BVA9504700 DOCKET NO. 93-07 772 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Reno, Nevada THE ISSUE Entitlement to an increased rating for a bilateral hearing loss, currently evaluated as 40 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD P. M. Lynch, Associate Counsel INTRODUCTION The veteran's active military service extended from June 1946 to March 1947 and from May 1948 to December 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 1992 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Reno, Nevada which continued a 40 percent rating for a bilateral hearing loss. It is noted that in June 1992 the veteran submitted a statement to the effect that he wished to pursue his previously denied claim for entitlement to service connection for a heart condition based on radiation exposure. This issue has not been developed for appellate consideration is referred to the RO for appropriate action. REMAND The veteran's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, he has presented a claim which is plausible. However, for the reasons that follow, it appears that the statutory duty to assist the veteran mandated by 38 U.S.C.A. § 5107(a) has not yet been fully met. The veteran contends that the RO erred in denying his claim for an increased rating for a bilateral hearing loss. He argues that his disability is more severely disabling than currently evaluated. In his substantive appeal dated in April 1992, the veteran stated that he had recently received additional treatment for his condition at the University of Nevada in Reno, Nevada and at the VA medical centers in San Francisco, California and in Reno, Nevada. However, these complete medical records are not currently associated with the claims folder. The duty to assist requires that VA obtain the veteran's complete medical records. See Ferraro v. Derwinski, 1 Vet.App. 326 (1991). Therefore, the RO should make arrangements to obtain the veteran's complete medical records from these facilities and associate them with the claims folder. Moreover, the veteran has contended that he experiences vertigo with occasional nausea and that he walks with a staggering gait. The RO has not adjudicated the question of whether the veteran's vertigo and staggering problems are part of or in any way associated with the service connected hearing loss. The United States Court of Veterans Appeals has held that it would not review appeals in a piecemeal fashion, and that a decision on a given claim for an increased rating is not a final order when an "inextricably intertwined" question remains undecided and pending. See Harris v. Derwinski, 1 Vet.App. 180 (1991). It is evident that the resolution of the issue of service connection for the veteran's vertigo and staggering problem could have a significant impact on the disability evaluation to be assigned for his service connected hearing loss. Therefore, the question needs to be adjudicated prior to further review on appeal. To ensure that VA has met its duty to assist the claimant in developing the facts pertinent to the claim and to ensure full compliance with due process requirements, the case is REMANDED to the RO for the following development: 1. The RO should contact the veteran and request that he provide the names and addresses of all health care providers which have treated him for his bilateral hearing loss, vertigo with occasional nausea and staggering gait since his discharge from service. The Board is particularly interested in obtaining the records of any treatment that the veteran received at the VA Medical Centers in San Francisco, California and in Reno, Nevada. The Board is also interested in the records of any treatment received by the veteran at the University of Nevada in Reno, Nevada. 2. After securing the necessary releases, the RO should obtain all treatment reports and hospital treatment folders from all private health care providers listed by the veteran that are not already on file, including those from the University of Nevada in Reno, Nevada. The RO should also obtain all treatment records pertaining to the veteran's condition from the VA medical centers in San Francisco, California and in Reno, Nevada. If any records are not available, that fact and the reason(s) should be annotated in the claims folder. 3. Following the above, the veteran should be afforded an examination by a VA physician specializing in ear disorders. The report of examination should include a detailed account of all manifestations of any bilateral ear disorder found to be present. All necessary tests, including audiological studies should be conducted and the examiner should review the results of any testing prior to completion of the report. The specialist should express an opinion as to the probability that any current vertigo with occasional nausea or staggering gait is part of or caused by the service-connected bilateral hearing disorder. A copy of this remand and the claims folder must be made available to and reviewed by the examiner prior to the examination. The specialist should provide complete rationale for all conclusions reached. 5. The RO should review the examination reports and determine if they are adequate for rating purposes and in full compliance with this remand. If not, the report(s) should be returned to the examiner(s) for corrective action. 6. Finally, the RO should formally adjudicate whether service connection is warranted for any vertigo with occasional nausea or staggering gait found on examination. The RO should then review the issue originally certified for appeal. Once the foregoing has been accomplished, and if the benefits are not granted to the satisfaction of the veteran, both the veteran and his representative should be furnished a supplemental statement of the case covering all the pertinent evidence, law and regulatory criteria. They should be afforded a reasonable period of time in which to respond. Thereafter, the case should be returned to the Board for further appellate consideration. The veteran need to take no action until so informed. The purpose of this REMAND is assist the veteran and to obtain clarifying information. JOAQUIN AGUAYO-PERELES 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) (1994).