BVA9505901 
DOCKET NO.  93-08 103     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri

THE ISSUES

Entitlement to an increased evaluation for arthritis of the knees
and shoulders, currently rated 20 percent disabling.

Entitlement to increased (compensable) evaluations for
sarcoidosis, bilateral high frequency hearing loss, a laceration
scar of the left hand, the residuals of a right elbow dislocation
and a right inguinal hernia, post operative.

Entitlement to a total rating for compensation purposes based on
individual unemployability.

REPRESENTATION

Appellant represented by: Missouri Veterans Commission

ATTORNEY FOR THE BOARD

Hilary L. Goodman, Counsel

REMAND

The veteran had active duty for training from May 1957 to
November 1957 and active service from January 1958 to July 1977.

This appeal arises from a March 1992 rating determination which
continued the 20 percent disability evaluation for arthritis of
the knees and shoulders, continued the non-compensable disability
evaluations for sarcoidosis, bilateral high frequency hearing
loss, a laceration scar of the left hand, the residuals of a
right elbow dislocation and a right inguinal hernia, post
operative, and denied a total rating for compensation purposes
based on individual unemployability.

The veteran has raised the issue of service connection for
arthritis of the feet.  While numerous references to the contents
of the veteran's service medical records are contained in the
veteran's claims file, the record currently before the Board of
Veterans' Appeals (Board) does not include his service medical
records.  He has indicated that he was treated at the Department
of Veterans Affairs (VA), Medical Center, St. Louis, through
March 1989, and underwent testing at Fort Leonard Wood Army
Hospital in November and December 1990.  These medical records
have not been obtained.

VA examinations of the veteran were conducted in August 1991 and
July 1992.  Neither examination report included any findings on
physical examination relating to the veteran's right elbow.  The
former examination report did not refer to the veteran's left
hand laceration scar and the latter examination report identified
the scar but did not provide a description of the scar necessary
for rating purposes.  Neither examination report included
specific findings on range of motion studies of the veteran's
knees or shoulders.

In Harris v. Derwinski, 1 Vet.App. 180 (1991), the United States
Court of Veterans Appeals stated that, when two issues are
"inextricably intertwined," a decision on one issue would have a
significant impact on a claim for the second issue.  The Board
believes that, in light of the Harris decision, the question of
the veteran's possible entitlement to service connection for
arthritis of the feet should be resolved prior to final appellate
consideration of the issue of an increased evaluation for
arthritis of the knees and shoulders.

In view of the foregoing, the Board finds that the issue of a
total rating for compensation purposes based on individual
unemployability should be deferred and the remaining issues
should be REMANDED to the originating agency for the following
action:

1.  The originating agency should request
legible copies of all of the veteran's
outpatient and inpatient treatment records
from both the VA Medical Center, St. Louis,
and Fort Leonard Wood Army Medical Center.
Legible copies of all of the veteran's
outpatient treatment records  dated
subsequent to January 1992 and all
inpatient treatment records should be
requested from the VA Medical Center,
Columbia.  All records obtained should be
made part of the record.

2.  The originating agency should associate
the veteran's service medical records with
his claims file.

3.  After the requested medical records
have been secured, the originating agency
should schedule the veteran for an
orthopedic examination to evaluate the
current severity of the arthritis of the
knees and shoulders and to identify and
evaluate the current residuals of his right
elbow dislocation.  All necessary tests and
studies, including range of motion studies,
should be conducted and all clinical
manifestations should be reported in
detail.  The examining physician should be
given access to the veteran's claims file
for a sufficient period of time prior to
the examination to allow for a complete
review of the record.

4.  The originating agency should also
schedule the veteran for an audiometric
examination to evaluate the current
severity of his  bilateral high frequency
hearing loss, a respiratory examination, to
include pulmonary function testing, to
identify and evaluate any current residuals
of sarcoidosis and a surgical examination
to identify any current residuals of his
right inguinal hernia, post operative, and
to evaluate the left hand laceration scar.
All other necessary tests and studies
should be conducted and all clinical
manifestations relating to each disability
should be reported in detail.  The
audiologist and examining physician(s)
should be given access to the veteran's
claims file for a sufficient period of time
prior to the examinations to allow for a
complete review of the record.

5.  Upon completion of the above, the
originating agency should adjudicate the
claim of service connection for arthritis
of the feet and promulgate a separate
rating decision.  Thereafter, the veteran
and his representative are to be informed
of the determination by letter that
includes his appellate rights.

Following review, if the determination made on the issue of an
increased evaluation for arthritis of the knees and shoulders or
a compensable disability evaluation for sarcoidosis, bilateral
high frequency hearing loss, a laceration scar of the left hand,
the residuals of a right elbow dislocation or a right inguinal
hernia, post operative,  remains unfavorable to the veteran, a
supplemental statement of the case which sets forth the evidence
received since the statement of the case should be issued to the
veteran and his representative.  They should be given the
appropriate period of time in which to respond.  Thereafter, the
case should be returned to the Board for further consideration,
if in order.  No action is required by the veteran until he
receives further notice.  The purpose of this REMAND is to obtain
clarifying medical information and afford the veteran due
process.

          EUGENE A. O'NEILL
          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).