BVA9501632 DOCKET NO. 93-11 731 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to restoration of a 30 percent evaluation for service-connected hypersensitive scar of left thigh with retained foreign bodies and marked limitation of motion of left knee due to loss of muscle mass following surgery to remove neuroma and foreign bodies, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Michele M. Florack, Associate Counsel REMAND The veteran served on active duty from February 1952 to July 1955. This appeal to the Board of Veterans' Appeals (Board) arises from a December 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The veteran was afforded a hearing before a traveling member of the Board sitting in St. Petersburg, Florida, in September 1993. At that hearing, the veteran testified that he experienced pain, weakness, instability, numbness, and fatigue of the left leg due to his service-connected disability. He testified that medications prescribed to him for pain interfered with his ability to function by putting him in a "stupor." He also indicated for the first time that he was currently receiving Social Security Administration (SSA) benefits. Where there has been a determination that the veteran is entitled to SSA benefits, the records concerning that decision are often needed by the VA for evaluation of pending claims and must be obtained. Murincsak v. Derwinski, 2 Vet.App. 363 (1992). These records are not contained in the claims file. A complete review of the veteran's claims file also revealed that a recent evaluation from private physician M. A. Schwartz, M.D., recommended that an EMG should be performed on the veteran to rule out any radiculopathy or axonal distribution to the muscles. No such test was performed, or is of record. Furthermore, in the course of the July 1991 VA examination (the examination on which the RO based its proposal to reduce the veteran's compensation for his service-connected left leg disorder) the examiner ordered X-rays of the veteran's left leg and hip to discover the cause of the veteran's limp. X-ray report of the left femur revealed early pagetoid changes of the left upper femur. X-ray report of the veteran's hip showed Paget's disease of the right femur and early pagetoid changes of the (left?) femur. The results of these X-rays were not discussed as to how they related to the veteran's left leg disability. The Board acknowledges that this July 1991 VA examination was originally deemed inadequate by the RO based on the absence of range of motion studies. By RO request, the defect was cured by range of motion studies done in August 1991. The VA has a duty to assist a veteran in the development of 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 records and medical exami- nations where indicated by the facts and circumstances of the case. 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 RO for the following development: 1. The veteran should be afforded a VA examination by an orthopedic specialist to determine how the veteran's left leg disability (hypersensitive scar of left thigh with retained foreign bodies and marked limitation of motion of left knee due to loss of muscle mass following surgery to remove neuroma and foreign bodies) is manifested and the severity of the pathology. The claims folder should be made available to the examiner for review before the examination. In particular, the implication, if any, of the July 1991 X- rays of the veteran's left femur and hip should be discussed. 2. The veteran should be afforded a VA examination by a neurologist to determine how the veteran's left leg disability (hypersensitive scar of left thigh with retained foreign bodies and marked limitation of motion of left knee due to loss of muscle mass following surgery to remove neuroma and foreign bodies) is manifested and the severity of the pathology. The claims folder should be made available to the examiner for review before the examination. In particular, EMG studies should be performed and discussed. 3. The RO should obtain from the Social Security Administration the records pertinent to the appellant's claim for Social Security disability benefits as well as the medical records relied upon concerning that claim. When the above-requested development is completed, the case should again be reviewed by the RO. If the veteran's claim remains denied, the veteran and his representative should be furnished an appropriate supplemental statement of the case. After they have had an adequate opportunity to respond, the case should be returned to the Board for further appellate review, if in order. The purpose of this REMAND is to obtain clarifying data. J. U. JOHNSON 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. (CONTINUED ON NEXT PAGE) 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).