BVA9505196 DOCKET NO. 93-10 436 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Denver, Colorado THE ISSUES 1. Entitlement to service connection for hiatal hernia. 2. Entitlement to service connection for bilateral knee disability. 3. Entitlement to service connection for right ankle disability. 4. Entitlement to service connection for bilateral foot disability. 5. Entitlement to service connection for chronic bronchitis. 6. Entitlement to service connection for chronic pharyngitis. 7. Entitlement to service connection for low back disability other than degenerative disc disease. 8. Entitlement to an increased (compensable) evaluation for degenerative disc disease of the lumbar spine. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD G. Wm. Thompson, Counsel INTRODUCTION After completing more than 26 years of active military service, the veteran retired in April 1991. This appeal arises from a May 1991 rating decision of the Department of Veterans Affairs (VA), Denver, Colorado, Regional Office (RO) that, in pertinent part, denied service connection for hiatal hernia, bilateral knee condition, chronic right ankle sprain, bilateral foot condition, chronic bronchitis, chronic pharyngitis, and low back injury. Based on the hearing officer's November 1992 decision, by rating action in December 1992, service connection was established for degenerative disc disease of the lumbar spine, and a noncompensable rating was assigned. At that time service connection for scoliosis and sacralization of the lower spine was denied. REMAND The Board notes that several defects, such as flat feet, hallux valgus, hammer toes, and an anomaly of the left tibial tuberosity were noted during examinations in service but were not found on the post service examination by the VA. Additionally, a private examiner in November 1991 found low back disability, including hypertrophic spurring, not reported on VA examination in February 1992. Also of note is the revelation that the veteran received chiropractic treatment for low back problems in 1982. This case is remanded for actions as follows: 1. The RO, with the help of the veteran, should attempt to secure all records of private treatment for the veteran's back. The Board is especially interested in any chiropractic treatment in the 1980's, or thereafter. 2. The veteran should be permitted to submit or identify any other evidence in support of his claim. Medical evidence of claimed disabilities and any incidents of the veteran's service would be helpful. Evidence identified should be obtained by the RO. Any post-service treatment at a service medical facility, by a private physician, or from the VA, should be obtained. 3. The veteran should be examiner by a VA orthopedic specialist in order to determine the nature, extent and status of any knee, right ankle, and lumbar disability. The examination should be conducted in accordance with the Physician's Guide for Disability Evaluation Examinations. All necessary special studies and tests are to be accomplished. The Board is especially interested in defects in the left tibial tuberosity compatible with Osgood Schlatter's disease, and all disability of the lumbar spine. After review of the veteran's entire claims folder, and examination of the veteran, the examiner should provide an opinion as to the etiology and date of onset of the lumbar scoliosis first reported in 1974, the etiology and presence of sacralization of L5 if any, and the presence of degenerative disc disease and arthritis in the lumbar spine. The claims folder and a separate copy of this remand should be made available to the examiner prior to the examination. 4. The veteran reported in hearing testimony in October 1992, that he was diagnosed as having a hiatal hernia in service. Service medical records show that barium swallows in the late 1960's revealed a deviation of the esophagus to the left. The veteran should be examined by a VA internal medicine specialist in order to determine whether the veteran has an esophagus abnormality and/or hiatal hernia. All necessary special studies and tests are to be performed. The examination should be conducted in accordance with the Physician's Guide for Disability Evaluation Examinations. The claims folder and a separate copy of this remand should be made available to the examiner prior to the examination. 5. In light of the March 1982 findings in service of flat feet, hallux valgus and hammer toes, and calluses reported in February 1991, the veteran should be examined by a VA podiatrist in order to determine the extent and status of all foot disability. All necessary special studies and tests are to be performed The examination should be conducted in accordance with the Physician's Guide for Disability Evaluation Examinations. The claims folder and a separate copy of this remand should be made available to the examiner prior to the examination. Following completion of the foregoing, the RO must review the claims folder and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, including if any requested examination does not include all test reports, special studies or opinions requested, appropriate corrective action is to be implemented. Thereafter, the case should be reviewed. If any claim for service connection is found to be not well grounded, the veteran should be advised of the type of evidence needed to establish a well-grounded claim. If any benefit sought remains denied, the veteran and his representative should be provided with a supplement statement of the case and be given opportunity to respond. The case should then be returned to the Board for further appellate consideration. The issues of service connection for chronic bronchitis and chronic pharyngitis, and entitlement to an increased rating for degenerative disc disease are deferred pending this remand. RENÉE M. PELLETIER 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. (CONTINUED ON NEXT PAGE) 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).