BVA9505249 
DOCKET NO.  93-14 495     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Portland,
Oregon

THE ISSUES

1.  Entitlement to service connection for impaired hearing.

2.  Entitlement to service connection for tinnitus.

REPRESENTATION

Appellant represented by:  The American Legion

ATTORNEY FOR THE BOARD

B. Anderson, Counsel

REMAND

The appellant had active duty from September 1950 to June 1952.

This appeal arises from a December 1992 rating decision of the
Portland, Oregon, regional office (RO).  In that decision, the RO
denied service connection for hearing loss and tinnitus as
secondary to treatment given for the appellant's service-
connected tuberculosis (TB).  The RO has acknowledged that drugs
prescribed for treatment of the TB can be ototoxic, but denied
the benefits sought on the basis of a determination that it is
most common to find the complaints of these problems "immediately
upon taking the medication, or shortly thereafter."  No authority
for this was cited.  The United States Court of Veterans Appeals
has repeatedly ruled that neither the RO rating board nor the
Board of Veterans' Appeals (Board) may rely on its own
unsubstantiated medical judgment.

In any event, the appellant disputes the medical judgment of the
RO, and expresses concern that not all of his Department of
Veterans Affairs (VA) medical records have been associated with
the claims folder.  The RO has attempted to obtain medical
records from the Roseburg and Kerrville VA medical facilities.
The appellant reports that his records were initially maintained
at Muskogee, and the claims file indicates that he was first
treated there in July-August 1954.  An August 1962 letter from
the Director of the VA outpatient clinic, apparently at Muskogee,
indicated that the appellant had been followed there regularly,
the last occasion being in May 1962.  It does not appear that
additional records have been requested from that location.

The record shows that the appellant was treated at the Kerrville
VA TB sanatorium from August 1954 to January 1955 and that he was
prescribed streptomycin (SM) 1 gm. twice per week, and
aminosalicylic acid (PAS) 12 gm. daily, during that time.  On
examination in January 1956, the appellant reported that he had
continued the medication until he recently developed dizziness
and numbness, and it was recommended that he continue with a
regimen of isoniazid (INH) and PAS for one more year.

To ensure that VA has met its duty to assist the claimant in
developing the facts pertinent to the claim and to ensure full
compliance with due process requirements, the case is REMANDED to
the RO for the following development:

1.  The RO should make another attempt to
secure the appellant's VA outpatient clinic
medical records from the Muskogee,
Roseburg, and Kerrville facilities.  If
obtained, they should be associated with
the claims file.

2.  Thereafter, the claims folder should be
made available to an appropriate VA
physician, preferably a specialist in ear,
nose and throat disorders, for review of
the types and dosages of TB medications
prescribed, and an opinion as to the degree
of probability, if any, that the
appellant's claimed impaired hearing and
tinnitus are causally or etiologically
related to treatment for TB.  If necessary
in the opinion of the physician, the
veteran should be scheduled for a current
examination.

After the development requested above has been completed to the
extent possible, the RO should again review the record.  The
appellant and representative should be furnished with a
supplemental statement of the case and given the applicable
opportunity to reply.  Thereafter, the case should be returned to
the Board, if in order.  The Board intimates no opinion as to the
ultimate determination warranted in this case.  The appellant
need take no action until so notified.

          CHARLES E. HOGEBOOM
          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 action has been taken in
accordance with the Veterans' Benefits Improvements Act of 1994,
Pub. L. No. 103-446, § 303, 108 Stat. 4645, ___ (1994), and 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).