BVA9503835 DOCKET NO. 92-04 789 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Whether new and material evidence has been submitted to reopen claims for service connection for a liver disorder and an acquired eye disability, each as secondary to service-connected diabetes mellitus. 2. Entitlement to a total compensation rating based on individual unemployability. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Richard F. Williams, Counsel INTRODUCTION The veteran served on active duty from October 1971 to June 1974. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 1991 decision by the Department of Veterans Affairs (VA), St. Petersburg, Florida Regional Office (RO), which denied service connection for a liver disorder and an acquired eye disability, each as secondary to service-connected diabetes mellitus, and a total compensation rating based on individual unemployability. REMAND The veteran's claim for a total compensation rating based on individual unemployability is well-grounded, meaning it is not inherently implausible, and a review of the file reveals there is a further duty to assist him in developing facts pertinent to this claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103, 3.159 (1993). According to the information on file, the last VA examination was performed several years ago, in March 1991, to evaluate the severity of the veteran's service-connected diabetes mellitus (rated 60 percent), peripheral neuropathy of the right upper extremity (rated 20 percent), and peripheral neuropathy of both lower extremities (each rated 60 percent). However, the last examination is somewhat dated, and the veteran has alleged having increased impairment. Thus, a current examination is warranted. Littke v. Derwinski, 1 Vet.App. 90, 92-93 (1991); Green v. Derwinski, 1 Vet.App. 121, 123-124 (1991); Caffrey v. Brown, 6 Vet.App. 377, 381 (1994). It is also my judgment that more thorough medical (including neurological) examinations would be helpful in resolving this issue. Further, inasmuch as an examiner thought that the veteran's eye symptoms may have been neuropathy due to diabetes mellitus, an opinion from an eye examiner as to the etiology of the condition would be helpful. Hence, this case is REMANDED to the RO for the following actions: 1. The veteran should undergo a VA medical examination for the purpose of determining the current severity of his service- connected diabetes mellitus. Any impairment of health or limitation of activity attributable to diabetes should be reported. The examiner should note the veteran's weight, all medications (i.e., insulin) and dosages, any history of episodes of ketoacidosis or hypoglycemic reactions (including frequency, duration and treatment) and separately list each residual of diabetes (i.e., cardiovascular, skin, etc.). The degree of functional impairment of each separately listed residual should be fully described. The complete rationale for the opinion as to the degree of industrial impairment stemming from diabetes and diabetic sequelae should be provided. All indicated tests should be accomplished. The claims file must be made available to and reviewed by the examiner prior to the examination. 2. The RO should have the veteran undergo a neurological examination relative to service-connected peripheral neuropathy of the right upper and lower extremities. All indicated tests should be accomplished. The degree of functional impairment of each extremity should be fully described (i.e., sensory, motor, etc.). The complete rationale for the opinion as to the degree of industrial impairment from all neurological residuals of diabetes should be provided. The claims folder must be provided to and reviewed by the physician in conjunction with the examination. 3. The RO should have the veteran undergo an opthamological examination to determine the etiology and severity of any eye disorder manifested. The examiner should specifically note whether there is any eye pathology attributable to diabetes. All indicated tests should be accomplished. The claims folder must be provided to and reviewed by the physician in conjunction with the examination. 4. The veteran should also undergo a VA social and industrial survey. This should include, in part, a compilation of his work and educational history and details concerning all health problems. 5. Thereafter, the RO should review the claims for whether new and material evidence has been submitted to reopen a claim for service connection for an acquired eye disability secondary to service-connected diabetes mellitus and a total compensation rating based on individual unemployability. In reviewing the latter, care should be taken to clearly identify each separate residual of diabetes, assigning separate ratings for each such residual. Thereafter, if the veteran is not satisfied with the decision, he and his representative should be issued a supplemental statement of the case, and they should be given an opportunity to respond. The case should then be returned to the Board. Appellate consideration of the issue of whether new and material evidence has been submitted to reopen a claim for secondary service connection for a liver disorder will be deferred pending completion of the requested development noted above. M. CHEEK 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).