BVA9505384 
DOCKET NO.  93-03 117     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Jackson,
Mississippi

THE ISSUES

1.  Entitlement to service connection for sinusitis and a dental
condition.

2.  Entitlement to an increased rating for residuals of fracture
of the right side of the face, currently evaluated as 10 percent
disabling.

3.  Entitlement to increased (compensable) ratings for a right
eye disorder and residuals of a fracture of the left side of the
face.

ATTORNEY FOR THE BOARD

Joseph P. Gervasio, Jr., Counsel

INTRODUCTION

The veteran served on active duty from November 1979 to July
1987.

This case comes to the Board of Veterans' Appeals (Board) on
appeal of rating decisions of the Jackson, Mississippi, Regional
Office (RO) of the Department of Veterans Affairs (VA), which
denied service connection for sinusitis and gingivitis; rated the
service-connected residuals of a fracture of the right side of
the face as 10 percent disabling; and rated the service-connected
residuals of a fracture of the left side of the face, residuals
of an appendectomy, and a right eye disorder as noncompensable.

REMAND

The veteran has claimed service connection for sinusitis as
secondary to his facial fractures.  He was given a special ear,
nose and throat (ENT) evaluation by VA in December 1991.  The
examiner recommended that additional testing, X-ray examination
and a CT scan study, be performed, after which the veteran should
be reevaluated.  The examiner specifically indicated in a
handwritten notation on the examination report that the veteran
needed to be rescheduled to see a doctor after the CT scan study
was performed.  The studies were accomplished in January and
April 1992, but the follow-up examination was not scheduled.  It
is noted that while the report of the CT scan did not indicate
that there was an abnormality of the sinuses, the X-ray study
showed questionable opacification of the right maxillary sinus.

The Board may not rely on its own medical expertise, but must use
only independent medical evidence.  Colvin v. Derwinski,
1 Vet.App. 171 (1991).  Where an examination report recommends
further review or additional diagnostic studies, failure to
accede to the recommendations renders the examination inadequate
for rating purposes.  Green v Derwinski, 1 Vet.App. 121 (1991).

Also in connection with the claim for service connection for
sinusitis, the veteran has referred to treatment by a Dr. Austin.
He submitted an October 1992 ENT (ear, nose, and throat)
examination report which contains no diagnosis and no information
identifying its source.  It cannot be determined whether this is
the report from Dr. Austin.  Therefore, an attempt to obtain Dr.
Austin's records must be made.

Entitlement to an increased rating for status post appendectomy
was addressed in the supplemental statement of the case, but was
never mentioned by the veteran in his notice of disagreement or
substantive appeal (VA Forms 9 dated in Dec. 1992 and Jan. 1993).
Accordingly, this issue has not been appealed and is not before
the Board.

In his October 1992 notice of disagreement, the veteran spoke of
"occlusive complaints."  This was interpreted by the RO to refer
to a dental condition diagnosed as gingivitis.  However, in his
January 1993 Form 9 the veteran explained that he meant occlusion
of the breathing passages.  I note that a deviated septum was
diagnosed by VA on radiologic study of the sinuses in April 1992.
Service connection for a deviated septum should be adjudicated by
the RO.  The veteran has also referred to an overbite, which is a
dental "occlusive" problem, but it appears that this condition is
already rated as part of his service-connected facial fracture
residuals, as these residuals are rated under 38 C.F.R. Part 4,
Diagnostic Code 9904 (1994) (malunion of mandible).

Finally, the veteran has repeatedly complained of headaches which
he attributes to his facial injuries.  Entitlement to service
connection for headaches should be adjudicated by the RO.

Under these circumstances, the case must be REMANDED for the
following:

1.  The RO should obtain records of the
veteran's treatment by Dr. Austin, whose
address is provided in the October 1992
notice of disagreement.

2.  The RO should arrange for the veteran
to undergo a special ENT examination to
ascertain whether he has sinusitis and, if
so, whether it is related to his service-
connected facial fracture residuals.  The
claims folder must be made available to,
and reviewed by, the examiner.  Any
additional indicated tests that are deemed
necessary should be performed.

When this action is completed, the claim should be reviewed by the
RO.  Should any decision remain adverse, the veteran and his
representative should be furnished a supplemental statement of the
case and afforded a reasonable opportunity to respond.
Thereafter, the case should be returned to this Board for further
appellate consideration.  The remaining issues on appeal must be
held in abeyance pending the above requested development.

          J. E. DAY
          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).