BVA9507684 
DOCKET NO.  93- 11 585    )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Indianapolis,
Indiana

THE ISSUES

1.  Entitlement to service connection for a right ankle and foot
disability, secondary to service connected residuals of a shell
fragment wound to Muscle Group XIV.

2.  Entitlement to an increased rating for residuals, shell
fragment wound, upper third, right thigh, Muscle Group XIV,
severe, currently evaluated as 40 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

J. A. McDonald, Associate Counsel

INTRODUCTION

The veteran served on active military duty from October 1943 to
February 1946.  This case comes before the Board of Veterans'
Appeals (hereinafter Board) on appeal from the Department of
Veterans Affairs Regional Office in Indianapolis, Indiana
(hereinafter RO).

It appears from a statement of the veteran in April 1993, that
the issue of entitlement to service connection for a back
disability, secondary to the veteran's service-connected right
thigh disorder, has been raised.  This issue has not been
developed for appellate review and is referred to the RO for
appropriate consideration.

REMAND

The veteran contends that he presently has a right ankle and foot
disability which is due to residuals of a shell fragment wound to
Muscle Group XIV of the right thigh.  A review of the evidence
reveals that while in service, the veteran incurred a perforating
shell fragment wound to his right upper third thigh, with
severance of the profunda femoral artery and vein, which were
ligated.

In reviewing the post-service medical evidence of record as it
relates to a right ankle and foot disability, complaints
concerning the veteran's ankle and foot include coldness,
numbness, and pain.  A Department of Veterans Affairs
(hereinafter VA) examination conducted in October 1991 reported
the tunnel distribution of the saphenous nerve at the foot was
decreased in sensation which was compatible with the femoral
nerve injury.  Post traumatic neurological pain related to the
sensory distribution of the femoral nodes was diagnosed.
However, on VA examination in December 1992, the examiner noted
subjectively increasing paresthesia in the feet which he opined
was likely due to a sciatic nerve function and not the femoral
nerve function.  As the etiology of a foot and ankle disability
bears directly on the matter on appeal, and there appears to be a
conflict on this issue, the Board has determined that further
development of the evidence is necessary.

The VA has a duty to assist the veteran in the development of
facts pertinent to his claim.  38 U.S.C.A. § 5107(a) (West 1991);
38 C.F.R. § 3.103(a) (1994).  The United States Court of Veterans
Appeals has held that the "fulfillment of the statutory duty to
assist . . . includes the conduct of a thorough and
contemporaneous medical examination . . . so that the evaluation
of the claimed disability will be a fully informed one."  Green
v. Derwinski, 1 Vet.App. 121, 124 (1991).  Moreover, this duty
includes an additional VA examination by a specialist, when
necessary.  Hyder v. Derwinski, 1 Vet.App. 221 (1991).  The Board
therefore concludes that a VA examination by a neurologist would
provide a record upon which a fair, equitable, and procedurally
correct decision on the veteran's claim for entitlement to
service connection for a right foot and ankle disability, can be
made.  38 C.F.R. §§ 3.326, 3.327 (1994).

Accordingly, the case is remanded to the RO for the following
action:

1.  The veteran should be afforded a VA
examination by an neurologist, in order to
more accurately determine the exact nature
and etiology of his claimed right foot and
ankle disability.  The examination should
be performed in accordance with the VA's
PHYSICIAN'S GUIDE FOR DISABILITY EVALUATION
EXAMINATIONS.  All pertinent symptomatology
and findings should be reported in detail.
Any indicated diagnostic tests and studies
should be accomplished.  The claims file
must be made available to the examiner
prior to the examination.

2.  Upon completion of these actions, the
RO should review the veteran's claims.
With regard to the veteran's claim for an
increased rating for residuals, shell
fragment wound, upper third, right thigh,
Muscle Group XIV, the RO should consider
the applicability of 38 C.F.R.
§ 3.321(b)(1) relating to extraschedular
evaluations.

If the veteran's claims are not granted, he and his
representative should be provided with an appropriate
supplemental statement of the case on all issues properly on
appeal and be afforded an opportunity to respond.  Thereafter,
the case should be returned to the Board for further appellate
consideration.  The Board intimates no opinion, either legal or
factual, as to the ultimate disposition warranted in this case,
pending completion of the requested development.

          CONSTANCE B. TOBIAS
          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).