BVA9502794 
DOCKET NO.  93-03 901     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Montgomery,
Alabama

THE ISSUE

1.  Entitlement to an increased (compensable) rating for
chondromalacia of the right patella with medial plica syndrome.

2.  Entitlement to an increased (compensable) rating for
chondromalacia of the left patella with medial plica syndrome.

REPRESENTATION

Appellant represented by: Disabled American Veterans

ATTORNEY FOR THE BOARD

Alberto H. Zapata, Associate Counsel

INTRODUCTION

The veteran served on active duty from April 1984 to March 1988.

This matter comes to the Board of Veterans' Appeals (Board) on
appeal from a May, 1992 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Montgomery,
Alabama.

REMAND

The claims file contains a September 1992 VA orthopedic
examination report of the veteran in which the examiner makes
reference to prior outpatient records concerning evaluation of
the veteran in June 1991.  Those reports are not of record.

In that same September 1992 medical report, the examiner
concluded that further orthopedic evaluation was recommended.
However, no further orthopedic or general medical examination
reports of the veteran are of record.  The Board believes that as
part of the VA's duty to assist the veteran in the development of
his claim pursuant to 38 U.S.C.A. § 5107(a) (West 1991), the VA
must have the veteran examined by an orthopedist in light of the
recommendation, by its own physician, that orthopedic follow-up
of the veteran was in order.  The United States Court of Veterans
Appeals has declared that failure to follow up a suggestion by an
examining physician urging further medical evaluations is
incompatible with the VA's duty to assist the claimant.  Green v.
Derwinski, 1 Vet.App 121, 123 (1991).  In light of the reasons
stated above, the Board finds that further development is
warranted.

Accordingly, the case is REMANDED to the RO for the following
actions:

1.  The RO should attempt to obtain and
associate with the claims file copies of
the veteran's VA outpatient medical
records from the Montgomery, Alabama VA
Medical Center from June 1991 to the
present, including X-ray reports.

2.  The RO should also request that the
veteran identify, to the extent possible,
all health care providers from whom he has
received treatment for knee impairment in
recent years.  Then, with authorization
from the veteran, the RO should attempt to
obtain copies of all treatment records
identified by the veteran which are not
currently of record.

3.  Then , the RO should arrange for a VA
orthopedic examination of the veteran by a
board certified specialist, if available,
to determine the nature and extent of the
veteran's chondromalacia of the patellae
with medial plica syndrome.  All indicated
studies, including X-rays, should be
performed.  The claims file should be made
available to the examining physician so
that he may review it before the
examination of the veteran.

4.  Then, the RO should readjudicate the
issues on appeal.

If the benefit sought in appeal is not granted to the veteran's
satisfaction, or if a timely Notice of Disagreement is received
with respect to any other matter, the RO should issue a
Supplemental Statement of the Case for all issues in appellate
status, and the veteran and his representative should be provided
an opportunity to respond.  The case should then be returned to
the Board for further appellate consideration, if otherwise in
order.  By this REMAND, the Board implies no conclusion, either
legal or factual, as to any final outcome warranted.  No action
is required of the veteran until he is otherwise notified by the
RO.

          ROBERT E. SULLIVAN
          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).