BVA9505977 
DOCKET NO.  92-08 730     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Boston,
Massachusetts

THE ISSUES

1.  Entitlement to an increased rating for residuals of a left
knee injury, currently rated as 10 percent disabling.

2.  Entitlement to an increased (compensable) evaluation for
residuals of a right ankle injury.

REPRESENTATION

Appellant represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Michael P. Vander Meer, Associate Counsel

INTRODUCTION

The veteran served on active duty from January 1976 to December
1983.

This appeal arises from a September 1990 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
Boston, Massachusetts.  This case was last before the Board of
Veterans' Appeals (Board) in June 1993, at which time it was
remanded for further development.  Following completion of the
requested development, a rating decision entered in July 1994
continued to deny each issue on appeal and a Supplemental
Statement of the Case was issued the same month.

The appeal was returned to and redocketed at the Board in
February 1995.

REMAND

A review of the file indicates that the veteran has received VA
outpatient treatment since 1990 at the VA Outpatient Clinic (and
rheumatology clinic) in Jamaica Plain, Massachusetts.  However,
notwithstanding advisement of this consideration to the RO in the
June 1993 remand, it is noted that reports pertaining to such
treatment have not yet been obtained.  Further development in
this regard is specified below.

It is also noted that, pursuant to the June 1993 remand, the
veteran underwent examination by VA in December 1993.  However,
the Board is of the opinion that another VA examination, as
specified in greater detail below and to specifically include
pertinent X-ray examinations, should be performed before an
appellate decision is rendered.

The Board further notes that the issues of entitlement to
secondary service connection for obesity, fibromyalgia and
arthritis of the right ankle, referred to the RO in the June 1993
remand, remain unadjudicated.  Further development in this regard
is specified below.

Accordingly, the case is REMANDED for the following:

1.  The RO should contact the veteran and
request him to identify the names,
addresses and approximate dates of
treatment for any health care provider(s)
to include any VA medical facility other
than the VA facility in Jamaica Plain,
Massachusetts, who may possess records
pertinent to his claims in addition to
those which have previously been submitted.
Thereafter, in light of the response
received and after obtaining any necessary
authorization, the RO should take
appropriate action to obtain copies of any
clinical records indicated.  In any event,
the RO should obtain copies of all records
reflecting treatment rendered the veteran
since May 1990 at the rheumatology clinic
of the VA medical facility in Jamaica
Plain, Massachusetts, as well as all
records pertaining to regular outpatient
treatment rendered the veteran at the
Jamaica Plain facility since July 1990.

2.  Thereafter, the RO should arrange for
the veteran to undergo a VA orthopedic
examination to determine the current
severity of his service-connected residuals
of injury to the left knee and residuals of
injury to the right ankle.  X-ray
examinations of the left knee and right
ankle are specifically requested, and any
other diagnostic studies deemed necessary
should be performed.  In addition, the
examiner is specifically requested to offer
an opinion as to whether any ascertained
arthritic condition in the right ankle is
at least as likely as not to be related to
service-incurred injury involving such
ankle.  The claims folder must be made
available to the examiner for review prior
to the examination.  The rationale for all
opinions expressed should be fully
explained.

3.  Then, after undertaking any development
deemed necessary in addition to that
specified above, the RO should readjudicate
the issues on appeal, and adjudicate the
issues of entitlement to secondary service
connection for obesity, fibromyalgia and
arthritis of the right ankle.

4.  If either benefit sought on appeal is
not granted to the veteran's satisfaction,
the veteran and his representative should
be provided a Supplemental Statement of the
Case on all issues in appellate status, and
given the opportunity to respond.  The
veteran should be provided appropriate
notice of the requirements to perfect an
appeal with respect to any issue(s)
addressed therein which does not appear on
the title page of this decision.

Thereafter, the case should be returned to the Board for further
appellate consideration, if otherwise in order.  In taking this
action, the Board implies no conclusions, either legal or
factual, as to any ultimate outcome warranted.  No action is
required of the veteran until he is otherwise notified.

          ROBERT E. SULLIVAN
          Member, Board of Veterans' Appeals

(CONTINUED ON NEXT PAGE)

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).