BVA9501434 DOCKET NO. 93-03 580 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an increased evaluation for a skin disability, currently evaluated as 10 percent disabling. 2. Entitlement to service connection for a cerebral vascular accident with history of seizure disorder on a secondary basis. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Lori J. Wells-Green, Associate Counsel INTRODUCTION The veteran served on active duty from November 1969 to October 1976. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a March 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama, which granted the veteran's claim for pension but denied the claims at issue. REMAND Initially, the Board notes that the May 1992 Statement of the Case failed to advise the veteran of all pertinent laws and regulations regarding his increase rating claim. The veteran should be provided this information. At the veteran's December 1991 VA dermatology examination for compensation purposes the examiner diagnosed allergic contact dermatitis in almost total remission at that time. The examiner further found another skin disability beginning from the veteran's waist down to his toes and of unknown etiology. The examiner diagnosed livedo reticularis and noted that a workup was to be performed at the VA dermatology clinic. The Board is of the opinion that the etiology of the veteran's livedo reticularis and its relationship, if any, to the veteran's service-connected skin disability should be determined before an appellate decision is reached. Further, the Board notes that the VA compensation examination occurred over three years ago and believes that a more contemporaneous examination should be conducted in order to properly consider this appeal. The United States Court of Veterans Appeals has held that, under 38 U.S.C.A. § 5107(a) (West 1991), VA's duty to assist a veteran in obtaining and developing available facts and evidence to support a claim includes obtaining an adequate and contemporaneous VA examination which takes into account the records of prior medical treatment. Littke v. Derwinski, 1 Vet.App. 90 (1990). The United States Court of Veterans Appeals has also held that the duty to assist a veteran in obtaining and developing available facts and evidence to support his or her claim includes conducting an adequate examination during the active stage of the veteran's skin disability. See Ardison v. Brown, 6 Vet.App. 405 (1994). The Board is of the opinion that further medical development is necessary. Also pertinent to the veteran's claim would be procurement of the VA dermatology workup and any other ongoing treatment records pertaining to the veteran's service- connected skin disability. As to the veteran's claim for service connection for cerebral vascular accident with history of seizure disorder on a secondary basis, he should be afforded an opportunity to provide further evidence regarding this disability. Accordingly, the case is REMANDED to the RO for the following actions: 1. The RO should contact the VA Medical Center in Birmingham, Alabama, and request copies of treatment records for the veteran's skin disability dated from December 1991 to the present. 2. The RO should contact the veteran, and ask him to provide the names and addresses of all other health care providers who have recently treated him for a skin disability. Then, after any necessary authorization is obtained from the veteran, the RO should obtain those treatment records identified by the veteran which have not been previously secured. 3. After associating with the file all records obtained pursuant to the above directives, the RO should arrange for the veteran to undergo a VA dermatology examination, by a board certified specialist, if available, and when the veteran's skin disorder is active, to determine the extent of the service- connected skin disability. All indicated studies should be performed. The examiner should be specifically requested to address whether there is any exfoliation, exudation or itching present with the veteran's skin disorder, and, if so, to what extent. All affected areas including the feet should be specifically noted and described in detail. Further, the examiner should be specifically requested to offer an opinion, with complete rationale, as to the nature and extent of the veteran's livedo reticularis, and whether it is at least as likely as not that the veteran's livedo reticularis is the result of the veteran's service-connected skin disability. The veteran's claims file must be made available to the physician and reviewed prior to the examination. 4. With regards to the veteran's claim for service connection for cerebral vascular accident with history of seizure disorder on a secondary basis, the veteran should be afforded an opportunity to submit medical evidence supporting this claim. Should the veteran submit evidence of a well grounded claim on this issue, the RO should undertake any other indicated development and readjudicate the claim. 5. Thereafter, in light of the evidence obtained pursuant to the requested development, the RO should readjudicate the claim for increased rating for skin disability and, if appropriate, the claim for service connection. If the benefits sought on appeal are not granted to the veteran's satisfaction, a Supplemental Statement of the Case containing all pertinent laws and regulations as well as adequate reasons and bases should be issued and the veteran and his representative provided an opportunity to respond. Thereafter, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran until he is notified by the RO. F. JUDGE FLOWERS 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).