BVA9501034 DOCKET NO. 93- 07 471 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Houston, Texas THE ISSUES 1. Entitlement to an increased evaluation for a left flank scar with ventral hernia, currently evaluated as 40 percent disabling. 2. Entitlement to an increased evaluation for an incisional scar, the residual of a colon resection, currently evaluated as 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD L. M. Barnard, Counsel REMAND The veteran served on active duty from September 1942 to November 1945. This appeal arises from an August 1991 rating decision of the Houston, Texas, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to the benefits sought. This was confirmed and continued by a rating action issued in September 1992. The veteran contends, in essence, that his service-connected disorders at issue are more disabling than their current disability evaluations would suggest. He states that he suffers from two hernias which are clearly residuals of his service- connected surgical procedures. He asserts that these hernias are massive in nature and are inoperable because of muscle damage. Therefore, he believes that he is entitled to increased disability evaluations. VA has a duty to assist the veteran in the development of all facts that are pertinent to his claims. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1993). This includes the duty to obtain VA examinations that are an adequate basis upon which to determine entitlement to the benefits sought. Littke v. Derwinski, 1 Vet.App. 90 (1991). An examination by a specialist is recommended in those cases which present a complicated disability picture. Hyder v. Derwinski, 1 Vet.App. 221 (1991). In determining the disability evaluation, the VA has a duty to acknowledge and consider all regulations which are potentially applicable based upon the assertions and issues raised in the record and to explain the reasons used to support the conclusion. Schafrath v. Derwinski, 1 Vet.App. 589 (1991). These regulations include, but are not limited to 38 C.F.R. § 4.1, that requires that each disability be viewed in relation to its history and that there be an emphasis placed upon the limitation of activity imposed by the disabling condition, and 38 C.F.R. § 4.2 which requires that medical reports be interpreted in light of the whole recorded history, and that each disability must be considered from the point of view of the veteran working or seeking work. These requirements for the evaluation of the complete medical history of the claimant's condition operate to protect claimants against adverse decision based upon a single, incomplete or inaccurate report and to enable VA to make a more precise evaluation of the disability level and any changes in the condition A review of the evidence in this case revealed that the veteran was last examined by VA in April 1991. It is the finding of the undersigned that this examination does not provide an adequate basis upon which to reconcile the various clinical findings of record. This examination report does not describe the veteran's hernias in light of the criteria established by Code 7339. 38 C.F.R. Part 4, Diagnostic Code 7339 (1993). Therefore, it is not possible, based on this examination, to properly evaluate the extent and degree of severity of his hernias. Under the circumstances of this case, it is the conclusion of the undersigned that additional assistance is necessary, and this case is REMANDED to the RO for the following: The RO should afford the veteran a special VA surgical examination in order to fully evaluate and describe the nature and degree of severity of his two ventral hernias. Specifically, the examiner should comment upon whether these hernias are large or massive, are or are not supportable by a belt under ordinary conditions, and whether each one represents persistent, severe diastasis of recti muscles or extensive diffuse destruction or weakening of muscular and fascial support of the abdominal wall so as to be inoperable. All indicated special studies should be accomplished, together with photographs of the affected areas. The claims folder must be made available to the examiner for review prior to the examination so that the veteran's entire medical history can be taken into consideration. In the event that the veteran's claims remain denied, in whole or in part, he and his representative should be provided with an appropriate supplemental statement of the case, and the case record should be returned to the Board for further appellate review, if otherwise in order. C. P. RUSSELL 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).