Analysis of decisions on cases disposed of by Board of Veterans Appeals

Mr. MORSE. Now, with your permission, I should also like to submit a résumé of a typical claim for compensation or pension and a transcript of a typical hearing conducted by the Board of Veterans Appeals, which are also there marked as "Exhibits 3 and 4," with the permission of the Chair.

Mr. MITCHELL. Is there any objection?

It is so ordered.

Mr. MORSE. Thank you, Mr. Chairman.

(The résumé and transcript referred to follow :)

RÉSUMÉ OF ACTION IN TYPICAL CLAIM FOR COMPENSATION APPEALED TO BOARD OF VETERANS APPEALS

March 29, 1943: Letter from service organization to VA, enclosing veteran's application for compensation, claiming back injury in service, and power of attorney to service organization.

April 6, 1943: VA acknowledged veteran's letter. VA requested Army information.

June 11, 1943: Receipt of Army records by VA, showing service from November 25, 1940, to March 13, 1943, and enclosing treatment records.

July 8, 1943: Request by adjudication officer, VA, to Chief, Outpatient Service, for physical examination of veteran. Advice to veteran of action.

July 13, 1943: Veteran directed to report for examination on July 20, 1943. July 20, 1943: Veteran executed form showing he was single, no children, with parents partially dependent on him for support.

July 20, 1943: Letter from Public Health Service to VA Outpatient Service notifying that condition of veteran cannot be adequately determined by outpatient examination and hospital studies are necessary.

July 24, 1943: Notice of completion of hospitalization, with diagnoses of old fracture and chronic tonsillitis.

August 10, 1943: Rating granting service connection 20 percent from March 29, 1943 (day following date of discharge), for fracture chip fourth lumbar vertebra with arthritis, incurred during peacetime service.

September 3, 1943: Veteran notified of award action at peacetime rates and denial of payment at wartime rates.

September 28, 1943: Appeal by veteran, contending that although injury was received in peacetime service, it was aggravated by strenuous duties performed during wartime service.

October 11, 1943: Rating by regional office rating board, holding that fracture with arthritis was not incurred in or aggravated by World War II.

October 22, 1943: Letter from adjudication officer to service officer of right of hearing in connection with appeal.

April 20, 1944: Hearing at which claimant did not appear in person but was represented by service organization representative.

May 3, 1944: Adjudication officer executed certificate of adequacy of appeal. May 8, 1944: File transferred to Board of Veterans Appeals.

May 19, 1944: Service organization notified that hearing scheduled for June 12, 1944.

June 12, 1944: Presentation in veteran's behalf by service organization representative.

July 4, 1944: Board of Veterans Appeals requested additional Army information, including dates veteran was on maneuvers.

August 5, 1944: Report from War Department that information relative to veteran's participation in maneuvers not then available.

September 15, 1944: Board of Veterans Appeals followed up on request for Army information.

October 12, 1944: Further report received from War Department reporting no records relative to veteran's duty status while on maneuvers.

November 16, 1944: Decision by Board of Veterans Appeals to effect that evidence showed veteran incurred injury to the back in June 1941 prior to the time his organization went on maneuvers and that World War II service connection for back disability not shown.

November 21, 1944: Veteran and his representative were furnished copies of Board's decision.

May 25, 1945: Veteran was requested by originating agency to report for examination on June 13, 1945.

June 13, 1945: Veteran examined by VA. Complained of back pain, blood in urine and shoulder pain. Said he had been recently hospitalized at the Marine Hospital, Galveston, Tex. Diagnoses on VA exam: old fracture fourth lumbar vertebra, pes planus, arthritis secondary to fracture.

June 14, 1945: Request made for records at Marine Hospital.

July 2, 1945: Regional office rating board held that pes planus was not incurred in or aggravated by service.

July 18, 1945: Veteran and representative notified of rating action.

July 21, 1945: Marine Hospital again requested to forward hospital report. August 30, 1945: Report from Marine Hospital showing veteran came in with urinary complaints, but was discharged at his own request against medical advice "apparently not concerned with adequate treatment." Tentative diagnosis: suspected pyelitis.

October 3, 1945: Rating holding that pyelitis not incurred in or aggravated by service.

October 15, 1945: Veteran notified of rating action.

May 19, 1947: Rating action under 1945 schedule deferred pending reexamination of veteran.

March 8, 1948: Veteran reexamined. Complained of pains in back and right arm. Diagnoses: residuals, healed fracture, fourth lumbar vertebrae; post traumatic sclerosis and irregularity, fourth lumbar vertebrae, very mild; posttraumatic degeneration, third lumbar disc.

April 20, 1948: Previous degree of service-connected disability (20 percent) confirmed.

April 21, 1948: Veteran informed of rating action.

January 9, 1952: Electrocardiographic report record showing normal tracing with impression that veteran's symptoms are functional.

February 1, 1952: Hospital report received, showing veteran hospitalized in VA hospital from October 28, to December 2, 1951, with earlier treatment in private hospital. Diagnoses: hypochondriacal reaction; arthritis of thoracis vertebra, including fourth lumbar vertebra. Veteran discharged on his own request and demand.

January 23, 1952: Rating confirming 20 percent service-connected disability for chip fracture, fourth lumbar vertebra with arthritic changes. Held not service-connected: hypochondriacal reaction, pyelitis, pes planus.

February 1, 1952: Veteran informed of rating action.

June 16, 1952: Change in power of attorney received.

June 27, 1952: Statement received from private physician showing treatment of veteran since February 1951, with diagnosis of schizophrenia.

March 4, 1952: Examination of veteran in connection with application for hospital treatment. Impression : Anxiety neurosis.

August 13, 1952: Letter to veteran asking for employment information in connection with his application for pension.

August 18, 1952: Three lay affidavits received concerning veteran's physical condition and employability.

August 19, 1952: Employment statement received from veteran.

September 5 and 23, 1952: VA examination in connection with claim for pension. Diagnoses: epiphysitis, healed, L-4; congenital bow legs; hypochondriacal reaction, chronic, moderate, calculi small minor calyx, right kidney, mild.

October 27, 1952: Report received of VA hospitalization from October 11 to 16, 1952, with diagnosis of psychoneurosis.

November 18, 1952: Rating confirming 20 percent for service-connected disability of chip fracture, fourth lumbar vertebra with arthritic changes. Rated not permanent and total for pension purposes.

November 21, 1952: Veteran notified of denial of claim for nonservice pension. November 28, 1952: Rating for hospital or treatment purposes only. Active psychosis held not service-connected.

December 10, 1952: Report received showing hospitalization at VA hospital from October 31 to November 17, 1952. Diagnosis: anxiety reaction with hypochondriacal features.

April 27, 1953: Report received showing veteran hospitalized at VA hospital from December 23, 1952, to March 13, 1953. Diagnosis: anixety reaction and duodenal ulcer.

May 28, 1953: Report of readmission of veteran to VA hospital on May 10, 1953. He signed out against medical advice on same day.

March 11, 1955: Veteran executed change in power of attorney.

September 30, 1956: Inquiry by Congressman as to present status of veteran's application.

October 3, 1956: Congressman informed that veteran in receipt of compensation for 20 percent peacetime service-connected disability.

October 20, 1956: Inquiry from Congressman as to why veteran has been given a peacetime disability rating rather than a wartime classification.

November 6, 1956: Letter to Congressman explaining veteran incurred his disability prior to World War II.

November 8, 1956: Veteran came in to VA office complaining of poor physical condition. Hospitalization for examination and observation authorized. January 9, 1957: Report received of VA hospitalization for observation and examination from December 3 to 7, 1956. Diagnosis: chronic lumbosacial strain, chronal renal lithiasis.

February 15, 1957: Rating for service-connected condition of fracture, lumbar vertebra continued at 20 percent. Corrective action taken to grant service connection for renal lithiasis, 10 percent. Combined rating 30 percent.

February 28, 1957: Veteran notified of increase in compensation.

April 23, 1957: Veteran executed change in power of attorney.

May 24, 1957: Veteran again executed change in power of attorney.

July 11, 1957: Report received showing hospitalization of veteran in VA hospital from May 14 to 29, 1957. Diagnosis: Passive dependent personality, fracture of lumbar vertebra with arthritis.

August 5, 1957: Rating confirming and continuing prior rating.

August 27, 1957: Veteran executed another change in power of attorney. September 25, 1957: Letter from veteran stating he desired to file a supplemental claim for a nervous condition and alleging inservice treatment in 1942-43. October 4, 1957: Rating confirming and continuing prior rating. Request made of Department of Army for additional medical records.

November 22, 1957: Report received showing VA hospitalization from August 20 to October 18, 1957. Final diagnosis: Anxiety reaction.

November 26, 1957: Report received from Department of Army that no additional medical records found.

December 9, 1957: Rating confirming and continuing prior rating. February 18, 1958: Letter from veteran stating he was a patient at a private hospital for a week commencing February 6, 1958; on February 16 was a patient at the U.S. Marine Hospital and on February 17 was transferred by ambulance to VA hospital.

February 28, 1958: Report received showing hospitalization at U.S. Public Health Service Hospital from February 16 to 17, 1958, with diagnosis of renal calculus.

March 4, 1958: Rating confirming and continuing prior action. Case diaried for VA hospital report.

March 7, 1958: Veteran informed that no change in his disability compensation warranted on basis of report from U.S. Public Health Service Hospital. March 24, 1958: Report received of VA hospitalization from February 18 to 19, 1958. Diagnosis: Right kidney stone and right ureteral stone.

April 1, 1958: Rating confirming and continuing prior rating.

April 4, 1958: Letter to veteran informing him no change warranted in previous determination.

June 24, 1958: Report of contact from VA hospital-veteran discharged from hospital a.w.o.l. from unauthorized leave May 14, 1958.

July 11, 1958: Report received showing hospitalization at VA hospital from Feb. 17 to May 14, 1958. Discharged a.wo.l. Final diagnoses: Right kidney stone and right ureteral stone; anxiety reaction.

July 24, 1958: Rating denying service connection for anxiety reaction and claimed stomach ulcers.

July 28, 1958: Veteran notified of rating action.

December 23, 1958: Interim report from VA hospital, showing veteran admitted on November 3, 1958, and still a patient. Diagnoses: Renal calculi with hematuria; mild lumbosacral strain; acute anxiety reaction, very severe.

January 19, 1959: Rating confirming and continuing previous rating. January 23, 1959: Veteran notified that no change in disability compensation warranted and asked to submit copy of divorce decree.

February 4, 1959: Copy of divorce decree received, showing dissolution of marriage in November 1952.

April 29, 1959: Hospital report received showing final discharge on April 10, 1959, from VA hospital to which he was admitted November 3, 1958. Diognoses same as on interim report.

May 21, 1959: Rating confirming and continuing prior rating.

May 26, 1959: Letter to veteran notifying him no change in prior dete mination.

June 9, 1959: Report from VA hospital showing veteran hospitalized from April 27 to June 3, 1959. Diagnoses: Acute anxiety reaction; renal calculi with mild hematuria; mild lumbosacral strain; probably chronic gastritis.

July 1, 1959: Rating confirming and continuing previous rating action. July 2, 1959: Veteran notified no change warranted in previous determination. August 11, 1959: Veteran appealed for service connection for his stomach condition.

August 11, 1959: Rating confirming rating decision appealed from. August 18, 1959: Veteran's representative in agency of original jurisdiction waived hearing and stated no further evidence to submit.

September 10, 1959: Veteran informed his appeal being certified to Board of Veterans Appeals.

September 16, 1959: Appeal received in Board.

October 12, 1959: Claim reviewed and hearing by veteran's representative. January 15, 1960: Decision by Board of Veterans Appeals denying service connection for gastrointestinal disorder.

NAME:

Hearing held in the Board Room, Board of Veterans Appeals, Veterans' Administration, Washington, D.C., October 22, 1959, with the following members present:

CHAIRMAN. The Board has for consideration the claim of C. The veteran is present and is represented by . of

service organization. The question at issue on appeal is service connection for amputation, left lower extremity, as the result of and secondary to the service-connected skin condition.

(Veteran sworn.)

CHAIRMAN.

an opening statement on the appeal?

(representative), do you wish to make

REPRESENTATIVE. Yes, sir. Thank you, Mr. Chairman.
CHAIRMAN. Do you desire the file?

REPRESENTATIVE. No. Thank you. The records show this veteran served from February 28, 1941, until January 13, 1946, and he is properly service-connected for dermatophytosis of the feet and hands. The records further show that on September 20, 1958, he was involved in an accident which severely lacerated his left leg with a compound fracture of the tibia and fibula. The left leg was placed in a cast and a postoperative infection set in, necessitating amputation of the leg above the knee.

Ever since his discharge from World War II, the veteran has been under practically continuous treatment for his skin condition, during which time he was treated with nearly every known antibiotic, for which he had acquired a resistance.

We would like to refer specifically to the statement of record dated December 1, 1958, signed by Dr. This is part of Dr. -'s remarks: "It seems logical to assume that if a fresh laceration must be enclosed in a cast with an infected area that the laceration would certainly be infected by cross contamination. Moreover, since this patent had been treated for the serviceconnected disability by all the current antibiotics over the years, that the organisms that inhabited the foot infection would be largely resistant to normal antibiotics."

As late as August 25, 1958, the veteran was still under active treatment by Dr. for his severe dermatitis. There is no indication that the inquiry of September 20, 1958, was of such severity to warrant amputation. The records will show that because of the extent of the injury plus the infection, it was necessary to amputate the leg just above the knee.

The veteran is personally present this morning and wishes to present to the Board additional factual testimony concerning his case.

Q. Mr. you heard me state you were receiving treatment for your skin condition in August 1958. I wonder if you would relate to the Board the extent of this treatment and just what occurred?

because the

A. As I recall. at that time I went into Dr. secondary infection had set in the outbreak and he had prescribed, I don't recall exactly what the medication was except that among others there was the saltwater soaks and an ointment that he had me use two or three times a day. This was the treatment that I was undergoing at the time.

Q. Were you using an ointment and a salve on this leg, on the dermatitis? A. Yes.

Q. Where was the dermatitis confined to?

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