BVA9502005 DOCKET NO. 93-07 890 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an increased evaluation for hypertension, currently evaluated as 10 percent disabling. 2. Entitlement to an increased evaluation for a back disability, classified for rating purposes as degenerative disc disease and degenerative arthritis of the cervical spine and degenerative arthritis of the thoracic spine, and currently evaluated as 10 percent disabling. 3. Entitlement to an increased evaluation for kidney stones, currently evaluated as 10 disabling. 4. Entitlement to an increased (compensable) evaluation for residuals of a fracture of the right wrist. 5. Entitlement to an increased (compensable) evaluation for residuals of a fracture of the left wrist. 6. Entitlement to an increased (compensable) evaluation for allergic rhinosinusitis. ATTORNEY FOR THE BOARD Robert E. O'Brien, Counsel INTRODUCTION The veteran performed essentially continuous active service from April 1951 to December 1979. The veteran has appealed from the July 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama, which denied him entitlement to increased ratings for the disabilities at issue. Service connection is also in effect for residuals of a fracture of the right fifth finger, rated as noncompensable. His combined service-connected disability evaluation is 30 percent. REMAND Under the provisions of 38 U.S.C.A. § 5107(a) (West 1991), a person who submits a claim to VA has the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that his claims are well-grounded. If the individual meets this burden, VA has the duty to assist in developing the facts pertinent to the claims. A well-grounded claim is one that is plausible, that is, meritorious on its own or capable of substantiation. King v. Brown, 5 Vet.App. 19 (1993). In this case, the veteran complains that the service-connected disabilities at issue have worsened in severity and warrant increased schedular ratings. The Board finds this evidence is sufficient to establish that the claims are plausible and therefore well-grounded. Proscelle v. Derwinski, 2 Vet.App. 629 (1992). Accordingly, VA is obligated to assist in the development of the claims. With this is mind, the Board notes that in his substantive appeal, received by VA in December 1992, the veteran complained that he had not been accorded a VA medical examination to verify that his service-connected disabilities had increased in severity. The Board notes in reviewing the record that the veteran was last accorded a medical examination by VA for rating purposes in January 1980. In the substantive appeal, the veteran also referred to having received treatment for the disabilities at issue at several facilities, including theMarion Clinic and at Maxwell Air Force Base in Montgomery, Alabama. The veteran stated that he advised VA he had been going to Maxwell Air Force Base for treatment, but VA did nothing to obtain any records from that facility. Additionally, the veteran indicated that he had to give up his last job because of "my back condition and my arthritis condition. The VA did not even consider this fact." The July 1992 rating decision denied the veteran entitlement to a total disability rating based on individual unemployability due to service-connected disabilities, but neither the statement of the case nor the March 1993 supplemental statement of the case referenced this issue. Additionally, the July 1992 rating decision denied service connection for transient ischemic attack (residuals of a stroke), bilateral carpal tunnel syndrome, and a low back disability. In his December 1992 substantive appeal, the veteran insisted that he had a stroke in 1989 which he attributed to his service-connected hypertensive vascular disease, and he took issue with the denial of service connection for a low back disability and stated that he had carpal tunnel syndrome secondary to his service-connected wrist fractures. These matters were not developed by the RO. 38 U.S.C.A.§ 7105(d) (West 1991); 38 C.F.R.§ 19.26 (1993). In light of recent decisions of the United States Court of Veterans Appeals concerning the appropriate disposition of reasonably raised but undeveloped issues, including EF v. Derwinski, 1 Vet.App. 324 (1991), Myers v. Derwinski, 1 Vet.App. 127 (1991) and Harris v. Derwinski, 1 Vet.App. 180 (1991), the Board believes the case must be returned to the RO for appropriate action on these "inextricably intertwined" matters. The Board also notes that the veteran's service-connected degenerative disc disease of the cervical spine and degenerative arthritis of the cervical and thoracic spine have always been evaluated as one disability (originally rated 10 percent under Diagnostic Code 5290), and in the July 1992 rating decision, rated 10 percent disabling under Diagnostic Code 5293 of the VA's Schedule for Rating Disabilities. As these conditions involve different minor joint groups, it would appear that consideration should be given to rating them separately under the applicable schedular criteria. In light of the foregoing, to ensure that the VA has met its duty to assist the veteran in developing the facts pertinent to the claim, the case is REMANDED to the RO for the following actions: 1. The RO should contact the appellant and request that he provide the names and addresses of all health care providers who have treated him for the disabilities at issue, and specify the approximate dates of treatment, if possible. Then, after any necessary authorization is obtained from him, the RO should obtain copies of all treatment records (not already of record) from the health care providers identified. Of particular interest are medical records from the Selma Family Medicine Center, 429 Lauderdale Street, Selma, Alabama 36701, dating from 1992, and records from the Marion Clinic, P. O. Box 548, Marion, Alabama 36756, dating from 1992. Additionally, the Maxwell Air Force Base medical facility should be contacted and requested to provide the complete clinical records regarding treatment furnished the veteran in the past few years. 2. The RO should arrange for a contemporaneous VA medical examination of the veteran to determine the current nature and extent of impairment attributable to the various disabilities at issue on appeal. All indicated studies should be accomplished and all findings should be reported in detail. The claims file should be made available for review by each examiner(s) prior to examination. As to the matter of secondary service connection for carpal tunnel syndrome, claimed to be secondary to the bilateral wrist fracture residuals, the examiner should be asked to express an opinion, with detailed rationale, as to the etiology of the veteran's carpal tunnel syndrome. With regard to service connection for transient global amnesia, claimed to be secondary to the service-connected hypertension, the examiner should be asked to express an opinion as to the etiology of any transient global amnesia found. 3. Additionally, the veteran should be provided a VA social and industrial survey, focusing on his employment history, educational background and current day-to- day functioning. A written copy of the VA social work service report should be associated with the claims record. 4. Thereafter, the RO should readjudicate the claims for increased ratings listed on the title page. It should also provide the veteran a statement of the case on the issues of entitlement to service connection for carpal tunnel syndrome and transient global amnesia, as well as the veteran's claimed entitlement to a total compensation rating based on individual unemployability by reason of service-connected disabilities. Then, if the benefits sought on appeal are not granted to the veteran's satisfaction, he should be provided a supplemental statement of the case and be afforded an opportunity for response. The case should then be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required by the veteran until he is contacted by the RO. J.F. GOUGH 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) (1993).