BVA9507551 
DOCKET NO.  93-19 116     )       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 20 percent evaluation for a
duodenal ulcer.

REPRESENTATION

Appellant represented by: Veterans of Foreign Wars of the
United States

ATTORNEY FOR THE BOARD

C. M. Flatley, Counsel

INTRODUCTION

The veteran had active service from April 1966 to April 1970.
This case comes before the Board of Veterans' Appeals (Board) on
appeal from an August 1992 rating decision of the St. Petersburg,
Florida, Department of Veterans Affairs (VA) regional office
(RO), which effectuated a reduction of the evaluation assigned
for the veteran's duodenal ulcer from 20 percent, in effect from
January 1990, to 10 percent, effective November 1992.

The Board notes that in his notice of disagreement, the veteran
alleged that two ratable disabilities were present, apparently
associated with his gastrointestinal system; it is unclear if he
intended any action in this regard.  Further, in his substantive
appeal, the veteran alleged that his ulcer exacerbated his
nonservice-connected hypertension and noted that his headaches
were associated with gastroesophageal reflux attributable to his
duodenal ulcer.  These matters are referred to the RO for
appropriate action.  With regard to the veteran's argument as to
hypertension, the RO's attention is directed to the United States
Court of Veterans Appeals' (Court's) recent discussion of such
claims in Allen v. Brown, No. 93-245 (U.S. Vet. App. Mar. 17,
1995).

REMAND

The veteran alleges that symptomatology associated with his
duodenal ulcer has not decreased and that a reduction in the
evaluation assigned was not warranted.  In his substantive
appeal, the veteran reported that he had been treated on a number
of occasions at various medical facilities, including the VA
facility in Batavia, New York, as well as the "Buffalo Medical
Center" and the Florida Hospital.  In a statement received in
April 1993, the veteran also named individual physicians,
ostensibly VA physicians, from whom he received treatment.  The
veteran reported that he sought treatment at the Batavia VA
facility on an emergency basis on six occasions in 1992; the
record includes outpatient reports from that facility dated
through August 1992, with further evidence of outpatient
treatment in April 1993, as well as hospital discharge summaries
dated in November and in December 1992.  Records from the
Buffalo, New York VA facility through November 1992, are also
included in the file.

The veteran last underwent a VA examination in April 1992.  In
light of the veteran's complaints of increased symptomatology and
continued treatment, the Board concludes that additional clinical
data may prove helpful in evaluation the veteran's claim before a
final decision in his appeal.  Accordingly, this case is REMANDED
for the following:

1.  After any necessary information and
authorization are obtained from the
veteran, copies of records of any post-1991
treatment for the veteran's duodenal ulcer,
VA or private, inpatient or outpatient,
should be requested and incorporated into
the claims folder.

2.  A special VA gastrointestinal
examination should then be conducted to
determine the extent and severity of the
veteran's duodenal ulcer.  The examination
should be conducted in accordance with the
appropriate provisions of the VA's
Physician's Guide for Disability Evaluation
Examinations.  All indicated studies
required to identify any relevant pathology
should be conducted.  The examination
report should include a medical history
with notation of any time lost from work
due to the duodenal ulcer, a full
description of the veteran's symptoms,
clinical findings, and associated
functional impairment attributable to his
duodenal ulcer.  The examiner should
comment on the presence of any
gastrointestinal disorder other than the
veteran's duodenal ulcer and its
relationship, if any, to the veteran's
duodenal ulcer.  The veteran's claims
folder should be provided to the examiner
for review.

3.  The RO should then review the veteran's
claim.  All pertinent law, regulations
should be considered.  The veteran and his
representative should be provided with a
supplemental statement of the case, which
includes any additional pertinent law and
regulations and a full discussion of action
taken on the veteran's claim.  The
applicable response time should be allowed.

The case should then be returned to the Board, if in order, after
compliance with customary appellate procedures.  No action is
required of the veteran until he is so informed.  The Board
intimates no opinion as to the ultimate decision warranted in
this case, pending completion of the requested development.

          CHARLES E. HOGEBOOM
          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 action has been taken in
accordance with the Veterans' Benefits Improvements Act of 1994,
Pub. L. No. 133-446, § 303, 108 Stat. 4645, ___ (1994), and 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).