BVA9502988 
DOCKET NO.  92-12 410     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Los Angeles,
California

THE ISSUES

1.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for arthritis
of the hips, and, if so, whether the reopened claim may be
granted.

2.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for chronic
sacroiliac strain, and, if so, whether the reopened claim may be
granted.

3.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for
hemorrhoids.

4.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for rhinitis.

5.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for
sinusitis.

6.  Whether new and material evidence has been submitted to
reopen a claim of entitlement to service connection for heart
disability.

7.  Entitlement to service connection for hypertension.

8.  Entitlement to service connection for bilateral hearing loss.

9.  Entitlement to service connection for arthritis of the legs.

10.  Entitlement to service connection for arthritis of the back.

REPRESENTATION

Appellant represented by: AMVETS

ATTORNEY FOR THE BOARD

Nancy S. Kettelle, Counsel

INTRODUCTION

The veteran had active service from July 1942 to April 1947.

This matter came to the Board of Veterans' Appeals (Board) on
appeal from a February 1992 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Los Angeles,
California.

The decision below addresses the issues concerning arthritis of
the hips and chronic sacroiliac strain.  The remaining issues
will be addressed in the remand that follows.

CONTENTIONS OF APPELLANT ON APPEAL

The veteran contends that his arthritis of the hips and chronic
lumbosacral strain resulted from a crushing-type injury on board
ship in service.  He recalls being hospitalized with back pain
after he was caught between a gun mount and a heavy cable.  The
veteran states that ship's doctor told him that due to the injury
he would probably have arthritis in his back and hips during
later years.

DECISION OF THE BOARD

The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991), has reviewed and considered all of the
evidence and material of record in the veteran's claims file.
Based on its review of the relevant evidence in this matter, and
for the following reasons and bases, it is the decision of the
Board that new and material evidence has been submitted to reopen
the claim for service connection for arthritis of the hips.  It
is also the decision of the Board that new and material evidence
to reopen the veteran's claim of entitlement to service
connection for chronic sacroiliac strain has been received.

FINDINGS OF FACT

1.  In an unappealed September 1956 rating action the RO denied
service connection for arthritis of the hips and chronic
sacroiliac strain.

2.  Evidence added to the record since the September 1956 denial
of service connection for arthritis of the hips includes evidence
which is not duplicative or cumulative of evidence previously of
record and is sufficiently relevant and probative, when viewed in
the context of the evidence previously of record, to establish a
reasonable possibility of an outcome different from the prior
denial of the claim.

3.  Evidence added to the record since the September 1956 denial
of service connection for chronic sacroiliac strain includes
evidence which is not duplicative or cumulative of evidence
previously of record and is sufficiently relevant and probative,
when viewed in the context of the evidence previously of record,
to establish a reasonable possibility of an outcome different
from the prior denial of the claim.

CONCLUSIONS OF LAW

1.  Evidence received since the September 1956 RO rating action
denying entitlement to service connection for arthritis of the
hips is new and material, and the claim for service connection
for arthritis of the hips is reopened.  38 U.S.C.A. § 5108 (West
1991); 38 C.F.R. § 3.156(a) (1993).

2.  Evidence received since the September 1956 RO rating action
denying entitlement to service connection for chronic sacroiliac
strain is new and material, and the claim for service connection
for chronic sacroiliac strain is reopened.  38 U.S.C.A. § 5108
(West 1991); 38 C.F.R. § 3.156(a) (1993).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

Evidence of record in September 1956 when the RO denied service
connection for arthritis of the hips and chronic sacroiliac
strain included the veteran's service medical records which show
that in January 1945 the veteran complained of severe back pain
after an injury on the deck of the ship to which he was assigned.
Examination showed some limitation of forward motion of the
lumbar spine and moderate muscle spasm.  The veteran was treated
with heat to his back and bedrest for several days.  The
diagnosis was muscular strain, lumbosacral area.  At his
separation examination in February 1947, the veteran's spine and
extremities were evaluated as normal.

Also of record was a June 1956 medical certificate from Joe S.
Haskell, M.D., who reported that he had treated the veteran from
April 1949 to October 1951.  Dr. Haskell reported that clinical
findings and symptomatology included "sacroiliac and right hip
pain, old, since injury in Navy."

At a July 1956 VA examination, the veteran gave of history having
been squeezed between a heavy cable and a heavy platform on his
ship in service with injury in the area of his low back.  At the
examination, he complained of frequent pain in the right side of
the low back and right hip region.  The examining physician noted
right sacroiliac pain on all motions of the low back.  VA X-rays
of the lumbar spine and pelvis showed slight subchondral
sclerosis in both acetabula.  The clinical examiner, an
orthopedist, diagnosed the veteran as having chronic right
sacroiliac strain and traumatic arthritis of the hips based on
the X-rays.

As was noted earlier, the RO denied entitlement to service
connection for arthritis of the hips and chronic sacroiliac
strain in September 1956.  The veteran did not appeal the RO
decision.

Evidence added to the record includes a November 1990 VA X-ray
report in which it was reported that the veteran gave a history
of having had his hips crushed in service and was complaining of
increasing pain.  X-rays of the pelvis showed mild degenerative
changes involving both hips.  VA outpatient records show that in
June 1992, the veteran gave a history of an injury in service
involving his hips.  He complained of progressive pain initially
in the right hip but becoming worse in the left hip.  The
clinical diagnosis was severe degenerative joint disease of both
hips.  In June 1992, a VA radiologist reported that X-rays of the
pelvis showed post-traumatic degenerative joint disease of the
left hip joint and mild degenerative joint disease of the right
hip joint.

At a VA orthopedic examination in September 1993, the veteran
stated that he had had a back problem since 1945 when he was
squashed or mashed between a canon cable and a gun platform.  The
veteran said that after discharge from service he went to a
chiropractor on many occasions and was also treated with
medicines.  He stated that over the last six to eight years the
pain had become so bad that he finally had a left hip replacement
in July 1993.  The diagnoses after examination included chronic
lumbosacral strain and arthritis of the hips.  The physician
stated that he had reviewed the veteran's claims file and that
the findings on examination were consistent with the veteran's
history.

The threshold issue before the Board is whether new and material
evidence has been added to the record to reopen the veteran's
claims for service connection for arthritis of the hips and
chronic sacroiliac strain.  New evidence is evidence that is not
merely cumulative of other evidence in the record.  Colvin v.
Derwinski, 1 Vet.App. 171, 174 (1991).  Material evidence is
sufficiently relevant and  probative of the issue at hand to
establish a reasonable possibility that the outcome would be
different when the new evidence is considered in light of all the
evidence.  Id.  Further, for the purpose of determining whether a
claim should be reopened, the credibility of the evidence added
to the record is to be presumed.  Justus v. Principi, 3 Vet.App.
510, 513 (1992).

The report of the September 1993 VA orthopedic examination is new
and material with regard to the veteran's claims concerning both
arthritis of the hips and chronic sacroiliac strain.  The report
is obviously new since September 1956 and cannot be cumulative as
it considers information not in the record at that time.
Further, the VA physician specifically related the veteran's
current chronic lumbosacral strain and arthritis of the hips to
an inservice injury.  Thus, this evidence is relevant and
probative of the issues of service connection for these
disabilities and, if believed, presents a reasonable possibility
of an outcome different from the September 1956 RO decision.
Having determined that new and material evidence has been added
to the record, the veteran's claims for service connection for
arthritis of the hips and service connection for chronic
sacroiliac strain are reopened.  38 U.S.C.A. § 5108; 38 C.F.R.
§ 3.156(a).

ORDER

New and material evidence having been submitted, the veteran's
claims of entitlement to service connection for arthritis of the
hips and service connection for chronic sacroiliac strain are
reopened.

REMAND

Having determined that the veteran's claims of entitlement to
service connection for arthritis of the hips and service
connection for chronic sacroiliac strain have been reopened, the
merits of the claims must be evaluated in light of all the
evidence, both new and old.  Manio v. Derwinski, 1 Vet.App. 140,
146 (1991).  However, before those issues are reached, the Board
believes that further development, to include additional physical
examination of the veteran and collection of additional medical
records, should be undertaken.  The Board notes in particular
that the veteran has reported that prior to his July 1993 left
total hip replacement, the VA physician who was to do the
replacement reviewed his X-rays and indicated that his hip
problem was due to an old injury and that problems were also
evident in his low back.  The veteran also stated that the
physician who was to be in charge of performing the surgery was
the Chief of Orthopedics at the Jerry L. Pettis Memorial
Hospital, Loma Linda, California.  The RO should attempt to
obtain additional records related to the evaluation and treatment
of the veteran at that facility.

Upon further review of the record, the Board is of the opinion
that additional development as outlined below would also
facilitate its decision in the remaining issues in the case.

Accordingly, the case is REMANDED to the RO for the following
actions:

1.  The RO should obtain and associate
with the claims file copies of hospital
and outpatient treatment records for the
veteran from the VA Medical Center, Jerry
L. Pettis Memorial Hospital, Loma Linda,
California, dated from March 1993 to the
present.

2.  The RO should contact the veteran and
request that he provide the names,
addresses and approximate dates of
treatment for all health care providers
who have treated him for any of his
claimed disabilities at any time since
service.  With any necessary authorization
from the veteran, the RO should attempt to
obtain copies of treatment records
identified by the veteran which have not
been obtained previously.

3.  The RO should also advise the veteran
that he may submit additional evidence he
believes may support any of his claims.
Upon receipt of the veteran's response,
the RO should undertake any appropriate
development.

4.  Then, the RO should arrange for a VA
orthopedic examination of the veteran by a
board certified orthopedist, if available,
to determine the nature and extent of his
chronic sacroiliac strain and arthritis of
the hips, back and legs, if present.  All
indicated studies, to include X-rays
should be performed.  The orthopedist
should be specifically requested to
provide an opinion, with complete
rationale, as to the etiology of any
identified orthopedic disability, to
include an opinion as to whether it is at
least as likely as not that any current
sacroiliac strain or arthritis of the
hips, legs or back is related to service
trauma or lumbosacral strain treated in
service in 1945.  The claims file must be
made available to the orthopedist prior to
the examination.

5.  The RO should also arrange for a VA
ear, nose and throat examination by an
appropriate specialist, if available, and
a VA audiological evaluation to determine
the nature and extent of the veteran's
claimed hearing loss.  All indicated
studies should be performed.  The
physician and audiologist should be
requested to provide an opinion, with
complete rationale, as to whether it is at
least as likely as not that any hearing
loss was caused by noise exposure in
service.  The claims file must be made
available to the examiners prior to the
examinations.

6.  Thereafter, the RO should adjudicate
the issues of entitlement to service
connection for arthritis of the hips and
entitlement to service connection for
chronic sacroiliac strain based on a de
novo review of all evidence of record,
both new and old.  See Manio v. Derwinski,
1 Vet.App. 140 (1991).

7.  Also, in light of the evidence
obtained pursuant to the requested
development, the RO should determine
whether new and material evidence has been
added to the record to reopen the
veteran's claims for service connection
for hemorrhoids, rhinitis, sinusitis
and/or heart disability.  If so, the
claim(s) should be reopened and
adjudicated based on a de novo review of
all the evidence, both new and old.  Id.;
Colvin v. Derwinski, 1 Vet.App. 171
(1991).

8.  The RO should also readjudicate the
issues of entitlement to service
connection for arthritis of the back,
arthritis of the legs, hypertension, and
bilateral hearing loss.

If the benefits sought on appeal are not granted to the veteran's
satisfaction, the RO should issue a Supplemental Statement of the
Case, and the veteran and his representative should be provided
an opportunity to respond.  The case should then be returned to
the Board for further appellate consideration, if otherwise in
order.  By this REMAND, the Board intimates no opinion as to any
final outcome warranted.  No action is required of the veteran
until he is otherwise notified by the RO.

          SHANE A. DURKIN
          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.

NOTICE OF APPELLATE RIGHTS:  Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals within
120 days from the date of mailing of notice of the decision,
provided that a Notice of Disagreement concerning an issue which
was before the Board was filed with the agency of original
jurisdiction on or after November 18, 1988.  Veterans' Judicial
Review Act, Pub. L. No. 100-687, § 402 (1988).  The date which
appears on the face of this decision constitutes the date of
mailing and the copy of this decision which you have received is
your notice of the action taken on your appeal by the Board of
Veterans' Appeals.

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.  The above 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).