BVA9501935 DOCKET NO. 93-05 841 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUES 1. Entitlement to an increased rating for rheumatic heart disease with cardiac arrhythmia, hypertension, currently evaluated as 10 percent disabling. 2. Entitlement to an increased rating for right brain cerebrovascular accident, with temporary left side facial weakness, currently evaluated as 10 percent disabling. 3. Entitlement to an increased rating for left leg weakness, residual of cerebrovascular accident, currently evaluated as 10 percent disabling. 4. Entitlement to an increased (compensable) evaluation for right leg phlebitis. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL The Appellant, and his wife. ATTORNEY FOR THE BOARD K. Ehrman, Associate Counsel INTRODUCTION The veteran had honorable active service from October 1950 to July 1951. The appeal comes before the Board of Veterans' Appeals (the Board) from rating decisions of April 1990, May 1991, and December 1992, from the Seattle, Washington, Regional Office (the RO). The April 1990 rating decision assigned a 10 percent evaluation from June 1990 for right brain cerebrovascular accident (CVA herein), with temporary left sided paresis and facial weakness, residuals of CVA, following a temporary 100 percent schedular evaluation for a period of 6 months. That decision also established service connection for left lower extremity weakness, residuals of CVA, and a 10 percent evaluation was assigned from June 1990. The veteran has appealed those two issues, and he has appealed the May 1991 rating decision, which confirmed and continued a 10 percent evaluation for rheumatic heart disease with cardiac arrhythmia, hypertension. Additionally, the veteran has appealed the December 1992 rating decision, which confirmed and continued a noncompensable evaluation for right leg phlebitis. The Board notes that the rating decision of December 1992 also denied the veteran's November 1991 claim for entitlement to a total rating for compensation purposes based on individual unemployability due to service-connected disability. The veteran has not appealed that determination. The Board also notes the veteran's February 1993 claim for entitlement to a temporary total rating based on convalescence following surgery in September 1992, at the VA Medical Center at Seattle, Washington. While the RO was informed by that facility that no such treatment records exist for that date, treatment records from that facility, dated in December 1992, indicate that total left knee arthroplasty surgery was performed at that facility earlier in the year. Service-connection for left knee disability was denied by rating decision of December 1984, and that issue is not currently on appeal. REMAND Additional evidence was associated with the file after the case was certified for appeal. The regional office did not have an opportunity to review the evidence, and the parties have implied that the evidence is pertinent to the claim. The Board notes that a recent, detailed examination for the purpose of determining the degree of impairment due to phlebitis is not of record. We also note that the hearing officer commented that the veteran complained of symptoms that may have been consistent with phlebitis, however, an examination was not conducted. The regional office has arteriosclerotic heart disease as nonservice-connected (not shown). However, testing disclosed left ventricular hypertrophy, and coronary artery disease was diagnosed by the VA following examination in February 1990. Arteriosclerotic heart disease was also diagnosed by the VA during hospitalization in November 1989. In view of the diagnosis, the clinical finding, the provisions of 38 C.F.R. § 4.101 (1993), and the rating decision that arteriosclerotic heart disease is not shown, the Board believes that additional action is warranted. To ensure that the Department of Veterans Affairs (VA) has met its duty to assist the claimant in developing the facts pertinent to the claim and to ensure full compliance with due process requirements, the case is REMANDED to the regional office (RO) for the following development: 1. The veteran should be afforded a VA vascular examination to determine the extent of impairment due to phlebitis. The claims folder should be made available to the examiner for review before the examination. The examiner is to be informed of the rating criteria so that the examination report contains the necessary information. All positive and negative findings should be reported. 2. The regional office should adjudicate the issue of entitlement to service connection for arteriosclerotic heart disease. The regional office should consider the provisions of 38 C.F.R. § 4.101. 3. In view of the finding of electrocardiographic abnormality, left ventricular hypertrophy, a reported "flow murmur," and elevated blood pressure readings, the regional office should reconsider the issue of entitlement to an increased evaluation for rheumatic heart disease with cardiac arrhythmia, hypertension, currently evaluated as 10 percent disabling. The regional office should consider the provisions of 38 C.F.R. § 4.7 (1993). The regional office should also determine whether left ventricular hypertrophy is indicative of enlargement. 4. After the development requested above has been completed to the extent possible, the RO should again review the record. If any benefit sought on appeal, for which a notice of disagreement has been filed, remains denied, the appellant and representative, if any, should be furnished a supplemental statement of the case and given the opportunity to respond thereto. Thereafter, the case should be returned to the Board, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant need take no action unless otherwise notified. H. N. SCHWARTZ 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) (1993).