BVA9504900 DOCKET NO. 93-07 823 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an increased evaluation for gout of the left great toe, currently evaluated at 20 percent. 2. Entitlement to an increased evaluation for spondylosis, L5-S1, with paravertebral spasm, currently evaluated at 20 percent. 3. Entitlement to an increased evaluation for right patellectomy, medial meniscectomy with degenerative arthritis, currently evaluated at 10 percent. REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. ATTORNEY FOR THE BOARD Raymond F. Ferner, Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from an August 1990 rating decision of the Department of Veterans Affairs (VA) Regional Office in Louisville, Kentucky (RO) which denied the benefit sought on appeal. The veteran, who had active service from February 1977 to December 1987, appealed that decision to the BVA, and the case was received at the Board in April 1993. The veteran filed a claim for a total evaluation based on individual unemployability due to service-connected disabilities, and an October 1991 rating decision denied that claim. The record does not appear to reflect notice to the veteran of that decision, and statements from the veteran dated subsequent to that rating decision continued to express the veteran's position that he is unable to work due to his service-connected disabilities. The veteran has also requested consideration of a claim for service connection for hearing loss, and the Board notes that a February 1993 letter to the veteran informed him that a June 1988 rating decision had previously denied service connection for hearing loss. However, the February 1993 letter failed to notify the veteran of what steps he must take to reopen the claim for service connection for hearing loss. Lastly, it appears that the veteran has requested consideration of a claim for service connection for a psychiatric disorder. However, none of these matters is currently before the Board because they have not been prepared or certified for appellate review. Accordingly, these matters will be referred to the RO for appropriate action. REMAND A preliminary review of the record discloses that the veteran has been afforded two VA examinations in connection with his current appeal. However, neither of the two examination reports contains clinical findings concerning the range of motion or stability of the right knee. Such findings are necessary to evaluate the veteran's right knee disability under 38 C.F.R. § 4.71a, Diagnostic Codes 5257, 5260 and 5261 (1994). Also, while the VA examination performed in June 1990 described what might be considered slight limitation of lumbar spine motion, a VA outpatient treatment record dated in April 1991, one month following the March 1991 VA examination reported that there was marked reduction in the range of motion of flexion of the spine. Also, at the time of the March 1991 VA examination, the veteran was afforded a neurological examination. Following that examination the examiner indicated that: "No definitive radicular deficits are demonstrable on physical examination; however, the difficulty obtaining muscle stretch reflexes in either leg, unfortunately, detracts from the potential usefulness of this physical finding." In the Board's judgment, further examination and further clinical correlation of the veteran's complaints and the objective clinical findings shown on examination would be helping in resolving the issues on appeal. Therefore, in order to give the veteran every consideration with respect to the present appeal, further development of the case is necessary. At this time the Board will defer full consideration of all issues on appeal pending the development requested by this decision. Accordingly, this case is REMANDED for the following actions: 1. The RO should obtain and associate with the claims file treatment records pertaining to the veteran dated from December 1992 from the VA Outpatient Clinic in Mobile, Alabama, and VA Medical Center in Biloxi, Mississippi, as well as any other VA medical facility where the veteran reports he received treatment from 1992 to the present date. 2. The veteran should be afforded an orthopedic examination of his lumbar spine and right knee to ascertain the severity and manifestations of each disability. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, but should include complete range of motion studies. The examiner is requested to report complaints and clinical findings in detail and clinically correlate the complaints and clinical findings. Since it is important "that each disability be viewed in relation to its history[,]" 38 C.F.R. § 4.1 (1994), copies of all pertinent medical records in the veteran's claims file or in the alternative, the claims file, must be made available to the examiner for review prior to, and during, the examination. 3. The veteran should be afforded a neurological examination of his lumbar spine to ascertain the severity and manifestations of his disability. Any and all indicated evaluations, studies and tests deemed necessary by the examiner should be accomplished. The examiner is requested to report the complaints and clinical findings in detail and clinically correlate the complaints and clinical findings. Since it is important "that each disability be viewed in relation to its history[,]" 38 C.F.R. § 4.1 (1994), copies of all pertinent medical records in the veteran's claims file or, in the alternative, the claims file, must be made available to the examiner for review prior to, and during the examination. When the development requested has been completed, the case should again be reviewed by the RO on the basis of the additional evidence. If the benefits sought are not granted, the veteran and his representative should be furnished a supplemental statement of the case, and be afforded the applicable time period to respond before the record is returned to the Board for further review. The purpose of this REMAND is to obtain additional development, and the Board does not intimate any opinion as to the merits of the case, either favorable or unfavorable, at this time. The veteran is free, of course, to submit any additional evidence he desires to have considered in connection with his current appeal. No action is required of the veteran until he is notified. JACQUELINE E. MONROE 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).