BVA9500242 DOCKET NO. 93-06 146 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUES 1. Entitlement to service connection for residuals of injuries of the ankles and feet. 2. Entitlement to service connection for a hearing loss. 3. Entitlement to service connection for tinnitus. 4. Entitlement to service connection for refractive error of the eyes. 5. Entitlement to service connection for low back strain. 6. Entitlement to service connection for hypertension. 7. Entitlement to service connection for a heart disorder. 8. Entitlement to a compensable rating for post operative residuals of a right medial meniscectomy. REPRESENTATION Appellant represented by: AMVETS ATTORNEY FOR THE BOARD T. D. Harrigan, Counsel INTRODUCTION The veteran had more than 22 years of active military service and retired September 30, 1990. This case came before the Board of Veterans' Appeals (Board) on appeal from a June 1991 decision of the Seattle, Washington Regional Office (RO) of the Department of Veterans Affairs (VA) which denied service connection for residuals of tendinitis of the right foot and residuals of sprains of both ankles, a hearing loss, tinnitus, refractive error of the eyes and low back strain. The notice of disagreement with regard to those issues was received on July 24, 1991. The statement of the case was issued on September 4, 1991. The substantive appeal was received on September 17, 1991. While his case was in appellate status, the veteran raised the additional issues of entitlement to hypertension and a heart condition. Those issues were denied by the RO in a decision dated December 6, 1991. The notice of disagreement with regard to those issues and the additional issue of entitlement to a compensable rating for post operative residuals of a right medial meniscectomy (a zero percent rating had been assigned in the rating action of June 1991) was received on February 13, 1992. The statement of the case was issued on April 23, 1992. The substantive appeal was received on May 7, 1992. The veteran also raised the additional issue of entitlement to service connection for carpel tunnel syndrome. Service connection for that disorder was granted in a rating decision dated August 20, 1992 and a zero percent for right wrist fracture with tendon repair and carpal tunnel neuropathy was assigned.. A notice of disagreement with regard to that rating was received on October 14, 1992. The statement of the case with regard to that issue was issued on November 6, 1992. The veteran has not submitted a substantive appeal with regard to that issue and, accordingly, it is not before the Board on appeal at this time. The veteran has also filed a claim for exposure to Agent Orange which was denied by the RO on September 7, 1994. He has not filed a notice of disagreement with regard to that issue. REMAND The Board notes that an electrocardiogram (ECG) done in March 1991 reportedly showed a possible inferior infarct. An ECG done in April 1991 was reportedly normal. A VA physician reviewed those ECGS and one done in November 1974 and concluded that all three were all the same and were all normal. An ECG done in July 1991 reportedly showed an inferior infarct and possible left ventricular hypertrophy. On examination in July 1991 the veteran reported intermittent palpations. He has not had a recent examination by a specialist in cardiology. During service the veteran suffered various injuries to the ankles and feet. No findings with regard to the feet or ankles were reported on the VA examination of March 1991. Service medical records also reveal treatment for low back strain during service. the only finding with regard to the low back reported on the VA examination of March 1991 was that the back had normal motion. Normal knee motion was reported on the VA examination of March 1991, but later reports of treatment at a military facility show complaints of right pain and a finding of crepitus in the right knee. In view of the foregoing, it is our opinion that additional action is necessary before a final determination of this claim Accordingly, the claim is REMANDED for the following action: 1. The veteran should be examined by a specialist in cardiovascular diseases to determine the nature and extent of any cardiovascular disease found. Any indicated laboratory tests or other special testing procedures should be accomplished. The report of examination should include a complete description of any clinical manifestations found and an opinion as to the time of onset of any disorder found. The complete claims folder including the service medical records should be made available to the examiner for review prior to the examination. The examination should be conducted in accordance with the procedures outlined in the Physician's Guide for Disability Evaluation Examinations. 2. The veteran should also be accorded a special orthopedic examination to determine the nature and extent of any disorder of the ankles, feet, low back, or right knee found. Any indicated laboratory tests or other special testing procedures should be accomplished. The report of examination should include a complete description of any clinical manifestations. Copies of pertinent medical records including the March 1991 VA examination and out patient treatment records from the Madigan Army Medical Center should be made available to the examiner for review prior to the examination. The examination should be conducted in accordance with the procedures outlined in the Physician's Guide for Disability Evaluation Examinations. When the above action has been completed, the pending issues should be reevaluated by the RO and, in the event that the determination with regard to any issue remains adverse to the appellant, the claims folder and assembled data should be returned to the Board for completion of appellate review after compliance with the provisions of 38 U.S.C.A. § 7105 (West 1991). No action is required by the appellant unless he receives further notice. EUGENE A. O'NEILL 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 remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).