BVA9506176 DOCKET NO. 93-08 871 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUES 1. Entitlement to service connection for a bilateral knee disorder. 2. Entitlement to service connection for bilateral hearing loss. 3. Entitlement to service connection for acne. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD J.P. Reep, Associate Counsel INTRODUCTION The veteran served on active duty from October 1985 to November 1991. This matter came before the Board of Veterans' Appeals (the Board) on appeal from an October 1992 rating decision of the Atlanta, Georgia Regional Office (RO) of the Department of Veterans Affairs (VA), which, among other things, denied service connection for a bilateral knee disorder, bilateral hearing loss, and acne. On her VA Form 1-9, the veteran raised the additional issue of entitlement to service connection for a heart disorder. By rating decision dated in March 1993, service connection was denied for sinus tachycardia. The record does not contain any indication that the veteran was notified of this decision or of her right to appeal it. The RO should ensure that appropriate notification is provided to the veteran. REMAND An October 1985 reference audiogram report in the veteran's service medical records shows that audiometric readings were taken prior to duty in hazardous noise areas. Also, service medical records contain the report of a September 1989 examination which notes that the veteran had high frequency hearing loss, and recommends ear protection. However, audiometric testing in service consistently demonstrated thresholds of less than 25 decibels for all frequencies of 500, 1000, 2000, 3000, and 4000 Hertz. The report of the veteran's February 1992 VA examination includes a diagnosis of history of hearing loss, and a recommendation for an audiogram, although this apparently was not done. The veteran has contended on her VA Form 1-9, that a hearing test was not conducted at her VA examination. A suitable hearing test should therefore be arranged. Moreover, we note that the veteran's October 1991 separation examination contains a diagnosis of acne vulgaris. No entrance examination is of record; however, service medical records indicate that the veteran provided a history of acne which pre- existed service by several years. In addition, a January 1987 service medical record indicates that the veteran was "developing" cystic acne; the provisional diagnosis was "early" cystic acne. The Board finds that further development of the claim for service connection for acne, on the basis of aggravation, should be undertaken, particularly with respect to the status of this disorder prior to and at service entrance. Finally, the Board notes that the veteran has essentially argued that she has a separate bilateral knee disability which is asserted to be secondary to her service-connected back disability. This issue has not been adequately addressed, particularly with respect to consideration of 38 C.F.R. § 3.310(a) (1994). Accordingly, the case is REMANDED to the RO for the following actions: 1. The RO should contact the veteran and ask her if she received any professional medical treatment for acne prior to service and, if so, to provide the names and addresses of the facilities. If the veteran provides any such names and addresses, the RO should attempt to obtain any pertinent treatment records, and add them to the claims folder. 2. The RO should also contact the National Personnel Records Center and verify whether there may be any additional service medical records for the veteran. It should be particularly pointed out the service medical records now on file do not include the report of the veteran's service entrance examination. 3. Next, the RO should arrange appropriate examinations for the purpose of assessing the status of the claimed bilateral hearing loss, acne, and a bilateral knee disability. All appropriate testing should be conducted; the results reported. The examination for hearing loss should include an audiometry test. With regard to the skin examination, if the examiner finds chronic acne, the examiner should express an opinion as to its current status in comparison to the manifestations noted in service and on VA examination in February 1992 and, if obtained pursuant to this remand, in comparison to manifestations noted in preservice records or on entrance examination. With regard to the veteran's knees, the examiner should comment on whether any manifestations found present are actually associated with abnormality of either knee and, if so, whether there is an etiological relationship to the service- connected back disability, or whether any such findings are manifestations of the back disability in the lower extremities. Before conducting the examination, the examiner(s) should carefully review the veteran's claims folder. 4. The RO should then again consider the veteran's claims. If any of the claims remain denied, the veteran and her representative should be furnished with a supplemental statement of the case (SSOC) which contains an explanation of the RO's latest deliberations, and they should be afforded the opportunity to respond. The SSOC should reflect consideration of and include citation to the provisions of 38 C.F.R. § 3.385 (1994), regarding hearing loss, and 38 C.F.R. § 3.310(a) (1994), regarding the claimed knee disability. Then the case should be returned to the Board for further appellate consideration, if otherwise in order. The veteran need take no action until she is further notified by the RO. The purpose of this remand is to procure additional evidence and ensure due process of law. (CONTINUED ON NEXT PAGE) D. C. SPICKLER 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).