BVA9505435 DOCKET NO. 93-08 123 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUES 1. Entitlement to service connection for coronary artery disease. 2. Entitlement to restoration of a 30 percent evaluation for residuals of frostbite of the feet. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Ronald R. Bosch, Counsel INTRODUCTION The veteran served on active duty from June 1975 to July 1977. This appeal arises from November 1990, April 1991 and August 1991 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey. In November 1990, the RO reduced the evaluation for residuals of frostbite of both feet from 30 percent to 10 percent disabling. In April 1991, the RO denied entitlement to service connection for high blood pressure, and in August 1991 service connection was denied for coronary artery disease. Statements on file from the veteran indicate a desire on his part to claim service connection for scarring of his left leg, as well as entitlement to service connection for peptic ulcer disease secondary to frostbite medication. In as much as these issues are not inextricably intertwined with the issue of entitlement to service connection for coronary artery disease, the Board is referring them to the RO for appropriate action. REMAND A review of the service medical records discloses a clinical history of the veteran's having had rheumatic heart disease and a heart murmur since childhood. He was evaluated on one occasion for chest pain in October 1975. Physical examination in June 1975 disclosed a blood pressure of 126/90. Blood pressures in October 1975 were recorded as 148/108, 136/88, and 110/70. An October 1975 cardiology consultation report noted that the veteran’s chest pain was of non-cardiac origin. In his May 1992 appeal statement the veteran reports that high blood pressure readings in both arms were found when he was purportedly examined at the East Orange, New Jersey, VA Medical Center in 1978. While the veteran subsequently testified in June 1992 that hypertension was not found until 1985, records pertaining to the 1978 term of care, a term which is within the one year presumptive period, have yet to be requested by the RO. In view of the foregoing the Board is of the opinion that association of the 1978 VA treatment records alluded to by the veteran with the claims file is required, and that a contemporaneous VA cardiology examination, if warranted, would materially assist in the adjudication of the appeal. Therefore, pursuant to VA's duty to assist the veteran in the development of facts pertinent to his claim under 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1994), this case is REMANDED for the following action: 1. The RO should attempt to obtain and associate with the claims file photocopies of the complete records pertaining to the veteran's treatment in 1978 and thereafter at the VA Medical Center in East Orange, New Jersey. 2. The RO should then review the records received from 1978. If those records reveal that any blood pressure reading recorded in 1978 was above 150 systolic, or 90 diastolic, the RO should schedule the veteran for a comprehensive VA cardiology examination. The purpose of such a study would be to determine the nature, extent of severity, and etiology of any heart disease which may be present. The examination should be conducted in accordance with the diagnostic procedures outlined in the VA Physician's Guide for Disability Evaluation Examinations. All indicated studies should be conducted. The examiner is requested to provide an opinion as to whether it is at least as likely as not that any heart disease currently found on examination is related to blood pressure readings and other symptomatology reported in service. Moreover, the examiner should give an opinion as to etiology of any heart disease found on examination. Any opinion rendered should be accompanied by a complete rationale. The claims file must be made available to and reviewed by the physician prior to the examination. 3. Thereafter, if an examination was conducted, the RO should review the examination report and the requested opinion to ensure that they are in complete compliance with the instructions contained in this REMAND. If the examination report and opinion are not in complete compliance, the RO should take appropriate corrective action. 4. After undertaking any development deemed appropriate in addition to that specified above, the RO should readjudicate the issue of entitlement to service connection for coronary artery disease. The claim of entitlement to a restoration of a 30 percent evaluation for frostbite is deferred. If the benefits requested on appeal are not granted to the veteran's satisfaction, the RO should issue a supplemental statement of the case. A reasonable period of time for a response should be afforded. Thereafter, the case should be returned to the Board for final appellate review, 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 notified by the RO. DEREK R. BROWN 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).