BVA9508139 DOCKET NO. 93-15 593 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Waco, Texas THE ISSUE Entitlement to service connection for peroneal artery aneurysm with thromboembolism of the left lower extremity. REPRESENTATION Appellant represented by: Disabled American Veterans INTRODUCTION The veteran had active duty from June 1967 to June 1969. This matter arises from a decision rendered in January 1993 by the Department of Veterans Affairs Regional Office (RO) in Waco, Texas which denied entitlement to service connection for peroneal artery aneurysm with thrombophlebitis of the left lower extremity claimed as being secondary to the service-connected residuals of shell fragment wounds to the left calf and scrotum. The veteran's representative has raised the question of increased rating for the service-connected shell fragment wounds on the grounds that since there is a retained foreign body, the veteran should be given a higher rating for his service connected disabilities. Inasmuch as this issue was not decided by the RO and is not properly before the Board at this time, it is referred to the RO for actions deemed appropriate. REMAND The Department of Veterans Affairs (VA) has a statutory duty to assist a veteran in the development of the facts pertinent to any given claim for benefits which is found to be well grounded. 38 U.S.C.A. § 5107(a)(West 1991). A well-grounded claim is a plausible claim, and has been defined as one that is meritorious on its own or capable of substantiation. Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). While the veteran's claim is well grounded, the statutory duty that the VA has to assist him, have not yet been adequately fulfilled. The veteran is service-connected for residuals of shell fragment wounds to the left calf and left scrotum, each individually rated as noncompensably disabling. His main argument is that there exists an interrelationship between the service-connected shell fragment wounds and the subsequently developed peroneal artery aneurysm with thrombophlebitis due to the fact that a piece of shrapnel still embedded next to where the aneurysm occurred; and that also made the area more susceptible to additional disability. In Allen v. Brown, No. 93-245 (U.S. Vet. App. Mar. 17, 1995) the United States Court of Veterans Appeals (Court) held that a veteran is entitled to service connection for an increment in severity of a nonservice-connected disability attributable to a service-connected disability. Allen, slip op. at 16. The RO must review the veteran's claim in light of this recent Court decision. The veteran's representative asserts, that a proper examination with opinion was not conducted by the RO, but should be conducted prior to further review. According to the records on file, the veteran was hospitalized in November 1992 for complaints of pain in the left foot. He underwent an angiography which revealed the presence of an aneurysm in the left calf. However, it does not appear that the veteran has been examined by the VA for disability compensation purposes. Furthermore, no opinion was provided during the 1992 hospitalization regarding the relationship between the service connected shell fragment wounds and the veteran's aneurysm. In view of the fact that the case is being remanded, all records of treatment after the 1992 hospitalization should be obtained and associated with the claims folder. See Littke v. Derwinski, 1 Vet.App. 90 (1990); Hyder v. Derwinski, 1 Vet.App. 221 (1991). The Court has also held, that when the medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet.App. 171 (1991) and Halstead v. Derwinski, 3 Vet.App. 213 (1992). In light of the foregoing, the Board would be remiss if it were to attempt to decide the issue on appeal without first obtaining all the pertinent evidence that is missing and scheduling the veteran for a VA disability compensation examination. To ensure that the VA has met its duty to assist the claimant in developing the facts pertinent to the claim, the case is REMANDED to the RO for the following development: 1. The veteran should be asked to provide a list containing the names of all doctors and health care facilities (private and governmental) where he had been treated for his peroneal aneurysm and residuals of shell fragment wounds since his discharge from active service. Subsequently, and after securing the proper authorizations where necessary, the RO should make arrangements in order to obtain all the records of treatment from all the sources listed by the veteran which are not already on file. All information obtained should be made part of the file. The RO should also obtain all the records of any treatment at VA facilities which are not already on file. 2. Following the above, the veteran should be afforded a VA disability compensation examination limited to his peroneal artery aneurysm with thrombophlebitis and residuals of shell fragment wounds of the left extremity. All necessary special studies, tests or X-rays deemed necessary are to be accomplished. The results of any testing should be reviewed by the examiner prior to completion of the report. The report of examination should include a detailed account of all pathology found to be present. The examiner must express an opinion as to: (1) the degree of probability that the veteran's peroneal artery aneurysm with thromboembolism of the left leg is the proximate result of the service-connected residuals of shell fragment wound, and the effect of any retained foreign body that may still be embedded in the leg in the development of the aneurysm; and (2) whether there has been any increment in the severity of the veteran's peroneal artery aneurysm as a result of the service connected shell fragment wounds. A copy of this Remand and the entire claims folder must be made available to and be reviewed by the examiner prior to the examination. The specialist must provide complete rationale for all conclusions reached. The report of examination should be comprehensive. 3. The RO should review the examination report and determine if it is in full compliance with the instructions provided in this Remand. The RO must make sure that the questions posed to the examiner are properly answered. If not, the report should be returned to the examiner for corrective action. 4. The RO should adjudicate whether the veteran's peroneal artery aneurysm with thrombophlebitis of the left lower extremity was caused by or is in any way aggravated by the service-connected residuals of shell fragment wounds. In resolving this matter, the RO should give full consideration to the following decision: Allen v. Brown, No. 93- 245 (U.S. Vet. App. Mar. 17, 1995). If the benefits sought on appeal are not granted, the veteran and his representative should be furnished a supplemental statement of the case. This should include a recitation of all evidence considered. If the veteran fails to report for the examination, the supplemental statement of the case should include the provisions of 38 C.F.R. § 3.655 (1994). A reasonable period of time should then be given for the appellant's response. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action unless otherwise notified. 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) (1994).