BVA9501703 
DOCKET NO.  93-08 734     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in San Juan,
Puerto Rico

THE ISSUE

Entitlement to service connection for hypoglycemia.

REPRESENTATION

Appellant represented by: Puerto Rico Public Advocate for
Veterans Affairs

WITNESS AT HEARING ON APPEAL

Appellant

INTRODUCTION

The veteran served on active duty from February 1980 to January
1987.  This appeal arises from a March 1989 rating decision of
the San Juan, Puerto Rico, regional office (RO).  That rating
decision, in part, denied service connection for hypoglycemia.

REMAND

The veteran is service-connected for Still's disease, also known
as adult onset juvenile rheumatoid arthritis.  The record shows
that the veteran was hospitalized for evaluation of this
condition in January 1989, and that the evaluation included tests
for hypoglycemia.  The veteran has asserted that there is a
relationship between his service-connected Still's disease and
hypoglycemia.  The VA must make determinations based on medical
opinions.  Therefore, an opinion by a medical specialist should
be obtained with respect to this issue.  Additionally, records of
any subsequent treatments for hypoglycemia which are not in the
claims folder should be obtained.  Finally, the RO should obtain
and consider the decision and complete records of the Social
Security Administration (SSA) determination that the veteran was
disabled.

VA has a duty to assist the veteran in the development of his
claim.  38 U.S.C.A. § 5107(a) (West 1991).  In view of the
foregoing, the case is REMANDED to the RO for the following:

1.  The RO should obtain any necessary
releases and then request the SSA to provide
a copy of the decision and copies of all the
medical records considered in connection
with their determination that the veteran
was disabled in 1990.

2.  The veteran should be asked whether any
further treatment for hypoglycemia was
undertaken subsequent to the May 1989 VA
outpatient treatments.  If any treatments
took place, the RO should obtain and
associate with the claims folder copies of
all treatment records.  If any records are
not available, that fact should be noted.

3.  Following the above, the veteran should
be examined by a VA specialist in order to
determine whether he has chronic
hypoglycemia and whether any such disorder
is part of or caused by the service-
connected Still's disease.  The examination
report should contain detailed accounts of
all pathology found to be present,
including the current manifestations of
hypoglycemia, if present.  All necessary
tests should be conducted and the examiner
should review the results of the testing
prior to completion of the report.  The
entire claims folder and a copy of this
REMAND must be made available to and
reviewed by the examiner prior to the
examination.  The report of examination
must include the aforementioned opinion and
should contain complete rationale for the
conclusions reached.

4.  The RO should review the examination
report and determine if it is adequate for
rating purposes and in full compliance with
this Remand.  If not, the report should be
returned to the examiner for corrective
action.

5.  Following the above, the RO should
determine whether any existing
hypoglycemia, is part of or caused by the
service-connected Still's disease.

Following completion of these actions, the RO should review the
evidence and determine whether the veteran's claim may now be
granted.  If not, the veteran should be provided with an
appropriate supplemental statement of the case and afforded a
period of time to respond.  Thereafter, the case should be
returned to the Board for further appellate consideration.

No action is required by the veteran until he receives further
notice.

          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) (1993).