BVA9503247 
DOCKET NO.  89-45 391     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Milwaukee,
Wisconsin

THE ISSUES

1.  Entitlement to service connection for a liver disorder,
asthma, peptic ulcer disease, esophagitis, and flat feet.

2.  Whether new and material evidence has been submitted to
reopen the veteran's claims for service connection for a nervous
disorder, arthritis of both knees, a pulmonary disorder, acne
necrotica miliaris (claimed as skin disease secondary to liver
disorder), a sinus disorder and hemorrhoids.

3.  Entitlement to increased (compensable) evaluations for a
shell fragment wound scar of the right knee, and "healed
esophageal tear, claimed as esophagus and stomach condition."

4.  Entitlement to a 10 percent disability evaluation under the
provisions of 38 C.F.R. § 3.324 (1994).

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

WITNESS AT HEARING ON APPEAL

Appellant and wife

ATTORNEY FOR THE BOARD

P. Gutstein, Counsel

INTRODUCTION

The veteran served on active duty from October 1942 to December
1945.

This matter came before the Board of Veterans' Appeals (Board) on
an appeal from the April 1989 rating decision of the Department
of Veterans Affairs (VA), Milwaukee, Wisconsin, Regional Office
(RO), which denied service connection for a liver disorder,
asthma, peptic ulcer disease and esophagitis; which continued the
prior denial of service connection for a nervous disorder,
arthritis of both knees, a pulmonary disorder, acne necrotica
miliaris, a sinus disorder and hemorrhoids; which established
service connection under 38 U.S.C.A. § 1151 (West 1991) and
granted entitlement to service connection under 38 U.S.C.A.
§ 1151 (West 1991) for healed esophageal scar (claimed as
esophagus and stomach condition) and assigned a noncompensable
evaluation; and confirmed and continued the prior noncompensable
evaluation for shell fragment wound of the right knee.

The veteran filed a notice of disagreement in May 1989 and was
furnished a statement of the case in June 1989 that included only
the issues of entitlement to service connection for arthritis of
the knees and for increased ratings for residuals of the right
knee wound and healed esophageal tear.  He filed a substantive
appeal in July 1989.  He appeared at a hearing at the RO with his
wife in August 1989.  The veteran was furnished a supplemental
statement of the case in September 1989, which included all
issues not previously included in the original statement of the
case but included in the April 1989 rating decision.
Accordingly, the veteran filed another VA Form 1-9 on October 16,
1989.

The RO furnished the veteran a statement of the case in April
1993, as to the issue of entitlement to service connection for
pes planus, stemming from the April 1989 rating decision which
denied service connection for pes planus, followed by the
veteran's notice of disagreement in May 1989.  He filed a
substantive appeal as to this issue in May 1993.

The Board previously noted that the veteran was entitled to an
adjudication of the issue of entitlement to service connection
for tinnitus, psoriasis and pyorrhea with loss of teeth.  By
rating decision of April 1993, the RO denied service connection
for these disabilities.  The veteran's representative filed a
notice of disagreement from that determination in January 1994.
The RO issued a statement of the case on these issues in July
1994.  In a statement received in September 1994, the veteran
advised that he was withdrawing his appeal on these issues.

The veteran has been represented throughout his appeal by the
Veterans of Foreign Wars of the United States which has submitted
written argument in his behalf.

REMAND

In 1993 the Adjudication Officer of the RO requested a
gastrointestinal examination of the veteran and an opinion from
the Chief Outpatient Services of the VA Medical Center,
Milwaukee, Wisconsin regarding the present gastrointestinal
symptoms that could be attributed to the esophageal tear itself
and whether the peptic stricture for which the veteran received
repeated dilatations was permanently aggravated by the esophageal
tear in 1988.  The examination was performed and an opinion was
given in June 1993.  However, after the case was returned to the
Board additional evidence was received some of which had been
reviewed by the RO and some of which had not been reviewed by the
RO.  The additional evidence should be reviewed by the RO.

In addition in his November 1994 written argument, the veteran's
representative cites the findings of the Hartford Parkview Clinic
and questions whether these manifestations are, in fact, related
to the noncompensable disability of the esophagus.  He requests a
medical opinion after examination of the veteran.

Although this case has been the subject of Board remand on a
number of occasions previously, and an expeditious resolution of
the claim is desirable at this time, nevertheless, the medical
question raised requires resolution prior to final appellate
review.  Accordingly, the case is again REMANDED, pursuant to the
provisions of 38 U.S.C.A. § 5107(a) for the following action:

The RO should schedule the veteran for an
examination by a gastroenterologist or
other appropriate specialist for the
purpose of determining the extent and
severity of the veteran's esophageal tear,
for the purpose of determining the extent
and severity of that disability.  The
claims file should be made available in
connection with the study of the case.  The
examiner is requested to review the
findings made on the June 3, 1993, medical
report by the VA and the May 1994 report by
David Chen, M.D., of the Hartford Parkview
Clinic.  It is requested that the examining
physician determine whether any of the
reported disabilities of the
gastrointestinal tract including esophageal
diverticula, hiatal hernia, accompanied by
reflux and mild peptic duodenitis are
etiologically related to the esophageal
tear.

When this development has been completed, the case should again
be reviewed by the RO on the basis of the additional evidence
obtained.  If adverse action is continued, both the veteran and
his representative should be furnished a supplemental statement
of the case and be given an opportunity to respond thereto before
the claims files are returned to the Board for final appellate
review on all issues.  No action is required of the veteran until
he is notified.

          E. M. KRENZER
          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).