BVA9507156 
DOCKET NO.  93-12 533     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUES

Entitlement to service connection for a low back disorder,
including arthritis of the lumbosacral spine, and bilateral
defective hearing.

Entitlement to an increased (compensable) evaluation for a left
knee disorder.

REPRESENTATION

Appellant represented by: The American Legion

WITNESSES AT HEARINGS ON APPEAL

The veteran and his wife

ATTORNEY FOR THE BOARD

Richard V. Chamberlain, Counsel

INTRODUCTION

The veteran served on active duty from January 1986 to June 1991.

This appeal arises from an October 1991 rating decision by the
Department of Veterans Affairs (VA) Regional Office (RO) in St.
Petersburg, Florida, that denied service connection for a low
back disorder and hearing loss, and granted service connection
for patellofemoral syndrome of the left knee and assigned it a
zero percent rating.  The case was received at the Board of
Veterans' Appeals (Board) in June 1993.

During a hearing before the undersigned in Washington, D.C., in
November 1993, the veteran reiterated his desire to claim service
connection for Lyme disease, and not hypertension.  This claim
has not been adjudicated by the RO, and it is referred to the RO
for appropriate action.

REMAND

The record shows that the veteran's claims are well-grounded,
meaning that they are plausible.  Therefore, VA has a duty to
assist him in the development of facts pertinent to his claims.
38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103(a), 3.159
(1994).  The duty to assist includes obtaining all relevant
records and providing an adequate VA examination.  Murphy v.
Derwinski, 1 Vet.App. 78 (1990); Littke v. Derwinski, 1 Vet.App.
90 (1990).

In December 1993, color photographs of the veteran were
submitted.  Later, VA reports of his outpatient treatment in 1994
were submitted.  These records were received while the case was
at the Board, and the veteran has not waived initial
consideration of them by the RO.  Due process requires that the
RO consider all records and provide the veteran with a related
supplemental statement of the case.  38 C.F.R. § 20.1304(c).

VA reports of treatment in 1994 show that the veteran has
arthritis of the left knee; however, a review of the record shows
that he has not undergone a VA compensa-tion examination in
several years, since 1991.  The duty to assist includes providing
a thorough and contemporaneous examination that takes into
account prior medical evaluations and treatment.  Weggenmann v.
Brown, 5 Vet.App. 281 (1993).  Consequently, it is my judgment
that the veteran should undergo a VA compensation examination to
determine the current severity of his left knee disorder.

The duty to assist the veteran also includes obtaining reports of
ongoing treatment and/or examination while a claim is pending.
Murincsak v. Derwinski, 2 Vet.App. 363 (1992).  Any report of
recent treatment and/or examination of a disorder being
considered in this appeal should be obtained and associated with
the record.

The case is REMANDED to the RO for the following actions:

1.  The RO should ask the veteran and his
representative to identify all sources of
treatment and/or examination since June
1993 for the disorders being considered in
this appeal.  Exact locations and dates of
treatment and/or examination should be
provided.  After obtaining any needed
release forms, the RO should then directly
contact the sources and obtain copies of
all records not already on file.  38 C.F.R.
§ 3.159.

2.  The veteran should be scheduled for a
VA compensation examination to determine
the severity of his left knee disorder,
including arthritis.  All indicated
studies, including range of motion testing
of all joints affected by arthritis to
include the knees and lumbar spine (VA X-
rays of the lumbosacral spine in September
1991 showed arthritis) and ligamentous
testing of the knees, should be performed
and all clinical findings reported in
detail.  The examiner should express an
opinion as to the severity of the left knee
disorder, including any degree of
functional limitation caused by pain or
arthritis.  In order to assist the examiner
in providing the requested information, the
claims folder must be made available and
reviewed prior to the examination.

3.  After the above development, the RO
should review the claims.  If they are
denied, a supplemental statement of the
case should be provided to the veteran and
his representative covering all the
evidence received since the issuance of the
last supplemental statement of the case.

After the veteran and his representative are given an opportunity
to respond to the supplemental statement of the case, the file
should be returned to the Board.

          M. CHEEK
          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).