BVA9505532 
DOCKET NO.  93-13 084     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Reno, Nevada

THE ISSUE

Entitlement to an increased rating for chronic lumbosacral
sprain, currently evaluated as 10 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Michele M. Florack, Associate Counsel

REMAND

The veteran had active duty from June 1966 to August 1970.

The veteran contends that all of his back problems had their
genesis from the first injury during service.  Service connection
is in effect only for lumbosacral sprain.  Although past rating
decisions and a June 1990 decision by the Board of Veterans'
Appeals (Board) referred peripherally to back disorders other
than lumbosacral sprain as being attributable to intercurrent
injuries and not to be service-connected, the "issue" of
entitlement to service connection for a back disability other
than lumbosacral sprain has not yet been formally adjudicated by
the regional office (RO).  Since the issue on appeal is impacted
by the issue of entitlement to service connection for a back
disability other than lumbosacral sprain, the case must the
REMANDED to the RO for de novo review of the service connection
claim.  Accordingly, the RO should proceed with the following:

1.  The RO should review the file in order
to ensure that all pertinent medical
sources of treatment have been contacted
for copies of records in conjunction with
the veteran's post-service back injuries
(Incidents variously reported as 1971/2,
1980/1, 1985, 1989, and 1992); any
outstanding records should be obtained.
The RO should also obtain from the veteran
the locations and dates of any hospital or
outpatient treatment he has received for
his low back since August 1992.  The
complete clinical records of all such
treatment should be secured and associated
with his claims file.

2.  The veteran should be afforded a
complete Department of Veterans Affairs
orthopedic examination of his low back to
determine the nature and etiology of all of
the veteran's low back pathology.  In
preparation for that examination, the
examiner must review the veteran's claims
file, especially with regard to the
veteran's history of car accidents and back
injuries subsequent to service.  The
examiner should then be asked to provide an
opinion to the following: a) If disability
of the low back, other than chronic
lumbosacral sprain is found, what is the
degree of probability that each identified
disorder is etiologically or causally
related to the veteran's service or to the
veteran's chronic lumbosacral sprain?  b)
If there is no such relationship, what of
the veteran's current low back
pathology/symptoms can be attributed to the
service-connected chronic lumbosacral
sprain, and what pathology/symptoms can be
attributed to other disorder(s) of the low
back?  The opinion should be supported by
adequate explanation, and the examiner
should refer to the bases for his opinion
(e.g., medical records in the claims file,
veteran's history, etc.).  The claims
folder and a copy of this REMAND must be
made available to the examiner for review
prior to the examination.

3.  Inasmuch as the issues of service
connection for all disorders of the low
back, other than lumbosacral sprain, are
deemed to be "inextricably intertwined"
with the issue of increased rating for
chronic lumbosacral sprain, the RO should
take appropriate adjudicative action, and
provide the veteran and his representative
notice of the determination and the right
to appeal.  If a timely notice of
disagreement is filed, the veteran and his
representative should be furnished with a
statement of the case and given an
opportunity to respond thereto.

When the above-requested development is completed, the case
should again be reviewed by the RO.  If the veteran's claim for
an increased rating for chronic lumbosacral sprain remains
denied, the veteran and his representative should be furnished an
appropriate supplemental statement of the case.  After they have
had an adequate opportunity to respond, the case should be
returned to the Board for further appellate review, if in order.

          M. SABULSKY
          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).