BVA9500098 DOCKET NO. 93-05 812 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Manila, Philippines THE ISSUES Entitlement to an increased evaluation for residuals of a gunshot wound to the left thigh involving Muscle Groups XIV and XVII on the left, rated 50 percent disabling. Entitlement to an increased evaluation for osteoarthritis of the lumbar spine, hips, and sacroiliac joints, rated 40 percent disabling. Entitlement to an increased evaluation for residuals of a malunited fracture of the left femur with shortening of left lower extremity, rated 10 percent disabling. Entitlement to an increased evaluation for residuals of a gunshot wound to the left wrist, rated 10 percent disabling. Entitlement to a total rating for compensation purposes based on individual unemployability. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Richard V. Chamberlain, Counsel INTRODUCTION The veteran served on active duty during World War II. This appeal arises from a March 1992 rating decision and December 1992 hearing officer decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Manila, Philippines, that denied the issues listed on the first page of this remand. The case was sent to the Board of Veterans' Appeals (Board) in March 1992. During the course of the appeal, the veteran raised the issue of entitlement to service connection for cardiovascular disease, including hypertension. The matter has been addressed by the RO, entitlement was denied, and no appeal has been initiated concerning this matter. Hence, this matter is not ripe for appellate review, nor is it "inextricably intertwined" with the total disability rating issue on appeal. REMAND The record shows that the veteran's claims are well-grounded, meaning they are plausible. Hence, VA has a duty to assist him in developing facts pertinent to these well-grounded claims. 38 U.S.C.A. § 5107(a) (West 1991). The duty to assist includes obtaining all relevant records and providing an adequate VA examination. Murphy v. Derwinski, 1 Vet.App. 78 (1990); Littke v. Derwinski, 1 Vet.App. 90 (1990). There is a further duty to assist him in this case. First, a review of the record reveals that only volume II of the record was sent to the Board for review. Volume I needs to be associated with the record and sent to the Board for appellate consideration. Secondly, the veteran requested a total rating for compensation purposes at a hearing at the RO in June 1992, and the hearing officer denied this benefit in December 1992. However, a current VA Form 21-8940 was not obtained from the veteran concerning his employment history. M21-1, Part VI, Par. 7.52, 7.53. Third, the evidence raises various questions concerning the veteran's osteoarthritic pathology of multiple joints. For instance, a private medical report, dated in March 1992, indicates that he has osteoarthritis of the hands, and in his notice of disagree-ment he made a similar assertion. VA reports of examinations in January 1991 and August 1992 reveal significant differences in the range of motion of the lumbar spine. Rating decisions of record do not indicate that the RO has been assigned separate evaluations for arthritis of various joints. While a rating for osteoarthritis of the sacroiliac joints may be combined with that for osteoarthritis of the lumbar spine (38 C.F.R. § 4.45 (1993)), separate ratings are warranted for osteoarthritis of the hips. 38 C.F.R. Part 4, Code 5003 (1993). Under the circumstances, the veteran should undergo a current VA orthopedic examination to the determine the severity and extent of involvement of osteoarthritis of multiple joints. Weggenmann v. Brown, 5 Vet.App. 281 (1993). Further, reports of the veteran's current treatment for his service-connected disorders should also be obtained and associated with the record, as VA has a duty to obtain reports of ongoing treatment. Murincsak v. Derwinski, 2 Vet.App. 363 (1992). It is also the judgment of the Board that the veteran should undergo a VA social and industrial survey to determine the effects of his service-connected disabilities on his ability to work. Hence, the case is REMANDED to the RO for the following actions: 1. Volume I of the veteran's claims folder should be associated with the appellate record. 2. The RO should ask the veteran to complete and submit VA Form 21-8940 and to prepare a detailed list of sources (VA or non-VA) of treatment and examinations for his service-connected disabilities since August 1992. Names and addresses of the medical providers and dates of treatment should be reported. After obtaining any release forms from him, the RO should directly contact the medical providers and obtain this information. 38 C.F.R. § 3.159 (1993). 3. The veteran should be scheduled for a VA social and industrial survey, focusing on the effects of his service-connected disabilities on his ability to secure or follow gainful employment. 4. After the above development, the veteran should be scheduled for a VA orthopedic examination to determine the extent and severity of his service- connected osteoarthritis. He should be asked to note all joints affected by arthritic pain and each joint found to have arthritis should be examined. All indicated studies, including range of motion measured in degrees, length of the lower extremities, measured in inches, and X-ray studies of the affected arthritic joints, should be performed and all clinical findings reported in detail. The examiner should express an opinion as to the severity of any restriction of motion of any joint affected by arthritis, including any functional limitation due to pain, as well as an assessment of the overall degree of functional loss caused by the joint pathology. The examiner should support all opinions by discussing medical principles as applied to specific medical evidence in this case. In order to assist the physician in providing the requested information, the claims folder should be made available and reviewed prior to the examination. 5. After the above information is associated with the claims files, the RO should review the claims and assign separate ratings for each joint affected by the service-connected osteoarthritic pathology. If the veteran is dissatisfied with the RO's decision, an appropriate supplemental statement of the case should be sent to him and his representative. They should be afforded an opportunity to respond before the case is returned to the Board for further appellate consideration. M. CHEEK 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).