BVA9500796 
DOCKET NO.  93-23 823     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Waco, Texas

THE ISSUE

Entitlement to service connection for a low back disability.

REPRESENTATION

Appellant represented by: Texas Veterans Commission

ATTORNEY FOR THE BOARD

Alberto H. Zapata, Associate Counsel

INTRODUCTION

The veteran served on active duty from September 1991 to November
1991.

This matter comes to the Board of Veterans' Appeals (Board) on
appeal from a February, 1992 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Waco, Texas.

REMAND

The veteran is seeking service connection for low back disability
which he maintains was a proximate result of his recruit
training.  In the alternative, he maintains that a pre-existing
back condition was aggravated by his training in service.  The
veteran was given a medical discharge from service after a
Medical Board (MB) reviewed his service medical reports and
determined that the veteran had pre-existing degenerative disc
disease at the time of his enlistment.  The MB also determined
that although there was an increase in the severity of the
veteran's symptoms of low back pain while in service, at the time
of medical discharge, he had returned to a physical status equal
to that existing at the time of his enlistment.

The service medical records contain reference to radiological
studies contemporaneous with service from which a determination
of degenerative disc disease was made.  The record also contains
a private medical report created in October of 1989 approximately
2 years prior to service as part of the veteran's treatment for
low back pain.  Only the summary of the clinical findings is
contained in the claims file and no clinical notes or reports are
of record.  In this medical summary, reference is made to X-rays
and an impression given, however, clinical records and reports of
the radiologists who examined these private X-rays are not of
record.

Service medical records document the veteran's continued back
pain up to a week before medical discharge.  A service medical
report also indicates that the veteran was still being medicated
for back pain at the time of discharge.  Given the proximity of
his discharge date to this continued treatment for back pain, the
possibility that the veteran still had physical problems with his
back at the time of his discharge, beyond that which would be
expected as part of the natural progression of the disease, must
be explored.

Accordingly, the case is REMANDED to the RO for the following
actions:

1.  The RO should contact the veteran and
request that he provide the names and
addressees of all health care providers
who have treated him for a low back
disorder both prior to service and in the
years since his discharge.  After any
necessary authorization is obtained from
the veteran, the RO should obtain copies
of any treatment records identified by the
veteran which have not been previously
secured.

2.  Then, the RO should also obtain and
associate with the claims file the
clinical records, notes, and radiology
reports, if any, of the private physicians
treating the veteran for low back pain in
October 1989 .

3.  The RO should arrange for a VA
orthopedic and neurological examination of
the veteran by board certified
specialists, if available, to determine
the nature and extent of the veteran's low
back disability.  All indicated studies
including X-rays should be performed.  The
RO should arrange for the VA orthopedist
and neurologist to review the entire
claims file prior to any examination.  The
orthopedist should be requested to provide
an opinion, with complete rationale, as to
whether the veteran currently has
degenerative disc disease.  The examiners
should be requested to provide an opinion
again with complete rationale, as to
whether it is at least as likely than not,
that any degenerative disc disease or
other low back disorder is related to his
activities in service.  The claims folder
along with any newly obtained VA and
private medical records must be made
available to the VA examiners for review
before any examination of the veteran.

4.  The RO should review the examination
reports to ensure that they are adequate
for rating purposes and in compliance with
this Remand.  If not they should be
returned for corrective purposes.

5.  The RO should afford the veteran the
opportunity to submit additional evidence
in support of his claim.

6.  Thereafter, in light of information
obtained pursuant to requested
development, the RO should readjudicate
the issue of entitlement to service
connection for low back disability.

If the benefit sought on appeal is not granted to the veteran's
satisfaction, the RO should issue a Supplemental Statement of the
Case, and the veteran and his representative should be provided
an opportunity to respond.  The case should then be returned to
the Board for further appellate consideration, if otherwise in
order.  By this REMAND, the Board implies no conclusion, either
legal or factual, as to any final outcome warranted.  No action
is required of the veteran unless he is otherwise notified by the
RO.

          FRANK J. FLOWERS
          Member, Board of Veterans' Appeals

                                                    (Continued
Next Page)
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).