BVA9501839 
DOCKET NO.  93-10 489     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Pittsburgh, Pennsylvania

THE ISSUE

1.  Entitlement to an increased evaluation for the service-
connected mitral valve prolapse, currently evaluated at 10
percent disabling.

2.  Entitlement to service connection for neuropsychiatric
disorder secondary to the veteran's service-connected mitral
valve prolapse.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

The veteran

ATTORNEY FOR THE BOARD

K. E. Harrison, Associate Counsel

INTRODUCTION

The veteran had active military service from April 1965 to July
1966.  This matter is before the Board of Veteran's Appeals
(Board) on appeal from a November 1991 rating decision of the RO.

REMAND

During an August 1992 hearing at the RO, the veteran testified
that she had chest pains which ranged from discomfort to serious
pain with headaches and neck aches.  She noted that severe
attacks happened approximately once a month.  The veteran also
reported that her physician told her that she was experiencing
heart arrhythmia.

The Board notes that in the course of veteran's claim she states
that she is unable to work and has submitted evidence indicating
that in March 1991 the Social Security Administration has awarded
her disability benefits.  Therefore, development of pertinent
evidence in this regard is necessary.

The evidence of record raises the issue as to whether the
veteran's neuropsychiatric disorder is proximately caused by the
veteran's service-connected mitral valve prolapse.  This issue is
inextricably intertwined with the claim for an increased rating
for mitral valve prolapse and must be adjudicated.  Harris v.
Derwinski, 1 Vet.App. 180 (1990).

Based on its review of the record, the Board finds that the
veteran should be afforded appropriate examinations to ascertain
the current severity of the mitral valve prolapse and the likely
etiology of her anxiety neurosis.

Where the record before the Board is inadequate, a remand is
required.  Green v. Derwinski, 1 Vet.App. 121 (1991).  Therefore,
the case is REMANDED to the RO for the following actions:

1.  The RO should take appropriate steps to
contact the veteran in order to obtain
copies of all clinical records dealing with
treatment she has received for her service-
connected mitral valve prolapse since 1992.
This should include all records dealing
with her Social Security disability claim.

2.  The veteran should be afforded a
special VA examination by a specialist in
cardiology to ascertain the nature and
current severity of the veteran's mitral
valve prolapse.  The examiner should
express an opinion as to whether the
veteran's mitral valve prolapse is the
likely cause of her chest pain and any
degree of dyspnea on exertion, elevation of
systolic blood pressure, arrhythmia or
heart enlargement.  Any impairment of her
ability to perform ordinary manual labor
should be identified.  The examination
should conform to the requirements of
Chapter 6 of the VA Physician's Guide for
Disability Evaluation Examinations (IB 11-
56, March 1, 1985).  The claims folder
should be made available for review by the
examiner in connection with the
examination.

3.  The veteran should be afford a VA
neuropsychiatric examination in order to
determine the nature of any current
psychopathology.  The examiner should
express an opinion as to whether any
demonstrated psychiatric disorder is caused
by the service-connected mitral valve
prolapse.  The examination should conform
to the requirements of the VA Physician's
Guide for Disability Evaluation
Examinations (IB II-56, March 1, 1985).

4.  When the foregoing development has been
completed, the claim should be reviewed by
the RO.  If the decision remains adverse to
the veteran, in whole or in part, a
supplemental statement of the case should
be prepared and the veteran and his
representative should be given a reasonable
period of time for reply.

Thereafter, the claim should be returned to the Board for further
review, if in order.  No action is required of the veteran until
he receives further notice.  The purpose of this REMAND is to
obtain additional information.  The Board does not intimate any
factual of legal conclusions as to the outcome ultimately
warranted in this appeal.

          STEPHEN L. WILKINS
          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 you appeal.  38 C.F.R. § 20.1100(b) (1993).