BVA9508257 DOCKET NO. 93-14 493 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUES 1. Entitlement to service connection for bilateral hearing loss. 2. Entitlement to service connection for bilateral defective vision. 3. Entitlement to an increased evaluation for diabetes mellitus, currently evaluated at 20 percent disabling. 4. Entitlement to an effective date prior to January 2, 1991, for an award of disability compensation benefits for service- connected diabetes mellitus, residuals of a fracture of the right index finger and hemorrhoids. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Robert P. Regan, Counsel INTRODUCTION The appellant served on active duty from November 1979 to August 1989. This matter came before the Board of Veterans' Appeals (Board) on appeal of a July 1991 rating determination by the Department of Veterans Affairs (VA) Regional Office (RO) located in Nashville, Tennessee. In a report of contact, dated in September 1994, the appellant indicated that he had changed his address to Sacramento, California. Therefore, the appellant resides apparently within the jurisdiction of the RO in Oakland, California. REMAND A review of the service medical records reflects that a separation medical examination report is not on file. The appellant, during a hearing at the RO in June 1992, testified that he receives ongoing treatment at a VA medical facility for the diabetes mellitus. In March 1994, the appellant submitted a statement in which he reported that for the prior several months, he had received treatment at a VA medical facility for glucose control problems. He further indicated that he was seen on an emergency basis at the Audie L. Murphy VA Hospital in San Antonio, Texas, in February 1994. He further submitted a copy of a private laboratory report, dated in March 1994, which he indicated showed that his diabetes mellitus had worsened. The most recent VA medical examination for compensation purposes was conducted in March 1991. In view of the foregoing, the Board is of the opinion that a contemporaneous and thorough VA examination would be of assistance in rendering a determination in this case. Caffrey v. Brown, 6 Vet.App. 377 (1994); Littke v. Derwinski, 1 Vet.App. 90 (1990). Accordingly, in accordance with the statutory duty to assist the appellant in the development of evidence pertinent to his claim, the case is REMANDED for the following actions: 1. The RO should request the National Personnel Record Center in St. Louis, Missouri to conduct a search for the separation medical examination report. 2. After securing the necessary authorizations for release of information, the RO should obtain copies of all private medical records pertaining to treatment for the disabilities in issue, subsequent to August 20, 1990. The appellant should also be requested to furnish information regarding any other treatment, from the VA or private medical care providers, which he may have received since moving to Sacramento, California 3. The RO should also obtain copies of the treatment records from the VA facility in Nashville, Tennessee, subsequent to June 22, 1992, the emergency room records at the Audie L. Murphy San Antonio, Texas VA facility during and after February 1994, and any other records of VA or private health care, reported by the appellant. 4. A VA examination should be conducted by an endocrinologist in order to determine the severity of the diabetes mellitus. All indicated testing and any specialized examinations should be conducted. It is requested that the examiner render an opinion as to whether the appellant's insulin dosage may be classified as moderate or large per Diagnostic Code 7913 of VA's Schedule for Rating Disabilities, 38 C.F.R. part 4. The claims folder is to be made available to the examiner in conjunction with the examination. 5. VA examinations should also be conducted by a specialist in hearing disorders and an ophthalmologist in order to determine the nature and severity of any hearing loss and eye disabilities, respectively. All indicated testing, including audiological evaluation, should be performed. It is requested that the examiners render opinions as to whether any hearing loss or ocular disturbances found during the examinations are causally related to the service connected diabetes mellitus. The claims folder should be made available to the examiners in conjunction with the examinations. Thereafter, the case should be reviewed by the RO. If the benefits sought on appeal are not granted, the appellant and his representative should be furnished a supplemental statement of the case and an opportunity to respond. The case should then be returned to the Board for further appellate consideration. J.F. GOUGH 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).