BVA9500946 
DOCKET NO.  93-07 487     )       DATE
          )
          )

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

THE ISSUES

1.  Entitlement to an increased (compensable) evaluation for
service-connected flat feet.

2.  Entitlement to an increased rating for post-operative
residuals of chondromalacia of the left knee, currently evaluated
as 10 percent disabling.

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

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Kay F. Mayer, Associate Counsel

INTRODUCTION

The veteran had active duty from July 1976 to May 1980 and from
April 1987 to June 1991.

This matter came before the Board of Veterans' Appeals (Board) on
appeal from rating decisions of the Department of Veterans
Affairs (VA) Regional Office (RO) in Houston, Texas.

REMAND

The Board has noted the appellant indicated in his June 1992
notice of disagreement for the claims of increased ratings for
his service-connected left knee and flat feet disorders that he
raised the claim for service connection for a right knee
disorder.  He also indicated that it had been proposed that he
have surgery on his right knee.  He indicated in his August 1992
substantive appeal he was wearing supports on both knees.  While
the appellant did complain of pain in both his knees at the VA
examination in September 1991, that examination was conducted
prior to the appellant's making a claim for service connection
for a right knee disorder and his right knee was not examined.
Also, the representative has indicated that a treatment record
during service (December 1990) does show an impression that the
appellant had chondromalacia predominately of the left knee,
which indicates that the right knee might be involved.  In light
of the appellant's indication that he was advised to have surgery
on his right knee and that he wears a knee support for pain and
support, the Board believes the appellant should undergo a
further VA examination of his right knee and that all treatment
records for the appellant's claimed right knee disorder should be
obtained.  The Board also finds the examination of the feet in
September 1991 to be inadequate for rating under the rating
schedule criteria.  The VA has a duty to assist a veteran in
developing facts pertinent to a well grounded claim.  38 U.S.C.A.
§ 5107(a) (West 1991); 38 C.F.R. §§ 3.103, 3.159 (1993).  That
duty includes obtaining medical examinations where indicated by
the facts and circumstances of an individual case.  See Murphy v.
Derwinski, 1 Vet.App.78 (1990); Littke v. Derwinski, 1 Vet.App.
90 (1990).

To ensure that VA has met its duty to assist the appellant in
developing the facts pertinent to the claim, the case is REMANDED
to the regional office (RO) for the following development:

1.  The RO should obtain from the veteran
the names and addresses of all medical care
providers who treated the veteran for a
right knee disorder since discharge from
his first and second periods of service.
After securing the necessary authorizations
for release of his medical records, the RO
should obtain these records.

2.  The veteran should be afforded a VA
orthopedic examination to determine the
nature and extent of any right knee
disorder and the severity of his flat feet.
If any right knee disorder is found, the
examiner should indicate whether there is
any relationship between that disorder and
the appellant's service-connected left knee
disorder.  The examiner should also
indicate the location of the weight-bearing
line in the feet and should comment on the
presence or absence of pain on manipulation
and use of the feet.  All indicated tests
and studies should be performed, including
radiographic and range of motion studies.
The claims folder should be made available
to the examiner for review before the
examination.  The examiner should
adequately summarize the relevant medical
history and clinical findings and provide
detailed reasons for the medical
conclusions.  The examination should be
conducted and reported in accordance with
the provisions set forth in the VA
Physician's Guide for Disability Evaluation
Examinations.

The claim for an increased rating for postoperative residuals of
chondromalacia of the left patella shall be held in abeyance
pending the above development.

When this development has been completed, and if the benefits
sought are not granted, the case should be returned to the Board
for  further appellate consideration, after compliance with
appropriate appellate procedures, including issuance of a
supplemental statement of the case.  It is requested that the
statement specifically set forth the reasons and bases for the
decision.  No action by the appellant is required until he
receives further notice.  The Board intimates no opinion, either
legal or factual, as to the ultimate disposition warranted in
this case, pending completion of the requested development.

          HOLLY E. MOEHLMANN
          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).