BVA9507852 DOCKET NO. 93-12 738 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to an increased rating for low back strain with lumbosacral disc disease, currently evaluated as 40 percent disabling. 2. Entitlement to service connection for asthma. 3. Entitlement to service connection for hearing loss and tinnitus. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Darryl A. Joe, Associate Counsel INTRODUCTION The veteran had active military service from October 1961 to October 1981. This matter comes before the Board of Veterans' Appeals (the Board) on appeal from a rating decision of June 1992 by the St. Petersburg, Florida Regional Office (RO) of the Department of Veterans Affairs (VA), which increased the evaluation for the veteran's service-connected low back disorder to 40 percent and denied his claims seeking service connection for asthma and hearing loss. The veteran disagreed with the 40 percent evaluation. The Board acknowledges that in his notice of disagreement filed in August 1992, the veteran raised an additional issue of entitlement to service connection for tinnitus. The veteran's claim seeking service connection for tinnitus was thereafter denied by the RO in a rating action of January 1993. A supplemental statement of the case on this issue was forwarded to the veteran the following month. The veteran, in the current record, has not perfected his appeal with respect to the claim for service connection for tinnitus, so this issue is not yet in appellate status. If the veteran perfects his appeal, it should be added to the current appeal. Pursuant to VA's statutory duty to assist the veteran in the development of facts pertinent to his well-grounded claims, the Board will defer appellate review of the issues of entitlement to service connection for hearing loss and tinnitus. REMAND In regard to the claim of service connection for asthma, the veteran contends that the symptoms noted during service are similar to his present symptoms, thus proving that his asthmatic condition had its onset during his active military service. The veteran reports being seen in the Emergency room at Boulder City Hospital in December 1981 and also being seen by Joseph A. DeBellis, MD. The RO has obtained records from both of these sources. A January 20, 1982, treatment note from Dr. DeBellis notes that the veteran had been seen in the ER and the hospital reports of record show the veteran being seen in the Emergency room on several occasions, but do not include this January visit. In addition the doctor's records in 1983 show medication for asthma, but it is not clear when this treatment was initiated. The service medical records contain findings and diagnoses related to upper respiratory problems, including bronchitis. However, these records do not reflect any determinative findings of asthma during service. In view of the medical evidence currently of record, and the veteran's assertion that his present symptoms have persisted since service, the Board is of the opinion that further development should be undertaken to attempt to obtain additional treatment records and, following that, to ascertain whether the veteran's current disability is etiologically related to any incident of his active service. The veteran's service-connected low back disorder was increased to 40 percent disabling under Diagnostic Codes 5292-5293 of VA's Schedule for Rating Disabilities. 38 C.F.R. Part 4 (1994). The veteran contends he is entitled to a rating in excess of the 40 percent that was assigned by the June 1992 rating. The VA examination in February 1992 appears to be adequate for rating purposes. However, in view of his assertions and as the case is being remanded for development of other issues, he should be scheduled for orthopedic and neurological examinations of his back. In light of the above, further appellate consideration is deferred and this case is REMANDED to the RO for the following actions: 1. The RO should again contact Boulder City Hospital and request copies of the Emergency room and clinical records for the veteran's treatment in January 1982. All records so obtained should be associated with the veteran's claims folder. 2. The RO should again contact Dr. DeBellis and obtain records of all treatment or examinations that are not already of record. The RO should specifically obtain records pertaining to the veteran's treatment for asthma, with particular emphasis on when it was first diagnosed and treatment was initiated. All records so obtained should be associated with the veteran's claims folder. 3. To ensure that we have all of the available records, the veteran should be contacted and asked to provide the names and addresses of all medical care providers, both VA and private, who have furnished recent treatment for his service-connected low back disorder. Records not already on file should then be obtained and associated with the claims folder. 4. After the above development has been completed, the RO should then schedule the veteran for comprehensive VA orthopedic, neurologic and pulmonary examinations, to be conducted in conformity with VA's Physician's Guide for Disability Evaluation Examinations. The claims folder should be made available and reviewed by the examiner prior to the examinations. The examining pulmonologist should review the claims folder, paying special attention to the service medical records and all relevant postservice medical evidence relative to treatment for asthma. All indicated tests and studies should be undertaken, including X-ray films. The examiner should then express an opinion as to the probability of an etiological relationship, if any, between the veteran's current disorder and the symptoms noted during service. On the orthopedic and neurologic examinations all indicated tests and studies should be undertaken, including X-ray films and the examiners should be requested to report all clinical findings in detail. The RO should then again review the veteran's claims. If the issues on appeal remain denied, both the veteran and his representative should be issued a supplemental statement of the case and afforded the requisite 60 days within which to respond. 38 C.F.R. § 20.302(c) (1994). Thereafter, subject to current appellate procedure, the veteran's claim should be returned to the Board for further appellate consideration, if in order. By this REMAND, the Board intimates no opinion, either legal or factual, as to the ultimate determination warranted on the issues on appeal. S. L. COHN 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).