BVA9508134 
DOCKET NO.  93-10 735     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in Nashville,
Tennessee

THE ISSUES

1.  Entitlement to service connection for hearing loss.

2.  Entitlement to an increased rating for urticaria and tinea
dermatophytosis, currently rated as 10 percent disabling.

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Michael Martin, Counsel

REMAND

The veteran had active service from October 1965 to October 1967,
and from February 1972 to July 1992.  This matter came before the
Board of Veterans' Appeals (Board) on appeal from a decision of
September 1992 by the Department of Veterans Affairs (VA)
Nashville, Tennessee, Regional Office (RO).  The case was
previously remanded to the RO in February 1994 to afford the
veteran current examinations.

Pursuant to the Board's remand, the veteran underwent VA
audiology and ear, nose and throat (ENT) examinations in March
and April 1994, respectively.  The audiologist recommended the
ENT examination to explore the profound nature of hearing loss in
the veteran's left ear.  The physician diagnosed sensorineural
hearing loss secondary to noise exposure, but noted that an MRI
was required to rule out acoustic neuroma.

The veteran contends that he is entitled to service connection
for hearing loss because hearing loss which he had in his left
ear since childhood was aggravated by his service in Vietnam
during his period of active duty from 1965 to 1967.  The RO has
denied the claim because it was determined that hearing loss in
the left ear existed prior to service and was not aggravated by
service.  Significantly, however, the service medical records
which are contained in the veteran's claims file are all from his
later period of service (1972 to 1992).  There are no records
from his initial period of service.  The claims folder also does
not contain any documentation regarding efforts by the RO to
obtain such records.  The veteran has requested that additional
efforts be made in order to locate these service medical records.
The Board is of the opinion that, in light of the importance of
these records in evaluating the veteran's claim, another attempt
to locate such records is warranted. Copies of the veteran's
service personnel records should also be requested as they may
contain information regarding the veteran's exposure to noise
during service.

Recent decisions by the United States Court of Veterans Appeals
(Court) are also pertinent in cases involving questions of
aggravation of disabilities by service.  In Hensley v. Brown, 5
Vet.App. 155, 161 (1993), the Court held that a conclusion by the
Board that objectively measured worsening of left ear hearing
capacity during service did not constitute an increase in
disability may not be based on the Board's own unsubstantiated
medical conclusions but instead must be based on independent
medical evidence in the record or adequate quotation from
recognized medical treatises.  In Crowe v. Brown, No. 93-550
(U.S. Vet.App. Dec. 20, 1994), the Court held that a medical
opinion is required to determine (1) Whether there was a
worsening of a pre-existing disorder during service, and (2) If
so, whether there was clear and unmistakable evidence that the
increase in severity was due to the natural progress of the
disease.

Finally, the Board notes that a report of a dermatology
examination conducted by the VA in March 1994 shows that the
examiner advised the veteran to make an appointment as soon as
possible in the dermatology and allergy clinics.  The Board finds
that records from any such appointments would be helpful in
connection with the current appeal.  Accordingly, this case is
REMANDED for the following actions:

1.  The RO should attempt to obtain copies
of the service medical records from the
veteran's period of service from 1965 to
1967, and copies of the veteran's service
personnel records for both periods of
service.  The RO should also obtain copies
of any post-service treatment records
pertaining to either the veteran's hearing
loss or his service-connected skin
disorder.  Any documents which are obtained
should be added to the veteran's claims
file.

2.  A VA audiologist should be requested to
review the veteran's claims file and offer
a medical opinion as to whether the records
demonstrate that any pre-existing hearing
loss, particularly in the left ear,
increased in severity during service, and,
if so, whether the increase in severity was
beyond the normal progression of the
disease.  If any additional testing or
evaluation of the veteran is considered
necessary to provide an informed opinion,
such testing should be accomplished.  The
rationale for all opinions reached should
be stated.

Upon completion of the foregoing, the RO should again consider
the veteran's claims.  Unless the benefits sought are granted to
the veteran's satisfaction and he withdraws his appeal, the RO
should issue to the veteran a supplemental statement of the case
and allow him the appropriate period of time to respond.  Then,
the case should be returned to the Board for further appellate
review.

          CHARLES E. HOGEBOOM
          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).