notice violations.  In May 2004 the VA regional offices were directed to notify veterans of more specific information when filing reopened claims.  VA Fast Letter 04-08 (May 10, 2004).  VA must tell the veteran that in order to be deemed material, the additional evidence must pertain to the reason for the previous denial.  More importantly, in Kent v. Nicholson, 20 Vet. App. 1 (2006) the Court held that VA is required to review the bases for the previous denial and provide notice that would be necessary to substantiate the elements that were determined to be insufficient in the previous denial.  Id. at 10. 

In this case, the VA’s purported notice letters were all Kent deficient.  The Board acknowledged an April 2005 notice letter and also noted VA’s obligation pursuant to Kent.  The Board stated that the April 2005 letter “addressed some notice elements concerning his claims.”  [emphasis added]  Indeed, the April 2005 letter addressed “some” but not all of the required elements.  Neither the April 2005 letter nor any of VA’s other letters provided the necessary notice pursuant to Kent.  The Court decided Kent, of course, in 2006 and it is noteworthy that the record failed to contain any additional notice to the veteran subsequent to either VA Fast Letter 04-08 or Kent.

Specifically, the 2005 letter provided boilerplate language bereft of the specific notice required.  The VA stated in its letter: “Your claim was previously denied because the evidence submitted was not new and material to substantiate a finding of service connection.  Therefore, the evidence you submit must relate to this fact.”  Id.  The veteran argued that the VA used generalized language that is not consistent with Kent.  In addition, VA sent the veteran another letter in 2005, but it also provided merely generic information regarding new and material evidence.  Also, the 2004 VA letter simply advised the veteran that for evidence to be material it must pertain to the reason the claim was previously denied.  Otherwise, the September 2004 VA letter provided no further specific information.  The 2003 VA letter, moreover, failed to contain the required notice.  Similarly, the June 2000 VA letter stated generally that evidence not considered before is “new” and material means it applies to the specific issue the veteran is claiming.  Of course, all of the VA’s correspondence was prior to the Court’s decision in Kent, but it is noteworthy that these letters do not contain the information required.  However, subsequent to Kent, the VA issued an SOC in 2007, but it, too, contained only generic boilerplate information.  It failed to provide the specific notice required by Kent. 

Accordingly, the veteran argued that VA erred in failing to provide proper notice relative to his claim to reopen.  Moreover, the Board’s explanation of the notice issue is also deficient.  Although the Board cited to Kent, it provided no meaningful discussion of whether the notices, which VA issued prior Kent, actually complied with the Court’s decision.  The Board’s language suggested that the April 2005 letter provided only “some” of the notice elements, and failed to address that Kent was not decided until 2006 and there is no evidence that the VA sent any subsequent notice to the veteran following the Court’s decision in Kent.  Id.  Therefore, the Board’s explanation as to whether a Kent-compliant notice was sent was inadequate.  For these reasons, the veteran argued that a remand was warranted.

As to the merits of the claim, the Board’s reasons or bases statement was similarly inadequate.  In determining whether evidence is new and material for purposes of deciding whether a case should be reopened, “the credibility of the evidence is to be presumed.”  Fortuck v. Principi, 17 Vet. App. 173, 179 (2003) (citing Justus v. Principi, 3 Vet. App. 510, 513 (1992) (finding error because BVA – by appearing “skeptical” of statement – failed to presume credibility of statement prior to reopening stage)).  Only in cases in which the newly submitted evidence is “inherently false or untrue” does the Justus presumption of credibility not apply.  Duran v. Brown, 7 Vet. App. 216, 220 (1994). 

Here, the Board acknowledged that the veteran had an additional MRI and x-ray subsequent to the last rating decision that denied the claim.  For instance, the record reflects an MRI done in 2003, which documented the veteran’s right knee pathology.  The Board also acknowledged several of the private doctor’s recent reports that were submitted subsequent to the 2000 rating decision.  The Board noted the 2004 letter from the private doctor.  The private doctor stated that the right knee injury was due to the veteran’s service in the 1950s, and the doctor based his conclusion on the MRI and evaluation.

The 2000 rating decision, however, denied the claim because the medical conclusion submitted (meaning, the private doctor’s report) was uncorroborated by objective evidence of record and is speculative.  In other words, the VARO in June 2000 rejected the private doctor’s previous nexus opinion because it appeared to be predicated on the uncorroborated self-reported history of the veteran.  Id. 

On the other hand, subsequent to the June 2000 rating decision the veteran had additional radiographs in September 2003, and the private doctor offered a new nexus opinion this time predicating his opinion on recent radiographs.  As such, his March 2004 letter was a new opinion with a new predicate.  If the previous opinions were based on the lay history of the veteran, the private doctor’s new opinion was based on new radiographs. 

Instead of presuming the credibility of the private doctor’s letter the Board attenuated and appeared skeptical of his conclusions.  The Board stated that “[a]lthough the July 2000 and March 2004 letters reflect that [the private doctor] referred to additional findings from an MRI report and evaluation of the Veteran’s right knee to support his medical conclusion, they ultimately only contain cumulative evidence.”  If the prior reason for rejecting the private doctor’s opinion was due to his reliance on the veteran’s statements, then his reliance on MRI findings and an evaluation would appear to be a new basis for the opinion.  Therefore, this evidence would clearly be new in that it was a new basis for the opinion.  The Board discredited this evidence by saying that any MRI findings cited by the private doctor “were presumably already considered by him in his earlier medical statements.”  However, a review of the June 2000 rating decision suggests that VA considered the private doctor’s prior statements to be predicated solely on the uncorroborated lay history of the veteran—and thus the VARO’s rejection of the same.  Indeed, the   1999 letter from the private doctor indicates reliance on the veteran’s history as a basis for his conclusion.     The new evidence relies on a separate basis for the conclusion that was not previously proffered.  Therefore, the veteran argued that the Board impermissibly weighed the private doctor’s new statements rather than presuming their credibility.

On this issue of a private doctor’s reliance on the lay evidence, since the June 2000 rating decision, the CAVC and the Federal Circuit have decided several important and relevant cases that impact the veteran’s claim.  In Coburn v. Nicholson, 19 Vet. App. 427, 432 (2006), the Court held that a physician’s reliance on a veteran’s statement renders a medical report incredible only if the Board rejects the statements of the veteran.  Here, the VA has repeatedly rejected the opinions of the private doctor ostensibly because his nexus opinion was predicated on the lay history provided by the veteran.  Therefore, the CAVC’s decision in Coburn dramatically changes the analysis of the veteran’s claim.  Accordingly, the veteran argued that the Coburn decision has sufficiently liberalized the requirements for the veteran in this case such that the private doctor’s newly-submitted reports may carry new materiality given the constraints of Coburn.

In addition, the prior denial also, in essence, denied the claims because the veteran’s assertions regarding his in-service injury were not corroborated by the SMR’s.  Again, since the June 2000 rating decision, the Federal Circuit decided Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  It is improper for the Board to determine that the lay statements lack credibility simply because they were not corroborated by contemporaneous medical records.  See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  Lay evidence may provide sufficient support for a claim of service connection, and it is error for the Board to require medical evidence to support that lay evidence.  Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993). 

Accordingly, it is clear that the prior denial was also based on the alleged lack of corroborating service medical records.  Thus, the Federal Circuit’s issuance of the Buchanan decision makes it manifestly improper for VA to deny the claim solely on the grounds that the veteran’s assertions about is in-service injury are not corroborated by the SMR’s.  Thus, to the extent that the VA’s prior denials were predicated on the fact that the lay statements were insufficient absent confirmatory and contemporaneous SMR’s, the veteran submits that Buchanan would also alter the analysis of the materiality of the private doctor’s report. These arguments were presented to the Court.  Counsel for the Secretary opposed the veteran’s position.  The Court rendered a decision agreeing with the veteran’s position.  The Court overturned the Board’s decision and remanded the case for further adjudication.  On remand, VA granted service connection.

The facts of this case involve an in-service sexual assault.  In short, veteran stated that he was attacked and sexually assaulted during boot camp.  He explained that he did not report the rape to anyone at the time.  He observed that at the time, he was ashamed, horrified, and humiliated.  He believed that not telling anyone was the right thing to do.  Indeed, the VA C&P examiner confirmed that the veteran had not disclosed the nature of the attack to anyone due to profound shame.  Later, the veteran attempted to get away from the individual that had assaulted him.  And he made several excuses to try to get transferred.  The veteran was clear in his assertion that he got himself transferred by complaining about things other than the sexual assault.  The claims file corroborated the veteran’s multiple transfers to different occupational specialties.   

The VA provided the veteran with a C&P exam.  The VA examiner observed that the veteran never disclosed the nature of the attack to anyone.  Most importantly, the VA doctor opined that the veteran had PTSD related to the claimed in-service assault. 

The Board, nevertheless, denied the claim.  In this case, the applicable regulation is 38 C.F.R. § 3.304(f)(5).  This provision states, in relevant part:“If a posttraumatic stress disorder claim is based on in-service personal assault, evidence from sources other than the veteran’s service records may corroborate the veteran’s account of the stressor incident. . .  Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources.  Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment. . .”  38 C.F.R. § 3.304(f)(5) (emphasis supplied). 

The Board failed to account for the VA exam report within the context of its ability to corroborate the in-service stressor.  Until recently, the CAVC has held that a post-service psychiatric opinion could not be used to establish the occurrence of an in-service stressor.  See Cohen v. Brown, 10 Vet. App. 128, 145 (1997).  However, in Menegassi v. Shinseki, 638 F.3d 1379 (Fed. Cir. 2011), the Federal Circuit held that under 38 C.F.R. § 3.304(f)(5), medical opinion evidence may be submitted for use in determining whether the occurrence of a stressor is corroborated.  The Federal Circuit observed that section 3.304(f)(5) affords a veteran claiming PTSD from an in-service personal assault to submit evidence other than in-service medical records to corroborate the occurrence of a stressor. Id.  The Court noted that the regulation specifically designates that medical opinion evidence may be submitted. Id.  Therefore, the Federal Circuit held that the CAVC erred when it determined that a medical opinion based on a post-service examination of a veteran cannot be used to establish the occurrence of a stressor.  Id. 

In this case, the VA examiner opined that the veteran had PTSD related to the claimed in-service stressor.  The Board apparently dispensed with the analysis of the VA exam report on the grounds that it did not find the stressor credible.  By doing so, it violated the Federal Circuit’s ruling in Menegassi.  The Board should have weighed the VA examiner’s opinion when assessing the overall credibility of the claimed stressor.  Its failure in this regard constituted grounds for a remand.

When deciding an appeal, the BVA is required to consider all applicable provisions of law, and to provide an adequate statement of reasons or bases for its decision to enable a claimant to understand the precise basis for the decision, and also to facilitate review by the Court.  See 38 U.S.C. § 7104(a), (d)(1); Weaver v. Principi, 14 Vet. App. 301, 302 (2001) (per curiam order); Allday v. Brown, 7 Vet. App. 517, 527 (1995); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1991).  The Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 20 Vet. App. 188, 193 (2005). 

In this case, the Board noted the veteran’s contentions that he injured his cervical and lumbar spine in service.  However, the Board stated that the SMRs were negative for treatment or complaints relative to the neck or back.  Id.  Moreover, the Board found the nexus opinion of private doctor to be based on speculation in that there was allegedly no indication of a back or neck injury in service.  Further, the Board found the veteran’s statements unreliable and incredible.  It also stated that the veteran is not competent to render an etiological opinion and that there was no competent evidence to indicate that the neck and back problems were related to service. 

Although the Board discounted the statements of the veteran, the Board failed to mention the affidavit of his ex-wife, who was also a nurse.   She indicated that she had personal knowledge of the veteran’s injury to his neck and back in the 1980s, which immobilized him for periods of time.  She stated that as a nurse she provided treatment for his back condition.    Accordingly, if he was receiving treatment at home from his wife the nurse, this explained the absence of complaints in the service medical records.  In either case, the ex-wife’s affidavit was highly probative in that it presented information from an individual with personal knowledge of the facts at the time of the injury and it is from someone who is not merely a medical lay person.  See Cox v. Nicholson, 20 Vet. App. 563 (2007).  Essentially, the veteran submitted evidence from a medical professional who indicated that she treated the veteran for his spine condition in the 1980s and the Board made no mention of this evidence in its decision.  Again, the Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 20 Vet. App. 188, 193 (2005).  Here, the Board completely failed to address this evidence, and a remand was warranted.

The VA examiner who performed a VA examination on the veteran failed to review to the veteran’s claims file.  Although a medical examiner’s failure to review the claims file does not alone preclude her becoming aware of the relevant facts—sometimes claims file review is not even relevant to the medical issue(s)—the veteran argued that the consequences in this case were not innocuous. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 303 (2008).

In Nieves-Rodriguez, the Court noted that an examiner may become aware of the critical medical facts from means other than claims file review: an accurate medical history; review of pertinent medical literature; treating the claimant for an extended period of time. Nieves-Rodriguez, 22 Vet. App. at 303. Absent a review of pertinent medical literature and extended treatment of the claimant, though, an accurate medical history depends to a very large degree on a claims file review. The ultimate question is, in forming her expert opinion, what would the examiner learn from reviewing the claims file? Id. A VA examination report must contain sufficient detail; the failure to appreciate particular medical information in the claims file critical to medically valid, well-reasoned factual premises results in factual premises that are not accurate and an opinion that cannot receive any probative value. 38 C.F.R. §§ 4.1, 4.10; Nieves-Rodriguez, 22 Vet. App. at 304; Reonal v. Brown, 5 Vet. App. 458, 461 (1993); Jones v. Shinseki, 23 Vet. App. 382, 390 (2010).

But the VA examination report in this case contained only facts and conclusions. Nieves-Rodriguez, 22 Vet. App. at 304; (R. at (78-85)). And the facts that it does contain were not sufficient to familiarize the examiner with the medical information necessary for him to form an expert opinion. He did not review medical literature relating to fibromyalgia; he examined the veteran for a couple of hours only.

Had the VA examiner reviewed the veterans claims file he would have discussed a favorable medical opinion from a private doctor.

The issue in this case was not the Board’s determination that the evidence of record does not show a continuity of symptomatology; indeed, the veteran recognized that, at minimum, a twenty-year gap exists between his separation and his diagnosis of fibromyalgia. 38 C.F.R. § 3.303(b).  Rather, the core issue was the Board’s failure to provide adequate reasons or bases for deferring to the inadequate VA examination report; the Board was in no position to render a conclusion on whether the veteran’s symptoms of fibromyalgia have been continuous. 38 C.F.R. § 4.2; Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Furthermore, the Board committed clear error in finding that during the appeals period he was not diagnosed with fibromyalgia.  

Where the Board adopts as its own a VA examination that fails to discuss medical evidence favorable to the claimant the Board falls short of its responsibility to analyze the credibility and probative value of all material evidence and account for the evidence it finds persuasive or unpersuasive. Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). Medical evidence too speculative to establish the requisite nexus also is not sufficient to establish the absence of the nexus. McLendon v. Nicholson, 20 Vet. App. 79, 85 (2006) (citing Forshey v. Principi, 284 F.3d 1335, 1363 (Fed. Cir. 2002) (Mayer, J., dissenting)). The Court has made clear that a VA examination report is not speculative:

When an examiner has done all that reasonably should be done to become informed about a case . . . and the inability to render a requested opinion is adequately explained by the examiner or otherwise apparent in the Board’s review of the evidence.

Jones v. Shinseki, 23 Vet. App. 382, 391 (2010).

But in this case the VA examiner did not do all that reasonably should have been done to become informed about the case. As stated above, the VA examiner provided an opinion that lacked a foundation based upon the necessary facts and significant medical history 38 C.F.R. §§ 4.1, 4.2; Nieves-Rodriguez, 22 Vet. App. at 303-04. His statement that questions surround the medical predicate for any diagnosis of chronic pain syndrome is conclusory, unenhanced by any medical comment, and, therefore, is not competent medical evidence. Howell v. Nicholson, 19 Vet. App. 535, 539 (2006); McLendon, 20 Vet. App. at 85.

As indicated above, the Board’s assertion that even assuming that the veteran did suffer from fibromyalgia the evidence does not reflect continuity of symptomatology was simply premature.  Although it was determined that the veteran’s lay statements as to the continuity of his symptoms were not credible the Board did not discuss whether the favorable medical opinions were persuasive. Gabrielson, 7 Vet. App. at 40. Stated differently, the Board’s finding about continuity of symptomatology was directly related to the probative value assigned to the VA examination. But because the VA examiner and the Board failed to acknowledge and reconcile the prior opinions that provided a favorable medical etiology for the veteran’s fibromyalgia the Board failed to supply adequate reasons or bases to explain why it rejected—or at least ignored—these opinions. 38 U.S.C. § 7104(d)(1); Caluza v. Brown, 7 Vet. App. 498, 506 (1995). The Board’s error in not basing its decision on all of the evidence of record prejudiced the veteran.

Next, the Board provided an inadequate statement of reasons or bases with respect to the duty to provide a medical examination. The Board acknowledged the viability of establishing service-connection by showing a nexus with service.  But the Board’s discussion reflected the absence of an adequate medical nexus opinion.  The Board simply stated that the lay evidence on etiology carried less probative weight than the “clinical findings”. The Board did not further discuss the putative “clinical findings” or the existence of any medical opinions that provided affirmative negative evidence against the claim. 

Indeed, the Board’s reasons or bases relative to the duty to assist is conspicuously bereft of any discussion of the need for a medical examination.  The Board merely concluded that VA had obtained private and VA treatment records, and that the evidence of record was sufficient to evaluate the veteran’s claims.  The Board concluded that no further assistance was required.

The elements that trigger VA’s duty to provide a medical exam are well known. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). Briefly, in this case there was a well-documented in-service accident.  Accordingly, there was an in-service event (element one). McLendon, 20 Vet. App. at 81. Further, as noted above, there is, at the very least, evidence of recurrent symptoms of a disability.  Thus, the second element is satisfied. It should be noted that the Board’s adoption of the VA pension examination report exacerbated the McLendon problem because it caused the Board to overlook the evidence of a current diagnosis or the recurrent symptoms of a disability. Finally, with respect to the third and final element, the Court has stated that the types of evidence that “indicate” that a current disability “may be associated” with service include, but are not limited to, credible lay evidence of observable continuity of symptomatology. McLendon, 20 Vet. App. at 83.

With respect to element three, the veteran noted that the Board failed to consider and discuss the credibility of his family members’ lay statements. Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006). The Board’s failure to consider the credibility of relevant lay testimony has embarrassed its ability to render an appropriate McLendon analysis.  In sum, VA provided the VA examination for non-service-connected pension purposes. Accordingly, it is not surprising that the report did not contain a relevant etiological analysis. But had the Board considered all the evidence of record—including evidence of a current disability and lay evidence of continuity of symptomatology—it would have been compelled to provide the appropriate McLendon analysis. Unfortunately, the Board’s decision with respect to the duty to provide a medical examination was not amenable to judicial review because it failed to address VA’s duty under McLendon.  For these reasons, a remand was warranted.

Service medical records documented a persistent, dry, hacking cough, chest pain, and shortness of breath.  In December 2004 the veteran filed his claim for a “persistent cough leading to sarcoidosis”.  The medical evidence, however, demonstrated the existence of mild to moderate bronchioectasis involving the posterior aspect of the right upper lobe.  In March 2004 a private physician opined that the veteran’s bilateral bronchioectasis can be seen as related to bouts of prior infection, sarcoidosis and bronchiolitis.  Moreover, a radiologist in January 2004 diagnosed mild upper lobe interstitial disease.  The records also show a post-service diagnosis of sarcoidosis.  Under 38 C.F.R. § 4.97 restrictive lung disease includes sarcoidosis (DC 6846), and interstitial lung disease does not. 

In December 2008 a VA physician examined the veteran and provided a report.  However, the VA physician did not render an etiological opinion.  Subsequently, VA obtained another opinion in June 2009.  The VA examiner opined that the veteran’s current restrictive lung disease diagnosed as sarcoidosis was not related to the lung condition diagnosed during service because x-rays taken at that time did not show hilar adenopathy or diffuse reticulonodular changes..  The examiner did not render an etiological opinion on the interstitial lung disease or the bronchioectasis. 

A remand was required based on the Board’s inadequate statement of reasons or bases.  The Board failed to consider all possible claims raised by the evidence of record and for violations relative to Clemons v. Shinseki, 23 Vet. App. 1 (2009).  The VA has a duty to “determine all potential claims raised by the evidence, applying all relevant laws and regulations.”  Roberson v. Principi, 251 F.3d 1378, 1384 (Fed. Cir. 2001).  The VA must adjudicate all claims reasonably raised by the record.  See Andrews v. Nicholson, 421 F.3d 1278, 1282 (Fed. Cir. 2005).   

Here, it was clear that the veteran originally asserted his claim for a “persistent cough leading to sarcoidosis.”  It is also clear that his lung problems (which arguably are encompassed by a “persistent cough”) include interstitial lung disease and bronchioectasis.   In his October 2009 statement in support of the claim the veteran asserted a claim pursuant to 38 C.F.R. § 3.309(a) indicating that he was submitting proof regarding sarcoidosis and bronchioectasis.  Furthermore, the veteran provided an extensive discussion of bronchioectasis.  Accordingly, the veteran’s submissions, when read liberally, indicated that his claim broadly included any diagnosed lung condition that may be responsible for his persistent cough.  In determining all potential claims, VA must consider the reasonable expectations of a pro se claimant and must address whether the “appellant’s submissions in toto, have articulated a claim.”  Ingram v. Nicholson, 21 Vet. App. 232, 255-56 (2007). 

The Board narrowly defined the claim as being one solely for sarcoidosis.  The Board concluded that service connection was not warranted for sarcoidosis because the condition was not diagnosed in service or within one year thereafter, and the Board adopted the June 2009 VA examiner’s opinion that the sarcoidosis was not present in service and did not develop until post-service.  The Board did not otherwise consider the other diagnosed lung conditions.  The VA is to “fully and sympathetically develop the veteran’s claim to its optimum before deciding it on the merits.”  Hodge v. West, 155 F.3d 1356, 1362-63 (Fed. Cir. 1998).  Developing a claim to its optimum means applying all relevant law and regulation raised by the evidence regardless of how the claim is identified.  Norris v. West, 12 Vet. App. 413, 420 (1999).  Here, the veteran’s original claim was phrased broadly enough to encompass any lung disability associated with a persistent cough.  Moreover, his October 2009 statement in support of the claim impliedly indicated bronchioectasis was also part of his lung disability for which he was seeking benefits.

Accordingly, the Board’s decision did not contain a reasons or bases statement as to why it did not consider service connection for bronchioectasis or interstitial lung disease.  This is particularly problematic because one physician opined that the bilateral bronchioectasis could have been related toprior infection.  Here, the veteran had a persistent cough in the service.  As such, the question is raised as to whether the persistent cough in the service was the “prior infection” that resulted in the current diagnosis of bronchioectasis.  Moreover, the evidence shows at least two separate lung conditions: sarcoidosis and bronchioectasis.  The June 2009 VA examiner rendered an etiological opinion only as to the restrictive lung disease, which includes sarcoidosis.  He did not address the interstitial lung disease and bronchioectasis.  The examiner opined that the sarcoidosis was not related to the lung condition diagnosed during service.  But the VA examiner did not answer the fundamental question of whether the lung condition observed during service as a persistent, dry, hacking cough was bronchioectasis. 

In light of this evidence, the veteran argued that the Board erred in not addressing his entitlement to service connection based on DC 6601.  Although the Court reviews the selection of a diagnostic code (DC) under the arbitrary and capricious standard of review, see Butts v. Brown, 5 Vet. App. 532, 539 (1993) (en banc) (selection of a DC is a question of application of law to facts and is subject to Court review under the arbitrary-and-capricious standard), the Board is required to provide an adequate statement of reasons or bases for its selection.  See Suttman v. Brown, 5 Vet. App. 127, 133 (1993).  The Board did not address why it confined its analysis to only sarcoidosis.  The Board must “adjudicate all issues reasonably raised by a liberal reading of the appellant’s substantive appeal, including all documents and oral testimony in the record prior to the Board’s decision.”  Solomon v. Brown, 6 Vet. App. 396, 402 (1994)

Accordingly, the veteran submits that his claim should have included all diagnosed lung conditions related to his persistent cough.  Because the Board failed to address bronchioectasis as part of this claim, a remand is required.  For these reasons, a remand was warranted.

Argument: The Board’s conclusion that a medical examination is not necessary—an application of law to the facts—is reviewed under the arbitrary, capricious, abuse of discretion, or otherwise not in accordance with law standard of review. 38 U.S.C. § 7261(a)(3)(A); Marrero v. Gober, 14 Vet. App. 80, 81 (2000). But, in this case, the veteran argues that the Board’s reasons or bases as to why the duty to assist to provide a medical examination has not been triggered are not adequate. 38 U.S.C. §§ 5103A(d), 7104(d)(1); 38 C.F.R. § 3.159(c)(4); (R. at 8-9 (3-27)). Reasons-or-bases type errors are reviewed under the clearly erroneous standard of review. § 7261(a)(4); see Gilbert v. Derwinski, 1 Vet. App. 49, 52 (1990; Anderson v. City of Bessemer City, 470 U.S. 564, 573-74, 105 S.Ct. 1504, 1511 (1985; Locklear v. Nicholson, 20 Vet. App. 410, 413 (2006 (quoting United States v. U.S. Gypsum Co., 333 U.S. 364, 395 (1948) (“A factual finding is clearly erroneous ‘when although there is evidence to support it, the reviewing court on the entire evidence is left with a definite and firm conviction that a mistake has been committed.’; Padgett v. Nicholson, 19 Vet. App. 133, 147 (en banc) (“[T]he existence of some controverting evidence (that is, evidence that is not in the appellant’s favor) does not preclude this Court from carrying out the mandates [that it] ‘review the record of proceedings before the Secretary and the Board’ and then to ‘take due account of the Secretary’s application of’ . . . [the] benefit-of-the-doubt rule . . .) (internal citations omitted).

Here, the Board acknowledged that the record contains competent evidence that the veteran suffers from each of the claimed disabilities. See McLendon, 20 Vet. App. at 81-82. He in fact suffers from hypertension.

It should not be disputed that the second element for entitlement to a medical examination is satisfied, too. § 3.159(c)(4)(i)(B); Id. at 82. Several in-service blood-pressure readings appear to be elevated.  E.g. (130/80 mm/Hg), (140/100 mm/Hg), (138/96 mm/Hg), (130/78 mm/Hg), (116/78 mm/Hg), (136/84 mm/Hg), (140/90 mm/Hg). For a one-week period in 1972 the Army performed daily blood-pressure checks.  Although the one-week results were within normal limits this does not change the fact that numerous other readings were elevated.  Further, unlike in McLendon, in this case the evidence of an in-service “event, injury, or disease” is medical in nature—it is not contingent on the veteran’s credibility. Id. at 82. The Board’s conclusion that his STRs “do not show any diagnosis or treatment for hypertension” is without reasons or bases and does not address the conflicting nature of the in-service blood-pressure readings. 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet. App. 517, 527 (1995) (noting that the Board’s reasons-or-bases statements must explain the precise basis for its decision). So, even though some evidence controverts his position—for a very short period of his active-duty time blood-pressure readings appeared to be normal—a finding of clear error here is not precluded. See e.g. Padgett, 19 Vet. App. at 147; Locklear, 20 Vet. App. at 413. Whether during his service Mr. Bates suffered from hypertension is an issue material to the determination of the issue of entitlement to a medical examination and, not only should the Board have considered the benefit-of-the-doubt doctrine but also its focus on only one part of the evidence—a single STR that notes that blood-pressure readings were within normal limits—results in an unsubstantiated medical conclusion. 38 U.S.C. § 5107(d)(1); Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Indeed, other STRs refute the Board’s implicit finding that the absence of a contemporaneous, in-service diagnosis of hypertension indicates that he did not suffer from the disease. Contrary to the Board’s very terse analysis in this regard, the very same medical evidence that it references—STRs—establishes the actual existence of in-service evidence of high blood pressure. C.f. Buczynski v. Shinseki, 24 Vet. App. 221, 224 (2011) (citing Forshey v. Principi, 284 F.3d 1335, 1363 (Fed. Cir. 2002) (en banc) (noting that the absence of actual evidence does not establish substantive negative evidence); Santiago v. Brown, 5 Vet. App. 288, 292-93 (1993). Any reconciliation of these critical pieces of medical evidence would be best left to a licensed physician.

Also, the Board failed to render a specific determination as to whether there exists sufficient competent medical evidence to make a decision in the first. § 3.159(c)(4)(i); Id. at 84-85; (R. at (3-27)). A finding that there is no competent evidence that links to the veteran’s service his present hypertension—even if correct—is not the same as a finding that the record does not contain sufficient competent medical evidence to make a decision on the claims.  It is noteworthy too that, under McLendon, the fact that the veteran’s STRs do not mention specific complaints of hypertension does not establish the absence of a medical nexus. McLendon, 20 Vet. App. at 83.

So, the final issue concerns whether the evidence “indicates” that a disability, or its persistent or recurrent symptoms, “may” be associated with the veteran’s service. § 3.159(c)(4)(i)(C); McLendon, 20 Vet. App. at 83. The evidence need only “indicate” that symptoms of a disability—rather than a diagnosed disability—may be associated with service. Id. (citing Duenas v. Principi, 18 Vet. App. 512, 517-18 (2004)).

Under the contemporary domain of medical science, the veteran’s hypertension, along with diabetes mellitus, and obesity constitute the “insulin resistance,” or “metabolic” syndrome.[1] Here, to begin, the Board’s decision does not contain a proper application of the indicate / may-be-associated standard—the Board’s standard is much too high. As noted above, for each of the three claims the Board determined only that the record does not contain evidence “competent” to link to his active service any of the disabilities.  Section 3.159(c)(4) envisions a much lower threshold. Id.

Nonetheless, the veteran argues that, if it is suggested that the Board’s decision contains an implicit finding that the evidence does not indicate the requisite etiological link, the decision remains bereft of any reasons or bases for such a conclusion. See Dennis v. Nicholson, 21 Vet. App. 18, 22 (2007) (affirming that a mere listing of the evidence does not amount to an adequate statement of reasons or bases). In McLendon, the Court stated:

The types of evidence that ‘indicate’ that a current disability ‘may be associated’ with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology such as pain or other symptoms capable of lay observation.

Id.

Here, as noted above, STRs indeed “indicate” the occurrence of the interrelated symptoms of shortness of breath and sinus congestion when lying down at night. Numerous STRs also indicate elevated blood pressure. And STRs too indicate the onset of obesity that only worsened. It is noteworthy that the Board did not address the credibility of the veteran’s sworn testimony that during the late 1980s he received private treatment for hypertension. As such, the Board failed to address the reasons for the tacit rejection of this favorable lay evidence. Lathan v. Brown, 7 Vet. App. 359, 367 (1995); (R. at (3-27)). The same argument applies with respect to the STRs that document elevated blood pressure.

For these reasons, a remand was warranted.

[1] See M. Ip et al., Obstructive Sleep Apnea is Independently Associated with Insulin Resistance, 165 AM. J. RESPIR CRIT CARE MED 670, 670-76 (2002) (noting that known factors for this syndrome include OSA, hypertension, insulin resistance, and obesity, among others).

The Board conceded that the presumption of soundness attached to this particular case. 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b); (R. at 25 (3-29)). To rebut this presumption, the Board held that the Veteran’s consistent, reported history of pre-service depression and sleep problems alone “constitutes significant evidence which weighs heavily towards a finding” that he had a pre-service psychiatric condition.  The Board did not reference any VA medical examination reports or other opinions.  But medical history alone does not constitute clear and unmistakable evidence that a current medical condition existed pre-service. Crowe v. Brown, 7 Vet. App. 238, 246 (1994). Such a determination requires independent medical evidence. Crowe, 7 Vet. App. at 246 (citing § 3.304(b)(1)-(2)); Adams v. West, 13 Vet. App. 453, 456 (2000). In addition, the standard under § 3.304(b) is clear and unmistakable evidence—not “significant” evidence.  § 3.304(b). Here, the Board simply concluded that the Veteran’s self-reported history alone conclusively showed that prior to his service he suffered from a psychiatric condition, and this was error. Here, the Board failed to provide reasons or bases in determining that clear and unmistakable evidence rebuts the presumption of sound condition. Crowe, 7 Vet. App. at 246. Therefore, a remand is warranted.

For these reasons, a remand is warranted.

The veteran served on active duty during the Vietnam War.  The evidence of record indicated that he served in Operation Frequent Wind and Operation Eagle Pull in 1975.  The evidence revealed that these operations involved the evacuation of Saigon.  The evidence indicated that there was some ground fire during these operations. 

The veteran was diagnosed on several occasions with chronic PTSD.  The veteran indicated that his stressors included, among other things, his activities related to his battalion landing team activity.  The veteran also stated that he heard rockets while in Vietnam that seemed to remind him that he could be killed.  Indeed, the evidence of record contained published eye-witness accounts regarding the final days before the fall of Saigon, which corroborated that shells and rockets pounded the outskirts of the city.  The veteran further stated that his impressions upon arriving in Vietnam were that he would not go back home alive.  In considering these statements from the veteran, as well as others, the Vet Center diagnosed the veteran with PTSD in accordance with the DSM-IV.  In this regard, the Board conceded that the veteran’s statements could be construed as fear of hostile military takeover. 

The Board ostensibly denied the veteran’s claim for lack of a verifiable PTSD stressor.  Similarly, the Board observed that a VA exam was not provided for PTSD because the veteran has not provided proof of a verifiable PTSD stressor and “an examination would not aid in substantiating his claim.”

Interestingly, in acknowledging that the veteran’s statements may be construed as fear of a hostile military takeover, the Board stated that VA examiners have not confirmed that this would be adequate to support a diagnosis of PTSD and related that diagnosis to service. 

The Board’s decision on the duty to assist to provide an exam is problematic.  Under the new PTSD regulation, a veteran does not necessarily have to prove a verifiable stressor.  See 38 § C.F.R. 3.304(f)(3).  Thus, if the veteran had fear of hostile military or terrorist activity, and a VA psychologist or psychiatrist confirms that this is sufficient to support a PTSD diagnosis, then his statements alone can establish the stressor.  Here, the VA’s rationale for not providing an exam is based solely on his inability to corroborate a stressor—but yet it appeared to acknowledge that his statements evidenced fear of a hostile military takeover.  Under section 3.304(f) only a VA psychiatrist or psychologist can address the issue of PTSD in the context of fear of hostile military or terrorist activity.  Accordingly, there is a reasonable possibility of substantiating the claim if an exam was provided.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006). 

Phrased differently, the Board is essentially saying that it does not need to provide an exam because the veteran has not proven a stressor.  But yet the Board will not consider service connection under 38 § C.F.R. 3.304(f)(3) because no VA examiner has confirmed the sufficiency of the stressor and related it to service.  How is the veteran supposed to get such a VA exam unless the VA provides it?  In sum, given the evidence of the veteran’s time, place, and circumstances of service, he was likely exposed to events that could make one fearful of hostile military or terrorist activity.  Therefore, there is a reasonable possibility of substantiating the claim, and the Board erred in not providing an exam.

Given the evidence of potential fear of hostile activity while in Vietnam and the DSM-IV diagnosis of PTSD, the Board should have provided a more understandable statement of reasons or bases for its determination that no VA exam was required.  Although the alleged lack of a verifiable stressor may be sufficient to decline a VA exam prior to July 13, 2010, the veteran submits that the new regulation would require a more substantive consideration of the duty to provide an exam within the context of 38 § C.F.R. 3.304(f)(3).  The Board cannot conclude that an exam is not required because he has not proven a stressor when the new regulation provides an exception to that requirement, which can only be satisfied by a VA examiner.  See 38 § C.F.R. 3.304(f)(3).  A remand was therefore required.

38 C.F.R. § 3.321(b) provides for an extraschedular rating if there is an exceptional or unusual disability picture with “such related factors as marked interference with employment or frequent periods of hospitalization.”  See 38 C.F.R. § 3.321(b).  Extraschedular rating consideration is a part of an appellant’s claim for an increased rating. See   Bagwell v. Brown,   9 Vet. App. 337, 339 (1996).

In this particular case, the Board failed to apply the proper three-step analysis in analyzing the extraschedular consideration issue.  First, there must be a comparison between the level of disability and the established criteria found in the rating schedule to determine if the veteran’s disability picture is adequately contemplated by the rating schedule.  Thun v. Peake, 22 Vet. App. 111 (2008).  If not, the second step is to determine whether the claimant’s exceptional disability picture exhibits other related factors identified in the regulations as “governing norms”.  Id.; see also 38 C.F.R. § 3.321(b) (governing norms included marked interference with employment).   

In the present case, the Board offered a conclusory analysis and overlooked substantial evidence that demonstrates the veteran’s disability picture is far more severe than that which is contemplated by the present 30 percent rating.  The Board stated:

In this case, there is no showing that the veteran’s service-connected disability presents such an exceptional or unusual disability picture so as to warrant the assignment of a disability rating on an extraschedular basis.

The Board further stated that the “degree of disability specified under the rating schedule is generally adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability.”  The Board decision clearly failed to analyze this case according to the criteria set forth in the recent Thun case (which was decided several months prior to the issuance of the present Board decision). 

In addition, the Board failed to address the substantial evidence of marked interference with the veteran’s employment.  Id.  Under 38 U.S.C.A. § 7104(d)(1), a decision of the Board shall include a written statement of the Board’s findings and conclusions, and the reasons or bases for those findings and conclusions, on all material issues of fact and law presented on the record.  Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990).  Moreover, the Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).

Here, the evidence shows unambiguously that the veteran is totally unemployable—not merely suffering from frequent absences due to exacerbations, etc.  The veteran provided lay statements that he was terminated from his job because of the service-connected disorder.  He further explicitly stated that VA failed to consider his discharge from employment in his evaluation.  He also states that between 1970 and 1990 has had to leave several jobs due to the service-connected problem.  One of the veteran’s doctors opined that the disability is aggravated by any form of work causing repeated trauma.  Furthermore, the veteran’s lay statements are corroborated by his employer’s personnel records. 

The evidence also shows that the veteran is a mechanic by training.  The disability also affects his hands, which, according to the VA doctor, causes him pain.  Moreover, in his NOD, the veteran specifically made light of the VA’s conclusion that there was no marked interference with employment.  He stated that his employment records show that he has been employed less than 5 years in the 33 years since discharge as a result of the service-connected disability.    Again, the veteran’s assertions are supported by medical opinions.  In December 1975 a private doctor opined that the veteran’s service-connected disabilities prevent him from pursuing his career.  In January 1976 the doctors recommended that the veteran not pursue a program leading to further career advancement.        

All of the aforesaid evidence was absent from the Board’s analysis (with the possible exception of a casual reference to January 1976 letters from private doctors recommending employment limitations The Board’s analysis implied that the veteran’s impaired employment consisted of frequent absences or diminished income opportunities.   However, the evidence shows a disability picture of total occupational incapacity, which is predicated on more than merely the veteran’s statements.  The evidence contains doctor’s reports recommending against employment, official correspondence from the veteran’s employer stating he was being terminated due to the service-connected disability, and evidence of the veteran’s occupation as a mechanic which requires the ability to stand on his feet and use his hands, both of which are precluded due to the service-connected disability.  Accordingly, it is clear that Board failed to address the substantial evidence in favor of marked interference with employment (being employed less than 5 out of 33 years since discharge), and his unique occupation and its requirements.  The Board ostensibly concluded that there was an absence of exceptional factors warranting extraschedular consideration.  Yet, in rendering this conclusion, the Board failed to explain its rejection of the favorable evidence.  See Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).  Accordingly, a remand was warranted.

A remand is warranted was to a left elbow disability based on the Board’s inadequate reasons or bases.  Under 38 U.S.C.A. § 7104(d)(1), a decision of the Board shall include a written statement of the Board’s findings and conclusions, and the reasons or bases for those findings and conclusions, on all material issues of fact and law presented on the record.  Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990).  Moreover, the Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).

            With respect to the left elbow, the Board conceded that the veteran does suffer from olecranon bursitis with a bone spur on the left elbow.  It also conceded that he had in-service treatment for an injury to the left elbow.  However, as to the element of a nexus with service, the Board stated: “More importantly, there is no competent medical evidence that any left elbow arthritis or bursitis was in any way related to the in-service treatment.”  The Board further emphasized unequivocally that the record does not contain any clinical evidence that would tend to suggest that a chronic left elbow disability was incurred during military service.  The Board then cites the VA medical opinion of record that was not favorable to the veteran’s claim.

            Notwithstanding the Board’s assertions in this regard, the evidence of record did contain a favorable nexus opinion as to the left elbow.  Records from a private physician discussed the veteran’s problems with his left elbow.  The record then stated, with respect to the elbow, that “this is more likely than not due to Marine Corps service; mostly due to sighting a rifle (was a marksman tutor).” 

            Despite the presence of this favorable opinion in the record, there is no indication that the Board addressed this evidence in its decision.  In fact, the Board only discussed the unfavorable October 2006 VA exam report.  As noted above, the Board must explain its rejection of material evidence supporting the claim.  See Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).  There is absolutely no discussion of the favorable nexus opinion; the Board addressed only the negative opinion, and then broadly stated that that the record contained no medical evidence of a nexus.  The Board’s statements are clearly erroneous and its reasons or bases statement is inadequate for failing to address all material evidence of record.  See Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990).  Accordingly, a remand as to the left elbow issue was warranted.

The Board is required to consider all evidence of record and to address in its decision all potentially applicable provisions of law and regulation.  See 39 U.S.C.A. §7104(a); Weaver v. Principi, 14 Vet. App. 301, 302 (2001).  By its very nature, this requires consideration of lay evidence.  Moreover, 38 C.F.R. § 3.303(a) specifically references consideration of lay evidence.  See Gutierrez v. Principi, 19 Vet. App. 1 (2004).   

In addition, the Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 188, 193 (2005).  In this particular case, the veteran presented lay evidence of his in-service injury.  The veteran stated that he hurt his back while working on an engine in an aircraft.  The veteran stated that as a result of the in-service injury, he was off work for a week and was treated on an outpatient basis.  He indicated that this happened during the time period from 1982 to 1985.

The Board provided virtually no analysis of the veteran’s lay statements.  Essentially, the Board stated that there was no evidence, other than the veteran’s statements, to support the conclusion that the veteran suffered an in-service back injury.  Where was the analysis of the credibility of the lay evidence?  The veteran is not competent to render an etiologic opinion, but he is competent describe events and injuries he personally experienced.  In this respect, the Court in Washington v. Nicholson, 19 Vet. App. 362 (2005) cautioned that the Board must consider the purpose for which the lay evidence is being introduced.  By failing to properly analyze the lay evidence, the Board was tacitly committing Buchanan violations. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  Lay evidence may provide sufficient support for a claim of service connection, and it is error for the Board to require medical evidence to support that lay evidence.  Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993).  It is also error for the Board to treat lay testimony as merely part of the veteran’s contentions; it must explain its reasons for rejecting the testimony.  See Hatlestad v. Derwinski, 1 Vet. App. 164, 169-70 (1991).

Apparently, the Board deemed it unnecessary to analyze the lay evidence since there were no corroborating contemporaneous records.  The veteran submits that the failure to provide adequate reasons or bases statement relative to the lay evidence warrants a remand.

In addition, the veteran presented other documentary evidence at the hearing but never became part of the claims file.  The record reflects that the veteran presented the extant portions of a contemporaneous journal (although much of it was destroyed) that documented the in-service injury to his back.  The veteran presented this document at the hearing, which recorded his daily activities in the service.  Apparently, this journal was kept by the swing shift workers to allow the next shift to know what happened.  The veteran stated that he was the only person on the swing shift, and unless he left a journal entry, the next shift would not know what happened unless he woke them up.  For some reason, this document was never copied and placed in the claims file. 

Although the Federal Rules of Evidence are not applicable in this context (see Rucker v. Brown, 10 Vet. App. 67, 73 (1997)(noting that although the formal rules of evidence do not apply before the Board, reference to the Federal Rules of Evidence may be appropriate if it assists in articulating the reasons for a decision)), reference must be made to Federal Rule of Evidence 803(6), which provides for the admissibility of a memorandum, report, record, or data compilation, in any form, of acts, events, conditions, opinions, or diagnoses, made at or near the time by, or from information transmitted by, a person with knowledge, if kept in the course of a regularly conducted business activity, and if it was the regular practice of that business activity to make the memorandum, report, or record.  See Fed. R. Evid. 803(6).  Also, Federal Rule 803(1), a present sense impression, would also be analogous to the present case.  

The point is this: the veteran submitted highly probative evidence to prove that an incident involving his low back did occur during service, which may have been admissible even in the stricter evidentiary context of the Federal Rules of Evidence.  Nevertheless, one searches the Board decision in vain for any mention of this evidence.  Clearly, the Board failed to address this evidence as a basis to establish that the veteran injured his back in service.  (R. at 8-11).  Given the high probative nature of this evidence, it was error for the Board to reject it without any analysis.  See Bonner v. Nicholson, 188, 193 (2005).  The existence of a demonstrable in-service injury to the veteran’s back would have no doubt affected the Board’s analysis of the entire case.  As such, the veteran submits that the Board’s statement of reasons or bases is inadequate and a remand is warranted.               

A remand qas warranted as to a multiple sclerosis claim based on the Board’s inadequate reasons or bases statement and an inadequate medical opinion.

            The Board’s reasons or bases inadequacies concerned its analysis of direct service connection.  The Board stated that there was no evidence showing the veteran’s multiple sclerosis (“MS”) was caused by an incident in service, and thus direct service connection was not warranted.  The majority of the Board’s analysis, however, concerned whether the veteran’s in-service symptoms supported a later diagnosis of MS.  In this respect, the Board noted the April 2009 VA medical opinion which opined that the in-service symptoms were not the manifestations of MS and that her symptoms of MS were not manifest within 7 years of separation.  Beyond simply adopting the conclusions of the April 2009 VA medical examiner, the Board otherwise did not provide any significant discussion of whether an in-service event caused the later-diagnosed MS. 

            The Board’s failure in this regard is problematic in light of arguments raised below.  The veteran’s representative argued that the MS resulted from an in-service bus accident where the veteran suffered neurological trauma.  The Board noted the report of this in-service motor vehicle accident.  Indeed, SMRs from 1981 make reference to the accident where she hit her head.  She stated that since 1981 she has had headaches.  

            The veteran, through her representative, clearly argued that the VA examiner failed to address whether MS originated from trauma suffered in the in-service bus accident.  In support of this contention, the veteran’s representative cited to a scholarly, peer-reviewed article.  The article was quoted

[i]n some patients with MS, certain kinds of trauma (to the brain and/or spinal cord, including whiplash injuries) may act as a trigger at some time for the appearance of new or recurrent symptoms.

            It was further noted that researchers found that trauma to the central nervous system may alter the blood-brain-barrier which many researchers consider to be a critical step in the formation of MS lesions. 

            The veteran’s representative further argued that the research article, which he cited, suggested a basis for MS having traumatic origins (such as the in-service bus accident) “which deserved serious contemplation by both the VA examiner and adjudicator.”  The veteran argued that the VA exam should be returned as inadequate.  Id. 

            Indeed, the April 2009 VA exam report did not address direct service connection in the sense that it considered whether a traumatic event later caused MS.  The focus of the exam was to determine whether the veteran had the symptoms of MS in service or within 7 years of discharge.  The examiner concluded that there were no symptoms identified in service that were indicative of MS, and that it was less likely than not that the symptoms of MS manifested within 7 years of discharge. 

            The veteran was eventually diagnosed with MS, but the VA has yet to address whether the traumatic injury from the motor vehicle accident in 1981 was a trigger for the later development of MS.  Indeed, the September 2008 BVA remand observed, generally, that there was no medical opinion that addressed was incurred during or as a result of military service.  The examiner clearly addressed whether the MS began or was incurred during service or within 7 years thereafter.  But VA has never addressed whether a traumatic event in service caused the later diagnosed MS. 

            The Board’s statement, that there was no medical evidence showing that the MS was caused by an incident in service, underscores the inadequacy of the VA medical opinion.  The examiner clearly failed to consider all the issues.  Once the Secretary provides an examination, he is obliged to ensure its adequacy even if he was not legally required to provide it.  Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007). 

            More importantly, as the Court noted in Stefl v. Nicholson, 21 Vet. App. 120 (2007). “[a] medical nexus opinion finding a condition is not related to service because the condition is not entitled to presumptive service connection, without clearly considering direct service connection, is inadequate on its face.”  Stefl, 21 Vet. App. at 129.  The Court in Stefl vacated and remanded because the Board relied on an inadequate medical opinion.  Id. at 124.  In seeking a medical opinion, the VA “may not suggest an answer or limit the field of inquiry by the expert.”  Bielby v. Brown, 7 Vet. App. 260, 268 (1994).

            Here, the VA and its examiner limited the field of inquiry to simply whether the veteran had symptoms of MS during service or within 7 years thereafter.  The VA did not consider whether the in-service trauma was the etiological origin of the later-diagnosed MS.  The veteran, through her representative, cited medical research indicating a link between head and whiplash trauma—such as in a motor vehicle accident—and the later development of MS lesions.  She had an in-service motor vehicle accident.  The Board did not explain how the April 2009 exam was adequate in light of its limited scope and failure to address other possible in-service etiologies.  The Board simply noted that the veteran was afforded a VA exam.  The Board’s failure in this regard is problematic given the research cited by the veteran’s representative and its duty to pursue the “investigation of all possible in-service causes of [a] current disability, including those unknown to the veteran.”  Schroeder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000). 

            Phrased differently, the veteran raised a legitimate issue and theory of entitlement that was relevant given the facts of this case.  However, the Board did not address this contention and did not otherwise analyze the adequacy of the VA medical opinion in light of the veteran’s contentions and the research cited. 

            For this reason, the Board’s reasons or bases statement was inadequate.  Moreover, the VA medical opinion failed to address whether an in-service event caused the MS, and thus was inadequate on its face.  As the Court remanded for a similar issue in Stefl, a remand was required in this case.

A remand was warranted based on the Board’s inadequate statement of reasons or bases.

            By way of factual background, the veteran’s enlistment exam recorded a blood pressure of 120/68.  Although the regulations define hypertension as diastolic blood pressure predominantly 90 mm or greater, and isolated systolic blood pressure predominately 160 mm or greater with a diastolic blood pressure of less than 90 mm, see 38 C.F.R. § 4.104, DC 7101, Note 1, medical literature notes that various criteria for its threshold have been suggested.  See Dorland’s Illustrated Medical Dictionary, 31^st Ed. at 909 (2007).  The range of what is considered hypertension is from 140 mm systolic and 90 mm diastolic to as high as 200 mm systolic and 110 mm diastolic.  Moreover, the condition known as borderline or labile hypertension is “a condition in which the arterial blood pressure is sometimes within the normotensive range and sometimes within the hypertensive range.”  

            In this case, the veteran had numerous blood pressure recordings that were in the borderline hypertensive range.  For instance, contrary to the Board’s assertion, the veteran’s separation exam showed a blood pressure of 140/100.  And in box 74 of the separation exam it was noted that the veteran was actually diagnosed with mild high blood pressure.  While it is true that the same form also noted a blood pressure of 110/70, it also unequivocally stated: “BP today 140/100”.  The Board’s discussion of the separation exam results is conspicuous for its omission of this other finding indicative of hypertension.

In addition, many of the blood pressure recordings with a diastolic of 90 or more were also accompanied by a systolic pressure of at least 140. 

Notwithstanding, the Board attenuated these findings by suggesting that these recordings were somehow the result of an acute medical condition.  In this regard, the Board relied upon the statements of the December 2008 VA examiner.  The VA examiner stated:

No diagnosis of hypertension was made while in service.  Review of all blood pressure determinations obtained while in service do not support a diagnosis of hypertension while in service, nor the onset of hypertension.  Typically, isolated blood pressure elevations were recorded during evaluations for acute illness associated with discomfort or pain.  The preponderance of blood pressure recordings were normal.  Nov. 1988 exam includes one completely normal blood pressure reading, and one elevated recording, which is not diagnostic of hypertension.

In other words, the VA examiner attempted to explain and negate the abnormal blood pressure recordings by suggesting that they were the result of acute injury or illness rather than indicative of hypertension or borderline hypertension.

            However, a review of the record shows that the other allegedly normal blood pressure recordings of record were virtually always accompanied by complaints of acute injury or illness as well.  The rationale of the Board and VA examiner is that the high blood pressure noted in service was anomalous and attributable to acute distress, but if the so-called normal blood pressure recordings were also accompanied by complaints of acute medical conditions, then this would tend to negate the VA’s rationale.  In other words, if the VA examiner’s rationale was accurate, then it would be expected to find the blood pressure recordings wherein the pressure was normal to show an absence of acute complaints.  But this is not the case here.

Accordingly, it was suggested that the abnormal blood pressure recordings cannot be explained away by showing that the recordings are contemporaneous with acute problems because the normal recordings are virtually all accompanied by acute complaints as well.  Yet the Board and the VA examiner proffer this as a rationale, which clearly makes no sense when the entire medical record is reviewed.  The Board failed to explain why the examiner’s rationale for attenuating the abnormal recordings is valid when the normal readings also had contemporaneous complaints of acute pain or illness.  The Board stated that the elevated blood pressure was associated with infections, abdominal pain, shoulder pain, wrist pain, etc.  But so where most of the normal readings.  So how does the Board’s rationale make any sense?  That the abnormal blood pressure was associated with acute problems is not probative of anything if the normal blood pressure was also associated with acute problems. 

The requirement of providing adequate reasons and bases is a statutory mandate that the BVA must strictly adhere to in adjudicating a claim. 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet. App. 517, 527 (1995).  Under 38 U.S.C.A. § 7104(d)(1), a decision of the Board shall include a written statement of the Board’s findings and conclusions, and the reasons or bases for those findings and conclusions, on all material issues of fact and law presented on the record.  Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990).  Here, the Board’s statement of reasons or bases is invalid and indicative of a mere pretext. 

In addition, the Board failed to address the inadequacy of the VA exam.  The Board merely noted that an exam was provided.  Accordingly, the veteran submits that the VA examiner failed to take note of the condition known as borderline or labile hypertension, which is “a condition in which the arterial blood pressure is sometimes within the normotensive range and sometimes within the hypertensive range.”  Dorland’s Illustrated Medical Dictionary, 31^st Ed. at 909 (2007).  A review of the blood pressure recordings of record in this matter suggests borderline hypertension in service.  Nevertheless, the VA examiner failed to address whether the veteran had borderline hypertension in service and whether his current hypertension is etiologically related to the putative borderline hypertension indicated in service.  The examiner suggested the abnormal blood pressure was an isolated anomaly due to acute distress, but the veteran suggests that the fluctuating blood pressure records could be indicative of borderline hypertension, which the VA examiner failed to address.    

For these reasons a remand was warranted.

The veteran testified that he was treated for headaches and sinus problems during service.  He stated that his headaches began during service and continued ever since.  He further stated that he treated on active duty for a sinus problem.  The veteran indicated that he first experienced allergy and sinus symptoms while in the service and has experienced the problems ever since.  Indeed, in his Form 9 the veteran relied primarily on the fact that his sinus problem began during service.  

            However, in the February 2009 Statement of the Case, the VA denied the sinus claim because the STRs allegedly contained no evidence of treatment or diagnosis of a sinus condition.  With respect to the headaches and hearing loss, the VA stated in the February 2009 SOC that the STRs are negative for any treatment or diagnosis for headaches and that the veteran never submitted evidence that the condition currently exists.  Similarly, the January 2009 rating decision denied the sinus condition because the STRs allegedly showed no treatment or diagnosis for the condition while on active duty and because there was not chronic condition diagnosed at discharge. 

            Similarly, the Board denied the sinus, hearing loss, and headache claims because the STRs do not show complaints of hearing loss, headaches, or sinus problems.  The Board stated that the first time his hearing loss, headaches and sinus disorder were shown was in March 2006, May 2006 and May 2011.

            The Board stated that the veteran was not credible as to his hearing loss, headaches, and sinus disorder because the STRs allegedly do not contain any treatment or diagnosis for the claimed conditions.  With respect to the headaches, the Board stated that the evidence weighs against the claims “in that in-service incurrence is not demonstrated.”  In sum, the Board found that the alleged absence of evidence (presumably corroborating medical evidence) weighed against the claims.  The Board stated that the veteran’s testimony, “standing alone”, is not sufficiently credible to provide probative information. 

            The veteran is currently diagnosed with allergic rhinitis and chronic sinusitis.  He also has a headache condition that is noted in conjunction with his sinus problems.  In this regard, the veteran has asserted that his headaches are secondary to the sinus condition.   

            But the STRs are contrary to the Board’s findings.  The Board has repeatedly claimed that the STRs are negative for any in-service incurrence relative to the sinus or headache conditions.  However, in March 1981 the records show that the veteran presented for problems breathing and it was noted that he was taking Sinex and Sudafed.  The veteran also treated for symptoms of a runny nose in September 1979.  Additional cold symptoms were again noted in January 1981.  With respect to the headaches, the Board found no in-service incurrence.  But in September 1979 the STRs show that the veteran presented for treatment after falling and hitting his head. 

            When deciding an appeal, the BVA is required to consider all applicable provisions of law, and to provide an adequate statement of reasons or bases for its decision to enable a claimant to understand the precise basis for the decision, and also to facilitate review by the Court.  See 38 U.S.C. § 7104(a), (d)(1); Weaver v. Principi, 14 Vet. App. 301, 302 (2001) (per curiam order); Allday v. Brown, 7 Vet. App. 517, 527 (1995); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1991).  The Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 20 Vet. App. 188, 193 (2005). 

            In this case, with respect to the sinus and headache conditions, the Board’s reasons or bases is inadequate.  To the extent that its findings are predicated on the notion that the STRs are negative for any in-service incurrence, the STRs clearly show treatment with a sinus decongestant as well as other sinus symptoms, i.e. runny nose, difficulty breathing, etc.  The Board stated that the evidence weighed against the claims because there was no objective medical evidence during service or immediately thereafter.  The factual predicate for the Board’s decision, in substantial part, is erroneous.  The Board failed to consider this claim in light of the correct facts: that the STRs do indeed document in-service complaints relative to the sinus problem.  This warrants a remand.

            Moreover, there is an in-service incident relative to the head.  This is again contrary to the Board’s findings.  But the veteran has asserted a secondary relationship between the sinuses and the headaches and so a remand on the sinus claim should compel a remand on the headache claim as well.

            Notwithstanding the Board’s clear error in overlooking the positive STRs, its decision is problematic for reasons relating to Buchanan.  The Board decision in this case is basically saying that the lay evidence cannot be credible absent corroborating clinical records.  The Board’s decision makes clear that it improperly determined that the lay statements lacked credibility simply because they were not corroborated by contemporaneous medical records.  See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  Lay evidence may provide sufficient support for a claim of service connection, and it is error for the Board to require medical evidence to support that lay evidence.  Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993).  Specifically, the Board found the veteran not credible as to the hearing loss, headaches, and sinus disorder because the STRs were negative.  In other words, because the STRs did not corroborate the veteran’s lay evidence, the Board found him not credible.  The Board also stated that the veteran’s testimony, standing alone, is not sufficiently credible.  The phrase “standing alone” in the context of this decision, can only be interpreted to mean that the testimony, without corroborating contemporaneous medical records, is not credible.  The veteran submits that this is error and warrants a remand.

            Finally, it is true that the Board also found the absence of a nexus with service.  But the Board did not provide a medical opinion because the veteran’s “conclusory” lay statements alone were not enough to indicate an association with service.  But because of the Board’s clear error on the issue of in-service incurrence and the credibility of the veteran, a correct understanding of the facts would have an impact on the McLendon analysis.  For instance, the presence of a runny nose or similar allergy/sinus symptoms is capable of lay observation, see Charles v. Principi, 16 Vet. App. 370 (2002), and since the veteran was correct in his assertions regarding the in-service treatment, the Board’s basis for finding his testimony being not credible would be different.  The veteran clearly indicated he started to have the sinus symptoms in service and they continued ever since.  A favorable finding on his credibility (which included statements of continuity post-discharge), coupled with positive in-service treatment for a sinus condition, would be sufficient to indicate an association with service, thus triggering VA’s duty to provide an exam. 

            Furthermore, the Board cited to Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) for the proposition that conclusory generalized lay statements are not enough to indicate an association with service.  However, the veteran submits that Waters does not entirely support the Board’s decision.  The Federal Circuit interpreted the CAVC’s ruling to mean that in the absence of any medical evidence, a veteran’s own conclusory generalized lay statements were insufficient to establish the necessary nexus.  Waters v. Shinseki, 601 F.3d at 1278.  The Federal Circuit reasoned that since all veterans could make such a conclusory statement, a mere statement alone would eviscerate the carefully-drafted statutory standards.  Here, because the Board was under the erroneous impression that there was nothing in service, then it would appear at first blush that the veteran’s statements were indeed mere conclusory statements.  But the correct facts show more than mere statements.  The evidence shows clear in-service treatment for a condition that is capable of lay observation.  For this reason, the veteran submits that the matter should be remanded for the Board to reconsider the STRs relative to the sinus condition and headaches and then reconsider the McLendon issue.  Since the veteran has asserted a secondary relationship between the sinus and headaches, this issue should be remanded as well. 

            With respect to the left wrist laceration residuals, the January 2009 VAX did confirm the existence of laceration residuals, to wit: a scar.  The examiner merely opined that there are no residuals from the scar but he did not opine whether the scar was in fact a residual of the laceration.  The context of his report suggests that the scar is a residual of the laceration, but neither the examiner nor the Board addressed service-connection for the scar as a residual of the laceration.  The Board denied the laceration residuals claim because there was no evidence of a current diagnosis.  Is the scar not a diagnosed residual?  The rating code clearly countenances scars as being a diagnosed condition.  See 38 C.F.R. § 4.118, DC 7800-7805.  A remand was warranted for the Board to consider the scar as a current diagnosed condition as a residual of the in-service laceration. 

By way of factual background, in November 2006 the Veteran fell down some stairs in his home and onto his right knee.  The following evening VA Healthcare System admitted the Veteran.  A registered nurse assessed the Veteran and objectively noted that he was complaining of right-knee pain and ambulated with a limp.  The Veteran indicated that his right knee “gives out” and that this was the second time he had injured his right knee.  An hour and a half later, a VA doctor physically examined the Veteran and noted that although the ligaments in his right knee were “stable by exam,” the area above his right patella was tender and his right knee had mild edema, or an abnormal accumulation of fluid.  The doctor advised the Veteran that X-rays were negative for a right-knee fracture; rather, he had a contusion to his right knee.  The doctor prescribed ice, Motrin, and Vicodin.

            In January 2007 a physician at VA obtained an MRI of the Veteran’s right knee.  In January 2007 another doctor, an orthopedic surgeon at the VA, determined that the MRI revealed a torn right-quadriceps tendon. The doctor  noted “a palpable defect in the patellar tendon on the right” and a lag in the extensor function of the right quadriceps.  Moreover, he noted the Veteran’s complaint that weakness in his right knee caused him to fall and necessitated his use of a cane to ambulate.  He diagnosed the Veteran with a ruptured right-quadriceps tendon and prescribed surgical intervention to repair that defect.. That surgery was performed in January 2007.

            Shortly after that surgery VA received from the Veteran a claim for compensation under 38 U.S.C. §1151.  The Veteran contended that VA’s failure to diagnose and properly treat his right-knee condition resulted in an additional disability; namely, a torn right-quadriceps tendon. 

            The Board’s April 2011 decision characterized the threshold issue in this case as whether the evidence of record shows that VA’s treatment of the Veteran caused his additional disability and, if so, whether the care provided was the appropriate medical standard of care. 

            The Veteran submits that the Board committed prejudicial error in failing to request a medical examination and/or opinion.  With respect to disability compensation claims VA’s duty to assist includes the duty to obtain a medical examination and/or opinion when necessary to decide the claim. 38 U.S.C. §5103A(d); 38 C.F.R. §3.159(c)(4)(i). A medical examination and/or opinion are necessary where the evidence of record does not contain sufficient, competent medical evidence to decide the claim, but:

(A)       Contains competent lay or medical evidence of a current diagnosed disability or persistent or recurrent symptoms of disability;

(B)       Establishes that the veteran suffered an event, injury[,] or disease in service, or has a disease or symptoms of a disease [subject to presumptive service connection]; and

(C)       Indicates that the claimed disability or symptoms may be associated with the established event, injury, or disease in service or with another service-connected disability.

38 C.F.R. §3.159(c)(4)(i)(A)-(C); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Competent medical evidence that shows post-service treatment for a condition may satisfy the requirement that the claimed disability be associated with the established in-service event, injury, or disease. §§3.159(c)(4)(i)(C), 3.159(c)(4)(ii). Moreover, when considering whether a medical examination and/or opinion are necessary, the Board must provide a written statement of its reasons or bases for its conclusion. 38 U.S.C. §7104(d)(1); Bardwell v. Shinseki, 24 Vet. App. 36, 38 (2010).

            Here, that the Veteran suffers from a current, diagnosed disability is implicit in the Board’s conclusion that he suffers from an “additional disability.”  Moreover, the evidence of record establishes that the Veteran suffered an event—treatment—while in the care of VA healthcare providers. Furthermore, the evidence of record indicates that the Veteran’s claimed additional disability maybeassociated with his VA medical care, as he received subsequent treatment for the condition. (Id.); §3.159(c)(4)(i)(C); Bardwell, 24 Vet. App. at 39. (“[T]he third prong [of §3.159(c)(4)(i)] requires that there be an indication that the current disability relates to service.” (emphasis in original)); McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006)(The type of evidence that “indicates” that a current disability may be associated with military service includes credible evidence of continuity of symptomatology). As such, a medical examination and/or opinion were necessary to decide this claim. However, the Board did not provide any reasons or bases for its conclusion that such a medical examination and/or opinion were not necessary to decide the Veteran’s claim. §7104(d)(1); Bardwell, at 38. The Board simply stated that no medical opinion was necessary as the evidence of record is sufficient to decide the claim. 

            Furthermore, as stated above, in deciding §1151 claims the Board must determine whether the evidence of record shows that the care or treatment caused the additional injury and that VA failed to exercise the degree of care that would be expected of a reasonable healthcare provider. §1151(a); §3.361(d)(1). However, the Board is prohibited from proffering its own unsubstantiated medical conclusions. Colvin v. Derwinski, 1 Vet. App. 171, 174-75 (1991); Caldwell v. Derwinski, 1 Vet. App. 466, 470 (1991). The appropriate medical standard of care and the medical causation of [injury] are issues in the province of a medical expert.” Espiritu v. Derwinski, 2 Vet. App. 492, 494-95 (1992). 

            In this case, the Board acknowledged that VA did not obtain a medical opinion.  Although the Board stated that “the evidence of record is sufficient to decide the claim,” the Board did not provide any reasons or bases as to how it arrived at that conclusion.  For instance, the Board did not reference a recognized medical treatise. Colvin, 1 Vet. App. at 175; Sacks v. West, 11 Vet. App. 314, 317 (1998) (medical article and treatise evidence can provide important support when supplemented with the opinion of a medical professional).  The Board also failed to apply §3.159(c)(4)(i) and §5103A(d).  Absent a medical examination and/or opinion or recognized medical treatise evidence, upon what medical evidence did the Board rely in determining that a medical examination and/or opinion were not necessary to determine the Veteran’s claim? None; rather, the Board relied on its own unsubstantiated opinion.  The Board is not competent to render its own determination as to the medical standard of care.  A medical opinion was necessary in this case to establish the standard of medical care and to address whether there was a deviation therefrom that proximately caused the additional disability.  For these reasons, a remand was warranted.

VA has a duty to assist all claimants in obtaining evidence necessary to substantiate a claim.  38 U.S.C. § 5103A(a)(1.  This duty is neither optional nor discretionary.  Littke v. Derwinski, 1 Vet. App. 90, 92 (1990). 

Pursuant to 38 U.S.C.S. § 5103A(b)(1), as part of its duty to assist, the Secretary is required to “make reasonable efforts to obtain relevant records (including private records) that the claimant adequately identifies to the Secretary and authorizes the Secretary to obtain.”  Furthermore, if, after making reasonable efforts, the Secretary cannot obtain all of the relevant records, “the Secretary shall notify the claimant that the Secretary is unable to obtain records with respect to the claim.  Such a notification shall(A) identify the records the Secretary is unable to obtain; (B) briefly explain the efforts the Secretary made to obtain those records; and (C) describe any further action to be taken by the Secretary with respect to the claim.”  38 U.S.C.S. § 5103A(b)(2).

With respect to records from a federal agency or department, “the efforts to obtain those records shall continue until the records are obtained unless it is reasonably certain that such records do not exist or that further efforts to obtain those records would be futile.”  38 U.S.C.S. § 5103A(b)(3); see 38 C.F.R. § 3.159(c)(2) (2002).

In this case, the Board’s denial of the PTSD claim was predicated on the alleged absence of a corroborated stressor.  Accordingly, obtaining the veteran’s personnel file is crucial to corroborating his claimed in-service stressors.  In August 2004 the Board remanded this case to the RO to undertake additional efforts to locate the personnel records.  The Board stated “it is not clear that VA has exhausted all avenues of development in an effort to obtain the veteran’s personnel file.” 

In response, the manager of the Veteran’s Service Center attested that VA made a request for the personnel records in October 2004.  She further states that VA received a response advising that more information was needed.  As such, it appears that VA wrote to the veteran in March 2007, but made no further mention of the inability to obtain the records.  The veteran did fill out the appropriate forms, and provided the details of his in-service PTSD stressors.  (See R. at 114, 115, 118, 120, 121).  VA received these forms in March 2007.  Also in March 2007 the veteran reiterated his request that VA obtain his “field file”.

After March 2007 the next mention of the personnel files is contained in the June 2007 SSOC.  VA stated that it requested from the NPRC the personnel records from July 1974 to November 1974 and March 1977 to November 1978.  The SSOC states that VA received a reply that no records were found.  The June 2007 SSOC is the last mention of the missing personnel records; all other evidence does not demonstrate VA made any further efforts to locate these records or otherwise advise the veteran of the inability to obtain same.  

Accordingly, given that these are records maintained by a Federal agency, “the efforts to obtain those records shall continue until the records are obtained unless it is reasonably certain that such records do not exist or that further efforts to obtain those records would be futile.”  38 U.S.C.S. § 5103A(b)(3); see 38 C.F.R. § 3.159(c)(2) (2002).  According to VA it requested the records in October 2004 (R. at 198), and asked him to complete VA Form 21-0781 in March 2007 (which he did), and the records have still have not been obtained.  Yet, after March 2007 VA made no further efforts to continue in the search for these records. 

Additionally, VA never made a determination that it was reasonably certain that the records do not exist or that further efforts to obtain them would be futile.  Thus, the efforts to locate the records should have continued.  Since no such efforts were made (and no determination as to their non-existence or the futility of further searches), VA clearly failed to fulfill its duty to assist.

Moreover, 38 U.S.C.S. § 5103A(b)(2) also imposes a specific notice requirement in the event records cannot be obtained.  Here, VA noted that it received a reply that the personnel records were not found.  There was no description of VA’s attempts, and no discussion of the activities VA will take next.  At best, in January 2005 VA sent the veteran a letter advising that it could not locate the personnel records.  However, the specific criteria set forth in 38 U.S.C.S. § 5103A(b)(2) was not addressed.  Id. Based on VA’s failures in this regard, a remand is warranted.

In Stegall v. West, 11 Vet. App. 268 (1998) the Court stated that the Board is obligated by law to insure that the RO complies with its directives and compliance is neither optional nor discretionary.  Where the remand orders of the Board or the Court are not complied with, the Board errs as a matter of law.  Stegall, 11 Vet. App. at 271. 

Here, the August 2004 Board remand directed that additional steps be taken to obtain the personnel records.  In fact, the Board stated that VA has “not exhausted all avenues of development.”  Based on the discussion above, it is clear that the Board failed to ensure compliance with its prior remand directive.  As such, it has clearly erred and remand is warranted.

The Court has long held that the Board is statutorily required to articulate adequate reasons or bases for its findings and con­clusions on all material issues of fact and law presented by the record.  See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 

In this case, the Board’s reasons-or-bases statement is inadequate with respect to whether the duty to assist was satisfied.  The Board made a conclusory statement that the duty to assist had been satisfied, but then made no mention whatsoever of the missing personnel records and the previous difficulty in locating them.  In other words, since the personnel records are clearly with a Federal agency, they should have been obtained unless it was determined that it is reasonably certain they do not exist or that it would be futile to obtain them; see 38 C.F.R. § 3.159(c)(2) (2002).  The Board made no such determination in its discussion of the duty to assist.  Thus, efforts to obtain the records should have continued.  Since such efforts did not continue, then the Board was obligated to provide an adequate reasons-or-bases statement with respect to the criteria in 38 U.S.C.S. § 5103A(b)(3).  Without even a mention of the missing personnel records, the Board’s reasons-or-bases statement is clearly inadequate, warranting a remand.

As to the testicle disability, the Board cited to McLendon v. Nicholson, 20 Vet. App. 79 (2006) and the four elements that would trigger VA’s duty to provide an exam.  The Board then stated that the service medical records generally do not show treatment for the claimed disabilities (in this case the testicle disability).  Id.  It also stated that the conditions were not identified until many years after service.  Therefore, it concluded that the second and third prongs of McLendon have not been met.

In this case, in asserting that the second and third prongs of McLendon have not been met, the Board overlooked key evidence that demonstrates the testicle disability had its onset during service and is now chronic.  The records from February 1979 (approximately 3 months after discharge) show problems with the right testicle, and noted that the veteran had this problem in service but did not see a doctor.  Given the relatively contemporaneous nature of the February 1979 record (within 3 months of service) it has great probative value.  Indeed, it tends to demonstrate that the onset of the condition occurred during service—even though the veteran did not seek medical treatment.  Furthermore, also in February 1979, the veteran was observed to have probable chronic epididymitis. 

The second prong of McLendon, for instance, requires only that there be evidence establishing that an event, injury or disease occurred during service.  McLendon, 20 Vet. App. at 81.  The Board’s discussion on this issue, however, implies that the veteran must actually have treatment in service that is memorialized in the service medical records.  Hence, the Board notes that the service medical records generally do not show treatment for the claimed disabilities. The veteran submits that he does not need to have service medical records showing treatment, but merely evidence of an occurrence during service.  See Buchanan v. Nicholson, 451 F.3d 1331 (2006).  Accordingly, the relatively contemporaneous February 1979 record establishes the onset of the veteran’s right testicle problem during service.  The Board’s conclusion, then, that the second prong of McLendon is not met is erroneous.

Finally, as to the third prong of McLendon, there must be an indication that the disability or persistent symptoms of a disability “may be associated” with service.  McLendon, 20 Vet. App. at 81.  The requirement that there be an “indication” that the condition “may be” associated with service is “a low threshold.”  McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006).  Thus, the evidence that the condition had its onset during service coupled with the immediate post-service diagnosis of probable chronic epididymitis strongly suggestions an association.  Furthermore, the Board acknowledged the evidence from August 2003 where slight epididymal thickening was noted.  (R. at 19).  As such, the evidence shows (1) an in-service onset of the problem (albeit without treatment); (2) an immediate post-service impression of the problem being chronic; and (3) a recent medical record noting the same problem.  These three factors, when considered together and in totality, militate in favor of the indication that there may be an association with service. 

The Board’s discussion of the evidence and the second and third prongs of McLendon is conclusory and insufficient.  As such a remand was warranted as to this issue.

Similarly, in its discussion of service connection for the testicle disability, the Board again made light of the veteran’s lack of treatment for the testicle problem during service.  There is no requirement that the event, injury or disease be confirmed in the military records.  See Buchanan v. Nicholson, 451 F.3d 1331 (2006).  Yet, the Board decision seems to suggest that the medical records must confirm treatment in service.  The Board states: “While the veteran was diagnosed with possible epididymitis a few months after service separation, he did not by his own admission seek treatment for this disability during military service.”  His lack of treatment is of no moment unless the Board is impermissibly rejecting the self-described history of the veteran solely because of the absence of corroborating medical records.  See Buchanan v. Nicholson, 451 F.3d 1331 (2006).  Clearly, the Board’s statement of reasons or bases is inadequate with respect to the lay statements regarding the onset of the testicle disability.  

Parenthetically, it should be noted the Board states that the veteran did not seek treatment for the probable chronic epididymitis for allegedly 20 years after 1979.  However, by the VA’s own admission medical records from the Oklahoma City VAMC from 1979 to 1990 were missing.  Although VA in the June 2007 SSOC suggests that the records do not exist, the January 2005 correspondence from the VAMC instead states that the records have been “perpetualized” but that no records are found at this time; they said they would continue the search.”  Therefore, the Board’s unequivocal assertion that the veteran had no treatment for 20 years subsequent to 1979 is somewhat misleading.  The absence of 11 years of treatment records should prevent the Board from so emphatically concluding that there was no treatment for twenty years.  For these reasons, the matter required a remand for readjudication.

The veteran became homeless in April 2007.  He has also subsequently injured his shoulder and the doctor’s have deemed him to be totally unemployable.  When he was released from prison he still had some of the money, but he was faced with either utilizing the money for basic necessities or becoming homeless.  His current income was only approximately $300 per month.  The VA has confirmed that veteran stays at a homeless shelter.  Indeed, his financial status report shows an income of just $300 per month.  Prior to his release from prison, the veteran advised VA that once he gets out of prison he will have no housing, vehicle, clothing, food, or anything.  He told VA in advance of his prison release—and before the remaining funds were spent—that upon release from prison he would have no other means of support.  He stated that he may become homeless.  He further advised VA that his disabilities limit the type of work he can perform.

            Throughout the record are the veteran’s descriptions of his homelessness and inability to earn an income due to his disabilities.  In order to prevent homelessness, the veteran was forced to rely on the VA funds that had accumulated, but the funds ran out in December 2009.  From December 2009 to January 2010 he described having to eat out of garbage cans.  The VA issued a Statement of the Case in February 2006. 

            The record also shows that a significant amount of the VA money was misappropriated by those who apparently had access and control of his bank account during his incarnation. 

            It was also noted that the veteran is a paranoid schizophrenic (for which he is service-connected) and has a combined rating of 60 percent. 

            The Board’s analysis of the factors relevant to determining “equity and good conscience” was inadequate.  The Court observed in Stone v. Derwinski that “the primary consideration in applying the standard of equity and good conscience is whether collection of the indebtedness would constitute undue hardship.”  2 Vet. App. 56, 58 (1992).  The Court further stated that “[u]ndue hardship exists where collection, in installments if necessary, would seriously impair the veteran’s ability to provide for himself and his dependents with the necessities of life, including food, clothing, shelter, and medical attention.  Those require an examination of his current financial status with attention to his future prospects as well.”

            Here, the Board appeared to place great emphasis on the fact that the veteran allegedly spent some of the money with knowledge of the pending action for recovery of indebtedness.  The Board conceded that the veteran’s situation is clearly strained, but noted that while still incarcerated he had several thousand dollars in the bank.  The Board stated: “Therefore, while the current financial information leads to the conclusion that recovery of the debt endangers the veteran’s ability to provide for basic necessities, as he claims, the financial information presented soon after the Veteran learned of his sizeable overpayment does not show that he was in such dire financial straits at that time.” 

            The Board’s reasoning in this respect is flawed.  The veteran’s claim for waiver of recovery of indebtedness began while he was still incarcerated.  Clearly, his housing was provided by the State Department of Corrections and so the Board’s reasoning that the veteran somehow spent the money while his financial situation was not as severe does not make much sense.  Moreover, in March 2006 (prior to his release and while this matter was pending) the veteran notified VA that once he was released from prison he would have no housing, vehicle, clothing, food, or anything.  He expressly indicated that he would need the money to survive, noting that upon release from prison he would have no means of financial support.  He specifically advised VA that he may become homeless.  He also noted that his disabilities limited his employment prospects. 

            Essentially, the Board faulted the veteran for using the money to avoid homelessness for approximately a year following his release from prison.  Phrased differently, the Board attenuated the significance of the financial hardship on the grounds that the veteran should have elected to become homeless immediately following release from prison so as to repay a portion of the indebtedness.  The fact that the veteran had some money in the bank upon his release from prison only means that he was able to delay the onset of homelessness.  Indeed, once the money ran out the veteran became homeless and, for a period of time, resorted to eating out of garbage cans.  The Board’s position is further questioned on the grounds that the veteran advised VA before his release of his financial situation and possible homelessness and the VA could have made a decision on this claim before his release from prison.  

            Accordingly, there is nothing in the Board’s decision that indicates it considered the veteran’s future prospects and his financial need upon release from prison.  The Court’s decision in Stone mandates consideration of a veteran’s future prospects.  See Stone, supra, at 58.  Presently, the veteran’s income is about $300 per month, and the Board has essentially said that it is not against equity and good conscience for the veteran to remain homeless for the next 10 years simply because he chose to avoid immediate homelessness upon release from prison.  A careful reading of the Board’s rationale indicates that although it conceded extreme financial hardship, a waiver was not justified because the veteran used the money to avoid—for a short period of time—deprivation of the basic necessities of life.  Id. 

There is additional Board error in light of the Court’s findings in Cullen v. Brown, 5 Vet. App. 510 (1993).  In Cullen, the Court took exception to the Board’s failure to consider, inter alia, the magnitude of the veteran’s disability and the veteran’s future prospects in its calculations.  Id. at 512-13.  The veteran in Cullen was also a paranoid schizophrenic and the Court observed that the veteran could not reasonably anticipate gainful employment in the future.  Id.

Here, the veteran is also a service-connected paranoid schizophrenic and he has suffered an additional injury and is now totally disabled.  He has repeatedly advised VA of his homelessness and total inability to earn an income due to his disabilities.  Again, the Board’s decision fails to consider the magnitude of his disability and his future prospects for employment.  When considered, it is clear that to seek recovery of the debt would solidify the veteran’s homeless status for many years to come.  Yet, the Board’s analysis finds that its decision is not against equity and good conscience.  The Board also failed to consider that thousands of dollars was misappropriated by individuals who had access to his financial accounts while he was incarcerated.   

It is clear from Cullen that this Court deems the failure to consider factors such as future prospects and the magnitude of a veteran’s disability to be reasons or bases violations.  Cullen v. Brown, 5 Vet. App. at 512-13.  In Cullen, the Court found reasons or bases violations for failing to consider that the veteran was 70 percent service connected for schizophrenia and had no reasonable possibility for gainful employment.  Id.  The same facts exist in this case, and the Board failed to consider them.  Clearly, the Board in this case failed to consider several factors that the Court has deemed relevant.  A remand was, therefore, required. 

The veteran submitted new testimonial evidence demonstrating that during service he had numbness coming from both shoulders.  He stated that the numbness relative to the right shoulder began in service and continued to the present; and with some activities the entire forearm goes numb, preventing him from moving his arm to the side or front.  The veteran advised that he was initially treated for bursitis.  The new evidence of record also shows a long history of bilateral shoulder pain with upper extremity numbness to the fingers.  He describes the pain as starting at the shoulders and migrating down to the fingers.  The new evidence suggested that both arms were completely numb at times.  The numbness to the hands was also noted.  Moreover, possible thenar atrophy was noted in both hands.  Bilateral wrist and arm pain was noted since service. 

            Given these symptoms, the veteran’s new evidence showed that he was diagnosed with thoracic outlet syndrome.  The veteran also stated that the thoracic outlet syndrome is manifested with symptoms to both shoulders and arms.  The differential diagnosis in August 2008 was, indeed, thoracic outlet syndrome and the veteran was noted to have bilateral abduction impingement pain.  One doctor opined that the veteran has some sort of global neuropathy.  The symptoms and radiographic studies were noted to be consistent with thoracic outlet syndrome.

            The veteran indicated that he raised the question with the VA examiner relative to his nerves and whether it was associated with his shoulders.  More importantly, his service medical records show right shoulder pain, and pain in the right arm and right arm numbness down to this thumb.  The service medical records also noted the presence of his right shoulder and arm pain, described as a burning that becomes a pulling pain and pain into the forearm when he works out.  Right arm numbness and shooting pains were clearly noted in the SMR’s.

By contrast, the veteran’s 1993 application for benefits made a claim for a right shoulder condition/bursitis.  The veteran stated, in fact, that he was treated for bursitis in service.  Accordingly, his 1993 claim referred to right shoulder/bursitis, and the February 1994 rating decision stated the issue was right shoulder and bursitis of the right shoulder.  The 1994 rating decision never dealt with any upper extremity neurological issues.  Accordingly, the veteran clearly stated in a September 2005 statement that he wanted to open a claim for both hands and wrists and mentioned the numbness and burning in the forearm.  (These are the same complaints noted in service).  Moreover, the 1994 rating decision addressed a distinctly different condition (bursitis) and never addressed the now diagnosed thoracic outlet syndrome, which is manifested by the bilateral arm pain and numbness.

            Given the distinct difference between thoracic outlet syndrome and bursitis, the veteran submitted that the Board erred based on the Federal Circuit’s ruling in Boggs v. Peake, 520 F.3 1330 (2008).  In Boggs, the Court held that a properly diagnosed disease or injury cannot be considered the same factual basis as a distinctly diagnosed disease or injury.  Claims based on distinctly diagnosed diseases or injuries cannot be considered the same for purposes of 38 U.S.C. § 7104(b).  In other words, the veteran’s statement in September 2005, along with the medical evidence of a diagnosis for thoracic outlet syndrome, would be a new factual basis for purposes of 38 U.S.C. § 7104(b).  Moreover, the Federal Circuit stated in Ephraim v. Brown, 82 F.3d 399, 401 (Fed. Cir. 1996) that a newly diagnosed disorder (as in this case with thoracic outlet syndrome), even if related to a previously diagnosed disorder, cannot be the same claim when it was not previously considered.  The veteran’s bilateral shoulder pain and numbness to both arms is a distinct diagnosis and a new factual basis.  The Board clearly failed to address the issue of whether the evidence presented a new factual basis, especially considering that the neurological manifestations of the veteran’s condition were never previously addressed. 

            A remand was also warranted as to the increased rating claim on the left shoulder for similar and related reasons.  The Board is required to adjudicate all issues reasonably raised by a liberal reading of the veteran’s substantive appeal.  Brannon v. West, 12 Vet. App. 32, 34 (1998).  In Brannon, the veteran contended that the Board failed to adjudicate an implied claim for secondary service connection that was caused by the service-connected skin condition.  Id.  The Court in Brannon stated that the Board is required to adjudicate the issue or remand to the RO for further development; it just cannot ignore the issue.  Id.  In the present case, unlike Brannon where the appellant predicated his argument on information contained in medical records, the veteran submitted a specific written statement wherein he stated that he wanted to open a claim regarding the numbness to this arms and hands.  Any communication or action that indicates an intent to apply for benefits may be considered an informal claim.  Brannon at 35.  Here, there can be no doubt that the veteran expressed a clear intent to apply for benefits for the symptoms of numbness and pain radiating from his bilateral shoulders.  “A failure by the Board to address a relevant issue in a final decision is, in itself, subject to review under 38 U.S.C. § 7252(a)…since such failure is within the Court’s scope of review…”  Travelstead v. Derwinski, 1 Vet. App. 344, 348 (1991). 

Moreover, under Schafrath v. Derwinski, 1 Vet. App. 589, 592-93 (1991), the Board is required to consider all evidence of record and discuss all “potentially applicable” provisions of law or regulation.  As such, given the evidence of upper extremity neurological symptoms radiating from the shoulders the Board should have addressed the applicability of a rating under the potentially relevant diagnostic code for the condition.  A review of the Board decision indicates that nowhere did the Board address the potential applicability of any other diagnostic codes except for DC 5304 for muscle weakness.  The veteran clearly raised the issue as a claim, and also further highlighted the need for VA to conduct additional testing to assess the correlation between the shoulder impingement syndrome and the hand numbness. 

In addition, a remand was warranted for the Board’s failure to consider the veteran’s lay evidence relative to the DeLuca factors.   The Board must explain its rejection of material evidence supporting the claim.  See Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).  It failed to even mention the lay evidence with respect to the increased rating claim.  In particular, the veteran stated with repetitive use he loses the ability to use the arm.  The veteran further indicates that the impingement becomes so aggravated to the point of almost complete loss of motion.  He says when the left shoulder becomes aggravated he cannot even use it due to such severe pain.  He also states that when the shoulders flare-up he loses all function of his arms on a given day due to severe pain.  The pain becomes so debilitating that range of motion is diminished to virtually nothing and he loses the ability to even lift lightweight objections without severe burning sensations that extend the entire length of the arm.  At other times, states the veteran, when the aggravation occurs he loses complete use of his left shoulder and the condition can last up to 3 weeks.  He states that he was never evaluated during a flare-up.  Even the VA examiner in February 2000 conceded the possibility that during a flare-up it would be possible for functionality to be limited due to pain.  The evidence also showed that the veteran has flare-ups every 6 to 8 weeks and they last for 3 days.  The veteran also stated that range of motion on the left shoulder deteriorates at times to becoming almost useless.  The Board failed to address any of the veteran’s lay evidence detailing the severity of his symptoms.  For these reasons, the reasons-or-bases statement was inadequate and a remand was warranted. 

Also, the rating schedule makes a distinction between the dominant and nondominant arm.  See 38 C.F.R. § 4.73.  In this case, the Board stated that the veteran was right handed.  However, the veteran indicated he is ambidextrous.  The Board failed to address this information in its analysis of the increased rating claim.  Since this would potentially affect the rating, the Board’s failure in this regard warranted remand.

Finally, the veteran submitted that the left and right shoulder claims are inextricably intertwined.  In Harris v. Derwinski, 1 Vet. App. 180, 183 (1991), this Court held that if a decision on one issue could render any review by the Court meaningless and a waste of resources, then the claims are inextricably intertwined.  Here, as to the right shoulder, the veteran contends he raised a new claim based on a new factual basis, i.e. thoracic outlet syndrome associated with the right arm and hand numbness.  Similarly, with respect to the left shoulder increased rating claim, the thoracic outlet syndrome affects the left arm and shoulder as well.  The informal claim as to the new diagnosis affects the bilateral shoulders and arms, and it would be logical for both issues to be remanded together.          

The Board stated that “this claim turn [sic] on a medical matter—the relationship between current disability and service.”  Although by the Board’s own admission medical nexus was the central question in the case, the September 2005 VA examination report renders no opinion on the medical nexus issue.  The examiner provided a current diagnosis of bilateral patellofemoral syndrome, but no opinion on the nexus.  Remand is warranted because once the Secretary provides an examination, he is obligated to ensure its adequacy even if he was not legally required to provide it.  Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007).  This exam was clearly inadequate and based on the Court’s jurisprudence in Barr, a remand is warranted. 

Moreover, if a diagnosis is not supported by the findings on the examination report or if the report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes.  38 C.F.R. § 4.2 (1999), see also DeLuca v. Brown, 8 Vet. App. 202, 206 (1995) (citing 38 C.F.R. § 4.2).  Given the main issue in this case (medical nexus) relative to the bilateral leg disability, the Board should have returned the matter for an adequate medical exam that addressed the medical nexus issue.  Again, the failure in this regard warranted remand.

The Board also erred by not providing an adequate statement of reasons or bases as to whether the duty to assist was satisfied.  This Court has held that the Board is required by statute to articulate adequate reasons or bases for its findings and conclusions on all material issues of fact and law presented by the record.  Such explanations are necessary to enable the claimant to understand the Board’s decision, and to allow for meaningful judicial review.  See 38 U.S.C. § 7104(d)(1) (1991);Gilbert v. Derwinski, 1 Vet. App. 49, 56-57 (1990). 

The evidence of record raises a duty to assist issue.  VA has a duty to assist all claimants in obtaining evidence necessary to substantiate a claim.  38 U.S.C. § 5103A(a)(1).  Pursuant to subsection (d)(2), a medical examination/opinion should be provided when the record:

(1) contains competent evidence that the claimant has a current disability, or persistent or recurrent symptoms of disability; (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran’s active military, naval, or air service; but (4) does not contain sufficient medical evidence for the Secretary to make a decision on the claim, it is necessary for VA to make a decision on the claim. 

38 U.S.C. § 5103A(d)(2).   

There is evidence of record that would trigger the VA’s duty to provide a medical exam.  The veteran clearly has a current disability (element one).  Testimony was presented that indicated that he tripped on a wet floor and injured his left leg, and steel bunks fell down on the veteran’s legs while in service.  (element two). The veteran also testified to continuous problems with his legs since getting out of the service, and he has to take medication almost every day.  (element three).  The veteran is competent to proclaim that he injured his legs during service and that he experienced resulting pain.  Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Barr v. Nicholson, supra; Layno v. Brown, 6 Vet. App. 465, 469 (1994).  Moreover, the veteran is competent to provide lay testimony sufficient to “indicate” that his condition may be associated with service.  Charles v. Pincipi, 16 Vet. App. 370, 374-75 (2002).

As to element four, by the Board’s own admission, the record does not contain medical evidence of a nexus.  The Board is tacitly stating that a medical nexus opinion was needed when it discussed how the veteran, as a lay person, was not competent to provide this medical opinion.  Accordingly, there was not sufficient medical evidence to make a decision on the claim.    

Given this evidence, the Board did not discuss at all whether the duty to assist with respect to a medical exam had been satisfied.  Frankly, it was unclear from the Board’s decision whether it believed an exam was required or if the September 2005 exam fulfilled that duty.  The Board’s statement seems not to acknowledge the September 2005 exam report, and notes the lack of a medical nexus opinion.  If there was “no competent medical opinion establishing a nexus”, then did the VA have a duty to provide one?  The Board did not even discuss the issue.  Considering the evidence, a strong argument can be made on the McLendon issue, which should have been discussed.  Either the VA had a duty to provide an exam or not; or, the exam provided in September 2005 was inadequate since it did not address the medical nexus issue.  Regardless, the Board failed to address the duty to assist issue relative to an exam for the bilateral leg condition.  This failure warrants remand. 

Remand was also warranted on the issue of reopening the veteran’s pes planus claim for inadequate reasons and bases for (a) not considering Savage v. Gober, 10 Vet. App. 488 (1997) and Falzone v. Brown, 8 Vet. App. 398 (1998); and (b) failing to consider the presumption of aggravation.  38 U.S.C. § 1153; 38 C.F.R. § 3.306.

To comply with the reasons and bases requirement, the Board must analyze the credibility and probative value of the evidence, account for the evidence it finds persuasive or unpersuasive, and provide reasons for its rejection of evidence favorable to the claimant’s position. See Abernathy v. Principi, 3 Vet. App. 461, 465 (1992); Simon v. Derwinski, 2 Vet. App. 621, 622 (1992); Hatlestad v. Derwinski,1 Vet. App. 164, 169 (1991); Gilbert, supra,at 58-59.

In this case, the Board essentially ruled that the evidence submitted, which consisted of additional statements and his service medical records showing pes planus, was new but not material.  The Board concluded that the new evidence was not material because it did not address “the central question underlying the claim for service connection—whether there is a medical relationship between any currently diagnosed foot disability and service.”  In so concluding, the Board overlooked the Court’s ruling in Savage v. Gober, 10 Vet. App. 488 (1997).  Medical nexus evidence is not required for service connection under the continuity of symptomatology provisions of 38 C.F.R. 3.303(b).  Savage v. Gober at 497.  The Court in Savage further observed that unless the “relationship between the present disability and the continuity of symptomatology” is “one as to which a lay person’s observation is competent”, a medical nexus opinion would still be necessary.  Id. 

According to the Court in Falzone v. Brown, 8 Vet. App. 398, 405-06 (1998), flat feet is a condition capable of lay observation.  As such, the veteran submits that medical nexus evidence would not be required in this case.  The service medical records demonstrate a diagnosis and treatment for the flat feet and foot pain, and the veteran’s statement suggests continuity of symptoms.  The veteran stated that his legs and feet had been bothering him a lot through the years since service.  This evidence all speaks to a condition capable of lay observation (Falzone, supra) that had continuous symptoms after service, making medical nexus evidence unnecessary pursuant to Savage.

When viewed in the context of Savage and Falzone, the evidence the veteran submitted would be material since it relates to an unestablished fact necessary to substantiate the claim, to wit: the existence of a condition capable of lay observation and statements showing continuity of symptoms.  See 38 C.F.R. § 3.156(a).  The Board’s failure to analyze the evidence in light of the Court’s jurisprudence renders its statement of reasons and bases inadequate.      

Additionally, the testimony the veteran provided at the January 2007 hearing would also be material since it was probative of the issue of aggravation.  The veteran testified that he passed both pre-induction physicals in 1974 and 1980.  The veteran played sports and never had any problems with his feet prior to entrance into the service.  But he first noticed a problem during his first period of service.  The veteran’s representative also raised the issue of aggravation.  

On his entrance exam in May 1974 mild flat feet was noted on the report.  The veteran, however, never had any problems with his feet prior to service, and passed the entrance exam.  So he went from having “mild” flat feet, without any problems, to being directed by doctors not to do any “crawling, stooping, running, jumping, marching or standing for long period […]” after entering service.  The implication is clear.  Accordingly, it can fairly be argued that the condition increased in severity during service.  If so, the presumption of aggravation should apply.  See 38 U.S.C. § 1153; 38 C.F.R. § 3.306.

When viewed in the context of service aggravating a mild flat feet condition, the veteran’s statements and the service medical records are not only new but material.  The Board must include in its decision the precise basis for that decision and the Board’s response to the various arguments advanced by the claimant.  Hatlestad v. Derwinski, 1 Vet. App. 164, 169 (1991).  The veteran’s representative raised the issue of aggravation, but the Board never addressed it.  The Board never considered materiality from the perspective of whether service aggravated his flat feet condition.  The Board’s statement of reasons and bases is therefore inadequate.  A remand was warranted.

The Board is statutorily required to articulate adequate reasons or bases for its findings and conclusions on all material issues of fact and law presented by the record.  See Gilbert v. Derwinski, 1 Vet. App. 49 (1990).  Such explanations are necessary to enable the claimant to understand the Board’s decision, and to allow for meaningful judicial review.  See38 U.S.C. § 7104(d)(1); Gilbertv. Derwinski, 1 Vet. App. 49, 56-57 (1990).

In particular, 38 C.F.R. § 3.321(b)(1) provides for an extraschedular rating if there is an exceptional or unusual disability picture with “such related factors as marked interference with employment or frequent periods of hospitalization.”  (emphasis added) See 38 C.F.R. § 3.321(b)(1).  Extraschedular rating consideration is a part of an Appellant’s claim for an increased rating. See Bagwell v. Brown,   9 Vet. App. 337, 339 (1996); Floyd v. Brown,   9 Vet. App. 88, 96 (1996) (noting that extraschedular consideration is “always part” of an increased rating claim).  More specifically, an exceptional or unusual disability picture occurs when the diagnostic code (“DC”) criteria do not reasonably describe or contemplate the severity of the symptoms of the veteran’s service-connected disability.  See Thun v. Peake, 22 Vet. App. 111, 115 (2008).

In this case, the Board raised the issue of extraschedular evaluation but provided a conclusory statement, failing to address the specific evidence of the veteran’s total unemployability.  The Board stated:

However, the evidence does not show such an exceptional or unusual disability picture, with such related factors as marked interference with employment or frequent periods of hospitalization, as to render impractical the application of the regular schedular standards in rating any of those disabilities.  38 C.F.R. § 3.321(b)(1).  Rather, the record shows that the manifestations of the veteran’s carcinoma of the prostate are contemplated by those standards.  Accordingly, the currently assigned 40 percent evaluation is adequate, and no referral for extraschedular consideration is required.

In concluding that the evidence does not show an exceptional or unusual disability picture, the Board overlooked pertinent evidence.

For instance, the veteran’s service representative indicated that he suffers from uncontrollable incontinence.  The veteran states that he is required to urinate every hour.  The veteran indicated that he was forced to stop working in October 2003 as a result of the prostate disability.  He frequently has accidents as a result of the incontinence.  Moreover, the veteran indicates that Social Security deems him to be medically disabled, and he further indicated that he cannot work because he would be forced to take too many bathroom breaks.  The veteran unequivocally stated that he is unable to work.  The VA examiner in the February 2006 VA exam report also noted that the veteran had to stop working in 2003 because of his prostate.  Indeed, the veteran indicated that his medical problems prevent him from getting a job.  

The Board failed to address any of the evidence suggesting that the veteran is totally incapable of working.  If the veteran is totally unemployable due to his service-connected disability, how is a 40 percent rating consistent with the severity of his symptoms?  “In this connection, it will be remembered that a person may be too disabled to engage in employment although he or she is up and about and fairly comfortable at home or upon limited activity.”  38 C.F.R. § 4.10.

Additionally, 38 C.F.R. § 4.2 states that “[e]ach disability must be considered from the point of view of the veteran working or seeking work.”  See 38 C.F.R. § 4.2.  Accordingly, if the veteran is taking toilet breaks every hour and having incontinence on the job, it would make it impractical and unlikely that he would be able to find or maintain employment.  Moreover, his previous career was as a security guard for the U.S. Department of Energy.  How much security would he be providing if he was in the restroom all the time?  Clearly, an employee who spends such excessive amounts of time in the restroom is unproductive and not suited for employment.  As such, the veteran’s disability picture is unusual and he is totally unable to obtain a job—hence he has “marked interference with employment.”  Accordingly, the Board’s failure to address the evidence of unemployability within the context of its mention of 38 C.F.R. § 3.321(b)(1) renders its statement of reasons or bases inadequate.  A remand is warranted.         

               The VA must read all of the veteran’s submissions sympathetically to “determine all potential claims raised by the evidence, applying all relevant laws and regulations.”  Andrews v. Nicholson, 421 F.3d 1278, 1282 (Fed. Cir. 2005); see also Moody v. Principi, 360 F.3d 1306, 1310 (Fed. Cir. 2004).  The VA is required to adjudicate all claims raised by the law and evidence.  Szemraj v. Principi, 357 F.3d 1370, 1373 (Fed. Cir. 2004); Roberson v. Principi, 251 F.3d 1378, 1384 (Fed. Cir. 2001).  Additionally, VA’s duty to consider all potential claims must be based on the reasonable expectations of a pro se claimant and must address whether the “appellant’s submissions, considered in toto, have articulated a claim.”  Ingram v. Nicholson, 21 Vet. App. F.3d 232, 255-56 (2007).

            Here, the Board failed to address potential claims for a kidney disorder and an anxiety disorder as secondary to the service-connected prostate disability.  For instance, the veteran indicated that in 2003-2005 his cancer reappeared, which necessitated additional radiation treatment.  As a result, the veteran stated that his kidneys became damaged.  Indeed, records from January 2008 confirm loss of kidney function.  Cortical thinning of the right kidney was also noted.  The medical records, moreover, state that an eGFR test result of <60 ml/min/1.73 m squared indicated loss of kidney function.  The veteran’s eGFR (estimated glomerular filtration rate) in January 2008 was 49.  In April 2005 bilateral renal cortical atrophy was noted, as well as simple cystic formations. 

            Notwithstanding, the Board failed to address this potential claim raised based on the evidence of record and the veteran’s statements.  This omission is conspicuous given the provisions of 38 C.F.R. § 4.115b, DC 7528.  This provision states that “[i]f there has been no local reoccurrence or metastasis, rate on residuals as voiding dysfunction or renal dysfunction, whichever is predominant.”  38 C.F.R. § 4.115b, DC 7528.  Hence, evidence of renal dysfunction should have compelled the Board to address whether the veteran’s renal dysfunction was more predominant, entitling him to a higher rating.

            Therefore, in the alternative, the Board’s error on this issue could perhaps be more appropriately viewed as inadequate reasons or bases in the selection of a diagnostic code.  (Rather than as failure to address a secondary claim raised by the evidence.)  Although the Court reviews the selection of a diagnostic code (DC) under the arbitrary and capricious standard of review, see Butts v. Brown, 5 Vet. App. 532, 539 (1993) (en banc) (selection of a DC is a question of application of law to facts and is subject to Court review under the arbitrary-and-capricious standard), the Board is required to provide an adequate statement of reasons or bases for its selection.  See Suttman v. Brown, 5 Vet. App. 127, 133 (1993).  In this case, DC 7528 provides for two different avenues of analysis when considering the residuals associated with malignant neoplasms of the genitourinary system.  See 38 C.F.R. § 4.115b, DC 7528.  The residuals can be rated as voiding dysfunction or renal dysfunction, whichever is predominant.  Id.  Accordingly, as previously noted, the Board failed to provide an adequate discussion of which was predominant.  (It merely assumed voiding dysfunction was predominant.)  Given the evidence of renal dysfunction in the record, the Board should have addressed the renal dysfunction evidence within the context of the complete text of DC 7528, which allows for two possible methods for rating the residuals. 

            Additionally, the Board also failed to address the evidence of urinary tract infections that was raised in the record.  After the prostate surgery, the veteran stated that he now suffers from urinary tract infections.  He has had about 5 infections in the last 6 years.  The condition may also be rated as renal dysfunction.  See 38 C.F.R. § 4.115a.  This evidence further militates in favor of the argument that the Board should have addressed the applicability of the renal dysfunction criteria.  For these reasons, a remand was warranted.

            Next, the evidence of record also raised a secondary claim of anxiety or depression as a result of the service-connected disability.  The veteran stated, in his sworn testimony, that he has depression and anxiety because of his prostate problem.  Despite his unambiguous testimony, the Board failed to address whether this raised an informal claim for secondary service connection for anxiety or depression.  In Coker v. Nicholson, 19 Vet. App. 439, 441-42 (2006), the Court determined that the Board erred in failing to discuss whether the transcribed hearing testimony raises an informal claim.  Therefore, in this case, the veteran’s hearing testimony addressing his resulting anxiety or depression should have compelled the Board to discuss the possibility of an informal claim.  The failure in this regard warrants remand.

            Pursuant to Caffrey v. Brown, 6 Vet. App. 377 (1994), a veteran is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination. 

            In this case, the veteran submitted a statement in September 2008 indicating that his incontinence and kidneys have gotten worse since his last blood tests earlier in July 2008.  Although the last VA exam was only in July 2008, the veteran submits that his September 2008 statement should have triggered VA’s duty to provide another exam.  Nevertheless, the Board failed to discuss the issue of a new exam in light of the veteran’s allegations of a more severe condition since the last exam.  As such, a remand was warranted. 

The Board characterized the threshold question in this case as whether or not the veteran has a residual disorder resulting from the claimed in-service exposure to toxins.  Indeed, the center of controversy in this case concerns whether the veteran has chronic fatigue syndrome (“CFS”) and multiple chemical sensitivity syndrome (“MCSS”) or whether his symptoms are explained by a psychiatric diagnosis. 

            By way of background, the veteran submitted corroborating evidence that he was, in fact, exposed to various toxins, including lead and trichloroethylene in service.  The VA examiner in noted that the veteran’s hair analysis showed elevated lead, cadmium, mercury, and nickel.  The 1998 examiner recommended a neuropsychology exam to assess possible brain damage.  The examiner did, however, diagnosis depression. 

Acting on the examiner’s recommendation, the VA in July 1998 provided the veteran with a neuropsychology exam.  The July 1998 VA examiner diagnosed somatoform disorder, but stated that he could not make a final determination until VA completed the veteran’s CFS exam.  Subsequently, the CFS examiner confirmed the diagnosis of somatoform disorder.  Similarly, in November 2000 another VA examiner diagnosed somatoform disorder due to perceived sensitivity to man-made chemicals.  Interestingly, none of the VA examiners provided an etiological opinion for the diagnosed somatoform disorder.  

            There were other examiners who noted the psychological overlays to the veteran’s condition.  One examiner observed some anxiety, but diagnosed schizophrenia and mood disorder. 

            On the other hand, the veteran’s private physicians submitted numerous reports indicating that it was at least as likely as not that the veteran’s MCSS is related to service. 

            The VA obtained an IME in January 2005.  The IME doctor opined that the diagnosis of depression and anxiety explains the veteran’s fatigue symptoms.  The IME doctor further noted the question posed to her: whether it is as likely as not that the veteran’s chronic fatigue syndrome and/or multiple chemical sensitivity, if present or any other identifiable underlying chronic disability is due to the in-service exposure to toxins.  Although she concluded that psychiatric diagnoses explain the veteran’s symptoms, she did not provide an opinion as to whether or not the diagnosed somatoform disorder or depression/anxiety were related to service.  In fact, she stated: “It is my opinion that it is at least as likely as not that the veteran does not have either chronic fatigue syndrome or multiple chemical sensitivity.” 

            It is clear that neither the VA examiners nor the IME doctor provided any etiological opinion regarding the psychiatric disorders.  Interestingly, the veteran was diagnosed with anxiety in service and prescribed valium.  And the IME doctor said anxiety explains his symptoms.  Essentially, the examiners who favored a psychiatric explanation for the symptoms failed to provide an etiological opinion, which is problematic given at least some in-service diagnosis of a psychiatric problem. 

            In light of this, it is obvious that the Board failed to consider direct service connection for a psychiatric disorder.  As the Court noted in Clemons v. Shinseki, 23 Vet. App. 1 (2009), a veteran makes a claim for the symptoms regardless of the diagnosis.  As such, regardless of the diagnosis—whether the symptoms come from somatoform disorder or from lead poisoning—the issue is whether there is a nexus with service.  The Board failed to address this issue.  he Board simply ruled out CFS and MCSS and denied the claim.  The Board concluded that these conditions did not exist.  Instead, somatoform disorder existed, and VA should have addressed the possible nexus with service. 

Here, the Board failed to consider direct service connection for the condition it claimed was the correct diagnosis. 

In August 2009 a JMR was filed at the CAVC that remanded for, among other things, missing VA outpatient records.  In January 2010 the Board remanded this matter with directions that VA under take efforts to locate records from the VA outpatient clinic.  The Board noted that there was a record from June 1990 indicating a referral for outpatient treatment.  Accordingly, in May 2010 the AMC wrote to the VAMC requesting the missing records.  Although the June 2010 SSOC claims the VAMC found no records prior to December 2003, there is no response in the file from the VAMC.  Accordingly, there is no evidence in the file that VA actually received a negative response from the VAMC.  It appears that a letter was sent in May 2010, which received no response.   The record also documents the veteran’s referral to the VA from June 1990.  Moreover, in response to a purported negative reply (which is not in the file), VA provided no further follow up to obtain these records.

Pursuant to 38 U.S.C. § 5103A(b)(1), as part of its duty to assist, the Secretary is required to “make reasonable efforts to obtain relevant records (including private records) that the claimant adequately identifies to the Secretary and authorizes the Secretary to obtain.”  Furthermore, if, after making reasonable efforts, the Secretary cannot obtain all of the relevant records, “the Secretary shall notify the claimant that the Secretary is unable to obtain records with respect to the claim.  Such a notification shall(A) identify the records the Secretary is unable to obtain; (B) briefly explain the efforts the Secretary made to obtain those records; and (C) describe any further action to be taken by the Secretary with respect to the claim.”  38 U.S.C. § 5103A(b)(2).

With respect to records from a federal agency or department, “the efforts to obtain those records shall continue until the records are obtained unless it is reasonably certain that such records do not exist or that further efforts to obtain those records would be futile.”  38 U.S.C. § 5103A(b)(3); see 38 C.F.R. § 3.159(c)(2) (2002).

            In this case, the veteran submits that VA failed in its duty to assist.  Assuming for the sake of discussion that VA did receive an initial negative reply from the VAMC, further efforts should have been made.  VA sent one letter.  How can it be said that their efforts continued until it was reasonably certain that such records did not exist or that further efforts to obtain them would be futile?  See 38 U.S.C.S. § 5103A(b)(3); see 38 C.F.R. § 3.159(c)(2) (2002).  Moreover, the reference to the alleged absence of these records contained in the June 2010 SSOC does not satisfy all the notice requirements of 38 U.S.C. § 5103A(b)(2

            Consequently, the VA failed to comply with both the August 2009 and January 2010 remand directives from the Court and the Board, respectively.  The VAMC records were not obtained.  This raises a Stegall concern.  Moreover, the Board in the decision on appeal stated that there was no indication in the record that there are any missing records.  This was incorrect.  The evidence of record indicates that the VAMC records are still missing and that VA merely wrote one letter and then claimed there was a negative response—even though such alleged response is not in the file.  The veteran submits that the regulations require that more efforts be made to obtain federal records.  The Board should have addressed these issues in its discussion of the duty to assist, and explained how the duty to assist was yet satisfied despite VA undertaking no follow up efforts to locate the missing VA records.  The Board made no finding that the records do not exist or that further efforts to locate them would be futile.  As such, the veteran submited that the Board’s reasons or bases statement was inadequate.

The Board is required to consider all evidence of record and to address in its decision all potentially applicable provisions of law and regulation.  See 39 U.S.C.A. §7104(a); Weaver v. Principi, 14 Vet. App. 301, 302 (2001).

In this particular case, the Board failed to consider lay statements of the veteran and a service colleague.  The veteran stated that his separation from service was delayed due to albumin in his urine.  In addition, the veteran submitted a buddy statement from a friend, who went to meet the veteran at the time of his discharge and who corroborates the veteran’s assertion that his discharge was delayed due to albumin in his urine.   

The veteran further explains that he had protein in his urine at the time of discharge but due to human error it was not properly recorded in his medical records.  He left Korea and sailed to San Francisco, and then took a train to Camp Kilmer, N.J.  He was met at Camp Kilmer by his father and his friend.  He had a physical the day before and was then told to come back the next day without eating to have his urine checked again because they had found protein in it the other day.  The veteran admits to not scrutinizing his discharge or medical records at the time, which presumably would have disclosed the error.  The veteran clearly stated that he was told by a medical examiner that he had protein in his urine.  R-631.  The veteran states that this fact was never properly recorded in his medical records.  Finally, the lay evidence was also specifically raised by the veteran’s service representative.     

Notwithstanding, the Board’s decision is conspicuously lacking in any discussion of the lay evidence.  Rather, the Board treated the lay evidence simply as part of the veteran’s contentions.  Moreover, the Board rejected the medical opinions of the veterans’ private doctors in support of the claim because they are contradicted by the medical records, which appear to be negative for albumin or protein in the urine.  The Board noted that although the private doctors state that their reports are based on records showing protein in the urine during service, no such records were provided.

Accordingly, the Board summarily rejected the veteran’s lay evidence, citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992).  The Board observed that the veteran is not competent to offer diagnoses or medical opinions regarding the cause of his condition.  It further opined that the veteran is not competent to say that he had albumin in his urine during service.  

The veteran did not dispute the citation to Espiritu for the proposition that a lay person is not competent to make a medical diagnosis or provide a medical opinion on etiology.  The veteran does, however, dispute the Board’s conclusion that he is not competent to testify that he had albumin in his urine. 

In this respect, the Court in Washington v. Nicholson, 19 Vet. App. 362 (2005) cautioned that the Board must consider the purpose for which the lay evidence is being introduced.  A careful reading of the lay statements shows that the veteran was merely relating a diagnosis told to him by a medical examiner.  In fact, the lay evidence indicates his discharge was delayed a day and the stated reason for the delay was the protein in the urine.  The lay evidence was not offered as a diagnosis or an opinion on etiology, but merely to relate something the veteran had first-hand knowledge of, to wit: what he heard a medical examiner tell him after a routine urinalysis. 

The etiologic issues are fairly clear and not in dispute.  Essentially, medical evidence of record indicates that there is a clear relationship between protein in the urine and his current condition.  It is also stated in the record that proteinuria is an early sign of kidney problems.  The veteran also submitted medical literature, which is of record, that states that early kidney disease is often diagnosed with protein in the urine.  

The VA exam reports find against an etiological relationship between service and the current condition because they claim there is no evidence of medical or lab reports showing proteinuria or albuminuria in service.  The VA reports do not challenge the axiom that protein or albumin in the urine may be an early sign of kidney problems.  The VA examiners essentially conclude that since there were no medical records of protein or albumin in the urine in service, there is no nexus with service.

Therefore, the crux of the issue in this case was whether there were early symptoms in service of what was later diagnosed as chronic renal failure.  The veteran has offered lay evidence that he was told by medical examiners that he had protein in his urine, which delayed his discharge.  He further contends that a mistake was made and this positive urine test result was improperly recorded in his records.       

On the other hand, the Board’s decision, and the opinions of the VA examiners, rely exclusively on the fact that the medical records do not contain a reference to protein in the urine.  (Appellant acknowledges that the lack of contemporaneous records may be a factor the Board can consider and which weighs against the veteran’s lay evidence.)

This is the essence of the Board’s error.  The Board decision in this case is basically saying that the lay evidence cannot be credible absent corroborating clinical records.  The Board’s decision does not address the competency of the lay evidence.  Rather, the Board’s decision makes clear that it improperly determined that the lay statements lacked credibility simply because they were not corroborated by contemporaneous medical records.  See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).  Lay evidence may provide sufficient support for a claim of service connection, and it is error for the Board to require medical evidence to support that lay evidence.  Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993).  It is also error for the Board to treat lay testimony as merely part of the veteran’s contentions; it must explain its reasons for rejecting the testimony.  See Hatlestad v. Derwinski, 1 Vet. App. 164, 169-70 (1991).

Moreover, the veteran contends that it is error to conclude that he is not competent to testify as to a diagnosis told to him by a medical professional.  A witness must have personal knowledge in order to be competent to testify to a matter.  See Fed. R. Evid. 602.  (See Rucker v. Brown, 10 Vet. App. 67, 73 (1997)(noting that although the formal rules of evidence do not apply before the Board, reference to the Federal Rules of Evidence may be appropriate if it assists in articulating the reasons for a decision)).  Personal knowledge is that which comes to the witness through the use of his senses as opposed to their opinions or conclusions drawn from the facts.  United States v. Brown, 540 F.2d 1048, 1053 (10^th Cir. 1976) cert. denied, 429 U.S. 1100 (1977).   The veteran made clear that he was told and heard that he had protein in his urine, and as such he was merely reporting a contemporaneous medical diagnosis told to him by a medical examiner.  See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).  His lay evidence is not an etiological opinion or an attempt by a lay person to render a diagnosis.  Thus, the Board’s citation to Espiritu is misplaced on this point.

The Board must explain its rejection of material evidence supporting the claim.  Bonner v. Nicholson, 19 Vet. App. 188, 193 (2005).  There is simply no discussion of the lay evidence, either the veteran’s descriptions of what took place in June 1954 or the buddy statements.  Additionally, the veteran specifically contends that the medical records are wrong in that he was told he had protein in his urine, delaying his discharge.  The Board must provide a response to the various arguments advanced by the claimant.  Hatlestad v. Derwinski, 1 Vet. App. 164, 169 (1991).  Whether or not protein was in the urine at the time of service is a critical issue.   Hence, the conflict between the medical records and the veteran’s statements (including his allegation that the records are wrong) should have warranted a proper analysis.  In failing to even discuss the lay evidence while concomitantly focusing on the lack of contemporaneous medical evidence, the Board’s decision tacitly committed Buchanan-type errors.   

A U.S. Army Veteran served on active duty during three separate periods: September 1977 to August 1980, July 1983 to November 1983, and September 1988 to August 1990. The Veteran also served at Fort McClellan for military police training from September to December 1977 and weapons training for three weeks in 1989.

In April 2013, the Veteran was diagnosed with chronic lymphocytic leukemia (CLL) and subsequently filed a claim for service connection in June 2013. After a lengthy procedural history—including multiple VA denials and two Joint Motions for Remand (JMRs)—the Board again denied the claim in August 2023, rejecting service connection for CLL, including alleged exposure to herbicides and other toxic substances. The Veteran appealed to the Court.

In August 2025, the Court issued a memorandum decision vacating and remanding the Board’s ruling. The Court found that the Board had erred in evaluating evidence of actual exposure, citing several specific failures:

1. The Board did not adequately explain why lay statements and other record evidence could not support a finding of direct herbicide exposure.
2. The Board relied on statements of good water quality despite evidence of ill-tasting water, indications of herbicide use, and records showing lingering chemicals on base.
3. The Board mischaracterized a National Academy of Sciences (NAS) report as applying only to herbicide use outside Fort McClellan, such as in Vietnam.
4. The Board improperly discounted the probative value of a 2021 private medical opinion based on its reliance on lay evidence.

In a strongly worded statement, the Court found that, “[a]ll in all, the Board’s factual findings and probative value determinations were premised on its mischaracterizations of the evidence.  This resulted in a failure to address that evidence for the purpose it was offered: to establish that herbicides and toxic chemicals were present at the base and that the Veteran was exposed to such chemicals.”

This Veteran served on active duty in the U.S. Marine Corps from May 1973 to March 1976. He later joined the Texas Army National Guard, where he completed periods of active duty for training between August 1981 and June 1982, and again from July 1984 to July 1986.

In 1981, the Veteran sustained an injury when a truck backed up and pinned him between two vehicles. Following the incident, the Veteran experienced persistent neck pain and tingling sensations in both arms and hands. In February 2019, he filed a claim seeking service connection for bilateral upper extremity neuropathy. The VA granted service connection in April 2019 and assigned a 20% disability rating. Dissatisfied with the rating, the Veteran appealed. In March 2024, the Board of Veterans’ Appeals denied his request for a higher rating, prompting him to appeal the decision.

In August 2025, the Court issued a memorandum decision setting aside and remanding the Board’s ruling. The Court found that the Board had erred by requiring evidence of at least one “moderate” sensory symptom to justify an increased rating. The Court clarified that such a requirement was not supported by the applicable regulation (Diagnostic Code 8513). The Court also noted that the Board failed to define the term “moderate,” leaving the Veteran uncertain about the criteria used and the reasons for the denial.

The Court’s speed in deciding this case was notable. Judge Falvey issued his decision just two weeks after he was assigned the case.

The Veteran served on active duty in the U.S. Army from August 1989 to February 1990, and again from June 2004 to August 2005. In January 2014, the Veteran was granted service connection for PTSD with a 50% disability rating, effective from 2005. Seeking a higher rating, she filed for an increase in September 2015. The request was denied by both the Regional Office and the Board of Veterans’ Appeals, prompting her to appeal to the Court.

The parties agreed to a remand so the Board could consider evidence supporting a higher rating, including indications of suicidal ideation under the precedent set by Bankhead v. Shulkin, 29 Vet. App. 10 (2017). On remand, the Board awarded a 70% rating for PTSD beginning February 2016 but denied a rating higher than 50% prior to that date. The Veteran appealed again, and the parties entered a second remand agreement directing the Board to determine whether the appeal period extended earlier than September 2014.

In November 2022, the Board concluded that the appeal period began August 2005 but still denied a rating higher than 50% prior to September 2014. The Veteran appealed to the Court, arguing that the Board overlooked relevant case law and evidence of symptoms—particularly suicidal ideation—that could support a 70% rating.

In a February 2024 memorandum decision (No. 22-7223), the Court vacated and remanded the Board’s decision, finding that the Board erred by failing to differentiate suicidal ideation and risk of self-harm, as required by Bankhead. On remand, the Veteran submitted a private medical opinion and additional argument. Nevertheless, in September 2024, the Board again denied a rating higher than 50% for the period before September 2014.

The Veteran appealed once more, and in August 2025, the parties entered a third remand agreement (No. 25-0404). They acknowledged that the Board had failed to substantially comply with the Court’s February 2024 decision. Specifically, the Board had not properly distinguished between suicidal ideation and self-harm risk, as required under Bankhead, nor had it addressed potentially favorable evidence—including documented reports of suicidal ideation—that could support a higher rating.

The Veteran served on active duty in the U.S. Air Force from August 1963 to August 1967. In May 2022, the Veteran was granted service connection for peripheral neuropathy of bilateral lower extremities and assigned a 10% disability rating. The Veteran challenged the rating, but the Board of Veterans’ Appeals denied an increase in a December 2022 decision.

He appealed to the Court, asserting that the Board had wrongly denied a 20% rating by inaccurately concluding he had no motor function impairment. In an August 2024 memorandum decision, the Court agreed, finding the Board’s determination clearly erroneous. The Court held that while the Board acknowledged medical evidence showing the Veteran had trouble standing, balance problems, and an inability to walk for more than 15 minutes—all indicative of motor function impairment—it nevertheless concluded there was no motor function impairment.

Given that motor function is a key factor in evaluating peripheral neuropathy under the rating criteria, the Court held that the Board’s contradictory and flawed analysis warranted remand for further consideration.

The Veteran served on active duty in the U.S. Navy from July 1960 to January 1964. In November 1963, while stationed aboard the USS Boston, he was assigned to observe 8-inch gun target practice. Positioned above the guns and out of sight of the crew operating them, the Veteran was inadvertently exposed to the simultaneous discharge of all six barrels. The resulting shock wave struck the left side of his head, rendering him unconscious for four to five hours. Upon regaining consciousness, he experienced severe hearing loss, with a persistent ringing in his ears. He remained completely deaf for five days and was unable to comprehend speech for nearly a month following the incident.

In February 1966, a VA hearing examiner documented the Veteran’s hearing loss and constant bilateral ear ringing. He was formally diagnosed with tinnitus in December 1972. In February 2002, the Veteran filed a claim for service connection for tinnitus. The claim was granted in a May 2021 rating decision, which assigned an effective date of April 2021. The Veteran contested the effective date, and following further procedural developments, the Board denied an earlier effective date in a May 2024 decision, citing no clear and unmistakable error (CUE). The Veteran then appealed to the Court.

In his brief, the Veteran argued that the Board’s denial warranted reversal or, alternatively, a remand. After reviewing the brief, the Secretary agreed to a remand. In an August 2025 Joint Motion for Remand (JMR), both parties concurred that the Board had erred by failing to provide an adequate statement of reasons or bases for its decision. Specifically, the Board did not properly address the Court’s November 2023 JMR directive to consider the 1966 VA examiner’s notation of ringing in the Veteran’s ears—especially considering the partially missing November 1965 application. Additionally, the Board neglected to consider a relevant provision in the Veteran’s Benefits Administration M21-1 manual, which states that tinnitus falls within the scope of a hearing loss claim and should share the same effective date.

The Veteran served on active duty in the U.S. Marine Corps from July 1987 to July 1989. In September 2010, he underwent transforaminal lumbar interbody fusion (TILF) surgery at a VA facility, during which a pedicle screw was implanted in his spine. Following the procedure, the Veteran began experiencing severe pain and numbness. Seeking further evaluation from private medical providers, the Veteran was informed that the pedicle screw was loose and that he had sustained a pars fracture. In November 2011, he underwent corrective surgery to address the screw failure, followed by another VA surgery in November 2013 to remove the hardware.

In April 2014, the Veteran filed a claim under 38 U.S.C. § 1151 for a lower back disability resulting from the 2010 VA surgery. After an extended procedural history, the Board denied the claim in a May 2024 decision, concluding that compensation under Section 1151 was not warranted. The Veteran appealed the decision to the Court.

In August 2025, the parties entered into a Joint Motion for Remand (JMR), agreeing that the Board had erred in its denial. Specifically, the Board failed to adequately consider the Veteran’s hearing testimony that his private physicians had informed him the VA surgeon fractured his vertebra during the 2010 operation. The parties also agreed that the Board did not address whether a December 2023 VA medical opinion was based on an inaccurate factual premise. The examiner had asserted that the Veteran would have been aware of hardware failure due to a 2006 surgery, despite no evidence that hardware was used in that earlier procedure. Lastly, the Board did not explain whether the December 2023 opinion sufficiently addressed the foreseeability of hardware failure, particularly given that such a risk was not included in the informed consent provided to the Veteran prior to the 2010 surgery.

The Veteran served in the U.S. Navy from January 1976 to June 1983. In July 2013, he filed claims for service connection for headaches, hypertension, and kidney disease, citing an in-service incident in which he was wrongfully accused of threatening a commanding officer—an event that caused significant stress and anxiety. Following an extensive procedural history, the Board denied all three claims in a February 2024 decision, prompting the Veteran to appeal to the Court.

In a June 2025 memorandum decision, the Court vacated the Board’s ruling and remanded the claims for further consideration. Regarding headaches, the Court agreed with both parties that the Board had failed to consider evidence of functional impairment—specifically, the Veteran’s testimony that the severity of his headaches had caused him to miss work.

As for hypertension, the Court found that the Board erred in concluding that VA’s duty to assist did not require a medical examination. The Court noted that the Board had made no explicit determination about the credibility of the Veteran’s testimony and had overlooked whether his lay statements reasonably indicated a potential link between his condition and military service.

Finally, the Court remanded the chronic kidney disease claim as inextricably intertwined with the hypertension claim, requiring further development and adjudication.