BVA9506131 DOCKET NO. 93-11 771 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Phoenix, Arizona THE ISSUE Entitlement to service connection for hypertension. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD P. Greif, Associate Counsel INTRODUCTION The veteran had a period of active military service from July 1976 to March 1979. According to his Form DD-214, he had a total of 11 years, nine months and ten days of active military service. This matter came before the Board of Veterans' Appeals (Board) on appeal from an August 1992 rating decision from the Phoenix, Arizona, Regional Office (RO) of the Department of Veterans Affairs (VA). In that rating decision the RO denied, among other things, entitlement to service connection for hypertension. REMAND The veteran contends that prescription medicines taken for treatment of his service-connected disabilities have caused his hypertension. In essence, he contends that his hypertension is proximately due to, or the result of, his service-connected disabilities. In the alternative, the veteran asserts that he had hypertension in service which is sufficient to warrant service connection on a direct basis. In a September 1993 presentation, the veteran's representative argued that the case was not ready for final appellate review. He asserted that an independent medical expert should review the entire evidentiary record. The most recent VA examination accorded to the veteran was conducted in May 1992. However, such examination pertained to several service-connected disorders and did not include a cardiology examination nor an assessment of the nature of his hypertension. It is further noted that the records now before the Board have been identified as Volume 1 and 3. Volume 2 does not appear to have been forwarded to the Board or associated with the claims folder. In order to properly decide the veteran's claim, it is necessary for the RO to locate Volume 2 and associate it with the veteran's appellate folder. In view of the fact that the evidence of record does not include the necessary data to fairly adjudicate the issue on appeal, the Board is of the opinion that appellate action should be postponed. For this reason the Board will honor the representative's request and remand the case for further development. The United States Court of Veterans Appeals (Court) has held that the duty to assist the veteran in obtaining and developing available facts and evidence to support his claim includes obtaining evidence from any source, and obtaining adequate VA examinations. Littke v. Derwinski, 1 Vet.App. 90 (1990). This duty also includes obtaining available evidence to support the claim. Murphy v. Derwinski, 1 Vet.App. 78 (1990). In view of the foregoing, the Board finds further development is in order to assist the veteran in the development of his claim. Therefore, the case is REMANDED to the RO for the following action: 1. The RO should locate Volume 2 of the veteran's claims folder and associate that folder with Volumes 1 and 3 prior to further adjudication. 2. The veteran should be requested to furnish the names of all health care providers who have treated him for hypertension since his separation from service. After having obtained the appropriate releases, the RO should obtain copies of any other private medical records not already on file. The RO should also obtain copies of any VA outpatient and hospital records, not already on file, concerning treatment of this veteran. If any records are not available, that fact should be annotated in the claims folder. 3. After the foregoing is accomplished and the records are associated with the claims file, the veteran should be accorded an examination by a VA heart specialist to determine the nature, extent, and etiology of any hypertension the veteran may have. The report of examination should include a detailed account of all manifestations of the disorder found to be present. All necessary tests should be conducted, and the examiner should review the entire claims folder, including the service medical records and the results of any testing prior to completion of the report. The examination should be conducted in accordance with the diagnostic procedures outlined in the VA Physician's Guide for Disability Evaluation Examinations. The examiner must express an opinion as to whether any hypertension found on examination, was likely caused by, or is in any way related to, the veteran's service-connected disabilities, including any medication prescribed for the treatment of symptomatology associated with his service-connected disabilities. In this regard the examiner must take note of all different types of medications prescribed to the veteran over the years for the treatment of his service connected psoriasis and psoriatic arthritis and should comment on whether they could result in the development of hypertension. The examiner should express an opinion as to whether the veteran's hypertension is in any way related to the documented inservice blood pressure readings. He or she should also indicate whether hypertension was present during or within one year from the veteran's separation from military service, insofar as it is medically ascertainable. The specialist should provide complete rationale for all conclusions reached, including providing references to specific entries in the service medical records when appropriate. The claims folder and a copy of this remand must be made available to and reviewed by the examiner prior to the examination. 4. The RO should review the report of examination and determine if the opinions provided are in full compliance with this Remand. If not, the report should be returned to the examiner for corrective action. 5. After the foregoing, the RO should again formally adjudicate the issue of entitlement to service connection for hypertension. Following completion of these actions and, if the decision remains unfavorable, the veteran and his representative should be provided with a supplemental statement of the case and afforded a reasonable period of time in which to respond. Thereafter, in accordance with the current appellate procedures, the case should be returned to the Board for completion of appellate review. No action is required of the veteran until further notice is issued. 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).