KASOLD, Judge:
Veteran Angel Vazquez-Flores appeals through counsel a February 1, 2005, decision of the Board of Veterans’ Appeals (Board) that denied a disability rating greater than 30% for nephrolithiasis (kidney stones), and denied service connection for a neuropsychiatric disorder on a direct basis and as secondary to a service-connected renal disability. For the reasons set forth below, the Board’s decision will be set aside and these matters remanded for readjudication.
I. BACKGROUND
Mr. Vazquez-Flores served on active duty in the U.S. Army from July 1963 to July 1965 and from January 1966 to January 1969. Record (R.) at 26. He was granted service connection for nephroli-thiasis, and in April 1976 his disability rating was increased to 30%. R. at 242, 246. Additional evidentiary development followed, during which Mr. Vazquez-Flores submitted an April 1979 private mental evaluation report from Dr. Raul Correa Grau that reflects a diagnosis of moderately severe depressive reaction and April 1979 hospitalization records that reflect a diagnosis of schizophrenia. R. at 250-52, 274-75. After additional adjudication wherein a VA regional office (RO) denied his claim for service connection for a psychiatric disorder, Mr. Vazquez-Flores submitted a June 1982 private psychiatric evaluation report that opined that he had undifferentiated schizophrenia and that his condition “becomes more prominent when ph[y]sical symptomatology flares up.” R. at 280. He appealed the RO decision to the Board, and in September 1984 the Board, inter alia, denied service connection for an acquired psychiatric disorder on the basis that it was not incurred in or aggravated by service. R. at 296-305.
In August 1994, Mr. Vazquez-Flores sought to reopen his previously denied claim. R. at 358. He also claimed that his “service-connected kidney condition ha[d] [41]*41increased in severity.” Id. During the development of these claims, Mr. Vazquez-Flores submitted a July 1994 VA medical report that his nephrolithiasis caused depression. R. at 362. He also submitted a September 1995 letter from his private psychiatrist, Dr. Jose Juarbe, who opined that Mr. Vazquez-Flores’ “schizophrenic condition started back in 1964,” and that he considered the schizophrenia to be service connected. R. at 390. In February 1998, Dr. Juarbe testified before the RO that Mr. Vazquez-Flores had major depression that “without any doubt is related to his physical condition.” R. at 455. In August 2000, the RO issued to Mr. Vazquez-Flores a Supplemental Statement of the Case (SSOC) containing the diagnostic code (DC) criteria for nephrolithia-sis, hydronephrosis, and renal dysfunction. R. at 505-14. A November 2002 VA mental disorders examination report reflected that Mr. Vazquez-Flores had a diagnosis of recurrent, moderate major depressive disorder that was not related to service and was not precipitated or aggravated by Mr. Vazquez-Flores’ service-connected renal disability. The VA examiner stated that Mr. Vazquez-Flores “does not report any subjective complaint, any type of relationship between his renal symptoms and his psychiatric symptomatology,” and that his clinical history demonstrated no type of relationship between these conditions. R. at 585.
In the decision on appeal, the Board found that letters dated April 2001 from the RO and December 2003 from the Appeals Management Center (AMC) satisfied the Secretary’s 38 U.S.C. § 5103(a) duty to notify, and that a February 2004 SSOC satisfied the additional notice requirement in 38 C.F.R. § 3.159(b) (2007). R. at 18-20. The Board denied service connection for a neuropsychiatric disorder on both a direct basis and as secondary to a service-connected renal disability, and also denied an increased disability rating greater than 30% for nephrolithiasis.
Mr. Vazquez-Flores argues on appeal that the Board erred in its determination that adequate section 5103(a) notice on how to substantiate his claim had been provided. Specifically, he argues that the letters relied upon by the Board failed to explain the criteria for a disability rating greater than 30% for nephrolithiasis, including the possibility of rating the condition under an alternative DC. He further argues that notice that the evidence must show that his condition has “gotten worse” — without explaining what “worse” means in the context of the claim — is also insufficient. Mr. Vazquez-Flores also maintains that he should have been given notice on how to request an extrasehedular rating.
II. DISCUSSION
A. 38 U.S.C. § 5103(a) Notice
1. Required Notice in General
Upon receipt of a complete or substantially complete application for benefits, the Secretary is required to inform a claimant of any information and evidence not of record (1) that is necessary to substantiate the claim, (2) that the Secretary will seek to obtain, if any, and (3) that the claimant is expected to provide, if any. See 38 U.S.C. § 5103(a); Quartuccio v. Principi, 16 Vet.App. 183, 187 (2002) (failure to provide adequate section 5103(a) notice is remandable error); see also Paralyzed Veterans of Am. v. Sec’y of Veterans Affairs, 345 F.3d 1334, 1345-46 (Fed.Cir.2003) (section 5103(a) “applfies] only when a claim cannot be granted in the absence of additional necessary information described in the notice”). Regulations also provide that the Secretary is required to “request that the claimant provide any [42]*42evidence in the claimant’s possession that pertains to the claim.” 38 C.F.R. § 3.159(b)(1) (2007); see Pelegrini v. Principi, 18 Vet.App. 112, 121 (2004).
The purpose of section 5103(a) and § 3.159(b) is to require the Secretary to “provide affirmative notification to the claimant prior to the initial decision in the case as to the evidence that is needed and who shall be responsible for providing it.” Mayfield v. Nicholson, 444 F.3d 1328, 1333 (Fed.Cir.2006) (Mayfield II). However, section 5103(a) does not require a “predecisional adjudication” of the evidence because “the duty to notify deals with evidence gathering, not the analysis of already gathered evidence.” Locklear v. Nicholson, 20 Vet.App. 410, 415-16 (2006). Indeed, section 5103(a) notice “may be generic in the sense that it need not identify evidence specific to the individual claimant’s case (though it necessarily must be tailored to the specific nature of the veteran’s claim).” Wilson v. Mansfield, 506 F.3d 1055, 1062 (Fed.Cir.2007). Further, although adequate section 5103(a) notice need not be provided in a single notice letter, when multiple documents are used to provide adequate notice, they must relate to notice and “contain the same content or serve the same purpose as [section] 5103(a) notification.” Sanders v. Nicholson, 487 F.3d 881, 886 (Fed.Cir.2007); see also Mayfield II, 444 F.3d at 1335 (“The Board’s decision was based on an incorrect understanding of the law, specifically that [section 5103(a)] and [§ 3.159(b)] permitted compliance through a combination of unrelated pre- and post-decisional communications.”).
Generally, section 5103(a) notice must be given on “all five elements of a claim for service connection.” Dingess v. Nicholson, 19 Vet.App. 473, 487 (2006); see also D’Amico v. West, 209 F.3d 1322, 1327 (Fed.Cir.2000) (noting five elements of claim). Regarding the initial-disability-rating element of a claim for service-connected disability compensation, we held in Dingess that general section 5103(a) pre-adjudicatory notice regarding an initial disability rating must be provided, to wit:
[T]he Secretary must, at a minimum, notify the claimant that, should service connection be awarded, a schedular or extraschedular disability rating will be determined by applying relevant [DCs] in the rating schedule, found in title 38, Code of Federal Regulations, to provide a disability rating from 0% to as much as 100% (depending on the disability involved) based on the nature of the symptoms of the condition for which disability compensation is being sought, their severity and duration, and their impact upon employment. Moreover, consistent with the statutory and regulatory history, that notice must provide examples of the types of medical and lay evidence that the claimant could submit (or ask [the Secretary] to obtain) that are relevant to establishing a disability&emdash;e.g., competent lay statements describing symptoms, medical and hospitalization records, medical statements, employer statements, job application rejections, and any other evidence showing exceptional circumstances relating to the disability.
Dingess, 19 Vet.App. at 488 (citing 66 Fed.Reg. 45,620, 45,622 (Aug. 29, 2001)). However, when the application for benefits “suggests there is specific information or evidence necessary to resolve an issue relating to elements of a claim,” the Secretary “must consider that when providing notice and tailor the notice to inform the claimant of the evidence and information required to substantiate the elements of the claim reasonably raised by the application’s wording.” Id. at 488-89; see also Kent v. Nicholson, 20 Vet.App. 1, 9-10 [43]*43(2006) (holding more specific notice is required for claims to reopen). In short, the nature of the claim defines the scope of the notice required by section 5103(a). See Wilson and Dingess, both supra.
2. Required Notice for an Increased-Compensation Claim
In the claimant-friendly VA-benefits system, a claimant’s assertion that an already service-connected disability has worsened or increased in severity is a claim for additional (or increased) compensation. See 38 U.S.C. §§ 1110 (providing for the award of compensation for service-connected disabilities), 1114 (providing rates for disability compensation). An increased-compensation claim for a given disability is a new and separate claim for which section 5103(a) pre-adjudicatory notice is required. See 38 C.F.R. § 3.400 (2007) (recognizing claim for increase as separate from original claim or claim reopened after final disallowance); see also Smallwood v. Brown, 10 Vet.App. 93, 97 (1997). Unlike an initial claim for disability compensation where the evaluation of the claim is generally focused on substantiating service connection by evidence of an in-service incident, a current disability, and a nexus between the two, the nature of an increased-compensation claim centers primarily on evaluating the worsening of a disability that is already service connected. See Francisco v. Brown, 7 Vet.App. 55, 58 (1994); Proscelle v. Derwinski, 2 Vet.App. 629 (1992). That worsening generally is measured by the degree of the disability impairment, which in turn is measured by the symptoms exhibited and the effect that impairment has on the claimant’s employment and daily life. See 38 U.S.C. § 7104(d)(1); 38 C.F.R. § 4.10 (2007) (basis of disability evaluations is ability to function under ordinary conditions of daily life, including employment); Moore v. Nicholson, 21 Vet.App. 211, 218 (2007); Otero-Castro v. Principi, 16 Vet.App. 375, 381-82 (2002).
Accordingly, for an increased-compensation claim, section 5103(a) requires, at a minimum, that the Secretary notify the claimant that, to substantiate a claim, the claimant must provide, or ask the Secretary to obtain, medical or lay evidence demonstrating a worsening or increase in severity of the disability and the effect that worsening has on the claimant’s employment and daily life. Further, if the DC under which the claimant is rated contains criteria necessary for entitlement to a higher disability rating that would not be satisfied by the claimant demonstrating a noticeable worsening or increase in severity of the disability and the effect of that worsening has on the claimant’s employment and daily life (such as a specific measurement or test result), the Secretary must provide at least general notice of that requirement to the claimant. See Wilson, 506 F.3d at 1060-62; Moore and Otero-Castro, both supra; 38 C.F.R. § 4.10. Additionally, the claimant must be notified that, should an increase in disability be found, a disability rating will be determined by applying relevant DCs, which typically provide for a range in severity of a particular disability from 0% to as much as 100% (depending on the disability involved), based on the nature of the symptoms of the condition for which disability compensation is being sought, their severity and duration, and their impact upon employment and daily life. Dingess, 19 Vet.App. at 488; 38 C.F.R. § 4.10. As with proper notice for an initial disability rating and consistent with the statutory and regulatory history, the notice must also provide examples of the types of medical and lay evidence that the claimant may submit (or ask the Secretary to obtain) that are relevant to establishing entitlement to increased compensation — e.g., competent lay [44]*44statements describing symptoms, medical and hospitalization records, medical statements, employer statements, job application rejections, and any other evidence showing an increase in the disability or exceptional circumstances relating to the disability. See Dingess, supra.
S. Administrative Claims Processing
Section 5108(a) notice must be given before an initial decision on the claim is rendered in order to serve its statutory purpose of promoting development of the claim properly the first time. See Mayfield II, 444 F.3d at 1333 (“The purpose of the statute and the corresponding regulation is to require that the VA provide affirmative notification to the claimant pri- or to the initial decision in the case as to the evidence that is needed and who shall be responsible for providing it.”); 146 Cong. Rec. S9212-13 (Sept. 25, 2000) (statement of Sen. Rockefeller) (notice is intended to ensure that claim is “developed properly the first time the veteran submits an application for benefits” such that it will “lead to expedited decisionmaking and higher satisfaction in the process”). This purpose is wholly frustrated when inadequate notice leads to inadequate development of a claim prior to the initial decision.
To ensure that claimants receive the benefits to which they are entitled, Congress created a uniquely pro-claimant, nonadversarial VA-benefits adjudicatory system that contains several important procedural steps to promote that pro-claimant environment. See Wilson, 506 F.3d at 1060-62 (discussing statutory and regulatory provisions relating to the adjudicatory scheme); Sanders, 487 F.3d at 889 (noting the “uniquely pro-claimant benefits system” at VA); Hodge v. West, 155 F.3d 1356, 1362 (Fed.Cir.1998); Hayre v. West, 188 F.3d 1327, 1334 (Fed.Cir.1999) (veterans system is “uniquely claimant friendly system of awarding compensation”). Those procedural steps allow claimants who disagree with initial decisions on their claims to receive a Statement of the Case (SOC) (and an SSOC if necessary), explaining the reasons, law, and regulations governing that decision. Additionally claimants may receive further development of their claim if deemed proper by the Secretary, they may appear at a hearing, request a review by a decision review officer (DRO), and receive at least one review of the initial decision by the Board. See Disabled Am. Veterans v. Sec’y of Veterans Affairs, 327 F.3d 1339, 1346-47 (Fed.Cir.2003) (invalidating regulation that precluded claimant’s right to two reviews before the Agency); Dingess, 19 Vet.App. at 489-91 (discussing section 5103(a) within statutory adjudicatory scheme); see, e.g., 38 U.S.C. §§ 5104(a)-(b) (requiring notice of initial decision on claim, to include explanation of procedure for obtaining review of decision and, when benefit sought is denied, statement of reasons for decision and summary of evidence considered by Secretary), 7104(a) (vesting Board with jurisdiction over appeals from decision by Secretary on claim), 7105(d) (providing that after initial decision is rendered on claim, claimant may file Notice of Disagreement (NOD) and Secretary must attempt to resolve disagreement or issue SOC); see also 38 C.F.R. §§ 3.103(b)(1), (c) (requiring notice of any decision affecting payment of benefits or granting relief, to include notice of decision made, right to hearing, and notice of procedures necessary to initiate appeal), 3.103(c)(2) (providing that VA hearing officer has duty to “suggest the submission of evidence which the claimant may have overlooked and which would be of advantage to the claimant’s position”), 3.2600 (providing for review by DRO after NOD has been filed); 19.31(a) (2007) (providing for an SSOC to [45]*45be issued to inform claimant of material changes since the SOC or prior SSOC).
When an NOD is filed to the initial decision and there is alleged a notice error, the surest and often quickest way to correct that error is for the adjudicator to issue a new, adequate notice and readjudi-cate the claim. See Medrano v. Nicholson, 21 Vet.App. 165, 169 (2007) (Secretary “may cure timing defects by issuing a fully compliant [section 5103(a)] notification and then readjudicating the claim”); see also Mayfield II, 444 F.3d at 1333-34 (timing-of-notice defect may be cured by issuance of content-compliant section 5103(a) notice and subsequent readjudication). For those claims that are not resolved by the adjudicator and an appeal ultimately reaches the Board for final decision, the Board must necessarily consider any established predecisional notice error to be presumptively prejudicial. Cf. Sanders, 487 F.3d at 886, 891 (noting that the claimant has the burden of demonstrating notice error); Simmons v. Nicholson, 487 F.3d 892, 894-96 (Fed.Cir.2007) (claimant must establish that VA committed predecisional notice error before Court takes account of prejudice). The Board may evaluate for harmless error, however, such evaluation is subject to the Court’s de novo review. See Medrano, 21 Vet.App. at 170-71 (citing Mayfield v. Nicholson, 20 Vet.App. 537, 542-43 (2006) (Mayfield III)).
k. Rule of Prejudicial Error
In filings with the Court, an appellant generally must demonstrate error. See Sanders, 487 F.3d at 891 (appellant has burden of demonstrating section 5103(a) notice error); Hilkert v. West, 12 Vet.App. 145, 151 (1999) (en banc) (appellant has burden of demonstrating error); compare U.S. Vet.App. R. 28(a) (requiring appellant to provide the Court with a brief presenting all issues on appeal) with U.S. Vet.App. R. 28(1) (suspending Rule 28(a) and allowing a pro se veteran to submit an informal brief). Whether adequate section 5103(a) notice has been provided is reviewed under the “clearly erroneous” standard of review. See Garrison v. Nicholson, 494 F.3d 1366, 1370 (Fed.Cir.2007); Gordon v. Nicholson, 21 Vet.App. 270, 281 (2007) (section 5103(a) notice error is a factual determination reviewed under the “clearly erroneous” standard); Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990) (Board’s findings of fact are reviewed under the “clearly erroneous” standard of review in 38 U.S.C. § 7261(a)(4)). A finding of material fact is clearly erroneous when the Court, after reviewing the entire evidence, “ ‘is left with the definite and firm conviction that a mistake has been committed.’ ” Id. (quoting United States v. U.S. Gypsum Co., 333 U.S. 364, 395, 68 S.Ct. 525, 92 L.Ed. 746 (1948)).
When it is established on appeal to the Court that the Board has committed an error, the Court must take due account of the rule of prejudicial error. See 38 U.S.C. § 7261(b)(2) (Court shall “take due account of the rule of prejudicial error”); Newhouse v. Nicholson, 497 F.3d 1298, 1301 (Fed.Cir.2007) (stating “that the Veterans Court was required to examine whether any errors byVA were prejudicial and that it must do so based on the administrative record”); Conway v. Principi, 353 F.3d 1369, 1374-75 (Fed.Cir.2004). Although an appellant generally must establish that error is prejudicial, see Marciniak v. Brown, 10 Vet.App. 198, 201 (1997) (citing Parker v. Brown, 9 Vet.App. 476, 481 (1996) (appellant must demonstrate prejudice, or Court will conclude that a technical procedural defect is harmless)), once an appellant establishes that there was a section 5103(a) notice error, such error is presumptively prejudicial, see Sanders, 487 F.3d at 886, 891. A presumptively prejudicial notice error will re[46]*46quire reversal of the Board’s finding of adequate section 5103(a) notice unless the Secretary “can show that the error did not affect the essential fairness of the adjudication.” Id. at 889; see also Mlechick v. Mansfield, 503 F.3d 1340, 1345 (Fed.Cir.2007) (same); Intercargo Ins. Co. v. United States, 83 F.3d 391, 396 (Fed.Cir.1996) (procedural or substantive error is prejudicial when error results in “injury to an interest that the statute, regulation, or rule in question was designed to protect”).
To overcome the presumption of prejudice associated with a pre-adjudicato-ry notice error, the Secretary “must persuade the reviewing court that the purpose of the notice was not frustrated.” Sanders, 487 F.3d at 889; see also Mlechick, 503 F.3d at 1346 (holding that our Court reviews predecisional notice errors to determine whether any differences between notice given and section 5103(a) notice required “affect[ed] the fundamental fairness of the adjudication”). This may be done by demonstrating, for example, (1) that the claimant had actual knowledge of what was necessary to substantiate the claim and that the claim otherwise was properly developed, (2) that “a reasonable person could be expected to understand from the notice what was needed” to substantiate the claim,1 or (3) that the benefit could not be awarded as a matter of law. Sanders, 487 F.3d at 889 (reiterating examples noted in Mayfield v. Nicholson, 19 Vet.App. 103 (2005) (Mayfield I)).
Additionally, because the Court reviews only final Board decisions and not the initial or intermittent decisions rendered below, see 38 U.S.C. § 7252, and because reversal is not warranted unless an error affects the essential fairness of the adjudication, see Sanders, 487 F.3d at 886, the Court should consider whether the post-adjudicatory notice and opportunity to develop the case that is provided during the extensive administrative appellate proceedings leading to the final Board decision and final Agency adjudication of the claim, see, e.g., 38 U.S.C. §§ 5104(a)-(b), 7104(a), 7105(d); 38 C.F.R. §§ 3.103(b)(1), (c), (c)(2), 3.2600, 19.31(a) (2007), served to render any pre-adjudicatory section 5103(a) notice error non-prejudicial. See Sanders, 487 F.3d at 886 (recognizing that the purpose of the rule of prejudicial error is “‘to avoid wasteful proceedings on remand where there is no reason to believe a different result would have been obtained had the error not occurred’ ” (quoting In re Watts, 354 F.3d 1362, 1369 (Fed.Cir.2004))); see also Newhouse, 497 F.3d at 1301 (stating “that the Veterans Court was required to examine whether any errors by VA were prejudicial and that it must do so based on the administrative record”).2
[47]*47
5. Application in this Case
The record before the Board reveals that Mr. Vazquez-Flores was assigned a 30% disability rating for nephrolithiasis under 38 C.F.R. § 4.115b, DC 7508 (2007), the highest disability rating for that disability under that DC. However, DC 7508 cross-references 38 C.F.R. § 4.115b, DC 7509, “hydronephrosis,” which provides that severe hydronephrosis may be rated as renal dysfunction under 38 C.F.R. § 4.115a. Under § 4.115a, hypertension that is found to be 40% disabling under 38 C.F.R. § 4.104, DC 7101 (2007), is sufficient to increase a disability rating for nephrolithiasis to 60%. See 38 C.F.R. §§ 4.115a, 4.115b. Adequate section 5103(a) notice for Mr. Vazquez-Flores’ increased-compensation claim should have included, at a minimum, notification that he must either provide, or ask the Secretary to obtain, medical or lay evidence demonstrating the worsening of the disability and the effect of that worsening on his employment and daily life. Additionally, because at least some of the higher disability ratings authorized under the DC (and referenced DCs) under which Mr. Vazquez-Flores’ disability is rated are based on specific criteria beyond the obvious effect of the worsening of the disability and its effect upon his employment and daily life, the Secretary should have notified Mr. Vazquez-Flores, at least in general terms, of the information and evidence necessary to establish these more specific criteria. Further, if an increase in disability is found, a disability rating would be assigned by applying relevant DCs based on the nature, severity, and duration of the symptoms and their impact upon his employment and daily life to the extent permitted by law.
In this case, the Board relied on notice letters dated April 2001 and December 2003 and a February 2004 SSOC to find adequate notice. We observe that the Board relied on the February 2004 SSOC only to find compliance with § 3.159. The Board found that the April 2001 and December 2003 notice letters provided the notice required by section 5103(a). See Prickett v. Nicholson, 20 Vet.App. 370, 375-76 (2006) (concluding that Board found one letter alone satisfied Secretary’s section 5103(a) duty despite discussion of other documents within the decision). The Board considered the April 2001 letter to be a routine notice letter issued by the RO. [48]*48Although the Board noted that the December 2003 letter from the AMC was not a “formal” section 5103(a) notice letter, it nevertheless found that this letter informed Mr. Vazquez-Flores of the status of both of his claims and provided him basic notice required under section 5103(a). R. at 19; see R. at 928. Because the December 2003 letter was not a deci-sional notification and contained elements of notice required by section 5103(a), it was not improper for the Board to rely on it when determining whether adequate section 5103(a) notice had been provided to Mr. Vazquez-Flores. See Mayfield II, 444 F.3d at 1333 (post-decisional documents have contents and purposes different from those of compliant section 5103(a) notice documents and therefore cannot serve to satisfy the purpose of section 5103(a)); cf. Sanders, 487 F.3d at 886.
Nonetheless, neither of these letters provided to Mr. Vazquez-Flores the necessary information regarding substantiating his claim for a disability rating higher than the 30% rating currently assigned. The April 2001 letter does not advise how to substantiate an increased-compensation claim. Rather, it focuses only on what is necessary to substantiate a service-connection claim. R. at 550-53. The December 2003 letter advised him only to submit evidence that shows that his nephrolithiasis has “gotten worse.” R. at 928. It fails to explain that the evidence must demonstrate the effect of that worsening on his occupational and daily life or to provide, at least in general terms, the criteria beyond the effect of the worsening of the disability upon the occupational and daily life that is necessary to be awarded the higher disability rating for his condition. See 38 C.F.R. §§ 4.115a, 4.115b; Wilson, Moore, and Otero-Castro, all supra. Moreover, the totality of information provided in these documents was also confusing in that it provided differing versions of what was required to show entitlement to a higher disability rating. See Kent, 20 Vet.App. at 12 (incomplete and confusing information renders section 5103(a) notice inadequate). Accordingly, the lack of adequate information in the notice and the otherwise confusing nature of the notice leaves us with a definite and firm conviction that the Board’s finding that the Secretary provided section 5103(a)-compliant notice is clearly erroneous. See Gordon, supra.
Having found notice error, that error is presumptively prejudicial. See Sanders, 487 F.3d at 891. The Secretary argues that Mr. Vazquez-Flores was not prejudiced because the “record clearly shows that [he] had actual knowledge of what was necessary to substantiate his claim. Indeed, [Mr. Vazquez-Flores] was clearly advised of the evidence necessary to substantiate his claim.” Secretary’s Brief at 23. We are not convinced by the Secretary’s argument. To the extent he argues that the April 2001 and December 2003 letters clearly identified the information and evidence that would assist in substantiating Mr. Vazquez-Flores’ claim, his argument fails. As discussed above, these documents were incomplete and confusing concerning what was necessary for Mr. Vazquez-Flores to substantiate his claim for increased compensation.
Additionally, the Secretary’s assertion that Mr. Vazquez-Flores had actual knowledge of what was necessary to substantiate his claim appears to be premised on a misunderstanding that receipt of notice equates to actual knowledge. It does not. Actual knowledge is established by statements or actions by the claimant or the claimant’s representative that demonstrate an awareness of what was necessary to substantiate his or her claim. See Dalton v. Nicholson, 21 Vet.App. 23, 30-31 (2007); [49]*49see also Short Bear v. Nicholson, 19 Vet.App. 341, 344 (2005). To the extent the Secretary contends that by submitting evidence Mr. Vazquez-Flores demonstrated actual knowledge of what was needed to substantiate his claim, the Secretary proffers no evidence from the record on appeal that demonstrates such actual knowledge or understanding on the part of Mr. Vazquez-Flores. See Sanders, Dalton, and Short Bear, all supra. Finally, the record on appeal otherwise does not demonstrate that during the administrative appeal process Mr. Vazquez-Flores was provided the information necessary such that any defective predecisional notice error was rendered non-prejudicial in terms of the essential fairness of the adjudication.3,4 See Mlechick, Newhouse, and Sanders, all supra.
B. Statement of Reasons or Bases
The Board must include in its decision a written statement of the reasons or bases for its findings and conclusions, adequate to enable an appellant to understand the precise basis for the Board’s decision as well as to facilitate review in this Court. See 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet.App. 517, 527 (1995); Gilbert, 1 Vet.App. at 56-57. To comply with this requirement, the Board must analyze the credibility and probative value of the evidence, account for the evidence that it finds persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed.Cir.1996) (table); Gilbert, 1 Vet.App. at 57.
Mr. Vazquez-Flores argues that the Board, in denying his neuropsychiatric disorder claim, relied heavily on a November 2002 VA examination report despite the fact that the report is unclear as to the scope of a key statement, and without explaining evidence in the record that refutes that key statement. Specifically, the report states that Mr. Vazquez-Flores “does not report any subjective complaint, any type of relationship between his renal symptoms and his psychiatric symptoma-tology,” and that his clinical history shows no type of relationship between these conditions. R. at 585. This statement in the [50]*50November 2002 VA examination report may be read broadly to say that there is no medical evidence and no complaints of record from Mr. Vazquez-Flores regarding a relationship between his nephroli-thiasis and his psychological condition. However, the record contains at least three reports that, on their face, contradict this statement. See R. at 280 (June 1982 psychiatric evaluation report stating that Mr. Vazquez-Flores’ psychiatric condition “becomes more prominent when ph[y]sical symptomatology flares up”), 362 (July 1994 VA medical record reflecting that Mr. Vazquez-Flores’ complaints of depression were the result of his nephrolithiasis), 455 (February 1998 testimony of Dr. Juarbe that Mr. Vazquez-Flores’ major depression “without any doubt is related to his physical condition”). The Board erred in not explaining the discrepancy in this apparently contradictory information or why it gave greater weight to the November 2002 examination report than it gave to the contradictory information. See Gilbert, supra.
It is also possible that the November 2002 examination report can be read more narrowly to mean that, during that particular examination, Mr. Vazquez-Flores provided-no history or complaint to the examiner. The Board should have recognized and addressed the fact that the November 2002 examination report statement on this key issue could fairly be read broadly or narrowly, with differing meanings, and it should have either returned the examination report to the examiner for clarification of its meaning or explained why such action was not necessary. See Daves v. Nicholson, 21 Vet.App. 46, 51 (2007) (when medical examination report was susceptible to multiple fair but inconsistent meanings, Board erred in failing to seek clarification); 38 C.F.R. § 4.2 (2007).
C. Foreign Language Documents Contained in the Record on Appeal
The record on appeal contains numerous documents obtained from the Social Security Administration that are in a language other than English but are unaccompanied by an English translation, thus impeding judicial review. See, e.g., R. at 863-64, 866. The “Court conducts its reviews and deliberations in English. Any document transmitted to the Court (including one in the record on appeal) in a language other than English must be accompanied by an English translation that is certified by the translator, pursuant to 28 U.S.C. § 1746, as true and accurate.” U.S. Vet.App. R. 3(h). The parties are reminded that compliance with the Court’s Rules of Practice and Procedure is mandatory, not permissive.
D. Remand
Where, as here, the Board has failed to provide an adequate statement of reasons or bases and there have been other errors prejudicial to an appellant, the general remedy is to remand the affected matters for corrective action. See Tucker v. West, 11 Vet.App. 369, 374 (1998) (“[W]here the Board has incorrectly applied the law, failed to provide an adequate statement of reasons or bases for its determinations, or where the record is otherwise inadequate, a remand is the appropriate remedy.”). On remand, Mr. Vazquez-Flores may present any additional evidence and argument in support of the matters remanded, and the Board must consider any evidence and argument so presented. See Kay v. Principi, 16 Vet.App. 529, 534 (2002). These matters must be provided expeditious treatment on remand. See 38 U.S.C. §§ 5109B, 7112.
III. CONCLUSION
Upon consideration of the foregoing, the Board’s February 1, 2005, decision is SET [51]*51ASIDE, and the matters are REMANDED for readjudication consistent with this opinion.
KASOLD, Judge, filed the opinion of the Court. HAGEL, Judge, filed an opinion concurring in the result.