BVA9506244 
DOCKET NO.  93-08 730     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Waco, Texas

THE ISSUES

1.  Entitlement to service connection for a left knee disorder.

2.  Entitlement to service connection for a right knee disorder.

3.  Entitlement to service connection for a chronic left ear
disorder.

4.  Entitlement to service connection for chronic headaches.

5.  Entitlement to an increased evaluation for hallux valgus of
the left foot, currently evaluated as 10 percent disabling.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

S. D. Regan, Associate Counsel

REMAND

The veteran had active service from February 1988 to April 1991.
This matter came before the Board of Veterans' Appeals
(hereinafter "the Board") on appeal from an October 1991 rating
decision of the Waco, Texas Regional Office (hereinafter "the
RO") which granted service connection for hallux valgus of the
left foot with a 10 percent disability evaluation and denied
service connection for a left knee disorder, a right knee
disorder, a chronic left ear disorder and for chronic headaches.
The veteran has been represented throughout this appeal by the
Disabled American Veterans.

The veteran asserts on appeal that the RO erred in denying
service connection for a left knee disorder, a right knee
disorder, a chronic left ear disorder and for chronic headaches
and in failing to grant an evaluation in excess of 10 percent for
his service-connected hallux valgus of the left foot.  In
reviewing the record, the Board notes that the veteran was
afforded a Department of Veterans Affairs (hereinafter "VA")
general medical examination in August 1991.  No examination was
conducted as to the veteran's right knee as she apparently
related no complaints as to a right knee disorder.  However, in
her October 1992 substantive appeal, the veteran stated that
although her right knee had not bothered her much she did
experience mild pain and swelling on occasion.  Given the nature
of the veteran's contentions, and the lack of an examination of
the veteran's right knee the Board concludes that an additional
VA orthopedic evaluation would be helpful in resolving the issues
raised by the instant appeal.

Additionally, the Board observes that in her October 1992
substantive appeal, the veteran suggested that her claimed left
and right knee disorders were etiologically related to her
service-connected hallux valgus of the left foot because the
latter causes an impaired gait.  Although the RO developed the
issues of service connection for both a left and right knee
disorder on a direct basis, service connection for such disorders
as secondary to the veteran's service connected left foot
disorder has not been addressed and, the Board concludes it
should be.  The Board finds that the RO should formally consider
the issues of service connection for a left and right knee
disorder on both a direct basis and as secondary to the veteran's
service-connected hallux valgus of the left foot.

In light of the VA's duty to assist the veteran in the proper
development of her claim as mandated by the provisions of
38 U.S.C.A. § 5107(b) (West 1991) and as interpreted by the
United States Court of Veterans Appeals (hereinafter "the
Court") in Littke v. Derwinski, 1 Vet.App. 90, 92-93 (1990),
this case is REMANDED for the following action:

1.  The RO should schedule the veteran for
a VA orthopedic evaluation in order to
determine the present nature and severity
of her left knee disorder, her right knee
disorder as well as her service connected
hallux valgus of the left foot.  These
studies should be conducted in accordance
with the Physician's Guide for Disability
Evaluation Examinations.  All indicated
tests and studies should be accomplished
and the findings then reported in detail.
The claims folder should be made available
to the examiner for review prior to the
examination.

2.  The RO should formally adjudicate the
veteran's entitlement to service connection
for a left knee disorder and for a right
knee disorder on a direct basis and as
secondary to her service-connected hallux
valgus of the left foot.

When the requested action has been completed, and if her claim
continues to be denied, the veteran should be afforded a
reasonable period of time in which to respond to a supplemental
statement of the case.  Thereafter, subject to current appellate
procedures, the case should be returned to the Board for further
appellate consideration if appropriate.  The veteran need not
take any action unless she is further informed.  The purpose of
this REMAND is to allow for further development of the record.
No inference should be drawn from it regarding the final
disposition of the veteran's claim.

          E. W. SEERY
          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).