BVA9503065 DOCKET NO. 92-08 911 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE 1. Entitlement to service connection for herpes. 2. Entitlement to service connection for gonorrhea. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD A. S. Nemeth, Associate Counsel INTRODUCTION The veteran's active service extended from June 1980 to December 1986. The case originally came to the Board of Veterans' Appeals (Board) on appeal from a July 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, which, in part, denied the veteran's claim for service connection for herpes and gonorrhea. This matter was previously before the Board in October 1993, at which time it remanded the case for further development. REMAND The veteran contends that she currently has herpes and gonorrhea which she incurred and was treated for during service. In October 1993, the Board remanded the case for further development. The RO was to request further detailed information from the veteran regarding both her inservice and post-service treatment for herpes and gonorrhea, which it did. The veteran provided post-service medical records from NAVCARE, but did not provide further information regarding any inservice treatment. The RO was also required to arrange a VA examination to determine the extent and nature of any herpes or gonorrhea. The examination was provided in November 1993, however, the physician did not verify either condition. He noted that if the veteran needed verification of herpes, she should see him during an attack so he could perform a culture. He also did not state when her current condition became manifest although he was requested to do so. In the veteran's notice of disagreement dated July 1991, she stated that she had been hospitalized for gonorrhea for one week at the Malcolm Grow Medical Center, Andrews Air Force Base, sometime around 1981. She also stated that approximately one month after her hospitalization, she was diagnosed with herpes at the Malcolm Grow Medical Center's Outpatient Clinic. In its Remand, the Board requested that the RO obtain these records after they received more specific inormation from the veteran. She did not provide any further information and the RO made no further attempts to obtain additional records. The VA has a duty to assist the veteran to develop her case. It appears that it could be beneficial to the appellant's case for the RO to attempt to obtain additional service medical records, if there are any extant. The RO should make a specific request for all of the veteran's records from the Malcolm Grow Medical Center, Andrews Air Force Base, and attach them to the claims file. Additionally, as herpes is characterized by episodic manifestations, the RO should afford the veteran another VA examination, if and when there is a recurrence of the symptoms of the disease. In view of the foregoing, it is the opinion of the Board that this case should be remanded to the RO for the following development: 1. The RO should obtain from the veteran more specific information regarding treatment at the Malcolm Grow Medical Center, Andrews Air Force Base, to include the dates of treatment and the names of the physicians who have treated her for herpes and gonorrhea. The RO should inform the veteran that the information is necessary to obtain supportive evidence and that failure to cooperate could result in an adverse decision. The RO should obtain all necessary signed releases. Regardless of the veteran's response, the RO should make all of the necessary arrangements to obtain the Malcolm Grow records and any other additional service medical records from the service department. The records should then be associated with the claims file. 2. In view of the fact the examining physician must carefully review all of the service medical records, the RO should have all the service medical records assembled in chronological order. 3. The veteran reports that herpes symptoms recur every several months. If there is a recurrence of symptoms during the course of this remand, she should report for examination as instructed by the VA examiner during the November 1993 VA examination. In any event the veteran should be reexamined by the same physician who conducted the November 1993 examination, if he is available. If not, arrangments should be made with another physician. The examination should be scheduled only after all records development has been accomplished. The purpose of the examination is to determine the nature and extent of any current gynecologic disorder with special attention given to the presence of herpes or gonorrhea. The claims folder and a copy of this remand must be made available to and reviewed by the specialist prior to the examination. The examiner's attention is directed to the fact that service connection has been granted for cervical dysplasia and that medical records dated in February and March 1987, shortly after separation from service in December 1986, contain notations as to herpes infection. All necessary tests should be conducted. The examiner should review the results of any testing prior to the completion of the report. The physician is requested to review the service medical records and the treatment records after service and determine: a. if the current gynecologic disorder is related to the service-connected cervical dysplasia. b. if the veteran has or had a herpes infection or gonorrhea. c. if so, would either condition have been present in service as reflected in the service medical records? The examiner should provide complete rationale for all conclusions reached. 4. The RO should review the report of the aforementioned examination and determine if it is adequate for rating purposes and in full compliance with this remand. If not, it should be returned to the examiner for corrective action. Following the completion of these actions, the RO should review the veteran's claim and if the decision remains unfavorable, the veteran and her representative should be provided with a supplemental statement of the case and be afforded a reasonable period of time in which to respond. Thereafter, the case, in accordance with the current appellate procedures, should be returned to the Board for completion of appellate review. No further action on the part of the veteran is required until further notice. JAN DONSBACH 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).