BVA9503257 DOCKET NO. 93-11 038 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUE Entitlement to an increased evaluation for asthma, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Robert E. O'Brien, Counsel INTRODUCTION The veteran had active service from July 1950 to September 1951. This case comes before the Board of Veterans' Appeals (Board) on appeal from a February 1990 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Seattle, Washington. REMAND The veteran was accorded a rating examination by VA in May 1992. The clinical assessment was significant evidence of obstructive airway disease. Pulmonary function testing was requested and was performed about one month after the clinical evaluation. The pulmonary function testing was remarkable for a relatively mild degree of obstructive and restrictive airway disease. In November 1992, the examiner reviewed the aforementioned results and opined that the findings on physical examination in May likely reflected some mild exacerbation in the veteran's pulmonary process and that his pulmonary function tests obtained in June were likely more reflective of the veteran's best base line status. The examiner stated that he trusted his clinical judgment and remained of the opinion that the veteran was significantly limited by his pulmonary disease. He stated he would have been very interested in examining the veteran at the time of his pulmonary function tests to assess him for the degree of audible wheezing and for prolonged forced expiratory time. The examiner noted this case was a good example of the potential error encountered when an individual is seen for a single visit for a clinical problem with such a variable course as reactive airway disease and chronic obstructive pulmonary disease. The only subsequent medical evidence of record consists of reports of two VA outpatient visits in December 1993 and January 1994. Following the January 1994 visit, it was indicated the veteran was to return as necessary. However, no further records are in the claims folder. In view of the comments made by the VA examiner about the inconsistent results on clinical examination and on pulmonary function testing, the Board believes that a more contemporaneous and comprehensive medical examination with pulmonary function testing at the same time would be helpful. Accordingly, the case is REMANDED to the RO for the following actions: 1. The RO should contact the veteran and request that he provide the names and addresses of any health care providers who have treated him for his service-connected asthma in the recent past and specify the approximate dates of treatment, if possible. Then, after any necessary authorization is obtained from the veteran, the RO should obtain copies of any treatment records identified by the veteran. The VA Medical Center in Seattle, Washington, should also be contacted and asked to provide complete clinical records pertaining to treatment of the veteran since January 1994. 2. A special pulmonary examination should be arranged by VA to determine the current nature and extent of the veteran's service- connected asthma. The examination should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations (1985). Pulmonary function studies, as well as X-ray examination and all other indicated studies, should be performed as required by the examining physician. The claims folder, or copies of all relevant records contained therein, must be made available to the examiner for review in connection with the examination. The examiner should be requested to include in the medical history the frequency and duration of episodes of bronchial asthma, and the extent to which the disease interferes with work activities, including any time lost from employment. 3. Then, in light of the evidence obtained pursuant to the requested development, the RO should readjudicate the claim for increased rating for asthma, to include consideration of 38 C.F.R. § 3.321 (b)(1) (1994). A supplemental statement of the case should then be issued, and the veteran and his representative should be provided the applicable period in which to respond. Thereafter, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to the final outcome warranted. No action is required of the veteran until he is notified by the RO. CHARLES E. HOGEBOOM Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This action has been taken in accordance with the Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).